Sleep medicine最新文献

{"title":"Regional brain iron mapping in obstructive sleep apnea adults.","authors":"Bhaswati Roy, Susana Vacas, Daniel W Kang, Ravi S Aysola, Rajesh Kumar","doi":"10.1016/j.sleep.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.022","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) subjects show significant white matter injury, including myelin changes in several brain areas, potentially from impaired glial cells, contributing to increased iron levels that escalate neurodegeneration, but brain iron loads are unclear. Our aim was to examine regional brain iron load, using T2∗-relaxometry, in OSA adults before and after continuous positive airway pressure (CPAP) treatment over controls.</p><p><strong>Methods: </strong>We performed T2∗-weighted imaging using a 3.0-T MRI scanner on 35 OSA adults, who were followed after 3- and 9- mo CPAP treatment, and 67 controls. Using T2∗-weighted images, R2∗maps were calculated, normalized, and smoothed. The smoothed R2∗ maps, as well as average R2∗ values extracted from different brain regions were compared between OSA and controls using ANCOVA (covariates: age and sex) and paired t-tests in OSA adults.</p><p><strong>Results: </strong>Multiple brain areas in OSA showed increased R2∗ values before CPAP, indicative of higher iron, over controls and included the amygdala, insula, hippocampus, cerebellum, medulla, and pons nearby areas. The R2∗ values continued to increase in multiple sites at 3-mo CPAP treatment in OSA, and those sites included the cerebellum, thalamus, and cingulate. However, after 9-mo CPAP usage, none of the brain regions showed increased R2∗ values in OSA over baseline.</p><p><strong>Conclusions: </strong>OSA patients show increased iron content in multiple sites over controls, which progressively increased in several sites, even after 3-mo CPAP use, and started to clear after 9-mo. The findings suggest a means for intervention to lessen brain injury by interfering with iron accumulation in OSA.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"211-217"},"PeriodicalIF":3.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midday napping duration and risk of stroke: A prospective study in China.","authors":"Jiani Huang, Yuntao Wu, Liang Sun, Yesong Liu, Shouling Wu, Sheng Zhuang, Shuohua Chen, Xiang Gao","doi":"10.1016/j.sleep.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.012","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the potential effects of midday napping on risk of stroke in Chinese populations remains limited.</p><p><strong>Objectives: </strong>We aimed to prospectively investigate the association between midday napping and risk of subsequent stroke and stroke subtypes in the Kailuan study.</p><p><strong>Methods: </strong>Midday napping duration was obtained from a self-reported questionnaire. Incident stroke cases from baseline (2014) to December 31, 2020 were confirmed by review of medical records. The association of midday napping duration with risk of incident stroke and subtypes was examined using a Cox regression model, adjusting for potential confounders. We further investigated the joint effects of nocturnal sleep duration and midday napping on the risk of stroke.</p><p><strong>Results: </strong>A total of 96,899 individuals (21.0 % women; 51.9 ± 14.0 years) were included. During an average follow-up of 5.62 ± 0.69 years, 2539 incident stroke cases were documented. After adjusting for potential confounders, we found that participants with a midday napping duration of >60 min/day had higher risk of incident stroke (adjusted HR: 1.23; 95 % CI: 1.07, 1.42), compared with those without midday napping. Furthermore, significant joint effects were found in both nocturnal sleep duration (P-interaction=0.04) and snoring status (P-interaction= 0.005) on the association between midday napping duration and the risk of incident stroke, especially for participants who napped >60 min/day and slept ≤7 h/night compared with those who slept 7-8 h/night and did not take a nap, or those who napped >60 min/day and snored compared with those who did not take a nap and snore.</p><p><strong>Conclusions: </strong>We found that prolonged midday napping (>60 min/day) was associated with higher risk of stroke and the association was stronger among those with shorter nocturnal sleep duration or those who snored.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"205-210"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between sleep opportunity, sleep problems, and social jetlag and toddlers' adiposity: A cross-sectional study.","authors":"Ana Duarte, Silvana Martins, Cláudia Augusto, Maria José Silva, Luís Lopes, Rute Santos, Juliana Martins, Rafaela Rosário","doi":"10.1016/j.sleep.