Pub Date : 2023-09-25DOI: 10.3389/frsle.2023.1168511
Katherine S. Reis, Shannon Heald, Sophia Uddin, Kimberly M. Fenn, Howard C. Nusbaum
Previous research has demonstrated that a night's sleep can consolidate rote and generalized perceptual learning. Over a waking retention period following training, performance gains from learning significantly decline, but sleep can restore performance to levels found immediately after learning. Furthermore, when sleep precedes a waking retention period following training, performance is protected against loss. Other research demonstrating that rote learning can be consolidated by a night's sleep has shown that a relatively brief nap can consolidate rote learning. This suggests that short periods of sleep can produce consolidation, indicating that consolidation may not require successive sleep cycles over an entire night to emerge. However, previous research has demonstrated that there can be differences in sleep-dependent consolidation for rote and generalized learning. In this study, we investigated whether an opportunity for a 90-min midday nap was sufficient to consolidate generalized perceptual learning of synthetic speech. We recruited 75 participants from the University of Chicago community (mean age of 20.83) who completed a pretest, training, and posttest in the morning on perception of synthetic speech. Training and testing in this manner are known to result in substantial generalized learning of synthetic speech. Participants then returned in the afternoon and were either given an opportunity for a 90-min nap or remained awake for 90-min. Participants were then given another posttest later that evening, never hearing the same words twice during the experiment. Results demonstrated that participants who did not nap showed significant loss of learning at the evening posttest. In contrast, individuals who napped retained what they learned, and did not show loss of learning at the evening posttest. These results are consistent with the view that an opportunity for a 90-min midday nap can consolidate generalized learning, as only individuals with consolidated learning should be able to retain what they learned despite an intervening waking retention period. This is the first demonstration that generalized skill learning is subject to sleep-dependent consolidation in short durations of sleep and does not require a full night of sleep. This work has implications for understanding the basic neural mechanisms that operate to stabilize short-term learning experiences.
{"title":"A nap consolidates generalized perceptual learning","authors":"Katherine S. Reis, Shannon Heald, Sophia Uddin, Kimberly M. Fenn, Howard C. Nusbaum","doi":"10.3389/frsle.2023.1168511","DOIUrl":"https://doi.org/10.3389/frsle.2023.1168511","url":null,"abstract":"Previous research has demonstrated that a night's sleep can consolidate rote and generalized perceptual learning. Over a waking retention period following training, performance gains from learning significantly decline, but sleep can restore performance to levels found immediately after learning. Furthermore, when sleep precedes a waking retention period following training, performance is protected against loss. Other research demonstrating that rote learning can be consolidated by a night's sleep has shown that a relatively brief nap can consolidate rote learning. This suggests that short periods of sleep can produce consolidation, indicating that consolidation may not require successive sleep cycles over an entire night to emerge. However, previous research has demonstrated that there can be differences in sleep-dependent consolidation for rote and generalized learning. In this study, we investigated whether an opportunity for a 90-min midday nap was sufficient to consolidate generalized perceptual learning of synthetic speech. We recruited 75 participants from the University of Chicago community (mean age of 20.83) who completed a pretest, training, and posttest in the morning on perception of synthetic speech. Training and testing in this manner are known to result in substantial generalized learning of synthetic speech. Participants then returned in the afternoon and were either given an opportunity for a 90-min nap or remained awake for 90-min. Participants were then given another posttest later that evening, never hearing the same words twice during the experiment. Results demonstrated that participants who did not nap showed significant loss of learning at the evening posttest. In contrast, individuals who napped retained what they learned, and did not show loss of learning at the evening posttest. These results are consistent with the view that an opportunity for a 90-min midday nap can consolidate generalized learning, as only individuals with consolidated learning should be able to retain what they learned despite an intervening waking retention period. This is the first demonstration that generalized skill learning is subject to sleep-dependent consolidation in short durations of sleep and does not require a full night of sleep. This work has implications for understanding the basic neural mechanisms that operate to stabilize short-term learning experiences.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135864632","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 : 2023-09-21DOI: 10.3389/frsle.2023.1238508
