Sleep Medicine: X最新文献_第3页

Self-reported sleep variables, sleep quality, and quality of life assessment in transition to lemborexant in patients with Insomnia: the multicenter, open-label SOMNUS study 失眠患者自我报告的睡眠变量、睡眠质量和生活质量评估：多中心、开放标签的SOMNUS研究

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-09-25 DOI: 10.1016/j.sleepx.2025.100149

Motohiro Ozone , Susumu Hirota , Yu Ariyoshi , Kenichi Hayashida , Azusa Ikegami , Mitsunari Habukawa , Hayato Ohshima , Daisuke Harada , Hiroshi Hiejima , Nozomu Kotorii , Kenta Murotani , Yurie Nishi , Michinori Koebis , Takehiro Taninaga , Naohisa Uchimura

Aims

Lemborexant, a dual orexin receptor antagonist, is approved for treating adults with insomnia. We present diary-based sleep parameters, self-reported sleep quality, insomnia severity, and health-related quality of life following direct transition to lemborexant from previous treatment in Japanese patients with insomnia using data from the SOMNUS Study.

Methods

The prospective, nonrandomized, open-label, multicenter SOMNUS Study analyzed data from 90 patients across four cohorts of direct switching to lemborexant from Z-drugs (monotherapy cohort: n = 25), suvorexant (monotherapy cohort: n = 25, combination cohort: n = 21), and ramelteon (combination cohort: n = 19) up to 14 weeks.

Results

Diary-based sleep parameters (subjective sleep onset latency, subjective wake time after sleep onset, subjective total sleep time, and subjective sleep efficiency) significantly improved after transitioning to lemborexant in the 90 patients. At 2, 6, and 14 weeks, significant reductions in Insomnia Severity Index total scores were observed (−2.6 ± 3.81, −4.4 ± 5.13, and −5.3 ± 4.80, respectively; all p < 0.0001). Self-reported sleep quality and morning alertness also showed consistent, significant improvements across all time points. Short Form-8 physical component summary and mental component summary scores demonstrated positive trends, with notable improvements observed in the overall population by the end of the study. Treatment-emergent adverse events (TEAEs) occurred in 47.8 % of patients; most were mild or moderate in severity. No serious TEAEs occurred; somnolence was the most common TEAE.

Conclusions

These findings indicate that transitioning to lemborexant from previous insomnia treatment is efficacious in improving sleep parameters, insomnia severity, and health-related quality of life, with a favorable safety profile.

Trial registration

NCT04742699.

AimsLemborexant是一种双重食欲素受体拮抗剂，被批准用于治疗成人失眠。我们利用来自SOMNUS研究的数据，介绍了日本失眠患者在从之前的治疗直接过渡到lemborexant后，基于日记的睡眠参数、自我报告的睡眠质量、失眠严重程度和与健康相关的生活质量。方法前瞻性、非随机、开放标签、多中心的SOMNUS研究分析了来自4个队列的90例患者的数据，这些患者从z -药物（单药队列：n = 25）、suvorexant（单药队列：n = 25，联合队列：n = 21）和ramelteon（联合队列：n = 19）直接切换到lemborexant长达14周。结果90例患者的睡眠参数（主观睡眠开始潜伏期、主观睡眠开始后清醒时间、主观总睡眠时间和主观睡眠效率）在过渡到leborexant后显著改善。在第2周、第6周和第14周，观察到失眠严重程度指数总分显著降低（分别为- 2.6±3.81、- 4.4±5.13和- 5.3±4.80;p < 0.0001）。自我报告的睡眠质量和早晨警觉性也在所有时间点显示出一致的、显著的改善。Short Form-8的身体成分总结和精神成分总结得分显示出积极的趋势，在研究结束时，总体人群中观察到显着的改善。47.8%的患者出现治疗不良事件（teae）；大多数是轻度或中度的严重程度。未发生严重teae；嗜睡是最常见的TEAE。结论：从先前的失眠治疗中过渡到leborexant在改善睡眠参数、失眠严重程度和健康相关生活质量方面是有效的，并且具有良好的安全性。registrationNCT04742699审判。

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引用次数: 0

Metacognitive therapy for insomnia: An open cohort study on clinical outcomes and the role of cognitive-attentional syndrome factors in insomnia 失眠的元认知治疗：一项关于失眠的临床结果和认知-注意力综合征因素作用的开放队列研究

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-09-25 DOI: 10.1016/j.sleepx.2025.100153

Osame Salim , Serena Bauducco , Annika Norell , Pia Callesen

Background

Insomnia is a common and distressing disorder. Evidence suggests that metacognitive beliefs and maladaptive strategies, such as worry and rumination, may maintain insomnia.

