Sleep epidemiology最新文献

The clinical spectrum of neuropsychiatric manifestations of juvenile systemic lupus erythematosus (JSLE) can be quite variable and sleep problems have been reported as being one of the under-recognized needs of SLE patients.

Aim Determination of sleep abnormalities among lupus children and their effects on children's scholastic achievements.

Subjects This study was carried out on 38 children with systemic lupus erythematosus and thirty healthy children, whom their guardians agreed to volunteer in the study .

Methods In the current cross sectional study all children were subjected to full clinical examination, MRI brain of the patients, sleep history, Epworth sleepiness scale and the Sleep disturbances scale for children

Results 52.6% of the studied children had different sleep patterns, as follows:13.2% disorders of initiating and maintaining sleep (DIMS), 2.6% with Sleep breathing disorders (SBD), 10.5% with disorders of arousal (DA), 5.3% with sleep-wake transition disorders (SWTD), 2.6% with disorders of excessive somnolence (DOES), 7.9% with Sleep Hyperhidrosis (SHY), 7.9% with pathological total sleep disturbances score.

5.3% of children had excessive daytime sleepiness and 21% had moderate daytime sleepiness and 73.7% had normal daytime sleepiness.

Children with positive findings in brain MRI had different sleep disorders demonstrated as follows, 33.3% had disorders of initiating and maintaining sleep (DIMS). 16.7% had Sleep Hyperhidrosis (SHY).16.7% had pathological total sleep disturbances score.

Objective

The aim of this study was to investigate the effects of insomnia combined with obstructive sleep apnea (OSA) on sexual function and climacteric symptoms in postmenopausal women.

Methods

Our sample comprised 47 postmenopausal women distributed into 3 groups: 1) insomnia group, 2) OSA group, and 3) OSA + insomnia group. All participants completed the following questionnaires: the Insomnia Severity Index, the Female Sexual Function Index, and the Blatt-Kupperman menopausal index. Of the 47 participants, 34 women undergone polysomnography. The 3 groups were compared in respect of climacteric symptoms, sexual function score, and sleep.

Results

Our results showed that 85.1% of the postmenopausal women were classified with insomnia, 46.8% were diagnosed with OSA, and 82.9% had low sexual function. All groups had sleep efficiency of < 80%, wake after sleep onset of > 65 min, and a total sleep time of < 6 h, indicating poor sleep quality. There were no statistically significant differences among the groups in all sexual domains (desire, arousal, lubrication, orgasm, satisfaction, and pain). According to climacteric symptoms, the group of OSA + insomnia reported more climacteric symptoms when compared to OSA group.

Conclusions

In our sample, the presence of insomnia and OSA associated with postmenopause revealed a low score for sexual function. Climacteric symptoms were higher in the groups with insomnia, and the association with low sexual function can lead to worsening of clinical condition. This study emphasizes the importance to identify the sleep disorders that postmenopausal women may present and to consider the possible effects they may have in sexual dysfunction.

Postsecondary students frequently report high rates of anxiety and poor sleep quality. The association between poor sleep quality and anxiety is poorly understood in this population. We conducted a cross-sectional study of students enrolled in two faculties at Ontario Tech University (OTU) - Faculty of Health Sciences (FHS) and Faculty of Education (FEd), and students attending the Canadian Memorial Chiropractic College (CMCC) during the fall of 2017 to determine the prevalence of poor sleep quality and moderate to extremely severe anxiety, as well as the association between them. Participants completed self-report questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]), anxiety (Depression, Anxiety, and Stress Scale – 21 Items [DASS-21]), socio-demographic, lifestyle and health-related variables. Multivariable logistic regression was used to measure the association between poor sleep quality and moderate to extremely severe anxiety, as well as to control for covariates. A significant correlation between PSQI scores and DASS-21 anxiety scores was found in both populations: students who reported poor sleep quality were more likely to report moderate to extremely severe anxiety. This association decreased but still remained high even after controlling for important covariates (i.e., biological sex, stress, and depression).

