Sleep and Biological Rhythms最新文献

Sleep-related rhythmic movement disorder (SRMD) in adults is rare, posing a distinctive challenge for healthcare practitioners. These movements can lead to significant disruption in sleep and can be a potential indicator of underlying severe Obstructive Sleep Apnea (OSA). The aim of the study was to evaluate OSA patients presenting with SRMD and their management with positive airway pressure therapy (PAP). Data of patients (aged between 18 and 80 years) with OSA and video documentation of abnormal movements during sleep study were taken from the sleep registry for this study. SRMD was defined as per Polysomnographic scoring rules in the AASM Manual for the Scoring of Sleep and Associated Events. All these patients were treated with PAP therapy. Seven patients were diagnosed as rhythmic movement disorders while being evaluated as cases of obstructive sleep apnea (OSA) during level I polysomnography (PSG). These movements significantly decreased during titration with positive airway pressure. The most frequently seen movements were rhythmic repetitive cyclic leg movements, leg kicking and rolling seen in three patients, followed by head banging in two patients. Combination of more than two movements was present in one patient. These movements significantly decreased with PAP therapy usage during follow-up. OSA is one of the important causes of SRMD in adults. CPAP is effective in treating SRMD associated with sleep apnea, emphasizing the importance of an accurate diagnosis through Level 1 PSG.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00609-5.

Respiratory rate (RR) is known to fluctuate due to psychological stress, while obstructive sleep apnea (OSA) remains highly prevalent. Conventional contact-based monitoring may disturb sleep, particularly in patients with insomnia. This study aimed to develop a non-constraining, non-contact respiratory monitoring system capable of measuring RR during wakefulness and detecting signs of OSA during sleep-two physiologically distinct states assessed at separate time points. A prospective observational study was conducted using a millimeter wave radar (MWR) device to evaluate its accuracy in monitoring respiratory rate. Participants suspected of having OSA were recruited prior to undergoing diagnostic polysomnography (PSG). RR measurements were obtained while the participants were awake in various postures (supine, sitting, and lateral), as well as during sleep. The device's non-contact nature allowed assessment without interfering with sleep quality. The index of apnea and hypopnea during 1 h of sleep (AHI) monitored by polysomnography (PSG) was compared with 1 h of respiratory event index (REI) judged by an MWR system. Portable monitoring (PM) and percutaneous arterial O₂ (SpO₂) monitoring were done simultaneously. High correlations were observed between RRs obtained by MWR and respiratory inductance plethysmography at PSG while awake in every measured position (r = 0.92-0.99) (n = 60). The REI by MWR was significantly correlated with AHI determined by PSG, PM, or SpO₂ monitoring (p < 0.001). The Bland-Altman plot showed that the MWR used for AHI monitoring was acceptable. Predicted AHI by MWR monitoring relative to PSG was almost the same as with PM or SpO₂ monitoring. The developed MWR respiratory monitor was useful during wakefulness and sleep, detecting apnea and hypopnea. It is beneficial in multiple medical settings, including sleep apnea screening, critical care with and without sleep apnea, and managing critically ill patients and elderly individuals receiving home care with telemonitoring.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00612-w.

Purpose: The increasing burden of caring for children with disabilities brings about various psychological and physiological difficulties for mothers. The objective of this study was to investigate the relationship between chronotype characteristics and eating disorders and intuitive eating behavior tendencies of mothers with disabled children.

Methods: The study was a case-control study conducted in a private rehabilitation center in Turkey and included 50 mothers of disabled children with cerebral palsy and 56 mothers of healthy children. Socio-demographic information, Morningness-Eveningness Scale, Pittsburgh Sleep Quality Index (PSQI), Eating Disorder Examination Questionnaire-13 (EDE-Q-13), Intuitive Eating Scale-2 (IES-2) and anthropometric measurements were taken from the participants.

Results: Mothers of children with disabilities had significantly lower chronotype scores (47.20 ± 4.65) compared with mothers of healthy children (53.66 ± 5.31) (p < 0.001), with a lower proportion of morningness (p = 0.004). The EDE-Q-13 scores were higher for mothers of children with disabilities (1.72 ± 1.08) compared with those with healthy children (1.32 ± 0.97) (p = 0.046). In addition, mothers with disabled children showed higher rates in the subscales of binge eating and purging behaviors (p = 0.001 and p < 0.001, respectively) and sleep medication use (p = 0.002).

