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Elsevier Science
Sleep medicine

Elsevier Science

1389-9457

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    Discrepancy between subjective and objective sleepiness in adolescents

    Oka, YasunoriTanno, SakurakoShimizu, HiroshiFujino, Yoko...
    7页
    查看更多>>摘要：Background: Lack of correlation between subjective and objective measurements of daytime sleepiness is common. Here, the frequency of discrepancy between subjective and objective sleepiness, as well as possible predictors, were examined for an adolescent cohort.Methods: This study included pediatric patients (aged 10-18 years, n 1/4 211) with various sleep disorder symptoms were evaluated between August 2011 and February 2021. Subjective and objective sleepiness were assessed based on eleven or more scores of the Japanese version of Epworth Sleepiness Scale and a mean sleep latency of 8.0 min or less on the Multiple Sleep Latency Test, respectively. Patients were then classified as both subjectively and objectively sleepy, objectively sleepy, subjectively sleepy, and nonsleepy. Discrepancy-related factors were identified with multivariable logistic regression analysis.Results: The frequency of discrepancy between subjective and objective sleepiness was 46.4%, with 35.5% (75/211) of the patients exhibiting subjective sleepiness without objective sleepiness and 10.9% (23/211) of the patients exhibiting objective sleepiness without subjective sleepiness. Co-existence of neurodevelopmental disorders was associated more often with subjective sleepiness compared to nonsleepiness (odds ratio (OR), 4.12; 95% confidence interval (CI), 1.30 to 12.99) or concordant sleepiness (OR, 7.54; 95% CI, 2.43 to 23.38).Conclusions: Nearly half of the patients exhibited discrepancy between subjective and objective sleepiness, and it more often involved subjective sleepiness. Furthermore, age, bedtime, and neurodevelopmental disorders were identified as significant factors related to subjective sleepiness without objective sleepiness.
      原文链接:
    • NSTL
    • Elsevier

    Early signs of sleep-disordered breathing in healthy women predict carotid intima-media thickening after 10 years

    Kalleinen, NeaSaaresranta, TarjaPolo, OlliRaitakari, Olli T....
    6页
    查看更多>>摘要：Background: Cardiovascular disease (CVD) is the leading cause of death in women. The risk of CVD increases in women after menopause. The aim was to study how sleep parameters and cardiovascular risk factors in 46-year-old women predict future carotid intima-media thickness (IMT) 10 years after. Methods: Prospective study of 92 healthy women, aged 46 years, were studied at baseline and at 10-year follow-up. Polysomnography for sleep and breathing; blood samples for cholesterol, glucose and follicle stimulating hormone; blood pressure (BP), weight and height measurements; questionnaires for background variables and vasomotor symptoms were carried out at both time points. Carotid ultrasound was scanned for IMT at 10-year follow-up. Results: After adjusting for conventional risk factors, apnea-hypopnea index (AHI) during rapid-eye movement (REM) sleep was the only parameter at baseline that predicted IMT 10 years after (IMT mean: 13 81.4 [95% CI, 14.0-148.8]; IMT max: 13 104.7 [95% CI, 15.4-194.1]). At 10-year follow-up, higher arousal index (IMT mean: 13 55.6 [95% CI, 19.5-91.8]; IMT max 13 59.9 [95% CI, 11.4-108.4]) and lower vasomotor symptoms (IMT max: 13-60.5 [95% CI,-119.0 to-2.0]) were associated with concurrent higher IMT. The conventional risk factors at baseline did not associate with future IMT but 10 years after higher concurrent HbA1c (IMT mean: 13 11.0 [95% CI, 3.4-18.5]; IMT max 13 14.0 [95% CI, 4.1-23.8]) and systolic BP (IMT mean: 13 2.4 [95% CI, 1.1-3.7]; IMT max: 13 2.7 [95% CI, 1.03 to 4.53]) were associated with higher IMT. Conclusions: In healthy 46-year-old women, AHI during REM sleep predicted IMT 10 years after. The conventional risk factors (HbA1c and BP) only associated with the concurrent IMT at 10-year follow-up. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
      原文链接:
    • NSTL
    • Elsevier

