首页期刊导航|Sleep medicine
期刊信息/Journal information
Sleep medicine
Elsevier Science
Sleep medicine

Elsevier Science

1389-9457

Sleep medicine/Journal Sleep medicineSCIISTPBSCIAHCI
正式出版
收录年代

    Treatment initiation and utilization patterns of pharmacotherapies for early-onset idiopathic restless legs syndrome

    Vouri, Scott M.Brown, Joshua D.Setlow, BarryGoodin, Amie J....
    9页
    查看更多>>摘要：Objective/background: Restless legs syndrome (RLS) is a complex condition associated with circadian rhythm that disrupts sleep and can cause multisystemic consequences. This study assesses pharmacotherapy treatment initiation, estimates annual treatment prevalence, and assesses treatment patterns for early-onset idiopathic RLS. Methods: We used the MarketScan Commercial Claims Database from 2012 to 2019 to conduct a new user retrospective cohort study. Annual treatment prevalence was calculated from a cross-sectional sample. Newly diagnosed adults with early-onset (18-44 years) idiopathic RLS who initiated on and off-label gabapentinoids, dopamine agonists, or levodopa/carbidopa were included. Among monotherapy users who had one year of insurance enrollment, treatment patterns (single fill, continuous use of initiated therapy, switching, and add-on therapy) were examined and mean time on the initial treatment (as a measure of persistence) was calculated. Results: In total, 6, 828 patients were initiated on monotherapy treatment for early-onset idiopathic RLS in which 4,638 met all inclusion criteria. In 2019, annual prevalence of monotherapy treatment of diagnosed patients for ropinirole was 171.3/1,000 patients; 85.0/1,000 patients for pramipexole; and 132.1/1,000 patients for gabapentin. Overall, 22.3% (n = 1,033) of patients maintained their initiated pharmacotherapy for the entire year. Rotigotine had the longest persistence (mean 185.4 [161.4 SD] days) but this user group was the smallest (n = 29). Gabapentin enacarbil, pregabalin, and rotigotine use was low (2.8% total). Conclusion: Ropinirole, pramipexole, and gabapentin were initiated most often for early-onset idiopathic RLS. FDA-approved agents for RLS, including gabapentin enacarbil and rotigotine, were used less frequently. In general, persistence was low for all RLS study drugs examined. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Long working hours, work-related stressors and sleep disturbances among Chinese government employees: A large population-based follow-up study

    Qiu, DanLi, YiluLi, RuiqiHe, Jun...
    8页
    查看更多>>摘要：Currently, evidence on the associations between long working hours and sleep disturbances among the Chinese workers is lacking. This study aimed at explore the possible associations and underlying mechanisms between long working hours and sleep disturbances among Chinese government employees. A total of 16206 government employees were recruited at baseline and 11806 of which were available at follow-up. A digital self-reported questionnaire platform was established to collect information. Sleep disturbances were assessed by the Pittsburgh Sleep Quality Index (PSQI), long working hours was assessed by self-report. Binary logistic regression analysis and path analysis were conducted. The results showed that long working hours at baseline were significantly associated with poor sleep quality at follow up (OR: 1.29, 95% CI: 1.12 - 1.47). Long working hours at baseline were significantly associated with some specific sleep disturbance components at follow-up including long sleep latency (OR = 1.17, 95%CI: 1.01 - 1.38), as well as short sleep duration (OR = 1.26, 95%CI: 1.12 - 1.43), impairment of sleep efficiency (OR = 1.27, 95%CI: 1.01 - 1.26), sleep disturbances (OR: 1.39, 95%CI: 1.02 - 1.95) and daytime dysfunction (OR: 1.27, 95%CI: 1.08 - 1.49). Work stress and job dissatisfaction mediated the relationship between long working hours and sleep disturbances. Continued overtime work should be recognized as a risk factor for the development of sleep disturbances among Chinese government employees. Work stress and work dissatisfaction mediated the relationship between long working hours and sleep disturbances. Effective interventions should be provided to employees who have experienced long working hours. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Comparison of expiratory pressures generated by four different EPAP devices in a laboratory bench setting

