Pub Date : 2023-06-12eCollection Date: 2023-12-15DOI: 10.1016/j.sleepx.2023.100076
Johan H Therchilsen, Poul Kirketerp, Preben Homoe
Mandibular advancement devices (MAD) are used in sleep apnea with varying results. We aimed to examine whether or not a MAD should be an integral treatment modality in the care of our patients with obstructive sleep apnea. We designed a feasibility study and included 32 patients after meeting inclusion criteria. Only 3 patients did not finish the second sleep study exam. The intervention was an individually designed MAD and a sleep study exam was performed prior and post treatment. The outcome objective was an apnea-hypopnea index of under 10 and with a 50% reduction. Patient population had a baseline AHI of 19.0 and mean reduction of AHI with MAD treatment to 13.3 yielding a MAD efficacy rate of 31% when outcome objectives were applied. The average reduction in AHI was 24.8% with 9 of the 29 patients actually experiencing an increase in AHI with MAD treatment. When there was a reduction in AHI using the MAD device the AHI reduction rate was 49.1% and there was a tendency for better treatment outcome when apnea-hypopnea was predominantly supine. A mandibular advancement device serves as an important treatment modality in the care of patients with obstructive sleep apnea due to patient satisfaction and compliance. The broad range of treatment response to our MAD device highlights the importance of performing a sleep study exam after initiation of treatment with a MAD but also illustrates the complexity and need for individually tailored treatment for patients with obstructive sleep apnea.
{"title":"Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea.","authors":"Johan H Therchilsen, Poul Kirketerp, Preben Homoe","doi":"10.1016/j.sleepx.2023.100076","DOIUrl":"10.1016/j.sleepx.2023.100076","url":null,"abstract":"<p><p>Mandibular advancement devices (MAD) are used in sleep apnea with varying results. We aimed to examine whether or not a MAD should be an integral treatment modality in the care of our patients with obstructive sleep apnea. We designed a feasibility study and included 32 patients after meeting inclusion criteria. Only 3 patients did not finish the second sleep study exam. The intervention was an individually designed MAD and a sleep study exam was performed prior and post treatment. The outcome objective was an apnea-hypopnea index of under 10 and with a 50% reduction. Patient population had a baseline AHI of 19.0 and mean reduction of AHI with MAD treatment to 13.3 yielding a MAD efficacy rate of 31% when outcome objectives were applied. The average reduction in AHI was 24.8% with 9 of the 29 patients actually experiencing an increase in AHI with MAD treatment. When there was a reduction in AHI using the MAD device the AHI reduction rate was 49.1% and there was a tendency for better treatment outcome when apnea-hypopnea was predominantly supine. A mandibular advancement device serves as an important treatment modality in the care of patients with obstructive sleep apnea due to patient satisfaction and compliance. The broad range of treatment response to our MAD device highlights the importance of performing a sleep study exam after initiation of treatment with a MAD but also illustrates the complexity and need for individually tailored treatment for patients with obstructive sleep apnea.</p>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"1 1","pages":"100076"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55205736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-12DOI: 10.1016/j.sleepx.2023.100076
Johan H. Therchilsen , Poul Kirketerp , Preben Homoe
{"title":"Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea","authors":"Johan H. Therchilsen , Poul Kirketerp , Preben Homoe","doi":"10.1016/j.sleepx.2023.100076","DOIUrl":"https://doi.org/10.1016/j.sleepx.2023.100076","url":null,"abstract":"","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"6 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49775636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeting gut microbiome is the way forward in personalized medicine for obstructive sleep apnea","authors":"Mohit, Sangram Sandhu , Ashutosh Shrivastava, Pooran Chand","doi":"10.1016/j.sleepx.2023.100077","DOIUrl":"10.1016/j.sleepx.2023.100077","url":null,"abstract":"","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/c0/main.PMC10285271.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9717797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-22DOI: 10.1016/j.sleepx.2023.100073
Priscila Echevarria , Bianca Del-Ponte , Luciana Tovo-Rodrigues , Alicia Matijasevich , Camila S. Halal , Iná S. Santos
Objective/background
The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years.
