Frontiers in sleep最新文献

Objectives: Treatment with timed bright light and exogenous melatonin has been shown to effectively advance the sleep-wake rhythm in patients with Delayed Sleep-Wake Phase Disorder (DSWPD). However, the treatment protocol is demanding, which may negatively affect treatment adherence. The objective of the present study was thus to explore how young adults participating in a treatment study for DSWPD experienced the treatment protocol.

Method: Individual semi-structured interviews were conducted with 11 young adults with DSWPD. An introductory request was to rate whether they thought the treatment was worth the effort, with response options ranging from 0 to 100 (totally worth the effort). Interviews were analyzed using thematic analysis.

Results: The mean rating of the treatment was 72.5 (range 60-100), indicating that all participants considered the benefits to outweigh the effort. The thematic analysis resulted in three themes: (1) Benefits and gains (2) Costs and losses and (3) Improving the cost-benefit ratio in order to prevail with the treatment. Participants described benefits in terms of an advanced circadian phase, improved everyday lives and self-evaluation. However, adhering to treatment and the resulting circadian phase advance also involved certain costs and losses. Still, participants also described how cost could be reduced by gradually tailoring the treatment protocol and their daily routines to individual needs.

Conclusion: All participants considered the treatment to be worth the effort, but individual tailoring was necessary to minimize the effort/cost. The benefits of the treatment extended beyond sleep and circadian phase, positively affecting self-evaluation and beliefs regarding others' perception.

Introduction: Obstructive Sleep Apnea (OSA) is a chronic disease requiring life-long care, with clear benefit for those who remain adherent to positive airway pressure (PAP) therapy. Despite the efficacy of PAP, adherence to treatment has historically been low. The purpose of this study was to determine the impact of a streamlined OSA care pathway on quality of care and PAP adoption/adherence.

Methods: Two retrospective cohort studies were performed based on real-world data gathered as part of routine clinical care within a large comprehensive sleep care program. In Study 1, quality of OSA care was assessed by evaluating days spent between treatment steps of the care pathway, including time to diagnosis and treatment initiation. In Study 2, long-term PAP adoption, adherence, and persistence data were analyzed; PAP average minutes used per night and average nights per week were also calculated.

Results: In Study 1, patients (n = 42,687) typically underwent telehealth consultation within 5 days of OSA screening; completed Home Sleep Apnea Testing (HSAT) within 12 days from physician consultation; received testing results and recommendations within 9 days of completing HSAT; and initiated PAP within 8 days of a diagnosis. In Study 2 (N = 4,907), 84.3% of patients placed on therapy adopted therapy and 80.6% of those who adopted demonstrated short-term adherence. 82.6% of patients demonstrated long-term PAP adherence 1 year after adoption and 74.2% of patients persisted with PAP 2 years after adoption. PAP usage rates increased over time. By year 3, patients (n = 3,067) used their PAP device an average of 6.0 days per week, with mean usage of 6.4 h per night.

Discussion: Length of time between treatment steps was shorter than published reports. Rates of both short- and long-term adherence and persistence to PAP therapy were also higher than those observed in most prior studies. Average nightly use and nights per week used trend upward across the 3 years. These findings suggest that a comprehensive OSA care approach can effectively help more patients get on therapy and stay on therapy, providing an opportunity for the health and economic benefits reported in the literature.

This narrative review explores the intricate relationship between biological rhythms and the natural cycles of light and darkness, known as circadian rhythms. This review begins with an examination of empirical evidence dating back to 1729, which indicates that a particular plant displayed rhythmic behavior even in complete darkness. It then considers the evolution and significance of internal biological clocks in humans. The pivotal role of circadian rhythms in regulating physiological processes (e.g., sleep-wake cycles, body temperature, and hormone levels) emphasizing their influence on overall health and wellbeing is discussed. This review also highlights the critical importance of maintaining circadian timing alignment with the environment, as desynchronization can lead to a range of adverse outcomes, including cardiovascular, metabolic, and psychological disorders. By integrating the genetic, physiological, and behavioral mechanisms underlying and associated with biological clocks and rhythms in humans, this review aims to provide clinicians and researchers with a comprehensive perspective on the holistic nature of biological rhythms and their implications for health. Furthermore, the concepts associated with Chrono-intervention, such as chrononutrition and chronomedicine, are introduced as promising approaches to optimizing health outcomes by aligning interventions with the body's natural rhythms are introduced. Through this consideration, this review seeks to contribute to a deeper understanding of chronobiology and its potential applications in improving human health and performance.

