Sleep medicine最新文献

{"title":"The relationship between the vestibular system and the circadian timing system: A review.","authors":"Tristan Martin, Florane Pasquier, Pierre Denise, Damien Davenne, Gaëlle Quarck","doi":"10.1016/j.sleep.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.002","url":null,"abstract":"<p><p>This review attempts to analyze the relationship between the vestibular system and the circadian timing system. The activity of the biological clock allows an organism to optimally perform its tasks throughout the nychtemeron. To achieve this, the biological clock is subjected to exogenous factors that entrain it to a 24h period. While the most powerful synchronizer is the light-dark cycle produced by the Earth's rotation, research has led to the hypothesis of the vestibular system as a possible non-photic time cue used to entrain circadian rhythms. Demonstrated neuroanatomical pathways between vestibular nuclei and suprachiasmatic nuclei could transmit this message. Moreover, functional evidence in both humans and animals has shown that vestibular disruption or stimulation may lead to changes in circadian rhythms characteristics. Vestibular stimulations could be considered to act synergistically with other synchronizers, such as light, to ensure the entrainment of biological rhythms over the 24-h reference period.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"148-158"},"PeriodicalIF":3.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822701","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":"Gray matter structural alterations in idiopathic rapid eye movement sleep behavior disorder: A voxel-based meta-analysis.","authors":"Xi Wang, Yuming Li, Boyi Li, Huifang Shang, Jing Yang","doi":"10.1016/j.sleep.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.003","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a robust prodromal marker of α-synucleinopathies. Increased neuroimaging studies have explored the morphological abnormalities in iRBD, but yielded inconsistent results.</p><p><strong>Methods: </strong>We conducted a systematic review and a voxel-wise meta-analysis of whole-brain voxel-based morphometry (VBM) studies using the anisotropic effect size version of seed-based d mapping (AES-SDM) to investigate gray matter volume (GMV) alterations in iRBD.</p><p><strong>Results: </strong>A total of 11 studies with 12 comparisons that included 341 iRBD patients and 288 healthy controls (HCs) were identified. Patients with iRBD showed decreased GMV in the bilateral superior frontal gyri and gyrus rectus, the right temporal pole, right caudate, and right olfactory cortex, while increased GMV in the bilateral cerebellum and thalamus, and left superior occipital gyrus, relative to HCs. These findings remained largely unchanged in jackknife sensitivity analyses.</p><p><strong>Conclusion: </strong>These abnormalities may represent the structural brain underpinnings of cognitive and sensorimotor dysfunctions in patients with iRBD and could enhance our understanding of the early signs of neurodegeneration in the prodromal stage of a-synucleinopathies.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"114-121"},"PeriodicalIF":3.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819212","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 impact of neuropsychiatric burden on Restless Legs Syndrome (RLS) disease severity.","authors":"Mehmet Göktuğ Kılınçarslan, Özgül Ocak, Erkan Melih Şahin","doi":"10.1016/j.sleep.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.004","url":null,"abstract":"<p><strong>Objective: </strong>In patients with Restless Legs Syndrome (RLS), neuropsychiatric comorbidities like anxiety, depression, and somatization are common, yet the precise connection between somatization and RLS severity remains unclear. This study aims to elucidate the influence of neuropsychiatric comorbidities on RLS severity, focusing particularly on the role of somatization.