查看更多>>摘要：Objective: To evaluate the associations between sleep duration and total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Methods: The present study included 60,283 adults aged >18 years from the Chronic Disease and Risk Factor Surveillance in Nanjing. Generalized additive model (GAM) with forward stepwise selection method was used to analyze the nonlinear relationships between sleep duration and abnormal serum lipids. The reported effective degree of freedom (EDF) values in GAM indicates the degree of smooth curvature. EDF =1 is a sign of linear correlation between predictors and outcome. EDF >1 is the sign of a more complex relationship between sleep duration and abnormal serum lipids. Results: The evaluation of interaction of sex and sleep duration by using multivariable GAM revealed a Ushaped correlation between sleep duration and dyslipidemia (EDF = 4.60, P < 0.001), high TC (EDF = 3.38, P < 0.001), and high LDL-C (EDF = 3.67, P < 0.001) in male, and a U-shaped correlation between sleep duration and dyslipidemia (EDF = 4.69, P < 0.001), high TC (EDF = 3.33, P < 0.001), and high LDL-C (EDF = 3.21, P < 0.001) in female. There was a U-shaped correlation between sleep duration and high TG in male (EDF = 3.84, P < 0.001) and semi-linear correlation in female (EDF = 1.82, P = 0.028). Moreover, there was a linear correlation between sleep duration and low HDL-C in men (EDF = 1.04, P = 0.002), but no significant correlation in women (EDF = 3.18, P = 0.080). Conclusions: Both shorter and longer sleep durations were associated with abnormal serum lipid profiles in men and women. (c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Introduction: Variability and prolongation of ventricular repolarization -measured by changes in QT interval and QT variability are independently associated with ventricular arrhythmias, sudden death, and mortality but such studies did not examine the role of sleep-disordered breathing. We aimed to determine whether sleep-disordered breathing moderated the association between measures of ventricular repolarization and overall mortality. Methods: Eight hundred participants were randomly selected from each of the following four groups in the Sleep Heart Health Study: mild, moderate, severe or no sleep disordered breathing (n = 200 each). Overnight electrocardiograms were analyzed for QTc duration and QT variability (standard deviation of QT intervals, normalized QT interval variance and the short-term interval beat-to-beat QT variability). Cox proportional hazards penalized regression modeling was used to identify predictors of mortality. Results: Eight hundred of 5600 participants were randomly selected. The participants (68 +/- 10 years; 56.8% male) were followed for an average of 8.2 years during which time 222 (28.4%) died. QTc, SDQT, and QTVN were associated with the presence of SDB (p = 0.002, p = 0.014, and p = 0.024, respectively). After adjusting for covariates, the presence of sleep-disordered breathing did not moderate the association between QTc length, QT variability and mortality (p > 0.05). Conclusion: Sleep-disordered breathing was associated with some measures of ventricular repolarization. However, sleep-disordered breathing was not an effect modifier for the relationship between QTc and QT variability and mortality. (C) 2022 Elsevier B.V. All rights reserved.
Ji, YangLiang, YingminMak, Judith C. W.Ip, Mary S. M....
13页
查看更多>>摘要：With the current epidemic of obesity worldwide, the prevalence of various obesity-related diseases is constantly increasing. Obesity remains the strongest phenotypic risk factor in both obstructive sleep apnea (OSA) and non-alcoholic fatty liver disease (NAFLD). In OSA, intermittent hypoxia-reoxygenation and sleep fragmentation, as a result of recurrent episodes of upper airway obstruction during sleep, may give rise to a plethora of metabolic derangements downstream. Intermittent hypoxia (IH) is postulated to be an important mechanistic trigger for potential systemic impact on organs or tissues in OSA, and has served as a useful experimental model for seeking evidence for downstream effects of OSA. This narrative review focuses on the clinical association between OSA and NAFLD, and the role of IH in the progression of NAFLD in lean and diet-induced obese animal models. Understanding the roles of obesity and IH on NAFLD would advance our limited knowledge on the potential health consequences of OSA, a disease which is afflicting more and more people globally, and also in devising effective therapeutic strategies for this progressively common liver condition. (c) 2022 Elsevier B.V. All rights reserved.
Adams, Elizabeth L.Master, LindsayBuxton, Orfeu M.Savage, Jennifer S....
8页
查看更多>>摘要：Objective/background: Night wakings are common during infancy, with variability in infant self-soothing or requiring parent involvement to fall back asleep. Reasons for variable soothing behaviors are unclear and may be influenced by early-life sleep parenting practices. The study applied a novel method using sleep actigraphy in mother-father-infant triads to quantify infant-only wake bouts (i.e., "self-soothing") and examined associations between sleep parenting practices from 6 to 24 weeks of age. Patients/methods: Mother-father-infant triads (N = 20) wore sleep monitors for 1 week at infant ages 6, 15, and 24 weeks. Data were time-matched within families to quantify infant-only wake bouts (when infants woke in the night and parents remained asleep) to be indicative of infant self-soothing. Mothers reported on sleep parenting practices (e.g., feeding to sleep, putting infants to bed while awake) using the Brief Infant Sleep Questionnaire at each age. Mixed models tested associations between parenting practices and infant-only wake bouts. Results: Most mothers (69.5%) reported typically feeding their infants to sleep at bedtime; 27.1% reported typically putting infants to bed while still awake. Parenting practices associated with a greater proportion and frequency of infant-only wake bouts included not typically feeding infants to sleep during night wakings, putting infants to bed while still awake (at 24 weeks of age), and using a greater proportion of low-, rather than high-, stimulus soothing strategies during night wakings.Conclusion: These data suggest parenting practices, such as putting infants to bed when drowsy but still awake, are important strategies for promoting infant self-soothing during night wakings. (c) 2022 Elsevier B.V. All rights reserved.