Conclusions: Mothers with disabled children were found to have higher predisposition to evening chronotype, eating disorder scores and use of medical sleep medication than mothers with healthy children. Because this situation increases the risk of diseases such as obesity, cardiovascular diseases, type 2 diabetes and metabolic syndrome, it reveals the necessity of special nutrition and health follow-up programmes.

Aromatherapy may represent a low-cost intervention for disturbed sleep that presents minimal risks as compared with alternative pharmacotherapies. Confirmation of effectiveness and an understanding of the mechanism of action are necessary to support clinical applications. The present study evaluated the impact of two odorants (lavender and peppermint) on sleep behavior using a double-blinded, placebo-controlled design. Consistent with the marketed aromatherapy uses of these odorants, lavender was expected to improve sleep while peppermint was expected to enhance arousal and disrupt sleep. Fifty-nine undergraduate students completed two sleep sessions, 1 week apart, during which active or placebo aromatherapy was initiated at their intended sleep time. A wrist-worn tracking device was used to quantify sleep behavior in their typical sleep environment. Both lavender and peppermint aromatherapy significantly disrupted sleep relative to placebo as measured by reduced minutes asleep, F = 5.65(1, 59), p < 0.02, and sleep efficiency F = 5.59(1, 59), p < 0.02. However, peppermint produced significantly greater disruption than lavender, consistent with its purported arousal-enhancing properties. To the extent that lavender aromatherapy improves sleep, repeated applications may be required, establishing lavender as a sleep cue. It is hypothesized that the more substantial disruption of sleep caused by peppermint may result from activation of the trigeminal nerve upon inhalation.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00608-6.

Continuous positive airway pressure (CPAP) is the primary treatment for obstructive sleep apnea (OSA), with fixed pressure CPAP (FP-CPAP) and auto-titrating CPAP (Auto-CPAP) being the two modes. We examined the impact of CPAP on left ventricular ejection fraction (LVEF) in patients with OSA and heart failure with reduced ejection fraction (HFrEF). A meta-analysis of 10 randomized control trials (233 CPAP users, 242 controls) was conducted. LVEF was the primary outcome. CPAP significantly increased LVEF (mean difference: 3.72, 95% CI 2.21-5.23). FP-CPAP improved LVEF (4.84, 95% CI 3.23-6.45), while Auto-CPAP showed no significant effect. The cardiovascular benefits of CPAP in patients with OSA and HFrEF may vary by mode, suggesting a potential mode-specific effect between FP-CPAP and Auto-CPAP that warrants further investigation.

Supine-dependent OSA is a well-recognised OSA phenotype and may relate to craniofacial structure. Our aim was to assess whether craniofacial photos are able to identify positional OSA, specifically supine-isolated OSA, in comparison to non-positional OSA. Frontal and profile craniofacial photographs of participants were acquired according to a standardised protocol. Photographs were analysed and compared between non-positional and supine-isolated OSA groups. A total of 156 OSA patients were included (54.5% supine-isolated OSA, 45.5% with non-positional OSA). The supine-isolated group had a longer upper face height and greater upper-to-lower face height ratio, smaller face width, reduced face width-to-height ratio, and smaller mandibular width, length, and size of the mandibular base. Differences in facial measurements were no longer significant after adjustment for body size and OSA severity. Our study demonstrates that supine-isolated OSA can be identified using facial photography. Larger studies in groups matched for BMI and OSA severity are needed to confirm whether this technique may also capture other features related to supine-isolated OSA (i.e., differences in underlying skeletal structure).

The 3-Dimensional Sleep Scale (3DSS) is used to assess sleep quality, quantity, and phase. However, its reliability and validity were established using classical methods and it has a small validation sample size. We aimed to increase the sample size and update the statistical methods to validate the reliability and validity of the 3DSS. We conducted a web-based survey of approximately 3000 day-shift workers at four companies in Tokyo, Japan, between 2021 and 2022. The 15 questions in the 3DSS were tested for reliability and validity according to the COSMIN checklist. The maximum likelihood method and promax rotation were selected for exploratory factor analysis. Reliability was tested by calculating the intraclass correlation coefficient and McDonald's ω reliability coefficient. Convergent and discriminant validity were verified using multi-trait multi-method analysis. Cutoff values were verified using receiver operating characteristic curves and area under the curve (AUC). Existing measures used to validate the validity and cutoff values included the Athens Insomnia Scale, social jetlag, weekday sleep duration, and holiday waking time. Overall 2605 participants were included in the analysis after excluding non-responders, non-consenters, and absent employees. Exploratory factor analysis confirmed a three-factor structure for sleep phase, quality, and quantity. For convergent and discriminant validity, ideal correlations were observed for all subscales. The AUCs for sleep phase, sleep quality, and sleep quantity were 0.747, 0.812, and 0.819, respectively. The 3DSS offers sufficient reliability and validity as a sleep assessment scale. An English version of this scale should be developed in the future.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00600-0.