</p><p><strong>Methods: </strong>This cross-sectional analytical study was conducted at a tertiary hospital. All 113 RLS patients who followed in neurology clinic for at least a year were invited, and 87 participated. Data collection included sociodemographic details, the International Restless Legs Syndrome Study Group rating scale (IRLS), the Beck Depression Inventory, Beck Anxiety Scale, and Somatization Scale. Elastic-net regularized path analysis was used as the statistical method.</p><p><strong>Results: </strong>Among the 87 participants (70.1 % female, mean age 52.5 ± 13.2 years), the mean duration of RLS diagnosis was 4.95 ± 4.53 years. Univariate statistics revealed positive correlations among RLS severity, anxiety, depression, and somatization. Path analysis showed that somatization was associated with RLS severity (p = 0.014). Anxiety had no direct effect on RLS severity but influenced it indirectly through its positive association with somatization (p < 0.001). Depression was found to have no effect on RLS severity, either directly or through somatization.</p><p><strong>Conclusions: </strong>The relationship between anxiety and RLS severity is mediated by somatization. Furthermore, the association between RLS severity and somatization appears to be more significant than previously recognized, highlighting the importance of considering somatization in addressing the neuropsychiatric burden of RLS patients.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"82-87"},"PeriodicalIF":3.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795136","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":"Wider and faster degeneration of white matter in Parkinson's disease with possible REM sleep behaviour disorder.","authors":"Sijia Tan, Jiaqi Wen, Jianmei Qin, Xiaojie Duanmu, Chenqing Wu, Weijin Yuan, Qianshi Zheng, Tao Guo, Cheng Zhou, Haoting Wu, Jingwen Chen, Jingjing Wu, Hui Hong, Bingting Zhu, Yuelin Fang, Yaping Yan, Baorong Zhang, Minming Zhang, Xiaojun Guan, Xiaojun Xu","doi":"10.1016/j.sleep.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>In Parkinson's disease (PD), rapid eye movement (REM) sleep behaviour disorder (RBD) signifies a poorer prognosis, yet its impact on white matter (WM) degeneration remains unclear. The study examined the effect of RBD on WM alterations in PD progression.</p><p><strong>Methods: </strong>The study included 45 PD patients with possible RBD (PD-pRBD), 38 PD patients without possible RBD (PD-npRBD), and 79 healthy controls (HC). All patients underwent clinical assessments and diffusion MRI scans at least once a year for up to 4 visits. 79 HC underwent the same protocol at baseline. WM metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were calculated using tract-based spatial statistics. Linear mixed-effects models were conducted to examine the changes in clinical features and WM fibers.</p><p><strong>Results: </strong>At baseline, PD-npRBD showed increased RD in several regions, predominantly in bilateral uncinate fasciculus (UF) and inferior longitudinal fasciculus (ILF), compared to HC (P_FDR<0.05). During follow-up, PD-npRBD had further FA decrease in left UF and ILF (P_FDR<0.05). PD-pRBD showed reduced FA in several regions relative to HC at baseline (P_FDR<0.05), and faster FA decline in left UF and ILF than PD-npRBD during follow-up, with more extensive FA decrease in other regions such as anterior thalamic radiation and inferior fronto-occipital fasciculus (P_FDR<0.05). Moreover, increased RD in the left corticospinal tract correlated with motor symptoms (p = 0.045) in PD-pRBD.</p><p><strong>Conclusions: </strong>PD patients with pRBD demonstrated more extensive WM degeneration and accelerated degeneration in the left ILF and UF during the disease course. However, due to the lack of PSG verification, these results should be interpreted cautiously while directly relating to RBD. These findings provide new insights into the neural structural basis associated with the potential impact of RBD on PD progression.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"97-106"},"PeriodicalIF":3.