da Silva, Roberto PachecoMartinez, DenisRamos, Jhoana Mercedes UribeMartins, Emerson Ferreira...
10页
查看更多>>摘要：Objectives/background: The prevalence of obstructive sleep apnea (OSA) in people over 70 years can reach up to 95%. Aerobic or combined exercise programs have been shown to impact positively on OSA severity. Resistance training changes leg fluid retention. We hypothesized that through this mechanism it may have an impact on the OSA severity in older adults. Patients/methods: We evaluated changes in the respiratory event index (REI) of older adults with moderate-severe obstructive sleep apnea in a randomized, masked, controlled, parallel group trial. Participants between the age of 65 and 80 years with REI between 20 and 50 events/hour were assigned randomly to 12 weeks of resistance training or healthy life-style recommendations. Change in REI was the primary outcome. Muscle thickness, maximum strength, and physical function were secondary outcomes and body mass index (BMI) and body water content were assessed as mediators. Results: Twenty-three subjects were included, 57% men, aged 71 +/- 5 years, randomized to training (n = 12) and control intervention (n = 11). The baseline REI in the training and control groups were 30 +/- 7/h and 29 +/- 9/h; at follow-up, the delta REI were -3.6/hour (95% confidence interval-0.7 to-5.4) and 6.7/hour (5.2-8.6), respectively, with significant time x group interaction that remained significant after adjusting the generalized estimating equations model for delta BMI and delta body water content. Conclusions: Twelve weeks of resistance training in older adults significantly changed the respiratory event index and was well tolerated. Changes in body water content were slight but cannot be dismissed as contributing to REI reduction. (c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Objective: Different aspects of sleep problems tend to occur simultaneously, which could lead to adolescent health problems. We aimed to identify the distinct patterns of sleep problems and to explore their association with internalizing and externalizing problems. Methods: Secondary data from 11,831 adolescents from the Shandong Adolescent Behavior and Health Cohort were obtained and after data cleaning, 9,871 (50.1% females, mean age was 15.02 +/- 1.45 years) were used in this study. Sleep problems (short weeknight sleep duration, insomnia, daytime sleepiness, no post-lunch napping, and snoring), and covariates were measured at the baseline, and the internalizing and externalizing problems were measured at both the baseline and one-year follow-up. The latent class analysis was used to identify the patterns of sleep problems at the baseline. Linear mixed effect models were used to examine the relationship between classes of sleep problems and internalizing and exter-nalizing problems. Results: Three classes of sleep problems were identified, named as "short and disturbed sleep" (34.1%), "no post-lunch napping" (16.7%), and "no/mild sleep disturbance" (49.2%), respectively. The "short and disturbed sleep" class exhibited higher levels of internalizing and externalizing problems than the other two classes. Also, it showed a steeper decreasing trend in internalizing and externalizing problems over time. Conclusions: The findings shed light on the importance and significance of identifying the patterns of multiple sleep problems to effectively identify adolescents at higher risk of developing internalizing and externalizing problems, and to designate tailored intervention to eliminate co-occurring sleep problems to promote adolescent emotional and behavioral health. (c) 2022 Elsevier B.V. All rights reserved.
Cheung, Irene C. W.Thorne, Peter R.Hussain, SyedNeeff, Michel...
