Frontiers in sleep最新文献

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.

Introduction: This study evaluated the performance of a wrist-worn wearable, Verily Study Watch (VSW), in detecting key sleep measures against polysomnography (PSG).

Methods: We collected data from 41 adults without obstructive sleep apnea or insomnia during a single overnight laboratory visit. We evaluated epoch-by-epoch performance for sleep vs. wake classification, sleep stage classification and duration, total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency (SE), and number of awakenings (NAWK). Performance metrics included sensitivity, specificity, Cohen's kappa, and Bland-Altman analyses.

Results: Sensitivity and specificity (95% CIs) of sleep vs. wake classification were 0.97 (0.96, 0.98) and 0.70 (0.66, 0.74), respectively. Cohen's kappa (95% CI) for 4-class stage detection was 0.64 (0.18, 0.82). Most VSW sleep measures had proportional bias. The mean bias values (95% CI) were 14.0 min (5.55, 23.20) for TST, -13.1 min (-21.33, -6.21) for WASO, 2.97% (1.25, 4.84) for SE, -1.34 min (-7.29, 4.81) for SOL, 1.91 min (-8.28, 11.98) for light sleep duration, 5.24 min (-3.35, 14.13) for deep sleep duration, and 6.39 min (-0.68, 13.18) for REM sleep duration. Mean and median NAWK count differences (95% CI) were 0.05 (-0.42, 0.53) and 0.0 (0.0, 0.0), respectively.

Discussion: Results support applying the VSW to track overnight sleep measures in free-living settings. Registered at clinicaltrials.gov (NCT05276362).

Objectives: To identify factors to optimize long-term non-invasive ventilation (LT-NIV) use by exploring the experience of children using LT-NIV and their parents.

Study design and methods: A qualitative framework analysis method was used. Children aged 8-12 years who used LT-NIV for at least 3-months and their parents/guardians were approached to participate. Thematic analysis of data derived from focus group interviews, conducted separately for children and parents, was performed. Findings were coded and grouped into identified themes.

Results: Data analysis identified four themes: (1) "The double-edged sword," which identified benefits and challenges of LT-NIV use; (2) "Feeling different," where children and parents described fears, frustrations, and concerns including emotional and social implications, and physical changes; (3) "It's not just about the mask," highlighted the influence of equipment issues, including the mask interface, headgear, tubing and humidity, and their impact on tolerance and use of LT-NIV; and (4) "Through the eyes of experience-children and parents as experts for change," which captured ideas for the functional and aesthetic improvement of the equipment including the need for pediatric specific technology.

Conclusions: LT-NIV use has two sides; it helps to improve lives though requires an investment of time and commitment to ensure success. Investing in pediatric-specific equipment needs to be a priority as do alliances between healthcare providers, children who use LT-NIV, and their families. Future technology development and studies of adherence need to consider the experiences of children and their families to reduce the challenges and support optimal use of LT-NIV.

Purpose: Little is known regarding women's lived experiences of how diet impacts sleep. Based on ethnographic interviews among working-class women from Mexico City, our primary aim was to identify themes related to diet and sleep among midlife women. Informed by qualitative analyses, a secondary aim was to examine associations between tea and sleep duration in a broader cohort.

Materials and methods: We conducted a cross-sectional study that entailed in-depth ethnographic interviews about sleep and other behaviors, including diet, with a purposive sample of 30 women from the ELEMENT cohort. Ethnographer field notes and transcripts were analyzed using thematic analysis. Guided by findings from the interviews demonstrating that tea consumption might be associated with sleep, we conducted post-hoc analyses of the relationship between tea and sleep duration using data from food frequency questionnaires and actigraphy, respectively, in the broader cohort (n = 406).

Results: The mean (SD) age of the ethnographic sample was 50.0 (9.0) years. The top noted theme was the use of herbal tea (in Spanish infusion) to improve sleep; most women (29/30) discussed herbal teas, characterizing them as a "natural remedy" to facilitate sleep. The mean (SD) age of the broader sample (N = 406) was 48.4 (6.2) years. Post-hoc analyses revealed positive associations between tea without sugar (though not necessarily herbal tea) and sleep duration. We found that every serving of tea without sugar consumed was associated with an 18.0 min per night [β (SE) = 18.0 (7.8); p = 0.022] and a 13.4 min per night [β (SE) =13.4 (5.6); p = 0.017] increase in weekend and 7-day sleep duration, respectively.

Conclusions: Within a sample of 30 midlife women, dietary practices were described in relation to sleep, specifically the consumption of herbal teas to promote sleep.

Objective: The current study compared self-reported sleep in undergraduate students in Austria and the United States.

Methods: The Pittsburgh Sleep Quality Index responses from 292 Austrian university students (237 females) and 313 U.S. university students (189 females) were analyzed. In addition to the standard scoring procedure for the scale and the individual components of the scale, the data were also evaluated as separate sleep quality and sleep quantity factors using ANOVAs. Sleep timing (bedtime, wake-time, and midpoint) was also examined using independent t-tests.

Results: Austrian students reported better sleep quality and quantity than the U.S. students. In addition, Austrian students had more sleep disturbances and took longer to fall asleep but slept longer and used less sleep medication than U.S. students. Austrian students also went to bed earlier and woke up later than U.S. students.