Objectives

This study is the first trial of metacognitive therapy (MCT) for insomnia. It aimed to evaluate the effects of MCT on insomnia severity and examine how cognitive-attentional syndrome (CAS) components predict these changes.

Methods

An uncontrolled open cohort trial was conducted with 31 participants in a clinic setting. Participants received up to ten MCT sessions and completed weekly measures of insomnia severity, anxiety, depressive symptoms, and metacognitive beliefs, including maladaptive strategies. The primary outcome was remission status from pre-to post-treatment. Associations between components of the cognitive-attentional syndrome (CAS) and insomnia severity were examined using a mixed model. Follow-up data were collected at 3, 6, and 12 months.

Results

At post-treatment, 57 % of participants met remission criteria and 67 % scored below the clinical cut-off. Within-group effect sizes were large for the Insomnia Severity Index (Hedges’ g = 1.64) and moderate for anxiety (HADS-A, g = 0.67) and depression (HADS-D, g = 0.72). Among those providing follow-up data, 87.5 % remained at or further improved their insomnia symptoms by their last assessment. Moreover, both between-person averages and within-person changes in maladaptive CAS strategies significantly predicted ISI scores, whereas only within-person changes in CAS-negative metacognitions reached significance.

Conclusions

These preliminary findings indicate that metacognitive therapy (MCT) shows promise as an intervention for insomnia. However, large-scale, controlled trials are necessary to further evaluate its clinical utility for this condition.

背景：失眠是一种常见且令人痛苦的疾病。有证据表明，元认知信念和适应不良的策略，如担忧和沉思，可能会导致失眠。目的：本研究是首个失眠元认知疗法（MCT）的临床试验。该研究旨在评估MCT对失眠严重程度的影响，并研究认知-注意力综合征（CAS）成分如何预测这些变化。方法在临床环境下进行了一项31名受试者的非对照开放队列试验。参与者接受了多达10次的MCT治疗，并完成了失眠严重程度、焦虑、抑郁症状和元认知信念（包括适应不良策略）的每周测量。主要终点是治疗前到治疗后的缓解状态。认知-注意综合征（CAS）组成部分与失眠严重程度之间的关联采用混合模型进行检验。随访3、6、12个月。结果治疗后，57%的参与者达到缓解标准，67%的参与者得分低于临床临界值。失眠严重指数（Hedges ' g = 1.64）的组内效应量较大，焦虑（HADS-A, g = 0.67）和抑郁（HADS-D, g = 0.72）的组内效应量适中。在提供随访数据的人中，87.5%的人在最后一次评估时失眠症状仍然存在或进一步改善。此外，不适应CAS策略的人间平均值和人内变化都能显著预测ISI得分，而只有CAS负元认知的人内变化才有显著意义。结论这些初步发现表明元认知疗法（MCT）有望作为失眠的干预手段。然而，需要大规模的对照试验来进一步评估其在这种情况下的临床应用。

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引用次数: 0

Determining the relationship between sleep quality and reproductive health issues in fertile and infertile men and women: A cross-sectional study 确定可育和不育男女睡眠质量与生殖健康问题之间的关系：一项横断面研究

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-09-24 DOI: 10.1016/j.sleepx.2025.100151

Farangis habibi , Marzieh Azizi , Sepideh Peyvandi , Roya Nikbakht , Javad Setareh , Mohammad Ahmadi , Zohreh Shahhosseini

Background and objective

Reproductive health is an integral part of overall health. Sleep disorders and infertility may be reciprocally related. Therefore, the present study aims to investigate the association between sleep quality and reproductive health in fertile and infertile men and women.

