Pub Date : 2024-08-08DOI: 10.3389/frsle.2024.1461464
Ambra Stefani, John Winkelman
{"title":"Editorial: Insights in sleep-related movement disorders and parasomnias","authors":"Ambra Stefani, John Winkelman","doi":"10.3389/frsle.2024.1461464","DOIUrl":"https://doi.org/10.3389/frsle.2024.1461464","url":null,"abstract":"","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.3389/frsle.2024.1404684
Lucy A. Webster, Talha Ali, Jody Sharninghausen, Alexandra M. Hajduk, Thomas Gill, Brienne Miner
Aging-related changes and caregiver burden may increase the risk for sleep disturbances among older caregivers, yet few studies have examined the prevalence of insomnia and daytime sleepiness in this group. We examined the relationship of caregiver status with insomnia and daytime sleepiness among persons of advanced age (>75 years of age).Cross-sectional.Community.Yale Precipitating Events Project participants (n=383, mean age 84.4 years, 67% female, 12% African American, 25% caregivers).Caregivers were persons who reported caring for another person in the past week or caring for/helping a friend or relative >4 times in the past month. We examined the correlates of caregiver status, including demographic (age, sex, race/ethnicity, education, marital status), psychosocial (living alone, Medicaid eligibility, depressive symptoms, social support, hours volunteered), and physical (obesity, chronic conditions, medication use, self-rated health status, physical activity, functional disability, cognitive impairment) factors. We used the Insomnia Severity Index (ISI) to establish insomnia severity (ISI score 0–28) or clinically significant insomnia symptoms (ISI ≥8). We used the Epworth Sleepiness Scale to establish daytime sleepiness (ESS score 0–24) or hypersomnia (ESS ≥10). In nonparametric multivariable regression analyses, we examined the relationship of caregiver status with insomnia or daytime sleepiness.Compared to non-caregivers, caregivers were younger, more educated, less likely to be Medicaid eligible and had lower rates of depression, obesity, poor self-rated health, low physical activity, functional disability, and cognitive impairment. Mean ISI and ESS scores were in the normal range and similar among non-caregivers and caregivers (ISI scores of 6.9±5.6 and 6.9±5.4, and ESS scores of 6.4±4.7 and 6.1±4.3, in non-caregivers and caregivers, respectively). Multivariable-adjusted models demonstrated no significant differences in ISI and ESS scores between non-caregivers and caregivers (regression coefficients for ISI and ESS scores of −0.01 [95% CI = −1.58, 1.21] and −0.10 [−1.05, 1.21], respectively).When compared to older non-caregivers, older caregivers had more advantageous demographic, psychosocial, and physical profiles and had similar levels of insomnia and daytime sleepiness on standardized questionnaires. Future research is needed to elucidate contextual factors (e.g., caregiving intensity and care partner disease) that may increase the risk of sleep disturbances among caregivers of advanced age.
{"title":"Insomnia severity and daytime sleepiness in caregivers of advanced age","authors":"Lucy A. Webster, Talha Ali, Jody Sharninghausen, Alexandra M. Hajduk, Thomas Gill, Brienne Miner","doi":"10.3389/frsle.2024.1404684","DOIUrl":"https://doi.org/10.3389/frsle.2024.1404684","url":null,"abstract":"Aging-related changes and caregiver burden may increase the risk for sleep disturbances among older caregivers, yet few studies have examined the prevalence of insomnia and daytime sleepiness in this group. We examined the relationship of caregiver status with insomnia and daytime sleepiness among persons of advanced age (>75 years of age).Cross-sectional.Community.Yale Precipitating Events Project participants (n=383, mean age 84.4 years, 67% female, 12% African American, 25% caregivers).Caregivers were persons who reported caring for another person in the past week or caring for/helping a friend or relative >4 times in the past month. We examined the correlates of caregiver status, including demographic (age, sex, race/ethnicity, education, marital status), psychosocial (living alone, Medicaid eligibility, depressive symptoms, social support, hours volunteered), and physical (obesity, chronic conditions, medication use, self-rated health status, physical activity, functional disability, cognitive impairment) factors. We used the Insomnia Severity Index (ISI) to establish insomnia severity (ISI score 0–28) or clinically significant insomnia symptoms (ISI ≥8). We used the Epworth Sleepiness Scale to establish daytime sleepiness (ESS score 0–24) or hypersomnia (ESS ≥10). In nonparametric multivariable regression analyses, we examined the relationship of caregiver status with insomnia or daytime sleepiness.Compared to non-caregivers, caregivers were younger, more educated, less likely to be Medicaid eligible and had lower rates of depression, obesity, poor self-rated health, low physical activity, functional disability, and cognitive impairment. Mean ISI and ESS scores were in the normal range and similar among non-caregivers and caregivers (ISI scores of 6.9±5.6 and 6.9±5.4, and ESS scores of 6.4±4.7 and 6.1±4.3, in non-caregivers and caregivers, respectively). Multivariable-adjusted models demonstrated no significant differences in ISI and ESS scores between non-caregivers and caregivers (regression coefficients for ISI and ESS scores of −0.01 [95% CI = −1.58, 1.21] and −0.10 [−1.05, 1.21], respectively).When compared to older non-caregivers, older caregivers had more advantageous demographic, psychosocial, and physical profiles and had similar levels of insomnia and daytime sleepiness on standardized questionnaires. Future research is needed to elucidate contextual factors (e.g., caregiving intensity and care partner disease) that may increase the risk of sleep disturbances among caregivers of advanced age.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.3389/frsle.2024.1401023
L. Cromer, Sarah Beth Bell, Lauren E. Prince, Nicholas Hollman, Elissar El Sabbagh, Tara R. Buck
