Sleep medicine最新文献

{"title":"Risk factors and prognosis of acute ischemic stroke related restless legs syndrome","authors":"Xi-Xi Wang ,&nbsp;Ye Liu ,&nbsp;Jia-Min Song ,&nbsp;Yu-Lei Zhang ,&nbsp;Yu Wang ,&nbsp;Ondo G. William ,&nbsp;Ya Feng ,&nbsp;Yun-Cheng Wu","doi":"10.1016/j.sleep.2025.02.030","DOIUrl":"10.1016/j.sleep.2025.02.030","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies suggest that stroke may be associated with an increased prevalence of restless legs syndrome (RLS) as a comorbidity or a risk factor. We aimed to explore the association between acute ischemic stroke (AIS) and RLS, and the possible pathogenesis of acute ischemic stroke related restless legs syndrome (AIS-RLS), for guiding its diagnosis and treatment.</div></div><div><h3>Methods</h3><div>In this single-center, prospective study, we identified consecutive AIS patients and segregated into AIS-RLS group and non-AIS-RLS group based on the diagnostic criteria of RLS. The differences in baseline data, clinical features, examination results, stroke etiology, stroke location, and clinical prognosis (functional disability, cognitive and mood disorders) of the two groups were analyzed. Logistic regression analysis was used to evaluate the risk factors for RLS.</div></div><div><h3>Results</h3><div>A total of 201 AIS patients were included in our study, and 21 (10.45 %) demonstrated RLS. Compared with non-AIS-RLS group, AIS-RLS group patients had higher systolic blood pressure (SBP) at admission (<em>P</em> &lt; 0.05), higher mean 24-h SBP (<em>P</em> &lt; 0.01), higher mean 24-h diastolic blood pressure (DBP) (<em>P</em> &lt; 0.01), higher mean daytime SBP (<em>P</em> &lt; 0.01), higher mean daytime DBP (<em>P</em> &lt; 0.01), higher mean nocturnal SBP (<em>P</em> &lt; 0.01), higher mean nocturnal DBP (<em>P</em> &lt; 0.05), smaller variation coefficient of 24-h SBP (<em>P</em> &lt; 0.05). The distribution of AIS-RLS and non-AIS-RLS was not different for each subtype according to the cortical and subcortical classification of lesion sites. The NIHSS score, GAD-7 score and PHQ-9 score were higher at 7 days (<em>P</em> &lt; 0.05), and the modified Rankin scale (mRS) was higher at 3 months follow-up (<em>P</em> &lt; 0.05) in the AIS-RLS group. In the logistic regression, the higher SBP at admission had a statistically significant effect on AIS-RLS(OR = 1.030,<em>P</em> = 0.016)even after adjusting for age and gender(OR = 1.030,<em>P</em> = 0.014).</div></div><div><h3>Conclusion</h3><div>Stroke anatomy did not differ between AIS-RLS and non-AIS-RLS groups. AIS-RLS group patients tend to experience higher blood pressure. Moreover, AIS-RLS patients had worse clinical prognosis (functional disability and mood disorders) compared with non-AIS-RLS patients.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 75-81"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474585","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":"Robotic beds for the treatment of positional obstructive sleep apnea – A randomized cross-over pilot trial","authors":"Martina Meszaros ,&nbsp;Alexander Breuss ,&nbsp;Elisabeth Wilhelm ,&nbsp;Robert Riener ,&nbsp;Malcolm Kohler ,&nbsp;Esther I. Schwarz","doi":"10.1016/j.sleep.2025.02.025","DOIUrl":"10.1016/j.sleep.2025.02.025","url":null,"abstract":"<div><h3>Background</h3><div>Interventions leading to avoidance of supine position and thus reducing the likelihood of upper airway collapse during sleep are a treatment approach for positional obstructive sleep apnea (POSA). The aim of this randomized cross-over trial was to assess the effect of two actuated beds (trunk-elevation and sideward-tilting) on OSA severity and sleep fragmentation in POSA.</div></div><div><h3>Methods</h3><div>After baseline polysomnography, adult patients with POSA were randomly assigned to two nights of intervention in the intelligent sleep apnea bed ISABel1 and ISABel2. In the case of obstructive apnea or hypopnea, ISABel1 elevated the upper body by 50° and ISABel2 induced a unilateral bed tilt of 40°, with both interventions lasting 10 min. Sustained trunk elevations without sliding down (ISABel1) and position change from supine to non-supine (ISABel2) were defined as successful interventions.