    Performance of Somno-Art Software compared to polysomnography interscorer variability: A multi-center study

    Thiesse, LaurieStaner, LucFuchs, GilDehouck, Valentin...
    6页
    查看更多>>摘要：The visual scoring of gold standard polysomnography (PSG) is known to present inter- and intra-scorer variability. Previously, Somno-Art Software, a cardiac based sleep scoring algorithm, has been validated in comparison to 2 expert visual PSG scorers. The goal of this research is to evaluate the performances of the algorithm against a pool of scorers. Sixty PSG and actimetry recording nights, representative of clinical practice (healthy subjects and patients suffering from obstructive sleep apnea [OSA], insomnia or major depressive disorder), were scored by 5 different sleep scoring centers and by the Somno-Art Software. Intra-class correlation coefficient (ICC) and Wilcoxon Signed-Rank Test were calculated between each scorer and the average value of the 6 scorers, including Somno-Art Software. In addition, epoch-by-epoch agreement between scorers were analyzed. Somno-Art Software estimation of sleep efficiency, wake, N1+N2, N3 and REM sleep fit within the interscorer range for the full dataset and the subgroups, except for underestimating N3 sleep in OSA patients. Additionally, Somno-Art Software overestimated sleep latency compared to the average scoring for insomniacs (+4.7 +/- 1.6min). On the full dataset, Somno-Art Software had good (0.75 < ICC<0.90) or excellent (ICC>0.90) ICC scores for all sleep parameters except N3 sleep (moderate score, 0.50 < ICC<0.75). For the 4-stages epoch-by-epoch agreement, Somno-Art Software was slightly below that of the visual scorers except for the healthy sub-group where an overlap was demonstrated. Somno-Art Software sleep scoring shows a good interscorer reliability in the range of the 5 visual polysomnography scorers. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
      原文链接:
    • NSTL
    • Elsevier

    Polysomnographic validation of an under-mattress monitoring device in estimating sleep architecture and obstructive sleep apnea in adults

    Ding, FeihongCotton-Clay, AndrewFava, LauraEaswar, Venkat...
    8页
    查看更多>>摘要：Objective: The objective of this study is to evaluate the validity of an under-mattress monitoring device (Fullpower Technologies) in estimating sleep continuity and architecture, as well as estimating obstructive sleep apnea in an adult population. Methods: Adult volunteers (n=102, 55% male and 45% female, aged 40.6 +/- 13.7 years with a mean body mass index of 26.8 +/- 5.8 kg/m2) each participated in a one-night unattended in-lab study conducted by Fullpower Technologies. Each participant slept on a queen-sized bed with Sleeptracker-AI Monitor sensors placed underneath the mattress. Standard polysomnography (PSG) was simultaneously recorded on the same night. Researchers (FD and CK) were provided de-identified sleep studies and datasets by Fullpower Technologies for analysis. Sleep continuity measures, 30-s epoch-by-epoch sleep stages, and apnea and hypopnea events estimated by an automated algorithm from the Sleeptracker-AI Monitor were compared with the PSG recordings, with the PSG recordings serving as the reference. Results: Overall, the Sleeptracker-AI Monitor estimated similar sleep continuity measures compared with PSG. The Sleeptracker-AI Monitor overestimated total sleep time (TST) by an average of 6.3 min and underestimated wake after sleep onset (WASO) by 10.2 min. Sleep efficiency (SE) was similar between the Sleeptracker-AI Monitor and PSG (87.6% and 86.3%, respectively). The epoch-by-epoch accuracy of Sleeptracker-AI Monitor to distinguish 4-stage sleep (wake, light, deep, and REM sleep) was 79.0% (95% CI: 77.8%, 80.2%) with a Cohen's kappa of 0.676 (95% CI: 0.656, 0.697). Thirty-five participants (34.3%) were diagnosed with obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) > 5 based on PSG. Accuracy, sensitivity, and specificity for the Sleeptracker-AI Monitor to estimate OSA (an AHI >5) were 87.3% (95% CI: 80.8%, 93.7%), 85.7% (95% CI: 74.1%, 97.3%), and 88.1% (95% CI: 80.3%, 95.8%) respectively. The positive likelihood ratio (LR+) for AHI >5 was 7.18 (95% CI: 3.69, 14.0), and the negative likelihood ratio (LR-) for AHI >5 was 0.16 (95% CI: 0.072, 0.368). Conclusion: The Sleeptracker-AI Monitor had high accuracy, sensitivity, and specificity in estimating sleep continuity measures and sleep architecture, as well as in estimating apnea and hypopnea events. These findings indicate that Sleeptracker-AI Monitor is a valid device to monitor sleep quantity and quality among adults. Sleeptracker-AI Monitor may also be a reliable complementary tool to PSG for OSA screening in clinical practice. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
      原文链接:
    • NSTL
    • Elsevier

