Sleep Medicine: X最新文献_第6页

Sleep disorders after COVID-19 in Czech population: Post-lockdown national online survey 新冠肺炎后捷克人群的睡眠障碍：封锁后全国在线调查。

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-09-27 DOI: 10.1016/j.sleepx.2023.100087

Tereza Dvořáková , Radana Měrková , Jitka Bušková

Objective

This study aimed to determine the frequency, type, and correlates of a broad spectrum of sleep disorders in adults with COVID-19 up to 32 months after infection.

Methods

We conducted a national online survey (Jun 2021–Dec 2022), gathering information on COVID-19 diagnosis, acute disease course, and the subsequent development of sleep disorders from 1507 respondents (mean age 44.5 ± 13.1 years, 64.1% women).

Results

81.3% (1223) reported at least one sleep difficulty that either worsened or first appeared with COVID-19. Females reported a higher number of symptoms (2.03 ± 1.44 versus 1.72 ± 1.43 in men, p < 0.0001). Most common were insomnia symptoms (59.4%), followed by night sweats (38.4%), hypersomnolence (33.3%), vivid dreams or nightmares (26.4%), restless leg syndrome (RLS) (22.8%), and sleep-related breathing disorders (11.1%). All symptoms were associated with a more severe acute disease. A mild decreasing trend in the persistence of sleep symptoms with a longer latency since infection was observed, with 66.7% reporting at least half of their symptoms present at 3–5 months after acute infection, compared to 64.9% at 6–8 months, and 62.4% at 9–11 months (p = 0.0427). However, among those after 12 or more months, over half of the symptoms persisted in 69.5%. The frequency of vivid dreams and nightmares increased in association with COVID-19 in 32.9% (p < 0.001). 9.4% (141) reported new-onset or increased parasomnic manifestations after the infection.

Conclusions

Our research shows that sleep disturbances are a common and persistent manifestation of COVID-19 that affects a large proportion of the population and deserves careful monitoring.

目的：本研究旨在确定新冠肺炎成人感染后32个月内广泛睡眠障碍的频率、类型和相关性。方法：我们进行了一项全国在线调查（2020年6月至2022年12月），收集了1507名受访者（平均年龄44.5±13.1岁，女性64.1%）的新冠肺炎诊断、急性病程和随后的睡眠障碍发展信息。女性报告的症状数量更高（2.03±1.44，而男性为1.72±1.43，p结论：我们的研究表明，睡眠障碍是新冠肺炎的常见和持续表现，影响了很大一部分人群，值得仔细监测。

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引用次数: 0

Alterations of sleep initiation in NREM parasomnia after sleep deprivation – A multimodal pilot study 睡眠剥夺后非快速眼动睡眠异常的睡眠开始改变-一项多模式先导研究

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-09-14 DOI: 10.1016/j.sleepx.2023.100086

E. Miletínová , M. Piorecký , V. Koudelka , S. Jiříček , D. Tomeček , M. Brunovský , J. Horáček , J. Bušková

Objectives

NREM parasomnias also known as disorders of arousal (DOA) are characterised by abnormal motor and autonomic activation during arousals primarily from slow wave sleep. Dissociative state between sleep and wake is likely responsible for clinical symptoms of DOA. We therefore investigated potential dissociation outside of parasomnic events by using simultaneous 256-channel EEG (hdEEG) and functional magnetic resonance imaging (fMRI).

Methods

Eight DOA patients (3 women, mean age = 27.8; SD = 4.2) and 8 gender and age matched healthy volunteers (3 women, mean age = 26,5; SD = 4.0) were included into the study. They underwent 30–32 h of sleep deprivation followed by hdEEG and fMRI recording. We determined 2 conditions: falling asleep (FA) and arousal (A), that occurred outside of deep sleep and/or parasomnic event. We used multimodal approach using data obtained from EEG, fMRI and EEG-fMRI integration approach.

Results

DOA patients showed increase in delta and beta activity over postcentral gyrus and cuneus during awakening period. This group expressed increased connectivity between motor cortex and cingulate during arousals unrelated to parasomnic events in the beta frequency band. They also showed lower connectivity between different portions of cingulum. In contrast, the greater connectivity was found between thalamus and some cortical areas, such as occipital cortex.