Sleep is important for maintaining body homeostasis, and lack of sleep or poor sleep quality increases the risk of various diseases. In recent years, it has been shown that there is an interaction between the gut microbiota and brain function, known as the brain-gut interaction. Although several studies have examined the relationship between gut microbiota and sleep, most of them rely on subjective indicators, and there are few reports using objective sleep measurements. Therefore, the aim of this study was to clarify the relationship between gut microbiota and sleep using various statistical analysis methods based on data obtained from the database. First, we obtained data from the Sukoyaka Health Survey, and performed hierarchical clustering analysis of the electroencephalogram (EEG)-derived sleep parameters. We examined the intestinal bacteria that differed significantly among clusters, and the relationship between intestinal bacteria and EEG-derived sleep parameters using multiple regression analysis and causal search. Multiple regression analysis and causal search suggested a relationship between increased Sellimonas levels and increased non-rapid eye-movement (non-REM) sleep stage 2, and increased Alistipes levels and increased non-REM sleep stage 3. The results of the causal search indicated that Alistipes and Sellimonas may influence the duration of non-REM sleep stage.

Background: This study focuses on cultural influences and investigates sleep quality's impact on cognitive functions among university students in Tokyo and London. Recognizing sleep as vital for wellbeing and academic success, it explores factors affecting sleep quality and its cognitive impact in diverse educational settings.

Methods: A cross-sectional study was conducted with 400 students (200 per city). The Pittsburgh Sleep Quality Index (PSQI) assesses sleep quality. At the same time, cognitive tests, including the Rey Auditory Verbal Learning Test and the Stroop Test, evaluated memory, attention, problem-solving, and executive functions.

Results: Significant negative correlations emerged between PSQI scores and cognitive performance, indicating that poorer sleep quality correlated with diminished cognitive abilities across domains. Regression analyses confirmed sleep quality's predictive role in mental performance, controlling for demographics. These findings highlight sleep's critical role in cognitive functions within different cultural contexts.

Conclusion: This study underscores sleep quality's importance for academic success and reveals cultural variations influencing sleep patterns among Tokyo and London students. The findings suggest targeted interventions to enhance sleep quality and cognitive functioning in diverse educational settings, considering cultural nuances and lifestyle factors. Further research should explore longitudinal effects and intervention strategies to improve sleep and mental outcomes.

Background: Obstructive sleep apnea results from intermittent airway collapse during sleep. Despite its health risks, the prevalence and associated factors of OSA among hypertensive patients in Ethiopia remain unexplored.

Objective: This study assessed the prevalence and associated factors of high-risk OSA among hypertensive patients in referral hospitals within the Amhara Region, Northwest Ethiopia, in 2022.

Methods: A cross-sectional study was conducted in selected referral hospitals from 21 April to 14 June 2022. A systematic random sampling technique was employed. Data were collected through structured, pretested, interviewer-administered questionnaires, file reviews, and physical examinations. Data were entered in Epi-Data 4.6 and analyzed using Stata 14. Logistic regression was performed, and variables with p < 0.05 were regarded as significantly associated with high-risk OSA.

Results: Of the 412 participants (97% response rate), the mean age was 58.95 ± 12.6 years, with 55.1% being female. The prevalence of high-risk OSA was determined to be 43.93% (95% CI: 39.2-48.8). Significant factors included age > 65 years (AOR = 8.00, 95% CI: 4.48-14.14), diabetes mellitus (AOR = 4.7, 95% CI: 2.48-8.94), male sex (AOR = 4.2, 95% CI: 2.38-7.45), and large neck circumference (AOR = 3.13, 95% CI: 1.27-7.74).

Conclusion: High-risk OSA is prevalent among hypertensive patients, particularly in older males and those with diabetes or a large neck circumference. Routine OSA screening should be integrated into hypertension care. Future studies should utilize gold-standard tools and explore cause-and-effect relationships.

