Sleep medicine最新文献

{"title":"Serum levels of 1,3-β-D-glucan is correlated with NLRP3 inflammasome activation and insomnia severity in people with chronic insomnia disorder","authors":"Yasaman Afsari ,&nbsp;Fereshteh Atabi ,&nbsp;Zahra Aghelan ,&nbsp;Habibolah Khazaie ,&nbsp;Zahra Vakili ,&nbsp;Seyed Hosein Abtahi ,&nbsp;Mahan Rezaie Pouya","doi":"10.1016/j.sleep.2025.02.046","DOIUrl":"10.1016/j.sleep.2025.02.046","url":null,"abstract":"<div><div>This study aimed to explore the correlation between serum levels 1,3-β-D-glucan as a biomarker for gut microbiome imbalance and NLRP3 inflammasome/IL-1β axis activation and insomnia severity in humans with chronic insomnia disorder (CID). Blood samples were collected from 20 people diagnosed with CID based on the Pittsburgh Sleep Quality Index (PSQI) and video-polysomnography and 20 healthy individuals based on PSQI. 1,3-β-D-glucan, IL-1β, and NLRP3 protein serum levels were assayed using enzyme-linked immunosorbent assay (ELISA). 1,3-β-D-glucan, IL-1β, and NLRP3 protein serum concentrations in the CID group were significantly higher than in the control group. Also, we observed a significant positive correlation between the serum levels of these three factors in the CID group and a significant positive correlation between 1,3-β-D-glucan and insomnia severity index. Our findings suggest that 1,3-β-D-glucan may indicate gut microbiome imbalance in people with CID and may play an important role in the pathogenesis of chronic insomnia by activating the NLRP3/IL-1β inflammasome pathway. These results highlight the potential for dual therapeutic strategies targeting gut microbiota modulation and NLRP3 inflammasome inhibition to disrupt the neuroinflammatory cascade driving chronic insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 187-191"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535005","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":"Negative effects of cognitive behavioral therapy for insomnia: Psychometric evaluation of an insomnia-specific extension for the Negative Effect Questionnaire","authors":"Laura Simon ,&nbsp;Yannik Terhorst ,&nbsp;Ann-Marie Küchler ,&nbsp;Dieter Riemann ,&nbsp;David Daniel Ebert ,&nbsp;Alexander Rozental ,&nbsp;Kai Spiegelhalder ,&nbsp;Harald Baumeister","doi":"10.1016/j.sleep.2025.02.044","DOIUrl":"10.1016/j.sleep.2025.02.044","url":null,"abstract":"<div><h3>Introduction</h3><div>Negative effects of psychotherapy encompass unwanted events caused by the treatment. Evidence exists that cognitive behavioral therapy for insomnia (CBT-I) can lead to negative effects (e.g., exhaustion, reduced motivation). Psychometrically validated instruments are needed to enable systematic investigation of negative effects and their consequences. This study aimed to develop an insomnia-specific extension for the Negative Effect Questionnaire (NEQ) and to evaluate its psychometric properties.</div></div><div><h3>Method</h3><div>Based on a literature review, an item pool was developed as an extension to the NEQ. This item pool was iteratively refined. Both the NEQ and the developed item pool were administered to participants enrolled in a stepped-care model for insomnia that includes an internet-delivered CBT-I. The psychometric properties of the item pool were evaluated using confirmatory factor analyses (CFAs). Additionally, responses to open-ended questions were categorized and analyzed.</div></div><div><h3>Results</h3><div>Data from 210 participants were available. In the newly developed item pool, participants reported a mean of 4.7 negative effects (range: 0 to 22). CFA indicated a good fit (RSMEA = 0.05; SRMR = 0.07) of a model with five latent factors (somatic symptoms, cognitive symptoms, safety, emotional symptoms, daytime functioning). The correlation analyses between the model's latent factors and the NEQ subscales indicated adequate discriminant validity.