Sleep medicine最新文献

{"title":"Efficacy and safety of pitolisant in residual excessive daytime sleepiness for patients with obstructive sleep apnea adhering to continuous positive airway pressure therapy in the HAROSA studies: An individual patient meta-analytical approach","authors":"Dries Testelmans ,&nbsp;Philippe Lehert ,&nbsp;Jerryll Asin ,&nbsp;Johan Imschoot ,&nbsp;Christian Caussé ,&nbsp;Jean-Louis Pépin","doi":"10.1016/j.sleep.2025.02.003","DOIUrl":"10.1016/j.sleep.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Obstructive sleep apnea (OSA) is typically treated with continuous positive airway pressure (CPAP) therapy. Some patients experience residual excessive daytime sleepiness (EDS) under CPAP. Pitolisant demonstrated effectiveness in reducing EDS. An individual patient meta-analysis was conducted assessing the efficacy and safety of pitolisant 20 mg and 40 mg versus placebo to treat EDS in patients with OSA using CPAP.</div></div><div><h3>Methods</h3><div>A study-patient, hierarchical, random-effects model was used. Epworth Sleepiness Scale (ESS) and Oxford Sleep Resistance test (OSLER) were co-primary endpoints. Secondary endpoints included EDS-Z scores, fatigue, clinical global impression, and quality of life (QoL).</div></div><div><h3>Results</h3><div>The searches identified three randomized controlled trials. Individual patient data were derived from 423 patients (placebo: n = 120, pitolisant 20 mg: n = 183, pitolisant 40 mg: n = 120). Treatment effects on ESS were −3.20 (95 % confidence interval [CI]: 4.37, −2.00; <em>P</em> &lt; 0.001) and −3.57 (95 % CI: 4.87, −2.80); <em>P</em> &lt; 0.001) for the 20 mg and 40 mg doses, with corresponding standardized mean differences (SMD) of −0.71 (95 % CI: 0.45, −0.97) and −0.79 (95 % CI: 0.51, −1.08). Treatment effects in minutes for OSLER were 1.24 (95 % CI: 0.60, 1.10, SMD = 0.61; <em>P</em> = 0.001) and 1.21 (95 % CI: 0.06, 1.38, SMD = 0.51; <em>P</em> = 0.006). Pitolisant 40 mg was superior to the 20-mg dose for older age (≥50 years) and higher baseline apnea-hypopnea index values (≥15). No significant differences were observed for safety outcomes.</div></div><div><h3>Conclusion</h3><div>Pitolisant 20 mg and 40 mg were significantly therapeutically superior to placebo in treating residual EDS in patients with OSA who received CPAP on the outcomes for ESS, OSLER, and QoL.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 1-7"},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419982","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":"Sex-specific differences in overnight nitrate levels in persons with obstructive sleep apnea and type 2 diabetes","authors":"Gregory Pappas ,&nbsp;Andrew Gow ,&nbsp;Naresh M. Punjabi ,&nbsp;R. Nisha Aurora","doi":"10.1016/j.sleep.2025.02.011","DOIUrl":"10.1016/j.sleep.2025.02.011","url":null,"abstract":"<div><h3>Study objectives</h3><div>Sex-specific differences in OSA-associated symptoms and polysomnographic findings are well recognized. However, sex differences in intermediate pathways potentially linking OSA and cardiometabolic outcomes are limited. OSA is known to be associated with decreased nitric oxide (NO)-related vasodilation and endothelial dysfunction. The current study sought to characterize the independent association between OSA severity and overnight NO metabolites (i.e. markers of oxidative stress) and determine if there were differences by sex in persons with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>Adults with T2DM and undiagnosed OSA were recruited from the community. Demographic information, an overnight polysomnogram, and pre- and post-sleep plasma samples were collected. The association between OSA and nitrite and nitrate levels were examined using multivariable linear regression. Analyses were done for the entire sample and stratified by sex.</div></div><div><h3>Results</h3><div>The sample included 83 participants with 52 % men. Stratified, fully adjusted models showed that compared to women with mild OSA, women with moderate or severe OSA did not exhibit the expected decline in overnight nitrate levels: 4.84 μM (−12.3, 2.7: p = 0.09) and 5.82 μM (−4.7, 16.3: p &lt; 0.01) for moderate and severe OSA, respectively. Overnight nitrate levels decreased in males regardless of OSA severity, without significant differences across severity categories. An interaction between OSA severity and sex was seen for post-sleep nitrates in women with severe OSA.</div></div><div><h3>Conclusion</h3><div>The association between OSA and overnight nitrates varies by sex and OSA severity. Women with severe OSA did not have a decline in overnight nitrate levels whereas men did, suggesting they have higher overnight oxidative stress.