Sleep Medicine Reviews最新文献_第8页

Cannabis and sleep architecture: A systematic review and meta-analysis 大麻和睡眠结构：系统回顾和荟萃分析。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-12 DOI: 10.1016/j.smrv.2025.102164

Rob Velzeboer , Adeeb Malas , Sabrina Wei , Renee Berger , Varinder Parmar , Wayne W.K. Lai

Cannabis use for sleep is increasingly prevalent, yet its effects on sleep architecture remain unclear. This systematic review and meta-analysis examined polysomnographic evidence on cannabis’ impact on sleep parameters. Eighteen studies were identified, with nine suitable for meta-analysis. Findings indicate that cannabis administration does not consistently alter sleep duration, latency, wake time, efficiency, or sleep staging. While early studies suggested reductions in rapid eye movement sleep, these were primarily based on small-scale trials with high tetrahydrocannabinol doses and significant methodological limitations. More recent studies using larger samples and lower therapeutic doses of tetrahydrocannabinol have reported mixed (and often no) evidence of rapid eye movement (REM) suppression, and the evidence base remains very limited. However, withdrawal from active cannabis use was consistently associated with sleep disturbances, including reduced total sleeping times and prolonged sleep onset latency, as well as REM rebounds. Variability in study outcomes highlights the influence of factors such as dosage, cannabinoid composition, prior cannabis use, and health conditions. Further research using standardised protocols and larger samples is needed to clarify the relationship between cannabis and sleep architecture and to address the discrepancies between subjective sleep improvements and objective sleep metrics.

大麻用于睡眠越来越普遍，但其对睡眠结构的影响尚不清楚。这项系统综述和荟萃分析检查了大麻对睡眠参数影响的多导睡眠图证据。确定了18项研究，其中9项适合进行荟萃分析。研究结果表明，服用大麻不会持续改变睡眠持续时间、潜伏期、清醒时间、效率或睡眠阶段。虽然早期的研究表明快速眼动睡眠减少，但这些研究主要是基于高剂量四氢大麻酚的小规模试验和显著的方法局限性。最近使用更大样本和较低治疗剂量的四氢大麻酚的研究报告了混合（通常没有）快速眼动（REM）抑制的证据，证据基础仍然非常有限。然而，停止积极使用大麻一直与睡眠障碍有关，包括总睡眠时间减少、睡眠发作潜伏期延长以及快速眼动反弹。研究结果的可变性突出了剂量、大麻素成分、以前使用大麻和健康状况等因素的影响。需要使用标准化协议和更大样本进行进一步研究，以澄清大麻与睡眠结构之间的关系，并解决主观睡眠改善与客观睡眠指标之间的差异。

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引用次数: 0

Pharmacotherapy for obstructive sleep apnea: a critical review of randomized placebo-controlled trials 阻塞性睡眠呼吸暂停的药物治疗：随机安慰剂对照试验的重要回顾。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-12 DOI: 10.1016/j.smrv.2025.102169

Steven Luu , Daryl Emery Chee Yeow Chan , Nathaniel S. Marshall , Craig L. Phillips , Ronald R. Grunstein , Brendon J. Yee

Positive airway pressure therapy remains the gold standard treatment for obstructive sleep apnea (OSA), but challenges with adherence, acceptability, and side effects persist. Interest in pharmacological therapies has grown, culminating in the recent U.S. Food and Drug Administration approval of tirzepatide as the first pharmacotherapy for OSA. Our review critically examines the efficacy of pharmacologic treatments for OSA and highlights current limitations and future research directions.

We conducted a search of Medline and Embase for randomized controlled trials published from January 2005 to February 2025, identifying 41 studies investigating 37 different drugs or drug combinations.

Weight-loss therapies showed the most consistent and substantial improvements in OSA severity. Tirzepatide produced the largest reduction in apnea-hypopnea index and improved patient-reported outcomes and cardiometabolic risk factors. Other pharmacotherapies demonstrated modest and inconsistent effects on OSA severity, sometimes with side-effects that contradict the treatment goal to reduce daytime sleepiness.