Methods
With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions.
Results
1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7–19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6–8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; −0.62;-0.16 and β = -0.54; −0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10–2.32).
Conclusions
The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.
{"title":"Screen use and sleep duration and quality at 15 years old: Cohort study","authors":"Priscila Echevarria , Bianca Del-Ponte , Luciana Tovo-Rodrigues , Alicia Matijasevich , Camila S. Halal , Iná S. Santos","doi":"10.1016/j.sleepx.2023.100073","DOIUrl":"10.1016/j.sleepx.2023.100073","url":null,"abstract":"<div><h3>Objective/background</h3><p>The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years.</p></div><div><h3>Methods</h3><p>With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions.</p></div><div><h3>Results</h3><p>1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7–19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6–8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; −0.62;-0.16 and β = -0.54; −0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10–2.32).</p></div><div><h3>Conclusions</h3><p>The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/b1/main.PMC10251069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-18DOI: 10.1016/j.sleepx.2023.100072
Roshan Verma, Reshma Raj
We describe a case of 27 year old male who presented with history of breathing difficulty with episodes of apnea for 8 years. He was suspected to have obstructive sleep apnea and a nocturnal polysomnography showed Apnea-Hypopnea index of 34/hour and the lowest oxygen saturation of 78% and severe snoring in the night. Continuous positive airway pressure (CPAP) machine was advised from local hospital and he used for 2 month. Indirect laryngoscopy done showed bilateral abductor cord palsy. Contrast enhanced magnetic resonance imaging (CEMRI) of brain and contrast enhanced computed tomography (CECT) of chest and neck was normal study. Posterior cordotomy of left cord was done using coblation with resolution of symptoms of OSA.
Repeat nocturnal polysomnography showed apnea/hypopnea index 5 and lowest oxygen saturation of 95%.
{"title":"Idiopathic bilateral abductor cord palsy-can it be the cause of obstructive sleep apnea?","authors":"Roshan Verma, Reshma Raj","doi":"10.1016/j.sleepx.2023.100072","DOIUrl":"10.1016/j.sleepx.2023.100072","url":null,"abstract":"<div><p>We describe a case of 27 year old male who presented with history of breathing difficulty with episodes of apnea for 8 years. He was suspected to have obstructive sleep apnea and a nocturnal polysomnography showed Apnea-Hypopnea index of 34/hour and the lowest oxygen saturation of 78% and severe snoring in the night. Continuous positive airway pressure (CPAP) machine was advised from local hospital and he used for 2 month. Indirect laryngoscopy done showed bilateral abductor cord palsy. Contrast enhanced magnetic resonance imaging (CEMRI) of brain and contrast enhanced computed tomography (CECT) of chest and neck was normal study. Posterior cordotomy of left cord was done using coblation with resolution of symptoms of OSA.</p><p>Repeat nocturnal polysomnography showed apnea/hypopnea index 5 and lowest oxygen saturation of 95%.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/cd/main.PMC10238742.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleep is a physiological process that is essential to human physical, emotional, and mental health. Sleep difficulties affect an estimated 150 million individuals globally, with roughly 17% of the population in developing countries. As a result, the purpose of this study was to determine the prevalence and associated factors of poor sleep quality among textile and garment manufacturing workers in Addis Ababa, Ethiopia, in 2022.
Methods
A facility-based cross-sectional study was done from July 15th to August 15th, 2022, using a simple random sample technique. The degree of self-reported poor sleep quality was quantified using a validated, interviewer-administered, standardized Pittsburgh Sleep Quality Index. To determine the relationship between independent variables and poor sleep quality, multivariable logistic regression analysis was carried out with a p-value of less than 0.05 and a 95% confidence interval (CI).