    Relationship between stressful life events and sleep quality: The mediating and moderating role of psychological suzhi

    Pan, ZhaoxiaZhang, Dajun
    7页
    查看更多>>摘要：Objective: The present study investigated the relationship between stressful life events and sleep quality. Further, it explored the mediating and moderating role of psychological suzhi in the relationship between stressful life events and sleep quality. Method: The Adolescent Self-rating Life Events Checklist (ASLEC), Pittsburgh Sleep Quality Index (PSQI), and Concise Scale of Psychological Suzhi for College Students (Health Edition) were used to collect data from a sample of 1212 college students. SPSS 20.0 and SPSS macro Process, specially developed for assessing complex models including mediators and moderators, analyzed the data. Results: High scores for stressful life events were related to worse sleep quality, and high scores on psychological suzhi were closely related with better sleep quality. Psychological suzhi mediated and moderated the relationship between stressful life events and sleep quality. Conclusions: The results demonstrate that stressful life events can directly affect the sleep quality of college students and can indirectly affect sleep quality through affecting psychological suzhi. Additionally, psychological suzhi can buffer the adverse effects of stressful life events on sleep quality. This finding supports the hypothesis that psychological suzhi can act as a pressure buffer. The results enrich the research on the function mechanism of psychological suzhi and could inform future interventions for sleep disorders. (c) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Changes in sleep following internet-delivered cognitive-behavioral therapy for insomnia in women treated for breast cancer: A 3-year follow-up assessment

    Amidi, AliBuskbjerg, Cecilie R.Damholdt, Malene F.Dahlgaard, Jesper...
    7页
    查看更多>>摘要：Background: Sleep disturbances are common in women treated for breast cancer. We have previously shown that internet-delivered cognitive-behavioral therapy for insomnia (e-CBT-I) is an efficacious, low-cost treatment approach. Furthermore, research has shown that e-CBT-I can result in sustained improvements at 12 months post-treatment. However, given the complexity and long duration of posttreatment symptomatology in breast cancer patients, as well as the recommended use of anti-hormonal therapy for up to 10 years, it is relevant to investigate long-term (> 12 months) changes in sleep following e-CBT-I in this population. In the present study, we report data from a 3-year long-term follow-up assessment after e-CBT-I. Methods: Women treated for breast cancer with sleep disturbances (Pittsburg Sleep Quality Index [PSQI] global score > 5) who had previously been enrolled in a randomized-controlled trial investigating the efficacy of e-CBT-I (n = 255), were invited to participate in a 3-year follow-up study. All women in the initial control group had also been granted access to e-CBT-I. Assessment included self-reported sleep quality (PSQI), insomnia severity (Insomnia Severity Index, ISI), cancer-related fatigue and symptoms of depression. Within-group changes in these outcomes from baseline to the 3-year long-term follow-up assessment were analyzed. Results: A total of 131 women (51%) participated in the 3-year follow-up study of which 77 (59%) were from the initial intervention group and 54 (41%) from the initial control group. For the pooled sample, within-group improvements from baseline to the 3-year follow-up assessment corresponding to large effect sizes were observed in sleep quality (Cohen's d = 1.0 95% CI [0.78, 1.21]) and insomnia severity (Cohen's d = 1.36 CI 95% [1.12, 1.59]). Similar changes were observed in cancer-related fatigue (Cohen's d = 0.48 CI 95% [0.30, 0.66]) and symptoms of depression (Cohen's d = 0.80 CI 95%. [0.60, 0.99]). The proportion of patients with scores above established cut-offs on the PSQI and the ISI were 56.1% and 29.8%, respectively. Within the initial intervention group, 15.6% evidenced relapse at the 3-year assessment. Conclusion: Overall, these results indicate that long-term sleep quality and insomnia severity following the use of e-CBT-in women treated for breast cancer is significantly lower than the pre-treatment levels. However, a substantial proportion of participants still evidence sleep disturbances. (C) 2022 The Authors. Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Bidirectional Mendelian randomization to explore the causal relationships between Sleep traits, Parkinson's disease and Amyotrophic lateral sclerosis