</div></div><div><h3>Discussion</h3><div>The observed prevalence rates of insomnia-specific negative effects highlight the need to assess the negative effects of CBT-I with an insomnia-specific instrument. The CFA suggests that the 24-item NEQ-Insomnia is a valid instrument, suitable for standalone use or as an extension to the NEQ for assessing the negative effects of CBT-I.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 200-211"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551402","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":"Parkinson’s disease: News on the action of melatonin","authors":"Fulvio A. Scorza ,&nbsp;Raphael Wuo-Silva ,&nbsp;Josef Finsterer ,&nbsp;Feres Chaddad-Neto","doi":"10.1016/j.sleep.2025.02.038","DOIUrl":"10.1016/j.sleep.2025.02.038","url":null,"abstract":"<div><div>Melatonin has been shown to improve sleep quality in Parkinson's disease (PD) patients with good safety and tolerability. Beyond its neurological benefits, emerging evidence suggests that melatonin may exert cardioprotective effects, which could be relevant in the context of sudden unexpected death in PD (SUDPAR). PD is associated with high mortality rates, and autonomic dysfunction and cardiac abnormalities may play a role in SUDPAR. Translational studies suggest that melatonin concentrations could serve as potential biomarkers for cardiac dysfunction in PD. Melatonin supplementation has demonstrated neuroprotective properties by modulating apoptosis, autophagy, oxidative stress, inflammation, α-synuclein aggregation, and dopamine loss. Additionally, clinical data indicate that melatonin levels are altered in patients with coronary heart disease, heart failure, and stroke. Reduced melatonin production is associated with increased risk of cardiac events and sudden cardiac death. Given its anti-inflammatory, antioxidant, immunomodulatory, and vasomotor properties, melatonin may represent a promising adjunctive therapy for PD, potentially mitigating both neurological and cardiovascular risks.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"130 ","pages":"Pages 1-2"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580336","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":"Preliminary findings of DNA hypermethylation of MDGA1 in idiopathic restless legs syndrome","authors":"Xiao-Ying Zhu ,&nbsp;Xin-Rong He ,&nbsp;Yu Wang ,&nbsp;Chun-Ni Guo ,&nbsp;Hong-Ming Wang ,&nbsp;Xuan Li ,&nbsp;Xi-Xi Wang ,&nbsp;Jing Zhang ,&nbsp;Ya Feng ,&nbsp;Jing-Tao Feng ,&nbsp;Jia-Peng Zhao ,&nbsp;Shu-Qin Chen ,&nbsp;Yue Zhang ,&nbsp;Te Liu ,&nbsp;Yun-Cheng Wu","doi":"10.1016/j.sleep.2025.02.042","DOIUrl":"10.1016/j.sleep.2025.02.042","url":null,"abstract":"<div><h3>Background</h3><div>Both genetic and environmental factors contribute to the development of restless legs syndrome (RLS). Epigenetic mechanisms might play a vital role in RLS but remain underexplored. MDGA1, involved in synaptic inhibition, has been identified by genome-wide association studies as a potential risk gene for RLS. However, its role and underlying mechanisms in RLS are largely unknown.</div></div><div><h3>Objective</h3><div>To investigate the relationship between DNA methylation levels in the promotor region of MDGA1 and RLS susceptibility and phenotypes.</div></div><div><h3>Methods</h3><div>Two independent RLS cohorts (including three large RLS families) and healthy controls (HCs) were recruited. Clinical characteristics were recorded, and DNA methylation levels of CpG islands in the MDGA1 gene from peripheral blood mononuclear cells were measured. Associations between MDGA1 methylation (MDGA1m) and RLS phenotypes (age, sex, and family history) were also analyzed.</div></div><div><h3>Results</h3><div>A total of 62 idiopathic RLS (iRLS) patients (29 from Cohort 1 and 33 from Cohort 2) and 45 healthy controls (24 from Cohort 1 and 21 from Cohort 2) were included. MDGA1 methylation levels were significantly higher in iRLS patients compared to HCs. Among RLS families, both RLS patients and non-RLS family members showed hypermethylation compared to HCs. Moreover, a positive family history of RLS was associated with an increased risk of MDGA1 hypermethylation.