Sleep medicine最新文献_第4页

Longitudinal analysis of the bidirectional relationship between screen time and sleep: Exploring the role of physical activity 屏幕时间与睡眠之间双向关系的纵向分析：探索体育活动的作用。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.028

Elahe Nikooharf Salehi , Charlotte Brakenridge , Saeed Jaydarifard , Gregore Iven Mielke

Background

Excessive screen time and poor sleep duration have significant implications for children's health and well-being. Understanding the dynamic relationship between screen time and sleep duration, as well as the impact of physical activity in this relationship, is essential for promoting healthy behaviours. The aims of this study were to: 1) investigate the bidirectional relationship between screen time and sleep duration in children, and 2) explore the mediating role of physical activity in these associations.

Methods

Data were from 2064 children (47 % girls) who responded to time-use diaries at waves 3 (age 5), 6 (age 10), and 7 (age 12) of the Longitudinal Study of Australian Children (LSAC). Cross-lagged panel modelling was conducted to test bidirectional associations between screen time and sleep duration, with the mediating role of physical activity assessed using a lagged mediation model.

Results

A bidirectional association between screen time and sleep duration across ages 10 to 12 was observed. Screen time at 10 years of age was associated with sleep duration at 12 years of age (β = −0.071 [95%CI, −0.114 to −0.015]), and sleep duration at 10 years of age was associated with screen time at 12 years of age (β = −0.048 [95%CI, −0.087 to −0.002]). Moreover, increased levels of physical activity at age 12 reduced the negative impact of both screen time on sleep duration and sleep duration on screen time during the ages of 10 and 12.

Conclusion

Findings highlight a cyclical influence where each factor impacts the other over time. Interventions aimed at reducing screen time and increasing physical activity may help mitigate the negative effects of excessive screen time on sleep.

背景：屏幕时间过长和睡眠时间不足对儿童的健康和福祉有重大影响。了解屏幕时间和睡眠时间之间的动态关系，以及身体活动在这种关系中的影响，对于促进健康行为至关重要。本研究的目的是：1)研究儿童屏幕时间与睡眠时间之间的双向关系，2)探索体育活动在这些关联中的中介作用。方法：数据来自2064名儿童（47%为女孩），他们在澳大利亚儿童纵向研究（LSAC）的第3期（5岁）、第6期（10岁）和第7期（12岁）对时间使用日记有反应。交叉滞后面板模型用于测试屏幕时间和睡眠时间之间的双向关联，并使用滞后中介模型评估身体活动的中介作用。结果：在10到12岁的孩子中，屏幕时间和睡眠时间之间存在双向关联。10岁时的屏幕时间与12岁时的睡眠时间相关（β = -0.071 [95%CI, -0.114至-0.015]），10岁时的睡眠时间与12岁时的屏幕时间相关（β = -0.048 [95%CI, -0.087至-0.002]）。此外，12岁时体育活动水平的增加减少了10岁和12岁时屏幕时间对睡眠时间和睡眠时间对屏幕时间的负面影响。结论：研究结果强调了一种周期性影响，即每个因素随着时间的推移影响另一个因素。旨在减少屏幕时间和增加身体活动的干预措施可能有助于减轻屏幕时间过长对睡眠的负面影响。

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引用次数: 0

Long term noninvasive respiratory support in children with OSA-I and OSA-II: Data of a nation-wide study OSA-I和OSA-II患儿的长期无创呼吸支持：一项全国性研究的数据

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.11.039

Chiara Tommesani , Sonia Khirani , Alessandro Amaddeo , Bruno Massenavette , Priscille Bierme , Jessica Taytard , Nathalie Stremler , Melisande Baravalle-Einaudi , Julie Mazenq , Iulia Ioan , Cyril Schweitzer , Marie Emilie Lampin , Alexandra Binoche , Clemence Mordacq , Jean Bergounioux , Blaise Mbieleu , Robert Rubinsztajn , Elodie Sigur , Geraldine Labouret , Aline Genevois , Brigitte Fauroux

Purpose

The aim of the study was to analyze the characteristics of otherwise healthy children with obstructive sleep apnea (OSA; OSA-I) and children with OSA and non-syndromic obesity (OSA-II) treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in 2019 in France.