Vivien S. Piccin, Erick D. L. B. de Camargo, Rafaela G. S. Andrade, Vinícius Torsani, Fabíola Schorr, Priscilla S. Sardinha, Fernanda Madeiro, Pedro R. Genta, Marcelo G. Gregório, Carlos R. R. de Carvalho, Marcelo B. P. Amato, Geraldo Lorenzi-Filho
Background There is a lack of non-invasive methods for monitoring the upper airway patency during sleep. Electrical impedance tomography (EIT) is a non-invasive, radiation-free tool that has been validated to monitor lung ventilation. We hypothesized that electrical impedance tomography (EIT) can be used for monitoring upper airway patency during sleep. Methods Sleep was induced in 21 subjects (14 males, age 43 ± 13 years, body mass index 32.0 ± 5.3 kg/m 2 ) with suspected obstructive sleep apnea (apnea-hypopnea index: 44 ± 37 events/h, range: 1–122 events/h) using low doses of midazolam. Patients wore a nasal mask attached to a modified CPAP device, allowing variable and controlled degrees of upper airway obstruction. Confirmation of upper airway patency was obtained with direct visualization of the upper airway using nasofibroscopy ( n = 6). The changes in total neck impedance and in impedance in four cranio-caudal regions of interest (ROIs) were analyzed. Results Total neck impedance varied in concert with breathing cycles and peaked during expiration in all patients. Group data showed a high cross-correlation between flow and impedance curves ( r = −0.817, p < 0.001). Inspiratory peak flow correlated with simultaneous neck impedance ( r = 0.866, p < 0.001). There was a high correlation between total neck impedance and velopharynx area ( r = 0.884, p < 0.001), and total neck impedance and oropharynx area ( r = 0.891, p < 0.001). Conclusions Neck EIT is sensitive and captures pharyngeal obstruction under various conditions. Neck EIT is a promising method for real-time monitoring of the pharynx during sleep.
研究背景:缺乏非侵入性方法监测睡眠期间上呼吸道通畅。电阻抗断层扫描(EIT)是一种无创、无辐射的工具，已被证实可用于监测肺通气。我们假设电阻抗断层扫描(EIT)可用于监测睡眠期间的上呼吸道通畅。方法对21例疑似阻塞性睡眠呼吸暂停(呼吸暂停-低通气指数:44±37事件/h，范围:1 ~ 122事件/h)的患者(男性14例，年龄43±13岁，体重指数32.0±5.3 kg/ m2)采用低剂量咪达唑仑诱导睡眠。患者佩戴的鼻罩连接改良的CPAP设备，允许可变和可控程度的上气道阻塞。通过鼻纤维镜直接观察上呼吸道，确认上呼吸道通畅(n = 6)。分析颈部总阻抗和四个颅尾感兴趣区阻抗的变化。结果所有患者的颈部总阻抗随呼吸周期变化，在呼气时达到峰值。组内数据显示，流量和阻抗曲线之间具有高度的相互关系(r = - 0.817, p <0.001)。吸气峰值流量与同时颈部阻抗相关(r = 0.866, p <0.001)。颈部总阻抗与腭咽面积高度相关(r = 0.884, p <0.001)，颈部总阻抗和口咽部面积(r = 0.891, p <0.001)。结论颈部EIT反应灵敏，能捕捉到各种情况下的咽部梗阻。颈部EIT是一种很有前途的实时监测睡眠中咽部的方法。
{"title":"Feasibility of neck electrical impedance tomography to monitor upper airway dynamics during sleep","authors":"Vivien S. Piccin, Erick D. L. B. de Camargo, Rafaela G. S. Andrade, Vinícius Torsani, Fabíola Schorr, Priscilla S. Sardinha, Fernanda Madeiro, Pedro R. Genta, Marcelo G. Gregório, Carlos R. R. de Carvalho, Marcelo B. P. Amato, Geraldo Lorenzi-Filho","doi":"10.3389/frsle.2023.1238508","DOIUrl":"https://doi.org/10.3389/frsle.2023.1238508","url":null,"abstract":"Background There is a lack of non-invasive methods for monitoring the upper airway patency during sleep. Electrical impedance tomography (EIT) is a non-invasive, radiation-free tool that has been validated to monitor lung ventilation. We hypothesized that electrical impedance tomography (EIT) can be used for monitoring upper airway patency during sleep. Methods Sleep was induced in 21 subjects (14 males, age 43 ± 13 years, body mass index 32.0 ± 5.3 kg/m 2 ) with suspected obstructive sleep apnea (apnea-hypopnea index: 44 ± 37 events/h, range: 1–122 events/h) using low doses of midazolam. Patients wore a nasal mask attached to a modified CPAP device, allowing variable and controlled degrees of upper airway obstruction. Confirmation of upper airway patency was obtained with direct visualization of the upper airway using nasofibroscopy ( n = 6). The changes in total neck impedance and in impedance in four cranio-caudal regions of interest (ROIs) were analyzed. Results Total neck impedance varied in concert with breathing cycles and peaked during expiration in all patients. Group data showed a high cross-correlation between flow and impedance curves ( r = −0.817, p &lt; 0.001). Inspiratory peak flow correlated with simultaneous neck impedance ( r = 0.866, p &lt; 0.001). There was a high correlation between total neck impedance and velopharynx area ( r = 0.884, p &lt; 0.001), and total neck impedance and oropharynx area ( r = 0.891, p &lt; 0.001). Conclusions Neck EIT is sensitive and captures pharyngeal obstruction under various conditions. Neck EIT is a promising method for real-time monitoring of the pharynx during sleep.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136130984","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 : 2023-09-19DOI: 10.3389/frsle.2023.1173650
Todd M. Bishop, Westley A. Youngren, John S. Klein, Katrina J. Speed, Wilfred R. Pigeon