Methods

In this cross-sectional study, the population consists of 736 men and women who visited health centers in Behshahr County and the infertility center at Imam Khomeini Hospital in Sari in 2024. Four questionnaires were utilized in this study: Socio-Demographic-Medical Questionnaire, Pittsburgh Sleep Quality Index, Sexual Quality of Life Questionnaire, and the Depression Anxiety Stress Scale. After data collection, the data were entered into SPSS version 22. If the data distribution was normal, independent two-sample t-tests and one-way analysis of variance were used, and if the data distribution was not normal, nonparametric equivalents, Mann-Whitney U and Kruskal-Wallis tests, were used.

Result

The results showed a considerable difference in sleep quality between fertile and infertile individuals, particularly among females. Among infertile females, 65.9 % reported poor sleep quality (PSQI ≥6), compared to 49.6 % of fertile females, which showed a statistically significant difference (p = 0.007). In contrast, although a higher proportion of infertile males (36.8 %) reported poor sleep quality compared to fertile males (29.1 %), this difference was not statistically significant (p = 0.077).

Conclusion

We found that sleep disturbance and reproductive health are linked. Therefore, it is essential to manage sleep quality in infertile individuals by reproductive health professionals.

背景和目的生产性健康是整体健康的一个组成部分。睡眠障碍和不孕可能是相互关联的。因此，本研究旨在探讨睡眠质量与生殖健康之间的关系在育龄和不育的男性和女性。方法在这项横断面研究中，人口包括736名男性和女性，他们于2024年访问了Behshahr县的保健中心和萨里伊玛目霍梅尼医院的不孕不育中心。本研究采用社会人口医学问卷、匹兹堡睡眠质量指数、性生活质量问卷和抑郁焦虑压力量表。数据收集完成后，将数据输入SPSS version 22。如果数据分布为正态分布，则使用独立的双样本t检验和单向方差分析，如果数据分布不为正态分布，则使用非参数等效检验，即Mann-Whitney U检验和Kruskal-Wallis检验。结果研究结果显示，有生育能力的人和没有生育能力的人，尤其是女性，睡眠质量有很大差异。在不孕女性中，65.9%报告睡眠质量差（PSQI≥6），而在可育女性中为49.6%，差异有统计学意义（p = 0.007）。相比之下，尽管不孕男性的睡眠质量较差的比例（36.8%）高于有生育能力的男性（29.1%），但这一差异在统计学上并不显著（p = 0.077）。结论睡眠障碍与生殖健康之间存在一定的联系。因此，由生殖健康专业人员管理不孕症患者的睡眠质量至关重要。

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引用次数: 0

National trends in mortality associated with obstructive sleep apnea among adults with diabetes mellitus in the United States, 1999–2020 1999-2020年美国成人糖尿病患者与阻塞性睡眠呼吸暂停相关的死亡率趋势

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-09-02 DOI: 10.1016/j.sleepx.2025.100148

Ibrahim Nagmeldin Hassan , Siddig Yaqub , Muhsin Ibrahim , Nagmeldin Abuassa , Mohamed Ibrahim

Background

Obstructive sleep apnea (OSA) and diabetes mellitus are two prevalent and interrelated chronic conditions that contribute significantly to cardiovascular and metabolic mortality. However, national trends in OSA-related mortality among adults with diabetes remain poorly characterized.

Methods

We conducted a cross-sectional analysis of U.S. death certificate data from 1999 to 2020 using the CDC WONDER platform. Adults aged ≥25 years with diabetes mellitus (ICD-10: E10–E14) as the underlying cause of death and OSA (G47.33) as a contributing cause were included. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population, and temporal trends were assessed using Joinpoint regression.

Results

A total of 79,728 deaths were attributed to diabetes and OSA. The overall AAMR was 1.55 (95 % CI: 1.50 to 1.60), increasing significantly from 1999 to 2004 (APC: 19.42 %) and more gradually from 2005 to 2020 (APC: 6.86 %). Males had nearly double the mortality rate of females (2.13 vs. 1.07). The highest AAMRs were observed among American Indian or Alaska Native (2.16) and Black (1.98) individuals. Non-metropolitan areas had higher mortality than metropolitan areas (1.91 vs. 1.48), and the Midwest had the highest regional AAMR (1.95). Crude mortality increased with age, peaking at 5.42 in the 75–84 age group. State-level AAMRs varied nearly sixfold. Most deaths occurred at home (38.5 %), followed by inpatient facilities (32.8 %).