Methods

Data were collected from a national survey on paediatric home noninvasive ventilatory support. CPAP/NIV initiation criteria and duration, age at CPAP/NIV initiation, equipment used and CPAP/NIV settings, and objective compliance were analyzed.

Results

Patients with OSA-I and OSA-II represented 6 % (n = 84, 71 % males) and 10 % (n = 144, 72 % males) of the national cohort, respectively. The apnea-hypopnea index (63 % vs 76 %), alone or combined with nocturnal gas exchange (25 % vs 21 %, for OSA-II and OSA-I patients respectively) were used as initiation criteria of CPAP/NIV. OSA-II patients were older at CPAP/NIV initiation (mean age 11.0 ± 4.0 vs 6.8 ± 4.5 years, p < 0.001) and were treated for a longer time (2.3 ± 2.6 vs 1.3 ± 1.5 years, p = 0.008) than OSA-I patients. NIV was used in 6 % of OSA-I patients and 13 % of OSA-II patients (p = 0.142). Both groups used preferentially a nasal mask. Mean CPAP level was higher in OSA-II patients as compared to OSA-I patients (8.7 ± 2.0 vs 7.7 ± 2.4 cmH₂O, p = 0.02). Objective compliance was comparable (mean use 6.8 ± 2.6 vs 5.9 ± 3.0 h/night in OSA-I and OSA-II, respectively, p = 0.054).

Conclusion

Six and 10 % of children treated with long term CPAP/NIV in France in 2019 had OSA-I and OSA-II, respectively. Both groups were preferentially treated with CPAP and were comparable except for age, with OSA-II patients being older at CPAP/NIV initiation.

目的：本研究的目的是分析其他健康的阻塞性睡眠呼吸暂停（OSA）儿童的特征；2019年，在法国，OSA- i型和OSA- ii型儿童接受长期持续气道正压通气（CPAP）或无创通气（NIV）治疗。方法：收集全国儿童家庭无创通气支持调查数据。分析CPAP/NIV启动标准和持续时间、CPAP/NIV启动时的年龄、使用的设备和CPAP/NIV设置以及客观依从性。结果：osa - 1和OSA-II患者分别占全国队列的6% （n = 84，男性71%）和10% （n = 144，男性72%）。呼吸暂停-低通气指数（63% vs 76%），单独或联合夜间气体交换（分别为25% vs 21%， OSA-II和OSA-I患者）被用作CPAP/NIV的起始标准。OSA-II型患者在CPAP/NIV启动时年龄较大（平均年龄11.0±4.0岁vs 6.8±4.5岁，p 2O, p = 0.02）。客观依从性具有可比性（OSA-I和OSA-II患者的平均使用时间分别为6.8±2.6和5.9±3.0小时/晚，p = 0.054）。结论：2019年法国接受长期CPAP/NIV治疗的儿童中，分别有6%和10%患有OSA-I和OSA-II。两组均优先接受CPAP治疗，除年龄外具有可比性，OSA-II患者在CPAP/NIV开始时年龄较大。

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引用次数: 0

Co-occurring mental health problems in adolescents with ADHD and sleep problems 患有多动症和睡眠问题的青少年共同出现的心理健康问题。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.008

Finja Marten , Lena Keuppens , Dieter Baeyens , Bianca E. Boyer , Marina Danckaerts , Samuele Cortese , Wout Vandycke , Saskia Van der Oord

Objective

Sleep problems are highly prevalent and impairing in adolescents with ADHD. However, their relation with co-occurring mental health problems is still unclear. This study assessed whether adolescents with ADHD, with and without self-reported sleep problems, differ from each other in co-occurring mental health problems, and whether they differ from adolescents without ADHD. Furthermore, we examined whether the adolescents with ADHD and self-reported sleep problems do indeed have more disturbed sleep than the other two groups and lastly, whether these sleep differences are moderated by co-occurring mental health problems.