Introduction Suicide is a significant public health concern and its prevention remains a top clinical priority of the Veterans Health Administration. Periods of transition in care (e.g., moving from inpatient to outpatient care) represent a period of increased risk. Sleep disorders are prevalent amongst Veterans and are modifiable risk factor for suicide. The present study examined the relationship of sleep disorders to time to suicide attempt amongst Veterans known to have attempted suicide in the 180 days following discharge from a Mental Health Residential Rehabilitation Treatment Program. Method The present sample was comprised of all Veterans enrolled in services with the Veterans Health Administration known to have attempted suicide following discharge from a Mental Health Residential Rehabilitation Treatment Program during Fiscal Years 13 and 14 ( N = 1,489). To create this sample, electronic medical record data were extracted from two VHA data sources: the Corporate Data Warehouse and the Suicide Prevention Application Network. Results Cox regression models revealed that Veterans with a sleep disturbance ( N = 1,211) had a shorter time to suicide attempt than those without a sleep disturbance [Hazard Ratio (HR) = 1.16, CI (1.02–1.32)]. A subsequent Cox regression model including age, insomnia, nightmare disorder, and alcohol dependence revealed that sleep-related breathing disorders [HR = 1.19, CI (1.01–1.38)], alcohol dependence [HR = 1.16, CI (1.02–1.33)], and age group were associated with increased risk. Conclusion Findings indicate that sleep disturbance, primarily driven by sleep-related breathing disorders, was associated with time to suicide attempt in this sample of high-risk Veterans known to have attempted suicide in the 180 days following their discharge from a Mental Health Residential Rehabilitation Treatment Program. These findings reveal an opportunity to reduce risk through the screening and treatment of sleep disorders in high-risk populations.
{"title":"Sleep disorders and suicide attempts following discharge from residential treatment","authors":"Todd M. Bishop, Westley A. Youngren, John S. Klein, Katrina J. Speed, Wilfred R. Pigeon","doi":"10.3389/frsle.2023.1173650","DOIUrl":"https://doi.org/10.3389/frsle.2023.1173650","url":null,"abstract":"Introduction Suicide is a significant public health concern and its prevention remains a top clinical priority of the Veterans Health Administration. Periods of transition in care (e.g., moving from inpatient to outpatient care) represent a period of increased risk. Sleep disorders are prevalent amongst Veterans and are modifiable risk factor for suicide. The present study examined the relationship of sleep disorders to time to suicide attempt amongst Veterans known to have attempted suicide in the 180 days following discharge from a Mental Health Residential Rehabilitation Treatment Program. Method The present sample was comprised of all Veterans enrolled in services with the Veterans Health Administration known to have attempted suicide following discharge from a Mental Health Residential Rehabilitation Treatment Program during Fiscal Years 13 and 14 ( N = 1,489). To create this sample, electronic medical record data were extracted from two VHA data sources: the Corporate Data Warehouse and the Suicide Prevention Application Network. Results Cox regression models revealed that Veterans with a sleep disturbance ( N = 1,211) had a shorter time to suicide attempt than those without a sleep disturbance [Hazard Ratio (HR) = 1.16, CI (1.02–1.32)]. A subsequent Cox regression model including age, insomnia, nightmare disorder, and alcohol dependence revealed that sleep-related breathing disorders [HR = 1.19, CI (1.01–1.38)], alcohol dependence [HR = 1.16, CI (1.02–1.33)], and age group were associated with increased risk. Conclusion Findings indicate that sleep disturbance, primarily driven by sleep-related breathing disorders, was associated with time to suicide attempt in this sample of high-risk Veterans known to have attempted suicide in the 180 days following their discharge from a Mental Health Residential Rehabilitation Treatment Program. These findings reveal an opportunity to reduce risk through the screening and treatment of sleep disorders in high-risk populations.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135015605","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 : 2023-09-07DOI: 10.3389/frsle.2023.1228038
S. Mashaqi, Michael William, Stuart F. Quan, D. Combs, L. Estep, Salma I. Patel, Jyotsna Sahni, S. Parthasarathy
Sleep-disordered breathing (obstructive and central sleep apnea) are common in patients with heart failure with reduced ejection fraction. Herein, we report a 69-year-old patient with a history of severe heart failure and refractory ventricular arrhythmia who was diagnosed with a moderate degree of obstructive and central sleep apnea with Cheyne Stokes breathing. He underwent a successful implantation of left ventricular assist device. Our patient had a complete resolution of both obstructive and central sleep apnea 60 days post-LVAD implantation as confirmed by home sleep apnea test.
