Sleep最新文献

{"title":"Inferring Causality: Mendelian Randomization in Biomarker Studies in Obstructive Sleep Apnea.","authors":"Rene Cortese","doi":"10.1093/sleep/zsae274","DOIUrl":"10.1093/sleep/zsae274","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689010","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":"Talking to sleepwalkers? Response to communication efforts in Disorders of Arousals.","authors":"Yannis Idir, Régis Lopez, Amélie Barbier, Sony Saint-Auret, Emmanuel Morain, Raphaël Vollhardt, Inès Ben Haj Kacem, Arthur Le Coz, Ana Gales, Pauline Dodet, Smaranda Leu-Semenescu, Yves Dauvilliers, Isabelle Arnulf, Delphine Oudiette","doi":"10.1093/sleep/zsae272","DOIUrl":"https://doi.org/10.1093/sleep/zsae272","url":null,"abstract":"<p><strong>Study objectives: </strong>Disorders of arousal (DoA) are diagnosed on the basis of clinical criteria including inappropriate or absent responsiveness to communication attempts. Surprisingly, the ability of patients to interact with others during DoA episodes has not been systematically investigated. To address this gap, we conducted three studies.</p><p><strong>Methods: </strong>First, we used a retrospective questionnaire to assess verbal responsiveness during episodes in 61 adult patients with DoA (Study 1). Second, we used auditory stimulation during polysomnographically-verified N3 sleep to trigger DoA episodes in 14 patients. We then asked questions to test the possibility of verbal interactions during the episodes (Study 2). Third, we assessed the presence and quality of conversations with a bed partner in 364 home video-recorded episodes from 19 patients (Study 3).</p><p><strong>Results: </strong>In Study 1, most patients (81%) reported occasional conversations during parasomnia episodes. Patients' ongoing mental content influenced both their responses to questions during episodes and their perceptions of the outside world (including the identity of their interlocutor their environment). In study 2, auditory stimulation had a limited effect in inducing episodes (7/157 trials). One patient indirectly responded to our verbal prompts in a DoA episode. In Study 3, we found 37 video instances of discussion between patients and their partner.</p><p><strong>Conclusions: </strong>Overall, our findings suggest that DoA episodes are not a uniform state, but may instead encompass varying states of consciousness, characterized by different levels of responsiveness and a complex interplay between internal and external information processing. These results highlight the limitations of current diagnostic criteria for DoA.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682469","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 hypoxic burden and the risk of cognitive impairment in patients with obstructive sleep apnea.","authors":"Xiaoyu Huang, Zhengjiao Zhang, Xiaoxin Lan, Xuefeng Song, Yanzhao Dong, Siqi Jia, Haibo Yuan","doi":"10.1093/sleep/zsae269","DOIUrl":"https://doi.org/10.1093/sleep/zsae269","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is associated with increasing risk of cognitive impairment, but traditional hypoxic indicators can not accurately identify cognitive impairment. This study aimed to assess a new indicator, hypoxic burden, in cognitive impairment in OSA.</p><p><strong>Methods: </strong>A total of 116 patients with OSA were enrolled in this study. Daytime sleepiness and cognition were assessed by Epworth Sleepiness Scales (ESS) and Montreal Cognitive Assessment (MoCA), respectively. All participants underwent polysomnography. Hypoxic burden was derived from polysomnography and calculated according to a specific algorithm. All the subjects were divided into two groups. 77 were OSA with mild cognitive impairment (OSA+MCI) and 39 were OSA without mild cognitive impairment (OSA-MCI). The relationship between hypoxic burden and cognitive impairment was analyzed by establishing a series of logistic regression models.</p><p><strong>Results: </strong>Hypoxic burden was higher in OSA+MCI group compared with OSA-MCI group, while there was no significance found for the apnea-hypopnea index (AHI) between the two groups. After adjusting for various confounders, patients with OSA who had a higher total hypoxic burden and REM-hypoxic burden in the fourth quartile were found to have an increased risk of MCI compared to those in the first quartile. The adjusted ORs were 7.69 (95%CI 1.15-51.55) and 8.87 (95%CI 1.22-64.34), respectively. However, There was no significant association between the other traditional hypoxic parameters and cognitive function after adjusting for various confounders.</p><p><strong>Conclusion: </strong>Compared to the conventional hypoxic parameter, higher hypoxic burden is associated with cognition and may be an important indicator for assessing MCI in OSA.