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 159-164"},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394386","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":"Melatonin use in typically developing (TD) children: International Pediatric Sleep Association (IPSA) Expert Consensus Recommendations for Healthcare Providers","authors":"Melatonin Task Force,&nbsp;Judith Owens ,&nbsp;Narong Simakajornboon ,&nbsp;Suresh Kotagal ,&nbsp;Paul Gringras ,&nbsp;International Pediatric Sleep Association (IPSA) Practice and Policy Committee and the IPSA Board of Directors","doi":"10.1016/j.sleep.2025.02.002","DOIUrl":"10.1016/j.sleep.2025.02.002","url":null,"abstract":"<div><div>Although melatonin is widely used globally for the management of insomnia in children and adolescents, there are few clinical guidelines available for healthcare practitioners, particularly in typically developing (TD) children. Because existing data are either sparse or inconclusive, a task force comprised of pediatric sleep researchers and clinicians was established by the International Pediatric Sleep Association (IPSA) to first examine the available literature and to then develop a set of evidence-based (when possible) and consensus-based recommendations to guide practitioners in decision-making regarding melatonin use in pediatric insomnia. The following recommendations regarding appropriate indications for melatonin in children, considerations regarding timing and dosage, safety issues and caveats in recommending use of melatonin in pediatric clinical settings, are presented as a companion to a Technical Report summarizing the available literature.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 127-129"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372959","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":"Perspectives regarding consumer sleep technology and barriers to its use or adoption among adults in the United States","authors":"Mary Kress ,&nbsp;Nicholas R. Lenze ,&nbsp;Ruby J. Kazemi ,&nbsp;Allison K. Ikeda ,&nbsp;Punithavathy Vijayakumar ,&nbsp;Cathy A. Goldstein ,&nbsp;Jeffrey J. Stanley ,&nbsp;Michael J. Brenner ,&nbsp;Paul T. Hoff","doi":"10.1016/j.sleep.2025.02.004","DOIUrl":"10.1016/j.sleep.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>To explore perspectives about consumer sleep technology (CST) and barriers to its regular use and whether these vary by sociodemographic characteristics.</div></div><div><h3>Methods</h3><div>A multidisciplinary team developed a survey instrument which was disseminated to a national sample via an online platform. A mixed methods analysis using descriptive statistics, logistic regression, and thematic content analysis was employed.</div></div><div><h3>Results</h3><div>Among 897 survey respondents, mean age was 47.5 ± 16.9 years; 73.1 % identified as female, and 81.8 % as White. A total of 505 respondents (56.3 %) reported having tracked their sleep using CST. Concerns or barriers reported by respondents included cost (57.2 %), too many different types of CST (56.5 %), and data privacy/security concerns (38.7 %). Younger individuals (p &lt; 0.001) and those with annual household income $30,000 to $57,999 per year (p = 0.006) or &lt;$30,000 per year (p = 0.021) were more likely to report cost as a barrier in the adjusted analysis. Individuals with household income &lt;$30,000 (p = 0.004) or identifying as Asian (p = 0.002) or Black (p = 0.004) race were more likely to report data privacy/security concerns. Among those who already owned CST, 12.3 % reported sleep-related worry/orthosomnia and 17 % reported not trusting the data. Qualitative analyses corroborated these findings, emphasizing concerns with data privacy/security, sleep-related worry, lack of trust in data accuracy, and physical discomfort.</div></div><div><h3>Conclusions</h3><div>Despite the growing popularity of CST, there exist several concerns and barriers to its regular use that may have health equity implications. Further research incorporating diverse stakeholders is necessary to address these barriers and promote optimal use of technology.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 165-173"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402617","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":"Aminoacetone is associated with sleep latency","authors":"Sirui Zhou ,&nbsp;Xue Han ,&nbsp;Zhenzhen Shi ,&nbsp;Qiang Zhang ,&nbsp;John Cox ,&nbsp;Victoria Pak","doi":"10.1016/j.sleep.2025.02.006","DOIUrl":"10.1016/j.sleep.2025.02.006","url":null,"abstract":"<div><h3>Introduction</h3><div>This study conducted a targeted analysis of metabolites involved in inflammatory, oxidative stress, and neuronal pathways that were previously implicated with sleepiness based on our prior work identifying metabolites in these pathways in persons with OSA. We examine associations between sleep latency (based on the Pittsburgh Sleep Quality Index) which is an important indicator of sleep quality and daytime sleepiness, and metabolic concentrations to identify potential mechanisms linking the two.