Sleep Medicine Reviews最新文献

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Motor cortex excitability in restless legs syndrome: A systematic review and insights into pathophysiology via transcranial magnetic stimulation 不宁腿综合征的运动皮质兴奋性：通过经颅磁刺激的系统回顾和病理生理学的见解

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-20 DOI: 10.1016/j.smrv.2024.102027

Giuseppe Lanza , Maria Paola Mogavero , Raffaele Ferri , Tapas Pani

Restless Legs Syndrome (RLS) is a neurological disorder characterized by a complex and only partially understood pathophysiology. Numerous studies have investigated motor cortex excitability in RLS using transcranial magnetic stimulation (TMS), but a comprehensive systematic review assessing their methodological quality and synthesizing their findings is lacking. A systematic search of PubMed focused on various TMS parameters, including resting and active motor thresholds, motor evoked potential characteristics, contralateral and ipsilateral silent periods, and multiple measures of intracortical inhibition and facilitation. The quality of each study was evaluated using custom checklists and the modified Newcastle-Ottawa Quality Assessment Scale. Out of the studies screened, 21 (comprising 319 RLS patients and 278 healthy controls) met the inclusion criteria. Despite considerable variability in TMS methodologies—such as differences in the muscles tested, interstimulus intervals, testing timing, and the potential confounding effects of medications—a consistent finding was a reduction in short-interval intracortical inhibition, a key indicator of central inhibitory GABAergic activity. Additionally, altered post-exercise facilitation and delayed facilitation suggest abnormal motor plasticity in RLS patients. These findings suggest that despite the methodological heterogeneity, TMS abnormalities may play a crucial role in the pathophysiology of RLS. In this context, RLS symptoms are likely to originate at different levels within a complex neural network, ultimately leading to altered, possibly transient and circadian, excitability in a multifaceted neurophysiological system. While further rigorous research and reproducible evidence are needed, these insights may contribute to the identification of new diagnostic markers and the development of innovative therapeutic strategies for RLS.

不宁腿综合征（RLS）是一种神经系统疾病，其特征是复杂且仅部分了解的病理生理学。许多研究利用经颅磁刺激（TMS）研究了RLS的运动皮层兴奋性，但缺乏对其方法质量和综合研究结果的全面系统评价。PubMed系统检索了TMS的各种参数，包括静息和活动运动阈值，运动诱发电位特征，对侧和同侧沉默期，以及多种皮质内抑制和促进措施。每项研究的质量都使用自定义清单和修改后的纽卡斯尔-渥太华质量评估量表进行评估。在筛选的研究中，21项（包括319名RLS患者和278名健康对照）符合纳入标准。尽管经颅磁刺激方法存在相当大的差异——比如测试肌肉、刺激间隔、测试时间和药物潜在的混淆效应的差异——但一致的发现是短间隔皮质内抑制减少，这是中枢抑制性gaba能活性的关键指标。此外，运动后促进和延迟促进的改变表明RLS患者的运动可塑性异常。这些发现表明，尽管方法上存在异质性，但颅磁刺激异常可能在RLS的病理生理中起着至关重要的作用。在这种情况下，RLS症状可能起源于复杂神经网络中的不同层次，最终导致多层神经生理系统中的兴奋性改变，可能是短暂的和昼夜节律的。虽然需要进一步严格的研究和可重复的证据，但这些见解可能有助于确定新的诊断标记和开发创新的治疗策略。

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引用次数: 0

The effect of alcohol on subsequent sleep in healthy adults: A systematic review and meta-analysis 酒精对健康成人后续睡眠的影响：一项系统回顾和荟萃分析

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-19 DOI: 10.1016/j.smrv.2024.102030

Carissa Gardiner , Jonathon Weakley , Louise M. Burke , Gregory D. Roach , Charli Sargent , Nirav Maniar , Minh Huynh , Dean J. Miller , Andrew Townshend , Shona L. Halson