Conclusions

Mortality related to OSA in adults with diabetes has risen substantially across all demographics, underscoring the need for targeted interventions in high-risk groups.

背景：阻塞性睡眠呼吸暂停（OSA）和糖尿病是两种普遍存在且相互关联的慢性疾病，对心血管和代谢性死亡有重要影响。然而，成人糖尿病患者osa相关死亡率的全国趋势仍不明确。方法采用CDC WONDER平台对1999年至2020年美国死亡证明数据进行横断面分析。年龄≥25岁的糖尿病（ICD-10: E10-E14）为潜在死亡原因，OSA （G47.33）为辅助死亡原因。计算每10万人的年龄调整死亡率（AAMRs），并使用连接点回归评估时间趋势。结果糖尿病和OSA共导致79728例死亡。总体AAMR为1.55 (95% CI: 1.50 ~ 1.60)， 1999 ~ 2004年显著增加（APC: 19.42%）， 2005 ~ 2020年逐渐增加（APC: 6.86%）。男性的死亡率几乎是女性的两倍（2.13比1.07）。美国印第安人和阿拉斯加原住民（2.16）和黑人（1.98）个体的aamr最高。非大都市地区的死亡率高于大都市地区（1.91比1.48），中西部地区的AAMR最高（1.95）。粗死亡率随年龄增长而增加，75-84岁年龄组最高，为5.42。州一级的aamr相差近6倍。大多数死亡发生在家中（38.5%），其次是住院设施（32.8%）。结论：成人糖尿病患者与OSA相关的死亡率在所有人群中都大幅上升，强调了对高危人群进行有针对性干预的必要性。

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引用次数: 0

Effect of a saffron extract on sleep quality in adults with moderate insomnia: A decentralized, randomized, double-blind, placebo-controlled trial 藏红花提取物对中度失眠症成人睡眠质量的影响：一项分散、随机、双盲、安慰剂对照试验

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-07-09 DOI: 10.1016/j.sleepx.2025.100147

Julius Schuster , Christin Mundhenke , Hannah Nordsieck , Camille Pouchieu , Line Pourtau , Andreas Hahn

Aim

Natural interventions for sleep disturbances, such as saffron extract, are gaining scientific and clinical interest. This 3-arm, randomized, double-blind, placebo-controlled trial examined the effect of a standardized saffron extract (Safr’Inside™) on sleep, stress, and other associated psychological outcomes in 165 adults reporting moderate insomnia.

Methods

Participants received 30 mg, 20 mg saffron extract, or placebo for 4 weeks. The primary endpoint was the change in insomnia symptoms (Athens Insomnia Scale, AIS). Secondary outcomes were the Single-Item Sleep Quality Scale (SQS), Perceived Stress Scale (PSS), Patient Health Questionnaire-4 (PHQ-4), Positive and Negative Affect Schedule (PANAS), Epworth Sleepiness Scale (ESS), and World Health Organization Quality of Life (WHOQOL). Analyses followed an intention-to-treat (ITT) approach, with per-protocol (PP) confirmation.

Results

Among 150 completers, saffron extract led to a greater reduction in insomnia symptoms (AIS) than the placebo (between-group adjusted mean difference β = −0.95 [95 % CI: −1.79, −0.11], P < .05). In secondary analyses, sleep quality (SQS) improved significantly after 3 weeks and was sustained at week 4 in both saffron groups compared to placebo (30 mg vs placebo: β = 0.82 [95 % CI: 0.22, 1.41], P = .004; 20 mg vs placebo: β = 1.02 [0.43, 1.62], P < .001). Perceived stress (PSS) was significantly reduced with 30 mg or 20 mg saffron extract compared to placebo (30 mg vs placebo: β = −1.87 [95 % CI: −3.23, −0.53], P = .01; 20 mg vs placebo: β = −1.89 [95 % CI: −3.22, −0.52], P = .04). Some improvement in psychological symptoms (PHQ-4) was also observed with 30 mg saffron extract compared to placebo (β = −0.79 [−1.40, −0.18], P = .03). All other measures showed no significant differences. No serious adverse events occurred.