This study examined the efficacy of a five-module cognitive behavioral therapy for nightmares in children (CBT-NC) and improving sleep.Forty-six youth aged 6–17 years with sleep problems and at least weekly chronic and distressing nightmares were randomized to treatment (n = 23) or waiting list (n = 23) using a block four randomized design. Among participants, 65% (n = 30) were White, 4% (n = 2) were Black/African American, 2% (n = 1) were Asian American, 13% (n = 6) were Native American or Pacific Islander, and 15% (n = 7) were multiracial. Fifty percent of participants (n = 23) were cisgender girls, 35% were cisgender boys (n = 16), 7% were transgender boys (n = 3), and 9% were gender non-binary (n = 4). The baseline nightmare persistence ranged from 6 months to 13.5 years. The treatment adapted exposure, relaxation, and rescription therapy for trauma-related nightmares in adults and added elements of cognitive behavioral therapy for insomnia in children. Psychoeducation included topics of sleep and nightmares, relaxation, anxiety management, and sleep hygiene; the youth were guided through nightmare exposure and rescription.There was a statistically significant improvement in the number of nights with awakening (Cohen's d = 1.08), the number of weekly nightmares (Cohen's d = 0.82), and nightmare distress (Cohen's d = 1.05) for the treatment group compared to the wait-list group. Parent-reported youth sleep improved for the entire group from pretreatment to posttreatment (p < 0.001) but did not reach statistical significance for between-subjects analyses of the treatment group compared to the wait-list group (p = 0.05). Between-subjects analyses saw improvement for the treatment group compared to the wait-list group on internalizing and externalizing problems and suicidal thoughts and behaviors.This study supports the efficacy of CBT-NC for improving sleep maintenance, nightmare frequency and distress, and other mental health difficulties in youth. Preliminary evidence of possibly improving suicidal thinking and behavior is also presented.https://clinicaltrials.gov/study/NCT05588739, identifier: NCT05588739.
{"title":"Efficacy of a telehealth cognitive behavioral therapy for improving sleep and nightmares in children aged 6–17","authors":"L. Cromer, Sarah Beth Bell, Lauren E. Prince, Nicholas Hollman, Elissar El Sabbagh, Tara R. Buck","doi":"10.3389/frsle.2024.1401023","DOIUrl":"https://doi.org/10.3389/frsle.2024.1401023","url":null,"abstract":"This study examined the efficacy of a five-module cognitive behavioral therapy for nightmares in children (CBT-NC) and improving sleep.Forty-six youth aged 6–17 years with sleep problems and at least weekly chronic and distressing nightmares were randomized to treatment (n = 23) or waiting list (n = 23) using a block four randomized design. Among participants, 65% (n = 30) were White, 4% (n = 2) were Black/African American, 2% (n = 1) were Asian American, 13% (n = 6) were Native American or Pacific Islander, and 15% (n = 7) were multiracial. Fifty percent of participants (n = 23) were cisgender girls, 35% were cisgender boys (n = 16), 7% were transgender boys (n = 3), and 9% were gender non-binary (n = 4). The baseline nightmare persistence ranged from 6 months to 13.5 years. The treatment adapted exposure, relaxation, and rescription therapy for trauma-related nightmares in adults and added elements of cognitive behavioral therapy for insomnia in children. Psychoeducation included topics of sleep and nightmares, relaxation, anxiety management, and sleep hygiene; the youth were guided through nightmare exposure and rescription.There was a statistically significant improvement in the number of nights with awakening (Cohen's d = 1.08), the number of weekly nightmares (Cohen's d = 0.82), and nightmare distress (Cohen's d = 1.05) for the treatment group compared to the wait-list group. Parent-reported youth sleep improved for the entire group from pretreatment to posttreatment (p < 0.001) but did not reach statistical significance for between-subjects analyses of the treatment group compared to the wait-list group (p = 0.05). Between-subjects analyses saw improvement for the treatment group compared to the wait-list group on internalizing and externalizing problems and suicidal thoughts and behaviors.This study supports the efficacy of CBT-NC for improving sleep maintenance, nightmare frequency and distress, and other mental health difficulties in youth. Preliminary evidence of possibly improving suicidal thinking and behavior is also presented.https://clinicaltrials.gov/study/NCT05588739, identifier: NCT05588739.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.3389/frsle.2024.1380373
G. Mwenge, J. Bousata, Daniel Rodenstein
This retrospective study aimed to address acceptance and long-term adherence to Continuous Positive Airway Pressure (CPAP) treatment among non-responder patients to ImThera THN system who initially declined this therapy.We employed a structured outpatient approach to communicate THN study results, categorize initial CPAP nonadherence reasons, and encourage CPAP trials through tailored appointments. Recorded follow-ups addressed individual concerns, providing medical guidance and acknowledging person-specific challenges. Adherence data were collected using CPAP hour meters at predetermined intervals, following Belgium's social security stipulations.Between July 2014 and October 2016, eleven participants, including one woman, with prior CPAP experience (average 2 months) were enrolled. Initial non-adherence was linked to ENT or psychological factors. Ten patients agreed to CPAP trials, where interventions included changing CPAP brand, pressure adjustments, mask changes, and additional measures like cognitive-behavioral therapy and nasal spray. After 1 year, mean adherence was 6.3 ± 2 h/day, and average CPAP usage duration was 8.67 ± 2.13 years. As of November 2023, eight out of eleven patients were still actively using CPAPIn this investigation, we challenged the concept of CPAP non-adherence, highlighting evolving adherence and the significance of continuous monitoring and personalized interventions. Our findings underscore ongoing patient education, multidisciplinary support, and dynamic intervention adaptation for enhanced adherence in challenging patient populations. The results provide insights applicable to non-adherent patients with obstructive sleep apnea, emphasizing the importance of individualized care and sustained engagement for improved CPAP acceptance.