    Sleeper, GeoffreyRashidi, MajidStrohl, Kingman P.Najimi, Neda...
    6页
    查看更多>>摘要：Objective/background: Expiratory positive airway pressure (EPAP) has been a treatment option for patients with obstructive sleep apnea (OSA). ULTepap is a new FDA-cleared EPAP device that seals the nares with a nasal pillow interface. Comparisons of expiratory pressures generated by ULTepap and other EPAP devices like Provent, Bongo Rx, and Theravent are not available. We aimed to compare the backpressures created by these devices in an in vitro laboratory bench setting. Methods: A test rig was designed and fabricated to test the expiratory pressures generated by ULTepap, Provent, Bongo Rx, and Theravent. Airflow was generated by a linear actuator-driven piston in a syringe, and a range of flow rates was provided by varying the voltage input to the actuator. The resulting expiratory and inspiratory pressures were measured and resistances were calculated. Results: The backpressures generated by ULTepap and Provent were comparable at all flow rates. For flow rates at 99/142/212 ml/s, the expiratory pressures were 3.5/7.5/13.8 cmH2O for ULTepap and 4.5/8.5/14.5 cmH2O for Provent. Bongo Rx and Theravent devices produced substantially lower backpressures compared to ULTepap devices (0.8/1.8/3.5 cmH2O for Bongo Rx and 0.9/2.2/5.3 cmH2O for Theravent at flow rates of 99/142/212 ml/s). All four devices presented very low inspiratory flow resistance, with all generating 0.5 cmH2O or less at all flow rates. Conclusion: Not all FDA-cleared EPAP devices produce similar expiratory pressure profiles. ULTepap generated backpressures closest to that of Provent. Clinical trials comparing the efficacy, tolerance, and adherence of these EPAP devices in patients with OSA are warranted. Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Epidemiology and risk factors for sleep disturbances in children and youth with cerebral palsy: An ICF-based approach

    Chia, Aletheia ZhTan, Yi HuaYeo, Tong HongTeoh, Oon Hoe...
    6页
    查看更多>>摘要：Objectives and background: Children with cerebral palsy are at risk for sleep disorders, and there is a complex relationship between sleep and physical, environmental and functional factors in such children. The WHO International Classification of Functioning, Disability and Health model serves as a universal framework for describing and organizing functioning and disability. This study aimed to describe sleep disturbances in Singaporean children and youth with cerebral palsy, and develop a holistic framework for evaluating risk factors and potential management strategies for poor sleep. Methods: A cross-sectional analysis was conducted on 151 children and youth in a nationwide registry for cerebral palsy. The WHO International Classification of Functioning, Disability and Health for Cerebral Palsy Questionnaire was used to identify sleep disturbances. Risk factors analyzed were age, gender, ethnic background, financial assistance, the dominant motor feature of cerebral palsy, functional status, and comorbidities such as active epilepsy, hearing and visual impairments, generalized pain, muscle tone and involuntary contractions. Results: 46% had difficulty with sleep, with similar proportions having difficulty with amount, onset, maintenance and quality of sleep. On multivariate regression analysis, higher functional gross motor impairment as indicated by a GMFCS level of V (adjusted OR 4.24; 95% CI 1.09-19.0) and difficulty with involuntary contractions (aOR 2.80; 1.20-6.71) were significant factors for sleep difficulties. Conclusion: An ICF-based framework was useful in identifying possible contributory factors and strategies for managing poor sleep. Further studies with objective sleep measures would allow for better characterization of sleep disturbances in children and youth with cerebral palsy, and guide management. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Impact of moderate-to-severe obstructive sleep apnea on aggressive clinicopathological features of papillary thyroid carcinoma

