Behavioral Sleep Medicine最新文献

Background: Obstructive sleep apnea (OSA) patients exhibit neurological symptoms, driving research in sleep medicine and clinical neurology. Neurologists and radiologists explore detection methods to identify unique neural features associated with OSA in the atypical nervous system. Neuroimaging research in OSA encompasses studying the structural, functional connectivity (FC), and neurometabolic aspects of the brain. Limited resources and OSA's heterogeneity pose challenges to effective neuroimaging research. This study aims to conduct a bibliometric analysis of OSA neuroimaging research to identify key trends and emerging themes.

Methods: This research utilizes various techniques, including functional MRI, structural MRI, diffusion tensor imaging, magnetic resonance spectroscopy, and electroencephalography, among others. Publications from 1993 to 2023 were retrieved from Web of Science on neuroimaging. Analysis tools included Bibliometric.com, CiteSpace, VOSviewer, and R4.3.2.

Results: A total of 714 papers were published in 47 countries, with 651 articles, 55 reviews, and 8 meeting abstracts. The USA led in publications, with the University of California System contributing most, primarily in "Sleep" journal. The study identified 2916 authors, with Macey PM having the highest publication count. Recent years highlighted burst keywords such as network, classification, sleep staging, FC, and brain activity. Analysis of keyword clusters revealed "electroencephalography" with the longest temporal duration.

Conclusions: Neuroimaging in OSA research has gained increased attention. Incorporating behavioral sleep medicine insights could enhance understanding of OSA's impact on brain function and behavior. This study aims to assist researchers in identifying potential collaborators, institutions, and key themes, providing a comprehensive perspective on OSA neuroimaging research and related sleep disorders.

Objectives: The relationship between actigraphy-derived sleep parameters, day-to-day deviations in sleep parameters, and metabolic dysfunction-associated steatotic liver disease (MASLD), a new definition of nonalcoholic fatty liver disease (NAFLD), remains unclear. We aimed to explore the associations of sleep duration, midpoint, variability and irregularity with MASLD risk.

Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Sleep duration and midpoint were estimated from 4 to 7 days of 24-hour actigraphy measurements. Sleep duration and midpoint standard deviation were used as indicators of sleep variability and irregularity, respectively. MASLD was diagnosed according to the multi-society Delphi consensus. Hepatic steatosis was defined as fatty liver index ≥ 60. Multivariable weighted logistic regression models were used to explore correlations and perform subgroup analyses.

Results: A total of 5,316 participants were included, of whom 2,339 had MASLD. After adjusting for socio-demographic characteristics, lifestyle factors, and depression, compared to sleep variability < 60 minutes, the odds ratio (OR) [95% confidence interval (CI)] was 1.13 (0.96-1.34) for 60-90 minutes, and 1.17 (1.00-1.38) for > 90 minutes (P for trend = .034). After further adjustment for other sleep variables, short sleep duration (<7 hours) was associated with a 24% higher risk of MASLD (OR: 1.24, 95% CI: 1.01-1.53); compared to sleep irregularity < 38 minutes, OR (95% CI) was 1.27 (1.02-1.59) for 38-61 minutes and 1.43 (1.24-1.65) for > 61 minutes (P for trend = .003).

Conclusion: In addition to sleep duration, sleep irregularity may need to be considered in the prevention of MASLD.

Objectives: This study aims to compare amongst preschoolers, night sleep duration derived using the automated van Hees algorithm in GGIR (GGIR_VH) against the reference Sadeh algorithm (Actilife_SD), and subjective caregiver-reported sleep diaries against Actilife_SD.

Methods: Participants were 142 preschoolers (52.1% males), age 5.5 years, from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) birth cohort study. Weeklong actigraphy data was collected via the wGT3X-BT accelerometer (worn on the non-dominant wrist) with concurrent caregiver-reported sleep diaries. Analyses were conducted to compare the automated GGIR_VH and sleep diaries against the reference Actilife_SD. Intraclass correlations were calculated to compare the agreement levels. Bland-Altman plots were used to investigate the bias in the mean differences and limits of agreement (LoA). Repeated measures of ANOVAs were used to compare mean differences.

Results: For the intraclass correlation between automated GGIR_VH and reference Actilife_SD, there was moderate agreement for the nighttime total sleep duration (r = 0.66) and poor agreement between diary and Actilife_SD (r = 0.04). Bland-Altman plots revealed a positive bias when comparing diaries against Actilife_SD, where diaries reported longer sleep duration. In contrast, there was almost no bias and smaller LoAs for the comparison between GGIR_VH and Actilife_SD. ANOVAs showed that comparisons between diary (M = 9.36, SD = 1.16) and Actilife_SD (M = 6.93, SD = 1.12); and GGIR_VH (M = 6.76, SD = 1.30) and Actilife_SD both yielded significant differences.