Conclusions

Four weeks of 20 or 30 mg saffron extract may reduce insomnia and stress in middle-aged adults. Future research should assess longer interventions and explore which subgroups benefit most from saffron extract.

非自然干预睡眠障碍，如藏红花提取物，正在获得科学和临床的兴趣。这项三组随机、双盲、安慰剂对照试验检测了标准藏红花提取物（Safr 'Inside™）对165名报告中度失眠的成年人的睡眠、压力和其他相关心理结果的影响。方法受试者分别服用30 mg、20 mg藏红花提取物或安慰剂，疗程4周。主要终点是失眠症状的改变（雅典失眠量表，AIS）。次要结果为单项睡眠质量量表（SQS）、感知压力量表（PSS）、患者健康问卷-4 （PHQ-4）、积极和消极影响量表（PANAS）、Epworth嗜睡量表（ESS）和世界卫生组织生活质量量表（WHOQOL）。分析采用意向治疗（ITT）方法，并对每个方案（PP）进行确认。结果在150名完成者中，藏红花提取物比安慰剂更能减轻失眠症状(组间校正平均差β = - 0.95 [95% CI: - 1.79, - 0.11], P <；. 05)。在二次分析中，与安慰剂组相比，两组藏红花组的睡眠质量（SQS）在3周后显著改善，并持续到第4周(30 mg vs安慰剂：β = 0.82 [95% CI: 0.22, 1.41], P = 0.004；20 mg vs安慰剂：β = 1.02 [0.43, 1.62], P <；措施)。与安慰剂相比，30 mg或20 mg藏红花提取物显著降低了感知压力（PSS） (30 mg vs安慰剂：β =−1.87 [95% CI:−3.23,−0.53],P = 0.01；20毫克vs安慰剂:β=−1.89(95%置信区间CI:−3.22−0.52),P = .04点)。与安慰剂相比，30 mg藏红花提取物对心理症状（PHQ-4）也有一定改善（β = - 0.79 [- 1.40, - 0.18], P = .03）。其他指标均无显著差异。未发生严重不良事件。结论4周服用20或30毫克藏红花提取物可减轻中年人的失眠和压力。未来的研究应该评估更长时间的干预措施，并探索哪些亚群从藏红花提取物中获益最多。

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引用次数: 0

The effect and safety of sleep interventions on suicidal thoughts and behavior – A systematic review and meta-analyses 睡眠干预对自杀想法和行为的影响和安全性——一项系统综述和荟萃分析

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-06-18 DOI: 10.1016/j.sleepx.2025.100145

Paula von Spreckelsen , Daan Schouten , Natasha G. Waslam , Patricia Katuin , Henriette D. Heering , Caroline Planting , Niki Antypa , Liia Kivelä , Marike Lancel , Lizanne J.S. Schweren

Background

Sleep disturbances are a risk factor for suicidal ideation, suicide attempts and suicide. While recent findings suggest that improving sleep by psychotherapeutic sleep interventions exerts a positive effect on suicidality, there are also indications that certain sleep medications are associated with an increased risk for suicidality. Given these discrepancies, the current study systematically reviewed the effect of non-pharmacological and pharmacological sleep interventions on suicidality.

Methods

A systematic literature search of various scientific databases was conducted (March 2025). Randomized controlled trials that examined the effect of sleep interventions on suicidality were searched for.

Results

The search strategy resulted in 5037 unique articles. A total of k = 44 articles (N = 14965 participants) were included in the systematic review. The results indicate that sleep interventions, particularly psychotherapeutic sleep treatments (g = −0.17, [-0.26 to −0.08]), result in a small significant reduction of suicidal ideation. No conclusive evidence was found for the effect or safety of pharmacotherapy or light therapy targeting sleep disturbance on suicidality. The findings should be interpreted in light of the limited number of studies with often small sample sizes, methodological inconsistencies in monitoring suicidality as an adverse event, restrictions on the inclusion of people with suicidality, and reliance on suicidal ideation as an outcome measure of suicidality.

Conclusion

Health care professionals are recommended to apply psychotherapeutic sleep interventions, such as cognitive behavioral therapy for insomnia, to reduce suicidal ideation in clients with disturbed sleep. When prescribing medications for disturbed sleep, we recommend professionals to closely monitor clients for potential adverse effects on suicidality.

