Pub Date : 2024-03-06DOI: 10.3389/frsle.2024.1272726
Preetam Schramm, Emet Schneiderman, Jason Hui, Zohre German, William Stenberg, Ju Ying Lin
Obstructive sleep apnea (OSA) is a multisystem physiological disorder of breathing during sleep that may contribute to systemic physiological imbalances and can also be exacerbated by the use of some commonly prescribed medications.In a randomized parallel design trial, we included phenotypic mild to severe OSA mouth-breathing subjects (n = 36) confirmed by home polygraphy, to evaluate the efficacy of oral appliance plus mouth shield and oral appliance only during sleep on night 1 (T1) after 4 weeks (T2), and after 8 weeks (T3) of oral appliance therapy. Respiratory dynamics data were collected. Primary outcomes were respiratory event index and mouth breathing. Anamnesis on medication intake was collected at enrollment.The respiratory event index and the hypopnea index did not statistically differ between groups at T3. Oral appliance plus mouth shield and oral appliance only significantly reduced mouth breathing at T2 (p = 0.012) and T3 (p ≤ 0.001) compared with baseline. Exploratory analyses showed oral appliance plus mouth shield supine respiratory rate at T3 (p = 0.039) was marginally decreased compared with oral appliance only. The snore percentage did not differ statistically between groups at T3. Oral appliance only showed a marginal oxygen saturation increase (p = 0.019) at T3 compared with oral appliance plus mouth shield. At T3, medication users had persistent respiratory events, mouth breathing, and snoring compared with non-medication users. Logistic regression showed medication use may increase the odds of mouth breathing (OR = 1.148; p = 0.015) and snoring (OR = 1.036; p = 0.049).In our OSA-mouth breathing cohort, oral appliance only was similar to oral appliance plus mouth shield in attenuating the respiratory event index, hypopnea index, and mouth breathing after 8 weeks. Oral appliance only increased oxygen saturation at T3, while oral appliance plus mouth shield maintained a relatively narrow oxygen saturation range from T1–3. Oral appliance plus mouth shield marginally lowered the supine respiratory rate at T3 compared with oral appliance only. Persistent respiratory events, mouth breathing, and snoring were observed in medication users at T3.
阻塞性睡眠呼吸暂停（OSA）是一种多系统的睡眠呼吸生理紊乱，可能导致全身生理失衡，也可能因服用某些常用处方药而加重。在一项随机平行设计试验中，我们纳入了经家庭测谎仪确认的表型为轻度至重度 OSA 的口呼吸受试者（n = 36），以评估在口腔矫治器治疗 4 周后（T2）和 8 周后（T3）的第 1 天晚上（T1）和第 8 天晚上（T3）睡眠时使用口腔矫治器加护口罩和仅使用口腔矫治器的疗效。收集了呼吸动力学数据。主要结果是呼吸事件指数和口呼吸。在 T3 阶段，各组的呼吸事件指数和低通气指数没有统计学差异。与基线相比，口腔矫治器加护口罩组和仅口腔矫治器组在 T2（p = 0.012）和 T3（p ≤ 0.001）时明显减少了口呼吸。探索性分析显示，与仅使用口腔矫治器相比，T3（p = 0.039）时口腔矫治器加护口罩的仰卧呼吸率略有下降。在 T3 阶段，各组的打鼾比例没有统计学差异。与口腔矫治器加口罩组相比，仅使用口腔矫治器组在 T3 阶段的血氧饱和度略有增加（p = 0.019）。在 T3 阶段，与不使用药物的患者相比，使用药物的患者有持续的呼吸事件、口呼吸和打鼾。逻辑回归显示，使用药物可能会增加口呼吸（OR = 1.148; p = 0.015）和打鼾（OR = 1.036; p = 0.049）的几率。在我们的 OSA 口呼吸队列中，仅口腔矫治器与口腔矫治器加口罩在 8 周后减轻呼吸事件指数、低通气指数和口呼吸方面的效果相似。口腔矫治器仅在 T3 阶段提高了血氧饱和度，而口腔矫治器加护口罩则在 T1-3 阶段保持了相对较窄的血氧饱和度范围。与仅使用口腔矫治器相比，口腔矫治器加嘴罩在 T3 阶段略微降低了仰卧呼吸频率。在 T3 阶段，用药者出现了持续呼吸事件、口呼吸和打鼾。
