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White matter changes in patients with narcolepsy type 2: Peak width of skeletonized mean diffusivity study
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-16 DOI: 10.1016/j.sleep.2025.02.020
Sujin Kang , Dong Ah Lee , Jun Won Lee , Ho-Joon Lee , Kang Min Park
{"title":"White matter changes in patients with narcolepsy type 2: Peak width of skeletonized mean diffusivity study","authors":"Sujin Kang ,&nbsp;Dong Ah Lee ,&nbsp;Jun Won Lee ,&nbsp;Ho-Joon Lee ,&nbsp;Kang Min Park","doi":"10.1016/j.sleep.2025.02.020","DOIUrl":"10.1016/j.sleep.2025.02.020","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate white matter (WM) microstructural alterations in patients with narcolepsy type 2 (NT2) using Peak Width of Skeletonized Mean Diffusivity (PSMD), a novel imaging marker associated with small vessel disease (SVD). The study compared PSMD metrics between patients with NT2 and healthy controls to investigate structural disruptions and their implications for NT2 pathophysiology.</div></div><div><h3>Methods</h3><div>A total of 42 participants were enrolled, including 20 patients with newly diagnosed NT2 and 22 healthy controls. Diffusion tensor imaging (DTI) was performed using a 3 T MRI scanner. PSMD was calculated using a multi-step process involving preprocessing, skeletonization, application of a custom mask, and histogram analysis with the FSL program. PSMD values were compared between patients with NT2 and healthy controls, and correlation analyses were conducted to examine associations between PSMD and clinical variables.</div></div><div><h3>Results</h3><div>Patients with NT2 exhibited significantly higher PSMD compared to healthy controls (2.172 × 10<sup>−4</sup> mm<sup>2</sup>/s vs. 2.031 × 10<sup>−4</sup> mm<sup>2</sup>/s, <em>p</em> = 0.011). PSMD also positively correlated with age in both patients with NT2 (<em>r</em> = 0.608, <em>p</em> = 0.004) and healthy controls (<em>r</em> = 0.696, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Patients with NT2 demonstrate increased PSMD, indicating WM microstructural changes potentially linked to SVD. These findings highlight the utility of PSMD as a sensitive neuroimaging marker for detecting WM alterations in sleep disorders. Further studies are needed to validate these results and investigate the underlying mechanisms of WM changes in NT2.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 14-19"},"PeriodicalIF":3.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437160","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}
引用次数: 0
Investigating phase coupling of respiratory sinus arrhythmia and slow wave sleep in obstructive sleep apnea patients with and without depression
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-15 DOI: 10.1016/j.sleep.2025.01.036
Yahya Alzaabi, Ahsan H. Khandoker
{"title":"Investigating phase coupling of respiratory sinus arrhythmia and slow wave sleep in obstructive sleep apnea patients with and without depression","authors":"Yahya Alzaabi,&nbsp;Ahsan H. Khandoker","doi":"10.1016/j.sleep.2025.01.036","DOIUrl":"10.1016/j.sleep.2025.01.036","url":null,"abstract":"<div><div>Phase coherence (λ) between respiratory sinus arrhythmia (RSA) and respiration has emerged as a promising metric for assessing the role of autonomic nervous system (ANS) activity and slow wave sleep (SWS) activities in healthy subjects. This study aims to investigate how λ and SWS activity differ between Obstructive Sleep Apnea (OSA) patients with and without major depressive disorder (MDD) during overnight sleep and explore whether the correlation between λ and SWS activity exists among those OSA patients compared to healthy individuals. Overnight electroencephalogram (EEG), electrocardiograms (ECG), and breathing using plethysmography were recorded from 104 subjects, including 35 healthy individuals (control), 34 OSA subjects with MDD (OSAD+) and 35 OSA subjects without MDD (OSAD+). Slow wave activity was computed by the amplitude envelope of the EEG δ-wave (0.5–4 Hz). The interbeat intervals (RRI) and respiratory movement were derived from ECG. RRI and respiration were resampled at a frequency of 10 Hz, and the band passed filtered within the range of 