{"title":"Revitalizing CPAP adherence: lessons from THN study in patients with hypoglossal nerve stimulators","authors":"G. Mwenge, J. Bousata, Daniel Rodenstein","doi":"10.3389/frsle.2024.1380373","DOIUrl":"https://doi.org/10.3389/frsle.2024.1380373","url":null,"abstract":"This retrospective study aimed to address acceptance and long-term adherence to Continuous Positive Airway Pressure (CPAP) treatment among non-responder patients to ImThera THN system who initially declined this therapy.We employed a structured outpatient approach to communicate THN study results, categorize initial CPAP nonadherence reasons, and encourage CPAP trials through tailored appointments. Recorded follow-ups addressed individual concerns, providing medical guidance and acknowledging person-specific challenges. Adherence data were collected using CPAP hour meters at predetermined intervals, following Belgium's social security stipulations.Between July 2014 and October 2016, eleven participants, including one woman, with prior CPAP experience (average 2 months) were enrolled. Initial non-adherence was linked to ENT or psychological factors. Ten patients agreed to CPAP trials, where interventions included changing CPAP brand, pressure adjustments, mask changes, and additional measures like cognitive-behavioral therapy and nasal spray. After 1 year, mean adherence was 6.3 ± 2 h/day, and average CPAP usage duration was 8.67 ± 2.13 years. As of November 2023, eight out of eleven patients were still actively using CPAPIn this investigation, we challenged the concept of CPAP non-adherence, highlighting evolving adherence and the significance of continuous monitoring and personalized interventions. Our findings underscore ongoing patient education, multidisciplinary support, and dynamic intervention adaptation for enhanced adherence in challenging patient populations. The results provide insights applicable to non-adherent patients with obstructive sleep apnea, emphasizing the importance of individualized care and sustained engagement for improved CPAP acceptance.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.3389/frsle.2024.1322995
Toru Ishii, P. Taweesedt, Christina F. Chick, Ruth O'Hara, Makoto Kawai
Research on slow-wave sleep (SWS) began almost a century ago, not long after the discovery of electroencephalography. From maintaining homeostasis to memory function, the pivotal role of SWS in health has been established. The elucidation of its mechanisms and functions is directly related to the fundamental question of why people sleep. This comprehensive review first summarizes the basic science of SWS from anatomical and physiological aspects. It describes the fundamental mechanisms and functions of SWS, including hormonal regulation, developmental changes in SWS across the lifespan, and associations between SWS and optimal physical, psychological, and cognitive functions. Next, the relationship between SWS and physical and mental disorders, for which increasing knowledge has accumulated in recent years, is discussed from both research and clinical perspectives. Conditions such as memory impairment, sleep-disordered breathing, neurodevelopmental disorders, and various psychiatric disorders are of concern. The relationship between SWS and the glymphatic system, which is responsible for waste clearance in the brain, has also been explored, highlighting the potential neuroprotective role of SWS. Finally, we discuss the future direction of the field regarding whether interventions in SWS can improve health. We also address the problem of the inconsistent definitions of SWS, slow-wave activity, and slow oscillations. This review emphasizes the importance of discussing SWS from both macro- and microarchitectural perspectives and highlights its potential clinical and research impacts. By reviewing these aspects, we aim to contribute to a deeper understanding of SWS and the future development of this research field.