Insomnia is a highly prevalent sleep disorder, but its first line of treatment (Cognitive Behavioral Therapy for Insomnia - CBTi) is not widely available and affordable. Digital therapy has been an alternative to these limitations and its combination with pharmacological treatment may improve patients' clinical outcomes and therapy adherence. This was a real-world evidence study aimed to evaluate the efficacy of a CBTi smartphone app combined or not with sleep medication, based on a sample of users of a CBTi smartphone app (SleepUp®) registered between June 2020 and June 2022. Individuals were categorized into two groups (“dCBTi alone” and “dCBTi combined”) according to their self-reported use of sleep medication on the first day of treatment. Assessments were made based on the self-report of sleep logs (sleep quality and efficiency) and on insomnia severity (Insomnia Severity Index). Comparisons were made considering the first entry (baseline) and the mean of the last three days in which sleep logs were filled out (final). The final samples comprised 143 individuals: 73 (51%) reported using sleep medication at baseline, while 70 (49%) did not. In both groups, there was an improvement in sleep quality, (p<0.001), sleep efficiency (p<0.001), and insomnia severity (p<0.001). The magnitude of effects on sleep efficiency and insomnia severity was greater in the dCTBi combined group. This result indicates that dCBTi can be useful as an adjuvant treatment for insomnia.

Background

Idiopathic hypersomnia is a debilitating sleep disorder; however, little is known about the clinical presentation of patients receiving this diagnosis.

Methods

A retrospective cohort study of IBM® MarketScan® claims (January 2014 to September 2019) was conducted. Analysis cohorts included adults ≥18 years of age from the MarketScan population and a subset newly diagnosed with idiopathic hypersomnia. Diagnosis required ≥2 idiopathic hypersomnia claims separated by ≥1 and ≤180 days, and continuous enrollment ≥12 months before the diagnosis date. Descriptive statistics were reported for diagnosing medical specialties, objective sleep laboratory testing utilization, and comorbidities in the 12 months prior to diagnosis.

Results

From the general MarketScan cohort (N = 32,948,986), 4980 patients (0.015%) were newly diagnosed with idiopathic hypersomnia (mean age, 42.7 years; 66.9% female). The most common diagnosing medical specialties were pulmonary medicine (23.3%), neurology (14.4%), and internal medicine (11.4%). Only 44.4% of patients received objective sleep laboratory testing during the 12 months prior to diagnosis. The most common comorbidities were sleep apnea (49.5%), mood disorders (32.1%), depressive and anxiety disorders (31.0%, 30.7%, respectively), hyperlipidemia (30.1%), headache/migraine (23.9%), diabetes or use of diabetes/obesity medication (19.8%), hypertension (15.0%), and history of cardiovascular disease (14.3%).

Conclusions

These results suggest that idiopathic hypersomnia is diagnosed by multiple medical specialists, and less than half of clinicians utilize proximate sleep laboratory testing prior to patient diagnosis in real-world settings. Furthermore, patients commonly have cardiovascular, metabolic, and psychiatric comorbidities. Healthcare providers should consider these comorbidities and cardiometabolic risks when evaluating treatment options for idiopathic hypersomnia.

This study examined the association between daily working hours and accelerometer-based sleep duration, sleep efficiency, and number of awakenings per hour of sleep on the following night among 800 older public sector employees in Finland (mean age 63 years in the first measurement they participated in, 87% women) with 4,818 measurement nights in total. Information on working hours was derived from daily logs and categorized into: 1) 6 h, 2) 7, hours 3) 8 h, 4) 9 h, and 5) 10 or more hours of work. The most common category (i.e. workdays with 8 h of work) was used as the reference category in the analyses. Nights followed by a workday and a free day were analyzed separately. No differences were observed in sleep duration between the reference group and the other working hour categories when the next day was a workday nor when the next day was a free day. After a 6-hour workday, sleep efficiency was on average 1.0 percentage points higher and there were on average 0.13 less awakenings per hour of sleep when compared with the reference category. When the next day was a free day, no differences in sleep quality were observed. Thus, no clear indication of a dose-response relationship between working hours and either duration or quality of sleep was found. Furthermore, future research should further examine the possibility that the association between working hours and sleep is somewhat different depending on whether the workday is followed by another workday or a free day.

