Sleep and Biological Rhythms最新文献

The purpose of this study was to evaluate how the first oral administration of suvorexant affects PSG results in patients with severe obstructive sleep apnea (OSA). Single-center, prospective study conducted in a nonrandomized, uncontrolled, unblinded fashion. Undiagnosed 64 patients with suspected OSA underwent first-night PSG, and 30 patients with severe OSA (Apnea Hypopnea Index [AHI] ≥ 30 events/h) underwent second-night PSG testing after administration of 15 mg suvorexant. The change in AHI between the first and second nights was not significant, although the upper limit of the 95% confidence interval for the mean difference in AHI was high at 5.987.The mean duration of apnea on the second night was significantly prolonged compared to that on the first night, but there were no significant differences n 3% oxygen desaturation index, saturation of percutaneous oxygen<90% time. On the second night, total sleep time was significantly prolonged, mid-night awakenings decreased, REM sleep percentage increased, and REM latency was shorter. Because the environment for PSG testing is very different from the patient's home and many patients have difficulty sleeping, there are clinical cases in which PSG is performed with sleep medication. In this study, PSG after oral administration of 15 mg of suvorexant on the second night showed no significant difference or clear trend in AHI. However, the upper limit of the 95% confidence interval for the mean difference in AHI was greater than 5, suggesting that suvorexant may exacerbate AHI, even with the first administration.

In this paper, we investigated the relationship between different levels of sleep and the risk of suicide among depressive patients. The sample consisted of 301 adults with depression who were recruited from a hospital in Ningxia, China. The Pittsburgh Sleep Quality Index (PSQI) and the Self-Rating Depression Scale (SDS) were applied to evaluate the quality of sleep and the degree of depression. The Suicidal Risk Factor Assessment Form evaluated suicide risk. A Latent Class Analysis (LCA) has been performed with MPLUS 7.0 to investigate the most probable category of the PSQI sub-scales. Multivariate Logistic Regression was applied to analyse the relation between Sleep Quality and Suicide Hazard in Adult Depressive Patients. Classes identified were “Global sleep impairment”, “Poor sleep quality”, “Short sleep duration” and “Good sleep quality.” Patients with poor overall sleep quality and clear daytime dysfunction had a higher risk of suicide than those with good sleep quality. The results are helpful in understanding the relationship between the variability of sleep patterns and the risk of suicide among depressed people, and it is suggested that some sleep variables may have a higher predictive value than others. The results will provide guidance on how to improve and implement therapy for depressive disorders in adults, and to lower suicidal rates.

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs, worsened in the evening, occurring at rest, and relieved temporarily by movement. Although its pathophysiology remains incompletely understood, oxidative stress has been suggested. Uric acid (UA) is a marker associated with oxidative stress, and its reduced levels pose a risk for certain neurodegenerative diseases. In this study, we aimed to assess serum UA concentrations in RLS patients to gain insights into its role in the etiopathogenesis of the condition.: This study involved 200 individuals. Serum UA levels were compared with clinical parameters. Disease severity was assessed, categorizing patients into "mild," "moderate," "severe," and "very severe" subgroups. Comparative analysis of UA levels was conducted between these subgroups and the control group. Patients exhibited a statistically significant reduction in UA levels compared to controls (p = 0.001; p < 0.01). No significant disparities in UA levels were observed among patients based on RLS scores (p > 0.05). The generalized linear model in which UA serves as the dependent variable revealed statistically significant associations with the "moderate" and "severe" stages of RLS, as well as age (p < 0.05). Additionally, a ROC curve analysis was executed to evaluate the potential of UA as a biomarker. The ROC analysis, focusing on the patient-control classification, revealed a statistically significant area under the curve (AUC = 0.848, p < 0.001). Our study supports the hypothesis implicating serum UA levels in RLS pathogenesis. Further understanding of UA and its physiological effects will clarify on its role in RLS pathophysiology.

Although many studies have indicated a significant association between migraine and restless legs syndrome (RLS), few long-term longitudinal studies have examined RLS in patients with migraine. We conducted a single-center, 12-year, longitudinal study of migraine patients and assessed whether RLS was present in 2010, 2017, or 2022 to evaluate its associations with clinical factors. Headache-related disability was assessed using the Migraine Disability Assessment (MIDAS). Sleep quality, daytime sleepiness, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory-II (BDI-II), respectively. Of the 262 patients included at baseline (2010), 101 were available after 7 years (2017), and 74 were available after 12 years (2022). The RLS incidence rates were 13.7%, 20.8%, and 24.3% in 2010, 2017, and 2022, respectively. The RLS severity score did not significantly differ among the three time points. The persistent RLS group, defined as those who were positive for RLS at the last evaluation in addition to the first and/or second evaluations, had significantly higher MIDAS, BDI-II, PSQI and ESS scores than did the never RLS group, defined as those who did not exhibit RLS at any of the three time points. Our 12-year longitudinal study revealed significant impacts of RLS on the burden of patients with migraine.