Conclusion

Our findings suggest a complex alteration in falling asleep and arousal mechanisms at both subcortical and cortical levels in response to sleep deprivation. As this alteration is present also outside of slow wave sleep and/or parasomnic episodes we believe this could be a trait factor of DOA.

非快速眼动睡眠异象也被称为觉醒障碍(DOA)，其特征是在慢波睡眠唤醒期间异常的运动和自主神经激活。睡眠和清醒之间的分离状态可能是DOA临床症状的原因。因此，我们通过同时使用256通道脑电图(hdEEG)和功能磁共振成像(fMRI)来研究异速事件之外的潜在解离。方法8例DOA患者(女性3例，平均年龄27.8岁;SD = 4.2)和8名性别和年龄匹配的健康志愿者(3名女性，平均年龄= 26,5;SD = 4.0)被纳入研究。他们接受了30-32小时的睡眠剥夺，随后进行了脑电图和功能磁共振成像记录。我们确定了两种情况:入睡(FA)和觉醒(A)，发生在深度睡眠和/或异睡眠事件之外。我们采用多模态方法，使用EEG、fMRI和EEG-fMRI整合方法获得的数据。结果doa患者在觉醒期中枢后回和楔脑区δ和β活性增加。这一组表现出在与β频段异常事件无关的觉醒期间，运动皮层和扣带之间的连通性增加。他们还表现出不同部分之间的连通性较低。相比之下，丘脑和一些皮层区域(如枕叶皮层)之间的连通性更强。结论我们的研究结果表明，睡眠剥夺在皮层下和皮层水平上对入睡和觉醒机制有复杂的改变。由于这种变化在慢波睡眠和/或异睡眠发作之外也存在，我们认为这可能是DOA的一个特征因素。

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引用次数: 0

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers BOAH和No-apnea评分对轮班司机阻塞性睡眠呼吸暂停筛查的预测价值

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-09-09 DOI: 10.1016/j.sleepx.2023.100084

Luiz Antônio Alves de Menezes-Júnior , Virgínia Capistrano Fajardo , Raimundo Marques do Nascimento Neto , Silvia Nascimento de Freitas , Fernando Luiz Pereira de Oliveira , Fausto Aloísio Pedrosa Pimenta , George Luiz Lins Machado-Coelho , Adriana Lúcia Meireles

Objective

To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers.

Methods

Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated.

Results

Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706).

Conclusion

In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

目的评价BOAH(身体质量指数、观察到的呼吸暂停、年龄和高血压)和No-apnea评分对轮班工人阻塞性睡眠呼吸暂停(OSA)风险的诊断价值。方法对男性轮岗工人和重型越野机械驾驶员进行横断面研究。BOAH评分是基于身体质量指数、睡眠时的呼吸暂停、年龄和高血压。无呼吸暂停评分基于颈围和年龄。根据呼吸暂停低通气指数(AHI)，将OSA的严重程度分为轻度OSA (AHI≥5/h)、中度至重度OSA (AHI≥15/h)和重度OSA (AHI≥30/h)。计算敏感性、特异性、阳性预测值、阴性预测值和曲线下面积(AUC)。结果119名受访工人中，84.0%的人AHI≥5,46.2%的人AHI≥15,14.3%的人AHI≥30。AHI≥5,BOAH评分2分，AUC为0.679，敏感性为41.0%，特异性为94.7%。无呼吸暂停评分，3分AHI≥5,AUC为0.692，敏感性为70.0%，特异性为68.4%。此外，使用至少一项阳性评分，与AHI≥5的单一测试相比，AUC更高(AUC = 0.727)。当两项评分均为阳性时，AHI≥30时AUC较高(AUC = 0.706)。结论在轮班工人和重型越野机械驾驶员中，BOAH和No-apnea评分可作为识别睡眠呼吸暂停风险个体的有效工具。此外，匹配评分可以提高对OSA的预测。

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引用次数: 0

Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study 吸烟对睡眠结构和呼吸参数包括呼吸暂停的影响:Tab-OSA研究的结果

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-09-07 DOI: 10.1016/j.sleepx.2023.100085

Sibylle Mauries , Léa Bertrand , Justine Frija-Masson , Hélène Benzaquen , Sophie Kalamarides , Karine Sauvage , Michel Lejoyeux , Marie-Pia d’Ortho , Pierre A. Geoffroy