0.1–0.4 Hz before the Hilbert transform was used to extract instantaneous phases of the RSA and respiration. From the analytical signal of the Hilbert transform, the phase coherence (λ) and amplitude of RSA (A<sub>RSA</sub>) were quantified. Additionally, the heart rate variability (HRV) features were calculated. Our results showed that overnight λ was significantly greater, while the Low Frequency (LF) and High Frequency (HF) components of the HRV were significantly lower in OSAD+ compared to OSAD-. In addition, overnight δ-wave activity was greater in OSAD- compared to both OSAD+ and control groups. Using auto- and cross-correlation analyses, we found that overnight profiles of λ and δ-wave were correlated only in healthy individuals compared to OSAD+ and OSAD-, indicating that sleep apnea may only have an impact on this cortical-cardiorespiratory correlation rather than depression. Our findings suggest that λ and SWS activity appear to be biomarkers for assessing depression in OSA patients, whereas their correlation pattern may serve as a marker for only OSA. This could enhance diagnostic precision and provide valuable insights into the complex physiological mechanisms underlying the corambid of OSA and MDD.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 105-117"},"PeriodicalIF":3.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510688","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}
引用次数: 0
Efficacy and safety of GLP-1 receptor agonists in the management of obstructive sleep apnea in individuals without diabetes: A systematic review and meta-analysis of randomized, placebo-controlled trials
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-13 DOI: 10.1016/j.sleep.2025.02.010
Chia Siang Kow , Dinesh Sangarran Ramachandram , Syed Shahzad Hasan , Kaeshaelya Thiruchelvam
{"title":"Efficacy and safety of GLP-1 receptor agonists in the management of obstructive sleep apnea in individuals without diabetes: A systematic review and meta-analysis of randomized, placebo-controlled trials","authors":"Chia Siang Kow ,&nbsp;Dinesh Sangarran Ramachandram ,&nbsp;Syed Shahzad Hasan ,&nbsp;Kaeshaelya Thiruchelvam","doi":"10.1016/j.sleep.2025.02.010","DOIUrl":"10.1016/j.sleep.2025.02.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Obstructive sleep apnea (OSA) is a common sleep disorder that disrupts breathing during sleep. While continuous positive airway pressure therapy is the standard treatment, poor adherence has led to exploration of alternative treatments. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to reduce body weight and may help manage OSA. This systematic review and meta-analysis evaluated the efficacy and safety of GLP-1 RAs in individuals with OSA and elevated body weight who are without diabetes.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in September 2024 across multiple databases. Randomized controlled trials (RCTs) evaluating GLP-1 RAs for OSA in adults with a body mass index (BMI) ≥30 kg/m<sup>2</sup> were included. The primary outcomes were changes in the apnea-hypopnea index (AHI) and overall adverse events. Meta-analyses were performed using a random-effects model.</div></div><div><h3>Results</h3><div>Three RCTs were included in the analysis. Pooled results showed that GLP-1 RA treatment significantly reduced AHI compared to placebo, with a weighted mean difference (WMD) of −16.6 events per hour (95 % confidence interval [CI]: −27.9 to −5.3). However, GLP-1 RAs were associated with a higher frequency of adverse events, with an odds ratio (OR) of 1.62 (95 % CI: 1.16 to 2.24) compared to placebo.</div></div><div><h3>Conclusion</h3><div>GLP-1 RAs effectively reduce OSA severity, offering a promising alternative for individuals with OSA and elevated body weight. However, the increased risk of side effects must be considered. Further long-term studies are needed to confirm the sustained benefits and safety of GLP-1 RAs in OSA management.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 40-44"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437162","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}
引用次数: 0
Response to “Letter to the editor regarding ‘Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea’ by Kushida et al.”