Alcohol is commonly consumed prior to bedtime with the belief that it facilitates sleep. This systematic review and meta-analysis investigated the impact of alcohol on the characteristics of night-time sleep, with the intent to identify the influence of the dose and timing of alcohol intake. A systematic search of the literature identified 27 studies for inclusion in the analysis. Changes in sleep architecture were observed, including a delay in the onset of rapid eye movement (REM) sleep and a reduction in the duration of REM sleep. A dose-response relationship was identified such that disruptions to REM sleep occurred following consumption of a low dose of alcohol (≤0.50 g∙kg⁻¹ or approximately two standard drinks) and progressively worsened with increasing doses of alcohol. Reductions in sleep onset latency and latency to deep sleep (i.e., non-rapid eye movement stage three (N3)) were only observed following the consumption of a high dose of alcohol (≥0.85∙g kg⁻¹ or approximately five standard drinks). The effect of alcohol on the remaining characteristics of sleep could not be determined, with large uncertainty observed in the effect on total sleep time, sleep efficiency, and wake after sleep onset. The results of the present study suggest that a low dose of alcohol will negatively impact (i.e., reduce) REM sleep. It appears that high doses of alcohol may shorten sleep onset latency, however this likely exacerbates subsequent REM sleep disruption. Future work on personal and environmental factors that affect alcohol metabolism, and any differential effects of alcohol due to sex is encouraged.

喝酒通常是在睡觉前喝，因为人们相信喝酒有助于睡眠。本系统综述和荟萃分析调查了酒精对夜间睡眠特征的影响，目的是确定饮酒剂量和饮酒时间的影响。对文献的系统检索确定了27项研究纳入分析。观察到睡眠结构的变化，包括快速眼动（REM）睡眠的开始延迟和快速眼动睡眠的持续时间缩短。确定了一种剂量-反应关系，即在饮用低剂量酒精（≤0.50 g∙kg-1或大约两种标准饮料）后会出现快速眼动睡眠中断，并随着酒精剂量的增加而逐渐恶化。睡眠开始潜伏期和深度睡眠潜伏期（即非快速眼动第三阶段（N3））的减少仅在饮用高剂量酒精（≥0.85∙g kg-1或约5标准饮料）后观察到。酒精对睡眠其他特征的影响尚不能确定，对总睡眠时间、睡眠效率和睡眠后觉醒的影响存在很大的不确定性。目前的研究结果表明，低剂量的酒精会对快速眼动睡眠产生负面影响（即减少）。高剂量的酒精可能会缩短睡眠潜伏期，但这可能会加剧随后的快速眼动睡眠中断。鼓励对影响酒精代谢的个人和环境因素的进一步研究，以及性别对酒精的任何不同影响。

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引用次数: 0

Circadian immunometabolism: A future insight for targeted therapy in cancer 昼夜节律免疫代谢：洞察癌症靶向治疗的未来

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-19 DOI: 10.1016/j.smrv.2024.102031

Manendra Singh Tomar , Mohit , Ashok Kumar , Ashutosh Shrivastava

Circadian rhythms send messages to regulate the sleep-wake cycle in living beings, which, regulate various biological activities. It is well known that altered sleep-wake cycles affect host metabolism and significantly deregulate the host immunity. The dysregulation of circadian-related genes is critical for various malignancies. One of the hallmarks of cancer is altered metabolism, the effects of which spill into surrounding microenvironments. Here, we review the emerging literature linking the circadian immunometabolic axis to cancer. Small metabolites are the products of various metabolic pathways, that are usually perturbed in cancer. Genes that regulate circadian rhythms also regulate host metabolism and control metabolite content in the tumor microenvironment. Immune cell infiltration into the tumor site is critical to perform anticancer functions, and altered metabolite content affects their trafficking to the tumor site. A compromised immune response in the tumor microenvironment aids cancer cell proliferation and immune evasion, resulting in metastases. The role of circadian rhythms in these processes is largely overlooked and demands renewed attention in the search for targets against cancer growth and spread. The precision medicine approach requires targeting the circadian immune metabolism in cancer.