Background

The interaction between smoking and sleep seems appears to be bidirectional, but few studies evaluated the impact of smoking and its cessation on objective sleep parameters. In this context, this new study aimed to assess the impact of smoking and its cessation on sleep architecture and on ventilatory sleep parameters, particularly the presence of sleep apnea syndrome (apnea-hypopnea index (AHI)≥15). Methods: Patients hospitalized for polysomnographic sleep exploration were compared according to their smoking status: active smokers (AS), former smokers (FS), non-smokers (NoNi). Psychiatric and non-psychiatric co-morbidities and treatment or substance use were taken into account in the analyses.

Results

A total of 170 participants were included (N = 37 FS, 39 AS, 86 NoNi). A significant decrease in the mean nocturnal O₂ saturation was observed for FS and AS compared to NoNi. No differences were found regarding AHI. Regarding sleep architecture, we observed a significant decrease in the slow wave sleep duration for AS compared to NoNi, and interestingly not between FS and NoNi.

Conclusion

This study suggests that current smokers suffer from alterations in both sleep architecture and ventilatory parameters, the later appears to persist even after smoking cessation.

吸烟与睡眠之间的相互作用似乎是双向的，但很少有研究评估吸烟和戒烟对客观睡眠参数的影响。在此背景下，这项新研究旨在评估吸烟和戒烟对睡眠结构和通气睡眠参数的影响，特别是睡眠呼吸暂停综合征(呼吸暂停-低通气指数(AHI)≥15)的存在。方法:采用多导睡眠探查法对住院患者的吸烟状况进行比较:主动吸烟者(AS)、前吸烟者(FS)、非吸烟者(NoNi)。分析中考虑了精神病学和非精神病学合并症以及治疗或药物使用。结果共纳入170名受试者(N = FS 37, AS 39, NoNi 86)。与NoNi相比，FS组和AS组的平均夜间氧饱和度显著降低。在AHI方面没有发现差异。关于睡眠结构，我们观察到与NoNi相比，AS组的慢波睡眠持续时间显著减少，有趣的是，FS组和NoNi组的慢波睡眠持续时间没有减少。本研究表明，当前吸烟者的睡眠结构和通气参数都发生了改变，后者似乎在戒烟后仍持续存在。

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引用次数: 0

BASET scoring: A novel simple biometric score for screening and grading obstructive sleep apnea BASET评分:一种用于筛选和分级阻塞性睡眠呼吸暂停的新型简单生物特征评分

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-08-14 DOI: 10.1016/j.sleepx.2023.100083

Abdelbaset M. Saleh , Magda A. Ahmed , Eman A. El Said , Nabil J. Awadalla , Amira A.M.M. Attia

Background

Polysomnography (PSG) is the gold-standard diagnostic tool for Obstructive Sleep Apnea (OSA). However, the availability of PSG is limited, and OSA is widely underdiagnosed; more than 80% of most developed nations undiagnosed. There is no diagnostic validated simple tool with clear cutoff point for predicting and roll out patient with OSA in primary care clinics significantly alters clinical outcomes.

Objectives

Our study aimed to assess the validity of BASET scoring as a new potential tool for screening and grading the severity of OSA patients.

Methods

After institution review board approval and formal patient consent, 144 subjects for suspected OSA and their relatives were enrolled. All subjects were subjected to a full night PSG study after history taking, sleep questionnaires, and physical examination, including BASET score components: B= Body Mass Index (BMI), A= Abdominal circumference (AC), S = Snoring, E= Epworth Sleepiness Scale, and T= Tongue teeth imprint. ROC analysis that used to assess the optimal cutoff point of the BASET score and to compare its accuracy for predicting OSA with Berlin and STOP-Bang scores.