{"title":"Case report: A case of complete resolution of obstructive and central sleep apnea with Cheyne Stokes breathing in a patient with heart failure 60 days post-left ventricular assist device implantation","authors":"S. Mashaqi, Michael William, Stuart F. Quan, D. Combs, L. Estep, Salma I. Patel, Jyotsna Sahni, S. Parthasarathy","doi":"10.3389/frsle.2023.1228038","DOIUrl":"https://doi.org/10.3389/frsle.2023.1228038","url":null,"abstract":"Sleep-disordered breathing (obstructive and central sleep apnea) are common in patients with heart failure with reduced ejection fraction. Herein, we report a 69-year-old patient with a history of severe heart failure and refractory ventricular arrhythmia who was diagnosed with a moderate degree of obstructive and central sleep apnea with Cheyne Stokes breathing. He underwent a successful implantation of left ventricular assist device. Our patient had a complete resolution of both obstructive and central sleep apnea 60 days post-LVAD implantation as confirmed by home sleep apnea test.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87027351","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 : 2023-09-06DOI: 10.3389/frsle.2023.1207232
Emma Lardant, François Vialatte, Céline Ramdani, Frédéric Chauveau, C. Gauriau, Léna Storms, Marion Trousselard, Damien Léger
Insomnia is highly prevalent in the general population, and is commonly associated with somatic and psychiatric comorbidities. However, its origins remain poorly-understood. Recently, adverse childhood events (ACE), including traumatic experiences, have been found to be significantly associated with both insomnia and Post-Traumatic Stress Disorders (PTSD). Many patients with PTSD suffer from sleep disorders. However, we know much less about traumatic childhood experiences in patients with insomnia and PTSD.Our exploratory study investigated a cohort of 43 patients (14 males, 29 females) clinically diagnosed with chronic insomnia at a sleep center, and systematically evaluated their condition using the trauma history questionnaire (THQ), and the PTSD checklist (PCL-5).Our results show that 83.72% of insomnia patients reported at least one traumatic event, while the prevalence of PTSD symptoms was 53.49%. For 11.6% of patients, insomnia began in childhood, while for 27.07% it began in adolescence. PCL-5 scores were associated with higher Insomnia Severity Index (ISI) scores, but not trauma. ISI scores were also higher for women, and positive relationships were observed between ISI scores, PCL-5 scores and the number of self-reported traumatic events among women.These exploratory results highlight that the relationship between PTSD symptoms and insomnia could be sex-specific. They also highlight the importance of PTSD symptoms screening for patients diagnosed with chronic insomnia.