    Liang, FayaWang, MinhongHan, PingLin, Peiliang...
    6页
    查看更多>>摘要：Objective: Obstructive sleep apnea (OSA) may to be strongly associated with cancer mortality. The risk hazards of OSA regarding aggressive features of papillary thyroid carcinoma (PTC) remain unclear. The main objective of this study was to explore the relationship between OSA and aggressive features of PTC. Methods: We prospectively studied 210 patients (54 men, 156 women; age 43 +/- 13 years) with PTC. Indices of sleep respiratory disturbance and oxygen desaturation were determined by polysomnography with the apnea-hypopnea index (AHI) and lowest oxygen saturation (LSaO2), respectively. PTC aggressive features were assessed by postoperative histopathological analysis. Multivariant logistic regression models adjusting for demographic and OSA-related factors were generated to determine OSA risk hazards for aggressive PTC features. Results: The prevalence of moderate-to-severe OSA (defined as AHI of >15) was 20% in PTC patients. Those in the moderate-to-severe OSA group had higher BMI and more aggressive PTC features. Moderate-to-severe OSA was associated with increased odds of larger tumor size (OR, 4.31; 95% CI, 1.79-10.37; p = 0.001), capsular invasion (OR, 2.96; 95% CI, 1.42-6.16; p = 0.004), multifocality (OR, 3.11; 95% CI, 1.52-6.39; p = 0.002), central (OR, 4.7; 95% CI, 1.77-12.49; p = 0.003) and lateral (OR, 5.94; 95% CI, 2.27-15.54; p < 0.001) cervical lymph node metastasis, and BRAF mutation (OR, 2.88; 95% CI, 1.31-6.31; p = 0.008). Moderate to severe hypoxemia did not correlated with aggressive PTC behaviors. Conclusions: OSA is a common respiratory disturbance in PTC. Aggressive PTC features in patients with moderate-to-severe OSA implicate OSA as a cause of cancer progression. Respiratory disturbance events have a greater impact on PTC aggressiveness than hypoxia. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Comparison of hypoglossal nerve stimulation with bruxism on polysomnography

    Rodriguez, JesusKogan, Dmitriy
    2页
      原文链接:
    • NSTL
    • Elsevier

    Feasibility of split night polysomnography in children to diagnose and treat sleep related breathing disorders

    Bendiak, Glenda N.Gerdung, Christopher A.Castro-Codesal, Maria L.Nettel-Aguirre, Alberto...
    6页
    查看更多>>摘要：Study objectives: The gold standard test for diagnosis of sleep related breathing disorders (SRBD) in children is diagnostic polysomnography (PSG). This is often followed by a titration PSG to identify optimal non-invasive ventilation (NIV) pressures. Access to pediatric PSG is limited, resulting in delays to diagnosis and initiation of treatment. Split-night PSGs (snPSG) combine a diagnostic and titration PSG into a single night study. Although described in adults, the pediatric literature on this topic is sparse. The objective of this study was to describe a large cohort of children who utilized snPSG to diagnose SRBD and initiate NIV. Methods: This multi-center study analyzed clinical and PSG data from children with SRBD who had initiated NIV following a snPSG. Data from diagnostic and titration portions of the snPSG were analyzed separately. Results: The study included 165 children who initiated NIV following a snPSG. The majority of children (61.8%) were initiated on NIV for upper airway obstruction. The population included children with medical complexity, including those with central nervous system disorders (17.0%), musculoskeletal/neuromuscular disorders (12.1%), and cardiac disorders (1.2%). Moderate to severe SRBD was present in 87.2% of children with a median apnea-hypopnea index (AHI) of 16.6 events/hour (IQR: 8.2, 38.2). The median AHI was reduced on treatment to 7.6 events/hour (IQR: 3.3, 17.1), with fewer subjects meeting criteria for severe SRBD. Conclusions: snPSG is technically feasible in children, facilitating the diagnosis of SRBD and initiation of NIV, even in those with high medical complexity. (C) 2022 The Authors. Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Increased incidence of leukemia in patients with obstructive sleep apnea: Results from the national insurance claim data 2007-2014

