Miner, BriennePisani, Margaret A.Lusczek, Elizabeth R.Knauert, Melissa P....
3页
查看更多>>摘要：The cosinor model, in which a cosine curve is fitted to periodic data within a regression model, is a frequently used method for describing patterns of cyclical activity such as circadian rhythms. For circadian variables of interest (eg, melatonin and heart rate) that do not take on negative values, the assumption of normally distributed residuals required by the general linear model, which is most commonly used for cosinor analysis, may not be appropriate. Alternatively, a generalized linear model with the gamma distribution (GZLM-gamma) is specifically defined to accommodate non-negative outcomes. Herein, we demonstrate the improved fit and gains of efficiency in detection of circadian rhythm afforded by using the GZLM-gamma in cosinor models of heart rate, actigraphic activity, and urinary 6-sulfatoxymelatonin. Notably, this improved detection of circadian rhythm allows retention of additional patients for downstream analyses, further improving study power.(c) 2022 Published by Elsevier B.V.
查看更多>>摘要：Background: The dual orexin receptor antagonist daridorexant did not impact nighttime respiratory function as assessed by the apnea/hypopnea index (AHI) and nocturnal oxygen saturation (SpO(2)) and improved sleep in patients with mild to moderate obstructive sleep apnea (OSA). These analyses were supplemented with further evaluations of various indices of OSA severity and sleep variables.Methods: In this randomized, double-blind, placebo-controlled, two-period, crossover study, 50 mg daridorexant or placebo was administered every evening for 5 days to 28 patients with mild to moderate OSA. Treatment differences (daridorexant placebo) were explored for indices of OSA severity including the number and duration of apneas and hypopneas, mean and lowest nocturnal SpO(2), sleep duration during each hour of polysomnography recording, and the number and mean and longest duration of awakenings.Results: After repeated-dose daridorexant, more respiratory events were observed compared to placebo, ie., treatment difference of 16.4 events (90% confidence interval:-0.4, 33.2) which is explained by a longer total sleep time. However, no treatment difference was detected for the longest duration of apneas and hypopneas (1.5 s [-8.3, 11.2] and 8.2 s [-6.6, 23.0], respectively), and lowest SpO(2) (0.9% [-0.3, 2.1]). The number of awakenings was similar between daridorexant and placebo while daridorexant shortened the longest duration by 16.2 min (8.5, 23.8). Overall, results were similar after single and repeated dosing for both respiratory and sleep aspects. Conclusion: These results suggest safe use of daridorexant in patients with mild to moderate OSA. Clinical trial registration: ClinicalTrials.gov NCT03765294. A study to investigate the effects of ACT 541468 on nighttime respiratory function in patients with mild to moderate obstructive sleep apnea. https://clinicaltrials.gov/ct2/show/NCT03765294.(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/).
Tereshko, YanLettieri, ChristianGigli, Gian LuigiNilo, Annacarmen...
4页
查看更多>>摘要：Two patients diagnosed with Nocturnal Groaning were treated with intramuscular injection of botulinum toxin type A (BoNT/A) in the thyroarytenoid muscle with significant reduction of groaning episodes. Treatment with BoNT/A may be an effective therapy of Nocturnal Groaning, but large clinical studies are needed to determine its role in this clinical setting. (c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Background: Although aggressive dream content is considered a distinctive feature of REM Sleep Behavior Disorder (RBD) and patients often report violent dreams during medical interviews, nonviolent behaviors (eating, drinking, urinating) and pleasant actions (e.g laughing, singing, dancing) or simply elemental, jerky limb movements are frequently observed during video-polysomnography. As a first-line pharmacological treatment, clonazepam has been shown to reduce motor symptoms during REM sleep, but its effect on dream content remains unclear. Here, we aimed to prospectively assess the dream content of individuals with drug-naive isolated RBD (iRBD) and iRBD patients treated with clonazepam.Methods: Thirteen (12 Male, 1 Female; age 65.38 +/- 10.95) iRBD patients treated with clonazepam (iRBD-T), eleven (9 M, 2 F; age 68.90 +/- 6.8) drug-naive patients (iRBD-NT) and twelve (8 M, 1 F; age 63.33 +/- 12.88) healthy control subjects of comparable age kept a dream diary over a 3-week period. Dream content analysis was conducted according to the Hall and Van de Castle method (HVdC). The Threat Simulation Scale (TSS) was employed to assess the frequency of threatening contents.Results: A total of 214 dream reports were collected. No significant differences were found in the fre-quency of threatening dream contents between the iRBD subsamples and healthy control subjects (p = 0.732). The HVdC analysis detected higher levels of Friendliness in iRBD patients compared to the control group (p = 0.036). Increased levels of Aggressiveness were only observed when differentiating dreams in which dream enactment behaviors (DEB) were present compared to dreams without DEBs, both in the iRBD-T group (p = 0.007) and the iRBD-NT group (p = 0.012).Conclusion: Our study shows no difference in the frequency of violent or threatening dreams in drug-naive iRBD patients, clonazepam-treated iRBD patients and healthy control individuals. Aggressiveness is more frequent when DEBs are reported, suggesting motor disinhibition could require sufficiently dra-matic and emotionally intense dreams, independent of clonazepam treatment.(c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Objective: To compare the efficacy of different dosage regimens of saffron supplementation on improving sleep quality among healthy adults, patients with insomnia or type 2 diabetes and patients under Methadone maintenance treatment (MMT). Methods: PubMed, Embase, The Cochrane Library and other databases were searched from inception until October 2021. Randomized controlled trials (RCTs) investigating the efficacy saffron supplemen-tation on sleep quality were included. Data were extracted independently by 2 investigators and assessed the study quality by the Cochrane risk-of-bias tool. The measurements include Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Restorative Sleep Questionnaire (RSQ). Results: The pooling of the effect sizes showed that saffron group achieve a notable treatment effect on PSQI (MD:-2.14; 95% CI:-2.86 to-1.42; P < 0.01), ISI (MD:-2.63; 95% CI:-3.70 to-2.55; P < 0.01) and RSQ (MD: 7.05; 95% CI: 1.48 to 12.62; P = 0.01) compared with placebo group. Conclusion: Saffron supplementation as a treatment for improving sleep quality have promising clinical application as its great improvement on all efficacy outcomes and no serious adverse advents occurred as the dose was increased. The dose of 100 mg saffron supplementation per day was proved to achieve excellent and more stable curative effect on improving sleep quality in our subgroup analysis. However, further investigation is necessary to confirm the efficacy and long-term safety of different doses of saffron for insomnia. (c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Objective: To investigate changes in the level of gamma-aminobutyric acid (GABA) in the left dorsolateral prefrontal cortex (DLPFC) of patients with chronic insomnia treated with real repetitive transcranial magnetic stimulation (rTMS) as compared to sham-rTMS, as measured with H-1-Magnetic Resonance Spectroscopy (H-1-MRS). Methods: Forty chronic insomnia participants were randomized to either real or sham rTMS group. The rTMS was administered once per day Continuously for 14 days with the stimulation over the left DLPFC. Left DLPFC GABA level relative to creatine (Cr) was measured by H-1-MRS. Insomnia symptom was evaluated by Insomnia Severity Index (ISI). MRS and ISI were assessed among all participants before and after treatment. This study was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100047255). Results: After treatment, the ISI score in real rTMS group was markedly decreased as compared to prerTMS (t =-4.25, p < 0.001, Cohen's d = 0.90), whereas no significant change in ISI was observed in the group of sham rTMS. In addition, we observed a significant increase of GABA+/Cr concentration in the real rTMS group after stimulation (0.37 +/- 0.11 to 0.40 +/- 0.11, p = 0.039), but that of sham did not (0.38 +/- 0.10 to 0.39 +/- 0.11, p = 0.151). However, there was no significant association between the change of GABA+/Cr in left DLPFC and the changes of ISI scores in the two groups. Conclusion: 1 Hz rTMS has the potential to increase GABA + level in left DLPFC of patients with chronic insomnia, and warrants further investigation. (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/).