The primary objective of this study was to investigate bedroom environment and parental awareness surrounding junior and high school students. A secondary aim was to explore the relationship between these factors and sleep-related problems in adolescents. A web-based questionnaire survey was conducted in October 2023 with responses from 590 parents of junior high school students and 607 parents of high school students. The survey assessed bedroom environment, parental awareness, and adolescents' lifestyles and sleep. Descriptive statistics were used to determine the actual conditions of the bedroom environment and parental awareness. To examine the factors associated with sleep-related problems in adolescents, we conducted logistic regression analysis. Approximately 40% of the adolescents had bedrooms with east-facing windows, and more than half used blackout curtains. Seventy percent of parents of junior high school students and 60% of parents of high school students paid attention to adolescents' sleep duration. Logistic regression analyses showed that sleep-related problems were not significantly associated with the bedroom environment, whereas higher parental awareness of ensuring adequate sleep time was associated with reduced odds of insufficient sleep (OR = 0.36 in junior high school students, OR = 0.49 in high school students; p < 0.05) and late chronotype (OR = 0.57 and 0.63, respectively; p < 0.05) in both groups. This study clarified the bedroom environment and parental awareness of adolescents. While bedroom environment showed no association with sleep-related problems, parental awareness remained crucial in addressing these issues in both junior and high school students.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00601-z.

This study aimed to evaluate the bidirectional relationship between sleep and pain in Japanese patients with chronic pain through a prospective analysis of the impact of pain on sleep and the impact of sleep on pain the following day, based on both objective and subjective measures. Sleep and pain parameters were recorded every day for a 7-day period in 36 patients with chronic pain. Objective sleep data were collected using an actigraph, and total sleep time, sleep onset latency, total wake time after sleep onset, and sleep efficiency were determined. Subjective ratings of sleep and pain intensity were obtained using sleep diaries and a pain scale. A mixed-effects model was used for data analysis, and the bidirectional relationship between pain and sleep was examined in each direction. Sleep efficiency measured by actigraphy was significantly higher on days when pain before sleep was less intense (p < 0.05), but pain intensity did not affect subjective sleep satisfaction. Sleep efficiency did not affect pain after sleep the next day, but pain after sleep was significantly less intense on days when sleep satisfaction was high (p < 0.0001). The results of this study suggest that the relationship between pain and sleep is bidirectional, but objective sleep data and subjective ratings of sleep were inconsistent. Improvement of perceived sleep quality may be necessary in patients who do not notice any change in their sleep quality despite achieving better sleep efficiency through treatment.

Purpose: Narcolepsy diagnosis relies on polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT), though concerns remain regarding their diagnostic accuracy and reliability. Nocturnal sleep-onset rapid eye movement periods (SOREMPs) are a known feature of narcolepsy. This study investigated the clinical significance of nocturnal SOREMP in narcolepsy diagnosis and its association with test-retest reliability.

Methods: We retrospectively reviewed 109 patients who underwent at least two MSLTs. Patients were categorized into nocturnal SOREMP (n = 40) and non-nocturnal SOREMP (n = 69) groups based on PSG findings. Only MSLT-identified SOREMPs were used for diagnosis. Group comparisons and follow-up changes were analyzed using t-tests, chi-square tests, or Wilcoxon signed-rank tests.

Results: The nocturnal SOREMP group had more SOREMPs (3.50 vs. 2.23), shorter mean sleep latency (1.99 vs. 4.77), and higher initial narcolepsy diagnosis rates (92.5% vs. 63.8%). Diagnostic stability was significantly higher in the nocturnal group (90.0% vs. 50.7%). Among narcolepsy type 2 (NT2) patients, those with nocturnal SOREMP showed complete diagnostic retention (100%), whereas only 27.3% of those without nocturnal SOREMP did. In a subgroup analysis, patients who had a nocturnal SOREMP on at least one of the two PSGs exhibited significantly higher diagnostic stability (93.9%) than those without nocturnal SOREMP on either test (50.0%). Similarly, NT2 retention was 100% in the former versus 16.7% in the latter.

Conclusions: Nocturnal SOREMP may serve as a specific marker for narcolepsy, suggesting potential utility in supporting diagnostic consistency. Its presence appears to be associated with improved diagnostic reliability, particularly in NT2.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00598-5.