Conclusions: Overall, the automated GGIR_VH algorithm showed moderate agreement compared to the reference Actilife_SD. In contrast, sleep diaries overestimated sleep duration when compared to Actilife_SD.

Aims and objective: This study aims to evaluate the effect of meditation-based mind-body interventions (MBIs) (Mindfulness, Tai Chi, Yoga, and Qigong) for older adults with poor sleep quality.

Background: Poor sleep quality exerts negative impact on life quality of old adults. The meditation-based mind-body interventions, with merits of simplicity, practicality, accessibility, and widespread dissemination, have been widely used to improve sleep in the older adults. However, the effects of MBIs on sleep quality of old adults are largely unknown.

Method: A comprehensive systematic review and meta-analysis were carried out following the PRISMA-P guidelines. Embase, PubMed, CINAHL, PsycINFO, Cochrane Library, Web of Science, and CNKI databases were searched to gather randomized controlled trials (RCTs) on the effects of MBIs on older adults with poor sleep quality. Study quality was evaluated by the Cochrane Risk of Bias tool.

Results: This study included 11 randomized controlled trials (with 1,052 participants) published between 2008 and 2023. Compared to the control group, there was a significant improvement in sleep quality (SMD= -0.66, 95%CI [-0.894, -0.426], P<0.00001), depression (SMD=-1.60, 95% CI [-1.89, 0.23], P=0.005), and anxiety (SMD= -1.46, 95% CI [-3.67, 0.75], P=0.026) for older adults with poor sleep quality. However, there was no statistically significant difference in the treatment effect for stress (SMD= -4.45, 95% CI [-10.24, 1.35], P=0.196).

Conclusion: Meditation-based mind-body interventions significantly improved the sleep quality of older adults with poor sleep quality. Nevertheless, more evidence is needed to support this.

Registration: The protocol for this study was registered with PROSPERO (CRD42023445082). https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=445082.

Prospero registration number: CRD42023445082.

Measurement reactivity, where the act of measuring a behavior changes that behavior, has been documented across various health outcomes. However, its effects on sleep remain understudied, despite the widespread use of sleep diaries in clinical and research settings. In this randomized experiment, 190 healthy young adults (aged 18-40 years; 63% female) were assigned to complete either a sleep diary (Consensus Sleep Diary) or a physical activity diary (Physical Activity Scale) for seven days. All participants completed the Pittsburgh Sleep Quality Index (PSQI) and the International Physical Activity Questionnaire (IPAQ) before and after the diary period. Daily diary completion rates were high (97.3%). Linear mixed-effects models revealed no significant main effects of time (pre vs. post) or condition (sleep vs. physical activity diary), and no significant interaction between time and condition for either PSQI or IPAQ scores. These results suggest stability in sleep quality and physical activity measures, with no evidence of measurement reactivity. An exploratory analysis comparing "good" and "poor" sleepers (based on baseline PSQI scores) found a significant effect of sleep quality group and a time × group interaction on PSQI scores. In this adequately powered short-term study of young adults, we found no evidence of measurement reactivity to daily sleep diaries. These findings suggest that in healthy individuals, completing a week of sleep diaries is unlikely to impact PSQI scores substantially. We discuss our results in terms of the direct controllability of sleep quality, which might make it less susceptible to measurement reactivity relative to other health outcomes.

Objectives: Individuals with idiopathic hypersomnia (IH) report several subjective emotional and cognitive symptoms, as well as impairments in daily functioning. Coping strategies are frequently used, but their effectiveness is perceived to be minimal. The aim of the present study was to delve into the patient perspective on navigating life with IH, emphasizing patients' personal narratives.

Method: Utilizing a purposeful sample method, twelve participants diagnosed with IH underwent telephone interviews guided by a semi-structured protocol. The interviews were subjected to thematic analysis to extract relevant themes.

Results: Analysis unveiled three primary themes along with subthemes: 1) Being confined, characterized by excessive daytime sleepiness, negative emotional processes and cognitive disturbances, 2) Missing out on life, involving loss of time and adverse social consequences, and 3) Trying to cope, encompassing strategies like napping, adapting, activating oneself and mentally fighting sleepiness, while also embracing acceptance and self-compassion.

Conclusions: The identified themes reflected numerous aspects previously reported to be associated with living with IH. Notably, the study brought novel subthemes to light, such as the existential dilemma of "sleeping one's life away" and feelings of guilt and shame. Furthermore, the study underscored the significance of acceptance and self-compassion as coping strategies.

