Sleep and Biological Rhythms最新文献

Our study aimed to assess the prevalence and determinants of sleep disturbances among pregnant women in Kolar District, Karnataka, India. It focused on specific disturbances, such as obstructive sleep apnea (OSA), insomnia, restless leg syndrome (RLS), excessive daytime sleepiness (EDS), and poor sleep quality across pregnancy trimesters. A cross-sectional community-based study among 251 pregnant women was conducted. Sleep disturbances using validated tools, including the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI), STOP-Bang and single-question RLS screener tool were measured. Bivariate logistic regression was followed by multivariate logistic regression identified significant predictors. Sleep disturbances were highly prevalent, with poor sleep quality being most common (39.84%), followed by OSA (13.55%), EDS-moderate and severe category (11.56%), insomnia (9.6%), and RLS (6.80%). Proportion of pregnant women who screened positive for any sleep disturbance was 49.4%. Disturbances increased as pregnancy progressed, particularly in the third trimester. Significant predictors included increased neck circumference (aOR 1.08; p = 0.003), high-risk pregnancy (aOR 3.37; p < 0.001), and pregnancy trimester. Primigravida women were less likely to experience sleep issues compared to multigravida women (aOR 0.54; p = 0.034). High-risk pregnancies were associated with increased odds of OSA, insomnia, and EDS. Our study highlights the significant burden of sleep disturbances among pregnant women, with poor sleep quality being the most prevalent. High-risk pregnancies, increased neck circumference, and multigravida status were key determinants. Our findings emphasize the need for targeted interventions to improve maternal sleep quality and reduce potential adverse outcomes.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-024-00556-7.

Sleep-disordered breathing is common among patients with heart failure with preserved ejection fraction (HFpEF), and might impact their quality of life due to nighttime hypoxemia and awakenings. However, the factors contributing to deterioration in quality of life remain unclear. This study investigated the factors associated with quality of life deterioration in patients with HFpEF and sleep-disordered breathing. This prospective cross-sectional study included inpatients with HFpEF (left ventricular ejection fraction of ≥ 50%). Sleep-disordered breathing and quality of life were evaluated using polysomnography and the Short Form-8 Health Survey, respectively. The patients were grouped based on thei median physical and mental component summary Short Form-8 Health Survey scores. Among the 31 patients with HFpEF (aged 73.7 ± 10.9 years; 67.7% women; left ventricular ejection fraction, 65.3% ± 8.1%), the median apnea-hypopnea index was 11.5 per hour. Although no differences in parameters related to sleep-disordered breathing were found among the physical component summary-stratified groups, the low mental component summary group exhibited significantly lower nadir oxygen saturation than those exhibited by the high mental component summary group (84.3 ± 5.7% vs. 88.5 ± 3.9%; p = 0.02); this difference remained significant even when adjusted for potential confounders (β = 0.43; p = 0.02). Nocturnal hypoxemia may be a contributing factor to the decline in the mental health aspect of quality of life in patients with HFpEF. Thus, clinicians should consider hypoxemia when managing HFpEF and sleep-disordered breathing.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-024-00554-9.

[This corrects the article DOI: 10.1007/s41105-022-00389-2.].

This study aimed to investigate the prevalence of daytime sleepiness (DS) and its impact on quality of life (QOL) in outpatients with schizophrenia in the maintenance phase, as well as to identify the factors associated with DS. A total of 191 outpatients with schizophrenia completed a self-administered questionnaire including questions on lifestyle, sleep habits, DS, QOL, and sleep disorders. Insomnia, DS, and QOL were evaluated by the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), and the MOS 8-Item Short-Form Health Survey (SF-8), respectively. The prevalence of DS was assessed with two cut-off points, ESS ≥ 11 (ESS11-DS) and ESS ≥ 8 (ESS8-DS). Psychiatric symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Logistic regression analyses were used to identify factors associated with DS. The prevalence of ESS11-DS and ESS8-DS was 7.3% and 21.5%, respectively. Seven of eight QOL domains were reduced in the ESS11-DS group, and four of eight QOL domains were reduced in the ESS8-DS group. In both groups, the Mental Component Summary Score of the SF-8 was decreased. On logistic regression analyses, severity of insomnia was associated with both ESS11-DS and ESS8-DS. Moreover, negative symptoms were associated with ESS11-DS. Psychotropic medications were not associated with either ESS11-DS or ESS8-DS. The present findings suggest that focusing on improving insomnia, rather than reducing medication dosage, may be more important in ameliorating DS and, consequently, QOL in patients with schizophrenia in the maintenance phase.

A bout of leisure-time physical activity improves sleep on the subsequent night. However, whether breaking up sedentary time during the workday improves sleep is unknown. The purpose of this study was to examine whether breaking up prolonged sitting by standing during the workday leads to better sleep the following night. 25 inactive adults (16 males, 42.4 ± 11.8 years, body mass index: 31.9 ± 5.0 kg/m²) participated in a randomized crossover trial consisting of two simulated 8-h workdays involving prolonged sitting (SIT) or alternating sitting and standing every 30 min (SIT-STAND). Sleep was assessed on the night following each workday. Participants completed a diary and wore a wrist accelerometer (Actiwatch Spectrum) to assess multiple dimensions of sleep (e.g., timing, duration, wakefulness, quality). Paired t-tests and Hedges' g effect sizes evaluated differences in sleep across conditions. Self-reported wakefulness after sleep onset (WASO) was significantly lower following SIT-STAND compared to SIT (13.9 ± 30.1 min vs. 23.2 ± 38.6 min; p = 0.03, g = - 0.51), mirrored by a small-sized nonsignificant reduction in accelerometer-assessed WASO following SIT-STAND compared to SIT (32.7 ± 13.6 min vs. 40.8 ± 25.8 min; p = 0.06, g = - 0.38). Mean accelerometer-based activity levels during sleep were also lower following SIT-STAND compared to SIT (10.8 ± 14.5 vs. 14.7 ± 10.4 counts/min; p = 0.03, g = - 0.47). Other sleep outcomes (e.g., bed- and wake-time, total sleep time, sleep onset latency) were not different between conditions. Alternating sitting and standing rather than prolonged sitting during a simulated workday modestly reduces night-time wakefulness. Whether similar benefits occur with long-term reduction in workplace sedentary behavior deserves further exploration.

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.