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814324","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":"Long term noninvasive respiratory support in children with OSA-I and OSA-II: Data of a nation-wide study.","authors":"Chiara Tommesani, Sonia Khirani, Alessandro Amaddeo, Bruno Massenavette, Priscille Bierme, Jessica Taytard, Nathalie Stremler, Melisande Baravalle-Einaudi, Julie Mazenq, Iulia Ioan, Cyril Schweitzer, Marie Emilie Lampin, Alexandra Binoche, Clemence Mordacq, Jean Bergounioux, Blaise Mbieleu, Robert Rubinsztajn, Elodie Sigur, Geraldine Labouret, Aline Genevois, Arnaud Becourt, Eglantine Hullo, Isabelle Pin, Stéphane Debelleix, François Galodé, Stéphanie Bui, Johan Moreau, Marie Catherine Renoux, Stefan Matecki, Marc Lubranno Lavadera, Rachel Heyman, Michael Pomedio, Laurence Le Clainche, Plamen Bokov, Alexandra Masson, Pauline Hangard, Celine Menetrey, Mikael Jokic, Elsa Gachelin, Caroline Perisson, Anne Pervillé, Agnes Fina, Lisa Giovannini-Chami, Emmanuelle Fleurence, Audrey Barzic, Audrey Breining, Morgane Ollivier, Guillaume Labbé, Laurianne Coutier, Guillaume Aubertin, Brigitte Fauroux","doi":"10.1016/j.sleep.2024.11.039","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.11.039","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to analyze the characteristics of otherwise healthy children with obstructive sleep apnea (OSA; OSA-I) and children with OSA and non-syndromic obesity (OSA-II) treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in 2019 in France.</p><p><strong>Methods: </strong>Data were collected from a national survey on paediatric home noninvasive ventilatory support. CPAP/NIV initiation criteria and duration, age at CPAP/NIV initiation, equipment used and CPAP/NIV settings, and objective compliance were analyzed.</p><p><strong>Results: </strong>Patients with OSA-I and OSA-II represented 6 % (n = 84, 71 % males) and 10 % (n = 144, 72 % males) of the national cohort, respectively. The apnea-hypopnea index (63 % vs 76 %), alone or combined with nocturnal gas exchange (25 % vs 21 %, for OSA-II and OSA-I patients respectively) were used as initiation criteria of CPAP/NIV. OSA-II patients were older at CPAP/NIV initiation (mean age 11.0 ± 4.0 vs 6.8 ± 4.5 years, p < 0.001) and were treated for a longer time (2.3 ± 2.6 vs 1.3 ± 1.5 years, p = 0.008) than OSA-I patients. NIV was used in 6 % of OSA-I patients and 13 % of OSA-II patients (p = 0.142). Both groups used preferentially a nasal mask. Mean CPAP level was higher in OSA-II patients as compared to OSA-I patients (8.7 ± 2.0 vs 7.7 ± 2.4 cmH₂O, p = 0.02). Objective compliance was comparable (mean use 6.8 ± 2.6 vs 5.9 ± 3.0 h/night in OSA-I and OSA-II, respectively, p = 0.054).</p><p><strong>Conclusion: </strong>Six and 10 % of children treated with long term CPAP/NIV in France in 2019 had OSA-I and OSA-II, respectively. Both groups were preferentially treated with CPAP and were comparable except for age, with OSA-II patients being older at CPAP/NIV initiation.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"67-72"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790651","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":"Role of polysomnography in the management of obstructive sleep apnea during the first year of life in robin sequence: A prospective and longitudinal study.","authors":"Laurianne Coutier, Romane Gyapay, Aurore Guyon, Marine Thieux, Robin Pouyau, Sébastien Blanc, Sonia Ayari, Lucie Griffon, Agnès Giuseppi, Pauline Adnot, Adrien Aubin, Brigitte Fauroux, Véronique Abadie, Patricia Franco","doi":"10.1016/j.sleep.2024.11.041","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.11.041","url":null,"abstract":"<p><strong>Objectives: </strong>To prospectively assess, using polysomnography (PSG), the evolution in obstructive sleep apnea (OSA) in infants with Robin Sequence (RS) during their first year of life and to evaluate the role of PSG in OSA treatment.</p><p><strong>Methods: </strong>Prospective and longitudinal study conducted in 2 tertiary hospitals (2018-2021). Data from 2 PSG (PSG1 0-3 months of life, PSG2 6-10 months of life) performed in RS infants in different sleep positions/conditions (without treatment: supine [SP]; with treatment: lateral [LP], prone [PP], respiratory support) were analyzed. OSA treatment type were compared before and after both PSG.