{"title":"Obstructive sleep apnea mouth breathing phenotype response to combination oral appliance therapy","authors":"Preetam Schramm, Emet Schneiderman, Jason Hui, Zohre German, William Stenberg, Ju Ying Lin","doi":"10.3389/frsle.2024.1272726","DOIUrl":"https://doi.org/10.3389/frsle.2024.1272726","url":null,"abstract":"Obstructive sleep apnea (OSA) is a multisystem physiological disorder of breathing during sleep that may contribute to systemic physiological imbalances and can also be exacerbated by the use of some commonly prescribed medications.In a randomized parallel design trial, we included phenotypic mild to severe OSA mouth-breathing subjects (n = 36) confirmed by home polygraphy, to evaluate the efficacy of oral appliance plus mouth shield and oral appliance only during sleep on night 1 (T1) after 4 weeks (T2), and after 8 weeks (T3) of oral appliance therapy. Respiratory dynamics data were collected. Primary outcomes were respiratory event index and mouth breathing. Anamnesis on medication intake was collected at enrollment.The respiratory event index and the hypopnea index did not statistically differ between groups at T3. Oral appliance plus mouth shield and oral appliance only significantly reduced mouth breathing at T2 (p = 0.012) and T3 (p ≤ 0.001) compared with baseline. Exploratory analyses showed oral appliance plus mouth shield supine respiratory rate at T3 (p = 0.039) was marginally decreased compared with oral appliance only. The snore percentage did not differ statistically between groups at T3. Oral appliance only showed a marginal oxygen saturation increase (p = 0.019) at T3 compared with oral appliance plus mouth shield. At T3, medication users had persistent respiratory events, mouth breathing, and snoring compared with non-medication users. Logistic regression showed medication use may increase the odds of mouth breathing (OR = 1.148; p = 0.015) and snoring (OR = 1.036; p = 0.049).In our OSA-mouth breathing cohort, oral appliance only was similar to oral appliance plus mouth shield in attenuating the respiratory event index, hypopnea index, and mouth breathing after 8 weeks. Oral appliance only increased oxygen saturation at T3, while oral appliance plus mouth shield maintained a relatively narrow oxygen saturation range from T1–3. Oral appliance plus mouth shield marginally lowered the supine respiratory rate at T3 compared with oral appliance only. Persistent respiratory events, mouth breathing, and snoring were observed in medication users at T3.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262257","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 : 2024-03-05DOI: 10.3389/frsle.2024.1329774
Laura Miller, Mya Dockrill, Penny V Corkum, Sara F. L. Kirk, Michelle Stone
Research has demonstrated various negative effects of poor sleep on overall health in children. Engaging in physical activity during the day is often recommended to help children sleep better. Limited research has examined this recommendation for preschool children, although physical activity is generally supported as a healthy sleep practice. When measuring physical activity and sleep, objective measures (e.g., accelerometers) are recommended as opposed to subjective measures (e.g., parental reports). The purpose of the current study was to examine the relationship between objectively measured sleep (key variables included sleep efficiency, sleep onset latency, and sleep duration) and physical activity (operationalized as mean daily total physical activity) among preschool-aged children in Nova Scotia, Canada. Children (n = 29) wore a wrist accelerometer to objectively measure sleep and wore an accelerometer on their waist to measure physical activity for nine consecutive days. Overall, linear regression analyses demonstrate physical activity as a predictor of sleep efficiency but not total sleep time or sleep onset latency among preschool-aged children. Future research should examine the causal relationships between sleep efficiency and physical activity by conducting interventions to increase physical activity and determining the impact on sleep efficiency.