    Suh, Jeffrey D.Kim, Jin KookCho, Jae HoonLee, Eun Jung...
    6页
    查看更多>>摘要：Purpose: Prior research suggests a link between obstructive sleep apnea (OSA) and the likelihood of developing a variety of solid tumors; however, there are no studies assessing OSA and leukemia. This study is the first to identify a potential association between OSA and leukemia using data from the Korea National Health Insurance Service database. Methods: A total of 162,646 patients (>= 20 years of age and without any cancer history) newly diagnosed with OSA between 2011 and 2017 were included. A control group of 813,230 subjects was selected using propensity score matching based on age and sex. The mean follow-up time was 4.4 +/- 2.0 years. The primary endpoint was newly diagnosed leukemia of any type. The leukemia hazard ratio (95% confidence interval [CI]) was calculated for patients with OSA and compared with that of patients in the control group. Results: The incidence of leukemia among patients with OSA was significantly higher than that in the controls (1.35 [1.05-1.74]). The hazard ratio was the highest, 1.74 in those under 40 years, and gradually decreased with age, to 1.38 in those aged 40-65 years and 0.96 in those over 65. In particular, the incidence of lymphoid leukemia (2.06 [1.18-3.60]) was higher than that of myeloid (1.34 [1.00-1.81]) or unspecified leukemia (0.60 [0.20-1.58]). Conclusion: OSA is associated with an increased incidence of leukemia, particularly in patients younger than 40 years of age. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier

    Effect of positive airway pressure therapy of obstructive sleep apnea on circulating Angiopoietin-2

    Gottlieb, Daniel J.Lederer, David J.Kim, John S.Tracy, Russell P....
    3页
    查看更多>>摘要：Background: Obstructive sleep apnea (OSA) has been identified as a possible contributor to interstitial lung disease. While positive airway pressure (PAP) is effective therapy for OSA, it causes large increases in lung volumes during the night that are potentially deleterious, analogous to ventilator-induced lung injury, although this has not been previously studied. The goal of this study was to assess the impact of PAP therapy on four biomarkers of alveolar epithelial and endothelial injury and extracellular matrix remodeling in patients with OSA. Methods: In 82 patients with moderate to severe OSA who were adherent to PAP therapy, surfactant protein D, osteopontin, angiopoietin-2, and matrix metalloprotease-7 were measured by ELISA in serum samples collected before and 3-to 6-months after initiation of PAP therapy. Results: An increase in angiopoietin-2 level of 0.28 ng/mL following PAP therapy was observed (p = 0.007). This finding was replicated in an independent sample of OSA patients. No significant change was detected in surfactant protein D, osteopontin, or matrix metalloprotease-7. Conclusions: This finding raises concern for a possible adverse impact of PAP therapy on vascular endothelium. Published by Elsevier B.V.
      原文链接:
    • NSTL
    • Elsevier

    Pain-related beliefs about sleep as a predictor of insomnia symptoms and treatment acceptability

    Ravyts, Scott G.Perez, ElliottnellDzierzewski, Joseph M.
    6页
    查看更多>>摘要：Objective: Dysfunctional beliefs about sleep and pain are common among individuals experiencing recurrent pain and may inadvertently maintain insomnia symptoms. Thus, the present study sought to determine the level at which pain-related beliefs about sleep may predict insomnia and assess whether pain-related beliefs about sleep predict attitudes towards insomnia treatment above other known factors. Patients/methods: Data consisted of 999 individuals (M age = 44.18, 45.75% male) who participated in an online study about sleep and health across the lifespan. Beliefs about sleep and pain were measured via the pain-related beliefs and attitudes scale (PBAS) while insomnia and pain were assessed using the insomnia severity index (ISI) and a visual analogy scale, respectively. Attitudes towards insomnia treatment was measured using the insomnia treatment acceptability scale (ITAS). Results and conclusion: A score of 6.10 out of 10 on PBAS optimized sensitivity (66.40%) and specificity (66.90%) for insomnia classification. Pain-related beliefs about sleep predicted treatment acceptability of both behavioral (beta = .46, p < . 001) and pharmacological treatments (beta = 0.50, p < .001) over and above insomnia symptoms, pain severity, or sleep-self efficacy. Results underscore the importance of cognitive behavioral factors as it relates to insomnia among individuals with comorbid pain and are relevant to the developments of models which seek to understand attitudes towards insomnia treatment. (C) 2022 Elsevier B.V. All rights reserved.
      原文链接:
    • NSTL
    • Elsevier