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.006","url":null,"abstract":"<p><p>This study aims to analyze the associations between sleep characteristics, including sleep opportunity, problems and social jetlag, and toddlers' adiposity. It is part of a larger research project involving 344 children (mean ± SD age of 23.6 ± 6.3 months). Children's length/height, weight and waist circumference were measured at childcare centers. Body Mass Index (BMI), weight-for-length/height, and waist-to-length/height were calculated and classified according to percentiles, serving as surrogates of adiposity. Sleep problems were evaluated through questionnaire. Sleep opportunity was reported by parents and defined as the difference between bedtime and wake-up time. Social jetlag was calculated based on sleep midpoints. Parental questionnaires provided sociodemographic characteristics. Total energy intake was determined from a two-day dietary record, and motor development was assessed using the Bayley-III scales. Generalized linear models were used in the analysis. We found that nighttime sleep opportunity on weekdays was inversely associated with BMI percentile (B = -5.57, 95 % CI -9.79 to -1.35), even with covariates included. Additionally, later bedtime on weekend days were associated with lower weight-for-length/height and waist-to-length/height (B = -4.16, 95 % CI -8.01 to -0.30, and B = -10.62, 95 % CI -15.38 to -5.87, respectively), even when adjusted for potential confounders. Later bedtime on weekdays was associated with lower waist-to-length/height (B = -8.85, 95 % CI -14.95 to -2.74). Social jetlag was associated with lower waist-to-length/height (B = -7.19, 95 % CI -13.47 to -0.90). Future research is needed to clarify these associations and to encourage lifestyle-based interventions aimed at optimizing sleep patterns within this age group.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"172-177"},"PeriodicalIF":3.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of vertigo with adult obstructive sleep apnea: A systematic review and meta-analysis.","authors":"Kun-Tai Kang, Ming-Tzer Lin, Meiho Nakayama, Yi-Ho Young, Wei-Chung Hsu","doi":"10.1016/j.sleep.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.014","url":null,"abstract":"<p><strong>Background: </strong>Several studies have demonstrated a relationship between vertigo and obstructive sleep apnea (OSA) in adults. This review examined the association between vertigo and OSA and investigated the effects of OSA treatment on vestibular function.</p><p><strong>Methods: </strong>Searches were conducted in PubMed, MEDLINE, EMBASE, Cochrane, Scopus, and Web of Science databases. Two authors independently searched the databases up to November 2023. Meta-analysis of caloric test, cervical vestibular evoked myogenic potential (cVEMP), and ocular vestibular evoked myogenic potential (oVEMP), between adults with and without OSA was done.</p><p><strong>Results: </strong>Overall, 28 studies were identified, and most of which focused on vestibular dysfunction in the OSA group. Compared with controls, adults with OSA had an increased risk of abnormal caloric test results (odds ratio [OR] = 4.8), absence of cVEMP (OR = 7.9), absence of oVEMP (OR = 6.2), decreased n1p2 amplitude (standardized mean difference [SMD] = -0.78), decreased p1n1 amplitude (SMD = -0.92), decreased p1n1 interval (SMD = -2.37) in cVEMP testing and prolonged n1 latency (SMD = 0.81) and decreased p1n1 amplitude (SMD = -0.51) in oVEMP testing. Three population-based studies implied a high risk of vertigo in adult OSA, although not statistically significant (OR = 2.53, 95 % confidence interval = 0.97 to 6.61). According to 3 studies, OSA is relatively prevalent among patients with vertigo. Another 3 studies regarding OSA treatment on vestibular functions revealed inconsistent findings.</p><p><strong>Conclusion: </strong>Adults with OSA exhibit abnormalities in caloric, cVEMP, and oVEMP test results, indicating impairments in the semicircular canal, saccule, and utricle.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"194-204"},"PeriodicalIF":3.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actigraphy validation in behavioral variant frontotemporal dementia.","authors":"Ludovica Tamburrino, Benedetta Tafuri, Valentina Gnoni, Salvatore Nigro, Alessia Giugno, Daniele Urso, Stefano Zoccolella, Marco Filardi, Giancarlo Logroscino","doi":"10.1016/j.sleep.