Sleep medicine最新文献

{"title":"CBT-I for prevention and early intervention in mental disturbances: A systematic review and meta-analysis","authors":"Laura Palagini ,&nbsp;Giulia Aquino ,&nbsp;Gaspare Alfi ,&nbsp;Leonardo Massoni ,&nbsp;Matteo Gambini ,&nbsp;Mario Miniati ,&nbsp;Donatella Marazziti ,&nbsp;Dieter Riemann ,&nbsp;Angelo Gemignani ,&nbsp;Pierre A. Geoffroy","doi":"10.1016/j.sleep.2024.10.033","DOIUrl":"10.1016/j.sleep.2024.10.033","url":null,"abstract":"<div><div>Insomnia is well-known to be both a risk factor and a prodrome for psychiatric disorders, including mood, anxiety and psychotic disorders, as well as for suicide risk. In this framework, targeting insomnia may constitute a preventive strategy or an early intervention against the development or the recurrence of psychiatric disorders. Cognitive behavioral therapy for insomnia (CBT-I) is considered the first line treatment for chronic insomnia, even when comorbid with psychiatric disorders. Accordingly, the present work aimed at systematically reviewing available data on the effects of CBT-I for prevention or early intervention of psychiatric disorders.</div></div><div><h3>Method</h3><div>The available data on the effect of CBT-I on insomnia and mental health prevention/early intervention were systematically reviewed. We conducted a systematic search on PubMed, Scopus, Psychinfo electronic databases for English literature, published until March 2024, according to PRISMA Guidelines.</div></div><div><h3>Results</h3><div>From the literature systematic search, 83 articles were eligible, and, at end, 11 studies were retained. Seven randomized controlled-trials examined the effects of CBT-I for the prevention of depressive symptoms, 1 for anxiety disorder, 1 for psychotic disorders, and 4 for suicidal risk. Results of meta-analyses on depressive symptoms showed that CBT-I for insomnia was effective in reducing depressive (z = −6.8466, p &lt; 0.0001; RE Model = −0.5168 (95 % CI: 0.6648 to −0.3689); k = 6), and insomnia symptoms as well (z = −3.7126, p = 0.0002; RE Model = −0.8074 (95 % CI: 1.2336 to −0.3811); k = 5). Studies indicated some heterogeneities among them that may limit interpretations, with the impossibility of meta-analyzing suicidal, anxiety, and psychotic symptoms.</div></div><div><h3>Conclusions</h3><div>Currently data support the hypothesis that targeting insomnia with CBT-I may represent an early effective intervention in mental disorders, especially mood disorders.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 650-658"},"PeriodicalIF":3.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628561","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":"Efficacy comparison of aerobic exercise, combined exercise, oropharyngeal exercise and respiratory muscle training for obstructive sleep apnea: A systematic review and network meta-analysis","authors":"Ruihao Tang,&nbsp;Jintao Pan,&nbsp;Ying Huang,&nbsp;Xiping Ren","doi":"10.1016/j.sleep.2024.10.026","DOIUrl":"10.1016/j.sleep.2024.10.026","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) has become a global health concern. Aerobic exercise (AE), combined exercise (CE), respiratory muscle training (RMT), and oropharyngeal exercise (OE) can improve OSA to some extent.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy of these four interventions in patients with OSA through a more comprehensive systematic review and network meta-analysis.</div></div><div><h3>Methods</h3><div>Web of Science, PubMed and Embase databases were searched for observational studies reporting AE, CE, RMT, and OE for the treatment of OSA. RevMan software (version 5.3) was used to evaluate the quality of the included literatures. Network meta-analysis was performed by using STATA software (version 14.0) with \"network\" command. The node-splitting analysis was performed for inconsistency test. Sensitivity analysis was assessed. A funnel plot and Egger's test were used to investigate publication bias.