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Sleep medicine
Elsevier Science
Sleep medicine

Elsevier Science

1389-9457

Sleep medicine/Journal Sleep medicineSCIISTPBSCIAHCI
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    Nocturnal pulse oximetry as a possible screening method for obstructive sleep apnea in infants with laryngomalacia

    Makhout S.Boudewyns A.Van Hoorenbeeck K.Verhulst S....
    5页
    查看更多>>摘要：? 2022 Elsevier B.V.Objective: Laryngomalacia can be an important cause of obstructive sleep apnea (OSA) in infants. Nocturnal oximetry is a cheap and safe method in comparison to polysomnography for the detection of sleep-disordered breathing. The aim of this study is to evaluate the validity of nocturnal oximetry as a diagnostic tool for OSA in infants with laryngomalacia. Methods: This retrospective study included infants with laryngomalacia and a clinical suspicion of OSA who underwent a polysomnography at the Antwerp University Hospital. The oximetry was rescored manually, blinded to the polysomnography results, according to four different scoring methods. An obstructive apnea–hypopnea index (oAHI) ≥ 2/h on polysomnography was used to define OSA. Results: This study included 53 patients with laryngomalacia (51% boys, mean age 3.72 ± 0.26 months). A diagnosis of OSA was established in 46 patients (87%) by polysomnography. Among the four different scoring methods, the scoring according to Brouillette et al., yielded the highest diagnostic accuracy with a sensitivity and specificity of 91% and 25% respectively and with a negative and positive predictive value of 25% and 91%, respectively. Correlations and the Bland–Altman plot showed a wide limit of agreement for laboratory polysomnography oAHI and nocturnal oximetry ODI. Conclusion: Our data show that overnight pulse oximetry has a high sensitivity and PPV to diagnose OSA in infants with laryngomalacia. However, the low specificity and NPV indicate that PSG is still needed to exclude OSA in cases with normal oximetry.
      原文链接:
    • NSTL
    • Elsevier

    Restless legs syndrome severity in the National RLS Opioid Registry during the COVID-19 pandemic

    Wipper B.Romero-Gutierrez C.Winkelman J.W.
    6页
    查看更多>>摘要：? 2022 Elsevier B.V.Objective/background: No research has yet assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on restless legs syndrome (RLS). We hypothesized that RLS symptom severity would be increased during the COVID-19 pandemic in a sample of patients with diagnosed RLS. Patients/methods: The National RLS Opioid Registry is a longitudinal observational study of patients using opioid medications for treatment of RLS. Questionnaires assessing RLS symptom severity, medication dosages, sleep disturbance, depression, and anxiety are administered at baseline and at recurring 6-month surveys. Survey responses from the outset of the pandemic in April/May 2020 were compared to responses completed by other participants in January/February 2020 (between-subjects analysis), as well as responses by the same participants at baseline, approximately six months later in September 2020 through February 2021, and approximately one year later in March through June 2021 (within-subjects analyses). Results: These analyses provide evidence for higher RLS symptom severity scores at the outset of the COVID-19 pandemic in the US. Symptom severity scores were still elevated on subsequent questionnaires completed over six months into the pandemic but had returned towards baseline by the spring of 2021. Participants with increases in RLS severity were significantly more likely than others to see increases in sleep disturbance, depression, and anxiety. Conclusions: This is the first study demonstrating increased RLS symptom severity during the earliest stage of the COVID-19 pandemic. These findings warrant similar investigations in other patient populations and suggest that clinicians should attend to RLS symptoms during times of socioeconomic and/or political uncertainty.
      原文链接:
    • NSTL
    • Elsevier

    Diabetes and anxiety were associated with insomnia among Japanese male truck drivers