</p><p><strong>Results: </strong>Among the 45 RS infants included (median [IQR] age 2[1-2] months at PSG1 and 8[6-8] months at PSG2), 27 had available data from both PSG1/PSG2. Sleep efficacy without treatment (SP) tended to be lower at PSG1 than PSG2 (77%[66-84] versus 88%[78-96], p=0.0048). At PSG1 without treatment, 77% of infants had a severe OSA; OAHI significantly decreased between PSG1 and PSG2 (17/h[10-36 versus 5/h[3-7], p<0.0001). At PSG1 under treatment, despite an improvement in OAHI, OSA remained severe for 81% of infants in LP, 47% in PP, and 85% with respiratory support (16/h[11-21],10/h[6-17],18/h[11-20], respectively). PSG1 led to a change in treatment for 40% of infants (de-escalation 18%; escalation 22%).</p><p><strong>Conclusion: </strong>Sleep and OSA improved spontaneously during the first months of life in RS infants, approaching near-normal at 8 months of age. Early PSG led to a change in management strategy in nearly half the RS infants, highlighting that PSG represents a precious tool to optimize OSA treatment.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"73-81"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791587","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":"Impact of sleep characteristics on IVF/ICSI outcomes: A prospective cohort study.","authors":"Shrijan Bariya, Yun Tao, Ruiqing Zhang, Ming Zhang","doi":"10.1016/j.sleep.2024.11.038","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.11.038","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Infertility affects millions of individuals worldwide, imposing significant personal and societal burdens. Assisted reproductive technologies (ART), such as IVF and ICSI, provide hope for many, yet clinical pregnancy rate per embryo transfer remains around 35 %. Modifiable lifestyle factors, including sleep, may influence ART outcomes. However, the relationship between specific sleep characteristics and IVF/ICSI success is unclear. This study aims to explore the associations between sleep characteristics and various IVF/ICSI outcomes. Additionally, we investigated if perceived stress mediates these relationships.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective cohort study enrolled 174 women undergoing IVF/ICSI at Zhongnan Hospital of Wuhan University from December 2021 to December 2023. Prior to initial ART treatment, participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10). IVF/ICSI outcomes such as the number of retrieved oocytes, matured oocytes, number of fertilized oocytes, fertilization rate, good-quality embryos, blastocyst formation rate and early pregnancy outcome (implantation and clinical pregnancy) were obtained from medical records. We employed multivariate generalized linear models to assess the associations between sleep characteristics and IVF/ICSI outcomes. Dose-response relationships between napping duration and maturation rate were analyzed using generalized additive models. Mediation analysis was used to assess the role of stress in the relationship between sleep characteristics and IVF/ICSI outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Women reporting poor sleep quality had significantly fewer retrieved oocytes (-22.89 %, 95%CI: 37.82 %, -4.00 %) and matured oocytes (-22.01 %, 95%CI: 37.54 %, -2.62 %). Those sleeping ≥10 h per night had fewer retrieved oocytes (-30.68 %, 95%CI: 48.88 %, -6.00 %), matured oocytes (-27.17 %, 95%CI: 46.57 %, -0.73 %), and good-quality embryos (-45.64 %, 95%CI: 65.43 %, -14.51 %). Women experiencing difficulty falling asleep more than three times a week had a significant reduction in blastocyst rates (-64.40 %, 95 % CI: 85.55 %, -12.30 %). Those reporting difficulty falling asleep less than once a week had fewer retrieved oocytes (-28.89 %, 95%CI: 47.34 %, -3.98 %), and matured oocytes (-27.77 %, 95%CI: 46.90 %, -1.73 %). Napping exceeding 1 h daily was associated with a significantly lower oocyte maturation rate (-73.8 %, 95%CI: 88.91 %, -38.06 %). A significant non-linear dose-response relationship