</div></div><div><h3>Results</h3><div>Based on 24 studies involving a total of 956 patients with OSA, AE, CE and OE were found to have significant effects on Apnea Hypopnea Index (AHI), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), while RMT had a significant effect solely on PSQI and ESS. In the network meta-analysis, CE was considered most likely to be the effective intervention in improving AHI (SUCRA: 87.8 %), and OE was likely to be the best intervention in improving PSQI (SUCRA: 75.8 %) and ESS (SUCRA: 94.9 %).</div></div><div><h3>Conclusions</h3><div>AE, CE and OE all improved AHI, PSQI and ESS, but there was no significant difference in the improvement effect among these three interventions. Considering the complexity of the intervention process and the differences in effects, it is recommended that the effect size and applicability of various interventions should be comprehensively considered when choosing specific interventions. The findings need to be further confirmed based on larger and more rigorous randomized controlled trials so that clinicians could develop better protocols for patients with different needs.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 582-590"},"PeriodicalIF":3.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547544","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":"Cardiopulmonary coupling predictors of blood pressure response to positive airway pressure therapy","authors":"Yue-Nan Ni ,&nbsp;Fei Lei ,&nbsp;Xiangdong Tang ,&nbsp;Zongan Liang ,&nbsp;Hugi Hilmisson ,&nbsp;Robert Joseph Thomas","doi":"10.1016/j.sleep.2024.10.025","DOIUrl":"10.1016/j.sleep.2024.10.025","url":null,"abstract":"<div><h3>Rationale</h3><div>The effect of continuous positive airway pressure (CPAP) treatment on reducing cardiovascular disease risk in sleep apnea subjects remains inconclusive. It is plausible that pathological respiratory chemoreflex activation (high loop gain) is a predictive signal biomarker.</div></div><div><h3>Objective</h3><div>To determine whether narrow band (e-LFC_NB%) metric derived from cardiopulmonary coupling analysis is related with blood pressure reduction after CPAP.</div></div><div><h3>Methods</h3><div>A secondary analysis of the Apnea Positive Pressure Long-term Efficacy Study (APPLES). The elevated low frequency coupling – narrow band (e-LFC_NB %) metric derived from cardiopulmonary coupling analysis detects periodic breathing (as a surrogate for high loop gain), and was estimated in baseline polysomnogram. Linear regression analysis was performed to identify the potential association between e-LFC_NB% of total sleep time and the observed reduction in blood pressure following the specified treatment.</div></div><div><h3>Results</h3><div>A total of 388 subjects received CPAP and had e-LFC_NB % measurements. At 2 months, 90/322 subjects had e-LFC_NB ≥ 4 % at baseline. At 6 months 137/313 subjects had e-LFC_NB higher than 2 % at baseline. For morning systolic blood pressure, e-LFC_NB ≥ 4 % [β: 2.534, standard error (SE): 1.198, <em>p</em>: 0.035] was positively related with the extent of systolic blood pressure reductions after 2 months CPAP treatment and e-LFC_NB ≥ 2 % was marginally related with systolic blood pressure decrement after 6 months (β: 2.162, SE: 1.173, <em>p</em>: 0.066). For the morning diastolic blood pressure, e-LFC_NB ≥ 2 % predicted reductions at 6 months of treatment (β: 1.883, SE: 0.888, <em>p</em>: 0.035).</div></div><div><h3>Conclusion</h3><div>e-LFC_NB % (probable high loop gain) was positively related to systolic blood pressure reduction (short-term) and diastolic blood pressure reduction (longer-term), following CPAP.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 576-581"},"PeriodicalIF":3.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547543","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 effects of sleep duration on the risk of dementia incidence in short and long follow-up studies: A systematic review and meta-analysis","authors":"Connie Howard ,&nbsp;Naaheed Mukadam ,&nbsp;Esther K. Hui ,&nbsp;Gill Livingston","doi":"10.1016/j.sleep.2024.10.022","DOIUrl":"10.1016/j.sleep.2024.10.022","url":null,"abstract":"<div><div>Sleep duration's association with future dementia could be a cause or consequence, or both. We searched electronic databases on 14^th April 2023 for primary peer-reviewed, longitudinal studies examining the relationship between sleep duration and dementia with any follow-up duration. We meta-analysed studies examining brief (≤6 h/night) and extended sleep duration (≥9 h/night) separately and divided the studies into those with follow-up periods of less or more than 10 years. The quality of evidence was assessed using the Newcastle-Ottawa scale. 