{"title":"From macro to micro: slow-wave sleep and its pivotal health implications","authors":"Toru Ishii, P. Taweesedt, Christina F. Chick, Ruth O'Hara, Makoto Kawai","doi":"10.3389/frsle.2024.1322995","DOIUrl":"https://doi.org/10.3389/frsle.2024.1322995","url":null,"abstract":"Research on slow-wave sleep (SWS) began almost a century ago, not long after the discovery of electroencephalography. From maintaining homeostasis to memory function, the pivotal role of SWS in health has been established. The elucidation of its mechanisms and functions is directly related to the fundamental question of why people sleep. This comprehensive review first summarizes the basic science of SWS from anatomical and physiological aspects. It describes the fundamental mechanisms and functions of SWS, including hormonal regulation, developmental changes in SWS across the lifespan, and associations between SWS and optimal physical, psychological, and cognitive functions. Next, the relationship between SWS and physical and mental disorders, for which increasing knowledge has accumulated in recent years, is discussed from both research and clinical perspectives. Conditions such as memory impairment, sleep-disordered breathing, neurodevelopmental disorders, and various psychiatric disorders are of concern. The relationship between SWS and the glymphatic system, which is responsible for waste clearance in the brain, has also been explored, highlighting the potential neuroprotective role of SWS. Finally, we discuss the future direction of the field regarding whether interventions in SWS can improve health. We also address the problem of the inconsistent definitions of SWS, slow-wave activity, and slow oscillations. This review emphasizes the importance of discussing SWS from both macro- and microarchitectural perspectives and highlights its potential clinical and research impacts. By reviewing these aspects, we aim to contribute to a deeper understanding of SWS and the future development of this research field.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-05DOI: 10.3389/frsle.2024.1410856
Rosemary Gibson, Hannah Lowe, Erina Korohina, Anna Rolleston
Sleep is vital for health in older adulthood. Ethnic disparities have been noted with regards to sleep health. However, culturally appropriate approaches to sleep as a broader social experience are lacking.Here, sleep-related group interviews were conducted in the form of hui (group meetings and discussions) with eleven participants of a health service intervention for older Māori (the Indigenous people of New Zealand) and their whānau (extended family). Notes were collated and analyzed thematically.Four key themes were constructed that represent the key conversations and ideas. These concerned the conceptualizing of sleep—including appreciation for its somatic role but also the spiritual properties of sleep states; the changing obligations around sleep and wake—including individual and communal time use and changing cultural and familial obligations with advancing age; and the barriers and facilitators for supporting sleep—including the social and spiritual nature of communal sleeping, the schedules and sleep of others, as well as holistic and environmental methods for relaxation. Findings demonstrate the multifaceted nature of sleep and aging among Māori. Culturally relevant interpretations of sleep practices and disturbances were offered and are beyond typical Western models which are predominantly medicalized.This work aids the understanding and representation of sleep as a social and cultural perspective within the New Zealand context. This provides foundations for future participatory research to design culturally appropriate approaches to assessing and supporting sleep health in forms that are meaningful for aging well across cultures.
{"title":"Māori perspectives on sleep and aging","authors":"Rosemary Gibson, Hannah Lowe, Erina Korohina, Anna Rolleston","doi":"10.3389/frsle.2024.1410856","DOIUrl":"https://doi.org/10.3389/frsle.2024.1410856","url":null,"abstract":"Sleep is vital for health in older adulthood. Ethnic disparities have been noted with regards to sleep health. However, culturally appropriate approaches to sleep as a broader social experience are lacking.Here, sleep-related group interviews were conducted in the form of hui (group meetings and discussions) with eleven participants of a health service intervention for older Māori (the Indigenous people of New Zealand) and their whānau (extended family). Notes were collated and analyzed thematically.Four key themes were constructed that represent the key conversations and ideas. These concerned the conceptualizing of sleep—including appreciation for its somatic role but also the spiritual properties of sleep states; the changing obligations around sleep and wake—including individual and communal time use and changing cultural and familial obligations with advancing age; and the barriers and facilitators for supporting sleep—including the social and spiritual nature of communal sleeping, the schedules and sleep of others, as well as holistic and environmental methods for relaxation. Findings demonstrate the multifaceted nature of sleep and aging among Māori. Culturally relevant interpretations of sleep practices and disturbances were offered and are beyond typical Western models which are predominantly medicalized.This work aids the understanding and representation of sleep as a social and cultural perspective within the New Zealand context. This provides foundations for future participatory research to design culturally appropriate approaches to assessing and supporting sleep health in forms that are meaningful for aging well across cultures.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.3389/frsle.2024.1349537
Julie A. Onton, Katherine C. Simon, Allison B. Morehouse, Alessandra E Shuster, Jing Zhang, Andres Pena, S. Mednick
Visual scoring of sleep electroencephalography (EEG) has long been considered the gold standard for sleep staging. However, it has several drawbacks, including high cost, time-intensiveness, vulnerability to human variability, discomfort to patients, lack of visualization to validate the hypnogram, and no acknowledgment of differences between delta and slow oscillation deep sleep. This report highlights a spectral scoring approach that addresses all these shortcomings of visual scoring. Past algorithms have used spectral information to help classify traditional visual stages. The current method used the clearly visible spectral patterns to develop new spectral stages, which are similar to but not the same as visual stages. Importantly, spectral scoring delivers both a hypnogram and a whole-night spectrogram, which can be visually inspected to ensure accurate scoring.This study compared traditional visual scoring of 32-channel polysomnography with forehead-only spectral scoring from an EEG patch worn concurrently. The PSG was visually scored by trained technicians and the forehead patch was scored spectrally. Because non-rapid eye movement (NREM) stage divisions in spectral scoring are not based on visual NREM stages, the agreements are not expected to be as high as other automated sleep scoring algorithms. Rather, they are a guide to understanding spectral stages as they relate to the more widely understood visual stages and to emphasize reasons for the differences.The results showed that visual REM was highly recognized as spectral REM (89%). Visual wake was only scored as spectral Wake 47% of the time, partly because of excessive visual scoring of wake during Light and REM sleep. The majority of spectral Light (predominance of spindle power) was scored as N2 (74%), while less N2 was scored as Light (65%), mostly because of incorrect visual staging of Lo Deep sleep due to high-pass filtering. N3 was scored as both Hi Deep (13 Hz power, 42%) and Lo Deep (0–1 Hz power, 39%), constituting a total of 81% of N3.The results show that spectral scoring better identifies clinically relevant physiology at a substantially lower cost and in a more reproducible fashion than visual scoring, supporting further work exploring its use in clinical and research settings.