Weight-loss agents, particularly tirzepatide, represent a promising and now clinically viable treatment option. While endotype-targeted approaches are conceptually attractive, many agents were too early in their testing/re-purposing phase to demonstrate improvements in sleepiness, quality of life or sustained reductions of OSA severity; or were insufficiently targeted at the endotype they might best treat.

气道正压治疗仍然是阻塞性睡眠呼吸暂停（OSA）的金标准治疗方法，但在依从性、可接受性和副作用方面仍然存在挑战。对药物治疗的兴趣越来越大，最近美国食品和药物管理局批准替西帕肽作为OSA的第一个药物治疗。我们的综述严格检查了OSA药物治疗的有效性，并强调了当前的局限性和未来的研究方向。我们在Medline和Embase检索了2005年1月至2025年2月发表的随机对照试验，确定了41项研究，调查了37种不同的药物或药物组合。减肥疗法在OSA严重程度上表现出最一致和最显著的改善。替西帕肽对呼吸暂停低通气指数的降低最大，并改善了患者报告的结果和心脏代谢危险因素。其他药物治疗对OSA严重程度的影响不大且不一致，有时其副作用与减少白天嗜睡的治疗目标相矛盾。减肥药，特别是替西帕肽，是一种很有前途的治疗选择，现在临床上是可行的。虽然内源性靶向方法在概念上很有吸引力，但许多药物在测试/重新利用阶段还为时过早，无法证明改善嗜睡、生活质量或持续降低OSA严重程度；或者没有充分靶向它们可能最好治疗的内源性肿瘤。

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引用次数: 0

The impairments of sleep loss on core executive functions: General and task-specific effects 睡眠缺失对核心执行功能的损害：一般和特定任务的影响

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-11 DOI: 10.1016/j.smrv.2025.102163

Yixuan Cao , Tian Xie , Ning Ma

This meta-analysis quantified the impact of sleep loss (including both total sleep deprivation and partial sleep restriction) on core components of executive function: working memory, inhibitory control, and cognitive flexibility. A systematic search of Scopus, Web of Science, and PubMed identified 79 relevant publications. Using random-effects models, pooled effect sizes for reaction time and accuracy metrics were estimated separately within each task category. All reaction time metrics, except for cognitive flexibility, increased significantly following sleep loss, with medium to near-large effect sizes. Analysis of accuracy metrics revealed medium to large effect sizes on task-switching and task-repeat performance of cognitive flexibility, as well as on working memory maintenance, whereas a small effect size was observed on resolving interference inhibition. These findings highlight pervasive damage to all executive function components and suggest that the impaired common factor of executive functions may underpin sleep loss–related deterioration. Furthermore, the discrepancies between reaction time and accuracy effect sizes indicate opposite speed-accuracy trade-offs following sleep loss between interference inhibition and cognitive flexibility. This study provides essential evidence for understanding how sleep loss affects different components of executive function, emphasizing the importance of exploring sleep loss–related impairments from a comprehensive perspective.

这项荟萃分析量化了睡眠缺失（包括完全睡眠剥夺和部分睡眠限制）对执行功能核心组成部分的影响：工作记忆、抑制控制和认知灵活性。通过对Scopus、Web of Science和PubMed的系统搜索，确定了79篇相关出版物。使用随机效应模型，在每个任务类别中分别估计反应时间和准确性指标的综合效应大小。除认知灵活性外，所有反应时间指标在睡眠不足后都显著增加，效应大小中等至接近于大。准确度指标分析显示，在认知灵活性的任务转换和任务重复表现以及工作记忆维持方面存在中等到较大的效应，而在解决干扰抑制方面存在较小的效应。这些发现强调了对所有执行功能组成部分的普遍损害，并表明执行功能受损的共同因素可能是睡眠不足相关恶化的基础。此外，反应时间和准确性效应大小之间的差异表明，睡眠不足后，干扰抑制和认知灵活性之间的速度-准确性权衡是相反的。这项研究为理解睡眠不足如何影响执行功能的不同组成部分提供了必要的证据，强调了从全面的角度探索睡眠不足相关损伤的重要性。

