Frontiers in sleep最新文献

Introduction: Sleep app use has become widespread in recent years. Still, understanding of characteristics of users and the impact of sleep app usage remains limited.

Methods: A sample of 940 young adults (18-30 years) living in the UK were recruited from Prolific (online research platform offering researchers access to survey panels) and invited to participate in a survey on the use and experience with sleep apps. Both sleep app users and non-users were invited. The survey included questions about demographics, morningness (Horne-Östberg Morningness-Eveningness Questionnaire-reduced scale), insomnia symptoms (Bergen Insomnia Scale), personality (HEXACO: Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience), in addition to sleep app usage and how such use is experienced. A logistic regression analysis was conducted to identify characteristics of sleep app users. Factor analysis was used to elucidate dimensions of sleep app use experiences. Scores on the items making up each factor were then regressed on demographic variables, morningness, insomnia symptoms and personality.

Results: In all, 36.8% of the participants reported using or having used sleep apps. Use was positively associated with age, insomnia symptoms, and conscientiousness. The factor analysis revealed three factors coined: trust/objectification (trust in sleep app results), negative (e.g., becoming stressed) and positive (e.g., prioritize sleep more) perceived effects. Trust/objectification was positively associated with age and agreeableness, and inversely related to high education and openness to experience. Insomnia symptoms and emotionality were associated with perceived negative effects. Morningness and male gender were associated with perceived positive effects whereas high education had an inverse relationship with perceived positive effects.

Discussion: The use of sleep apps was widespread. Different responses to sleep app usage were observed and linked to various individual variables. The findings suggest that perceived effects of sleep apps usage should be considered in light of individual differences. Research on sleep apps is still in its early stages, and several suggestions (recommendations) for future studies are outlined.

Introduction: Sleep duration in youth is a key factor that significantly influences mental health. However, there have been limited studies examining the direct impact of adolescents' sleep on life satisfaction. This study aims to analyze the effects of adolescents' sleep duration on their life satisfaction.

Methods: For this purpose, data from the Korean Children and Youth Panel Survey (KCYPS) conducted by the National Youth Policy Institute (NYPI) were utilized, specifically focusing on the 4th-grade panel data (N = 2,378; 52.4% male; 47.6% female). Analysis revealed a rapid decline in youth sleep duration upon entering junior high school. Consequently, the data were categorized into two periods for analysis: Year I (4th grade) to Year IV (7th grade), and Year IV (7th grade) to Year VII (10th grade).

Results: Using the autoregressive cross-lagged (ARCL) model, it was found that sleep duration during Years IV-VII significantly influenced life satisfaction over time. An increase in sleep duration led to a subsequent increase in life satisfaction over time with statistical significance. Specifically, sleep duration during 7th grade exhibited a significant static influence on life satisfaction at 8th grade (β = 0.025, p < 0.03), while sleep duration during 8th grade statically affected life satisfaction during 9th grade (β = 0.026, p < 0.03). Moreover, sleep duration at 9th grade had a static influence on life satisfaction during 10th grade, with statistical significance (β = 0.027, p < 0.03).

Discussion: Based on the findings of this study, implications and suggestions for future research were discussed. It is essential to create an environment that promotes adequate sleep for adolescents, even after they enter junior high school.

Introduction: Poor sleep quality negatively impact health, reducing quality of life and increasing disease risk. For the elderly, poor sleep quality lead to fatigue and reduced mobility, increasing the risk of falls. In Vietnam, no studies have explored the relationship between sleep quality and fall risk in the elderly. This study aimed to determine the correlation between sleep quality and fall risk among the elderly, providing knowledge for fall prevention in this population in Vietnam.

Methods: A cross-sectional study was conducted on 404 elderly patients who visited and were treated as outpatients at Thai Binh University Hospital from October 2023 to June 2024. Direct interviews were conducted using the Fall Risk Questionnaire (FRQ) from STEADI-CDC-2017 (USA), and the Pittsburgh Sleep Quality Index (PSQI) with a cut-off score of 7 to assess sleep quality. The FRQ tool used a cut-off score of 4 to evaluate fall risk.

Results: The percentage of elderly at risk of falls was 19.6%. The average PSQI score was 11.0 ± 2.7, with 358 (88.6%) elderly patients showing poor sleep quality. Logistic regression analysis showed that higher PSQI scores in the elderly significantly correlated with an increased risk of falls (OR = 1.16, 95% CI: 1.02-1.32, p = 0.03). Elderly individuals with the highest PSQI scores had a higher risk of falls compared to those with the lowest PSQI scores.

Conclusion: Poor sleep quality are closely related to fall risk among the elderly, alongside other factors such as religion, education, comorbidities, and participation in recreational activities.