</div></div><div><h3>Conclusion</h3><div>Our study identified hypermethylation of the MDGA1 gene in the peripheral blood of RLS cases, which may be linked to family history.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 264-273"},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578762","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":"Effects of dexmedetomidine and propofol on the key endotypes of OSA: A randomized, single-blind, placebo-controlled, crossover trial","authors":"Chunbo Li ,&nbsp;Haiting Fan ,&nbsp;Yujuan Duan ,&nbsp;Dan Wang ,&nbsp;Yang Lin ,&nbsp;Wenjun Xin ,&nbsp;Renqiang Ma ,&nbsp;Weiping Wen ,&nbsp;Yan Wu","doi":"10.1016/j.sleep.2025.02.041","DOIUrl":"10.1016/j.sleep.2025.02.041","url":null,"abstract":"<div><h3>Background</h3><div>Drug-induced sleep has been shown to facilitate the diagnosis of obstructive sleep apnea (OSA). However, the effects of commonly used sedatives, such as dexmedetomidine and propofol, on the endotypic traits of OSA remained unclear.</div></div><div><h3>Objective</h3><div>We aim to investigate the impact of dexmedetomidine and propofol on OSA endotypic traits.</div></div><div><h3>Methods</h3><div>We conducted a randomized, single-blind, placebo-controlled, crossover trial in adult patients with OSA, comparing the OSA endotypic traits and polysomnography parameters among the interventions of placebo, dexmedetomidine and propofol.</div></div><div><h3>Results</h3><div>16 patients completed the trial and were enrolled for analysis. Both dexmedetomidine and propofol worsened pharyngeal collapsibility as indicated by a lower Vpassive (mean difference: 6.1 [95 % CI -9.1 to −3.0]%_eupnea for dexmedetomidine versus placebo, <em>p</em> = 0.040; −16.5 [95 % CI -24.1 to −9.0]%_eupnea for propofol versus placebo, <em>p</em> &lt; 0.001), with propofol causing a greater effect (−10.4 [95 % CI -17.8 to −3.2]%_eupnea for propofol versus dexmedetomidine, <em>p</em> &lt; 0.001). Dexmedetomidine maintained upper airway gain, while propofol diminished it compared to placebo (<em>p</em> = 0.001). Both dexmedetomidine and propofol increased arousal threshold (<em>p</em> = 0.006 and <em>p</em> &lt; 0.001, respectively). Dexmedetomidine had no effect on loop gain, whereas propofol elevated it (<em>p</em> = 0.004). Compared to placebo, dexmedetomidine had no impact on apnea-hypopnea index (AHI) or saturation of peripheral oxygen (SpO₂). During propofol sedation, AHI in stages N1 (<em>p</em> &lt; 0.001), N2 (<em>p</em> &lt; 0.001) and the entire NREM (<em>p</em> = 0.038) sleep showed increases, and nadir SpO₂ for NREM stage exhibited a decrease (<em>p</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>Dexmedetomidine had less impact on OSA endotypic traits compared to propofol, and had no negative effects on AHI and SpO₂.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 132-139"},"PeriodicalIF":3.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521137","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":"Insomnia features and patient-reported daytime sleepiness in patients with obstructive sleep apnea","authors":"Gouveris H. ,&nbsp;Deiß A. ,&nbsp;Hackenberg B. ,&nbsp;Bahr-Hamm K. ,&nbsp;Huppertz T. ,&nbsp;Ludwig K. ,&nbsp;Matthias C. ,&nbsp;Simon P.","doi":"10.1016/j.sleep.2025.02.035","DOIUrl":"10.1016/j.sleep.2025.02.035","url":null,"abstract":"<div><div>Previous preliminary evidence suggests insomnia features playing a major causative or confounding role in daytime sleepiness in obstructive sleep apnea (OSA) patients. We investigated further this hypothesis in a larger OSA patient cohort. In a cross-sectional study in a tertiary medical center, consecutive patients presenting with suspected OSA, but without other sleepiness-promoting comorbidities, and tested by in-lab polysomnography (PSG) were