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引用次数: 0

The effects of mandibular advancement devices on pediatric obstructive sleep apnea: An umbrella review 下颌推进装置对儿童阻塞性睡眠呼吸暂停的影响：综述

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-11 DOI: 10.1016/j.smrv.2025.102166

Yaqi Li , Tingting Zhao , Lizhuo Lin , Jingyuan Zhang , Sunliu Liu , Yueyi Wu , Carlos Flores-Mir , Fang Hua , Hong He

This umbrella review evaluated the effects of mandibular advancement devices (MADs) on pediatric obstructive sleep apnea (PedOSA). We searched six databases for systematic reviews published up to June 2025, that included children with polysomnography (PSG)-diagnosed OSA managed with MADs. The primary outcome was the change in the apnea-hypopnea index (AHI). Secondary outcomes included oxygen saturation and skeletal/dental changes. Twelve systematic reviews, including 7 meta-analyses, were included. Management with MADs resulted in a reduction in AHI and a slight improvement in sagittal mandibular position. However, significant heterogeneity was observed due to variations in device designs, treatment duration, and patient characteristics. Most findings were based on before-after studies, with limited randomized controlled trials, reducing the robustness of the results. The methodological quality of the included systematic reviews, assessed using AMSTAR 2, was predominantly low or critically low, indicating significant flaws. A corrected covered area (CCA) analysis revealed substantial overlap (20.7 %) in primary studies. While MADs show promise as an adjunctive therapy for PedOSA management in indicated cases, the low methodological quality of the included systematic reviews limits the strength of the evidence. High-quality primary studies and systematic reviews are needed to confirm the impact of MADs in PedOSA management and guide clinical practice.

本综述评估了下颌推进装置（MADs）对儿童阻塞性睡眠呼吸暂停（PedOSA）的影响。我们检索了截至2025年6月发表的6个数据库的系统综述，其中包括患有多导睡眠图（PSG）诊断的OSA并使用MADs治疗的儿童。主要终点是呼吸暂停低通气指数（AHI）的变化。次要结局包括血氧饱和度和骨骼/牙齿变化。纳入了12项系统综述，包括7项荟萃分析。MADs治疗导致AHI的降低和矢状下颌位置的轻微改善。然而，由于器械设计、治疗时间和患者特征的差异，观察到显著的异质性。大多数研究结果是基于前后对照研究，随机对照试验有限，降低了结果的稳健性。使用AMSTAR 2评估纳入的系统评价的方法学质量主要为低或极低，表明存在重大缺陷。经过校正的覆盖面积（CCA）分析显示，在主要研究中存在大量重叠（20.7%）。虽然MADs有望在指示病例中作为PedOSA管理的辅助疗法，但所纳入的系统评价的低方法学质量限制了证据的强度。需要高质量的初步研究和系统评价来证实MADs对PedOSA管理的影响并指导临床实践。

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引用次数: 0

The impact of traumatic brain injury on sleep and associated neuroimaging changes: A systematic review 外伤性脑损伤对睡眠和相关神经影像学改变的影响：系统综述。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-11 DOI: 10.1016/j.smrv.2025.102155

Jacob S. Shaw , Kaylee Woodard , Akshay Krieg , Barry R. Bryant , Sabrina Kentis , Aaron I. Esagoff , Anne Reisch , Rachel M. Salas , Matthew E. Peters , Michael J.C. Bray