Results
The prevalence of poor sleep quality was 75.4% (95% CI: 70.8, 80). Working more than 8 h per day (AOR = 2.83, 95% CI: 1.01, 7.94), work dissatisfaction (AOR = 3.27, 95% CI: 1.52–7.05), and using electronic materials before sleeping (AOR = 2.08, 95% CI: 1.01–4.30) were all associated with poor sleep quality.
Conclusion
Poor sleep quality was common among garment and textile industrial workers. Work dissatisfaction, working hours, and the utilization of electronic materials before bedtime were all substantially related to poor sleep quality, which should be taken into account and addressed early to reduce poor sleep quality.
{"title":"Poor sleep quality and associated determinants among textile and garment manufacturing workers in Addis Ababa, Ethiopia","authors":"Genanew Kassie Getahun , Adisu Genene , Trhas Tadesse","doi":"10.1016/j.sleepx.2023.100075","DOIUrl":"10.1016/j.sleepx.2023.100075","url":null,"abstract":"<div><h3>Background</h3><p>Sleep is a physiological process that is essential to human physical, emotional, and mental health. Sleep difficulties affect an estimated 150 million individuals globally, with roughly 17% of the population in developing countries. As a result, the purpose of this study was to determine the prevalence and associated factors of poor sleep quality among textile and garment manufacturing workers in Addis Ababa, Ethiopia, in 2022.</p></div><div><h3>Methods</h3><p>A facility-based cross-sectional study was done from July 15th to August 15th, 2022, using a simple random sample technique. The degree of self-reported poor sleep quality was quantified using a validated, interviewer-administered, standardized Pittsburgh Sleep Quality Index. To determine the relationship between independent variables and poor sleep quality, multivariable logistic regression analysis was carried out with a p-value of less than 0.05 and a 95% confidence interval (CI).</p></div><div><h3>Results</h3><p>The prevalence of poor sleep quality was 75.4% (95% CI: 70.8, 80). Working more than 8 h per day (AOR = 2.83, 95% CI: 1.01, 7.94), work dissatisfaction (AOR = 3.27, 95% CI: 1.52–7.05), and using electronic materials before sleeping (AOR = 2.08, 95% CI: 1.01–4.30) were all associated with poor sleep quality.</p></div><div><h3>Conclusion</h3><p>Poor sleep quality was common among garment and textile industrial workers. Work dissatisfaction, working hours, and the utilization of electronic materials before bedtime were all substantially related to poor sleep quality, which should be taken into account and addressed early to reduce poor sleep quality.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/9b/main.PMC10220473.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-05DOI: 10.1016/j.sleepx.2023.100074
Bjørn Bjorvatn , Guri Rørtveit , Ingrid Rebnord , Siri Waage , Knut Erik Emberland , Ingeborg Forthun
Objective
The objective was to assess the association between self-reported infections and sleep duration, sleep debt, chronic insomnia, and insomnia severity.
Methods
In total, 1023 participants were recruited from the Norwegian practice-based research network in general practice to a cross-sectional online survey with validated questions about sleep habits and insomnia symptoms (Bergen Insomnia Scale (BIS) and Insomnia Severity Index (ISI)), and whether they had experienced various infections during the last three months. Data were analyzed with chi-square tests and logistic regressions with adjustment for relevant confounders.
Results
Self-reported short sleep duration (<6 h) was significantly associated with increased odds of throat infection (OR = 1.60), ear infection (OR = 2.92), influenzalike illness (OR = 1.81) and gastrointestinal infection (OR = 1.91) whereas long sleep duration (>9 h) was associated with increased odds of throat (OR = 3.33) and ear infections (OR = 5.82), compared to sleep duration of 6–9 h, respectively. Sleep debt of >2 h was associated with increased odds of the common cold (OR = 1.67), throat infection (OR = 2.58), ear infection (OR = 2.84), sinusitis (OR = 2.15), pneumonia/bronchitis (OR = 3.97), influenzalike illness (OR = 2.66), skin infection (OR = 2.15), and gastrointestinal infection (OR = 2.80), compared to no sleep debt. Insomnia (based on BIS and ISI) was associated with throat infection (OR = 2.06, 2.55), ear infection (OR = 2.43, 2.45), sinusitis (OR = 1.82, 1.80), pneumonia/bronchitis (OR = 2.23, 3.59), influenzalike illness (OR = 1.77, 1.90), skin infection (OR = 1.64, 2.06), gastrointestinal infection (OR = 1.94, 3.23), and eye infection (OR = 1.99, 2.95).