昼夜节律发出信息，调节生物的睡眠-觉醒周期，从而调节各种生物活动。众所周知，睡眠-觉醒周期的改变会影响宿主的新陈代谢，并显著降低宿主的免疫力。昼夜节律相关基因的失调对各种恶性肿瘤至关重要。癌症的特征之一是新陈代谢改变，其影响波及周围的微环境。在此，我们回顾了将昼夜节律免疫代谢轴与癌症联系起来的新兴文献。小代谢物是各种代谢途径的产物，通常在癌症中受到干扰。调节昼夜节律的基因也会调节宿主的新陈代谢，并控制肿瘤微环境中的代谢物含量。免疫细胞渗入肿瘤部位对发挥抗癌功能至关重要，而代谢物含量的改变会影响免疫细胞向肿瘤部位的迁移。肿瘤微环境中受损的免疫反应有助于癌细胞增殖和免疫逃避，从而导致转移。昼夜节律在这些过程中的作用在很大程度上被忽视了，需要在寻找抗癌生长和扩散的靶点时重新加以关注。精准医疗方法需要针对癌症的昼夜节律免疫代谢。

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引用次数: 0

Proposing a definition for sleep disorders: An epistemological review 提出睡眠障碍的定义：认识论回顾。

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-18 DOI: 10.1016/j.smrv.2024.102028

Christophe Gauld , Jerome C. Wakefield , Jean-Arthur Micoulaud-Franchi

To establish an overarching definition of what constitutes a sleep disorder, it is essential to know which health conditions should be included in the classifications of sleep disorders and to better distinguish the normal from the pathological in sleep medicine. This would bring together several professional organizations in their understanding of this hitherto heterogeneous concept. However, no consensus regarding a general definition of a sleep disorder currently exists. We explore two of the main frameworks used in medical epistemology that could be used to define sleep disorders rigorously: harmful dysfunction analysis (HDA) and symptom network theory. For each framework, we detail the conceptual background, the method for applying it to the establishment of a general definition of a sleep disorder, the application to main sleep disorders of the ICSD-3-TR (with an emphasis on insomnia disorder) and a discussion of the main aspects of these two general definitions in the context of sleep medicine. The complementarity between the two definitions could then be considered as an “epistemic hub” which could serve to clarify the debate about what sleep disorders are, so that our understanding of them and their clinical management improve.

要对什么是睡眠障碍做出总体定义，就必须知道哪些健康状况应被纳入睡眠障碍的分类中，并更好地区分睡眠医学中的正常与病理。这将汇集多个专业组织对这一迄今尚未统一的概念的理解。然而，目前还没有就睡眠障碍的一般定义达成共识。我们探讨了医学认识论中可用于严格定义睡眠障碍的两个主要框架：有害功能障碍分析（HDA）和症状网络理论。对于每种框架，我们都会详细介绍其概念背景、将其应用于建立睡眠障碍一般定义的方法、将 ICSD-3-TR 应用于主要睡眠障碍的情况（重点是失眠障碍），并讨论这两种一般定义在睡眠医学中的主要方面。这两个定义之间的互补性可被视为一个 "认识论枢纽"，有助于澄清关于睡眠障碍的争论，从而提高我们对睡眠障碍的认识和临床治疗水平。

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引用次数: 0

Effectiveness of digital cognitive behavioral therapy for insomnia on professional activity: A systematic review and meta-analysis of randomized controlled trials 数字认知行为疗法治疗失眠对职业活动的影响：随机对照试验的系统回顾和荟萃分析。

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-15 DOI: 10.1016/j.smrv.2024.102024

Dédrie Zettor , Francky Teddy Endomba , Achille Pierandrei , Jean-Michel Pinoit , Jean-Christophe Chauvet-Gelinier , Nathalie Forestier , Aymard Hussami

This meta-analytic review aimed to assess the effectiveness of digital cognitive behavioral therapy for insomnia (dCBT-I) on professional activity.

We systematically explored PubMed, Web of Science and PsycINFO until August 2023. We targeted randomized controlled trials using dCBT-I and assessing professional activity. We used the standardized mean difference (SMD), and the Der Simonian-Laird random effects model, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

From the 494 papers initially identified, 11 were finally selected, including 4723 participants from Europe, Japan, and North America. People treated with dCBT-I had lower scores for work-related rumination (SMD = −3.28; 95 % CI: −6.18; −0.39), lower costs of lost productivity due to presenteeism (SMD = −0.55; 95 % CI: −0.77; −0.33), and lower presenteeism scores (SMD = −1.05; 95 % CI: −1.79; −0.31). Three studies displayed a high risk of bias, while eight were classified as “some concern”. Publication bias could not be assessed due to the small number of studies, and the certainty of evidence was low or very low.