To examine whether the effects of low sleep quality, sleep deprivation, and chronotype on daytime cognitive function varied by age group. All data were collected online. We obtained the data from 366 employed people in their 20s, 40s, or 60s. The participants were required to fill out a questionnaire comprising of the Pittsburgh Sleep Quality Index, an Ultra-Short Version of the Munich ChronoType Questionnaire, and Karolinska Sleepiness Scale, and perform the online Stroop task through the web browser on their own PC. The results of analyses of variance showed that people in their 20s had more of an evening chronotype, while those in their 20s and 40s experienced more sleep loss than those in their 60s. Stroop interference, reflecting decline in selective attention, was greater in people in their 60s. The results of structural equation modeling showed that sleep loss tended to relate to lower Stroop interference in people in their 20s. Additionally, people in their 60s exhibited a significant relationship between lower sleep quality and lower Stroop interference in the reaction time. At least in this study, interindividual differences in sleep loss, chronotype, and sleep quality did not have a strong effect on cognitive function measured using the online Stroop task in the 40s age group. However, people in their 20s with sleep loss and those in their 60s with lower sleep quality showed higher selective attention, the mechanism of which requires further research.

The ovarian steroid hormones, estrogen and progesterone, the levels of which fluctuate dynamically with the estrous cycle, alter circadian behavioral rhythms in mammals. However, it remains unclear whether the sleep–wake rhythm fluctuates with the menstrual cycle in humans. To ascertain the relationship between the menstrual cycle and sleep–wake rhythms, we evaluated the objective and long-term sleep–wake rhythms of ten healthy women using a recently developed wearable device. The results showed a strong negative correlation between the sleep midpoint and the quasi-peak value (an indicator of rhythm robustness), and a positive correlation between the length of the menstrual cycle (days) and social jetlag (hours). These results suggest that healthy women with late sleeping habits have a disturbed sleep–wake rhythm and that irregular habits prolong the menstrual cycle. The sleep midpoint and quasi-peak values showed variations during the menstrual cycle. The quasi-peak values in the follicular phase were significantly higher than those in the menstrual and luteal phases. In rodents, the phase of locomotor activity rhythm advances, and activity increases at night during proestrus. The increase in quasi-peak values during the follicular phase, when estrogen is relatively high, may be due to the increased activity caused by estrogen. These results suggest that ovarian steroid hormones influence sleep–wake rhythms in women. Verifying the results of this study under various conditions is necessary; however, accurately predicting the day of ovulation using only the acquisition of sleep–wake rhythms with wearable devices will be possible.

This study aimed to investigate the occurrence and age-related changes of the first night effect (FNE) in school-age children using both macro (sleep architecture) and micro (frequency analysis) structures to polysomnography (PSG) data. PSG data from two consecutive nights were obtained from 38 healthy children aged 6–15 years. Sleep variables and power spectral analysis were compared between the two nights. The relationship between age and the difference in sleep variables and power values between the two nights was examined using correlation analysis. The first night showed significant reductions in total sleep time, sleep efficiency, N1, N2, and REM sleep, as well as significant increases in sleep onset latency and wake after sleep onset. The decrease in N3 and the increase in N2 due to FNE were positively and negatively correlated with age, respectively. Spectral analysis showed no effect of FNE for most variables, but there was a trend toward an increase in the convergence value of the δ band with age. FNE occurs in school-age children, and its manifestation changes with age. The decrease in N3 and increase in N2 become more pronounced with age, while the enhancement of low-frequency power is consistent across ages. These findings highlight the importance of considering age and specific sleep indicators when interpreting pediatric PSG results and underscore the need for a multi-level approach to understanding sleep changes across development.

To explore brain function alterations in chronic insomnia (CI). 65 CI patients and 48 healthy controls were included to analyze abnormal alterations in brain spontaneous activity using static regional homogeneity (sReHo) and dynamic regional homogeneity (dReHo) methods. CI patients focused on decreased sReHo in bilateral lingual gyrus, bilateral middle occipital gyrus, bilateral inferior occipital gyrus and right superior occipital gyrus; decreased dReHo in bilateral superior occipital gyrus, bilateral cortical area around the talus fissure, and right middle occipital gyrus. CI patients exhibit abnormal activity in multiple brain regions, which can reflect the sleep quality index.