</div></div><div><h3>Results</h3><div>Six adult men (57 ± 11 years, BMI 28 ± 4 kg/m2, AHI 39 ± 15/h) with POSA were included. Neither trunk elevation (ISABel1) nor side tilt (ISABel2) – approximately 10 interventions per night – significantly reduced apnea-hypopnea index (AHI), whereas trunk elevation showed a tendency to reduce supine AHI. Actuated beds had no effect on sleep efficiency and arousals. Only 13 % of side tilts in ISABel2 resulted in a successful shift to a non-supine position. The time to the next respiratory event after bed movement was longer in the trunk elevating bed than in the side-tilting bed.</div></div><div><h3>Conclusion</h3><div>Trunk elevating beds decrease supine AHI and both side-tilting and trunk elevating beds increase the time to the next obstructive apnea or hypopnea.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 94-100"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488215","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":"Associations of reproductive factors and circadian syndrome in middle-aged and elderly women: A nationwide cross-sectional study from China, the United Kingdom and the United States","authors":"Linli Liu ,&nbsp;Pengming Sun ,&nbsp;Jun Lin ,&nbsp;Sanshan Wu","doi":"10.1016/j.sleep.2025.02.026","DOIUrl":"10.1016/j.sleep.2025.02.026","url":null,"abstract":"<div><div>Circadian Syndrome (CircS) was recently recognized as a novel predictor of cardiovascular disease (CVD) risk, with reproductive factors playing an important role in CVD risk. Yet, studies linking reproductive factors to CircS remain sparse. Data on middle-aged and elderly women were extracted from three nationally representative surveys: the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study on Ageing (ELSA) provided the training set, and the National Health and Nutrition Examination Survey (NHANES) constituted the validation set. We employed logistic regression to evaluate the association between self-reported reproductive factors and CircS risk, with inverse probability of treatment weighting (IPTW) and subgroup analyses conducted to verify the stability. A total of 11,721 participants were analyzed. CircS prevalence differed significantly across countries, with 51.40 % in China and 20.19 % in the United Kingdom. Early menarche (age &lt;12 years) correlated with increased CircS risk in CHARLS (OR 1.38 [95 % CI 0.99–1.92]; <em>p</em> = 0.061), ELSA (OR 1.64 [95 % CI 1.36–1.98]; <em>p</em> &lt; 0.001), and NHANES (OR1.52 [95 % CI: 1.21–1.89]; <em>p</em> &lt; 0.001). Premature menopause (age &lt;40 years) was associated with a roughly 30 % higher CircS risk. A shorter reproductive lifespan was significantly linked to CircS, with this relationship emerging at a reproductive lifespan of ≥40 years in CHARLS (OR1.39 [95 % CI: 1.04–1.84]; <em>p</em> = 0.024). The aforementioned correlations retained significance following IPTW and subgroup analyses. Early menarche, premature menopause, and abbreviated reproductive lifespans may negatively affect CircS. Public health strategies should incorporate menstrual cycle-related reproductive health into primary CircS prevention.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 283-291"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593294","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":"Are sleep and awake bruxism associated with sleep quality and duration in adults? A systematic review and meta-analysis","authors":"Guilherme Azario de Holanda,&nbsp;Thiago Azario de Holanda,&nbsp;Maísa Casarin","doi":"10.1016/j.sleep.2025.02.023","DOIUrl":"10.1016/j.sleep.2025.02.023","url":null,"abstract":"<div><div>The objective of this systematic review was to investigate the association between sleep quality with awake bruxism or sleep bruxism in adult individuals. Inclusion criteria comprised observational studies conducted in adults related to the research question, assessing bruxism by instrumental or non-instrumental approaches, and sleep quality by subjective or objective measures, or sleep duration. Sleep disorders, syndromes, neurological and psychiatric disorders, or psychotropic medications were excluded. PubMed, Embase, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were searched until August 2024. Risk of bias was assessed by the JBI Critical Appraisal Checklist tool for cross-sectional studies, and the Newcastle-Ottawa scale for case-control studies. Independent meta-analyses comparing awake or sleep bruxism individuals with