Method

Three groups of adolescents (13–17 years): 1) with ADHD and comorbid self-reported sleep problems (N = 56), 2) with ADHD but without self-reported sleep problems (N = 25), and 3) without ADHD (N = 56) were assessed. Group comparisons were done for symptoms of co-occurring mental health problems, self- and parent-reported sleep problems, and objective and subjective sleep parameters. Exploratively, moderating effects of co-occurring mental health problems on sleep differences between groups are examined.

Results

Compared to those without self-reported sleep problems, adolescents with ADHD and comorbid self-reported sleep problems experienced significantly more co-occurring symptoms of mental health problems, especially depression. They also scored higher on all sleep problems, and had a longer sleep onset latency and lower sleep efficiency based on subjective and objective sleep measures. Depression and anxiety moderated objectively measured sleep differences.

Conclusion

Co-occurring mental health problems, especially depressive symptoms, are more prevalent in adolescents with ADHD and sleep problems and partially moderate the relation with sleep. This indicates that when adolescents with ADHD present with sleep problems in clinical practice, it is essential to also assess symptoms and other mental health problems and vice-versa.

目的：睡眠问题在青少年多动症患者中非常普遍且有损害。然而，它们与同时发生的精神健康问题的关系尚不清楚。这项研究评估了有或没有自我报告睡眠问题的ADHD青少年在共同发生的心理健康问题上是否不同，以及他们是否与没有ADHD的青少年不同。此外，我们研究了患有多动症和自我报告睡眠问题的青少年是否确实比其他两组有更多的睡眠紊乱，最后，这些睡眠差异是否被共同发生的心理健康问题所缓和。方法：将13 ~ 17岁青少年分为3组，分别为：1)有ADHD伴发自述睡眠问题（N = 56）、2)有ADHD但无自述睡眠问题（N = 25）和3)无ADHD （N = 56）。对同时出现的心理健康问题的症状、自我和父母报告的睡眠问题、客观和主观睡眠参数进行组间比较。探索性地，共同发生的心理健康问题对组间睡眠差异的调节作用进行了检查。结果：与那些没有自我报告睡眠问题的青少年相比，患有多动症和共病自我报告睡眠问题的青少年明显经历了更多的精神健康问题的共同症状，尤其是抑郁症。根据主观和客观的睡眠测量，他们在所有睡眠问题上得分更高，睡眠潜伏期更长，睡眠效率更低。抑郁和焦虑缓和了客观测量的睡眠差异。结论：青少年ADHD伴睡眠问题的心理健康问题，尤其是抑郁症状的共存更为普遍，且在一定程度上缓和了ADHD与睡眠的关系。这表明，当患有多动症的青少年在临床实践中出现睡眠问题时，也有必要评估症状和其他精神健康问题，反之亦然。

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引用次数: 0

Sex differences in clinical and polysomnographic features of obstructive sleep apnea: The Turkish sleep apnea database (TURKAPNE) cohort 阻塞性睡眠呼吸暂停的临床和多导睡眠图特征的性别差异：土耳其睡眠呼吸暂停数据库（TURKAPNE）队列。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.018

Aylin Pihtili , Esen Kiyan , Baran Balcan , Semih Arbatli , Aykut Cilli , Nejat Altintas , Aylin Özsancak Ugurlu , Canan Gündüz Gürkan , Mehmet Sezai Tasbakan , Nese Dursunoglu , Hamza Ogun , Ali Nihat Annakkaya , Sinem N. Sökücü , Hikmet Firat , Özen K. Basoglu , Yüksel Peker

Background

Previous reports from relatively small clinical cohorts have suggested that the clinical presentation of obstructive sleep apnea (OSA) differs between men and women.