evaluated prospectively for excessive daytime sleepiness (EDS) using the Epworth Sleepiness Scale (ESS) and for insomnia using the Insomnia Severity Index (ISI) respectively. Two hundred and thirty patients (63 female; average age: 54,1 y) were included in this OSA treatment-naïve cohort. ISI values correlated best (Spearman's rho = 0,29, p &lt; .001) with the total ESS score than any PSG -associated metric did. Especially ISI item 7- (interference of sleep problems with daily functions, r = 0,33, p &lt; .001) and item 2 - (difficulty staying asleep, r = 0,28, p &lt; .001) and to a lesser degree item 4 - (satisfaction with own current sleep patterns, r = 0,23, p = 0,025) scores showed significant correlations. Notably, no single significant correlation was found between ESS score and any PSG-metric at all. In a multiple regression analysis, the ISI item 7 score emerged as the sole significant independent predictor of the ESS score. We conclude that insomnia may significantly impact patient-reported daytime sleepiness in OSA patients. We suggest that assessment of insomnia symptoms and features (e.g. by means of ISI) should always be performed in OSA patients reporting daytime sleepiness. We propose that these preliminary findings should be validated in larger and diverse cohorts of OSA patients.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 292-296"},"PeriodicalIF":3.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593295","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":"Determinants of substance use patterns in patients with narcolepsy type 1: A multi-center comparative cross-sectional study","authors":"Laure Peter-Derex ,&nbsp;Emmanuel Fort ,&nbsp;Benjamin Putois ,&nbsp;Nora Martel ,&nbsp;François Ricordeau ,&nbsp;Hélène Bastuji ,&nbsp;Isabelle Arnulf ,&nbsp;Lucie Barateau ,&nbsp;Patrice Bourgin ,&nbsp;Yves Dauvilliers ,&nbsp;Rachel Debs ,&nbsp;Pauline Dodet ,&nbsp;Benjamin Dudoignon ,&nbsp;Patricia Franco ,&nbsp;Sarah Hartley ,&nbsp;Isabelle Lambert ,&nbsp;Michel Lecendreux ,&nbsp;Laurene Leclair-Visonneau ,&nbsp;Damien Léger ,&nbsp;Martine Lemesle-Martin ,&nbsp;Benjamin Rolland","doi":"10.1016/j.sleep.2025.02.037","DOIUrl":"10.1016/j.sleep.2025.02.037","url":null,"abstract":"<div><h3>Objectives</h3><div>In this multi-center cross-sectional study, we compared substance use patterns (SUPs) between patients with narcolepsy type 1 (NT1) and controls, and investigated, among patients, factors associated with the consumption of the main psychoactive substances.</div></div><div><h3>Methods</h3><div>Adult patients with NT1 and controls completed questionnaires about tobacco, alcohol, and cannabis use patterns. Unadjusted bivariable then multivariate analyses (adjusted for sex, age, education, family status, and depression) were performed to compare SUPs between controls and patients, and to explore socio-demographic, psycho-behavioral, and clinical determinants of consumptions.</div></div><div><h3>Results</h3><div>We included 235 patients (63.8 % women, 36.4 ± 14.7 years) and 166 controls (69.9 % women, 40.3 ± 14.4 years). Substances co-consumptions were frequent in both groups. Patients with NT1 were more frequently current smokers (32.3 % vs. 20.1 %, p &lt; 0.01) or e-cigarettes users (12.1 % vs 2.4 %, p &lt; 0.001) than controls, while no difference was observed for cannabis use and alcohol misuse. Only the increased likelihood of vaping remained significant in adjusted analysis. Among NT1 patients, smoking was associated with disrupted nighttime sleep (OR[95%CI] = 2.28[1.02–5.12], p &lt; 0.05) and less obesity (OR = 0.24[0.09–0.59], p &lt; 0.05). Alcohol misuse was associated with sleep paralysis (OR = 2.11[1.13–3.91], p &lt; 0.05) and treatments (modafinil: OR = 2.14[1.15–4.01], p &lt; 0.05; sodium oxybate: OR = 0.41[0.17–0.97], p &lt; 0.05). Tobacco and cannabis consumptions were associated with lower physical activity (OR = 0.46 [0.24–0.87], p &lt; 0.05 and OR = 0.25[0.10–0.66], p &lt; 0.01). Alcohol misuse and cannabis use were associated with rule breaking behaviors (OR = 5.89[1.61–21.60], p &lt; 0.05 and OR = 8.52[1.79–40.48], p = 0.01).