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.009","url":null,"abstract":"<p><strong>Background: </strong>Actigraphy is increasingly being used to assess sleep in patients with neurodegenerative diseases. However, information on its accuracy relative to polysomnography (PSG) in this clinical population remains scarce. This study investigates the performance of actigraphy compared to PSG in patients with behavioral variant frontotemporal dementia (bvFTD), which is the leading form of early-onset dementia.</p><p><strong>Methods: </strong>Eighteen patients with bvFTD (10 males, mean age 70.50 ± 8.48 years) underwent overnight, in-home PSG while concurrently wearing an actigraph on their non-dominant wrist. Actigraphy performance was assessed through discrepancy analysis, Bland-Altman plots, and epoch-by-epoch analysis (EBE). Analyses were conducted separately for the Cole-Kripke and UCSD scoring algorithms.</p><p><strong>Results: </strong>Discrepancy analysis highlighted that the Cole-Kripke and UCSD algorithms overestimate total sleep time (by 43 and 60 min, respectively) and sleep efficiency (by 7.13 % and 10.33 %, respectively). The Cole-Kripke algorithm also overestimates sleep onset latency (by 7.75 min). Wake after sleep onset (WASO) showed a negative proportional bias for both algorithms, indicating that actigraphy underestimates WASO for subjects with longer PSG-measured WASO. In the EBE analysis, the Cole-Kripke algorithm shows an accuracy of 84 % (sensitivity 93 %, specificity 62 %) and the UCSD algorithm an accuracy of 85 % (sensitivity 96 %, specificity 57 %).</p><p><strong>Conclusions: </strong>In patients with bvFTD, actigraphy significantly overestimates total sleep time, sleep latency, and sleep efficiency, while underestimating WASO. Clinicians and researchers using actigraphy to study sleep in bvFTD must carefully consider these measurement biases and correct for them based on the results of previous comparison studies.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"178-184"},"PeriodicalIF":3.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-occurring mental health problems in adolescents with ADHD and sleep problems.","authors":"Finja Marten, Lena Keuppens, Dieter Baeyens, Bianca E Boyer, Marina Danckaerts, Samuele Cortese, Wout Vandycke, Saskia Van der Oord","doi":"10.1016/j.sleep.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.008","url":null,"abstract":"<p><strong>Objective: </strong>Sleep problems are highly prevalent and impairing in adolescents with ADHD. However, their relation with co-occurring mental health problems is still unclear. This study assessed whether adolescents with ADHD, with and without self-reported sleep problems, differ from each other in co-occurring mental health problems, and whether they differ from adolescents without ADHD. Furthermore, we examined whether the adolescents with ADHD and self-reported sleep problems do indeed have more disturbed sleep than the other two groups and lastly, whether these sleep differences are moderated by co-occurring mental health problems.</p><p><strong>Method: </strong>Three groups of adolescents (13-17 years): 1) with ADHD and comorbid self-reported sleep problems (N = 56), 2) with ADHD but without self-reported sleep problems (N = 25), and 3) without ADHD (N = 56) were assessed. Group comparisons were done for symptoms of co-occurring mental health problems, self- and parent-reported sleep problems, and objective and subjective sleep parameters. Exploratively, moderating effects of co-occurring mental health problems on sleep differences between groups are examined.</p><p><strong>Results: </strong>Compared to those without self-reported sleep problems, adolescents with ADHD and comorbid self-reported sleep problems experienced significantly more co-occurring symptoms of mental health problems, especially depression. They also scored higher on all sleep problems, and had a longer sleep onset latency and lower sleep efficiency based on subjective and objective sleep measures. Depression and anxiety moderated objectively measured sleep differences.</p><p><strong>Conclusion: </strong>Co-occurring mental health problems, especially depressive symptoms, are more prevalent in adolescents with ADHD and sleep problems and partially moderate the relation with sleep. This indicates that when adolescents with ADHD present with sleep problems in clinical practice, it is essential to also assess symptoms and other mental health problems and vice-versa.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"107-113"},"PeriodicalIF":3.