Objective

We aimed to explore sex differences in clinical and polysomnographic features of OSA in a large nationwide registry.

Methods

Participants from the ongoing Turkish Sleep Apnea Database (TURKAPNE) Study from 34 centers were included in the current analysis. OSA was defined as an apnea-hypopnea index (AHI) ≥5 events/hour and was classified as mild, moderate, and severe according to AHI cut-offs 5, 15, and 30 events/hour, respectively.

Results

In all, 7130 patients (2259 women) were included. OSA was observed in 6323 (88.7 %), of whom 70.2 % were male and 29.8 % were female. In the OSA group, women were older (56.7 ± 11.9 vs. 49.5 ± 11.3 years; p < 0.001) and more obese (body mass index 34.3 ± 7.2 vs. 31.4 ± 5.6 kg/m²; p < 0.001) and had lower AHI (29.8 ± 24.1 vs. 36.8 ± 26.2 events/h; p < 0.001) than men. Loud snoring and witnessed apnea were more common in men than in women whereas women were more frequently presented with insomnia, headache, and mood changes. Women had significantly less total sleep time, less sleep efficiency, and longer sleep latency compared with men (p < 0.001 for each). Additionally, comorbid diseases such as diabetes mellitus, hypertension, asthma, psychiatric disorders, hypothyroidism as well as drug use were more common in women than in men independent of age and obesity (p < 0.05 for each).

Conclusions

Our results suggest significant sex differences in clinical and polysomnographic features in this nationwide Turkish adult population. Women with OSA have more symptom burden and comorbidities despite having a less severe AHI.

背景：先前来自相对较小临床队列的报告表明，阻塞性睡眠呼吸暂停（OSA）的临床表现在男性和女性之间有所不同。目的：我们的目的是在全国范围内的大型登记中探讨阻塞性睡眠呼吸暂停的临床和多导睡眠图特征的性别差异。方法：来自34个中心正在进行的土耳其睡眠呼吸暂停数据库（TURKAPNE）研究的参与者被纳入当前的分析。OSA定义为呼吸暂停低通气指数(AHI)≥5个事件/小时，并根据AHI临界值分别为5、15和30个事件/小时分为轻度、中度和重度。结果：共纳入7130例患者（2259名女性）。6323例（88.7%）出现OSA，其中男性70.2%，女性29.8%。在OSA组中，女性年龄较大(56.7±11.9∶49.5±11.3岁；p 2;结论：我们的研究结果表明，在土耳其全国成年人群中，临床和多导睡眠图特征存在显著的性别差异。尽管AHI较轻，但OSA患者有更多的症状负担和合并症。

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引用次数: 0

Assessment of sedative activity of Chrysin: Behavioral approach with pharmacokinetics, toxicological profile and molecular docking 黄菊花素镇静作用的评价：药代动力学、毒理学和分子对接的行为学方法。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.007

Md Sakib Al Hasan , Md Shimul Bhuia , Salehin Sheikh , Sumaya Akter Bithi , Md Abu Saim , Hossam Kamli , Siddique Akber Ansari , Nowreen Tabassum Ahammed , Muhammad Torequl Islam

The purpose of this study was to investigate the sedative effects of Chrysin (CHR) along with modulatory effects on diazepam (DZP) and flumazenil (FLU) in an animal sleep model produced by thiopental sodium (TS). Additionally, we explored the pharmacokinetics and potential GABA_A receptor interactions of CHR through computational studies. Swiss albino mice were treated with intraperitoneal administration of CHR (5 and 10 mg/kg), DZP (2 mg/kg), and FLU (0.1 mg/kg) either alone or in combination. Sleeping onset and duration were measured following TS administration. Molecular docking was performed to investigate CHR's binding affinity with GABA_A (PDB: 6X3X) receptors. Results found that CHR significantly (p < 0.05) reduced sleep latency and increased sleep duration in a dose-dependent manner compared to the control group. The highest dose (CHR-10) exhibited the most potent significant sedative effect with onset (11.57 ± 1.74 min) and duration (172.86 ± 7.37 min). Combination therapy of CHR-10 with DZP resulted in synergistic effects, further enhancing sleep duration. In molecular docking, CHR demonstrated a higher binding affinity (−8.9 kcal/mol) for GABA_A receptors compared to DZP (−8.7 kcal/mol) and FLU (−6.6 kcal/mol). CHR also showed favorable pharmacokinetic properties with high intestinal absorption and low toxicity. CHR exhibits promising sedative activity, with the potential to enhance the effects of traditional sedatives like DZP. However, further research, including clinical trials and detailed mechanistic studies, is warranted to explore its full therapeutic potential.