Sleep disturbances are among the most common neuropsychiatric symptoms following traumatic brain injury (TBI). However, no review has sought to identify the major neuroimaging correlates of post-TBI sleep disturbances across multiple imaging modalities. This systematic review aimed to describe post-TBI neuroimaging changes associated with self-reported and objective markers of sleep disturbance using computed tomography (CT), magnetic resonance imaging (MRI), and quantitative electroencephalography (qEEG). 21 studies were included in this review, comprising the data of 3176 individual with TBI and 396 individuals without TBI. While acute intracranial abnormalities on CT were not reliable predictors of self-reported symptoms of insomnia, measures of axonal integrity on diffusion tensor imaging (DTI), particularly involving cortico-subcortical white matter tracts such as the uncinate fasciculus, were highly associated with self-reported sleep disturbance. Individuals with TBI were also found to have decreased delta power and increased beta power on qEEG during sleep, providing preliminary support for the functional role of the hypothalamus in the pathogenesis of post-TBI sleep disturbance. Key study limitations include small sample sizes and heterogeneity of TBI severity and chronicity. Functional neuroimaging studies are needed that elucidate which alterations in white matter connectivity may be most implicated in the neurocircuitry of post-TBI sleep disturbance.

睡眠障碍是创伤性脑损伤（TBI）后最常见的神经精神症状之一。然而，尚无综述试图通过多种成像方式确定脑外伤后睡眠障碍的主要神经影像学相关因素。本系统综述旨在通过计算机断层扫描（CT）、磁共振成像（MRI）和定量脑电图（qEEG）描述脑外伤后与自我报告和客观睡眠障碍标志物相关的神经影像学变化。本综述纳入了21项研究，包括3176例TBI患者和396例非TBI患者的数据。虽然CT上的急性颅内异常并不是自我报告的失眠症状的可靠预测指标，但弥散张量成像（DTI）的轴突完整性测量，特别是涉及皮质-皮质下白质束（如钩侧束）的测量，与自我报告的睡眠障碍高度相关。研究还发现，脑外伤患者睡眠时qEEG的δ功率下降，β功率增加，这为下丘脑在脑外伤后睡眠障碍发病机制中的功能作用提供了初步支持。主要的研究局限性包括样本量小和TBI严重程度和慢性程度的异质性。需要功能性神经影像学研究来阐明哪些白质连接的改变可能与脑外伤后睡眠障碍的神经回路最相关。

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引用次数: 0

Nonobvious connections between napping and stroke: a systematic review and meta-analysis 午睡和中风之间不明显的联系：一项系统回顾和荟萃分析。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-09-06 DOI: 10.1016/j.smrv.2025.102157

Radosław Kaźmierski , Szymon Jurga , Izabela Wojtasz , Joanna Kostanek , Maria Łukasik , Cezary Watala

We present a meta-analysis and systematic review of research on the relationships between various aspects of naps and stroke risk. Two searches were conducted: a bibliographic search in four electronic databases for published articles that considered associations between the duration of napping and stroke risk versus a reference group (who did not nap) (n = 13) from inception up to July 15, 2024. The second search analyzed different features of napping (e.g., frequency, mild or severe napping, planned or unplanned, etc.) and stroke risk (n = 7). We found that the studies were very methodologically heterogeneous. Several publications reported more than one effect size. These differences allowed us to build models that describe the associations between napping and stroke. We used a funnel plot to estimate publication bias and employed a model of random effects for the analysis. The duration of naps was significantly associated with stroke risk; naps of 1–30 min had an odds ratio (OR) of 1.27, whereas naps >90 min had an OR of 1.79. Mutated forest plots were used to visualize the overall effects. We describe the pathomechanisms associated with an increased risk of hypertension and diabetes, mild inflammation, and other risk factors for stroke.