Introduction: Excessive daytime sleepiness (EDS) is a key symptom for patients with obstructive sleep apnea (OSA). Despite important limitations in the longitudinal monitoring of EDS, the Epworth Sleepiness Scale (ESS), the Maintenance of Wakefulness Test, and the Multiple Sleep Latency Test (MSLT) are the best available objective tests to predict EDS. Limited information exists on the day-to-day fluctuations of sleepiness symptoms from the everyday life perspective of OSA patients. The most feared is sudden sleep episodes that cause traffic accidents. The following study protocol investigates the novel possibilities of ultra-long-term Electroencephalography (EEG) (ULT-EEG) home monitoring in sleepy OSA patients with a subcutaneous implant. We hypothesize that the high-frequency testing from ULT-EEG, in combination with an ecological momentary assessment (EMA), can provide the information to develop new electrophysiological monitoring of sleep propensity as an alternative to the well-established, yet subjective, ESS.

Methods: This clinical exploratory and experimental study will include 15 treatment-naïve patients with severe OSA, with a baseline ESS score above 10. The subjects will be implanted with a two-channel subcutaneous EEG monitoring device upon inclusion and a confirmative polysomnography MSLT. Subcutaneous EEG is recorded 24/7 for 6 weeks before and 6 weeks during continuous positive airway pressure (CPAP) treatment. Daily assessments with the Karolinska Sleepiness Scale, the Psychomotor Vigilance Task test, and a sleep/nap diary will be collected using EMA methods.

Discussion: This study combines data collection from sleepy OSA patients' natural environments using ULT-EEG and EMA methods to obtain sleepiness metrics suitable for developing and preliminarily validating the possibilities of ULT-EEG sleepiness monitoring. We aim to prove a new concept of monitoring sleepiness symptoms in OSA patients and gain new insights into CPAP-related sleepiness rehabilitation.

Ethics and dissemination: All participants will provide written informed consent to participate in this study. Ethical approval from the Region Zealand Ethics Committee on 13/09/2021 (SJ939, EMN-2021-06803). The study will be conducted in accordance with local legislation and institutional requirements and comply with the Declaration of Helsinki and the General Data Protection Regulation (GDPR).

Introduction: Sleep apnea can have severe negative health effects, including cardiovascular diseases, metabolic disorders, and decreased quality of life. Continuous positive airway pressure (CPAP) therapy is highly effective and the gold standard treatment for sleep apnea; however, traditionally fragmented sleep healthcare has resulted in low levels of treatment adoption and adherence. A recent white paper analysis of traditional health plan claims found that a comprehensive model significantly outperformed traditional health plans with higher rates of adoption (80 vs. 49%), adherence (62 vs. 25%), and persistence (53 vs. 11%) to CPAP therapy, which resulted in lower total healthcare costs. To understand the patient experience in these models of care, this study compared patient satisfaction between the traditional sleep care approach and a clinically integrated, comprehensive sleep care program.

Methods: A survey was developed to understand differences in the patient experience with the two different care models with respect to: access to sleep care, including time from initial appointment to seeing a sleep specialist, referral and insurance process; ease of sleep testing process and receiving a diagnosis; adoption, quality of education, and training with CPAP; ongoing adherence support with CPAP, and quality of life. Data were compared using descriptive statistics and Chi-square analyses.

Results: A significantly higher proportion of patients in the comprehensive model were satisfied with all measured points in the patient's journey. Notably, twice as many patients in the comprehensive model were very satisfied with: ease of navigating the testing process, time between diagnosis and CPAP adoption, insurance navigation for CPAP approval, and availability and level of ongoing CPAP support. Comprehensive care patients experienced fewer work disruptions due to sleep apnea: only 7% missed work in the past 3 months, compared to 58% in the traditional model.

Discussion: Overall, the study highlights the benefits of a comprehensive care model in improving patient satisfaction with their sleep apnea journey and overall quality of life for individuals with sleep apnea. Pairing this positive patient experience data with prior data from the same treatment model shows that removing obstacles within a patient's journey positively impacts satisfaction while simultaneously improving adherence rates and reducing total healthcare costs.

Obstructive sleep apnea (OSA) is a common sleep disorder associated with serious neurological and cardiovascular complications. Intermittent hypoxia and reoxygenation, a key feature of OSA, produces molecular signals that activate various inflammatory pathways, notably the inflammasome-a multiprotein complex that promotes the release of pro-inflammatory cytokines including IL-18 and IL-1β. This results in systemic inflammation, which contributes to the development of the neurological and cardiovascular complications seen in OSA. In this review, we will first examine the pathways through which intermittent hypoxia induces inflammasome activation. Then, we will connect the inflammasome to the downstream neurological and cardiovascular effects of OSA. Finally, we will explore potential interactions between the inflammasome and OSA treatments including Continuous Positive Airway Pressure therapy and glucagon like peptide-1 receptor agonists (GLP-1RAs).