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-13 DOI: 10.1016/j.sleep.2025.02.014
Clete A. Kushida , Gary K. Zammit , Jocelyn Y. Cheng , Dinesh Kumar , Margaret Moline
{"title":"Response to “Letter to the editor regarding ‘Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea’ by Kushida et al.”","authors":"Clete A. Kushida ,&nbsp;Gary K. Zammit ,&nbsp;Jocelyn Y. Cheng ,&nbsp;Dinesh Kumar ,&nbsp;Margaret Moline","doi":"10.1016/j.sleep.2025.02.014","DOIUrl":"10.1016/j.sleep.2025.02.014","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Page 195"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430337","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}
引用次数: 0
Aperiodic and periodic components of resting-state EEG in primary insomnia
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-13 DOI: 10.1016/j.sleep.2025.02.007
Duo Bai , Yatong Guo , Simon Jülich , Xu Lei
{"title":"Aperiodic and periodic components of resting-state EEG in primary insomnia","authors":"Duo Bai ,&nbsp;Yatong Guo ,&nbsp;Simon Jülich ,&nbsp;Xu Lei","doi":"10.1016/j.sleep.2025.02.007","DOIUrl":"10.1016/j.sleep.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is one of the most prevalent health concerns within the general population, with a multitude of existing electroencephalographic (EEG) spectral studies supporting heightened levels of high-frequency EEG activity as an index of cortical arousal. Nevertheless, traditional spectral analysis has been limited by its inability to distinguish between aperiodic and periodic elements. In contrast, a novel method, Spectral Parameterization (SpecParam), can separate these components and reveal the neural mechanisms of cortical arousal.</div></div><div><h3>Methods</h3><div>The aperiodic and periodic activities of 42 insomnia disorder (ID) patients and 45 age- and sex-matched healthy controls (HC) were evaluated during eyes-closed resting state. The associations between behavioral scales and aperiodic/periodic parameters were further examined to elucidate the underlying psychophysiological significance.</div></div><div><h3>Results</h3><div>We found that the aperiodic exponent was diminished in the ID group compared to the HC group. Additionally, the ID group exhibited an elevated central frequency and a more constrained bandwidth for periodic activity within the alpha band. Within-group correlation analyses revealed that a reduced exponent was associated with worse sleep quality and more frequent failures in inhibitory control within the ID group.</div></div><div><h3>Conclusions</h3><div>A smaller exponent within the ID group may reflect impaired inhibitory neuronal activity, potentially leading to cortical hyperarousal. The association of a smaller exponent with deteriorated sleep quality and impaired inhibitory control supports this hypothesis. Furthermore, the increased center frequency of the alpha band across extensive brain regions, along with a narrower alpha bandwidth in the left frontal and right parieto-occipital regions, may represent abnormal manifestations associated with excessive arousal. In summary, these results support the role of aperiodic activity as an index of impaired excitation/inhibition balance in neural activity within in ID group.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 45-54"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444857","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}
引用次数: 0
Quality of life and its associates in narcolepsy 1 and 2 types and idiopathic hypersomnia
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-12 DOI: 10.1016/j.sleep.2025.02.019
K. Galušková , S. Nevšímalová , I. Příhodová , S. Dostálová , A. Mazouchová , K. Šonka