This review provides positive results regarding the effectiveness of dCBT-I on the professional activity of people with insomnia symptoms or disorder. However, further studies are needed to reinforce our findings.

本荟萃分析综述旨在评估数字化失眠认知行为疗法（dCBT-I）对职业活动的影响。我们对PubMed、Web of Science和PsycINFO进行了系统检索，直至2023年8月。我们的目标是使用 dCBT-I 并对职业活动进行评估的随机对照试验。我们使用了标准化均值差异（SMD）和 Der Simonian-Laird 随机效应模型，并遵循了《系统综述和元分析首选报告项目》指南。从最初确定的 494 篇论文中，最终选出了 11 篇，其中包括来自欧洲、日本和北美的 4723 名参与者。接受dCBT-I治疗者的工作相关遐想得分较低（SMD = -3.28；95 % CI：-6.18；-0.39），因缺勤而损失的生产力成本较低（SMD = -0.55；95 % CI：-0.77；-0.33），缺勤得分较低（SMD =-1.05；95 % CI：-1.79；-0.31）。三项研究显示偏倚风险较高，八项研究被列为 "值得关注"。由于研究数量较少，无法对发表偏倚进行评估，证据的确定性较低或很低。本综述就 dCBT-I 对失眠症状或失眠症患者职业活动的有效性提供了积极的结果。然而，还需要进一步的研究来巩固我们的发现。

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引用次数: 0

Designing sleep disruption: The digital persuasion underlying screen use and sleep 设计睡眠干扰：屏幕使用和睡眠背后的数字说服。

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-15 DOI: 10.1016/j.smrv.2024.102026

David A. Reichenberger , Gina Marie Mathew , Ruth K. Brombach , Lauren E. Hartstein , Isaac R. Rodriguez , Nicole P. Bowles , Joseph M. Dzierzewski , Lauren Hale

引用次数: 0

Circadian realignment and depressed mood: A systematic review 昼夜节律调整与抑郁情绪：系统综述

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-12 DOI: 10.1016/j.smrv.2024.102022

Delainey L. Wescott , Brant P. Hasler , Jill E. Foust , Kathryn A. Roecklein

Chronotherapeutic interventions aimed at realigning the circadian system can improve depression. This systematic review evaluated the current evidence for circadian realignment as an antidepressant mechanism. A comprehensive search was conducted in studies that implemented a chronotherapeutic intervention in samples with depression and/or delayed sleep/circadian timing using PubMed, EMBASE, Cochrane Central Register of Controlled Trials (Wiley), Europe PMC, and PsycINFO. The Downs and Black checklist was used to evaluate study quality. There were 58 studies included, of which 23 studies reported the association between realignment and depression. Circadian realignment was associated with improved depression in studies that included participants with baseline delays and elevated depression. Randomized clinical trials measuring circadian phase markers are needed to further elucidate circadian realignment as an antidepressant mechanism.

旨在调整昼夜节律系统的时间治疗干预可以改善抑郁症。本系统综述评估了昼夜节律调整作为抗抑郁机制的现有证据。我们使用 PubMed、EMBASE、Cochrane Central Register of Controlled Trials (Wiley)、Europe PMC 和 PsycINFO 对在抑郁症和/或睡眠/昼夜节律延迟样本中实施昼夜节律治疗干预的研究进行了全面检索。唐斯和布莱克核对表用于评估研究质量。共纳入 58 项研究，其中 23 项研究报告了昼夜节律调整与抑郁之间的关系。在纳入基线延迟和抑郁程度升高的参与者的研究中，昼夜节律调整与抑郁程度的改善有关。要进一步阐明昼夜节律调整作为一种抗抑郁机制，需要进行测量昼夜节律相位标记的随机临床试验。

引用次数: 0

Reliability and validity of instruments containing reported sleep measures among children from birth to <5 years of age: A systematic review 包含出生至 5 岁以下儿童睡眠测量报告的工具的可靠性和有效性：系统回顾。

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-12 DOI: 10.1016/j.smrv.2024.102023