{"title":"Chronic insomnia: are patients also suffering from PTSD symptoms?","authors":"Emma Lardant, François Vialatte, Céline Ramdani, Frédéric Chauveau, C. Gauriau, Léna Storms, Marion Trousselard, Damien Léger","doi":"10.3389/frsle.2023.1207232","DOIUrl":"https://doi.org/10.3389/frsle.2023.1207232","url":null,"abstract":"Insomnia is highly prevalent in the general population, and is commonly associated with somatic and psychiatric comorbidities. However, its origins remain poorly-understood. Recently, adverse childhood events (ACE), including traumatic experiences, have been found to be significantly associated with both insomnia and Post-Traumatic Stress Disorders (PTSD). Many patients with PTSD suffer from sleep disorders. However, we know much less about traumatic childhood experiences in patients with insomnia and PTSD.Our exploratory study investigated a cohort of 43 patients (14 males, 29 females) clinically diagnosed with chronic insomnia at a sleep center, and systematically evaluated their condition using the trauma history questionnaire (THQ), and the PTSD checklist (PCL-5).Our results show that 83.72% of insomnia patients reported at least one traumatic event, while the prevalence of PTSD symptoms was 53.49%. For 11.6% of patients, insomnia began in childhood, while for 27.07% it began in adolescence. PCL-5 scores were associated with higher Insomnia Severity Index (ISI) scores, but not trauma. ISI scores were also higher for women, and positive relationships were observed between ISI scores, PCL-5 scores and the number of self-reported traumatic events among women.These exploratory results highlight that the relationship between PTSD symptoms and insomnia could be sex-specific. They also highlight the importance of PTSD symptoms screening for patients diagnosed with chronic insomnia.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89402524","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 : 2023-09-01DOI: 10.3389/frsle.2023.1261276
Marie Bruyneel
Obstructive sleep apnea (OSA) is a common disorder. Its prevalence is increasing worldwide, partially due to increasing rates of obesity, and OSA has a well-documented impact on physical health (increased risk of cardiovascular and metabolic disorders) and mental health, as well as major socioeconomic implications. Although continuous positive airway pressure treatment (CPAP) remains the primary therapeutic intervention for moderate to severe OSA, other treatment strategies such as weight loss, positional therapy, mandibular advancement devices (MAD), surgical treatment, myofunctional therapy of upper airways (UA) muscles and hypoglossal nerve stimulation are increasingly used. Recently, several trials have demonstrated the clinical potential for various pharmacological treatments that aim to improve UA muscle dysfunction, loop gain, or excessive daytime sleepiness. In line with the highly heterogeneous clinical picture of OSA, recent identification of different clinical phenotypes has been documented. Comorbidities, incident cardiovascular risk, and response to CPAP may vary significantly among phenotypes. With this in mind, the purpose of this review is to summarize the data on OSA phenotypes that may respond to pharmacological approaches.
{"title":"Obstructive sleep apnea phenotypes eligible for pharmacological treatment","authors":"Marie Bruyneel","doi":"10.3389/frsle.2023.1261276","DOIUrl":"https://doi.org/10.3389/frsle.2023.1261276","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common disorder. Its prevalence is increasing worldwide, partially due to increasing rates of obesity, and OSA has a well-documented impact on physical health (increased risk of cardiovascular and metabolic disorders) and mental health, as well as major socioeconomic implications. Although continuous positive airway pressure treatment (CPAP) remains the primary therapeutic intervention for moderate to severe OSA, other treatment strategies such as weight loss, positional therapy, mandibular advancement devices (MAD), surgical treatment, myofunctional therapy of upper airways (UA) muscles and hypoglossal nerve stimulation are increasingly used. Recently, several trials have demonstrated the clinical potential for various pharmacological treatments that aim to improve UA muscle dysfunction, loop gain, or excessive daytime sleepiness. In line with the highly heterogeneous clinical picture of OSA, recent identification of different clinical phenotypes has been documented. Comorbidities, incident cardiovascular risk, and response to CPAP may vary significantly among phenotypes. With this in mind, the purpose of this review is to summarize the data on OSA phenotypes that may respond to pharmacological approaches.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80071415","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 : 2023-08-24DOI: 10.3389/frsle.2023.1224610
P. Mcphee, S. Georgiades, Andrea Andrade, P. Corkum, A. Vaccarino, Heena Cheema, Rachel Chepesiuk, A. Iaboni, J. Gorter
The objectives of this study were to determine rates of sleep disturbances in children with neurodevelopmental disorders (NDDs) within and across disorders and compared to typically developing (TD) children and to describe differences above and below the clinical cut-off for sleep disturbances. In addition, we explored the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and health-related quality of life (HRQOL) in children with NDDs.We conducted cross-sectional data analyses of an existing database with community-dwelling children with NDDs (n = 1438) and TD children (n = 140) aged 4–12 years. Parent-reported measures on sleep disturbances using the Children's Sleep Habits Questionnaire (CSHQ), internalizing symptoms using the Revised Children's Anxiety and Depression Scale, and HRQOL using the KINDL-R were assessed. Hierarchical linear regression examined the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and HRQOL in children with NDDs.Children with NDDs (8.5 ± 2.1 years, 69.9% M) had significantly greater total sleep disturbance index (TSDI) than TD children [(8.6 ± 2.3 years, 60.0% M) (mean difference = 6.88 [95% CI 5.37, 8.40]; p < 0.001) (n = 838 NDDs (58.3%); n = 120 TD (86.7%)]. Children with severe NDDs reported significantly greater TSDI above the clinical cut-off (i.e., ≥41; CSHQ) than those with less severe NDDs (p < 0.001). Internalizing symptoms (β = −0.082 [95% CI −0.144, −0.019]; p = 0.011) and TSDI (β = −0.226 [95% CI −0.380, −0.073]; p = 0.004) were significantly associated with HRQOL in children with NDDs.Surveillance and management of sleep and internalizing symptoms are needed to improve HRQOL in children with NDDs. Commonalities in sleep disturbances for children with NDDs support transdiagnostic interventions to treat sleep.