</div></div><div><h3>Conclusion</h3><div>Patients with NT1 do not seem less vulnerable to psychoactive substance use/misuse. Consumptions patterns are associated with multiple dimensions of the disease including sleep-related symptoms, comorbidities, treatments, and psycho-behavioral factors.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 148-166"},"PeriodicalIF":3.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521139","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":"The role of objective sleep duration, continuity, and architecture for subjective sleep perception: Findings from an intensive longitudinal study using heart-rate variability to infer objective sleep indicators","authors":"Justin Hachenberger ,&nbsp;Sebastian Baron ,&nbsp;Manuel Schabus ,&nbsp;Sakari Lemola","doi":"10.1016/j.sleep.2025.02.040","DOIUrl":"10.1016/j.sleep.2025.02.040","url":null,"abstract":"<div><div>This study investigates the relationship between objective sleep indicators derived from heart rate variability (HRV) and sleep perception in young adults using an intensive longitudinal design over 14 consecutive nights. The sample included 178 participants aged 18–29 years from two separate studies, who provided data via daily sleep diaries. Using a multi-resolution convolutional neural network model, heart rate variability measured via ambulatory electrocardiography was used for sleep stage classification. Within-subject analyses revealed that longer total sleep time, higher sleep efficiency, more slow-wave sleep, and more rapid-eye-movement sleep were associated with better sleep perception, while longer wake after sleep onset was linked to poorer sleep perception. Notably, no significant associations were found on the between-subject level. The objective sleep indicators explained nearly five times as much variance in sleep perception at the within-subject level than at the between-subject level. Additionally, gender, as well as depressive symptoms and insomnia symptoms measured at baseline did not moderate the within-subject associations between objective sleep indicators and sleep perception. These findings underscore the importance of sufficient sleep duration, quality of sleep architecture, and sleep continuity for individuals' perceptions of their sleep on a nightly basis. The study's use of HRV-derived sleep staging over multiple nights represents a methodological strength, providing detailed and less intrusive assessment compared to traditional polysomnography. Furthermore, these results are particularly important for clinical applications, as they can be basis for individualized interventions to improve sleep perception.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 167-174"},"PeriodicalIF":3.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527122","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":"Regional cerebral blood perfusion impairment in type 1 narcolepsy patients: An arterial spin labeling study","authors":"Lin Xu ,&nbsp;Ruilin Zhang ,&nbsp;Rong Xue ,&nbsp;Linlin Wang ,&nbsp;Zhu Ai ,&nbsp;Lili Li ,&nbsp;Wei Wu ,&nbsp;Zuojun Wang","doi":"10.1016/j.sleep.2025.02.036","DOIUrl":"10.1016/j.sleep.2025.02.036","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the pathophysiological characteristics of cerebral blood flow (CBF) in patients with narcolepsy type 1 (NT1) via the arterial spin labeling (ASL) technique.</div></div><div><h3>Methods</h3><div>Thirty patients with diagnostic NT1 (PTs) and 34 age- and sex-matched healthy controls (HCs) were recruited for this study. Basic information was collected, and clinical evaluation and neuroimaging, including ASL and T1-3DBRAVO, was performed. The z-normalized CBF (zCBF) and spatial coefficient of variation (sCoV) were calculated, and the changes in NT1 were compared via analysis of covariate (ANCOVA). Furthermore, spearman's correlation analysis between impaired regional perfusion and clinical features was performed. Age, sex, and normalized grey matter volume were included as covariates.