{"title":"Associations of objectively measured physical activity and sleep in preschoolers aged 3 to 6 years","authors":"Laura Miller, Mya Dockrill, Penny V Corkum, Sara F. L. Kirk, Michelle Stone","doi":"10.3389/frsle.2024.1329774","DOIUrl":"https://doi.org/10.3389/frsle.2024.1329774","url":null,"abstract":"Research has demonstrated various negative effects of poor sleep on overall health in children. Engaging in physical activity during the day is often recommended to help children sleep better. Limited research has examined this recommendation for preschool children, although physical activity is generally supported as a healthy sleep practice. When measuring physical activity and sleep, objective measures (e.g., accelerometers) are recommended as opposed to subjective measures (e.g., parental reports). The purpose of the current study was to examine the relationship between objectively measured sleep (key variables included sleep efficiency, sleep onset latency, and sleep duration) and physical activity (operationalized as mean daily total physical activity) among preschool-aged children in Nova Scotia, Canada. Children (n = 29) wore a wrist accelerometer to objectively measure sleep and wore an accelerometer on their waist to measure physical activity for nine consecutive days. Overall, linear regression analyses demonstrate physical activity as a predictor of sleep efficiency but not total sleep time or sleep onset latency among preschool-aged children. Future research should examine the causal relationships between sleep efficiency and physical activity by conducting interventions to increase physical activity and determining the impact on sleep efficiency.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140397873","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 : 2024-02-27DOI: 10.3389/frsle.2024.1356644
Marc Comair, Sandy Awad, Pritha Ghosh
Sleep-related movement disorders (SRMD) are common, often troublesome, conditions in the elderly. Although these disorders can impact people of all ages, there are different considerations when diagnosing and managing SRMD in the elderly. In this review, we discuss SRMD in the elderly, focusing on recent developments in the areas of restless leg syndrome, periodic limb movement disorder, nocturnal muscle cramps, and sleep-related bruxism. In addition to reviewing these entities more generally, we highlight key considerations in addressing these in conditions in older adults.
{"title":"Sleep related movement disorders in the elderly: a review of recent literature","authors":"Marc Comair, Sandy Awad, Pritha Ghosh","doi":"10.3389/frsle.2024.1356644","DOIUrl":"https://doi.org/10.3389/frsle.2024.1356644","url":null,"abstract":"Sleep-related movement disorders (SRMD) are common, often troublesome, conditions in the elderly. Although these disorders can impact people of all ages, there are different considerations when diagnosing and managing SRMD in the elderly. In this review, we discuss SRMD in the elderly, focusing on recent developments in the areas of restless leg syndrome, periodic limb movement disorder, nocturnal muscle cramps, and sleep-related bruxism. In addition to reviewing these entities more generally, we highlight key considerations in addressing these in conditions in older adults.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425174","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 : 2024-02-16DOI: 10.3389/frsle.2024.1278086
Anna M. May, J. Dalton
Adherence to positive airway pressure (PAP) therapy for sleep apnea is suboptimal, particularly in the veteran population. Accurately identifying those best suited for other therapy or additional interventions may improve adherence. We evaluated various machine learning algorithms to predict 90-day adherence.The cohort of VA Northeast Ohio Health Care system patients who were issued a PAP machine (January 1, 2010–June 30, 2015) had demographics, comorbidities, and medications at the time of polysomnography obtained from the electronic health record. The data were split 60:20:20 into training, calibration, and validation data sets, with no use of validation data for model development. We constructed models for the first 90-day adherence period (% nights ≥4 h use) using the following algorithms: linear regression, least absolute shrinkage and selection operator, elastic net, ridge regression, gradient boosted machines, support vector machine regression, Bayes-based models, and neural nets. Prediction performance was evaluated in the validation data set using root mean square error (RMSE).The 5,047 participants were 38.3 ± 11.9 years old, and 96.1% male, with 36.8% having coronary artery disease and 52.6% with depression. The median adherence was 36.7% (interquartile range: 0%, 86.7%). The gradient boosted machine was superior to other machine learning techniques (RMSE 37.2). However, the performance was similar and not clinically useful for all models without 30-day data. The 30-day PAP data and using raw diagnoses and medications (vs. grouping by type) improved the RMSE to 24.27.Comparing multiple prediction algorithms using electronic medical record information, we found that none has clinically meaningful performance. Better adherence predictive measures may offer opportunities for personalized tailoring of interventions.