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 88 participants newly diagnosed and untreated for OSA who underwent an overnight in-lab or at home sleep study recruited from the Emory Mechanisms of Sleepiness Symptoms Study (EMOSS). Fasting morning blood plasma samples were collected after the overnight sleep study. A multiple linear regression model was utilized to examine the association between metabolites of interest and sleep latency, controlling for baseline covariates of age, sex, body mass index (BMI), race, smoking status, and apnea hypopnea index (AHI).</div></div><div><h3>Results</h3><div>Among the targeted metabolites, aminoacetone showed a significant association with sleep latency (adjusted mean (SE) = −0.39 (0.11); p = 0.00072). Participants with sleep onset latency &gt;60 min had lower levels of aminoacetone than patients with sleep onset latency &lt;15 min.</div></div><div><h3>Conclusion</h3><div>This is the first study to evaluate the relationship between aminoacetone and sleep latency in participants with newly diagnosed OSA. Our findings suggests that aminoacetone is associated with sleep latency in participants with OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 183-186"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402612","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":"Comparative efficacy of non-pharmacological interventions for adults with sleep apnea: A systematic review and network meta-analysis","authors":"Spyridon N. Papageorgiou ,&nbsp;Ioannis Konstantinidis ,&nbsp;Alexandra K. Papadopoulou ,&nbsp;Fani Apostolidou-Kiouti ,&nbsp;Ioannis Avgerinos ,&nbsp;Athanasia Pataka ,&nbsp;Theodore Eliades ,&nbsp;Apostolos Tsapas ,&nbsp;Anna-Bettina Haidich","doi":"10.1016/j.sleep.2025.02.008","DOIUrl":"10.1016/j.sleep.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Sleep apnea is associated with cardiovascular risk, work productivity, occupational/traffic accidents, and quality-of-life (QoL); however uncertainty exists regarding optimal treatment. We performed a systematic review on the efficacy of non-pharmacological interventions for adults with sleep apnea.</div></div><div><h3>Method</h3><div>We searched MEDLINE, Scopus, Virtual-Health-Library and Web-of-Science through June 2023 for parallel/cross-over randomized trials on adults with sleep apnea (apnea-hypopnea-index&gt;5 events/hour). Study selection, data extraction and risk-of-bias assessment were performed in duplicate, followed by frequentist network meta-analyses.</div></div><div><h3>Results</h3><div>Ultimately, 197 unique trials were included (15,931 patients; mean age 51.4 years; 78.9 % male) assessing 25 treatments. Positive Airway Pressure (PAP) (alone or combined with health behaviour modification) consistently improved more apnea-hypopnea-index or daytime sleepiness and physical/mental QoL in obstructive sleep apnea (OSA) patients compared to all other interventions but was not always well-tolerated. Mandibular advancement devices (MAD) yielded the greatest improvement in depression, while also improving objective/subjective apnea-outcomes, and physical/mental QoL—albeit less than PAP and less for moderate/severe cases. Acupuncture, health behaviour modifications, surgical maxillomandibular advancement, minor oral surgery, oropharyngeal training, oxygen supplementation, or electrical neurostimulation might improve apnea-related outcomes, but weak evidence exists. Finally, electrical neurostimulation performed best for central sleep apnea and PAP performed best for positional OSA. Confidence in the network meta-analysis estimates was low due to non-adherence issues that was rarely directly assessed in included trials with objective measures.</div></div><div><h3>Conclusion</h3><div>PAP (alone or with co-interventions) performed best for the treatment of adult OSA patients regardless of disease severity. For patients not tolerating PAP, MADs might be a good alternative, but confer smaller improvements overall. However, adherence issues and the heterogenous response increase the complexity of OSA treatment.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 130-138"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378998","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":"Childhood adversities and long-term sleep problems: The mediating role of affective symptoms. A prospective population study","authors":"Raimo K.R. Salokangas ,&nbsp;Tiina From ,&nbsp;Henri R.W. Salokangas ,&nbsp;Lara Lehtoranta ,&nbsp;Seppo Koskinen ,&nbsp;Jarmo Hietala","doi":"10.1016/j.sleep.2025.01.035","DOIUrl":"10.1016/j.sleep.2025.01.035","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleep disturbances are known to impact mental and physical health. In cross-sectional population studies, adverse childhood experiences (ACEs) associate with sleep problems (SPs), with potential variations by sex. In a prospective population study, we tested whether the effect of ACEs on SPs differs between males and females.