Results

This study included 63 OSAS patients, 33 (52.38%) males and 30 (47.62%) females, and 81 controls; 22 (27.16%) males and 50 (72.84%) females. The Cronbach's alpha for the 5 BASET score components was 0.846, indicating the internal consistency reliability of the scale. Moreover, BASET score has a moderately strong positive significant correlation (r = 0.778, p<0.001) with AHI. By ROC analysis, the accuracy of the three measures was generally high, with BASET score predicting OSA most accurately (AUC=0.984, 95%CI: 0.956–0.999), followed by STOP-Bang (AUC=0.939, 95%CI: (0.887–0.972) and Berlin (AUC=0.901, 95%CI: 0.841–0.945). The AUC of BASET score was significantly higher compared to the Berlin score (difference= 0.0825, 95%CI: 0.039–0.125) and STOP-Bang score (difference= 0.0447, 95%CI: 0.011–0.078). On the other hand, there was no difference between the AUC of Berlin and STOP-Bang scores (difference=0.0378, 95%CI: 0.006 - 0.081 4). BASET score was significantly (p<0.001) associated with OSA grades,

Conclusion

BASET score is a convenient, reliable, and valid tool for diagnosing OSA. BASET score is more accurate for predicting OSA than Berlin and STOP-Bang scores, while there is no difference between Berlin and STOP-Bang scores. BASET score indicates OSA grades.

Registration of clinical trials by number

NCT05511974.

Name of the registry

ClinicalTrials.gov URL: https://clinicaltrials.gov/

背景多导睡眠图（PSG）是阻塞性睡眠呼吸暂停（OSA）的金标准诊断工具。然而，PSG的可用性有限，OSA的诊断普遍不足；大多数发达国家80%以上未确诊。在初级保健诊所中，没有一种诊断验证的简单工具可以预测和推广OSA患者，从而显著改变临床结果。目的我们的研究旨在评估BASET评分作为筛查和分级OSA患者严重程度的一种新的潜在工具的有效性。方法在机构审查委员会批准和患者正式同意后，纳入144名疑似OSA受试者及其亲属。所有受试者在进行病史记录、睡眠问卷调查和体检后，均接受了一项通宵PSG研究，包括BASET评分组成部分：B=体重指数（BMI）、a=腹围（AC）、S=打鼾、E=埃沃斯睡眠量表和T=舌牙印记。ROC分析，用于评估BASET评分的最佳截止点，并将其预测OSA的准确性与Berlin和STOP-Bang评分进行比较。结果本研究包括63例OSAS患者，其中男性33例（52.38%），女性30例（47.62%），对照组81例；男性22例（27.16%），女性50例（72.84%）。5个BASET分数组成部分的Cronbachα为0.846，表明量表的内部一致性可靠性。此外，BASET评分与AHI具有中等强度的正显著相关性（r＝0.778，p＜0.001）。通过ROC分析，这三项指标的准确性普遍较高，BASET评分预测OSA最准确（AUC=0.984，95%CI:0.956-0.999），其次是STOP-Bang（AUC=0.939，95%CI:（0.887–0.972）和Berlin（AUC=0.0901，95%CI:0.841–0.945）。BASET评分的AUC显著高于Berlin评分（差异=0.0825，95%CI:0.039–0.125）和STOP-Ban评分（差异0.0447，95%CI:0.011–0.078）。另一方面，Berlin的AUC和STOP-Bang评分之间没有差异（差异=0.0378、95%CI:0.06-0.081 4）。BASET评分与OSA分级显著相关（p＜0.001）。结论BASET评分是诊断OSA的一种方便、可靠、有效的工具。BASET分数在预测OSA方面比Berlin和STOP-Bang分数更准确，而Berlin和STOP-Bang分数之间没有差异。BASET分数表示OSA等级。临床试验注册编号NCT05511974。注册名称ClinicalTrials.gov网址：https://clinicaltrials.gov/

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引用次数: 0

Beyond sleep duration: Sleep timing is associated with BMI among Brazilian adults 睡眠时间之外:巴西成年人的睡眠时间与身体质量指数有关

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-07-26 DOI: 10.1016/j.sleepx.2023.100082

Giovana Longo-Silva , Anny Kariny Pereira Pedrosa , Priscilla Marcia Bezerra de Oliveira , Jéssica Ribeiro da Silva , Risia Cristina Egito de Menezes , Patricia de Menezes Marinho , Renan Serenini Bernardes

Objectives

To examine the association of sleep duration and timing with BMI among adults. Also, to identify obesogenic and unhealthy behaviors (e.g.diet/sleep quality, physical activity, screen time, smoking) associated with short sleep duration and late bedtime.