{"title":"Quality of life and its associates in narcolepsy 1 and 2 types and idiopathic hypersomnia","authors":"K. Galušková ,&nbsp;S. Nevšímalová ,&nbsp;I. Příhodová ,&nbsp;S. Dostálová ,&nbsp;A. Mazouchová ,&nbsp;K. Šonka","doi":"10.1016/j.sleep.2025.02.019","DOIUrl":"10.1016/j.sleep.2025.02.019","url":null,"abstract":"<div><h3>Objective and background</h3><div>Health-related quality of life (HRQoL) is reduced in narcolepsy type 1 (NT1), but proper information on HRQoL in narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) is lacking. This study examines HRQoL of NT1, NT2, IH, and healthy controls (HC) and assesses the HRQoL associates in these diseases.</div></div><div><h3>Patients and methods</h3><div>117 adults (64 NT1, 22 NT2, 31 IH; 61.5 % women; 38.3 ± 12.0 years; 71.8 % treated) and 41 HC (53.7 % women; 35.9 ± 9.6 years) completed questionnaires assessing sleepiness, fatigue, symptoms severity, sleep inertia, depressive and anxiety symptoms, HRQoL, and underwent a semi-structured interview. Data were analyzed using the Mann-Whitney and Kruskal-Wallis tests, Spearman's correlation coefficient, and regression analysis.</div></div><div><h3>Results</h3><div>HRQoL of NT1, NT2, and IH, separately, was poorer compared to HC (p &lt; 0.001). According to the 36-Item Short Form Health Survey, the mental HRQoL was more impaired in NT2 and IH than NT1 (p &lt; 0.05) in association with more pronounced depressive symptoms (p &lt; 0.01; p &lt; 0.05, respectively) and sleep inertia (p &lt; 0.01; p &lt; 0.01, respectively). Psychiatric disorders were more prevalent in NT2 and IH versus NT1 (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>HRQoL is reduced in NT1, NT2, and IH, with this reduction being more pronounced in NT2 and IH. Poor mental HRQoL of NT2 and IH was associated both with the severity of depressive symptoms and more intense sleep inertia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 31-39"},"PeriodicalIF":3.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437155","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}
引用次数: 0
A longitudinal study of the bi-directional relations between parental bedtime and nighttime involvement and infant sleep
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-10 DOI: 10.1016/j.sleep.2025.02.017
Ofek Matzliach, Avel Horwitz, Dar Ran-Peled, Liat Tikotzky
{"title":"A longitudinal study of the bi-directional relations between parental bedtime and nighttime involvement and infant sleep","authors":"Ofek Matzliach,&nbsp;Avel Horwitz,&nbsp;Dar Ran-Peled,&nbsp;Liat Tikotzky","doi":"10.1016/j.sleep.2025.02.017","DOIUrl":"10.1016/j.sleep.2025.02.017","url":null,"abstract":"<div><h3>Objective</h3><div>This longitudinal study assessed the prospective bidirectional links between parental involvement during bedtime and nighttime and infants' sleep during the first year of life.</div></div><div><h3>Methods</h3><div>The sample included 207 families at 4 months, 177 at 8 months, and 154 at 12 months. Infant sleep was assessed at home for seven nights using actigraphy, sleep diaries, and the Brief Infant Sleep Questionnaire (BISQ). Parental bedtime and nighttime involvement were reported daily by parents through sleep diaries at all time points.</div></div><div><h3>Results</h3><div>Concomitant associations (controlling for sleeping arrangements) were found between parental bedtime and nighttime involvement and between infant objective and reported sleep quality measures (i.e., number of night-wakings, wake after sleep onset [WASO], and subjective infant sleep problems). Structural Equation Modeling analyses demonstrated significant prospective associations: Higher parental bedtime involvement at 4 months predicted an increase in infant number of night-wakings from 4 to 8 months. Moreover, higher levels of parental bedtime and nighttime involvement at 8 months predicted an increase in infant WASO from 8 to 12 months. Only one SEM model demonstrated a significant cross-lagged link from infant sleep quality to parental involvement: More perceived infant sleep problems at 4 months predicted a decrease in parental bedtime involvement from 4 to 8 months.</div></div><div><h3>Conclusions</h3><div>The findings suggest that higher levels of parental involvement in soothing the infant to sleep at bedtime and nighttime predict poorer infant sleep quality. Only limited evidence was found for infant-driven links.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 55-66"},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454648","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}
引用次数: 0
Correlation between changes of sleep quality and brain functional connectivity patterns in COVID-19 patients: A three-month longitudinal cohort study
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-10 DOI: 10.1016/j.sleep.2025.02.016