Objectives: Insomnia disorder is a public health challenge associated with impaired cognitive functioning, reduced quality of life, and adverse mental health outcomes. This study examined the effectiveness of SleepCogni, an active-feedback device, in reducing insomnia symptom severity and improving perceived sleep quality in individuals with insomnia disorder.

Method: A two-arm, parallel-group trial design was used, with 80 participants randomized to either the experimental group or the placebo control group. Participants provided self-reported measures of insomnia severity, sleep continuity, and user experience as main outcome variables.

Results: Repeated measures analysis of variance showed that participants in the experimental group reported significantly greater improvements in insomnia symptom severity than the control group (Time × Treatment). Although the mean difference did not reach the threshold for clinical significance, 37.5% of the participants achieved this threshold within 1 week of treatment. Mixed-effects models showed significant improvements in sleep efficiency and total sleep time, based on sleep diary records. Finally, an independent samples t-test and content analysis indicated a more positive user experience in the experimental group.

Conclusion: The SleepCogni device appears to be a useful tool for improving sleep outcomes in individuals with insomnia disorder, showing effects on both insomnia severity and subjectively evaluated sleep. The SleepCogni device presents a useful intervention that might be used alone or as a complement to increase the effectiveness of existing treatments, such as cognitive behavioral therapy for insomnia.

Clinical trial registration: https://osf.io/rswcb, identifier: osf-registrations-rswcb-v1.

Introduction: Obstructive sleep apnea (OSA) is a highly prevalent chronic disorder that is challenging to monitor clinically. While single-night laboratory-based polysomnography (PSG) is the current gold standard for OSA assessment, its utility is limited by cost and inaccessibility. Overnight pulse oximetry is a feasible approach for simplified at-home monitoring of OSA. In this study, we evaluate the performance of a modified finger-worn pulse oximetry device ("Ring") for OSA assessment.

Methods: In all, 25 patients with OSA [age: 55.5 ± 7.7 years (mean ± SD), body mass index (BMI): 31.8 ± 5.1 kg/m², 14M:11F, and Fitzpatrick scale score I-II: 15, III-IV: 6, and V-VI: 4] completed up to four in-laboratory PSG studies with simultaneous Ring oximetry measurements (90 studies in total). Correlation and agreement analyses compared Ring-derived measures of the oxygen desaturation index (ODI4_RING, desaturations ≥4%) against PSG measures (ODI4_PSG and AHI4_PSG). Likewise, Ring-derived hypoxic burden (HB_RING) was compared against its PSG counterpart (HB_PSG). Receiver operator characteristic (ROC) curve analysis quantified the ability of ODI4_RING to identify moderate-to-severe OSA (AHI4_PSG > 15 events/h).

Results: Median [interquartile range (IQR)] of AHI4_PSG was 18.0 [9.6, 31.7] events/h. ODI4_RING was positively correlated with ODI4_PSG (Pearson r = 0.87, root mean square error [RMSE] = 6.6 events/h, intraclass correlation [ICC] = 0.85) and AHI4_PSG (r = 0.85, RMSE = 7.1 events/h, ICC = 0.84). The bias (mean difference) and limits of agreement (1.96 SD) between ODI4_PSG and ODI4_RING were 2.9 and 14.2 events/h, while for AHI4_PSG and ODI4_RING, the bias and limits of agreement were 1.4 and 16.3 events/h, respectively. HB_RING was positively correlated with HB_PSG (r = 0.75, RMSE = 24.6% min/h, ICC = 0.73), with a mean difference of 3.7% min/h and limits of agreement of 60.6% min/h. The receiver operator characteristic curve analysis of ODI4_RING to identify moderate-to-severe OSA produced an area under the curve of 0.92 (ODI4_PSG > 15 events/h, "excellent") and 0.84 (AHI4_PSG > 15 events/h, "excellent").

Conclusion: Our results show that a low-cost, convenient, and simple-to-use finger-worn pulse oximeter is a reliable tool for continuous monitoring of OSA severity and therapy responses. It also offers excellent discriminative value for screening moderate-to-severe OSA in this population.