本研究旨在探讨菊花素（CHR）在硫喷妥钠（TS）诱导的动物睡眠模型中的镇静作用以及对地西泮（DZP）和氟马西尼（FLU）的调节作用。此外，我们通过计算研究探讨了CHR的药代动力学和潜在的GABAA受体相互作用。瑞士白化病小鼠分别腹腔注射CHR（5和10 mg/kg）、DZP （2 mg/kg）和FLU （0.1 mg/kg）。服用TS后测量睡眠开始时间和持续时间。通过分子对接研究CHR与GABAA （PDB: 6X3X）受体的结合亲和力。结果发现，与DZP （-8.7 kcal/mol）和FLU （-6.6 kcal/mol）相比，CHR具有显著的p A受体。CHR还表现出良好的药代动力学特性，具有高肠吸收和低毒性。CHR具有良好的镇静作用，有可能增强DZP等传统镇静剂的作用。然而，进一步的研究，包括临床试验和详细的机制研究，有必要探索其全部治疗潜力。

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引用次数: 0

Changes in sleep duration status and risk of high carotid intima-media thickness in children: A prospective cohort study 儿童颈动脉内膜-中膜厚度增高与睡眠时间状态的变化：一项前瞻性队列研究。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.036

Yuxiao Zhu , Chongran Ma , Yanan Qiao , Min Zhao , Miaobing Zheng , Lili Yang , Bo Xi

Background

Short sleep duration is common in the pediatric population and is associated with an increased risk of high carotid intima-media thickness (cIMT), a marker of subclinical atherosclerosis. However, little is known regarding whether changes in sleep duration status over time can alter the risk of high cIMT in children.

Objectives

To examine the association between changes in sleep duration status and high cIMT in a cohort study of Chinese children.

Methods

A total of 1115 children aged 6–11 years were enrolled in 2017 and then followed up in 2021 in the Huantai Childhood Cardiovascular Health Cohort Study. Children were categorized into four groups based on their sleep duration status (short vs. normal) at baseline and follow-up: persistent normal sleep duration, incident short sleep duration, resolved short sleep duration, and persistent short sleep duration. High cIMT was defined as cIMT levels ≥ age- and sex-specific 90th percentile values of this population.

Results

Compared with children who maintained normal sleep duration, those with incident short sleep duration (odds ratio [OR]: 1.71, 95 % confidence interval [CI]: 1.05–2.77) or persistent short sleep duration (OR: 4.07, 95 % CI: 2.10–7.89) had a significantly increased risk of high cIMT at follow-up. Conversely, children who had short sleep duration at baseline but normal sleep duration at follow-up did not have an increased risk of high cIMT (OR: 1.08, 95 % CI: 0.47–2.49).

Conclusion

The development or persistence of short sleep duration is associated with an increased risk of high cIMT in children, whereas the resolution of short sleep duration may reduce such risk. These findings underscore the importance of preventing and managing short sleep duration to promote cardiovascular health in children.