Conclusions: The current results indicate that sleep in undergraduate students varies across countries. A major difference between the two groups of students was the university setting with the Austrian students living in a large urban area and the U.S. students living in a rural college town, suggesting that the environment could impact student sleep and sleep choices. Finally, the current data indicate that examining sleep quality as a separate factor from sleep quantity provides additional information about sleep in college students. Better documenting sleep and sleep habits in college students across different countries can address important differences that universities and societies can use to help improve sleep and wellbeing in their students.

Here, we aimed to clarify the factors that cause individual differences in manual spindle detection during sleep by comparing it with automatic detection and to show the limitations of manual detection. Polysomnography (PSG) signals were recorded from ten young male participants, and sleep stages were classified based on these signals. Using time-frequency analysis, we detected sleep spindles from the single-channel electroencephalography (EEG) of C4-A1 within the same PSG data. Our results show a detailed accuracy evaluation by comparing the two skilled scorers' outputs of automatic and manual sleep spindle detection and differences between the number of sleep spindle detections and spindle time length. Additionally, based on automatic detection, the distribution of Cohen's kappa for each scorer quantitatively showed that individual scorers had detection thresholds based on EEG amplitude. Conventionally, automatic detection has been validated using manual detection outputs as the criterion. However, using automatic detection as the standard and analyzing the manual detection outputs, we quantitatively showcased the differences in individual scorers. Therefore, our method offers a quantitative approach to examining factors contributing to discrepancies in sleep spindle detection. However, individual differences cannot be avoided when using manual detection, and automatic detection is preferable when analyzing data to a certain standard.

Introduction: Identifying prognostic factors of treatment outcome may assist in customizing an intervention to a patient's needs. Hence, we conducted a secondary analysis of data from a randomized controlled trial to investigate the effectiveness of an internet-based cognitive behavioral therapy for insomnia (iCBT-I) to find patient characteristics that may predict the change of insomnia severity after treatment.

Materials and methods: In this exploratory analysis involving 94 chronic insomnia patients, we examined the predictive value of several self-reported measures, medical history, and sociodemographic variables to psychological distress with separate linear regression models. The main outcome was the Insomnia Severity Index score improvement from pre- to post-treatment.

Results: The study found that duration of insomnia, b (SE) = -0.02 (0.01), p = 0.01, and attitudes about the expected treatment success, b (SE) = 0.80 (0.27), p = 0.004, were predictors of a better outcome. Moreover, a better outcome was associated with a lower level of the following traits: attention seeking, b (SE) = -1.06 (0.51), p = 0.04; grandiosity, b (SE) = -1.50 (0.57), p = 0.01; distractibility, b (SE) = -1.57 (0.75), p = 0.04; and rigid perfectionism, b (SE) = -1.32 (0.65), p = 0.05.

Conclusion: Our results suggest that iCBT-I might be particularly beneficial for patients with higher expectations from the therapy and those who have a shorter duration of insomnia. Some pronounced personality traits, such as attention seeking, grandiosity, distractibility, and rigid perfectionism, may predict worse outcomes. However, because this was a post-hoc analysis, our results must be considered exploratory and verified in further studies.

Clinical trial registration: https://clinicaltrials.gov/study/NCT04300218?cond=NCT04300218&rank=1, Identifier NCT04300218.

Background: It has been suggested that a short nap in the afternoon may improve sleepiness, alertness, and task performance. The present study evaluated the effects of a 30-min rest with a new nap chair on task performance, sleepiness, and neurophysiological measures.

Methods: A randomized controlled crossover trial with a 1-week interval was carried out at the BOOCS Clinic Fukuoka in Japan. The subjects were male workers aged 20 to 64 years with suspected brain fatigue, which was defined by the Profile of Mood Status 2. The intervention was a 30-min rest with an office chair or a nap chair. The primary outcome was the performance in the Uchida-Kraepelin test. The secondary outcomes included the Karolinska Sleepiness Scale and 15-min heart rate variability (HRV). The changes after the nap-chair rest and office-chair rest were compared. Repeated measures analysis of variance with nesting was used in the statistical analysis.

Results: Twenty participants were eligible and entered the crossover trial. The overall 15-min score in the Uchida-Kraepelin test improved after the nap-chair rest and after the office-chair rest to almost the same extent (5.9 vs. 5.5 points, P = 0.68). The Karolinska Sleepiness score significantly decreased after the nap-chair rest, and the between-treatment difference in the decrease was highly significant (P = 0.0004). The average duration of sleep during rest was prominently longer in the nap-chair rest than in the office-chair rest (19.0 vs. 7.6 min, P = 0.002). No participants experienced REM sleep during the rest. LF and HF powers of the HRV were greater during the nap-chair rest than during the office-chair rest, the difference in the HF power being substantial.

Conclusion: A 30-min rest with the nap chair did not appreciably improve the performance in the Uchida-Kraepelin test as compared with the office-chair rest. The nap-chair rest induced a substantially longer sleep accompanied with a parasympathetic activation, thereby resulting in a material improvement in sleepiness after the rest.