21页
查看更多>>摘要：Background: Obstructive sleep apnea (OSA) has been linked to multiple co-morbidities, and some research points to a potential relationship between OSA and hearing and balance dysfunction, and the benefits of continuous positive airway pressure (CPAP) treatment. Objective: The present study was undertaken as a scoping review of research on OSA and its impact on hearing and balance function in adults and children and whether the treatment of CPAP would affect hearing and balance function. Method: Online databases were used to identify 45 papers published that used hearing and balance assessments concerning OSA and CPAP therapy as a primary outcome. The secondary outcome was the subjective perception through validated questionnaires. Results: Whilst the data on the effect of OSA on middle ear function remains inconclusive, most papers demonstrate an increase in hearing thresholds, an absence of otoacoustic emissions (OAE) and delayed auditory brainstem response (ABR) in adults with OSA. Nystagmus and abnormal vestibular evoked myogenic potentials (VEMPs) were observed in the small number of papers. The positive pressure from CPAP significantly and transiently increases middle ear pressure, however, its effects on other auditory regions and the vestibular system remains inconclusive. Research on hearing and balance function in children with OSA is limited. Conclusions: Narrow assessments of hearing and balance are not sufficient to understand the nature of hearing and balance function in OSA patients and the effect of CPAP therapy. More comprehensive as-sessments are necessary to observe peripheral and central changes in the auditory and vestibular pathways.(c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Background: Obstructive sleep apnea (OSA) remains massively underdiagnosed, due to limited access to polysomnography (PSG), the highly complex gold standard for diagnosis. Performance scores in predicting OSA are evaluated for machine learning (ML) analysis applied to 3D maxillofacial shapes. Methods: The 3D maxillofacial shapes were scanned on 280 Caucasian men with suspected OSA. All participants underwent single night in-home or in-laboratory sleep testing with PSG (Nox A1, Resmed, Australia), with concomitant 3D scanning (Sense v2, 3D systems corporation, USA). Anthropometric data, comorbidities, medication, BERLIN, and NoSAS questionnaires were also collected at baseline. The PSG recordings were manually scored at the reference sleep center. The 3D craniofacial scans were processed by geometric morphometrics, and 13 different supervised algorithms, varying from simple to more advanced, were trained and tested. Results for OSAS recognition by ML models were then compared with scores for specificity and sensitivity obtained using BERLIN and NoSAS questionnaires. Results: All valid scans (n = 267) were included in the analysis (patient mean age: 59 +/-; 9 years; BMI: 27 +/- 4 kg/m(2)). For PSG-derived AHI >= 15 events/h, the 56% specificity obtained for ML analysis of 3D craniofacial shapes was higher than for the questionnaires (Berlin: 50%; NoSAS: 40%). A sensitivity of 80% was obtained using ML analysis, compared to nearly 90% for NoSAS and 61% for the BERLIN questionnaire. The auROC score was further improved when 3D geometric morphometrics were combined with patient anthropometrics (auROC = 0.75). Conclusion: The combination of 3D geometric morphometrics with ML is proposed as a rapid, efficient, and inexpensive screening tool for OSA. (c) 2022 Elsevier B.V. All rights reserved.
查看更多>>摘要：Background: Depressive symptoms typically exhibit sex differences among medical students and are associated with bedtime procrastination (BP) and self-control. However, it remains unclear whether sex differences exist in the relationship between these variables. Methods: A cross-sectional observational study was conducted among 402 medical students from a public university in China. Students' depressive symptoms, BP, and trait self-control were assessed using the Chinese version of the Beck Depression Inventory (BDI)-II, the Bedtime Procrastination Scale, and the Self-control Scale, respectively. Applying a BDI cutoff value of 14, 364 valid participants were divided into non-depressed (<14) and depressed (>14) groups. Results: Binary logistic regression revealed that BP was an independent predictor of the prevalence of depressive symptoms in women only. Hierarchical regression showed that high BP levels were independently positively correlated to more depressive symptoms only in non-depressed women. In contrast, low self-control levels were independently negatively correlated to more depressive symptoms in non depressed and depressed female students. Furthermore, structural equation modeling reflected the mediating role of BP between self-control and depressive symptoms in the non-depressed female group only. Conclusions: Sex differences exist in the effect of BP on depressive symptoms as well as the relationship between self-control and depressive symptoms among Chinese medical students. As a moderator, sex regulates the mediating effect of BP on the relationship between self-control and depressive symptoms in the non-depressed group. These findings provide a sex-specific perspective for targeted prevention and intervention of depressive symptoms among high-risk medical students, especially during the non depressed period.(c) 2022 Elsevier B.V. All rights reserved.
Calvo-Schimmel, AlejandraPaul, Steven M.Cooper, Bruce A.Harris, Carolyn...
14页
查看更多>>摘要：Objective: /Background - Depression and sleep disturbance are significant problems during chemotherapy. Study purposes were to identify subgroups of patients with distinct joint depression AND sleep disturbance profiles and evaluate for differences in demographic and clinical characteristics, severity of symptoms, and quality of life (QOL) outcomes among these subgroups. Patients/methods: Oncology outpatients (n = 1331) completed measures of depression and sleep disturbance six times over two chemotherapy cycles. Latent profile analysis, that modeled the two symptoms together, was done to identify the distinct joint depression and sleep disturbance profiles. Results: Five distinct profiles were identified (i.e., no depression or sleep disturbance (None, 21.4%); no depression and moderate sleep disturbance (32.3%); subsyndromal depression and very high sleep disturbance (20.4%); moderate depression and moderate sleep disturbance (17.7%); and high depression and very high sleep disturbance (8.2%)). Compared to the None class, the other four classes were more likely to be female; less likely to be employed; had a higher comorbidity burden; and had a lower functional status. Patients in the two very high sleep disturbance classes had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and fatigue as well as lower levels of energy, cognitive function, and poorer QOL. Conclusions: Over 45% of the patients had subsyndromal to high levels of depression AND moderate or very high levels of sleep disturbance. Characteristics associated with the higher risk profiles can be used to screen patients at increased risk for both symptoms. (c) 2022 Elsevier B.V. All rights reserved.
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