    Sugano Y.Miyachi T.Ando T.Iwata T....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Objective/Background: Insomnia among truck drivers may contribute to traffic accidents. We previously reported that truck drivers had adverse lifestyle habits, including smoking and drinking alcohol, in addition to enforced sedentarism making them more vulnerable to lifestyle-related diseases. This study aimed to investigate the association between insomnia and diabetes, as well as the effect of anxiety related to driving tasks on this association. Patients/Methods: A total of 755 male truck drivers under 65 years of age who belonged to Akita prefecture Truck Association in Japan were investigated. Insomnia and State-Trait Anxiety Inventory (STAI) score were assessed using a self-administered questionnaire in 2020. Insomnia was defined in accordance with International classification of sleep disorders-third edition. Diabetes was defined as a fasting blood glucose level of ≥126 mg/dL and/or use of anti-diabetic drugs using data obtained from health checkups in 2018. Results: The proportions of truck drivers with insomnia and diabetes were 13.9% and 9.7%, respectively, which were higher than those in the general working population in Japan. After adjusting for age, smoking, drinking, daily hours of driving and sleep, and hypertension, the STAI score (odds ratio [OR] for the highest quartile vs. the lowest: 3.88, 95% confidence interval [CI]: 1.84–8.18) and diabetes (OR: 2.49, 95% CI: 1.11–5.60) were found to be associated with insomnia. A statistical interaction with STAI scores was not observed between diabetes and insomnia. Conclusions: The present study demonstrated that diabetes and anxiety are independently and significantly associated with insomnia in male Japanese truck drivers.
      原文链接:
    • NSTL
    • Elsevier

    Do preterm babies sleep differently than their peers? Sleep characteristics and their associations with maternal depression and parenting stress

    Zengin Akkus P.Bahtiyar-Saygan B.
    8页
    查看更多>>摘要：? 2022 Elsevier B.V.Objectives: The findings regarding the association between prematurity, sleep problems, and maternal psychological well-being are mixed. This study examined preterm- and term-born infants’ sleep patterns, ecology, and problems, in addition to the associations of these patterns with maternal parenting stress and depressive symptomatology. Methods: In total, 84 mothers of infants between 6 and 17 months of corrected age, in which 40 were preterm infants and 44 were healthy full-term infants, participated in the study. Children's sleep was evaluated by the Brief Infant Sleep Questionnaire. Maternal depressive symptoms were screened by the Edinburgh Postnatal Depression Scale. Maternal parenting stress was measured via the Parenting Stress Index-Short Form. Results: In preterm infants, lower total and nocturnal sleep duration and later falling asleep time were identified compared to term infants. Regarding sleep ecology, the percentages of poor sleepers, mother's perception of child's and her own sleep problems were similar in both groups. While the most common method of falling asleep was ‘rocking the baby’ in the preterm group, it was ‘breastfeeding’ in the term group. In both groups, the maternal perception of sleep problems positively predicted maternal parenting stress. Lastly, compared to good sleepers, higher maternal parenting stress, higher maternal perception of mother's and child's sleep problems, and lower infants' age were identified among poor sleepers. Conclusions: Despite many similarities in the sleep characteristics of preterm and term infants, several differences in sleep patterns and sleep ecology of preterm infants were identified. Since the maternal perception of sleep problems was found to predict parenting stress, guidance on infant sleep is suggested to support families.
      原文链接:
    • NSTL
    • Elsevier

    Telemedicine and insomnia: a comprehensive systematic review and meta-analysis

    Sharafkhaneh A.Salari N.Khazaie S.Ghasemi H....
    14页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: Telemedicine has been introduced as a new and effective method in dealing with public health challenges, improving access to health care, and reducing healthcare costs in today's world. Insomnia is the most common sleep disorder that can be managed with cognitive behavioural therapy, however, access to skilled therapists is an issue. Telemedicine improves access to care and thus, it may facilitate management of insomnia. The aim of this study was to assess whether telemedicine can be as effective as traditional in person sleep medicine service for the diagnosis, follow-up, and treatment of insomnia. Methods: In this systematic review and meta-analysis, studies related to telemedicine and insomnia were identified and selected, using the keywords of telemedicine, insomnia, sleep disorder, treatment, non-pharmacological treatment. The international databases of Embase, ProQuest, ScienceDirect, Scopus, PubMed and Web of Science (WoS), and Google Scholar were searched without a lower time limit, and until July 12, 2021. Data were analysed within the Comprehensive Meta-Analysis (version 2) software, and the significance level of the test was considered P ? 0.05. Results: A systematic review of 16 selected studies showed that telemedicine interventions have a positive effect on improving insomnia in different groups. The meta-analysis was performed on 2 studies. Based on the results, CBTI interventions based on telemedicine have a greater effect on improving chronic insomnia than face to face CBTI with an average difference of 2.05 ± 0.66 based on the random effects model. Moreover, the difference between the mean in the telemedicine intervention group and the non-intervention group was 0.65 ± 0.19, which shows the positive effect of the telemedicine intervention. Conclusion: The use of telemedicine in treatment of insomnia not only accelerates access to sleep services, but can also improve the efficiency of health services in terms of time and cost, as well as therapeutic effects.
      原文链接:
    • NSTL
    • Elsevier