31 studies fulfilled the inclusion criteria. For brief sleep duration, a meta-analysis of short follow-up studies (≤10 years) found a 46 % increased risk of future dementia (relative risk [RR] – 1·46; 95 % Confidence Intervals [CIs] 1·48–1·77; I² = 88·92 %, 6 studies). Studies with long follow-ups (&gt;10 years) did not show a significantly increased risk (RR – 1·12; 0·95–1·29; I² = 65·91 %; 5 studies). For extended sleep duration, a meta-analysis of short and long follow-up studies reported an increased risk of dementia (respectively RR - 2·20; 1·11–3·3; I² = 94·17 %; 4 studies and RR – 1·74; 1·30–2·18; I² = 86·56 %; 4 studies). Our findings suggest that brief sleep duration might be a prodromal symptom but not a risk factor of dementia. Extended sleep duration may be a risk factor. However, our results had high heterogeneity limiting external validity and generalisability.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 522-530"},"PeriodicalIF":3.8,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508358","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":"Melatonin on sleep in Parkinson’s disease: A randomized double blind placebo controlled trial","authors":"Ramkumar Sugumaran ,&nbsp;Kadarla Shiva Sai Krishna ,&nbsp;Jayaram Saibaba ,&nbsp;Sunil K. Narayan ,&nbsp;S. Sandhiya ,&nbsp;M. Rajeswari","doi":"10.1016/j.sleep.2024.10.020","DOIUrl":"10.1016/j.sleep.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are one of the most common non-motor symptoms in Idiopathic Parkinson's Disease (IPD) patients. However, the effect of melatonin on sleep problems in Parkinson's disease patients is unclear.</div></div><div><h3>Aims and objectives</h3><div>To study the effect of melatonin on sleep in IPD patients through subjective and objective assessment.</div></div><div><h3>Methods</h3><div>Between August 2023 to February 2024, we conducted a randomized, double-blind, placebo-controlled trial on IPD patients. We randomized eligible subjects to melatonin (3 mg) (n = 43) or placebo (n = 43) for 8 weeks. The primary endpoint was sleep quality assessed through the Pittsburgh sleep quality index and daytime sleepiness using Epworth sleepiness scale. Secondary endpoints were polysomnographic sleep parameters, quality of life, motor and non-motor symptoms. Assessments were done at baseline and at the end of 8 weeks.</div></div><div><h3>Results</h3><div>We screened 107 IPD patients and 86 patients were included in the study. Seventy three patients (melatonin, 35 and placebo, 38) completed the study. The mean change in Pittsburgh Sleep Quality Index (PSQI) score between the two groups was 1.87 (95 % CI: 1.5–2.1; p = 0.001) and Epworth Sleepiness Scale (ESS) score was 1.25 (95 % CI: 0.80–1.71; p = 0.001) favoring melatonin. The mean difference between the two groups for Non-Motor Symptoms Scale (NMSS) was 6.11 (95 % CI 5.27–6.92; p = 0.001), Parkinson's Disease Questionnaire (PDQ 39) 8.12 (95 % CI 6.97–9.50; p = 0.001) &amp; Polysomnography (PSG) parameters [sleep latency 8.36 (95 % CI 4.38–12.34; p = 0.001) and total sleep time 14.51 (95 % CI 5.00–24.41; p = 0.005)] favoring melatonin. Side effects attributable to melatonin were minimal.</div></div><div><h3>Conclusion</h3><div>Melatonin is an effective and safe treatment option for sleep problems in PD patients, and beneficial effects on sleep quality are associated with improved non-motor symptoms and quality of life. We need to emphasize the fact that though we had statistically significant changes in our outcomes, it is not clear whether such changes would have real-life impact (meaningfulness) that would be relevant to licensing authorities or management as patients in our study are young, have short disease duration, have high use of anticholinergics and on modest levodopa equivalent dose. So, we are doubtful if this could be generalized to the typical PD population who are older, have longer disease duration and are on potentially sedating medications or not.