背景：短睡眠时间在儿科人群中很常见，并且与颈动脉内膜-中膜厚度（cIMT）升高的风险相关，cIMT是亚临床动脉粥样硬化的标志。然而，随着时间的推移，睡眠持续时间的变化是否会改变儿童高cIMT的风险，我们知之甚少。目的：在一项中国儿童队列研究中，探讨睡眠持续时间状态变化与高cIMT之间的关系。方法：在环台儿童心血管健康队列研究中，于2017年入组1115名6-11岁儿童，并于2021年进行随访。根据儿童在基线和随访时的睡眠持续时间状态（短与正常），将儿童分为四组：持续正常睡眠时间、突发短睡眠时间、解决短睡眠时间和持续短睡眠时间。高cIMT被定义为cIMT水平≥该人群年龄和性别特异性的第90百分位值。结果：与保持正常睡眠时间的儿童相比，突发睡眠时间短（优势比[OR]: 1.71, 95%可信区间[CI]: 1.05-2.77）或持续睡眠时间短（OR: 4.07, 95% CI: 2.10-7.89）的儿童在随访时发生高cIMT的风险显著增加。相反，基线时睡眠时间短但随访时睡眠时间正常的儿童没有增加高cIMT的风险（OR: 1.08, 95% CI: 0.47-2.49）。结论：短睡眠时间的发展或持续与儿童高cIMT风险增加有关，而短睡眠时间的解决可能会降低这种风险。这些发现强调了预防和管理短睡眠时间对促进儿童心血管健康的重要性。

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引用次数: 0

We must change our behaviour if CPAP adherence rates are to improve… 如果要提高CPAP依从率，我们必须改变我们的行为....

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.031

S. Amanda Sathyapala (Dr) , Koula Asimakopoulou (Professor) , Timothy Charles Skinner (Professor)

引用次数: 0

Regional brain iron mapping in obstructive sleep apnea adults 阻塞性睡眠呼吸暂停成人脑铁的区域定位。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.022

Bhaswati Roy , Susana Vacas , Daniel W. Kang , Ravi S. Aysola , Rajesh Kumar

Purpose

Obstructive sleep apnea (OSA) subjects show significant white matter injury, including myelin changes in several brain areas, potentially from impaired glial cells, contributing to increased iron levels that escalate neurodegeneration, but brain iron loads are unclear. Our aim was to examine regional brain iron load, using T2∗-relaxometry, in OSA adults before and after continuous positive airway pressure (CPAP) treatment over controls.

Methods

We performed T2∗-weighted imaging using a 3.0-T MRI scanner on 35 OSA adults, who were followed after 3- and 9- mo CPAP treatment, and 67 controls. Using T2∗-weighted images, R2∗maps were calculated, normalized, and smoothed. The smoothed R2∗ maps, as well as average R2∗ values extracted from different brain regions were compared between OSA and controls using ANCOVA (covariates: age and sex) and paired t-tests in OSA adults.

Results

Multiple brain areas in OSA showed increased R2∗ values before CPAP, indicative of higher iron, over controls and included the amygdala, insula, hippocampus, cerebellum, medulla, and pons nearby areas. The R2∗ values continued to increase in multiple sites at 3-mo CPAP treatment in OSA, and those sites included the cerebellum, thalamus, and cingulate. However, after 9-mo CPAP usage, none of the brain regions showed increased R2∗ values in OSA over baseline.

Conclusions

OSA patients show increased iron content in multiple sites over controls, which progressively increased in several sites, even after 3-mo CPAP use, and started to clear after 9-mo. The findings suggest a means for intervention to lessen brain injury by interfering with iron accumulation in OSA.