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of transcranial alternating current stimulation on EEG spectral power during subsequent sleep: A randomized crossover study.","authors":"Yuan Shi, Xin Tian, Taomei Li, Yuexia Hu, Yuqing Xie, Huixian Li, Yun Li, Ning Jiang, Xiangdong Tang, Yanyan Wang","doi":"10.1016/j.sleep.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.011","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the instant impact of transcranial alternating current stimulation (tACS) on sleep brain oscillations.</p><p><strong>Methods: </strong>Thirty-six healthy subjects were randomly assigned to receive tACS and sham stimulation in a crossover design separated by a one-week washout period. After stimulation, a 2-h nap polysomnography (PSG) was performed to obtain Electroencephalogram (EEG) data and objective sleep variables, and self-reported subjective sleep parameters were collected at the end of the nap. EEG spectral analyses were conducted on the EEG data to obtain the absolute and relative power for each sleep stage during the nap. The associations between power values and objective and subjective measurements were analyzed using Spearman or Pearson correlation coefficients.</p><p><strong>Results: </strong>The tACS group presented higher power in slow wave activity (SWA) and delta frequency bands and lower alpha, sigma and beta power values compared to the sham group during the N2 and N3 sleep stages. SWA and delta power were positively associated with sleep duration and sleep efficiency relevant parameters; while alpha, sigma and beta power were positively associated with prolonged sleep latency and wakefulness related variables. PSG, self-reported and sleep diary measured objective and subjective sleep parameters were comparable between the tACS and the sham groups.</p><p><strong>Conclusion: </strong>Our results support that tACS could promote sleep depth in microstructure of sleep EEG, manifesting as an increase in EEG spectral power in low frequency bands and a decrease in high frequency bands. The registration number of this study is ChiCTR2200063729.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"185-193"},"PeriodicalIF":3.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining static and dynamic functional connectivity analyses to identify male patients with obstructive sleep apnea and predict clinical symptoms.","authors":"Lifeng Li, Liming Song, Yuting Liu, Muhammad Ayoub, Yucheng Song, Yongqiang Shu, Xiang Liu, Yingke Deng, Yumeng Liu, Yunyan Xia, Haijun Li, Dechang Peng","doi":"10.1016/j.sleep.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.013","url":null,"abstract":"<p><strong>Background and purpose: </strong>Patients with obstructive sleep apnea (OSA) experience chronic intermittent hypoxia and sleep fragmentation, leading to brain ischemia and neurological dysfunction. Therefore, it is important to identify features that can differentiate patients with OSA from healthy controls (HC) and provide insights into the underlying brain alterations associated with OSA. This study aimed to distinguish patients with OSA from healthy individuals and predict clinical symptom alterations using cerebellum-whole-brain static and dynamic functional connectivity (sFC and dFC, respectively), with the cerebellum as the seed region.</p><p><strong>Methods: </strong>Sixty male patients with OSA and 60 male HC matched for age, education level, and sex were included. Using 27 cerebellar seeds, sliding-window analysis was performed to calculate sFC and dFC between the cerebellum and the whole brain. The sFC and dFC values were then combined and used in multiple machine-learning models to distinguish patients with OSA from HC and predict the clinical symptoms of patients with OSA.</p><p><strong>Results: </strong>Patients with OSA showed increased dFC between cerebellar subregions and the superior and middle temporal gyri and decreased dFC with the middle frontal gyrus. Conversely, increased sFC was observed between cerebellar subregions and the cerebellar lobule VI, cingulate gyrus, middle frontal gyrus, inferior parietal lobules, insula, and superior temporal gyrus. Combined dynamic-static FC features demonstrated superior classification performance with a support vector machine in discriminating OSA from HC. In clinical symptom prediction, FC alterations contributed up to 30.11 % to cognitive impairment, 55.96 % to excessive sleepiness, and 27.94 % to anxiety and depression.</p><p><strong>Conclusions: </strong>Combining cerebrocerebellar sFC and dFC analyses enables high-precision classification and prediction of OSA. Aberrant FC patterns reflect compensatory brain reorganization and disrupted cognitive network integration, highlighting potential neuroimaging markers for OSA.