{"title":"Validation of spectral sleep scoring with polysomnography using forehead EEG device","authors":"Julie A. Onton, Katherine C. Simon, Allison B. Morehouse, Alessandra E Shuster, Jing Zhang, Andres Pena, S. Mednick","doi":"10.3389/frsle.2024.1349537","DOIUrl":"https://doi.org/10.3389/frsle.2024.1349537","url":null,"abstract":"Visual scoring of sleep electroencephalography (EEG) has long been considered the gold standard for sleep staging. However, it has several drawbacks, including high cost, time-intensiveness, vulnerability to human variability, discomfort to patients, lack of visualization to validate the hypnogram, and no acknowledgment of differences between delta and slow oscillation deep sleep. This report highlights a spectral scoring approach that addresses all these shortcomings of visual scoring. Past algorithms have used spectral information to help classify traditional visual stages. The current method used the clearly visible spectral patterns to develop new spectral stages, which are similar to but not the same as visual stages. Importantly, spectral scoring delivers both a hypnogram and a whole-night spectrogram, which can be visually inspected to ensure accurate scoring.This study compared traditional visual scoring of 32-channel polysomnography with forehead-only spectral scoring from an EEG patch worn concurrently. The PSG was visually scored by trained technicians and the forehead patch was scored spectrally. Because non-rapid eye movement (NREM) stage divisions in spectral scoring are not based on visual NREM stages, the agreements are not expected to be as high as other automated sleep scoring algorithms. Rather, they are a guide to understanding spectral stages as they relate to the more widely understood visual stages and to emphasize reasons for the differences.The results showed that visual REM was highly recognized as spectral REM (89%). Visual wake was only scored as spectral Wake 47% of the time, partly because of excessive visual scoring of wake during Light and REM sleep. The majority of spectral Light (predominance of spindle power) was scored as N2 (74%), while less N2 was scored as Light (65%), mostly because of incorrect visual staging of Lo Deep sleep due to high-pass filtering. N3 was scored as both Hi Deep (13 Hz power, 42%) and Lo Deep (0–1 Hz power, 39%), constituting a total of 81% of N3.The results show that spectral scoring better identifies clinically relevant physiology at a substantially lower cost and in a more reproducible fashion than visual scoring, supporting further work exploring its use in clinical and research settings.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140990562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Insomnia (IS) and circadian rhythm sleep-wake disorders (CRSWD) are complex disorders with limited and unsatisfactory treatment options that can even cause some side effects. By analyzing blood metabolites to reveal underlying biological processes, studies of sleep and the complex interactions between its influencing factors can be elucidated. Therefore, we hope to bring new hope for the treatment of these diseases through blood metabolites.Investigating the causal link between blood metabolites and IS and CRSWD.A genome-wide association study (GWAS) for 486 metabolites was used as the exposure, whereas two different GWAS datasets for sleep disorders were the outcome, and all datasets were obtained from publicly available databases. We employed the standard inverse variance weighting (IVW) method for causal analysis, supported by the MR-Egger method, weighted median (WM) method, and MR-PRESSO method for sensitivity analysis to mitigate the impact of pleiotropy. Genetic correlation between IS, CRSWD, and blood metabolites was explored through linkage disequilibrium analysis (LDSC), while Multivariable MR analysis (MVMR) elucidated whether these metabolites exhibit a direct association with IS and CRSWD. Further, we conducted metabolic pathway analysis to identify the specific metabolites driving these relationships.Employing meticulous MVMR analysis, we have identified specific metabolites that independently influence IS, including 2-hydroxypalmitate (OR 2.95, 95%CI 1.05–8.31 P = 0.040), X-11786-Methylcysteine (OR = 0.25, 95%CI 0.08–0.76 P = 0.014), and salicylate (OR 0.89, 95%CI 0.83–0.95 P = 9 × 10–4). In the context of CRSWD, our findings reveal direct associations with metabolites such as carnitine (OR 0.02, 95%CI: 0.00–0.20, P = 0.002), levulinate (OR 0.06, 95%CI: 0.01–0.64, P = 0.020), p-cresol sulfate (OR 0.25, 95% CI: 0.09–0.67, P = 0.006), and X-14208-Phenylalanylserine (OR 0.36, 95% CI: 0.16–0.81, P = 0.014). These discoveries contribute to a nuanced understanding of the distinct metabolic signatures underlying IS and CRSWD.