Objective: Using data from a nationwide recruitment campaign for an RCT evaluating digital cognitive behavioral therapy for prenatal insomnia, we tested whether a recruitment message that identified a racial/ethnic disparity in sleep quality (sleep disparities message) would increase the proportion of participants who engaged in study screening compared to a recruitment message without identified ethnic/racial disparities (standard message). We also tested whether the magnitude of the association of message type with completed eligibility screening varied by race/ethnicity.

Method: Pregnant people (n = 203,664) were randomly assigned to receive a sleep disparities or standard recruitment e-mail. A total of 1,782 pregnant people opened the recruitment e-mails. We used chi-square tests to compare the proportions of e-mails that led to study screening outcomes between the two e-mail message conditions.

Results: The chi-square tests revealed that a smaller proportion of prospective participants who received a sleep disparities message visited the screening website X² = 8.83, p = .003 and completed a study screener X² = 4.92, p = .026 compared to those who received a standard message. Results of a logistic regression detected no statistically significant interactions between race/ethnicity and message type on the probability of a completing a study screener.

Conclusion: Manipulating and measuring the effects of recruitment messages can identify effective strategies for diversifying the participant pools in CBT-I trials.

Objectives: Many teenagers suffer chronic sleep loss, which could potentially be mitigated by later school start times to accommodate the natural shift in their circadian timekeeping system favoring later bedtimes. This study explored experiences of senior students from a school in Aotearoa New Zealand with later school start times.

Method: Semi-structured interviews were conducted with 14 students, purposively sampled for equivalent numbers starting later every day (9:45 A.M.), or on just one weekday (10:00 A.M.). Transcripts were analyzed using reflexive thematic analysis.

Results: Four themes were identified that addressed the impact of later starts on sleep struggles, daily functioning, student autonomy, and routines and scheduling. Most perceived later starts as positively influencing their sleep quality, concentration, productivity, and personal well-being. The importance of autonomy over their learning, and impact of different start times on students' schedules was also emphasized. Major disadvantages were lack of free classes and potentially later finish times.

Conclusions: The experiences of later school start times for these adolescents were largely positive across a variety of life domains. Findings support the need for sleep health to be considered within school's health education and policy to address the unmet health concerns of chronic sleep loss in teens.

Objectives: This study assessed the feasibility of Sleepfit, an app-based sleep intervention for shiftworkers, to evaluate participant reach, engagement, and interaction.

Methods: The RE-AIM framework guided the feasibility assessment. Participants from various shiftwork industries (e.g. healthcare, mining) completed a 14-day trial of the Sleepfit app, alongside baseline and post-intervention surveys. Descriptive statistics were used to evaluate participant enjoyment and engagement, including daily app usage and the number of activities completed.

Results: Among the 110 enrolled shiftworkers, 53 (48%) completed post-intervention assessments, and 34 (30.9%) adhered to the full study protocol. Of those who completed baseline surveys, 85.4% downloaded and used Sleepfit, engaging with an average of 17.3% of available activities, with shiftwork-specific modules like "Coping with Shiftwork" showing the highest engagement. Participants cited lack of time, inconvenience, and losing interest as reasons for discontinuing app use.

Conclusions: This study indicates the potential feasibility of app-based interventions like Sleepfit to improve shiftworkers' sleep health through tailored, relevant content. Future studies should consider longer durations and larger samples, incorporating wearable technology to enhance data accuracy and assess sustained effects across varied shift schedules.

Objectives: This pilot study aimed to preliminarily assess the effectiveness of Acceptance and Commitment Therapy (ACT) vs. Motivational Interviewing (MI) in battling sleep disturbances and academic procrastination among Malaysian undergraduates.

Method: In this single-blind, quasi-experimental study, thirty undergraduate students were randomly assigned to either six online therapist-led Acceptance and Commitment Therapy (ACT) sessions (n = 15) or six online therapist-led Motivational Interviewing (MI) sessions (n = 15). The Tuckman Procrastination Scale, Pittsburgh Sleep Quality Index, and Psy-Flex were administered at baseline, the end of session 3, session 6, and one-month follow-up.

Results: Participants in both groups showed significant improvement in academic procrastination, sleep disturbances, and psychological flexibility(p < .001, η² = .62), with outcomes improved progressively after three sessions, six sessions, and at the one-month follow-up. There was no statistically significant difference between the effectiveness of ACT and MI.

Conclusions: This novel study provides preliminary support for the application of ACT and MI in reducing academic procrastination and sleep disturbances concurrently among undergraduates, with a greater number of sessions leading to better outcomes.The comparable effectiveness of both therapies implies possible flexibility in clinical practice, enabling practitioners to select an intervention based on factors like student preferences, therapist expertise, and resource availability. Future studies should explore the mechanisms and moderating factors influencing the effectiveness of these interventions through well-designed randomized controlled trials (RCTs) with larger sample sizes.