control individuals were performed when there were at least two studies for each sleep outcome. Thirty-two studies assessing a total of 4706 individuals were included. Meta-analyses showed no differences between sleep bruxism and control individuals regarding polysomnography parameters (sleep efficiency, sleep latency, awakenings, wake after sleep onset, and sleep duration). Pittsburgh Sleep Quality Index showed higher scores for sleep bruxism individuals compared to control individuals (MD = 1.98; 95 % CI = 0.96–3.00) and for awake bruxism individuals compared to control individuals (MD = 1.99; 95 % CI = 0.42–3.57). In total, 12 studies were rated as low risk of bias, 15 as moderate risk of bias, and 5 as high risk of bias. The certainty of evidence was rated as very low. Objective sleep quality was not associated with sleep bruxism, while subjective sleep quality was associated with both sleep and awake bruxism.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 175-186"},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of age on sleep duration and health outcomes: Evidence from four large cohort studies","authors":"Jianhong Liao ,&nbsp;Yunhan Shi ,&nbsp;Yanru Li ,&nbsp;Demin Han","doi":"10.1016/j.sleep.2025.02.024","DOIUrl":"10.1016/j.sleep.2025.02.024","url":null,"abstract":"<div><h3>Background</h3><div>Sleep duration (SD) is a critical determinant of health, with both short and long SD associated with increased risks of morbidity and mortality. However, distinct ages may exhibit unequal sleep needs. Few studies have addressed the modulation of age on SD associated all-cause mortality (AM). This study aimed to investigate age- and gender-specific associations between SD and AM.</div></div><div><h3>Methods</h3><div>Four national cohort studies were conducted: National Health and Nutrition Examination Survey (NHANES), Survey of Health, Ageing and Retirement in Europe (SHARE), Chinese Longitudinal Healthy Longevity Survey (CLHLS), and China Health and Retirement Longitudinal Study (CHARLS). Data pre-processing such as integration, weighting and interpolation was conducted following cohort-specific user manuals. Restricted cubic spline (RCS) was used to test the nonlinear relationship. Kaplan-Meier and Cox regression survival analysis were used to evaluate the association between SD and AM. The moderation of mortality by SD was subsequently investigated in adult, middle-age, elderly and longevity.</div></div><div><h3>Results</h3><div>RCS analysis showed a nonlinear correlation between SD and AM in the four cohorts(P &lt; 0.001). Survival analysis reveals 6–8 h to be the optimal SD. Subgroup analyses showed a higher risk in adults with ≤5 h than ≥9 h (HR: 2.95 [1.90–4.59] vs 1.83 [1.08–3.12]), and a similar risk in middle age (HR: 2.42 [1.76–3.32] vs 2.44 [1.64–3.61]). In contrast, four datasets suggest a higher risk of the elderly being affected by long SD. Adults (HR = 1.82 [1.14–2.92], P = 0.012) and middle age (NHANES: HR = 1.50 [1.04–2.16], P = 0.029; SHARE: HR = 3.04 [1.10–8.41], P = 0.032) significantly increased the risk of short sleep compared to elderly.</div></div><div><h3>Conclusions</h3><div>SD associated mortality risk varies with age. Young adults should avoid poor sleep, while elderly should avoid sleeping too much.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 140-147"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521138","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":"Web-based cognitive-behavioral therapy for insomnia in cancer survivors: The OncoSleep randomized trial","authors":"Maria I. Clara ,&nbsp;Annemieke van Straten ,&nbsp;Josée Savard ,&nbsp;Maria C. Canavarro ,&nbsp;Ana Allen Gomes","doi":"10.1016/j.sleep.2025.02.021","DOIUrl":"10.1016/j.sleep.2025.02.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Insomnia is highly prevalent among cancer survivors and can have serious implications if inadequately treated. Cognitive-behavioral therapy for Insomnia (CBT-I) is recommended as the first-line treatment for insomnia but is rarely available to cancer survivors. We tested the effectiveness of a web-based CBT-I program, OncoSleep, in cancer survivors.