失眠（IS）和昼夜节律睡眠-觉醒障碍（CRSWD）是一种复杂的疾病，其治疗方法有限且效果不理想，甚至会产生一些副作用。通过分析血液代谢物来揭示潜在的生物过程，可以阐明睡眠及其影响因素之间复杂的相互作用。研究血液代谢物与IS和CRSWD之间的因果关系，以486种代谢物的全基因组关联研究（GWAS）为暴露，以两种不同的睡眠障碍GWAS数据集为结果，所有数据集均来自公开数据库。我们采用标准的反方差加权（IVW）方法进行因果分析，并辅以MR-Egger方法、加权中位数（WM）方法和MR-PRESSO方法进行敏感性分析，以减轻多效性的影响。我们通过连锁不平衡分析（LDSC）探讨了IS、CRSWD和血液代谢物之间的遗传相关性，而多变量磁共振分析（MVMR）则阐明了这些代谢物是否与IS和CRSWD有直接关联。通过细致的 MVMR 分析，我们确定了独立影响 IS 的特定代谢物，包括 2-羟基棕榈酸酯（OR 2.95，95%CI 1.05-8.31 P = 0.040）、X-11786-甲基半胱氨酸（OR = 0.25，95%CI 0.08-0.76 P = 0.014）和水杨酸酯（OR 0.89，95%CI 0.83-0.95 P = 9 × 10-4）。在 CRSWD 的背景下，我们的研究结果显示与肉碱（OR 0.02，95%CI：0.00-0.20，P = 0.002）、左旋肉碱（OR 0.06，95%CI：0.01-0.64，P = 0.020）、对甲酚硫酸盐（OR 0.25，95%CI：0.09-0.67，P = 0.006）和 X-14208-Phenylalanylserine （OR 0.36，95%CI：0.16-0.81，P = 0.014）。这些发现有助于深入了解 IS 和 CRSWD 的不同代谢特征。
{"title":"Investigation of causal effects of blood metabolites on insomnia and circadian rhythm sleep wake disorders","authors":"Zheng Lv, Liyuan Huang, Yongfu Song, Yuejiao Lan, Shizhuo Sun, Yongji Wang, Yinan Ding, Xiaodan Lu","doi":"10.3389/frsle.2024.1333154","DOIUrl":"https://doi.org/10.3389/frsle.2024.1333154","url":null,"abstract":"Insomnia (IS) and circadian rhythm sleep-wake disorders (CRSWD) are complex disorders with limited and unsatisfactory treatment options that can even cause some side effects. By analyzing blood metabolites to reveal underlying biological processes, studies of sleep and the complex interactions between its influencing factors can be elucidated. Therefore, we hope to bring new hope for the treatment of these diseases through blood metabolites.Investigating the causal link between blood metabolites and IS and CRSWD.A genome-wide association study (GWAS) for 486 metabolites was used as the exposure, whereas two different GWAS datasets for sleep disorders were the outcome, and all datasets were obtained from publicly available databases. We employed the standard inverse variance weighting (IVW) method for causal analysis, supported by the MR-Egger method, weighted median (WM) method, and MR-PRESSO method for sensitivity analysis to mitigate the impact of pleiotropy. Genetic correlation between IS, CRSWD, and blood metabolites was explored through linkage disequilibrium analysis (LDSC), while Multivariable MR analysis (MVMR) elucidated whether these metabolites exhibit a direct association with IS and CRSWD. Further, we conducted metabolic pathway analysis to identify the specific metabolites driving these relationships.Employing meticulous MVMR analysis, we have identified specific metabolites that independently influence IS, including 2-hydroxypalmitate (OR 2.95, 95%CI 1.05–8.31 P = 0.040), X-11786-Methylcysteine (OR = 0.25, 95%CI 0.08–0.76 P = 0.014), and salicylate (OR 0.89, 95%CI 0.83–0.95 P = 9 × 10–4). In the context of CRSWD, our findings reveal direct associations with metabolites such as carnitine (OR 0.02, 95%CI: 0.00–0.20, P = 0.002), levulinate (OR 0.06, 95%CI: 0.01–0.64, P = 0.020), p-cresol sulfate (OR 0.25, 95% CI: 0.09–0.67, P = 0.006), and X-14208-Phenylalanylserine (OR 0.36, 95% CI: 0.16–0.81, P = 0.014). These discoveries contribute to a nuanced understanding of the distinct metabolic signatures underlying IS and CRSWD.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.3389/frsle.2024.1346806
S. Bauducco, Katja Boersma, Michael Gradisar
During adolescence, peers gain a central role and with the availability of technology, socializing can occur around the clock. Very few studies have focused on the role of peers in adolescents' sleep using social network analyses. These analyses describe peer relationships and social positions in a defined context (e.g., school) based on friendship nominations. Adolescents who receive many nominations can be defined as “popular,” which has been found to have its costs (i.e., shorter sleep duration) but also benefits (i.e., fewer insomnia symptoms). The aim of this study was to partially replicate and expand previous findings in a large Swedish sample of adolescents.The sample included 1,394 adolescents (46% girls, Mage = 15.3, SD = 0.53, range 14–18) from 16 public schools in middle Sweden. Adolescents reported on their weekly sleep duration, insomnia symptoms, anxiety, depression, alcohol use, demographics, and nominated up to three friends in school. We used R to calculate outgoing nominations and incoming nominations. Linear regressions were used to examine the association between popularity and sleep, controlling for confounding variables (demographics, emotional problems). Finally, we explored sex differences.Controlling for confounders, popular adolescents reported shorter sleep duration (B = −3.00; 95% CI [−5.77, −0.19]), and popular girls reported more insomnia symptoms (B = 0.36; 95% CI [0.04, 0.68]). There were no significant associations found for boys.Popularity was linked to shorter sleep duration (up to −27 min for the most popular teens). Moreover, girls may pay a price for their popularity by experiencing more insomnia symptoms. Sex differences and potential mechanisms should be further explored.