Participants

Participants (n=755) were part of exploratory, population-based research, with data collection in a virtual environment.

Methods

For purposes of characterizing the population we considered short sleepers<7h/night, and the population bedtime median was used to stratify participants into early and late sleepers (before and after 23:08). Student's t-test and chi-square test were performed to assess differences in characteristics between groups. Linear regression analyses were conducted to determine the association of sleep duration, bedtime, and wake-up time with BMI. Quantile regression was estimated for the 25th, 50th, and 75th quantiles to identify the distributional correlations between BMI and sleep variables. Restricted cubic splines were also used to study the shape of the association between sleep-BMI. Analyses were adjusted for potential confounding variables.

Results

BMI decreased by 0.40Kg/m2 for each additional hour of sleep duration [95%CI=-0.68,-0.12,p=0.005] and increased by 0.37 kg/m² for each additional hour of bedtime [95%CI=0.12,0.61,p=0.003]. The association between bedtime and BMI remained even after adjustment for sleep duration. These effects were higher and stronger with higher BMI values (p75^th). Wake-up time did not show statistically significant associations.

Conclusions

Because we found that beyond sleep duration, bedtime was significantly associated with BMI, our data reflect the pertinence of assessing sleep timing patterns in disentangling sleep-obesity association. Insights into the characteristics, obesogenic and unhealthy behaviors related to short and late sleep may support specific strategies to prevent and treat excess body adiposity and other negative health outcomes.

目的研究成年人睡眠时间和时间与BMI的关系。此外，识别与睡眠时间短和就寝时间晚有关的肥胖和不健康行为（如饮食/睡眠质量、体育活动、屏幕时间、吸烟）。参与者参与者（n=755）是探索性的、基于人群的研究的一部分，在虚拟环境中收集数据。方法为了表征人群的特征，我们认为短睡眠者<；7小时/晚，使用人群就寝时间中位数将参与者分为早睡者和晚睡者（23:08之前和之后）。采用学生t检验和卡方检验来评估各组之间特征的差异。进行线性回归分析，以确定睡眠时间、就寝时间和起床时间与BMI的关系。对第25、第50和第75分位数进行了分位数回归估计，以确定BMI和睡眠变量之间的分布相关性。限制性三次样条曲线也被用于研究睡眠BMI之间的关联形状。针对潜在的混杂变量对分析进行了调整。结果BMI每增加一小时下降0.40Kg/m2[95%CI=-0.68，-0.12，p=0.005]，每增加一个小时增加0.37kg/m2[95%CI=0.12，0.61，p=0.003]。BMI值越高，这些影响越大（p75th）。起床时间没有显示出统计学上显著的相关性。结论由于我们发现，在睡眠时间之外，就寝时间与BMI显著相关，我们的数据反映了评估睡眠时间模式在解开睡眠-肥胖关系中的相关性。深入了解与睡眠时间短和晚有关的特征、肥胖和不健康行为，可能会支持预防和治疗过度肥胖和其他负面健康结果的特定策略。

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引用次数: 1

The relationship between typical dreams and mental health of residents in village-in-city 城中村居民典型梦境与心理健康的关系

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-07-14 DOI: 10.1016/j.sleepx.2023.100081

Yuhang Li , Wenwen Zhang , Le Han , Mei Li , Huihui Jing , Hongbin Lu , Ning Liu , Xueyang Han , Mingzhu Su , Tao Yang , Fang Yin , Bin Xie , Xue Zou

Aim

This study aimed to explore the relationship between typical dreams and the mental health of residents in village-in-city.

Methods

This study used the Chinese version of the Typical Dreams Questionnaire and Symptom Checklist 90 (SCL-90) to investigate the mental health status and typical dream themes of 1,190 residents recruited through random sampling from a village-in-city in Xi'an. Correlation analysis, t-test, and binary regression analysis were performed on the data using SPSS 24.0.

Results

The five most frequent dream themes among residents in the village-in-city were "falling"; "school, teacher, study"; "being chased but not physically injured"; "enjoying delicious food"; and "repeatedly trying to do something," in the given order. The most frequent dream theme with negative SCL-90 factors was "falling" and with positive SCL-90 factors was "school, teacher, study." Typical dreams on different themes were significantly correlated with SCL-90 factors. The theme of "enjoying delicious food" was not significantly associated with most factors in SCL-90.