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689011","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 EEG Biomarkers of Psychopathology: Are We Finally Making Progress?","authors":"Elizabeth A Klingaman, Philip R Gehrman","doi":"10.1093/sleep/zsae270","DOIUrl":"https://doi.org/10.1093/sleep/zsae270","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676831","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":"Factors influencing the PAP-adherence of elderly European sleep apnoea patients in the ESADA cohort.","authors":"Aino Lammintausta, Ulla Anttalainen, Izolde Bouloukaki, Sophia E Schiza, Athanasia Pataka, Francesco Fanfulla, Stefan A Mihaicuta, Sébastien Bailly, Ludger Grote, Jan A Hedner, Tarja Saaresranta","doi":"10.1093/sleep/zsae266","DOIUrl":"https://doi.org/10.1093/sleep/zsae266","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676826","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":"Association of OSA with Soluble Biomarkers of Lung and Vascular Injury: The Multi-Ethnic Study of Atherosclerosis.","authors":"Daniel J Gottlieb, Spencer L Hansen, Robyn L McClelland, Elaine Cornell, John S Kim, Russell P Tracy, David J Lederer, Susan Redline, Sanja Jelic","doi":"10.1093/sleep/zsae271","DOIUrl":"https://doi.org/10.1093/sleep/zsae271","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682491","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":"Evaluating the performance of open-source and proprietary processing of actigraphy sleep estimation in children with suspected sleep disorders: A comparison with polysomnography.","authors":"Aliye B Cepni, Sarah Burkart, Xuanxuan Zhu, James White, Olivia Finnegan, Srihari Nelakuditi, Michael Beets, David Brown Iii, Russell Pate, Gregory Welk, Massimiliano de Zambotti, Rahul Ghosal, Yuan Wang, Bridget Armstrong, Elizabeth Adams, Vincent van Hees, R Glenn Weaver","doi":"10.1093/sleep/zsae267","DOIUrl":"10.1093/sleep/zsae267","url":null,"abstract":"<p><strong>Study objectives: </strong>Evaluate the performance of actigraphy-based open-source and proprietary sleep algorithms compared to polysomnography in children with suspected sleep disorders.</p><p><strong>Methods: </strong>In a sleep clinic, 110 children (5-12 years, 54% female, 50% Black, 82% with sleep disorders) wore wrist-placed ActiGraph GT9X during overnight polysomnography. Actigraphy data were scored as sleep or wake using open-source GGIR and proprietary ActiLife software. Discrepancy and epoch-by-epoch analyses were conducted to assess agreement between algorithms and polysomnography, along with equivalence testing.</p><p><strong>Results: </strong>The open-source vanHees2015 algorithm showed good accuracy (79.5% ± 12.0%), sensitivity (81.1% ± 13.5%), and specificity (66.0% ± 23.8%) for sleep detection but was outperformed by the proprietary ActiLife algorithms. The magnitude and trend of bias for total sleep time, sleep efficiency, sleep onset latency, and wake after sleep onset were similar between algorithms. Total sleep time and sleep efficiency were statistically equivalent for the Cole-Kripke (Actilife) and vanHees2015 algorithms compared to the Sadeh (Actilife) algorithm. The Cole-Kripke (ActiLife) demonstrated higher sensitivity (90.5%) to detect sleep but lower specificity (61.2%) than Cole-Kripke (GGIR) (sensitivity: 62.7%, specificity: 79.9%). Sadeh and Cole-Kripke estimated sleep outcomes were not statistically equivalent between implementations in ActiLife and GGIR.</p><p><strong>Conclusions: </strong>The open-source vanHees2015 algorithm performed well but slightly worse than the proprietary ActiLife algorithms in children. The open-source nature vanHees2015 makes it ideal for clinical pediatric use. Implementation of the Sadeh and Cole-Kripke algorithms in the proprietary ActiLife and open-source GGIR software yield different sleep estimates, so comparisons between studies using these different implementations should be avoided.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669222","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 of objective daytime sleepiness with impaired glucose metabolism in patients with obstructive sleep apnea: a multi-omics study.","authors":"Le Chen, Baixin Chen, Yanyuan Dai, Qimeng Sun, Jun Wu, Dandan Zheng, Alexandros N Vgontzas, Xiangdong Tang, Yun Li","doi":"10.1093/sleep/zsae240","DOIUrl":"https://doi.org/10.1093/sleep/zsae240","url":null,"abstract":"<p><strong>Study objectives: </strong>To examine the joint effect of obstructive sleep apnea (OSA) and objective excessive daytime sleepiness (EDS) on glucose metabolism and the underlying mechanisms.</p><p><strong>Methods: </strong>We included 127 patients with OSA. The multiple sleep latency test (MSLT) and Epworth sleepiness scale (ESS) were used to assess objective and subjective EDS, respectively. Disordered glucose metabolism was defined as either a physician diagnosis or having fasting blood glucose levels ≥ 5.6 mmol/L. Values of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) higher than the median values of our sample were defined as high fasting insulin and insulin resistance. Serum metabolomics and fecal microbiota were used to explore underlying mechanisms.</p><p><strong>Results: </strong>Lower MSLT values were associated with higher levels of fasting blood glucose, fasting insulin, and HOMA-IR. Furthermore, objective EDS was associated with increased odds of disordered glucose metabolism, elevated fasting insulin, and insulin resistance. Dysregulation of serum valine degradation and dysbiosis of fecal Bacteroides thetaiotaomicron were associated with impaired glucose metabolism in OSA with objective EDS. No association between subjective EDS and impaired glucose metabolism was observed.