Bei Peng , Ying Liu , Yuxin Chen , Xiaoyan Zhou , Yan Zhang , Jinli Huang , Jiazhu Huang , Ruijing Sun , Shihuan Lin , Lixia Qin , Yian Lu , Mingming Zhao , Demao Deng
{"title":"Correlation between changes of sleep quality and brain functional connectivity patterns in COVID-19 patients: A three-month longitudinal cohort study","authors":"Bei Peng ,&nbsp;Ying Liu ,&nbsp;Yuxin Chen ,&nbsp;Xiaoyan Zhou ,&nbsp;Yan Zhang ,&nbsp;Jinli Huang ,&nbsp;Jiazhu Huang ,&nbsp;Ruijing Sun ,&nbsp;Shihuan Lin ,&nbsp;Lixia Qin ,&nbsp;Yian Lu ,&nbsp;Mingming Zhao ,&nbsp;Demao Deng","doi":"10.1016/j.sleep.2025.02.016","DOIUrl":"10.1016/j.sleep.2025.02.016","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore variations of brain functional connectivity patterns among post-COVID-19 patients with different outcomes of sleep quality.</div></div><div><h3>Methods</h3><div>Post-COVID-19 patients were prospectively enrolled and categorized into improvement or deterioration groups based on changes in sleep quality after a three-month follow-up. Functional MRI and blood samples were collected, while a battery of assessments was administered to evaluate sleep quality, mental status, and cognition. Baseline and follow-up data were compared to identify post-infection alterations. Brain functional networks and graph theory analysis were employed to derive network properties, with subsequent investigation into the correlation between these properties, sleep and psychological assessment scores, and blood test outcomes.</div></div><div><h3>Results</h3><div>The graph theory analysis revealed a significantly increase in global efficiency (Eglob) and local efficiency (Eloc), and a decrease in λ, in the improvement group. A notable enhancement of frontoparietal network (FPN) were observed. The deterioration group exhibited a significant increase in Eloc and λ, along with a decrease in Eglob. Furthermore, the deterioration group demonstrated a lower level of Eglob at follow-up. With respect to network strength, all networks except FPN showed significantly higher values in the improvement group. Pittsburgh Sleep Quality Index and Self-Rating Anxiety Scale scores differed between two groups.</div></div><div><h3>Conclusion</h3><div>Changes in sleep quality following COVID-19 infection are associated with brain functional connectivity patterns. Decreased Eglob is related to worsened sleep quality. The normalized strength of FPN serves as a key indicator for improved sleep quality, while other networks also play roles in regulating sleep quality.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 187-194"},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420443","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}
引用次数: 0
The diagnostic and therapeutic value of time in bed extension in Insufficient Sleep Syndrome
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-08 DOI: 10.1016/j.sleep.2025.02.013
Marco De Pieri , Anna Castelnovo , Silvia Miano , Mauro Manconi
{"title":"The diagnostic and therapeutic value of time in bed extension in Insufficient Sleep Syndrome","authors":"Marco De Pieri ,&nbsp;Anna Castelnovo ,&nbsp;Silvia Miano ,&nbsp;Mauro Manconi","doi":"10.1016/j.sleep.2025.02.013","DOIUrl":"10.1016/j.sleep.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>Insufficient sleep syndrome (ISS) represents an emerging health concern but remains poorly defined as a diagnostic entity, though included in the international classification of sleep disorders. In the present study, we aimed to clarify the longitudinal course of ISS and to identify prognostic factors by comparing remitting and non-remitting patients.</div></div><div><h3>Methods</h3><div>A chart-review was realized, retrieving fifty-five patients with ISS (aged 39.8 ± 16.6 years, with 44.6 % of women) who underwent a comprehensive clinical evaluation at baseline and during a follow-up visit after 3–6 months. This evaluation included sleep symptoms, sleep logs, medications, and comorbidities. Additionally, actigraphy, video-polysomnography, and a multiple sleep latency test were conducted at baseline, and at the same moment standard psychoeducation on sleep was provided.