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 502-509"},"PeriodicalIF":3.8,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508353","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":"Genetic polymorphisms and bruxism: A scoping review","authors":"Júlia Meller Dias de Oliveira ,&nbsp;Manuella Salm Coelho ,&nbsp;Renata Paz Leal Pereira ,&nbsp;Patrícia Pauletto ,&nbsp;Joyce Duarte ,&nbsp;João Armando Brancher ,&nbsp;Juliana Feltrin-Souza ,&nbsp;Eliete Neves Silva Guerra ,&nbsp;Carla Massignan ,&nbsp;Graziela De Luca Canto","doi":"10.1016/j.sleep.2024.10.024","DOIUrl":"10.1016/j.sleep.2024.10.024","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have highlighted the multifactorial nature of bruxism, with behavioral, psychosocial, and physiological factors, including genetic predisposition, contributing to its development. However, the role of genetic markers in determining susceptibility to bruxism remains poorly understood, with limited studies offering significant findings.</div></div><div><h3>Objectives</h3><div>To identify the current knowledge to investigate the susceptibility of genetic markers for sleep (SB) and/or awake bruxism (AB).</div></div><div><h3>Materials and methods</h3><div>Seven electronic databases and two grey literature platforms were searched up to January 2024. We included studies that related different types of genes and/or genetic polymorphisms with different types of bruxism, regardless of age or sex of the participants. To be included the study must have described the form of detection of bruxism.</div></div><div><h3>Results</h3><div>A total of 21 reports were included. Of these, 16 were primary research reports. The remaining five articles consisted of four systematic reviews and a literature review incorporating a systematic mapping process, and network visualization. Within the pool of 16 primary study reports, seven focused on the association of genetic polymorphisms with both SB and AB, while seven concentrated solely on the association with SB. One primary study reported results related to probable AB and one article did not specify the bruxism type. Regarding all the studied genes and polymorphisms, significant association results were obtained for 15 polymorphisms from 11 different genes. Self-reported SB was associated with genes from the serotonergic (<em>5HTR2A</em>) and dopaminergic pathways (<em>DRD2</em>, <em>DRD3</em>, and <em>ANKK1</em>), as well as genes encoding enzymes (<em>COMT</em> and <em>MMP9</em>) and proteins (<em>ACTN</em>3 and <em>ANKK1</em>). Instrumentally reported SB was linked only to the reverse telomerase gene (<em>TERT</em>). Self-reported AB was associated with the <em>ACTN3</em> and <em>ANKK1</em> genes.</div></div><div><h3>Conclusion</h3><div>This review identified 30 genes and 56 polymorphisms variations potentially associated with either SB or AB. However, few presented significant results regarding positive associations, mostly acting at neurotransmitter pathways. The authors recommend further studies to determine the susceptibility of genetic markers as a risk factor for bruxism.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 554-575"},"PeriodicalIF":3.8,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535009","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":"Sleeping on the edge: Adolescents living at moderate altitude report greater sleep need","authors":"Alexandria Montenegro,&nbsp;Giovanni Alvarado,&nbsp;Ashleigh Hilton,&nbsp;Cara A. Palmer","doi":"10.1016/j.sleep.2024.10.017","DOIUrl":"10.1016/j.sleep.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Research in adults suggests that altitude impacts the restorative properties of sleep and increases risk for mental health concerns. The aim of this study was to extend this research to an adolescent sample to examine how living at altitude may be associated with greater sleep need and mental health symptoms during a period of the life-span when risk for insufficient sleep and mental health difficulties is high.