在青春期，同龄人扮演着重要的角色，而且随着科技的发展，社交活动可以全天候进行。很少有研究通过社交网络分析来关注同伴在青少年睡眠中的作用。这些分析是根据友谊提名来描述特定环境（如学校）中的同伴关系和社会地位。获得许多提名的青少年可被定义为 "受欢迎的人"，研究发现这有其代价（即睡眠时间缩短），但也有好处（即失眠症状较少）。本研究的目的是在瑞典青少年的大样本中部分复制和扩展之前的研究结果。样本包括来自瑞典中部 16 所公立学校的 1394 名青少年（46% 为女生，平均年龄 = 15.3，标准差 = 0.53，范围为 14-18 岁）。青少年报告了他们每周的睡眠时间、失眠症状、焦虑、抑郁、酗酒、人口统计学特征，并提名了最多三位在校好友。我们使用 R 来计算出提名和入选提名。在控制混杂变量（人口统计学、情绪问题）的情况下，我们使用线性回归分析了受欢迎程度与睡眠之间的关系。最后，我们探讨了性别差异。在控制了混杂变量后，受欢迎的青少年报告的睡眠时间较短（B = -3.00；95% CI [-5.77, -0.19]），而受欢迎的女孩报告的失眠症状较多（B = 0.36；95% CI [0.04, 0.68]）。受欢迎程度与睡眠时间缩短有关（最受欢迎的青少年睡眠时间最短为-27分钟）。此外，女孩可能会为其受欢迎程度付出代价，出现更多失眠症状。性别差异和潜在机制有待进一步研究。
{"title":"Sleepy and popular? The association between popularity, sleep duration, and insomnia in adolescents","authors":"S. Bauducco, Katja Boersma, Michael Gradisar","doi":"10.3389/frsle.2024.1346806","DOIUrl":"https://doi.org/10.3389/frsle.2024.1346806","url":null,"abstract":"During adolescence, peers gain a central role and with the availability of technology, socializing can occur around the clock. Very few studies have focused on the role of peers in adolescents' sleep using social network analyses. These analyses describe peer relationships and social positions in a defined context (e.g., school) based on friendship nominations. Adolescents who receive many nominations can be defined as “popular,” which has been found to have its costs (i.e., shorter sleep duration) but also benefits (i.e., fewer insomnia symptoms). The aim of this study was to partially replicate and expand previous findings in a large Swedish sample of adolescents.The sample included 1,394 adolescents (46% girls, Mage = 15.3, SD = 0.53, range 14–18) from 16 public schools in middle Sweden. Adolescents reported on their weekly sleep duration, insomnia symptoms, anxiety, depression, alcohol use, demographics, and nominated up to three friends in school. We used R to calculate outgoing nominations and incoming nominations. Linear regressions were used to examine the association between popularity and sleep, controlling for confounding variables (demographics, emotional problems). Finally, we explored sex differences.Controlling for confounders, popular adolescents reported shorter sleep duration (B = −3.00; 95% CI [−5.77, −0.19]), and popular girls reported more insomnia symptoms (B = 0.36; 95% CI [0.04, 0.68]). There were no significant associations found for boys.Popularity was linked to shorter sleep duration (up to −27 min for the most popular teens). Moreover, girls may pay a price for their popularity by experiencing more insomnia symptoms. Sex differences and potential mechanisms should be further explored.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-11DOI: 10.3389/frsle.2024.1323967
Li Jun, Li Xiong, Yu Wen, Yongxiang Wang
Insomnia affects the quality of life of a significant number of individuals worldwide. Despite the fact that pharmaceutical sleep treatments have shown brief enhancements in sleep quality, these are still not recommended for the long-term management of sleep issues. To deal with this problem, our study aims to assess the effectiveness of auricular acupressure for treating insomnia by conducting a systematic review and meta-analysis.Data from randomized controlled trials (RCTs) of auricular acupressure for insomnia was collected from five English-language databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, and CINAHL) and four Chinese databases (CBM, CNKI, CQVIP, and Wanfang). Relevant data were extracted by two reviewers. I2 statistics were adopted to appraise heterogeneity. A network meta-analysis was applied to compare the effect of auricular acupressure with other methods.In all, 23 RCTs involving a total of 1,689 patients were included. The results demonstrated a significant decrease in the Pittsburgh Sleep Quality Index (PSQI) score for the intervention group compared to the control group [SMD = −1.30, 95% CI (−1.65, −0.96), I2 = 90%]. Furthermore, the group receiving auricular acupressure in addition to usual care showed a lower PSQI score compared to the usual care group [SMD = −1.13, 95% CI (−1.33, −0.93), I2 = 23%]. Auricular acupressure was found to enhance the effectiveness of estazolam in improving PSQI score, with the combination of auricular acupressure and estazolam resulting in a lower PSQI score [MD = −4.8, 95% CI (−7.4, −2.1)]. Importantly, no serious adverse events were reported. In patients with insomnia following stroke, the intervention group (which received auricular acupressure) exhibited a lower PSQI score compared to the control group [SMD = −0.74, 95% CI (−1.03, −0.46), I2 = 0%]. Similarly, in patients with insomnia related to cancer, the intervention group (receiving auricular acupressure) demonstrated a lower PSQI score compared to the control group [SMD = −0.99, 95% CI (−1.37, −0.61), I2 = 0%].The effects of auricular acupressure on insomnia are comparable to those of estazolam. Furthermore, auricular acupressure can serve as a complementary treatment to estazolam or other interventions, effectively improving symptoms of insomnia.