Conclusions
These novel findings support the notion that people who have insufficient sleep or sleep problems are at increased risk of infections.
{"title":"Self-reported short and long sleep duration, sleep debt and insomnia are associated with several types of infections: Results from the Norwegian practice-based research network in general practice – PraksisNett","authors":"Bjørn Bjorvatn , Guri Rørtveit , Ingrid Rebnord , Siri Waage , Knut Erik Emberland , Ingeborg Forthun","doi":"10.1016/j.sleepx.2023.100074","DOIUrl":"10.1016/j.sleepx.2023.100074","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to assess the association between self-reported infections and sleep duration, sleep debt, chronic insomnia, and insomnia severity.</p></div><div><h3>Methods</h3><p>In total, 1023 participants were recruited from the Norwegian practice-based research network in general practice to a cross-sectional online survey with validated questions about sleep habits and insomnia symptoms (Bergen Insomnia Scale (BIS) and Insomnia Severity Index (ISI)), and whether they had experienced various infections during the last three months. Data were analyzed with chi-square tests and logistic regressions with adjustment for relevant confounders.</p></div><div><h3>Results</h3><p>Self-reported short sleep duration (<6 h) was significantly associated with increased odds of throat infection (OR = 1.60), ear infection (OR = 2.92), influenzalike illness (OR = 1.81) and gastrointestinal infection (OR = 1.91) whereas long sleep duration (>9 h) was associated with increased odds of throat (OR = 3.33) and ear infections (OR = 5.82), compared to sleep duration of 6–9 h, respectively. Sleep debt of >2 h was associated with increased odds of the common cold (OR = 1.67), throat infection (OR = 2.58), ear infection (OR = 2.84), sinusitis (OR = 2.15), pneumonia/bronchitis (OR = 3.97), influenzalike illness (OR = 2.66), skin infection (OR = 2.15), and gastrointestinal infection (OR = 2.80), compared to no sleep debt. Insomnia (based on BIS and ISI) was associated with throat infection (OR = 2.06, 2.55), ear infection (OR = 2.43, 2.45), sinusitis (OR = 1.82, 1.80), pneumonia/bronchitis (OR = 2.23, 3.59), influenzalike illness (OR = 1.77, 1.90), skin infection (OR = 1.64, 2.06), gastrointestinal infection (OR = 1.94, 3.23), and eye infection (OR = 1.99, 2.95).</p></div><div><h3>Conclusions</h3><p>These novel findings support the notion that people who have insufficient sleep or sleep problems are at increased risk of infections.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/a3/main.PMC10200965.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.1016/j.sleepx.2023.100071
Jung-Won Shin , Seonyeop Kim , Bomi Park , Yoon Jung Shin , Sunyoung Park
Objective
This study investigated demographic, sleep related symptoms and mental health status as predictors of clinically significant treatment responses to cognitive behavioral therapy in adults who have good adherence for the cognitive behavioral therapy for insomnia (CBT-I) program in primary insomnia.
Methods
A total of 42 adults with primary insomnia disorder were treated with CBT-I at a university hospital from June 2020 to January 2021. Demographic variables were surveyed and sleep-related symptoms were measured using self-reported questionnaires before and after the intervention, comprising a 6-week interval. The treatment responder group was defined as patients with an Insomnia Severity Index change score >7 compared to baseline. Logistic regression and paired t-test examined whether these factors predicted treatment outcomes for CBT-I.