</div></div><div><h3>Methods</h3><div>Data were collected from 105 adolescents aged 10–17 years residing at moderate-high altitudes. Parents reported on sociodemographics and adolescent depressive and anxiety symptoms, and adolescents reported on their subjective sleep need and sleep duration. Altitude was calculated using U.S. Geological Survey data.</div></div><div><h3>Results</h3><div>Adjusting for age, sex, socioeconomic status, rurality, and sleep duration, living at higher altitude was associated with reports of greater sleep need. Altitude was unrelated to mental health symptoms.</div></div><div><h3>Discussion</h3><div>The majority of adolescents do not obtain the recommended amount of sleep. These findings suggest that adolescents living at moderate-high altitudes may be at further risk due increased sleep need at higher elevations.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 551-553"},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508356","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":"Acetazolamide as a therapeutic alternative for central sleep apnea in pediatric patient with FBXO28 gene mutation: A case report and review of literature","authors":"Kantisa Sirianansopa ,&nbsp;Reshma Amin","doi":"10.1016/j.sleep.2024.10.023","DOIUrl":"10.1016/j.sleep.2024.10.023","url":null,"abstract":"<div><div>Central sleep apnea (CSA) is a significant concern in children with neurodevelopmental disorders and genetic syndromes, where conventional treatments such as bilevel positive airway pressure (BiLevelPAP) therapy may be poorly tolerated. Acetazolamide, a carbonic anhydrase inhibitor, is an alternative treatment that induces a metabolic acidosis, which may help stabilize respiratory disturbances by enhancing ventilatory drive. However, evidence regarding its use in pediatric populations remains limited. We report the case of a 12-year-old male with an FBXO28 gene-related disorders with significant CSA. Due to intolerance to BiLevelPAP therapy, a trial of acetazolamide was initiated. The dose was adjusted to maintain a mild metabolic acidosis, with regular blood work and clinical monitoring to assess for potential side effects. Follow-up polysomnography (PSG) demonstrated significant improvements in the central apnea-hypopnea index (CAHI) and periodic breathing. No significant adverse effects were reported, and the family noted a substantial improvement in quality of life.</div></div><div><h3>Brief summary</h3><div>This case highlights that maintaining a mild metabolic acidosis with acetazolamide is sufficient to stimulate respiratory drive and stabilize breathing in pediatric CSA, while minimizing risks of electrolyte imbalances and long-term renal consequences. Our findings align with existing literature, which indicates that acetazolamide may be effective for CSA without hypoventilation in children, particularly those with genetic syndromes. Further research is necessary to establish standardized treatment protocols, optimal dosing, and long-term safety.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 479-482"},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475146","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 association between insomnia and cognitive decline: A scoping review","authors":"Xiaotu Zhang,&nbsp;Jiawei Yin,&nbsp;Xuefeng Sun,&nbsp;Zihan Qu,&nbsp;Jindan Zhang,&nbsp;Hongshi Zhang","doi":"10.1016/j.sleep.2024.10.021","DOIUrl":"10.1016/j.sleep.2024.10.021","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the association between insomnia and cognitive decline to provide insights for clinical interventions and future research.</div></div><div><h3>Methods</h3><div>The PubMed, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases were systematically searched to identify studies on the association between insomnia and cognitive decline published within the last decade. The quality of the included studies was evaluated, followed by data extraction and summary analysis.