失眠影响着全球许多人的生活质量。尽管药物睡眠治疗能短暂提高睡眠质量，但仍不建议用于长期治疗睡眠问题。针对这一问题，我们的研究旨在通过系统综述和荟萃分析来评估耳穴按摩治疗失眠症的有效性。耳穴按摩治疗失眠症的随机对照试验（RCT）数据来自五个英文数据库（Cochrane Central Register of Controlled Trials、MEDLINE、EMBASE、AMED 和 CINAHL）和四个中文数据库（CBM、CNKI、CQVIP 和 Wanfang）。相关数据由两名审稿人提取。采用 I2 统计法评估异质性。采用网络荟萃分析比较耳穴贴敷与其他方法的效果。共纳入 23 项研究，涉及 1,689 名患者。结果显示，与对照组相比，干预组的匹兹堡睡眠质量指数（PSQI）得分明显下降[SMD = -1.30, 95% CI (-1.65, -0.96)，I2 = 90%]。此外，与常规护理组相比，在常规护理基础上接受耳穴穴位按摩的干预组的 PSQI 分数更低[SMD = -1.13, 95% CI (-1.33, -0.93)，I2 = 23%]。研究发现，耳穴穴位按摩可增强艾司唑仑改善 PSQI 评分的效果，耳穴穴位按摩和艾司唑仑联合使用可降低 PSQI 评分[MD = -4.8，95% CI (-7.4, -2.1)]。重要的是，没有严重不良事件的报告。在中风后失眠患者中，干预组（接受耳穴穴位按摩）的 PSQI 得分低于对照组 [SMD = -0.74，95% CI (-1.03, -0.46)，I2 = 0%]。同样，在癌症相关失眠患者中，与对照组相比，干预组（接受耳穴穴位按摩）的 PSQI 得分较低 [SMD = -0.99，95% CI (-1.37，-0.61)，I2 = 0%]。此外，耳穴按摩可作为艾司唑仑或其他干预措施的辅助治疗，有效改善失眠症状。
{"title":"Effectiveness of applying auricular acupressure to treat insomnia: a systematic review and meta-analysis","authors":"Li Jun, Li Xiong, Yu Wen, Yongxiang Wang","doi":"10.3389/frsle.2024.1323967","DOIUrl":"https://doi.org/10.3389/frsle.2024.1323967","url":null,"abstract":"Insomnia affects the quality of life of a significant number of individuals worldwide. Despite the fact that pharmaceutical sleep treatments have shown brief enhancements in sleep quality, these are still not recommended for the long-term management of sleep issues. To deal with this problem, our study aims to assess the effectiveness of auricular acupressure for treating insomnia by conducting a systematic review and meta-analysis.Data from randomized controlled trials (RCTs) of auricular acupressure for insomnia was collected from five English-language databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, and CINAHL) and four Chinese databases (CBM, CNKI, CQVIP, and Wanfang). Relevant data were extracted by two reviewers. I2 statistics were adopted to appraise heterogeneity. A network meta-analysis was applied to compare the effect of auricular acupressure with other methods.In all, 23 RCTs involving a total of 1,689 patients were included. The results demonstrated a significant decrease in the Pittsburgh Sleep Quality Index (PSQI) score for the intervention group compared to the control group [SMD = −1.30, 95% CI (−1.65, −0.96), I2 = 90%]. Furthermore, the group receiving auricular acupressure in addition to usual care showed a lower PSQI score compared to the usual care group [SMD = −1.13, 95% CI (−1.33, −0.93), I2 = 23%]. Auricular acupressure was found to enhance the effectiveness of estazolam in improving PSQI score, with the combination of auricular acupressure and estazolam resulting in a lower PSQI score [MD = −4.8, 95% CI (−7.4, −2.1)]. Importantly, no serious adverse events were reported. In patients with insomnia following stroke, the intervention group (which received auricular acupressure) exhibited a lower PSQI score compared to the control group [SMD = −0.74, 95% CI (−1.03, −0.46), I2 = 0%]. Similarly, in patients with insomnia related to cancer, the intervention group (receiving auricular acupressure) demonstrated a lower PSQI score compared to the control group [SMD = −0.99, 95% CI (−1.37, −0.61), I2 = 0%].The effects of auricular acupressure on insomnia are comparable to those of estazolam. Furthermore, auricular acupressure can serve as a complementary treatment to estazolam or other interventions, effectively improving symptoms of insomnia.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140714015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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