was observed between napping duration and maturation rate (p &lt; 0.001), with maturation rates initially increasing slightly with short naps but declining significantly with longer naps, particularly beyond 1 h. This relationship was significant among women with good sleep quality (PSQI ≤5) (p &lt; 0.001) and those with normal BMI (p = 0.0005). Perceived stress did not significantly mediate these associations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conc","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"122-135"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822700","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":"Evaluating the added-value of video recording in respiratory polygraphy for the diagnosis of obstructive sleep apnea in children","authors":"Yacine Touil ,&nbsp;Cyril Schweitzer ,&nbsp;Emeline Renard ,&nbsp;Manon Maréchal ,&nbsp;Sofia Da Mota ,&nbsp;Patricia Franco ,&nbsp;Laurianne Coutier ,&nbsp;Iulia Ioan","doi":"10.1016/j.sleep.2024.11.040","DOIUrl":"10.1016/j.sleep.2024.11.040","url":null,"abstract":"<div><div>Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA) in children but not always available. Abbreviated exams exist, such as respiratory polygraphy (RP), but are less accurate for OSA diagnosis. Video recording (video-RP) may provide a more precise estimation of the total sleep time (TST) compared to RP alone. The aim of this study was to evaluate the diagnostic power of video-RP compared to RP and PSG.</div><div>Overall, 68 PSG from 68 children (median [1st; 3rd quartile] age of 9 [7; 12]years) were included. After the interpretation of the initial PSG, the analysis was deleted, and the recording was analyzed by taking into account only the respiratory signals and video recording (video-RP). Finally, a third interpretation, after deleting the previous, was performed by considering only the respiratory signals (RP).</div><div>The median [1st; 3rd percentile] obstructive apnea-hypopnea index (OAHI) was underestimated in video-RP (4.1 [2.7; 6.5]/h) as well as RP (4.0 [2.7; 6.2]/h) compared to PSG (4.8 [2.9; 6.7]/h, <em>p = 0.02 and p = 0.01, respectively</em>). Bland-Altman analysis confirmed the underestimation of OAHI by video-RP and RP compared to PSG, the magnitude of the difference being −0.69 ± 2.16 and −0.78 ± 2.12, respectively. OSA severity grading was different when scored by video-RP and RP compared to PSG in 14 (21 %) children.</div><div>Video-RP underestimated the OAHI compared to PSG, similar to RP. Adding the video recording did not improve the diagnostic power of RP for the diagnosis of OSA. The use of video-RP at home should be investigated in future studies.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 177-184"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the differential response to exercise in adults with restless legs syndrome","authors":"K.L.J. Cederberg ,&nbsp;G.C. Ricciardiello Mejia ,&nbsp;E.M. Sikes ,&nbsp;E. Mignot","doi":"10.1016/j.sleep.2024.11.037","DOIUrl":"10.1016/j.sleep.2024.11.037","url":null,"abstract":"<div><h3>Objective/Background</h3><div>Restless legs syndrome (RLS) is a prevalent, sensorimotor sleep disorder characterized by the irresistible urge to move that is temporarily relieved by movement. Despite evidence for the benefits of exercise in RLS, inter-individual variation in the response to exercise exists, whereby some people experience symptom improvement while others report exacerbations. The present study examined factors that may account for differences in perceived responses to exercise in RLS.</div></div><div><h3>Patients/methods</h3><div>Participants (N = 527) completed a nationwide survey with items assessing RLS, physical activity, sedentary levels, and experiences with RLS responsiveness to exercise. Logistic regression analyses examined associations between individual characteristics (e.g., age, sex) and perceptions of improvement and exacerbation with exercise. Exploratory analyses examined characteristics associated with perceived positive responsiveness (i.e., exercise only improves RLS) or negative responsiveness (i.e., exercise only worsens RLS).