查看更多>>摘要：Temporal associations between moderate-to-vigorous physical activity (MVPA) at four different multi hour intervals during the day and the following indicators of sleep quality and sleep quantity in adolescents were examined. This research is a part of the CRO-PALS study, including 129 adolescents (48 boys, 81 girls; mean age +/- SD = 15.6 +/- 0.4 years) having complete data on sleep and MVPA measured by the SenseWear Pro3 Armband monitor. As data had a hierarchical structure, repeated measures multilevel modelling was used to assess the associations between PA and sleep. During school nights, in girls, morning MVPA was not related to following indicators of sleep quality and sleep quantity. At the same time, evening MVPA was linked with longer sleep onset latency (0 = 0.064; 95%CI = 0.025 to 0.103) and higher wake after sleep onset (0 = 0.156; 95%CI = 0.0482 to 0.2638). Moreover, during weekend nights, morning MVPA was not associated with sleep, while evening MVPA was accompanied by longer sleep onset latency (0 = 0.058; 95%CI = 0.023 to 0.093), higher wake after sleep onset (0 = 0.104; 95% CI = 0.012 to 0.20), and negatively with sleep efficiency (0 =-0.019; 95%CI =-0.037 to-0.001). In boys the specific multi-hour interval of performing physical activity was not associated with any of indicators of sleep quality. In conclusion, while no strong relations between MVPA and sleep were seen among boys, in girls morning hours MVPA resulted in better sleep patterns over school nights, while afternoon MVPA was followed with slight worsening of some indicators of sleep quality across the whole week. (c) 2022 Elsevier B.V. All rights reserved.
Johnson, Jennifer M.Durrant, Simon J.Law, Graham R.Santiago, Joao...
9页
查看更多>>摘要：Poor glycaemic control is found in diabetes, one of the most common, serious, non-communicable diseases worldwide. Trials suggest a relationship between glycaemic control and measures of sleep including duration and quality of sleep. Currently, the relationship between specific sleep stages (including slow-wave sleep (SWS), a sleep stage mainly found early in the night and linked to restorative functioning) and glycaemic control remains unclear. This systematic review aimed to synthesise the evidence of the effectiveness of specific sleep stage manipulation on measures of glycaemic control (insulin resistance, fasting and post-prandial glucose and insulin). Public databases (eg psychINFO, MEDLINE, Academic Search Complete, psychARTICLES, OpenDissertations, Scopus and Cochrane library) were searched for randomised controlled trials. Trials were included if they involved direct manipulation of SWS and/or rapid eye-movement sleep to explore the impact on measures of glycaemic control (insulin resistance, fasting and post-prandial glucose and insulin). Eight trials met the eligibility criteria, with four providing data for inclusion in one of the three meta-analyses. Insulin resistance was significantly higher in the SWS disruption when compared to the normal sleep condition, (p 1/4 0.02). No significant differences were found for measures of fasting or post-prandial glucose or insulin. Risk of bias was considered low for performance bias, detection bias and incomplete outcome data, with unclear selection bias. This is an emerging area of research and this review provides preliminary findings and recommendations for future research around optimising sleep stage disruption (to further explore mechanisms) and sleep stage enhancement techniques (to explore potential interventions). (C) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Background: Obesity is an important public health problem in the United States. Identifying modifiable risk factors could guide public health intervention efforts. In this study, we leveraged a nationally representative sample of the US population to examine sex differences in the association between short sleep and obesity among US adults. Methods: Publicly available cross-sectional national data were extracted from the National Health and Nutrition Examination Survey, 2015 through 2020. A multivariable survey logistic regression model was fitted for the association between short sleep (defined as less than 7 h of sleep in 24 h) and obesity, accounting for sample stratification, clustering, and weighing. Heterogeneity was assessed using interaction terms overall and by fitting a sex-stratified model. Results: A total of 15,562 persons aged 18 years and older were included in the study. The majority were non-Hispanic whites, 18-44 years of age, with at most a high school education. Short sleepers tended to be female (55.9%; 95% CI: 53.9, 57.9) while long (59.6%; 95% CI: 57.4, 61.7) and normal sleepers (51.9%; 95% CI: 50.5, 53.2) tended to be male. As compared with normal sleep duration, 7-9 h, short sleep duration was not significantly associated with obesity in the study population overall (OR = 0.95; 95% CI: 0.83-1.08) or among males (OR = 0.98; 95% CI: 0.86-1.12). However, short sleep was associated with increased odds of obesity among females (OR = 1.22; 95% CI: 1.01-1.49). Conclusions: There is sex-based heterogeneity in the association between short sleep and obesity among US adults. Further research should explore the factors responsible, and investigate the underlying mechanism. (c) 2022 Elsevier B.V. All rights reserved.
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