Results
Demographic variables did not predict treatment outcomes. Higher levels of anxiety were associated with a higher likelihood of treatment response (odds ratio [OR] = 1.234; confidence interval [CI]: 1.008–1.511). More severe insomnia at baseline was associated with a greater likelihood of treatment response (OR = 1.450; CI: 1.121–1.875). The lesser the dysfunctional beliefs and attitudes about sleep, the more effective the treatment response (OR = 0.943; CI: 0.904–0.984). Unlike the group of treatment responders, daytime function, depressive mood, and anxiety status did not improve in the group of treatment non-responders after CBT-I intervention.
Conclusions
Patients with severe insomnia and anxiety at baseline should be treated more aggressively with CBT-I. During treatment, patients’ mental health problems and daytime activities should be continuously monitored, in order to help improve these problems which might strengthen the effectiveness of CBT-I.
{"title":"Improving mental health and daytime function in adult insomnia patients predict cognitive behavioral therapy for insomnia effectiveness: A case-control study","authors":"Jung-Won Shin , Seonyeop Kim , Bomi Park , Yoon Jung Shin , Sunyoung Park","doi":"10.1016/j.sleepx.2023.100071","DOIUrl":"10.1016/j.sleepx.2023.100071","url":null,"abstract":"<div><h3>Objective</h3><p>This study investigated demographic, sleep related symptoms and mental health status as predictors of clinically significant treatment responses to cognitive behavioral therapy in adults who have good adherence for the cognitive behavioral therapy for insomnia (CBT-I) program in primary insomnia.</p></div><div><h3>Methods</h3><p>A total of 42 adults with primary insomnia disorder were treated with CBT-I at a university hospital from June 2020 to January 2021. Demographic variables were surveyed and sleep-related symptoms were measured using self-reported questionnaires before and after the intervention, comprising a 6-week interval. The treatment responder group was defined as patients with an Insomnia Severity Index change score >7 compared to baseline. Logistic regression and paired <em>t</em>-test examined whether these factors predicted treatment outcomes for CBT-I.</p></div><div><h3>Results</h3><p>Demographic variables did not predict treatment outcomes. Higher levels of anxiety were associated with a higher likelihood of treatment response (odds ratio [OR] = 1.234; confidence interval [CI]: 1.008–1.511). More severe insomnia at baseline was associated with a greater likelihood of treatment response (OR = 1.450; CI: 1.121–1.875). The lesser the dysfunctional beliefs and attitudes about sleep, the more effective the treatment response (OR = 0.943; CI: 0.904–0.984). Unlike the group of treatment responders, daytime function, depressive mood, and anxiety status did not improve in the group of treatment non-responders after CBT-I intervention.</p></div><div><h3>Conclusions</h3><p>Patients with severe insomnia and anxiety at baseline should be treated more aggressively with CBT-I. During treatment, patients’ mental health problems and daytime activities should be continuously monitored, in order to help improve these problems which might strengthen the effectiveness of CBT-I.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10119957/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the real-world effectiveness and safety of lemborexan for treating comorbid insomnia associated with other psychiatric disorders, and whether lemborexant helps reduce the dose of benzodiazepines (BZs).
Methods
This retrospective observational study was conducted on outpatients and inpatients treated by physicians of Juntendo University Hospital Mental Clinic between April 2020 and December 2021.
Results
Data of 649 patients who were treated with lemborexant were eventually enrolled. About 64.5% of patients were classified as the responder group. Response rates of ≥60% were recorded for most psychiatric disorders. Upon administration of lemborexant, diazepam-equivalent dose of BZs had been significantly reduced in participants (3.7 ± 8.2 vs. 2.9 ± 7.9, p < 0.001). The results of logistic regression analysis showed that outpatient (odds ratios: 2.310; 95% confidence interval [CI]: 1.32–4.05), shorter duration of BZ use (<1 year) (odds ratios: 1.512; 95% CI: 1.02–2.25), no adverse events (odds ratios: 10.369; 95% CI: 6.13–17.54), larger reduction of diazepam-equivalent dose of BZs upon introducing lemborexant prescription (odds ratios: 1.150; 95% CI: 1.04–1.27), and suvorexant was the replacement drug (odds ratios: 2.983; 95% CI: 1.44–6.19), which were significant predictors of good response.