</p><p><strong>Conclusion: </strong>OSA with objective, but not subjective, EDS is associated with an increased risk of disordered glucose metabolism and insulin resistance. Dysregulation of valine degradation and dysbiosis of Bacteroides thetaiotaomicron appear to link objective EDS and disordered glucose metabolism in OSA.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644699","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":"Physiological and Psychological Stress Reactivity in Narcolepsy Type 1.","authors":"Marieke Vringer, Denise Bijlenga, Jingru Zhou, Onno C Meijer, Christiaan H Vinkers, Gert Jan Lammers, Rolf Fronczek","doi":"10.1093/sleep/zsae265","DOIUrl":"https://doi.org/10.1093/sleep/zsae265","url":null,"abstract":"<p><strong>Study objectives: </strong>Narcolepsy type 1 (NT1) is a chronic sleep-wake disorder, characterized by a loss of hypocretin production. Unexpectedly, in post-mortem tissue of people with NT1 there is a loss of corticotrophin-releasing hormone (CRH) in the paraventricular nucleus. CRH is known as activator of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress. This activation results in the release of the stress hormones adrenocorticotropic hormone (ACTH) and cortisol. We hypothesize an altered physiological and psychological stress response in NT1.</p><p><strong>Methods: </strong>Participants were people with NT1 (n=14) and matched healthy controls (n=12). The Trier Social Stress Test for Groups (TSST-G), a validated socially evaluated stress test in controlled settings, induced acute stress. We measured ACTH and cortisol levels in blood before and at three timepoints after the TSST-G. We also measured subjective stress and heart rate levels.</p><p><strong>Results: </strong>In both groups, acute stress led to increases in ACTH (p=0.006), cortisol (p<0.001), heart rate (p<0.001) and subjective stress (p<0.001). Subjectively, people with NT1 experienced more stress than controls (p<0.001). No differences were found in heart rate, cortisol, and ACTH between people with NT1 and controls at any timepoint. Secondary analyses showed that men with NT1 had lower cortisol levels immediately after stress induction than men in the control group (p=0.002).</p><p><strong>Conclusions: </strong>People with NT1 show an increased subjective stress response, but no changes in their endocrine or cardiovascular stress reactivity. Further research is required to determine the impact of reduced CRH production and gender in NT1.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639800","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":"Measuring energy expenditure in narcolepsy using doubly-labelled water and respiration chamber calorimetry.","authors":"Claire E H M Donjacour, Jari K Gool, Paul F Schoffelen, Loek Wouters, Sebastiaan Overeem, Gert Jan Lammers, Hanno Pijl, Klaas R Westerterp","doi":"10.1093/sleep/zsae263","DOIUrl":"https://doi.org/10.1093/sleep/zsae263","url":null,"abstract":"<p><strong>Study objectives: </strong>Hypocretin deficiency causes type 1 narcolepsy, a condition characterised by excessive daytime sleepiness, cataplexy, and fragmented nocturnal sleep. Two-thirds of people with narcolepsy are also overweight, of which half are obese. The pathophysiology behind weight gain in people with narcolepsy remains unknown. We assessed a possible decrease in energy expenditure as a cause for overweight in narcolepsy using respiration chamber calorimetry and doubly labelled water.</p><p><strong>Methods: </strong>Ten males with type I narcolepsy and nine matched (for age, sex, and BMI) healthy controls were enrolled. Subjects stayed in a respiration chamber for 24 hours. They subsequently received doubly labelled water and wore an accelerometer for two weeks to assess energy expenditure and physical activity under daily living conditions. Total daily energy expenditure, resting energy expenditure, overnight metabolic rate, physical activity level and activity-induced energy expenditure were measured.</p><p><strong>Results: </strong>No significant differences were found in resting energy expenditure, mean 24-hour respiration chamber energy expenditure, overnight metabolic rate and activity-induced energy expenditure when comparing people with narcolepsy type 1 to controls. Physical activity was also comparable between groups.</p><p><strong>Conclusion: </strong>Energy expenditure in narcolepsy type 1 is similar to matched controls, suggesting comparable metabolism and physical activity rates. It remains possible that metabolic changes are most pronounced around disease onset. In addition, patients had to discontinue their medication which may have influenced the results. Still, our findings suggest that other factors may also play a role in weight gain in narcolepsy, such as differences in dietary behaviour.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639691","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}