我们对小睡与中风风险之间关系的研究进行了荟萃分析和系统回顾。研究人员进行了两项搜索：在四个电子数据库中进行文献检索，检索从研究开始到2024年7月15日，考虑午睡时间与中风风险之间关系的已发表文章与参考组（不午睡）（n = 13）的文献。第二个搜索分析了午睡的不同特征（如频率、轻度或重度午睡、计划或非计划午睡等）和中风风险（n = 7）。我们发现这些研究在方法上存在很大差异。一些出版物报道了一个以上的效应量。这些差异使我们能够建立描述午睡和中风之间联系的模型。我们使用漏斗图来估计发表偏倚，并采用随机效应模型进行分析。小睡时间与中风风险显著相关；小睡1-30分钟的优势比（OR）为1.27，而小睡90分钟的优势比为1.79。突变的森林图被用来可视化整体效果。我们描述了与高血压、糖尿病、轻度炎症和其他中风风险因素增加相关的病理机制。

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引用次数: 0

Optimizing timing and dose of exogenous melatonin administration in neuropsychiatric pediatric populations: a meta-analysis on sleep outcomes 优化时间和剂量外源性褪黑素给药在神经精神儿科人群：睡眠结果的荟萃分析

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-08-30 DOI: 10.1016/j.smrv.2025.102158

Simone Bruno , Giovanni Cenerini , Letizia Lo Giudice , Francy Cruz-Sanabria , Davide Benedetti , Alessio Crippa , Simona Fiori , Raffaele Ferri , Gabriele Masi , Ugo Faraguna

Melatonin is known to be effective in improving sleep in pediatric patients affected by neurological and psychiatric conditions. However, no guidelines exist advising the most effective treatment schedule. This systematic review and meta-analysis aimed to identify the dose, time of administration and treatment duration associated with the maximal treatment efficacy. The systematic search, conducted across multiple databases following PRISMA guidelines and including studies published up to April 30, 2024, yielded 21 studies. Mean differences in sleep-related variables between the treatment and the placebo group were considered as study outcomes. Dose-response curves and meta-regression models were fitted to test the effect of treatment-related parameters. Melatonin significantly reduced Sleep onset latency and increased Sleep efficiency and Total sleep time. Sleep onset latency reduction was associated with an advancement in the time between administration with respect to bedtime, while increased Sleep efficiency and Total sleep time with longer treatment durations. Melatonin reached the maximal efficacy between 2 and 4 mg/day. Our results suggest a dose and time of administration that may enhance melatonin's sleep promoting effects (2–4 mg, 3 h before bedtime) and, if replicated by large clinical trials, could guide clinical practice in managing sleep disturbances in children experiencing neuropsychiatric conditions.

众所周知，褪黑素可以有效改善受神经和精神疾病影响的儿科患者的睡眠。然而，没有指导方针建议最有效的治疗方案。本系统综述和荟萃分析旨在确定与最大治疗效果相关的剂量、给药时间和治疗持续时间。根据PRISMA指南，在多个数据库中进行了系统搜索，包括截至2024年4月30日发表的研究，共获得21项研究。治疗组和安慰剂组之间睡眠相关变量的平均差异被视为研究结果。拟合剂量-反应曲线和元回归模型，检验治疗相关参数的影响。褪黑素显著降低睡眠潜伏期，提高睡眠效率和总睡眠时间。睡眠发作潜伏期的减少与两次给药之间就寝时间的提前有关，而睡眠效率和总睡眠时间的增加与治疗持续时间的延长有关。褪黑素在2至4毫克/天之间达到最大功效。我们的研究结果表明，服用褪黑素的剂量和时间可以增强褪黑素的睡眠促进作用（2-4毫克，睡前3小时），如果在大型临床试验中得到证实，可以指导临床实践，治疗患有神经精神疾病的儿童的睡眠障碍。

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引用次数: 0

Role of heart rate variability analysis in differentiating patients with idiopathic REM sleep behaviour disorders from healthy subjects. A systematic review with meta-analysis 心率变异性分析在区分特发性快速眼动睡眠行为障碍患者与健康受试者中的作用荟萃分析的系统综述

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-08-30 DOI: 10.1016/j.smrv.2025.102160

Clara Gino , Laura Adelaide Dalla Vecchia , Monica Parati , Davide Sattin , Serena Covino , Graziella Cappelletti , Alessandro Pincherle , Beatrice De Maria

Introduction

Autonomic nervous system (ANS) alteration has been acknowledged for disrupted sleep and α-synucleopaties. Since idiopathic REM sleep behavior disorder (iRBD) precedes α-synucleopaties, ANS function indices could predict conversion. Heart rate variability (HRV) analysis could better define cardiac ANS in iRBD.