</div></div><div><h3>Method</h3><div>In a Finnish population-based study, 3142 individuals aged 30–64 years (56 % female) completed questionnaires about ACEs in 2000 and SPs in 2000 and in 2011. The effects of ACEs on SPs were analysed using repeated measures ANOVA and path analyses.</div></div><div><h3>Results</h3><div>Multiple ACEs associated with subjective SPs in adulthood, even after controlling for sex, age, marital status, education, income, smoking, alcohol abuse, chronic illness, and continuous pain. Of the ACE dimensions, social disadvantage was associated with SPs in both sexes. The effects of multiple ACEs and social disadvantage on SPs were partially mediated by affective symptoms, depression and anxiety. Family conflicts and maternal mental health problems associated with SPs only in females, and this association was also mediated via affective symptoms.</div></div><div><h3>Conclusion</h3><div>ACEs, especially social disadvantage, are associated with SPs in the adult general population. This prospective study suggests sex differences in the observed associations. Specifically, family conflicts and maternal mental health problems associate with SPs in females only, with the affective symptom domain as the main mediator. For effective treatment of long-term SPs, it is important to investigate patients' childhood living conditions and their childhood family's emotional atmosphere. Childhood psychological distress requires attention particularly in females.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 110-116"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101906","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 ,&nbsp;Yuming Li ,&nbsp;Boyi Li ,&nbsp;Huifang Shang ,&nbsp;Jing Yang","doi":"10.1016/j.sleep.2024.12.003","DOIUrl":"10.1016/j.sleep.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 114-121"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","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":"Sleep apnea endotypes and their implications for clinical practise","authors":"Bradley A. Edwards ,&nbsp;Shane A. Landry ,&nbsp;Luke D.J. Thomson ,&nbsp;Simon A. Joosten","doi":"10.1016/j.sleep.2024.12.021","DOIUrl":"10.1016/j.sleep.2024.12.021","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) is now recognized to be a multifactorial disorder caused by several endotypes that differ between individuals and patient populations. In order to understand the current clinical implications of OSA endotypes, this review aims to examine the current state of play in endotype measurements, endotype modification and their impact on clinical outcomes/prognosis. In summary, the field has developed multiple techniques to measure the endotypes over the last few decades. There is now good proof-of-concept evidence that a priori knowledge of an individual’s OSA endotype traits may be useful in helping to guide treatment decisions. However, in order to truly deliver a personalized medicine approach to the treatment of OSA, we need to address critical gaps in: understanding OSA endotype treatment thresholds, and the impact of OSA modification on patient centred outcomes and hard clinical endpoints. Such efforts will benefit from a united, collaborative approach that involve partnerships between academics and consumers (i.e. patients, healthcare providers, industry).</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 260-266"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898273","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":"Upper airway obstructive events on noninvasive ventilation in NMD adolescents","authors":"Simona Basilicata ,&nbsp;Lucie Griffon ,&nbsp;Clément Poirault ,&nbsp;Brigitte Fauroux ,&nbsp;Nevena Jovicic ,&nbsp;Alessandro Amaddeo ,&nbsp;Sonia Khirani","doi":"10.1016/j.sleep.2024.12.015","DOIUrl":"10.1016/j.sleep.2024.12.015","url":null,"abstract":"<div><div>Home noninvasive ventilation (NIV) is expanding worldwide for pediatrics and is mainly indicated to treat nocturnal alveolar hypoventilation. Nasal mask is the most common interface used in children, but oronasal mask may be indicated in case of excessive mouth leaks or facial weakness. Obstructive events caused by the oronasal mask have been reported in a few studies on adult patients, but never in pediatrics. Some strategies to prevent their occurrence have been proposed, such as the increase of expiratory positive airway pressure (EPAP), the use of automatic adjusted EPAP or the switch to a nasal mask. We report here the cases of 2 adolescents with neuromuscular diseases, who experienced upper airway obstructive events by an oronasal mask. The management of these patients to improve NIV efficacy is described and discussed in line with the adult literature.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 235-238"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898275","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}