{"title":"Comparison of machine learning approaches for positive airway pressure adherence prediction in a veteran cohort","authors":"Anna M. May, J. Dalton","doi":"10.3389/frsle.2024.1278086","DOIUrl":"https://doi.org/10.3389/frsle.2024.1278086","url":null,"abstract":"Adherence to positive airway pressure (PAP) therapy for sleep apnea is suboptimal, particularly in the veteran population. Accurately identifying those best suited for other therapy or additional interventions may improve adherence. We evaluated various machine learning algorithms to predict 90-day adherence.The cohort of VA Northeast Ohio Health Care system patients who were issued a PAP machine (January 1, 2010–June 30, 2015) had demographics, comorbidities, and medications at the time of polysomnography obtained from the electronic health record. The data were split 60:20:20 into training, calibration, and validation data sets, with no use of validation data for model development. We constructed models for the first 90-day adherence period (% nights ≥4 h use) using the following algorithms: linear regression, least absolute shrinkage and selection operator, elastic net, ridge regression, gradient boosted machines, support vector machine regression, Bayes-based models, and neural nets. Prediction performance was evaluated in the validation data set using root mean square error (RMSE).The 5,047 participants were 38.3 ± 11.9 years old, and 96.1% male, with 36.8% having coronary artery disease and 52.6% with depression. The median adherence was 36.7% (interquartile range: 0%, 86.7%). The gradient boosted machine was superior to other machine learning techniques (RMSE 37.2). However, the performance was similar and not clinically useful for all models without 30-day data. The 30-day PAP data and using raw diagnoses and medications (vs. grouping by type) improved the RMSE to 24.27.Comparing multiple prediction algorithms using electronic medical record information, we found that none has clinically meaningful performance. Better adherence predictive measures may offer opportunities for personalized tailoring of interventions.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961117","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 : 2024-02-14DOI: 10.3389/frsle.2024.1271167
Mattina A. Davenport, Joseph W. Sirrianni, D. Chisolm
Pediatric sleep problems can be detected across racial/ethnic subpopulations in primary care settings. However, the electronic health record (EHR) data documentation that describes patients' sleep problems may be inherently biased due to both historical biases and informed presence. This study assessed racial/ethnic differences in natural language processing (NLP) training data (e.g., pediatric sleep-related keywords in primary care clinical notes) prior to model training.We used a predefined keyword features set containing 178 Peds B-SATED keywords. We then queried all the clinical notes from patients seen in pediatric primary care between the ages of 5 and 18 from January 2018 to December 2021. A least absolute shrinkage and selection operator (LASSO) regression model was used to investigate whether there were racial/ethnic differences in the documentation of Peds B-SATED keywords. Then, mixed-effects logistic regression was used to determine whether the odds of the presence of global Peds B-SATED dimensions also differed across racial/ethnic subpopulations.Using both LASSO and multilevel modeling approaches, the current study found that there were racial/ethnic differences in providers' documentation of Peds B-SATED keywords and global dimensions. In addition, the most frequently documented Peds B-SATED keyword rankings qualitatively differed across racial/ethnic subpopulations.This study revealed providers' differential patterns of documenting Peds B-SATED keywords and global dimensions that may account for the under-detection of pediatric sleep problems among racial/ethnic subpopulations. In research, these findings have important implications for the equitable clinical documentation of sleep problems in pediatric primary care settings and extend prior retrospective work in pediatric sleep specialty settings.