Olga Antsygina , Scott Rollo , Nora McRae , Jean-Philippe Chaput , Mark S. Tremblay

Valid and reliable sleep measures during the early years are crucial for practitioners and researchers seeking accurate evaluation methods. The authors in this review systematically examined the psychometric properties of instruments containing reported sleep measures in children from birth to <5 years of age. The search was conducted using several electronic databases, including MEDLINE, EMBASE, PsycINFO, Web of Science, CINAHL, SPORTDiscus, Scopus and HaPI, with the most recent update on August 30, 2022. The quality of the included studies was assessed using the COSMIN methodology. A total of 79 studies were analyzed. However, none of these measures had undergone a comprehensive evaluation of all psychometric properties. Unfortunately, suitable reported sleep measures for children aged 0–4.99 years could not be identified through this review. Further research is needed to develop and validate psychometrically robust sleep assessment tools for this specific age group.

对于寻求准确评估方法的从业人员和研究人员来说，有效可靠的幼儿期睡眠测量方法至关重要。这篇综述的作者们系统地研究了包含睡眠测量报告的工具的心理测量特性，这些工具适用于从出生到 6 岁的儿童。

引用次数: 0

A scoping review of self-help cognitive behavioural therapy for insomnia 失眠症认知行为自助疗法范围综述。

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-10 DOI: 10.1016/j.smrv.2024.102021

R.C. Lake , R.E. Tucker , A.L. Murphy , A. Pencer , K. Kruglova , D.M. Gardner

Uptake of cognitive behavioural therapy for insomnia (CBTI) as first-line therapy of chronic insomnia has been restricted by a shortage of trained therapists, access barriers, and limited awareness of self-help alternatives. Self-help CBTI has emerged as a practical alternative, offering ready access, convenience, and dissemination and scalability efficiency. Yet, evidence syntheses of limited data have suggested its effectiveness and acceptability may be inferior to face-to-face CBTI and others have questioned its fidelity with CBTI standards. We conducted a scoping review to map and characterize self-help CBTI research, focusing on its core components, delivery methods, use of coaching support, and growth. Our review included 174 reports of 145 unique studies, 106 of which were randomized trials, with 65 published since 2020. Findings revealed that self-help CBTI maintained the essential core components (time-in-bed restriction, stimulus control, relaxation techniques, cognitive therapy, and sleep hygiene/education) and structure of conventional CBTI with many, but not all, including different types and formats of coaching support. The expanding body of evidence suggests that self-help CBTI is an evolving field, warranting further analysis to delineate its role in filling the treatment gap for chronic insomnia.

作为慢性失眠症的一线疗法，失眠认知行为疗法（CBTI）的使用率一直受到训练有素的治疗师短缺、使用障碍以及对自助替代疗法认识有限等因素的限制。自助式 CBTI 已成为一种实用的替代疗法，它具有随时可用、方便、传播和可扩展性强等优点。然而，对有限数据的证据综合表明，其有效性和可接受性可能不如面对面的 CBTI，还有人质疑其是否符合 CBTI 标准。我们对自助式 CBTI 研究进行了范围界定，重点关注其核心内容、交付方法、教练支持的使用和发展。我们的综述包括 145 项独特研究的 174 份报告，其中 106 项为随机试验，65 项自 2020 年以来发表。研究结果表明，自助式 CBTI 保持了传统 CBTI 的基本核心内容（卧床时间限制、刺激控制、放松技巧、认知疗法和睡眠卫生/教育）和结构，其中许多（但不是全部）包括不同类型和形式的辅导支持。越来越多的证据表明，自助式 CBTI 是一个不断发展的领域，值得进一步分析，以确定其在填补慢性失眠治疗空白方面的作用。

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引用次数: 0

Weighing the evidence for excess weight and weight loss in the management of obstructive sleep apnea.‘Fat’ or fiction? 权衡在阻塞性睡眠呼吸暂停治疗中超重和减肥的证据。"肥胖 "还是虚构？

IF 11.2 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2024-11-09 DOI: 10.1016/j.smrv.2024.102020

Craig L. Phillips, Julia L. Chapman, Brendon J. Yee

引用次数: 0

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