This systematic review with meta-analysis purpose was to investigate the HRV indices role in differentiating iRBD and controls.

Method

Included studies (three databases screened) compare HRV indices in iRBD and controls during REM, non-REM (NREM) or wake phases. Outcomes included HRV indices in time and frequency domains. Meta-analysis performed for HRV indices computed standardized mean difference with 95 % confidence intervals.

Results

The 22 included studies had unbalanced age groups, mostly composed of males. An overall lower HRV and cardiac vagal modulation emerged in iRBD. Almost all studies evaluated HRV parameters only during wakefulness and most of those separated NREM and REM phases, better highlighting differences between iRBD and controls.

Conclusion

Results suggest an overall reduced HRV and cardiac vagal modulation in iRBD patients. Furthermore, separated analysis of the different sleep stages better differentiate subjects with iRBD.

Further longitudinal studies on larger populations would reach more conclusions defining relationships between HRV and neurodegenerative diseases in prodromic stages.

自主神经系统（ANS）的改变已被认为是睡眠中断和α-突触核的原因。由于特发性快速眼动睡眠行为障碍（iRBD）先于α-突触，因此ANS功能指标可以预测转换。心率变异性（HRV）分析可以更好地定义iRBD患者的心脏ANS。本系统综述以荟萃分析为目的，探讨HRV指标在区分iRBD和对照组中的作用。方法入选研究（筛选的3个数据库）比较iRBD患者和对照组在REM、非REM （NREM）和觉醒阶段的HRV指数。结果包括时域和频域HRV指数。对HRV指数进行荟萃分析，计算标准化平均差异，置信区间为95%。结果纳入的22项研究的年龄组不平衡，主要由男性组成。iRBD患者HRV整体降低，心脏迷走神经调节。几乎所有的研究都只评估了清醒时的HRV参数，而且大多数研究都将非快速眼动期和快速眼动期分开，从而更好地突出了iRBD与对照组之间的差异。结论：结果表明iRBD患者HRV和心脏迷走神经调节总体降低。此外，不同睡眠阶段的分离分析可以更好地区分iRBD受试者。对更大人群的进一步纵向研究将得出更多结论，确定HRV与前驱期神经退行性疾病之间的关系。

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引用次数: 0

The effects of daylight saving time and clock time transitions on sleep and sleepiness: a systematic review 日光节约时间和时钟时间转换对睡眠和困倦的影响：系统回顾

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-08-30 DOI: 10.1016/j.smrv.2025.102161

Andrea Romigi , Valentina Franco , Egeria Scoditti , Giulia Milan , Francesco Ceriello , Diego Centonze , Sergio Garbarino

Background

Daylight Saving Time (DST) has been a subject of debate concerning its impact on human health, particularly sleep patterns and daytime sleepiness. This systematic review aims to synthesize existing research on the effects of DST on sleep quality, duration, and sleepiness, identifying gaps, and setting a future research agenda.

Methods

A comprehensive literature search was conducted across multiple databases, according to the PRISMA guidelines. The included studies were those that examined the impact of DST on sleep outcomes and daytime sleepiness in populations aged 6–85 years, using objective and subjective measures of sleep.

Results

The review analyzed 27 studies, revealing heterogeneous findings. The transition to DST was associated with adverse effects on sleep duration and quality, as well as increased sleepiness, more evident in evening chronotypes.

Conclusions

Although the transition to DST appears to negatively affect sleep patterns, particularly in spring and among evening chronotypes, definitive conclusions are hampered by methodological inconsistencies and external influences. This review highlights the need for future research employing standardized, objective measures across representative samples to elucidate the true impact of transitions to and from DST and the difference between standard time and permanent DST on sleep and daytime functioning. Addressing these gaps is crucial for informed public health policies.