Introduction

Sleep is a prerequisite for mental health, but data are lacking with regard to sleep quality in voluntary emergency and rescue workers. In this analysis of data from a larger study, we assess sleep quality and explore possible risk and protective factors of Swiss alpine rescue personnel.

Methods

Using data from an online survey of 465 mountain rescuers, we estimated sleep quality with the Pittsburg Sleep Quality Index (PSQI). Participants additionally completed the PTSD Checklist-5 (PCL-5), the Perceived Stress Scale-10 (PSS-10) and the General Health Questionnaire-12 (GHQ-12).

Results

Only 14% of the participants indicated poor sleep quality. Moreover, higher scores on the GHQ-12, PCL-5, and PSS-10 emerged as risk factors for poor sleep quality.

Conclusion

Our results indicate a good sleep quality in Swiss alpine rescue personnel. Risk factors for poor sleep quality were poorer general mental health, the presence of PTSD symptoms, and higher perceived stress.

Purpose

We aimed to analyze the risk of injury in different age and gender groups experiencing parasomnias.

Methods

We collected clinical data of adult parasomnia patients seen between 2007 and 2023, from the database of the Institute of Behavioral Sciences Semmelweis University in Budapest. We classified them by age (19–39 and ≥40 years) and biological sex groups. Binary logistic regression was calculated to find the association between alcohol and tobacco use and dangerous activities, using odds ratios (ORs) at 95% CIs.

Results

Out of 45 parasomnia patients (64.5% female, and 73.4% in the 19–39 years age group), 69% experienced somnambulism and 20% had nightmare disorder. Dangerous behaviors and injuries related to sleepwalking included shoulder dislocation (6.3%), injury from breaking objects (25%), and sex without consent (12.5%). In our results, alcohol use was associated with parasomnia events 21-fold in males compared to females (p<0.05). Dangerous behavior was significantly higher in males and younger, than in older adults (OR: 4.91 and 4.61, p<0.05).

Conclusion

Parasomnias require particular care due to the risk of injury. The remarkably high odds of dangerous sleepwalking activities in males and young adults require further attention and explanation.

Objective/Background

This study aimed to compare the changes in sleep quality and use of sleep medications among beneficiaries of health plans, as well as the associated factors.

Patients/Methods

Data from two cross-sectional surveys from the 2013 and 2019 National Health Survey were used. Sleep quality and use of sleep medications were assessed using structured questions. Descriptive analyses were performed using frequency and 95% confidence interval (95% CI). Inferential analyses were performed using Poisson Regression, whose values were reported as Prevalence Ratio (PR) with their respective 95% confidence intervals.

Results

From 2013 to 2019, the prevalence of sleep problems increased from 27.1 (95%CI: 25.9-28.3) to 36.7% (95%CI: 35.5-38.0), whereas the use of sleep medications increased from 8.1 (95%CI: 7.4-8.8) to 10.0% (95%CI: 9.3-10.7). In comparation with men, sleep problems were associated with female sex in 2013 (PR: 1.46; 95%CI: 1.33-1.59) and 2019 (PR: 1.35; 95%CI: 1.27-1.44), even when adjusted for confounding factors. Sleep medications were also associated with female sex in 2013 (PR: 2.41; 95%CI: 1.98-2.94) and 2019 (PR: 1.89; 95%CI: 1.63-2.20), as well as in the adjusted model. Smoking was associated with sleep problems and use of sleep medications, however physical activity and alcohol intake no. Both sleep problems and use of sleep medications were also associated with older age and low education.

Conclusions

We found an increase in sleep problems in the two weeks before the interview among beneficiaries of health plans, as well as in the use of sleep medications.