</div></div><div><h3>Results</h3><div>Compared with that of HCs, the zCBF of PTs significantly differed in regions of fronto-temporal-occipital cortex, right insula and posterior insula, and left rostral/dorsal anterior cingulate gyrus (ACG) (<em>P</em> &lt; 0.006). Moreover, the sCoV was significantly altered in the frontotemporal cortex, rostral ACG, right hippocampus, and posterior insula (<em>P</em> &lt; 0.003). In PTs, positive correlations were identified between the zCBF of the right superior/middle frontal gyrus (SFG/MFG) and mean sleep latency, and between the zCBF of the left SFG of the frontal pole and sleep hallucination severity. Moreover, the sCoV of the right MFG/hippocampus were positively associated with Rapid Eye Movement efficiency and negatively associated with Hamilton Anxiety Scale score, respectively.</div></div><div><h3>Conclusion</h3><div>PTs exhibited abnormal regional perfusion in the frontal-temporal-occipital cortex and limbic system regions, which may serve as patient-specific imaging markers. Alterations in perfusion may lead to the clinical manifestations of underlying psychological and sleep disorders in PTs.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 122-130"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511295","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":"Differential respiratory function response in paediatric spinal muscular atrophy types 2 and 3 treated with nusinersen over 3 years","authors":"Archana Chacko ,&nbsp;Peter D. Sly ,&nbsp;Robert S. Ware ,&nbsp;Brett Dyer ,&nbsp;Sean Deegan ,&nbsp;Nicole Thomas ,&nbsp;Leanne M. Gauld","doi":"10.1016/j.sleep.2025.02.034","DOIUrl":"10.1016/j.sleep.2025.02.034","url":null,"abstract":"<div><h3>Aim</h3><div>To establish whether the initial positive effect of nusinersen (NUS) on respiratory outcomes in the first year of treatment was maintained in children with Spinal Muscular Atrophy (SMA) type 2 and to further define the effect on children with type 3 treated over 3 years.</div></div><div><h3>Methods</h3><div>A prospective observational study of children with type 2 and 3 beginning NUS in Queensland, Australia between June 2018–December 2020 was undertaken. Investigations conducted included age-appropriate lung function and polysomnography. Lung function data for two-years preceding NUS initiation was retrospectively collected. Change in lung function/polysomnography was assessed using mixed effects linear regression.</div></div><div><h3>Results</h3><div>24 of 30 children with type 2 and 3 SMA (14 males; 2.6–15.8) were included (type 2 n = 12; type 3 n = 12). No child had respiratory-related admissions during the period of study. For type 2, annual decline in FVC z-score pre-treatment was −0.75 (95 % CI: 1.14, −0.39, p &lt; 0.001), and for the first 3 years on NUS was −0.20 ([95 % CI: 0.33, −0.06, p = 0.01] difference p = 0.008). For type 3 minimal change was seen: pre-NUS and post FVC z-scores −0.20 (95 % CI: 1.00, 0.61 p = 0.05) and −0.46 (95 % CI: 0.88, −0.04 p = 0.40) respectively (difference p = 0.46). Mean change in total apnoea-hypopnoea indices (total AHI) in type 2 tended to reduce −1.75 (95 % CI: 4.95–0.9, p = 0.24); type 3 appeared to remain stable (−0.39 [95 % CI: 1.1–0.33, p = 0.28). One child with type 2 ceased NIV due to normalisation of total AHI and gas exchange.</div></div><div><h3>Conclusion</h3><div>Nusinersen lung function (FVC-z-scores) stability seen in the first year was maintained over 3 years and the total AHI tended to improve in type 2, but the long-term effects in type 3 are less clear.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 354-362"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642490","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}