日光节约时间（DST）对人类健康的影响一直是争论的主题，尤其是对睡眠模式和白天嗜睡的影响。本系统综述旨在综合目前关于夏令时对睡眠质量、持续时间和困倦的影响的研究，找出差距，并制定未来的研究议程。方法根据PRISMA指南，在多个数据库中进行综合文献检索。纳入的研究使用客观和主观的睡眠测量方法，研究了夏令时对6-85岁人群的睡眠结果和白天嗜睡的影响。结果该综述分析了27项研究，揭示了不同的发现。向夏令时的过渡与睡眠持续时间和质量的不利影响以及嗜睡的增加有关，这在晚上的时间类型中更为明显。结论：虽然夏时制的转变似乎对睡眠模式产生了负面影响，特别是在春季和夜间睡眠类型中，但由于方法的不一致和外部影响，最终结论受到阻碍。这篇综述强调了未来的研究需要采用标准化的、客观的测量方法，在有代表性的样本中阐明夏令时转换和从夏令时转换的真正影响，以及标准时间和永久夏令时之间对睡眠和白天功能的差异。解决这些差距对于制定知情的公共卫生政策至关重要。

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引用次数: 0

Interpreting the mandibular jaw movement signal in pediatric obstructive sleep apnea diagnosis: A technical and practical review 解释下颌骨运动信号在儿童阻塞性睡眠呼吸暂停诊断：技术和实践综述

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-08-29 DOI: 10.1016/j.smrv.2025.102159

Jean-Benoit Martinot , Nhat-Nam Le-Dong , Julie Cassibba , Didier Clause , Jean-Louis Pépin , David Gozal

Pediatric obstructive sleep apnea (OSA) is a common yet often underdiagnosed condition, partly due to limited access to polysomnography. Mandibular jaw movement (MJM) analysis offers a promising alternative to conventional home sleep apnea testing in children, capturing the dynamic interactions between respiratory drive and upper airway musculature, enabling accurate identification of, and critical insights into, sleep-disordered breathing events.

This technical and practical review provides a structured framework for understanding and interpreting MJM signals during sleep in pediatric patients. It begins with the physiological basis and technical aspects of using a single-point contact device with integrated inertial sensors. It offers step-by-step instructions for interpreting MJM signals, from distinguishing sleep stages to identifying obstructive and central apneas, hypopneas, and respiratory effort-related arousals. The review is accompanied by an atlas of 30 annotated examples that illustrate key MJM signal patterns across scoring tasks.

Key findings from several clinical studies on the utility of MJM analysis in pediatric OSA are also summarized.

As the demand for accessible and accurate home-based diagnostic tools grows, MJM analysis stands out as an effective option for both the diagnosis and monitoring of pediatric OSA, with the potential to transform routine clinical practice and improve patient access to care.

儿童阻塞性睡眠呼吸暂停（OSA）是一种常见但常被诊断不足的疾病，部分原因是由于多导睡眠图的限制。下颌运动（MJM）分析为传统的儿童家庭睡眠呼吸暂停测试提供了一个有希望的替代方案，捕捉呼吸驱动和上呼吸道肌肉组织之间的动态相互作用，能够准确识别和关键洞察睡眠呼吸障碍事件。这项技术和实践综述为理解和解释儿科患者睡眠中的MJM信号提供了一个结构化的框架。它从使用集成惯性传感器的单点接触装置的生理基础和技术方面开始。它为解释MJM信号提供了一步一步的指导，从区分睡眠阶段到识别阻塞性和中枢性呼吸暂停、低呼吸和呼吸努力相关的唤醒。该审查是伴随着30个注释的例子，说明关键的MJM信号模式跨评分任务的地图集。总结了几项关于MJM分析在儿童OSA中的应用的临床研究的主要发现。随着对可获得和准确的家庭诊断工具的需求不断增长，MJM分析作为儿科OSA诊断和监测的有效选择脱颖而出，具有改变常规临床实践和改善患者获得护理的潜力。

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引用次数: 0