方法采用中国版典型梦问卷和症状自评量表90（SCL-90），对西安市某农村随机抽取1190名居民的心理健康状况和典型梦主题进行调查。采用SPSS 24.0对数据进行相关分析、t检验和二元回归分析。结果城中村居民最常见的五个梦境主题为“跌倒”；“学校、教师、学习”；“被追赶但未受身体伤害”；“享受美食”；以及按照给定的顺序“反复尝试做某事”。症状自评量表（SCL-90）因子为负的做梦主题最常见的是“跌倒”，症状自评质表（SCL-90-）因子为正的做梦主题是“学校、老师、学习”。不同主题的典型梦与SCL-90因子显著相关。在症状自评量表（SCL-90）中，“享受美食”主题与大多数因素无显著相关性。

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引用次数: 0

Relationship between sleep problems and headaches among adolescents: Pelotas 2004 Birth cohort 青少年睡眠问题与头痛的关系:Pelotas 2004年出生队列

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-07-08 DOI: 10.1016/j.sleepx.2023.100079

Isabel Oliveira Bierhals , Gabriel Santana Pereira de Oliveira , Iná S. Santos , Camila S. Halal , Luciana Tovo-Rodrigues , Alicia Matijasevich , Fernando C. Barros

Objective

To investigate the cross-sectional association between sleep problems (the exposure) and headaches (the outcome) among 15-year-olds from the Pelotas 2004 Birth Cohort, a population-based study in the south of Brazil.

Method

The occurrence of headaches was obtained through the question: “Do you usually suffer headaches?” and the ICHD-3 criteria were used to classify as: tension-type headache, headache with characteristics of migraine with or without aura, or other. Regarding sleep, the weekly frequency in the last month of insomnia and bad dreams/nightmares, and self-reported sleep quality were investigated. Unadjusted and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression with robust variance.

Results

A total of 1916 adolescents were analyzed. The prevalence of headaches was 51.6% (69.0% in females and 34.8% in males): 31.8% (39.7% vs. 24.1%) reported tension-type headache; 14.7% (21.9% vs. 7.8%), headaches with characteristics of migraines without aura; 3.6%, headaches with characteristics of migraines with aura; and 1.5% (5.1% vs. 2.3%), other types. Adolescents with insomnia ≥3 times/week presented higher probability of headaches (PR = 1.54; 95%CI 1.23–1.93), compared with those with no problems falling asleep or maintaining sleep. Among those who classified their sleep as poor/very poor, the probability of headaches was 33% higher (PR = 1.33; 95%CI 1.13–1.57) than among those who classified their sleep as very good.

Conclusions

Headaches were highly prevalent among the adolescents and were related to sleep problems even after allowing for several confounders.

目的调查巴西南部Pelotas 2004年出生队列中15岁青少年的睡眠问题（暴露）和头痛（结果）之间的横断面相关性，这是一项基于人群的研究。方法头痛的发生是通过以下问题获得的：“你经常头痛吗？”并且ICHD-3标准被用于分类：紧张型头痛、具有偏头痛特征的头痛（有或没有先兆）或其他。关于睡眠，调查了上个月失眠和噩梦/噩梦的每周频率，以及自我报告的睡眠质量。使用具有稳健方差的泊松回归计算具有95%置信区间的未调整和调整的患病率（PR）。结果对1916名青少年进行分析。头痛的患病率为51.6%（女性69.0%，男性34.8%）：31.8%（39.7%对24.1%）报告了紧张型头痛；14.7%（21.9%对7.8%），头痛具有无先兆偏头痛的特征；3.6%，头痛具有先兆偏头痛的特征；以及其他类型的1.5%（5.1%对2.3%）。与入睡或保持睡眠没有问题的青少年相比，失眠≥3次/周的青少年出现头痛的概率更高（PR=1.54；95%CI 1.23-1.93）。在那些将睡眠分为差/非常差的人中，头痛的概率比那些将睡眠划分为非常好的人高33%（PR=1.33；95%CI 1.13-1.57）。结论头痛在青少年中非常普遍，即使考虑到一些混杂因素，也与睡眠问题有关。