</div></div><div><h3>Methods</h3><div>Cancer survivors with insomnia (n = 154) were randomly assigned (1:1) to digital CBT-I (6 weekly self-guided modules plus online clinician support) or a waitlist control group. Patient-reported outcome measures of insomnia severity (primary outcome), daytime functioning, and sleep diaries were administered online at baseline and post-treatment (8 weeks). Intention-to-treat analyses were performed using mixed-effects models. Statistical tests were two-sided.</div></div><div><h3>Results</h3><div>The treatment group reported an average 11.0-point reduction in the Insomnia Severity index (ISI), compared to a 1.4-point reduction in the control group (<em>p&lt;</em>.001). Statistically significant group-by-time interactions were observed: web-based CBT-I produced significant, large effects for improvements in insomnia severity (<em>d</em> = −2.56), cognitive functioning (<em>d</em> = 0.95), physical (<em>d</em> = 1.24) and psychological quality of life (<em>d</em> = 0.80), and fatigue (<em>d</em> = −1.35). Small-to-large effect sizes were found for reductions in anxiety (<em>d</em> = −0.77), depression (<em>d</em> = −0.71), and pain (<em>d</em> = −0.40). Change in insomnia severity mediated the effect of digital CBT-I on daytime outcomes.</div></div><div><h3>Conclusions</h3><div>Web-based CBT-I with clinician support appears to be an effective treatment for insomnia in cancer survivors, offering meaningful benefits for comorbid symptoms and quality of life. Further studies with active comparisons and longer follow-up periods are needed to confirm these findings. Digital CBT-I could be integrated into cancer rehabilitation programs to reduce the burden of insomnia. [ClinicalTrials.gov: <span><span>NCT04898855</span><svg><path></path></svg></span>].</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 67-74"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463447","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":"Sleep problems in youth with WAGR syndrome","authors":"Gavriela B. Kalish-Schur ,&nbsp;Mahalakshmi Somayaji ,&nbsp;Lisa J. Meltzer ,&nbsp;Christopher M. Cielo","doi":"10.1016/j.sleep.2025.02.018","DOIUrl":"10.1016/j.sleep.2025.02.018","url":null,"abstract":"<div><h3>Objectives</h3><div>Children with WAGR syndrome, an ultra-rare genetic condition associated with deletion of the brain-derived neurotrophic factor (BDNF), may be at increased risk for sleep problems, but there are limited data assessing sleep in this population. This study aimed to compare sleep disturbances and sleep-disordered breathing in youth with WAGR syndrome compared to healthy youth.</div></div><div><h3>Methods</h3><div>Parents of youth with WAGR syndrome and healthy controls completed an online survey including demographics, the PROMIS Pediatric Sleep Disturbance item bank, and the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorders scale (PSQ-SRBD).</div></div><div><h3>Results</h3><div>Fifteen youth with WAGR syndrome, median (interquartile range) age 10 (7,11) years and 27 controls 9 (6, 10) years were included. PROMIS Sleep Disturbance T-scores were higher in youth with WAGR syndrome (58.1 [53.3, 66.1]) versus controls (52.5 [44.3, 58.3], p = 0.03) indicating more sleep disturbance. Melatonin was used for sleep in 7 (47 %) youth with WAGR syndrome versus 3 (11 %) controls (p = 0.009). PSQ-SRBD scores were greater in youth with WAGR syndrome (0.52 [0.45, 0.65]) compared to controls (0.09 [0.05, 0.18], p &lt; 0.001); 93 % of youth with WAGR syndrome had elevated PSQ-SRBD scores. One-third of youth with WAGR syndrome reported having a diagnosis of obstructive sleep apnea. No differences in sleep outcomes were identified based on BDNF deletion status in those with WAGR syndrome.</div></div><div><h3>Conclusions</h3><div>Sleep disturbances and sleep-disordered breathing are prevalent in youth with WAGR syndrome. Diverse cohorts with clinical data including polysomnography are needed to confirm these findings.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 101-104"},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488216","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":"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 × 10⁻⁴ mm²/s vs. 2.031 × 10⁻⁴ mm²/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}

{"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_RSA) 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}

{"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/m² 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}