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":"23 20","pages":""},"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 : 2024-08-07eCollection Date: 2024-01-01DOI: 10.3389/frsle.2024.1420245
Cassandra M Godzik, Delaina D Carlson, Oleksandra I Pashchenko, Grace A Ballarino, Jennifer A Emond
Objective: We leveraged an observational, repeated-measures study to examine the within-child associations between sleep quality and emotional self-regulation, controlling for between-child effects.
Methods: Children aged 3-5 years and one parent each were recruited from the community in northern New England between 2019 and 2022. Parents completed online surveys at baseline and 2, 4, and 6 months post-baseline. Child sleep quality was measured with the validated Children's Sleep Habits Questionnaire modified for preschoolers; higher scores indicate worse sleep quality (range 32-96). Child emotional self-regulation was measured with the validated Child Social Behavior Questionnaire; higher scores indicate better emotional self-regulation (range 1-7). Adjusted mixed-effects linear regression was used to model the associations between nighttime sleep quality (exposure) and emotional self-regulation (outcome) measured at each of the four study time points while disaggregating the between- and within-child effects.
Results: Children (n = 91) were largely white, non-Hispanic (88.7%), and from a higher social-economic status. Sleep quality scores averaged 38.9 (SD: 6.6) at baseline; 23.1% of children had scores >41, which is considered evidence of significant sleep problems. Emotional self-regulation scores averaged 4.2 (SD: 1.0). There was a significant within-child association between sleep quality and emotional self-regulation. Specifically, a decrease in sleep quality at any one time point, relative to each child's mean sleep quality, related to worse emotional self-regulation [standardized beta, βs = -0.31; 95% CI (0.53, -0.09)]; the between-child effect was not significant. Results were consistent when limited to children with complete data at all study visits (n = 78).
Conclusions: The findings support a causal, within-child association between sleep quality and emotional self-regulation in preschool-aged children, with effects evident over 6 months.
{"title":"Within-child associations between sleep quality and emotional self-regulation over 6 months among preschool-aged (3- to 5-year-old) children.","authors":"Cassandra M Godzik, Delaina D Carlson, Oleksandra I Pashchenko, Grace A Ballarino, Jennifer A Emond","doi":"10.3389/frsle.2024.1420245","DOIUrl":"10.3389/frsle.2024.1420245","url":null,"abstract":"<p><strong>Objective: </strong>We leveraged an observational, repeated-measures study to examine the within-child associations between sleep quality and emotional self-regulation, controlling for between-child effects.</p><p><strong>Methods: </strong>Children aged 3-5 years and one parent each were recruited from the community in northern New England between 2019 and 2022. Parents completed online surveys at baseline and 2, 4, and 6 months post-baseline. Child sleep quality was measured with the validated Children's Sleep Habits Questionnaire modified for preschoolers; higher scores indicate worse sleep quality (range 32-96). Child emotional self-regulation was measured with the validated Child Social Behavior Questionnaire; higher scores indicate better emotional self-regulation (range 1-7). Adjusted mixed-effects linear regression was used to model the associations between nighttime sleep quality (exposure) and emotional self-regulation (outcome) measured at each of the four study time points while disaggregating the between- and within-child effects.</p><p><strong>Results: </strong>Children (<i>n</i> = 91) were largely white, non-Hispanic (88.7%), and from a higher social-economic status. Sleep quality scores averaged 38.9 (<i>SD</i>: 6.6) at baseline; 23.1% of children had scores >41, which is considered evidence of significant sleep problems. Emotional self-regulation scores averaged 4.2 (<i>SD</i>: 1.0). There was a significant within-child association between sleep quality and emotional self-regulation. Specifically, a decrease in sleep quality at any one time point, relative to each child's mean sleep quality, related to worse emotional self-regulation [standardized beta, βs = -0.31; 95% CI (0.53, -0.09)]; the between-child effect was not significant. Results were consistent when limited to children with complete data at all study visits (<i>n</i> = 78).</p><p><strong>Conclusions: </strong>The findings support a causal, within-child association between sleep quality and emotional self-regulation in preschool-aged children, with effects evident over 6 months.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"3 ","pages":"1420245"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01eCollection Date: 2024-01-01DOI: 10.3389/frsle.2024.1230958
Hugi Hilmisson, Robert Joseph Thomas, Solveig Magnusdottir
Introduction: High blood pressure (HBP) is an independent, modifiable driver of cardiovascular (CV) morbidity and mortality. Nocturnal hypertension and non-dipping of blood pressure (NdBP) may be early markers of HBP. Similar to patients with NdBP, individuals with non-dipping of heart rate (NdHR) during sleep have an increased risk of CV disease, CV events, and CV-related mortality. The aim of this analysis was to evaluate if cardiopulmonary coupling (CPC) analysis-derived sleep states [stable/unstable non-rapid eye movement (NREM) sleep] and concomitant heart rate (HR) changes can provide information about nocturnal blood pressure (BP).