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引用次数: 0

Sleep disruption, use of sleep-promoting medication and circadian desynchronization in spaceflight crewmembers: Evidence in low-Earth orbit and concerns for future deep-space exploration missions 太空飞行机组人员的睡眠中断、促进睡眠药物的使用和昼夜节律不同步:近地轨道证据和对未来深空探索任务的关注

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-07-07 DOI: 10.1016/j.sleepx.2023.100080

Manuel Albornoz-Miranda , Diego Parrao , Maximiliano Taverne

Introduction

The spaceflight environment presents unique demands on human physiology; among those demands, is sleep. Sleep loss and circadian desynchronization is a major concern for future deep-space exploration plans, including long-term crewed missions to the Moon and Mars.

Aims

Analyze evidence of sleep disruption in crewmembers during low-Earth orbit missions, identify the use of sleep-promoting medication among crewmembers and deepen the comprehension of challenges to sleep physiology for future missions to the Moon and Mars.

Results

Evidence consistently indicates a loss of sleep and circadian rhythm disruption during low-Earth orbit missions. Sleep duration is shortened especially the night before a critical operation and during circadian-misaligned sleep episodes. The prevalence of sleep-promoting medication ranges between 71% and 78%; medication is more frequently taken on circadian-misaligned sleep episodes. Regarding the Moon, Apollo astronauts had variable sleep duration. For some, sleep was restful while others had poor-quality sleep. Many reported fatigue and errors due to the lack of rest. A loss of the 24-h light/dark might be expected due to the Moon's complex illumination characteristics. Regarding Mars, one main challenge will consist in synchronizing the circadian clock to a Martian day (24.65 h).

航天环境对人体生理提出了独特的要求；睡眠就是这些需求之一。睡眠不足和昼夜节律不同步是未来深空探索计划的主要问题，包括长期载人登月和火星任务，确定机组人员使用促进睡眠药物的情况，并加深对未来月球和火星任务睡眠生理学挑战的理解。结果证据一致表明，在近地轨道任务中，睡眠不足和昼夜节律紊乱。睡眠时间缩短，尤其是在关键手术的前一天晚上和昼夜节律失调的睡眠期。促进睡眠药物的流行率在71%到78%之间；药物更频繁地用于昼夜节律失调的睡眠发作。关于月球，阿波罗宇航员的睡眠时间各不相同。对一些人来说，睡眠很好，而另一些人的睡眠质量很差。许多人报告说，由于缺乏休息，他们出现了疲劳和失误。由于月球复杂的照明特性，预计24小时的光照/黑暗会减少。关于火星，一个主要挑战是将昼夜节律时钟与火星日（24.65小时）同步。

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引用次数: 0

Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea. Narval CC™ 设备治疗阻塞性睡眠呼吸暂停的效果。

Q1 Medicine

Sleep Medicine: X

Pub Date : 2023-06-12 eCollection Date: 2023-12-15 DOI: 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.

下颌前突矫正器（MAD）被用于治疗睡眠呼吸暂停，但效果各不相同。我们的目的是研究 MAD 是否应该成为阻塞性睡眠呼吸暂停患者治疗过程中不可或缺的治疗方式。我们设计了一项可行性研究，纳入了 32 名符合纳入标准的患者。只有 3 名患者没有完成第二次睡眠检查。干预措施是单独设计的 MAD，治疗前后都进行了睡眠检查。结果目标是呼吸暂停-低通气指数低于 10 且降低 50%。患者的基线 AHI 为 19.0，经 MAD 治疗后，AHI 平均降低至 13.3，因此，当应用结果目标时，MAD 的有效率为 31%。AHI 的平均降低率为 24.8%，29 名患者中有 9 人在接受 MAD 治疗后 AHI 实际有所升高。当使用 MAD 设备降低 AHI 时，AHI 降低率为 49.1%，当呼吸暂停-低通气以仰卧位为主时，治疗效果更佳。下颌前突矫正器是治疗阻塞性睡眠呼吸暂停患者的一种重要方法，患者满意度高，依从性好。我们的下颌前突矫正器的治疗反应范围很广，这凸显了在开始使用下颌前突矫正器治疗后进行睡眠研究检查的重要性，同时也说明了阻塞性睡眠呼吸暂停患者个性化治疗的复杂性和必要性。

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引用次数: 0