Conclusion
Although this is a retrospective and observational study with many limitations, our study results suggest that lemborexant is effective and safe.
{"title":"Safety and real-world efficacy of lemborexant in the treatment of comorbid insomnia","authors":"Narimasa Katsuta, Keitaro Takahashi, Yui Kurosawa, Akane Yoshikawa, Yoshihide Takeshita, Yoshihiro Uchida, Seita Yasuda, Chihiro Kakiuchi, Masanobu Ito, Tadafumi Kato","doi":"10.1016/j.sleepx.2023.100070","DOIUrl":"10.1016/j.sleepx.2023.100070","url":null,"abstract":"<div><h3>Aim</h3><p>To investigate the real-world effectiveness and safety of lemborexan for treating comorbid insomnia associated with other psychiatric disorders, and whether lemborexant helps reduce the dose of benzodiazepines (BZs).</p></div><div><h3>Methods</h3><p>This retrospective observational study was conducted on outpatients and inpatients treated by physicians of Juntendo University Hospital Mental Clinic between April 2020 and December 2021.</p></div><div><h3>Results</h3><p>Data of 649 patients who were treated with lemborexant were eventually enrolled. About 64.5% of patients were classified as the responder group. Response rates of ≥60% were recorded for most psychiatric disorders. Upon administration of lemborexant, diazepam-equivalent dose of BZs had been significantly reduced in participants (3.7 ± 8.2 vs. 2.9 ± 7.9, p < 0.001). The results of logistic regression analysis showed that outpatient (odds ratios: 2.310; 95% confidence interval [CI]: 1.32–4.05), shorter duration of BZ use (<1 year) (odds ratios: 1.512; 95% CI: 1.02–2.25), no adverse events (odds ratios: 10.369; 95% CI: 6.13–17.54), larger reduction of diazepam-equivalent dose of BZs upon introducing lemborexant prescription (odds ratios: 1.150; 95% CI: 1.04–1.27), and suvorexant was the replacement drug (odds ratios: 2.983; 95% CI: 1.44–6.19), which were significant predictors of good response.</p></div><div><h3>Conclusion</h3><p>Although this is a retrospective and observational study with many limitations, our study results suggest that lemborexant is effective and safe.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091115/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9310545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleep disorders are accompanied by increased anxiety and somatic pain. In addition, it has been observed that anxiety and pain have a boosting effect on each other, resulting in continued sleep disturbances. Amygdala's (CeA) central nucleus plays a crucial role in these processes. Cinnamaldehyde (Cinn) is an aromatic compound with anti-anxiety, antioxidant, and sleep-promoting properties. The present study uses sleep-deprived rats to examine the effects of an intra-CeA injection of Cinn on pain and anxiety.
Methods
Sleep deprivation (SD) was induced using the platform technique. 35 male Wistar rats were divided into five groups. Anxiety state and nociception were evaluated among groups using formalin test (F.T.), open field test (OFT), and elevated plus maze (EPM). Anxiety tests (OFT and EPM) were conducted in all groups. The first group was undergone FT without induction of SD (SD−FT+). The second group received SD without FT(SD+FT−). The third group received both SD and FT(SD+FT+). The treatment and vehicle groups have undergone both SD and FT in addition to the respectively intra-CeA injection of Cinn (SD+FT+ Cinn) and Cinn vehicle (SD+FT+ VC). The recorded behaviors were analyzed between groups using IBM SPSS 24th version.