{"title":"Sleep, internalizing symptoms, and health-related quality of life in children with neurodevelopmental disorders: a cross-sectional analysis of cohort data from three research programs in Canada","authors":"P. Mcphee, S. Georgiades, Andrea Andrade, P. Corkum, A. Vaccarino, Heena Cheema, Rachel Chepesiuk, A. Iaboni, J. Gorter","doi":"10.3389/frsle.2023.1224610","DOIUrl":"https://doi.org/10.3389/frsle.2023.1224610","url":null,"abstract":"The objectives of this study were to determine rates of sleep disturbances in children with neurodevelopmental disorders (NDDs) within and across disorders and compared to typically developing (TD) children and to describe differences above and below the clinical cut-off for sleep disturbances. In addition, we explored the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and health-related quality of life (HRQOL) in children with NDDs.We conducted cross-sectional data analyses of an existing database with community-dwelling children with NDDs (n = 1438) and TD children (n = 140) aged 4–12 years. Parent-reported measures on sleep disturbances using the Children's Sleep Habits Questionnaire (CSHQ), internalizing symptoms using the Revised Children's Anxiety and Depression Scale, and HRQOL using the KINDL-R were assessed. Hierarchical linear regression examined the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and HRQOL in children with NDDs.Children with NDDs (8.5 ± 2.1 years, 69.9% M) had significantly greater total sleep disturbance index (TSDI) than TD children [(8.6 ± 2.3 years, 60.0% M) (mean difference = 6.88 [95% CI 5.37, 8.40]; p < 0.001) (n = 838 NDDs (58.3%); n = 120 TD (86.7%)]. Children with severe NDDs reported significantly greater TSDI above the clinical cut-off (i.e., ≥41; CSHQ) than those with less severe NDDs (p < 0.001). Internalizing symptoms (β = −0.082 [95% CI −0.144, −0.019]; p = 0.011) and TSDI (β = −0.226 [95% CI −0.380, −0.073]; p = 0.004) were significantly associated with HRQOL in children with NDDs.Surveillance and management of sleep and internalizing symptoms are needed to improve HRQOL in children with NDDs. Commonalities in sleep disturbances for children with NDDs support transdiagnostic interventions to treat sleep.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77393097","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 : 2023-08-17DOI: 10.3389/frsle.2023.1197297
Joey Lam, A. Williamson, Zainab Salih, Megan Heere, J. Mindell
Implementing a consistent bedtime routine is an empirically supported intervention to improve sleep in toddlers, but little is known about its association with social-emotional outcomes, and among children living in lower socioeconomic status (SES) contexts.This study examined the longitudinal associations between bedtime routines, social-emotional development, and caregiver educational attainment in toddlers presenting to primary care.Caregivers of 40 toddlers (Mage = 12.85 months, 57.5% female, 62.5% Black/African American) completed questionnaires on sociodemographic factors and child bedtime routine consistency at their 12-month well visit. At the 15- and 24-month well visits, data were collected on child bedtime routine consistency and social-emotional development, including the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) for social-emotional problems and competency and the Ages and Stages Questionnaire (3rd edition; ASQ-3) to assess communication and personal-social skills.Overall, the majority of families engaged in a consistent bedtime routine (≥5 nights/week) at all time points (63% at 12 months, 75% at 15 months, and 86% at 24 months). Controlling for concurrent bedtime routine consistency, toddlers with a more consistent bedtime routine at 12 months exhibited less dysregulation at age 15 months. Toddlers without a consistent bedtime routine at 15 months exhibited more externalizing and internalizing problems and dysregulation at 24 months. Furthermore, there was a significant interaction between bedtime routine consistency at 15 months and caregiver education for internalizing problems at 24 months, such that toddlers of caregivers with a high school education or less who lacked a consistent bedtime routine showed the most internalizing problems.Clinicians should consider recommending that families with toddlers incorporate a nightly bedtime routine not only to improve overall sleep health, but also to potentially optimize toddlers' positive social-emotional and behavioral trajectories, especially in families with lower educational attainment.