</div></div><div><h3>Results</h3><div>During the follow-up visit, 69 % of patients still met the criteria for a clinical diagnosis of ISS, experiencing symptoms such as daytime sleepiness, disrupted nighttime sleep, unrefreshing sleep, and sleep attacks. Comparing sleep patterns of remitters and non-remitters based on sleep diaries, we observed that remission is associated with not only an increase in total sleep time but also a more regular sleep schedule. This regularity includes a reduction in napping and a lesser difference in sleep timings between weekdays and weekends. However, comparing baseline clinical and instrumental data between remitters and non-remitters revealed no significant differences, hindering the use of these features as prognostic factors.</div></div><div><h3>Conclusions</h3><div>Given the low remission rate with standard treatment (i.e. psychoeducation on sleep), we propose the following: (1) Criterion E (extension of total sleep time results in resolution of the symptoms of sleepiness) should be considered as a therapeutic advice, and supportive rather than necessary for the diagnosis; (2) specific cognitive-behavioral therapy protocols targeting the cognitive factors underlying sleep-depriving behaviors are required, as single routine behavioral interventions are insufficient.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 219-228"},"PeriodicalIF":3.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471315","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}
引用次数: 0
Cardiopulmonary coupling estimated sleep quality and memory in children with obstructive sleep-disordered breathing
IF 3.8 2区 医学
Sleep medicine Pub Date : 2025-02-08 DOI: 10.1016/j.sleep.2025.01.024
Zhang Yuanjie , Wu Yunxiao , Robert Joseph Thomas , Tang Yufen , Zhengli , Xu Zhifei
{"title":"Cardiopulmonary coupling estimated sleep quality and memory in children with obstructive sleep-disordered breathing","authors":"Zhang Yuanjie ,&nbsp;Wu Yunxiao ,&nbsp;Robert Joseph Thomas ,&nbsp;Tang Yufen ,&nbsp;Zhengli ,&nbsp;Xu Zhifei","doi":"10.1016/j.sleep.2025.01.024","DOIUrl":"10.1016/j.sleep.2025.01.024","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between sleep quality/stability and memory in children with sleep-disordered breathing.</div></div><div><h3>Methods</h3><div>Children aged 5–12 years with suspected sleep-disordered breathing who visited the Sleep Center of Beijing Children's Hospital, from June 2022 to March 2023 were enrolled. All patients underwent polysomnography (PSG) and cardiopulmonary coupling monitoring (CPC) analysis based on the photoplethysmogram, and memory tests (immediate and delayed recognition and recall) before sleep and after sleep, respectively. In the CPC analysis, high frequency coupling (HFC) as percentage of total sleep time is stable sleep. A sleep quality index (SQI) integrates HFC, sleep duration and sleep fragmentation. The correlation between memory function and sleep quality/stability was analyzed. Cyclic variation in heart rate was quantified as a sleep apnea indicator (SAI).</div></div><div><h3>Results</h3><div>Patients were divided into three groups based on HFC: low (&lt;60), moderate (60–80) and high (&gt;80). A total of 152 children were included in the study, 100 males and 52 females, with an average age of 8.2 ± 1.7 years.HFC% was negatively correlated with AHI and OAHI (r: −0.32,p: &lt;0.01; r: −0.31, p: &lt;0.01), while LFC% was positively correlated with AHI and OAHI (r: 0.29, p: &lt;0.01; r: 0.28, p: &lt;0.01). The SQI and HFC was positively correlated with the delayed recall test score(r: 0.19, p: &lt;0.05), and with the recognition consolidation rate (r: 0.23, p: &lt;0.05). In contrast, LFC was negatively correlated with delayed recall test score (r:0.19, p: &lt;0.05), delayed recognition score (r:0.15,p &lt; 0.05), and recognition consolidation rate (r:0.21, p: &lt;0.01). SAI was negatively correlated with Recognition consolidation rate score (r: −0.17, p: &lt;0.05).</div></div><div><h3>Conclusions</h3><div>Sleep stability assessed via CPC may reflect a risk biomarker for memory function in children with OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 8-13"},"PeriodicalIF":3.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427711","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}
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