</div></div><div><h3>Results</h3><div>A total of 36 studies were included in the review. Both subjective and objective measures were utilized across 12 indices to assess sleep status, while cognitive function was evaluated using 5 scales and 34 tests. The results revealed a significantly increased risk of cognitive decline or Alzheimer's disease among patients with insomnia, alongside notable impairments in attention, memory, visuospatial abilities, executive function, and verbal memory. Comprehensive assessments of cognitive domains were more sensitive in detecting group differences compared to assessments of specific cognitive sub-functions. Furthermore, MRI analyses showed reduced gray matter volumes in regions such as the prefrontal cortex, cingulate gyrus, temporal lobe, and hippocampus, together with reduced integrity of the white matter in patients with insomnia.</div></div><div><h3>Conclusions</h3><div>The findings indicate a potentially bidirectional relationship between insomnia and cognitive decline, suggesting that each may influence and exacerbate the other. Insomnia may increase the risk of cognitive decline and appears to be associated with reduced gray matter volume and compromised white matter integrity in the brain, which could potentially lead to declines in attention, memory, visuospatial abilities, executive function, and verbal memory. Conversely, cognitive decline may contribute to the onset of insomnia, further deteriorating sleep quality. However, further research is necessary to fully comprehend this intricate relationship.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 540-550"},"PeriodicalIF":3.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508357","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 apnoea phenotypes in women: A cluster analysis from the ESADA cohort","authors":"A. Pataka ,&nbsp;J.L. Pepin ,&nbsp;M.R. Bonsignore ,&nbsp;S. Schiza ,&nbsp;T. Saaresranta ,&nbsp;I. Bouloukaki ,&nbsp;P. Steiropoulos ,&nbsp;G. Trakada ,&nbsp;R. Riha ,&nbsp;Z. Dogas ,&nbsp;D. Testelmans ,&nbsp;O.K. Basoglu ,&nbsp;S. Mihaicuta ,&nbsp;F. Fanfulla ,&nbsp;L. Grote ,&nbsp;S. Bailly","doi":"10.1016/j.sleep.2024.10.015","DOIUrl":"10.1016/j.sleep.2024.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>and Objectives: The clinical presentation of Obstructive Sleep Apnoea (OSA) differs between genders. This study aimed to identify the specific OSA phenotypes of women in the European Sleep Apnoea Database (ESADA) cohort.</div></div><div><h3>Materials and methods</h3><div>Latent class cluster analysis was applied to data from 9710 female OSA patients. Variables used included age, Body Mass Index (BMI), Epworth Sleepiness Scale (ESS), comorbidities (cardiovascular, pulmonary, psychiatric, metabolic, other) and the Apnoea Hypopnea Index (AHI).</div></div><div><h3>Results</h3><div>Four different clusters were found: <u>Cluster 1</u>“Women with ischemic heart disease” (38.3 %):middle aged (59 years [53–65]),overweight to obese (BMI 30.1 kg/m² [26.9–33.5]), AHI 22.9 events/h[17.4–30], ESS 9 [5,12] with the highest prevalence of ischemic heart disease (56 %). <u>Cluster 2</u>“Elderly women with comorbidities” (23 %): oldest (66 years[60–71]), obese (BMI 36 kg/m² [31.6–40.4]),AHI 46 events/h [30–60.1]),ESS 9 [6-13] with the highest prevalence of comorbidities. <u>Cluster 3</u>“Sleepy obese women” (16.2 %): the youngest (49 years [42–55]), sleepiest (ESS 12 [8-16]), most obese(BMI 43 kg/m²[37.6–48.9]) females with severe OSA (AHI 53.3 events/h [32–80.5]). <u>Cluster 4</u> “Women with mild OSA and low comorbidities\" (22.5 %): middle aged (53.5 years [46–60]) with BMI 29 kg/m²[25–34.1],ESS9 [5,13]),AHI 8.6events/h[6.9–10.4])and low prevalence of comorbidities. The distribution of the clusters differed across Europe. PAP administration was higher in Clusters 2 and 3 but low in Cluster 4.</div></div><div><h3>Conclusion</h3><div>Four distinct female phenotypes were identified with different clinical presentation and comorbidities. Sex-based phenotyping may provide improved risk stratification and personalized treatment.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 494-501"},"PeriodicalIF":3.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508355","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}