Introduction: Sleep dysregulation is highly prevalent in pediatric chronic pain conditions and associated with poorer clinical outcomes. Interactions between underlying circadian misalignments and pain in pediatric populations remain unclear. Dim-light melatonin onset collections conducted in external lab settings are standard for measuring circadian rhythmicity by examining fluctuations in melatonin levels. However, present limitations prevent us from capturing a typical night's sleep and minimize accessibility to broader populations due to geographic, financial, and temporal barriers. We investigated a novel approach in which participants complete collections in an entirely self-directed manner using an at-home diagnostic kit.

Methods: Participants included pediatric patients with diagnosed chronic pain and healthy controls. The 3-week protocol involved sleep, activity, and light tracking, self-reported sleep diaries, a survey determining morningness-eveningness chronotypes, one self-directed home dim-light melatonin onset collection with objective compliance measures, and assessment of study protocol acceptability.

Results and discussion: In a sample of pediatric patients with diagnosed chronic pain (N = 6, M_age =14.5, SD = 2.74, 66.7% female) and a subset of healthy controls (N = 6, M_age =13.3, SD=2.73, 50% female), both the Hockeystick method and 3 pg/ml dim-light melatonin onset threshold were employed to calculate salivary dim-light melatonin onset times in 8 of the 12 participants. On average, dim-light melatonin onset times were 1 h and 43 min earlier than self-reported sleep onset times. Our results illustrate the feasibility and accuracy of self-directed, remote dim-light melatonin onset collections in pediatric populations. With supplementary research validating this optimized approach to measure endogenous circadian phase, more specific aspects of sleep can be targeted in pain intervention strategies to further optimize clinical outcomes in a greater population of pediatric patients.

Loneliness and insomnia are endemic in college students, and emotion regulation is strongly related to both. Starting with a biopsychosocial framework, the present study tested a model in which emotional repair mediated the relationship between loneliness and insomnia, with the goal of using a potential mechanism of action to address loneliness. Participants were undergraduate students (N=1,513) in the United States who completed a survey including the Trait Meta-Mood Scale, Sleep Condition Indicator, and UCLA Loneliness Scale, amongst other measures. Insomnia had a significant total negative effect on loneliness, B = -0.46, 95% CI [-0.54, -0.39]. Emotional repair partially mediated this relationship, with an indirect effect of B = 0.015, 95% CI [-0.19, -0.12]. Participants with better sleep were more able to regulate their emotions, and thus tended to experience lower levels of loneliness. Treating insomnia (e.g., CBT-I) or skills associated with emotional repair and regulation (e.g., transdiagnostic approaches to emotion regulation) could reduce overall loneliness.

Despite being the gold-standard treatment for obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP) faces important challenges, particularly with patient adherence. Many individuals find CPAP difficult to tolerate due to noise, social inconveniences, characteristics inherently linked to their sleep disorder and side effects, including mask discomfort, air leaks, nasal congestion, and the unnatural sensation of exhaling against positive pressure. All this often leads to reduced usage, limiting CPAP's potential to deliver long-term health benefits. This review revisits the dynamics of pharyngeal collapse during sleep on PAP, offering a new interpretation that challenges the long-standing view that higher inspiratory pressure is required to maintain pharyngeal patency. Emerging evidence, combined with the knowledge from older studies, suggests that airway collapse often occurs near end-expiration, which may be the only time that substantial positive airway pressure is required. Efforts to improve CPAP compliance have reduced expiratory pressure, leading to the introduction of bilevel PAP (BPAP) and expiratory pressure relief algorithms, which may cause airway destabilization, without yielding the improvements in adherence that were initially anticipated. Thus, despite over three decades of innovation, which have also seen heated humidifiers and tubes, customized 3D-printed masks and auto-titrating PAP come to market, there has been limited success in systematically increasing long-term CPAP adherence rates. In response, we discuss novel approaches such as $\stackrel{.}{\text{V}}$ -Com^® and KairosPAP™ (KPAP™), which reduce inspiratory pressure and, in the case of KPAP™, also much of expiratory pressure, returning to full pressure only at the end of expiration. Recent studies suggest these technologies improve comfort and reduce unintentional leaks and may lead to better adherence without sacrificing treatment effectiveness. This aligns with the hypothesis that stabilizing the airway during end-expiration may be key to enhancing CPAP comfort and adherence. In conclusion, while technological advancements have improved the CPAP experience, further progress will likely come from solutions that better address patient comfort with the applied pressure. KPAP™ is one such innovation with the potential to enhance adherence, but additional research is needed to fully understand its long-term impact and effectiveness in PAP therapy for OSA.