    Dispositional mindfulness moderates the relation between brooding rumination and sleep problems in adolescents

    Yu X.Langberg J.M.Becker S.P.
    4页
    查看更多>>摘要：? 2022 Elsevier B.V.Objectives/background: This study examined whether dispositional mindfulness moderates the association between brooding rumination and sleep problems in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Participants/methods: Participants were 137 adolescents (ages 13–15 years; 64% male). Approximately half (47.4%; n = 65) were diagnosed with ADHD. Adolescents provided ratings of their dispositional mindfulness and brooding rumination. Both adolescents and parents provided ratings of adolescents’ sleep problems. Results: In analyses controlling for sex, race, study site, and group (ADHD vs. comparison), brooding rumination was associated with more adolescent- and parent-reported sleep problems only at low levels of dispositional mindfulness. This effect did not differ for adolescents with or without ADHD and was also unchanged when controlling for internalizing psychopathology symptoms. Conclusions: Our findings showed that dispositional mindfulness might buffer against the negative impact of brooding rumination on adolescent sleep. These findings may have important clinical implications and underscore the potential benefit of including mindfulness and other cognitive-behavioral approaches when treating sleep problems in adolescents.
      原文链接:
    • NSTL
    • Elsevier

    Management of the pediatric OSAS: what about simultaneously expand the maxilla and advance the mandible? A retrospective non-randomized controlled cohort study

    Meuric V.Thollon L.Remy F.Boyer E....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Objective/background: This retrospective non-randomized controlled cohort study aimed to evaluate the efficiency of simultaneous maxillary expansion and mandibular advancement for the management of pediatric OSAS. Patients/methods: The sample was composed of 94 children treated with an innovative orthopedic device to correct a Class II malocclusion associated with an OSAS. Polysomnographic recordings were performed before and after the treatment. We also included a group of 113 age-matched control patients who had the same pathologies, but who did not receive the orthopedic treatment at the time they undergone polysomnographic exams. Statistical tests evaluated the significance of the evolution of these data, both in treated and untreated control patients. Results: After nine months (±3 months) of treatment, respiratory OSAS symptoms significantly improved: the AHI significantly decreased as it became inferior to the pathological threshold (<1) for 53% of the treated patients' sample, with a greater proportion within the youngest age group (63%). Only two patients still presented a moderate OSAS after treatment, with an AHI slightly superior to 5. This positive evolution of OSAS respiratory symptoms was not observed within the control group, highlighting the real impact of the orthopedic treatment over the children's natural growth. However, sleep remained fragmented following the treatment. Conclusions: This study confirmed that simultaneous maxillary expansion and mandibular advancement induced a modification of the maxilla-mandibular anatomy, helping in the significant improvement of the respiratory OSAS symptoms. Then, considering these preliminary results, pediatric OSAS can be managed with this new orthopedic strategy, especially if it is performed early.
      原文链接:
    • NSTL
    • Elsevier

    REM sleep latency changes after version 2.1 of the AASM manual for scoring sleep

    Maya G.Gaig C.Iranzo A.Santamaria J....
    3页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: The classical criteria for scoring REM sleep changed in version 2.1 of the AASM manual for scoring sleep, by allowing N1 epochs with atonia precedent and contiguous to definite REM sleep to be scored as REM sleep in the absence of rapid eye movements when the EEG was compatible. This may shorten the REM latency in the Multiple Sleep Latency Test (MSLT) in naps with wake/N1 to REM transitions, characteristic of narcolepsy type 1. Since REM latency of <5 or <6 min is a biomarker of NT-1 we have assessed the impact of this change in scoring REM sleep in the MSLT. Methods: Ninety-two consecutive five-nap MSLT studies (460 naps) performed in our center between 2013 and 2019 for evaluation of hypersomnolence with ≥1 sleep onset REM (SOREM) naps were included. REM latencies were measured using both classical and new criteria. Results: SOREMs occurred in 255 (55.9%) naps, 134 directly from wake/N1. By using the new criteria REM latency shortened in 29.1% of these naps (mean 0.2 ± 0.5, range 0–3 min, p < 0.01), predominantly in females. Twenty-eight percent of MSLTs had at least one nap with a shortened REM latency (mean 0.1 min ± 0.2, p < 0.01). Only two MSLTs changed their REM latency to <5 min and none to <6 min with the new rules. Conclusions: The criterion to define REM sleep onset significantly influences its latency and should be considered when comparing studies performed before or after version 2.1 modification. The clinical relevance of this scoring change is probably minimal.
      原文链接:
    • NSTL
    • Elsevier