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"136-147"},"PeriodicalIF":3.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of sedative activity of Chrysin: Behavioral approach with pharmacokinetics, toxicological profile and molecular docking.","authors":"Md Sakib Al Hasan, Md Shimul Bhuia, Salehin Sheikh, Sumaya Akter Bithi, Md Abu Saim, Hossam Kamli, Siddique Akber Ansari, Nowreen Tabassum Ahammed, Muhammad Torequl Islam","doi":"10.1016/j.sleep.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.007","url":null,"abstract":"<p><p>The purpose of this study was to investigate the sedative effects of Chrysin (CHR) along with modulatory effects on diazepam (DZP) and flumazenil (FLU) in an animal sleep model produced by thiopental sodium (TS). Additionally, we explored the pharmacokinetics and potential GABA_A receptor interactions of CHR through computational studies. Swiss albino mice were treated with intraperitoneal administration of CHR (5 and 10 mg/kg), DZP (2 mg/kg), and FLU (0.1 mg/kg) either alone or in combination. Sleeping onset and duration were measured following TS administration. Molecular docking was performed to investigate CHR's binding affinity with GABA_A (PDB: 6X3X) receptors. Results found that CHR significantly (p < 0.05) reduced sleep latency and increased sleep duration in a dose-dependent manner compared to the control group. The highest dose (CHR-10) exhibited the most potent significant sedative effect with onset (11.57 ± 1.74 min) and duration (172.86 ± 7.37 min). Combination therapy of CHR-10 with DZP resulted in synergistic effects, further enhancing sleep duration. In molecular docking, CHR demonstrated a higher binding affinity (-8.9 kcal/mol) for GABA_A receptors compared to DZP (-8.7 kcal/mol) and FLU (-6.6 kcal/mol). CHR also showed favorable pharmacokinetic properties with high intestinal absorption and low toxicity. CHR exhibits promising sedative activity, with the potential to enhance the effects of traditional sedatives like DZP. However, further research, including clinical trials and detailed mechanistic studies, is warranted to explore its full therapeutic potential.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"88-96"},"PeriodicalIF":3.8,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in sleep-disordered breathing severity and post-stroke outcomes in the first year after stroke.","authors":"Christopher J Becker, Lynda D Lisabeth, Guanghao Zhang, Xu Shi, Madeline Kwicklis, Erin Case, Ronald D Chervin, Devin L Brown","doi":"10.1016/j.sleep.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.010","url":null,"abstract":"<p><strong>Background: </strong>Sleep-disordered breathing (SDB) is common among stroke survivors and is associated with worse functional, cognitive, and neurologic outcomes after stroke. Little is known about the association between changes in SDB and changes in these outcomes over time.</p><p><strong>Methods: </strong>Ischemic stroke (IS) patients identified through the Brain Attack Surveillance in Corpus Christi project were offered SDB testing with a portable respiratory monitor (ApneaLink Plus) shortly after stroke, and at 3-, 6-, and 12-months post-stroke. SDB was quantified using the respiratory event index (REI; apneas plus hypopneas per hour of recording). At 3-, 6-, and 12-months post-stroke, functional outcomes, cognitive outcomes, and neurologic outcomes were measured. Linear mixed models were fitted to obtain random slopes reflecting individual changes in REI and each of outcome over time, adjusted for multiple covariates. Associations between the resulting individual slopes for REI and each outcome were then evaluated using linear regression models.</p><p><strong>Results: </strong>Of 482 IS patients with at least one REI measurement, in fully adjusted models, faster reduction in REI was not associated with faster improvement in functional (β = -0.06; 95 % CI: -0.15, 0.03, p = 0.16), cognitive (β = -0.03; 95 % CI: -0.12, 0.06, p = 0.51), or neurologic outcomes (β = -0.04; 95 % CI: -0.13, 0.05, p = 0.41).</p><p><strong>Conclusions: </strong>In this observational study of stroke survivors, there was no clear association between the rate of improvement in SDB and improvement in functional, cognitive, or neurologic outcomes. It remains to be seen whether treatment of SDB might lead to improved outcomes among stroke survivors.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"167-171"},"PeriodicalIF":3.8,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}