{"title":"Bedtime routines, development, and caregiver educational attainment in toddlerhood","authors":"Joey Lam, A. Williamson, Zainab Salih, Megan Heere, J. Mindell","doi":"10.3389/frsle.2023.1197297","DOIUrl":"https://doi.org/10.3389/frsle.2023.1197297","url":null,"abstract":"Implementing a consistent bedtime routine is an empirically supported intervention to improve sleep in toddlers, but little is known about its association with social-emotional outcomes, and among children living in lower socioeconomic status (SES) contexts.This study examined the longitudinal associations between bedtime routines, social-emotional development, and caregiver educational attainment in toddlers presenting to primary care.Caregivers of 40 toddlers (Mage = 12.85 months, 57.5% female, 62.5% Black/African American) completed questionnaires on sociodemographic factors and child bedtime routine consistency at their 12-month well visit. At the 15- and 24-month well visits, data were collected on child bedtime routine consistency and social-emotional development, including the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) for social-emotional problems and competency and the Ages and Stages Questionnaire (3rd edition; ASQ-3) to assess communication and personal-social skills.Overall, the majority of families engaged in a consistent bedtime routine (≥5 nights/week) at all time points (63% at 12 months, 75% at 15 months, and 86% at 24 months). Controlling for concurrent bedtime routine consistency, toddlers with a more consistent bedtime routine at 12 months exhibited less dysregulation at age 15 months. Toddlers without a consistent bedtime routine at 15 months exhibited more externalizing and internalizing problems and dysregulation at 24 months. Furthermore, there was a significant interaction between bedtime routine consistency at 15 months and caregiver education for internalizing problems at 24 months, such that toddlers of caregivers with a high school education or less who lacked a consistent bedtime routine showed the most internalizing problems.Clinicians should consider recommending that families with toddlers incorporate a nightly bedtime routine not only to improve overall sleep health, but also to potentially optimize toddlers' positive social-emotional and behavioral trajectories, especially in families with lower educational attainment.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90519205","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 : 2023-08-16DOI: 10.3389/frsle.2023.1148316
C. D. Campbell, I. Sulaiman
Obstructive sleep apnea (OSA) is a common condition affecting an estimated 936 million individuals worldwide, leading to a considerable demand for diagnostic services. Polysomnography, the current gold standard for diagnosis, is resource intensive and inconvenient for patients and healthcare providers. The WatchPAT is an unobtrusive device for home OSA diagnosis. It utilizes peripheral arterial tomography in conjunction with heart rate, oximetry, actingraphy, and respiratory movements for the diagnosis of OSA. It has good correlation with polysomnography for OSA diagnosis and also reports sleep time and sleep staging. The WatchPAT device has reported sensitivities of 81–95%, specificities of 66–100%, positive predictive values of 79–96%, and negative predictive values of 92% for the determination of the apnea–hypopnea index (AHI). It has also been studied and its use validated in a variety of patient populations, including children, older adults, pregnant women, and those with comorbid medical conditions. The device has also been adopted for use in screening for cardiac arrhythmia and central sleep apnea, although neither use has become widespread. With the emergence of telemedicine and an increasing demand for sleep services, the WatchPAT device can be a useful aid in OSA diagnostics.