目的：阻塞性睡眠呼吸暂停（OSA）受试者表现出明显的白质损伤，包括几个脑区域的髓磷脂改变，可能来自神经胶质细胞受损，导致铁水平升高，加剧神经变性，但脑铁负荷尚不清楚。我们的目的是在持续气道正压（CPAP）治疗前后与对照组相比，使用T2 *松弛法检查OSA成人的区域脑铁负荷。方法：我们使用3.0 t MRI扫描仪对35名OSA成年人进行T2 *加权成像，这些成年人在接受3个月和9个月的CPAP治疗后随访，67名对照组。使用T2 *加权图像，计算R2 *映射，归一化和平滑。使用ANCOVA（协变量：年龄和性别）和配对t检验比较OSA成人和对照之间的平滑R2∗图以及从不同脑区提取的平均R2∗值。结果：与对照组相比，阻塞性睡眠呼吸暂停（OSA）患者多脑区R2 *值升高，表明铁含量升高，包括杏仁核、脑岛、海马、小脑、髓质和脑桥附近区域。经3个月CPAP治疗后，OSA患者多个部位的R2 *值持续增加，这些部位包括小脑、丘脑和扣带。然而，在使用CPAP 9个月后，没有任何脑区显示OSA的R2 *值高于基线。结论：OSA患者在多个部位的铁含量较对照组增加，即使在使用CPAP 3个月后，几个部位的铁含量也逐渐增加，并在9个月后开始清除。研究结果表明，通过干扰阻塞性睡眠呼吸暂停患者的铁积累，可以减轻脑损伤。

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引用次数: 0

A scoping review of sleep discrepancy methodology: What are we measuring and what does it mean? 对睡眠差异方法论的范围回顾：我们测量的是什么？它意味着什么？

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.11.016

Tom F. Walton , Melissa J. Ree , Simone N. Fueggle , Romola S. Bucks

Study objectives

To examine how past studies have conceptualised sleep discrepancy and identify and evaluate the methods used for its measurement and analysis.

Method

We searched MEDLINE, Embase, PsycINFO, CINAHL Plus, PubMed, Scopus, and Web of Science in April 2022 for studies comparing self-report and objective measures of sleep. Methodological information was extracted from relevant studies and included measures of self-report and objective sleep, sleep variables (e.g., total sleep time), derived discrepancy indices (e.g., difference scores), handling of repeated measurements, and methods of measure comparison (e.g., Bland-Altman analyses).

Results

Two hundred and forty-four relevant records were identified. Studies varied according to objective sleep measure; actigraphy algorithm, software, and rest interval; polysomnography setting and scoring criteria; sleep variables; self-report sleep measure; number of nights of objective recording; time frame of self-report measure; self-report sleep variable definition; sleep discrepancy derived index; presence and handling of repeated measurements; and statistical method for measure comparison.

Conclusions

Sleep discrepancy was predominantly conceived as discordance in sleep states or sleep time variables, and various forms of this discordance differed in their conceptual distance to sleep misperception. Furthermore, studies varied considerably in methodology with critical conceptual and practical implications that have received little attention to date. Substantive methodological issues were also identified relating to the use of derived indices for operationalising sleep discrepancy, defining objective sleep onset latency, calculating actigraphy rest intervals, measuring correlation and concordance, averaging sleep variables across nights, and defining sleep quality discrepancy. Solutions and recommendations for these issues are discussed.

研究目标：检查过去的研究是如何将睡眠差异概念化的，并确定和评估用于测量和分析的方法。方法：我们于2022年4月检索MEDLINE、Embase、PsycINFO、CINAHL Plus、PubMed、Scopus和Web of Science，以比较自我报告和客观睡眠测量的研究。方法信息从相关研究中提取，包括自我报告和客观睡眠、睡眠变量（如总睡眠时间）、衍生差异指数（如差异得分）、重复测量的处理和测量比较方法（如Bland-Altman分析）。结果：共鉴定出244份相关记录。根据客观睡眠测量，研究结果有所不同；活动描记算法、软件、休息间隔；多导睡眠图设置和评分标准；睡眠变量;自述睡眠量表；客观记录的夜数；自我报告测量的时间框架；自述睡眠变量定义；睡眠差异衍生指数；重复测量的存在和处理；并采用统计学方法进行计量比较。结论：睡眠差异主要被认为是睡眠状态或睡眠时间变量的不一致，各种形式的这种不一致与睡眠误解的概念距离不同。此外，研究在方法上有很大差异，具有重要的概念和实际意义，迄今很少受到注意。实质性的方法学问题也被确定为与使用衍生指数来操作睡眠差异、定义客观睡眠开始潜伏期、计算活动图休息间隔、测量相关性和一致性、平均夜间睡眠变量和定义睡眠质量差异有关。讨论了这些问题的解决方案和建议。