{"title":"Machine learning data sources in pediatric sleep research: assessing racial/ethnic differences in electronic health record–based clinical notes prior to model training","authors":"Mattina A. Davenport, Joseph W. Sirrianni, D. Chisolm","doi":"10.3389/frsle.2024.1271167","DOIUrl":"https://doi.org/10.3389/frsle.2024.1271167","url":null,"abstract":"Pediatric sleep problems can be detected across racial/ethnic subpopulations in primary care settings. However, the electronic health record (EHR) data documentation that describes patients' sleep problems may be inherently biased due to both historical biases and informed presence. This study assessed racial/ethnic differences in natural language processing (NLP) training data (e.g., pediatric sleep-related keywords in primary care clinical notes) prior to model training.We used a predefined keyword features set containing 178 Peds B-SATED keywords. We then queried all the clinical notes from patients seen in pediatric primary care between the ages of 5 and 18 from January 2018 to December 2021. A least absolute shrinkage and selection operator (LASSO) regression model was used to investigate whether there were racial/ethnic differences in the documentation of Peds B-SATED keywords. Then, mixed-effects logistic regression was used to determine whether the odds of the presence of global Peds B-SATED dimensions also differed across racial/ethnic subpopulations.Using both LASSO and multilevel modeling approaches, the current study found that there were racial/ethnic differences in providers' documentation of Peds B-SATED keywords and global dimensions. In addition, the most frequently documented Peds B-SATED keyword rankings qualitatively differed across racial/ethnic subpopulations.This study revealed providers' differential patterns of documenting Peds B-SATED keywords and global dimensions that may account for the under-detection of pediatric sleep problems among racial/ethnic subpopulations. In research, these findings have important implications for the equitable clinical documentation of sleep problems in pediatric primary care settings and extend prior retrospective work in pediatric sleep specialty settings.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139838550","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 : 2024-02-14DOI: 10.3389/frsle.2024.1271167
Mattina A. Davenport, Joseph W. Sirrianni, D. Chisolm
Pediatric sleep problems can be detected across racial/ethnic subpopulations in primary care settings. However, the electronic health record (EHR) data documentation that describes patients' sleep problems may be inherently biased due to both historical biases and informed presence. This study assessed racial/ethnic differences in natural language processing (NLP) training data (e.g., pediatric sleep-related keywords in primary care clinical notes) prior to model training.We used a predefined keyword features set containing 178 Peds B-SATED keywords. We then queried all the clinical notes from patients seen in pediatric primary care between the ages of 5 and 18 from January 2018 to December 2021. A least absolute shrinkage and selection operator (LASSO) regression model was used to investigate whether there were racial/ethnic differences in the documentation of Peds B-SATED keywords. Then, mixed-effects logistic regression was used to determine whether the odds of the presence of global Peds B-SATED dimensions also differed across racial/ethnic subpopulations.Using both LASSO and multilevel modeling approaches, the current study found that there were racial/ethnic differences in providers' documentation of Peds B-SATED keywords and global dimensions. In addition, the most frequently documented Peds B-SATED keyword rankings qualitatively differed across racial/ethnic subpopulations.This study revealed providers' differential patterns of documenting Peds B-SATED keywords and global dimensions that may account for the under-detection of pediatric sleep problems among racial/ethnic subpopulations. In research, these findings have important implications for the equitable clinical documentation of sleep problems in pediatric primary care settings and extend prior retrospective work in pediatric sleep specialty settings.