Results
SD did not lead to any significant difference in nociceptive behaviors in FT between groups SD−FT+ and SD+FT+ (P ≥ 0.05). At the same time, there was a considerable discrepancy in rearing behaviors (P < 0.006) and the number of fecal boli (P < 0.004) recorded in OFM between these groups. Treatment with Cinn led to decreased nociception (P < 0.038), decreased rearing behaviors (P < 0.01), and reduced defecation (P < 0.004) in group SD + FT+ Cinn in comparison to the group SD+FT+. There were no differences in anxiety test results between the first and second groups (P ≥ 0.05).
Conclusion
SD can lead to elevated anxiety, while intra-CeA injection of Cinn ameliorated both perceptions of acute pain and anxiety. Besides, the conduction of FT before the anxiety test led to no disturbance in the results of anxiety tests.
{"title":"Amelioration of pain and anxiety in sleep-deprived rats by intra-amygdala injection of cinnamaldehyde","authors":"Seyed Kaveh Hadeiy , Solomon Habtemariam , Zeinab Shankayi , Shima Shahyad , Hedayat Sahraei , Milad Asghardoust Rezaei , Farideh Bahrami","doi":"10.1016/j.sleepx.2023.100069","DOIUrl":"10.1016/j.sleepx.2023.100069","url":null,"abstract":"<div><h3>Background</h3><p>Sleep disorders are accompanied by increased anxiety and somatic pain. In addition, it has been observed that anxiety and pain have a boosting effect on each other, resulting in continued sleep disturbances. Amygdala's (CeA) central nucleus plays a crucial role in these processes. Cinnamaldehyde (Cinn) is an aromatic compound with anti-anxiety, antioxidant, and sleep-promoting properties. The present study uses sleep-deprived rats to examine the effects of an intra-CeA injection of Cinn on pain and anxiety.</p></div><div><h3>Methods</h3><p>Sleep deprivation (SD) was induced using the platform technique. 35 male Wistar rats were divided into five groups. Anxiety state and nociception were evaluated among groups using formalin test (F.T.), open field test (OFT), and elevated plus maze (EPM). Anxiety tests (OFT and EPM) were conducted in all groups. The first group was undergone FT without induction of SD (SD<sup>−</sup>FT<sup>+</sup>). The second group received SD without FT(SD<sup>+</sup>FT<sup>−</sup>). The third group received both SD and FT(SD<sup>+</sup>FT<sup>+</sup>). The treatment and vehicle groups have undergone both SD and FT in addition to the respectively intra-CeA injection of Cinn (SD<sup>+</sup>FT<sup>+</sup> Cinn) and Cinn vehicle (SD<sup>+</sup>FT<sup>+</sup> VC). The recorded behaviors were analyzed between groups using IBM SPSS 24th version.</p></div><div><h3>Results</h3><p>SD did not lead to any significant difference in nociceptive behaviors in FT between groups SD<sup>−</sup>FT<sup>+</sup> and SD<sup>+</sup>FT<sup>+</sup> (P ≥ 0.05). At the same time, there was a considerable discrepancy in rearing behaviors (P < 0.006) and the number of fecal boli (P < 0.004) recorded in OFM between these groups. Treatment with Cinn led to decreased nociception (P < 0.038), decreased rearing behaviors (P < 0.01), and reduced defecation (P < 0.004) in group SD + FT+ Cinn in comparison to the group SD<sup>+</sup>FT<sup>+</sup>. There were no differences in anxiety test results between the first and second groups (P ≥ 0.05).</p></div><div><h3>Conclusion</h3><p>SD can lead to elevated anxiety, while intra-CeA injection of Cinn ameliorated both perceptions of acute pain and anxiety. Besides, the conduction of FT before the anxiety test led to no disturbance in the results of anxiety tests.</p></div>","PeriodicalId":37065,"journal":{"name":"Sleep Medicine: X","volume":"5 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/43/main.PMC10323214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10167215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}