Method: Plethysmogram (pleth) signals from the HeartBEAT study (NCT01086800) were analyzed for CPC sleep states. Included in the analysis are sleep recordings from participants with acceptable pleth-signal quality at baseline (n = 302) and follow-up (n = 267), all having confirmed CV disease or CV-disease risk factors. The participants had a high prevalence of obstructive sleep apnea (OSA), 98.4% with moderate-OSA [apnea-hypopnea index (AHI) ≥ 15) and 29.6% severe OSA (AHI ≥ 30). A "heart-rate module" was created to evaluate the utility of identifying patients more likely to have BP dipping during sleep. Patients who did not have a decrease of ≥10% in their BP from wake to sleep were defined as NdBP and NdHR if their heart rate during stable-NREM sleep was higher than during unstable-NREM sleep.
Results: The most significant difference in minimum HR (HRmin) was observed when comparing BP dippers [56 ± 4 beats per minute (BPM)] and non-BP dippers (59 ± 4 BPM; p < 0.0001) during diastolic blood pressure in stable-NREM sleep. Higher HRmin were associated with an increased likelihood of being a non-dipper, with the strongest relationship with diastolic BP and stable-NREM sleep. Every increase of 1 BPM during stable-NREM sleep was associated with an ~4.4% increase in the probability of NdBP (p = 0.001). Subjects with NdHR have higher mean BP during sleep and wake periods than HR dippers. When continuous positive airway pressure therapy is efficacious, and a dipping pattern is achieved-physical and mental health is improved.
Conclusion: HR analytics in relation to the sleep period and the CPC spectrogram-estimated sleep states can provide novel and potentially clinically useful information on autonomic health. HR dipping (or not) may be a useful screener of BP dipping or non-dipping to identify individuals who may benefit from a formal assessment of 24-h ambulatory BP. Such a stepped approach may enable a more practical and applicable approach to diagnosing HBP.
Clinical trial registration: The Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) study is registered at clinicaltrials.gov/ct2/show/NCT01086800.
{"title":"Cardiopulmonary coupling-calculated sleep stability and nocturnal heart rate kinetics as a potential indicator for cardiovascular health: a relationship with blood pressure dipping.","authors":"Hugi Hilmisson, Robert Joseph Thomas, Solveig Magnusdottir","doi":"10.3389/frsle.2024.1230958","DOIUrl":"10.3389/frsle.2024.1230958","url":null,"abstract":"<p><strong>Introduction: </strong>High blood pressure (HBP) is an independent, modifiable driver of cardiovascular (CV) morbidity and mortality. Nocturnal hypertension and non-dipping of blood pressure (NdBP) may be early markers of HBP. Similar to patients with NdBP, individuals with non-dipping of heart rate (NdHR) during sleep have an increased risk of CV disease, CV events, and CV-related mortality. The aim of this analysis was to evaluate if cardiopulmonary coupling (CPC) analysis-derived sleep states [stable/unstable non-rapid eye movement (NREM) sleep] and concomitant heart rate (HR) changes can provide information about nocturnal blood pressure (BP).</p><p><strong>Method: </strong>Plethysmogram (pleth) signals from the HeartBEAT study (NCT01086800) were analyzed for CPC sleep states. Included in the analysis are sleep recordings from participants with acceptable pleth-signal quality at baseline (<i>n</i> = 302) and follow-up (<i>n</i> = 267), all having confirmed CV disease or CV-disease risk factors. The participants had a high prevalence of obstructive sleep apnea (OSA), 98.4% with moderate-OSA [apnea-hypopnea index (AHI) ≥ 15) and 29.6% severe OSA (AHI ≥ 30). A \"heart-rate module\" was created to evaluate the utility of identifying patients more likely to have BP dipping during sleep. Patients who did not have a decrease of ≥10% in their BP from wake to sleep were defined as NdBP and NdHR if their heart rate during stable-NREM sleep was higher than during unstable-NREM sleep.</p><p><strong>Results: </strong>The most significant difference in minimum HR (HR<sub>min</sub>) was observed when comparing BP dippers [56 ± 4 beats per minute (BPM)] and non-BP dippers (59 ± 4 BPM; <i>p</i> < 0.0001) during diastolic blood pressure in stable-NREM sleep. Higher HR<sub>min</sub> were associated with an increased likelihood of being a non-dipper, with the strongest relationship with diastolic BP and stable-NREM sleep. Every increase of 1 BPM during stable-NREM sleep was associated with an ~4.4% increase in the probability of NdBP (<i>p</i> = 0.001). Subjects with NdHR have higher mean BP during sleep and wake periods than HR dippers. When continuous positive airway pressure therapy is efficacious, and a dipping pattern is achieved-physical and mental health is improved.</p><p><strong>Conclusion: </strong>HR analytics in relation to the sleep period and the CPC spectrogram-estimated sleep states can provide novel and potentially clinically useful information on autonomic health. HR dipping (or not) may be a useful screener of BP dipping or non-dipping to identify individuals who may benefit from a formal assessment of 24-h ambulatory BP. Such a stepped approach may enable a more practical and applicable approach to diagnosing HBP.</p><p><strong>Clinical trial registration: </strong>The Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) study is registered at clinicaltrials.gov/ct2/show/NCT01086800.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"3 ","pages":"1230958"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-29eCollection Date: 2024-01-01DOI: 10.3389/frsle.2024.1452220
Scott Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, Joel L Prowting, Layth Tumah, Abed A Najjar, Hamza Khan, Muna Sankari, Oluwatobi Lasisi, Laurel A Ravelo, Paul E Peppard, M Safwan Badr, Abdulghani Sankari
[This corrects the article DOI: 10.3389/frsle.2023.1162652.].