{"title":"Machine learning data sources in pediatric sleep research: assessing racial/ethnic differences in electronic health record–based clinical notes prior to model training","authors":"Mattina A. Davenport, Joseph W. Sirrianni, D. Chisolm","doi":"10.3389/frsle.2024.1271167","DOIUrl":"https://doi.org/10.3389/frsle.2024.1271167","url":null,"abstract":"Pediatric sleep problems can be detected across racial/ethnic subpopulations in primary care settings. However, the electronic health record (EHR) data documentation that describes patients' sleep problems may be inherently biased due to both historical biases and informed presence. This study assessed racial/ethnic differences in natural language processing (NLP) training data (e.g., pediatric sleep-related keywords in primary care clinical notes) prior to model training.We used a predefined keyword features set containing 178 Peds B-SATED keywords. We then queried all the clinical notes from patients seen in pediatric primary care between the ages of 5 and 18 from January 2018 to December 2021. A least absolute shrinkage and selection operator (LASSO) regression model was used to investigate whether there were racial/ethnic differences in the documentation of Peds B-SATED keywords. Then, mixed-effects logistic regression was used to determine whether the odds of the presence of global Peds B-SATED dimensions also differed across racial/ethnic subpopulations.Using both LASSO and multilevel modeling approaches, the current study found that there were racial/ethnic differences in providers' documentation of Peds B-SATED keywords and global dimensions. In addition, the most frequently documented Peds B-SATED keyword rankings qualitatively differed across racial/ethnic subpopulations.This study revealed providers' differential patterns of documenting Peds B-SATED keywords and global dimensions that may account for the under-detection of pediatric sleep problems among racial/ethnic subpopulations. In research, these findings have important implications for the equitable clinical documentation of sleep problems in pediatric primary care settings and extend prior retrospective work in pediatric sleep specialty settings.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139778815","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 : 2024-02-12DOI: 10.3389/frsle.2024.1322761
Elizabeth Benge, Milena Pavlova, Sogol Javaheri
The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.
{"title":"Sleep health challenges among women: insomnia across the lifespan","authors":"Elizabeth Benge, Milena Pavlova, Sogol Javaheri","doi":"10.3389/frsle.2024.1322761","DOIUrl":"https://doi.org/10.3389/frsle.2024.1322761","url":null,"abstract":"The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139843336","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 : 2024-02-12DOI: 10.3389/frsle.2024.1322761
Elizabeth Benge, Milena Pavlova, Sogol Javaheri
The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.
{"title":"Sleep health challenges among women: insomnia across the lifespan","authors":"Elizabeth Benge, Milena Pavlova, Sogol Javaheri","doi":"10.3389/frsle.2024.1322761","DOIUrl":"https://doi.org/10.3389/frsle.2024.1322761","url":null,"abstract":"The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783335","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 : 2024-02-08DOI: 10.3389/frsle.2024.1339561
Marina Papadopoulou, Maria Sandalidou, Ioannis Kamarligkos, Nikolaos Kitsakis, Maria-Aggeliki Milonaki, Frideriki Zografou, George Kitsaras
Bedtime routines are amongst the most common, recurrent family activities with close associations for child health, development and wellbeing especially sleep. Despite the importance of bedtime routines, no previous study has examined them within the context of a Greek family.A mixed methods, stepped approach was used in this study. A cross-sectional study examined the prevalence and characteristics of bedtime routines (PRE) in families with young children and explored associations with parental mood (POMS) and child's sleep (CSHQ). A qualitative study using the Theoretical Domains Framework (TDF) examined barriers and facilitators for achieving optimal routines.Total of 54 parents with a mean age of 35.9 (SD = 5.95) completed the cross-sectional study while 20 parents participated in the interviews. There were strong positive correlations between total scores on the POMS and total scores on the CSHQ r = 0.482, p < 0.001 and strong negative correlation between total scores on the POMS and total scores on the PRE, r = −0.308, p = 0.023. In terms of barriers and facilitators, social desirability, social comparison, environmental factors and resistance from children were amongst the most common barriers to establishing a good bedtime routine.Bedtime routines are highly prevalent in Greek families with the quality of those routines varying between households. Addressing common barriers in achieving better bedtime routines could help families benefit in the short and long-term.