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引用次数: 0

The need for pediatric sleep education to enhance healthcare for children and adolescents: A global perspective from a survey of members of the international pediatric sleep association 需要儿科睡眠教育，以加强对儿童和青少年的保健：从国际儿科睡眠协会成员调查的全球视角。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.sleep.2024.12.005

Karen Spruyt , Kate Chan , Ridma Jayarathna , Oliviero Bruni

Introduction

Sleep concerns have become increasingly common over the past few decades. This study outlines the perceived needs and gaps in pediatric sleep education, drawing insights from a diverse international cohort of pediatric sleep health professionals.

Methods

International Pediatric Sleep Association (IPSA) members were invited to complete an online survey examining a variety of topics related to pediatric sleep education developed by the education committee.

Results

There were 111 survey respondents, largely comprised of medical healthcare providers, representing 39 countries. The majority of respondents worked with children and adolescents aged 0–18 years and endorsed the importance of both comprehensive and developmentally appropriate screening for sleep issues in clinical practice, ranging from bedtime behaviors and daytime dysfunction to sleep-related breathing and movement disorder symptoms. Respondents also stressed the importance of including diverse topics in pediatric sleep education, including behavioral sleep issues and sleep in neurodevelopmental disorders, thus underscoring the need for comprehensive training programs. Participants advocated for improved access to screening tools and intervention protocols. There was an identified notable gap in formal sleep education during professional training. Potential barriers identified included time constraints and a lack of resources.

Preferences for training online and through professional organization websites underscored the importance of accessible learning platforms. Integrating online resources into education programs could enhance accessibility and engagement.

Conclusion

The demand for enhanced sleep education underscores the complexity and significance of pediatric sleep health and highlights an urgent need for tailored and accessible sleep education programs to address the multifaceted challenges in pediatric sleep. Addressing educational needs helps cultivate a skilled workforce to manage pediatric sleep disorders and promote healthy sleep practices. Teaching activities and collaboration play crucial roles in advancing the pediatric sleep community.

导读：在过去的几十年里，睡眠问题变得越来越普遍。本研究概述了儿童睡眠教育的感知需求和差距，从不同的国际儿童睡眠健康专业人员队列中汲取见解。方法：邀请国际儿童睡眠协会（IPSA）成员完成一项在线调查，调查由教育委员会制定的与儿童睡眠教育相关的各种主题。结果：共有111个调查对象，主要由来自39个国家的医疗保健提供者组成。大多数受访者与0-18岁的儿童和青少年一起工作，并赞同在临床实践中对睡眠问题进行全面和发育适当筛查的重要性，从就床行为和白天功能障碍到与睡眠相关的呼吸和运动障碍症状。受访者还强调了在儿童睡眠教育中纳入不同主题的重要性，包括行为睡眠问题和神经发育障碍中的睡眠，从而强调了全面培训计划的必要性。与会者主张改善获得筛查工具和干预方案的机会。在专业培训期间，在正规睡眠教育方面存在明显差距。确定的潜在障碍包括时间限制和缺乏资源。对在线培训和通过专业组织网站进行培训的偏好强调了无障碍学习平台的重要性。将在线资源整合到教育项目中可以提高可访问性和参与度。结论：加强睡眠教育的需求强调了儿童睡眠健康的复杂性和重要性，并强调了迫切需要量身定制和可访问的睡眠教育计划来解决儿童睡眠的多方面挑战。解决教育需求有助于培养熟练的工作人员来管理儿科睡眠障碍并促进健康的睡眠习惯。教学活动和合作在促进儿童睡眠社区发挥着至关重要的作用。

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引用次数: 0