背景睡眠障碍是自杀意念、自杀企图和自杀的危险因素。虽然最近的研究结果表明，通过心理治疗性睡眠干预来改善睡眠对自杀有积极作用，但也有迹象表明，某些睡眠药物与自杀风险增加有关。鉴于这些差异，目前的研究系统地回顾了非药物和药物睡眠干预对自杀的影响。方法系统检索各类科学数据库的文献（2025年3月）。研究人员寻找了一些随机对照试验，以检验睡眠干预对自杀的影响。结果该搜索策略得到5037篇不重复文章。系统评价共纳入k = 44篇文章（N = 14965名受试者）。结果表明，睡眠干预，特别是心理睡眠治疗（g = - 0.17,[-0.26至- 0.08]），导致自杀意念的显着减少。没有确凿的证据表明针对睡眠障碍的药物治疗或光疗对自杀的影响或安全性。对研究结果的解释应考虑到研究数量有限，通常样本量小，将自杀作为不良事件进行监测的方法不一致，对有自杀倾向的人的纳入有限制，以及依赖自杀意念作为自杀行为的结果衡量标准。结论建议卫生保健人员采用睡眠心理治疗干预措施，如失眠认知行为治疗，以减少睡眠障碍患者的自杀意念。在处方治疗睡眠障碍的药物时，我们建议专业人员密切监测患者对自杀的潜在不利影响。

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引用次数: 0

Association of digital media use with sleep habits in school children: A cross-sectional study - Author reply 数字媒体使用与在校儿童睡眠习惯的关联：一项横断面研究-作者回复

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-06-14 DOI: 10.1016/j.sleepx.2025.100143

Doreswamy Chandranaik, Prawin Kumar

引用次数: 0

Artificial light exposure at night: A hidden risk factor for type 2 diabetes 夜间接触人造光：2型糖尿病的潜在危险因素

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-06-14 DOI: 10.1016/j.sleepx.2025.100146

Izere Salomon , Shema Sam , Yahya Ur Rehman , Intwari Munyaneza Hope

This study examines the effect of nighttime light exposure on the risk of developing type 2 diabetes Mellitus (T2DM), highlighting an often-overlooked environmental factor. While lifestyle choices such as diet and physical activity have long been recognized as critical risk factors for T2DM, emerging evidence suggests that artificial light at night (LAN) may also play a significant role. LAN disrupts circadian rhythms, which regulate sleep cycles and glucose metabolism, leading to metabolic dysfunction. Using data from the UK Biobank, researchers assessed the relationship between personal light exposure patterns and T2DM risk. Findings revealed that for every 10-lux increase in LAN, the risk of developing T2DM rises by 30 %. The study underscores the importance of circadian alignment in metabolic health and suggests that mitigating nighttime light exposure, especially in urban environments, could be a practical strategy for reducing T2DM risk. Raising awareness about the health risks of light pollution and advocating for healthier lighting solutions in public spaces could play a crucial role in T2DM prevention. Further research is needed to confirm these findings and explore interventions that reduce nighttime light exposure and its impact on diabetes risk.

本研究探讨了夜间光照对2型糖尿病（T2DM）发病风险的影响，强调了一个经常被忽视的环境因素。虽然饮食和体育活动等生活方式的选择一直被认为是2型糖尿病的关键风险因素，但新出现的证据表明，夜间人造光（LAN）可能也起着重要作用。LAN破坏调节睡眠周期和葡萄糖代谢的昼夜节律，导致代谢功能障碍。研究人员利用英国生物银行的数据，评估了个人光照模式与2型糖尿病风险之间的关系。研究结果显示，LAN每增加10勒克斯，患2型糖尿病的风险就增加30%。该研究强调了昼夜节律在代谢健康中的重要性，并建议减少夜间光照，特别是在城市环境中，可能是降低2型糖尿病风险的实用策略。提高人们对光污染健康风险的认识，并在公共场所倡导更健康的照明解决方案，可以在预防2型糖尿病方面发挥至关重要的作用。需要进一步的研究来证实这些发现，并探索减少夜间光照及其对糖尿病风险影响的干预措施。