</div></div><div><h3>Results</h3><div>Ordinal logistic regression identified lower RLS severity (OR = 0.83, <em>p</em> = 0.044), higher prevalence of a condition that could cause secondary RLS (OR = 1.76, <em>p</em> = 0.005), lower prevalence of periodic limb movements (OR = 0.52, <em>p</em> = 0.001), and higher physical activity levels (OR = 1.47, <em>p</em> &lt; 0.001) as significant, independent predictors of exercise improving RLS symptoms. Individual feature ordinal logistic regression identified female sex as significantly associated with exercise exacerbating symptoms (OR = 0.62, <em>p</em> = 0.008). Exploratory logistic regression identified people with higher BMI (OR = 0.69, <em>p</em> = 0.019) and higher RLS severity (OR = 0.70, <em>p</em> = 0.026) had lower odds of being positive responders to exercise.</div></div><div><h3>Conclusions</h3><div>The present study presents factors that might account for individual differences in the response to exercise. Overall, our results suggest that milder cases of RLS (lower severity, absence of PLMs), people with secondary forms of RLS, and those with a lower BMI may perceive exercise as more beneficial for symptoms. These should be considered in exercise-based management aimed at managing symptoms as the collective body of research supports the benefits of exercise in adults with <span>RLS</span>.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 1-8"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745872","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":"Abbreviated versions of the insomnia severity index to screen for comorbid insomnia among obstructive sleep apnea patients","authors":"Marcela Yanagimori ,&nbsp;Mariana D. Fernandes ,&nbsp;Gustavo F. Grad ,&nbsp;Aline B. Monare ,&nbsp;Bianca M.S.P. Garcia ,&nbsp;Ivana Rosanelli ,&nbsp;Paulo M.M.S. Mariano ,&nbsp;Sean P.A. Drummond ,&nbsp;Denise M. O'Driscoll ,&nbsp;Bradley A. Edwards ,&nbsp;Geraldo Lorenzi-Filho ,&nbsp;Pedro R. Genta","doi":"10.1016/j.sleep.2024.11.035","DOIUrl":"10.1016/j.sleep.2024.11.035","url":null,"abstract":"<div><h3>Study objectives</h3><div>The comorbidity of insomnia and obstructive sleep apnea (COMISA) is common and associated with adverse clinical consequences. While insomnia is often underdiagnosed among individuals with OSA, the identification of insomnia among these individuals may lead to improved medical care. Our objective was to assess the performance of two simplified tools (insomnia severity index-2 (ISI-2) and ISI-3) to identify insomnia among individuals with OSA. We hypothesized that the ISI-2 and ISI-3 perform well to diagnose insomnia among individuals with OSA.</div></div><div><h3>Methods</h3><div>Four different cohorts of individuals with sleep disorders were studied. Cohorts 1,2 and 3 included individuals with OSA. Cohort 4 included individuals with insomnia only. The performance of ISI-2 and ISI-3 was compared to ISI-7-based diagnosis of insomnia using receiving operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>Cohorts 1, 2, 3 and 4 included 490, 124, 39 and 118 individuals, respectively. Individuals from cohorts 1, 2 and 3 were middle-aged, obese and had severe OSA on average. Individuals from cohort 2 were predominantly male while from cohorts 3 and 4 were predominantly female. Individuals from cohort 4 were slightly younger, and eutrophic on average. Cohorts 3 and 4 had higher insomnia severity (ISI-7) than cohorts 1 and 2. Using cohort 1, the best cut-offs for ISI-2 and ISI-3 were ≥6 and ≥8, respectively. Area under the curve (AUC) for ISI-2 was .900, .951 and .893 among cohorts 1, 2 and 4, respectively. AUC for ISI-3 was .924, .961 and .936 among cohorts 1, 2 and 4, respectively.</div></div><div><h3>Conclusion</h3><div>ISI-2 and ISI-3 are accurate screening tools for insomnia among individuals with sleep disorders. Easy recognition of insomnia among individuals with COMISA may improve clinical outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 19-24"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745875","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}