[这更正了文章DOI: 10.3389/frsle.2023.1162652.]。
{"title":"Corrigendum: Role of automated detection of respiratory related heart rate changes in the diagnosis of sleep disordered breathing.","authors":"Scott Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, Joel L Prowting, Layth Tumah, Abed A Najjar, Hamza Khan, Muna Sankari, Oluwatobi Lasisi, Laurel A Ravelo, Paul E Peppard, M Safwan Badr, Abdulghani Sankari","doi":"10.3389/frsle.2024.1452220","DOIUrl":"https://doi.org/10.3389/frsle.2024.1452220","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frsle.2023.1162652.].</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"3 ","pages":"1452220"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"13 8","pages":""},"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":"120 27","pages":""},"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":" 40","pages":""},"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":"32 11‐12","pages":""},"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}
Insomnia is the most commonly reported sleep disorder among children and adolescents, impacting their cognitive, emotional, behavioral, and physical development. The prevalence of insomnia generally increases with age, often persisting into adulthood if unaddressed. Insomnia is exceedingly common among those with developmental disabilities and is frequently comorbid with a great range of psychiatric diagnoses. The COVID-19 pandemic has only increased the prevalence of insomnia among children and adolescents. Health care providers are routinely called upon to treat insomnia in the pediatric population. Psychoeducation and behavioral interventions, especially cognitive behavioral therapy for insomnia (CBT-I), remain the first line treatments, given empirical evidence for their efficacy and success in relapse prevention. However, medications are frequently employed in clinical practice, despite the fact that no medications are approved by the Food and Drug Administration (FDA) for the treatment of pediatric insomnia. This review was designed to educate and support practitioners who are treating children and adolescents who struggle with insomnia. A thorough narrative review was completed to identify all published medication studies of pediatric insomnia; the identified studies are described and then graded into four categories according to the strength of the evidence supporting their use, side effect profiles, co-morbidities, and overall risk vs. benefit of each pharmacological treatment. This review will help practitioners in making clinical decisions for their pediatric patients who suffer with insomnia.
{"title":"Pharmacological management of pediatric insomnia.","authors":"Sakshi Dhir, Nicolette Karim, Haley Berka, Jess Shatkin","doi":"10.3389/frsle.2024.1389052","DOIUrl":"10.3389/frsle.2024.1389052","url":null,"abstract":"<p><p>Insomnia is the most commonly reported sleep disorder among children and adolescents, impacting their cognitive, emotional, behavioral, and physical development. The prevalence of insomnia generally increases with age, often persisting into adulthood if unaddressed. Insomnia is exceedingly common among those with developmental disabilities and is frequently comorbid with a great range of psychiatric diagnoses. The COVID-19 pandemic has only increased the prevalence of insomnia among children and adolescents. Health care providers are routinely called upon to treat insomnia in the pediatric population. Psychoeducation and behavioral interventions, especially cognitive behavioral therapy for insomnia (CBT-I), remain the first line treatments, given empirical evidence for their efficacy and success in relapse prevention. However, medications are frequently employed in clinical practice, despite the fact that no medications are approved by the Food and Drug Administration (FDA) for the treatment of pediatric insomnia. This review was designed to educate and support practitioners who are treating children and adolescents who struggle with insomnia. A thorough narrative review was completed to identify all published medication studies of pediatric insomnia; the identified studies are described and then graded into four categories according to the strength of the evidence supporting their use, side effect profiles, co-morbidities, and overall risk vs. benefit of each pharmacological treatment. This review will help practitioners in making clinical decisions for their pediatric patients who suffer with insomnia.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"3 ","pages":"1389052"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"53 6","pages":""},"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}
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