{"title":"The role of the WatchPAT device in the diagnosis and management of obstructive sleep apnea","authors":"C. D. Campbell, I. Sulaiman","doi":"10.3389/frsle.2023.1148316","DOIUrl":"https://doi.org/10.3389/frsle.2023.1148316","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common condition affecting an estimated 936 million individuals worldwide, leading to a considerable demand for diagnostic services. Polysomnography, the current gold standard for diagnosis, is resource intensive and inconvenient for patients and healthcare providers. The WatchPAT is an unobtrusive device for home OSA diagnosis. It utilizes peripheral arterial tomography in conjunction with heart rate, oximetry, actingraphy, and respiratory movements for the diagnosis of OSA. It has good correlation with polysomnography for OSA diagnosis and also reports sleep time and sleep staging. The WatchPAT device has reported sensitivities of 81–95%, specificities of 66–100%, positive predictive values of 79–96%, and negative predictive values of 92% for the determination of the apnea–hypopnea index (AHI). It has also been studied and its use validated in a variety of patient populations, including children, older adults, pregnant women, and those with comorbid medical conditions. The device has also been adopted for use in screening for cardiac arrhythmia and central sleep apnea, although neither use has become widespread. With the emergence of telemedicine and an increasing demand for sleep services, the WatchPAT device can be a useful aid in OSA diagnostics.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73742439","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 : 2023-08-16DOI: 10.3389/frsle.2023.1193539
A. Chung, Leone Farquharson, A. Gopalkrishnan, S. Honaker
Approximately 3% of American children are affected by obstructive sleep apnea (OSA), yet Black children are 2–4 times more likely to experience OSA compared to White children. Little is known about parental experiences in detection, diagnosis, and treatment of OSA in their child, and how these experiences may differ by race. The study objective was to highlight convergent and divergent experiences between and across Black and White parents in the OSA detection process for their child.We conducted 27 semi-structured interviews with mothers whose child was referred for a diagnostic overnight polysomnogram (PSG) to assess for OSA. Parents described how their child was referred for a PSG and their perceptions and feelings throughout the detection process. Data were analyzed using a thematic descriptive approach. Frequency of themes were examined by race. Themes that were unique to one racial group were categorized as divergent, whereas themes described by individuals from both groups were categorized as convergent. Within the convergent themes, we examined the prevalence within each racial group, noting those that were more prevalent (>10% difference in prevalence) in one race or the other.The sample included 19 Black and 8 White mothers, who were 36 years old on average. Qualitative analysis yielded 21 themes across 5 categories that captured divergent and convergent experiences across Black and White mothers during the OSA detection process for their child. Divergent themes that were unique to Black mothers included It Takes a Village—Teacher, Misplaced Blame, Missing the Day/night Connection, Trust in Provider, and the belief that Snoring is Normal. Only one divergent theme among White parents emerged, worries about Dying in Ones Sleep. Additional convergent themes were identified that were more prevalent in one race compared to the other.Black and White mothers experienced different paths to detection and diagnosis for their child's sleep disordered breathing, that are affected by individual awareness, education, patient-provider interactions, and experiences with the healthcare system. Divergent themes such as Misplaced Blame among Black mothers were a potential indication of racism and health disparities.
{"title":"“Something is wrong!” A qualitative study of racial disparities in parental experiences of OSA detection in their child","authors":"A. Chung, Leone Farquharson, A. Gopalkrishnan, S. Honaker","doi":"10.3389/frsle.2023.1193539","DOIUrl":"https://doi.org/10.3389/frsle.2023.1193539","url":null,"abstract":"Approximately 3% of American children are affected by obstructive sleep apnea (OSA), yet Black children are 2–4 times more likely to experience OSA compared to White children. Little is known about parental experiences in detection, diagnosis, and treatment of OSA in their child, and how these experiences may differ by race. The study objective was to highlight convergent and divergent experiences between and across Black and White parents in the OSA detection process for their child.We conducted 27 semi-structured interviews with mothers whose child was referred for a diagnostic overnight polysomnogram (PSG) to assess for OSA. Parents described how their child was referred for a PSG and their perceptions and feelings throughout the detection process. Data were analyzed using a thematic descriptive approach. Frequency of themes were examined by race. Themes that were unique to one racial group were categorized as divergent, whereas themes described by individuals from both groups were categorized as convergent. Within the convergent themes, we examined the prevalence within each racial group, noting those that were more prevalent (>10% difference in prevalence) in one race or the other.The sample included 19 Black and 8 White mothers, who were 36 years old on average. Qualitative analysis yielded 21 themes across 5 categories that captured divergent and convergent experiences across Black and White mothers during the OSA detection process for their child. Divergent themes that were unique to Black mothers included It Takes a Village—Teacher, Misplaced Blame, Missing the Day/night Connection, Trust in Provider, and the belief that Snoring is Normal. Only one divergent theme among White parents emerged, worries about Dying in Ones Sleep. Additional convergent themes were identified that were more prevalent in one race compared to the other.Black and White mothers experienced different paths to detection and diagnosis for their child's sleep disordered breathing, that are affected by individual awareness, education, patient-provider interactions, and experiences with the healthcare system. Divergent themes such as Misplaced Blame among Black mothers were a potential indication of racism and health disparities.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77166309","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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