{"title":"Bedtime routines in Greek families: characteristics, barriers, and facilitators for establishing and maintaining optimal routines","authors":"Marina Papadopoulou, Maria Sandalidou, Ioannis Kamarligkos, Nikolaos Kitsakis, Maria-Aggeliki Milonaki, Frideriki Zografou, George Kitsaras","doi":"10.3389/frsle.2024.1339561","DOIUrl":"https://doi.org/10.3389/frsle.2024.1339561","url":null,"abstract":"Bedtime routines are amongst the most common, recurrent family activities with close associations for child health, development and wellbeing especially sleep. Despite the importance of bedtime routines, no previous study has examined them within the context of a Greek family.A mixed methods, stepped approach was used in this study. A cross-sectional study examined the prevalence and characteristics of bedtime routines (PRE) in families with young children and explored associations with parental mood (POMS) and child's sleep (CSHQ). A qualitative study using the Theoretical Domains Framework (TDF) examined barriers and facilitators for achieving optimal routines.Total of 54 parents with a mean age of 35.9 (SD = 5.95) completed the cross-sectional study while 20 parents participated in the interviews. There were strong positive correlations between total scores on the POMS and total scores on the CSHQ r = 0.482, p < 0.001 and strong negative correlation between total scores on the POMS and total scores on the PRE, r = −0.308, p = 0.023. In terms of barriers and facilitators, social desirability, social comparison, environmental factors and resistance from children were amongst the most common barriers to establishing a good bedtime routine.Bedtime routines are highly prevalent in Greek families with the quality of those routines varying between households. Addressing common barriers in achieving better bedtime routines could help families benefit in the short and long-term.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139850765","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 : 2024-02-08DOI: 10.3389/frsle.2024.1343393
Amber F. Tout, Nicole K. Y. Tang, T. Sletten, Carla T. Toro, Charlotte Kershaw, Caroline Meyer, S. W. Rajaratnam, T. Moukhtarian
Shift work can lead to sleep disturbances and insomnia during the sleeping period, as well as excessive sleepiness and fatigue during the waking period. While Cognitive Behavioral Therapy (CBT-i) is recommended as the first line of treatment for insomnia, key elements of CBT-i, such as maintaining a consistent sleep schedule, can be challenging for shift workers, highlighting the need for tailored sleep interventions. This mini review provides a narrative synthesis of non-pharmacological sleep interventions for shift workers and informs the development of a preventative, multicomponent sleep management programme.An informal review was conducted in line with Phase 1 of the Framework for the Development and Evaluation of Complex Interventions.A variety of strategies have been employed to help manage the impacts of shift work on sleep, including: CBT-i, adjusting shift schedules, controlled light exposure, sleep hygiene education, planned napping, caffeine consumption, and mind-body interventions (e.g., yogic relaxation).Recommendations, limitations, and directions for future research are discussed; notably, the role of the family, the commute to and from the workplace, and the eating behaviors of employees appear to have been overlooked in current intervention efforts. Digital CBT-i platforms could help to provide an effective, scalable, and low-cost method of reducing insomnia in shift workers.
{"title":"Current sleep interventions for shift workers: a mini review to shape a new preventative, multicomponent sleep management programme","authors":"Amber F. Tout, Nicole K. Y. Tang, T. Sletten, Carla T. Toro, Charlotte Kershaw, Caroline Meyer, S. W. Rajaratnam, T. Moukhtarian","doi":"10.3389/frsle.2024.1343393","DOIUrl":"https://doi.org/10.3389/frsle.2024.1343393","url":null,"abstract":"Shift work can lead to sleep disturbances and insomnia during the sleeping period, as well as excessive sleepiness and fatigue during the waking period. While Cognitive Behavioral Therapy (CBT-i) is recommended as the first line of treatment for insomnia, key elements of CBT-i, such as maintaining a consistent sleep schedule, can be challenging for shift workers, highlighting the need for tailored sleep interventions. This mini review provides a narrative synthesis of non-pharmacological sleep interventions for shift workers and informs the development of a preventative, multicomponent sleep management programme.An informal review was conducted in line with Phase 1 of the Framework for the Development and Evaluation of Complex Interventions.A variety of strategies have been employed to help manage the impacts of shift work on sleep, including: CBT-i, adjusting shift schedules, controlled light exposure, sleep hygiene education, planned napping, caffeine consumption, and mind-body interventions (e.g., yogic relaxation).Recommendations, limitations, and directions for future research are discussed; notably, the role of the family, the commute to and from the workplace, and the eating behaviors of employees appear to have been overlooked in current intervention efforts. Digital CBT-i platforms could help to provide an effective, scalable, and low-cost method of reducing insomnia in shift workers.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139852680","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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