    Effect of five nights of sleep extension on peripheral vascular function: a randomized crossover investigation into long sleep duration

    Gonzales J.U.Clark C.Anderson T.
    8页
    查看更多>>摘要：? 2022 Elsevier B.V.Long sleep duration, defined as ≥9 h, is associated with increased cardiovascular mortality. We sought to determine the effect of sleep extension on peripheral vascular health. Twelve middle-aged adults were randomly assigned to spend five nights with 8 h (control) or 10+ hours time in bed (TIB) in a crossover fashion. Sleep was assessed using wrist actigraphy. Peak reactive hyperemia in the forearm was measured using venous-occlusion plethysmography as an index of microvascular vasodilation. Nighttime and morning blood pressure was recorded along with pulse wave velocity (arterial stiffness). Average sleep duration was 7.1 ± 0.3 and 9.3 ± 0.3 h for 8 and 10+ hours TIB (P < 0.001), respectfully. On average, sleep was extended by 127 ± 29 min with nine participants reaching average sleep durations >9 h. Extended sleep did not change nighttime or morning blood pressure, or pulse wave velocity (all P > 0.05). In contrast, peak forearm vascular conductance (FVC, 0.27 ± 0.08 vs. 0.23 ± 0.07 ml/100 ml/min/mmHg, P = 0.02) and total excess blood flow (28 ± 9 vs. 24 ± 11 ml/100 ml, P < 0.01) were increased following sleep extension. The change in FVC and total excess blood flow were inversely correlated with the change in wake after sleep onset and TIB (both r = ?0.62, P < 0.05), but not with sleep duration. These results demonstrate that extended time in bed accompanied by long sleep durations does not impair peripheral vascular function, but rather, may increase microvasculature vasodilatory capacity in midlife adults.
      原文链接:
    • NSTL
    • Elsevier

    Light therapy for sleep disturbances in older adults with dementia: a systematic review, meta-analysis and meta-regression

    Tan J.S.I.Cheng L.J.Chan E.Y.Lau Y....
    14页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: Sleep disturbances in older adults with dementia are common. Light therapy may help in regulating their sleep or wake cycle. However, data in the literature on the effectiveness of light therapy for the people with the said condition remain inconclusive. Thus, further research is warranted. Objectives: This review aims to synthesize the best available evidence on the effectiveness of light therapy in reducing sleep disturbances among older adults with dementia. Methods: PubMed, Embase, Scopus, CINAHL, Cochrane Library, ALOIS, PsycInfo, Web of Science, ProQuest, OpenGrey, various trial registries and different journals specializing on sleep were searched without limitations on the year of publication. Cochrane's Risk of Bias Tool version 1 and GRADE criteria were used to assess risk of bias and certainty of evidence, respectively. Meta-analysis and meta-regression analyses were conducted using Stata software. Results: A total of 18 randomized controlled trials (RCTs) involving 1012 older persons with dementia were included. The meta-analysis revealed that light therapy significantly reduced night-time awakenings (p = 0.04), enhanced sleep quality (p = 0.01) and increased relative amplitude (p = 0.01) with a small to medium effect (g = 0.26–0.43). Subgroup analyses showed that studies conducted in the Western Pacific region had a larger effect size on sleep duration and efficiency than those conducted in other regions. Univariate random-effects meta-regression revealed that sample size was a significant covariate for the effect size of sleep duration and sleep efficiency. Conclusion: This study found that the majority of outcomes had a low level of certainty. Therefore, additional well-designed and large-scale trials must be conducted to achieve a more definitive conclusion.
      原文链接:
    • NSTL
    • Elsevier