    Di, HongkunZhu, YiXia, WenqiMeng, Xin...
    8页
    查看更多>>摘要：Objective: Sleep disturbances have been linked with Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS) in observational studies, and the comorbidity of PD and ALS has been reported in clinical case reports, but the causalities remain unclear. This study aims to examine bidirectional causal relationships between sleep traits, PD and ALS. Methods: Bidirectional two sample Mendelian randomisation (MR) analyses were conducted, with data from individuals of mainly European ancestry. Genetic instruments were obtained from the largest published genome-wide association studies (GWAS) concerning various sleep traits, PD and ALS. MR estimates from each genetic instrument were combined by inverse variance weighted method, with alternate methods (eg, weighted median, MR Egger, MR-PRESSO) and statistical graphs to assess horizontal pleiotropy and remove outliers. Results: MR analysis failed to observe any causal association between sleep disorders and PD, but found a possible causal effect of PD risk on ALS risk (odds ratio [OR] = 1.07; 95% CI: 1.01-1.14, P < 0.01), albeit with a horizontal pleiotropy. Furthermore, MR analyses indicated that excessive daytime sleepiness (EDS) (OR = 2.29; 95% CI: 1.04-5.03, P = 0.04) contributed to a modest increase in risk of ALS, but the reverse causalities were not significant. Higher risk of ALS may be associated with being a "morning person" (OR = 1.03, P = 0.02), a longer sleep duration (OR = 1.01, P < 0.01), and a mean of 9 h or more total sleep duration (beta = 0.02, P = 0.04). Conclusions: Aided by large-scale GWAS, a shortage of evidence supporting causal relationships of sleep traits and PD risk, while significant evidence supports that EDS, higher PD risk may causally influence ALS risk. Future researches are required to explore the underlying pathological mechanism as well as the clinically significance, and replicate our findings using independent samples when data become available. (C) 2022 Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Association between sleep disorder and atrial fibrillation: A nationwide population-based cohort study

    Chen, Chun-ChaoLin, Cheng-HsinYang, Tsung YehWang, Ta-Jung...
    7页
    查看更多>>摘要：Objectives: Sleep disorder (SD), especially sleep apnea, and its effect on atrial fibrillation (AF) are gathering attention. However, other SDs may also play an essential role in AF. The aim of the study is to investigate the effects of other SDs on the risk of atrial fibrillation development. Methods: This study investigated the risk of AF in people diagnosed with SD compared with that in age and sex-matched unaffected individuals. This longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database (NHIRD) of individuals diagnosed with SD from January 1, 2001, to December 31, 2012. Results: The sample consisted of 193,288 people with the SD, which include of 4406 people with sleep apnea, 73,704 people with insomnia, 107,395 people with sleep disturbance, 7,783 people with other SD, and 193,288 matched controls. A Cox proportional hazard regression was used to compute the risk of AF in people with SD and subgroup of SD, relative to that in people without SD. The AF incidences were 1.21-fold higher (95% CI 1.15-1.27) in the SD cohort, 1.19-fold higher (95% CI 0.91-1.56) in the sleep apnea cohort, 1.26-fold higher (95% CI 1.19-1.34) in the insomnia cohort, 1.15-fold higher (95% CI 1.08-1.22) in the sleep disturbance cohort, and 1.30-fold higher (95% CI 1.11-1.53) in other SDs, than in the control cohort, after age, sex, and comorbidities were adjusted. Conclusions: This nationwide population-based cohort study indicates a strong relationship between SD and incident AF, and insomnia has a higher impact on AF compared with other SD. (C) 2022 Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Translation, cross-cultural adaptation, and psychometric properties of the Hausa version of the Insomnia Severity Index among internally displaced persons in Africa