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引用次数: 0

Corrigendum/Erratum to “Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial” [Sleep Med: X 8 (2024) 100121] “镁- l -苏酸盐改善自我报告睡眠问题的成年人的睡眠质量和白天功能：一项随机对照试验”的勘误/勘误[sleep Med: x8 (2024) 100121]

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-06-03 DOI: 10.1016/j.sleepx.2025.100141

Heather A. Hausenblas , Tarah Lynch , Stephanie Hooper , Aahana Shrestha , Doug Rosendale , Jennifer Gu

引用次数: 0

The role of obstructive sleep apnea, neurofilaments and early CPAP intervention in post-stroke cognitive recovery 阻塞性睡眠呼吸暂停、神经丝和早期CPAP干预在脑卒中后认知恢复中的作用

Q1 Medicine

Sleep Medicine: X

Pub Date : 2025-05-31 DOI: 10.1016/j.sleepx.2025.100142

Petra Levicka , Miriam Slavkovska , Dominik Koren , Joaquim Ventosa , Ján Hlodak , Jana Papikova , Zuzana Gdovinova , Eva Feketeova

Stroke is a leading cause of disability worldwide, with cognitive impairment following stroke influenced by a complex interplay of modifiable and non-modifiable risk factors.

This study investigated the impact of obstructive sleep apnea (OSA) on cognitive outcomes after ischemic stroke (IS) and the predictive value of plasma neurofilament light chain (pNFL) levels. Seventy-three acute IS patients were analyzed, with 59 completing a three-month follow-up. Cognitive function (Montreal Cognitive Assessment, MoCA) was assessed. Patients underwent polygraphic screening for OSA in the acute phase, with treatment recommended when indicated, and pNFL levels measured at baseline and follow-up.

Results showed that 93.2 % of IS patients had OSA. Forty (72.7 %) of OSA patients (moderate, severe OSA) were recommended continuous positive airway pressure (CPAP). CPAP-treated patients in the acute phase demonstrated cognitive improvement at three-month follow-up (CPAP-treated: MoCA 23 vs 25 points, CPAP indicated untreated, MoCA 22 vs 22 points, p = 0.05). However, long-term adherence to CPAP was poor - only 25 % remained on therapy at three months. While pNFL levels correlated with infarct volume and significantly decreased over time, no correlation was found between OSA severity and CPAP treatment. Regression analysis identified age, prior stroke history, and anxiety as key predictors of cognitive and functional post-stroke outcome.

Early CPAP therapy could contribute to improved post-stroke cognitive performance. Decline in pNFL levels shows ongoing neuronal recovery; a direct relationship with OSA is inconclusive. Furthermore, advanced age, history of prior stroke, and anxiety symptoms emerged as significant contributors to poorer cognitive outcomes.

中风是世界范围内致残的主要原因，中风后的认知障碍受到可改变和不可改变的危险因素的复杂相互作用的影响。本研究探讨阻塞性睡眠呼吸暂停（OSA）对缺血性卒中（IS）后认知结局的影响及血浆神经丝轻链（pNFL）水平的预测价值。对73名急性IS患者进行了分析，其中59人完成了为期3个月的随访。认知功能（Montreal Cognitive Assessment, MoCA）评估。患者在急性期接受了OSA的多涂片筛查，有必要时推荐治疗，并在基线和随访时测量pNFL水平。结果显示，93.2%的IS患者存在OSA。40例（72.7%）OSA患者（中度、重度OSA）推荐持续气道正压通气（CPAP）。急性期接受CPAP治疗的患者在三个月的随访中表现出认知改善（CPAP治疗：MoCA 23分vs 25分，CPAP未治疗，MoCA 22分vs 22分，p = 0.05）。然而，CPAP的长期依从性很差，只有25%的患者在3个月时仍坚持治疗。虽然pNFL水平与梗死面积相关，且随时间显著降低，但OSA严重程度与CPAP治疗之间未发现相关性。回归分析发现，年龄、既往卒中史和焦虑是卒中后认知和功能预后的关键预测因素。早期CPAP治疗有助于改善脑卒中后的认知能力。pNFL水平下降表明神经元正在恢复；与OSA的直接关系尚无定论。此外，高龄、既往中风史和焦虑症状是导致认知结果较差的重要因素。

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引用次数: 0