    Salihu, D.Wong, E. M. L.Kwan, R. Y. C.Bello, U. M....
    7页
    查看更多>>摘要：Background: Although sleep disturbances and insomnia are common among Internally Displaced Persons(IDPs), these disorders remain largely understudied among victims fleeing ethnoreligious genocide. The Insomnia Severity Index (ISI), though a widely used measure of insomnia, has not been translated, crossculturally adapted, nor validated in common African languages. This paper aimed to translate, adapt and validate the ISI scale into Hausa, themost widely spoken non- Indo-European language in African continent. Methods: A six-stage validation model was used for the translation and adaptation of the ISI into Hausa [(ISI-Hausa), Item-Content Validity Index (I-CVI)=0.9 to 1.0]. The tool was administered among IDPs residing in Maiduguri, North-Eastern Nigeria, from October to November 2019. A total of 281 participants from six camps were recruited via convenience sampling. The psychometric properties of the scale were assessed using an Exploratory Factor Analysis (EFA), Cronbach's alpha (a) and Intraclass Correlation Coefficients (ICC) for determining factor structure, internal consistencyand test-retest reliability, respectively. Results: Exploratory factor reduction resulted in a two-factor solution, with " severity of insomnia " identified as the construct for Factor 1 and "impact of insomnia" as the construct for Factor 2. Factor 1 consisted of four scale items and Factor 2 consisted of three items. Factor loadings for each item ranged from 0.535-0.812. The scale demonstrated acceptable internal consistency (alpha=0.72) and good test-retest reliability (ICC=0.72) (p<0.001). Conclusion: The ISI-Hausa scale is a psychometrically sound and culturally relevant tool for assessing the severity and impact of insomnia among Hausa speaking IDPs in Africa. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Obstructive sleep apnea and road traffic accidents: a Danish nationwide cohort study

    Udholm, NichlasRex, Christian EmilFuglsang, MilosLundbye-Christensen, Soren...
    6页
    查看更多>>摘要：Study objectives: In this nationwide study, we investigate the risk and severity of all road traffic accidents in patients with obstructive sleep apnea (OSA). Methods: We used the unique Danish registries to identify all Danish citizens receiving a diagnosis of OSA between 1995 and 2015. As a reference cohort, we randomly selected 10 sex- and age-matched citizens for each patient. We used Poisson regression to calculate the incidens rate ratio (IRR) for all road traffic accidents (motor vehicle, bicycle, and pedestrian) in both groups, and Cox proportional regression analysis to compare risk of first motor vehicle accident. Lastly, we used Fischers' Exact test to compare severity of motor vehicle accident between the two groups. Results: We identified 48,168 patients with OSA, covering up to 24 years of follow-up. Patients with OSA had an increased risk of road traffic accidents when compared with the reference cohort (hazard ratio, 1.15; 95% CI, 1.10-1.20; IRR: 1.19; 95% CI, 1.14-1.29), especially motor vehicle accidents (hazard ratio, 1.29; 95% CI, 1.18-1.39; IRR 1.30; 95% CI, 1.20-1.42). The risk of accidents as pedestrian or bicyclist were not increased. Further, patients with OSA had a tendency to be involved in more severe motor vehicle accidents. Conclusions: This is the first nationwide study to estimate the risk of all road traffic accidents in patients with OSA. Our estimates show that patients with OSA have an increased risk of motor vehicle accidents, and greater severity of accidents, when compared with a large reference cohort. (C) 2022 The Author(s). Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier