Sleep最新文献

{"title":"Should we prescribe CPAP treatment in elderly patients with obstructive sleep apnea?","authors":"Maria R Bonsignore, Francesco Fanfulla, Carolina Lombardi","doi":"10.1093/sleep/zsaf142","DOIUrl":"https://doi.org/10.1093/sleep/zsaf142","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136539","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":"Prognostic Value Of Obstructive Sleep Apnea And Role Of Cpap Treatment In The Incidence Of Hypertensive Crisis.","authors":"Grace Oscullo, Thais Beaperthui, Jose Daniel Gómez-Olivas, Marina Anglés, Sergio Mompeán, Rosalía Martínez, Manuel Sánchez de la Torre, David Gozal, Miguel Angel Martinez-Garcia","doi":"10.1093/sleep/zsaf140","DOIUrl":"https://doi.org/10.1093/sleep/zsaf140","url":null,"abstract":"<p><strong>Study objectives: </strong>Hypertensive crises (HC) are not usually included in studies on the relationship between obstructive sleep apnea (OSA) and cardiovascular diseases. Consequently, our objective is to analyze the relationship between untreated OSA, treatment with CPAP and the incidence of HC.</p><p><strong>Methods: </strong>Prospective study of 1,021 individuals recruited for clinical suspicion of OSA. Sleep parameters, medical history and HC were recorded during follow-up. HC was considered by the presence of SBP/DBP>180/110 mmHg respectively in patients with compatible symptoms or damage of a target organ. Subjects were divided into three groups: (a) AHI≤15;n=401 (control group), (b) OSA treated with CPAP with good adherence; n=362, and (c) AHI>15 events/h with initial refusal of or non-compliance with CPAP treatment, n=249.</p><p><strong>Results: </strong>In the median follow up (16 [IQR: 13.7-17.8]) months, there were 58 incident HC events (7 the non-OSA group, 15 in the OSA group with good tolerance to CPAP, and 36 in the moderate-severe OSA group without/poor adherence to CPAP. Forty-six had arterial hypertension. In the survival analysis, those patients with moderate-to-severe OSA without CPAP had a fully adjusted risk of 2.91 (95%CI: 1.97-5.78; p<0.001), with the CPAP-treated group showing no evidence of increased HC risk (HR 1.12; p:NS) compared to the control group. Among hypertensive subjects, the relationship between moderate-to-severe untreated OSA and the risk of HC was greatly enhanced: HR 7.22 (CI: 2.81-12.5; p<0.001).</p><p><strong>Conclusions: </strong>Untreated/non adherent to CPAP patients with moderate-to-severe OSA are at significantly higher risk of incident HC, particularly if they suffer from hypertension. Treatment with CPAP has a favorable effect by reduces the HC risk to control levels.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133117","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":"Objective, but Not Subjective Daytime Sleepiness Predicts Mortality in Obstructive Sleep Apnea.","authors":"Yanyuan Dai, Alexandros N Vgontzas, Baixin Chen, Le Chen, Jun Wu, Dandan Zheng, Yun Li","doi":"10.1093/sleep/zsaf138","DOIUrl":"https://doi.org/10.1093/sleep/zsaf138","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) with objective but not subjective excessive daytime sleepiness (EDS) has been reported to be associated with cardiovascular comorbidity. We aimed to investigate the association between OSA with objective or subjective EDS and mortality in a general population sample.</p><p><strong>Methods: </strong>In this retrospective cohort study, we included 244 subjects with OSA and 553 subjects without OSA with a median follow-up duration of 8 years. Objective EDS was defined based on a mean latency value of the Multiple Sleep Latency Test (MSL) ≤8 minutes. Subjective EDS was defined based on the total score of the Epworth Sleepiness Scale (ESS) >10.</p><p><strong>Results: </strong>After adjusting for potential confounders, OSA with objective EDS was associated with an approximately 2.5-fold higher risk of all-cause mortality (hazard ratio [HR]=2.451, 95% confidence interval [95%CI]=1.319-4.556) and 3.9-fold higher risk of CVD mortality (HR=3.876, 95%CI=1.293-11.622) compared to subjects without OSA or objective EDS. Furthermore, subjects with OSA, objective EDS and CVD at baseline had about a 2.9-fold higher risk of all-cause mortality (HR=2.872, 95% CI=1.186-6.953) compared to subjects without OSA, objective EDS or CVD at baseline. In contrast, OSA with subjective EDS was not associated with increased hazard of all cause or CVD mortality.</p><p><strong>Conclusions: </strong>Objective EDS appears to be an important marker of the biological severity of OSA. Future studies to validate the findings in diverse populations and interventional studies are needed.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133113","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":"Sedative-hypnotics are associated with additional risk of suicide in older adults: a population-based case-control study.","authors":"Hang-Ju Yang, Yu-Han Huang, Wan-Ju Cheng","doi":"10.1093/sleep/zsaf136","DOIUrl":"https://doi.org/10.1093/sleep/zsaf136","url":null,"abstract":"<p><strong>Study objectives: </strong>To examine the pattern of sedative-hypnotic prescriptions associated with the risk of suicide behavior among older adults with and without insomnia.</p><p><strong>Methods: </strong>The study included 8 319 suicide cases and age- and sex-matched controls from the population-wide National Health Insurance Research Database. Suicide methods and insomnia were defined using diagnostic codes. The sedative-hypnotic use pattern was categorized by half-life, prescription volume measured in Defined Daily Doses (DDDs), and its temporal relationship with suicide. Odds ratios were employed to assess the risk of insomnia and the prescription patterns of sedative-hypnotics on suicide. Additionally, we compared suicide methods between sedative-hypnotics users and nonusers.</p><p><strong>Results: </strong>Insomnia was mildly associated with suicide behavior after adjusting for mental illnesses (adjusted RR = 1.82, OR = 1.86, 95% CI = 1.76-1.97), but the prescription of sedative-hypnotics was associated with 5-fold suicide risk (adjusted RR = 5.22, OR = 5.90, 95% CI = 5.11-6.82). Among patients with insomnia, a prescription volume of ≥ 31 DDDs per year, and a prescription within 90 days of the suicide index date were associated with increased suicide risk. Individuals prescribed sedative-hypnotics were more likely to suicide by methods involving sedative-hypnotic poisoning (21% vs. 0%).</p><p><strong>Conclusions: </strong>Among older adults, sedative-hypnotic prescription is associated with increased suicide risk and suicide by self-poisoning using such medications. Non-pharmacological treatment for insomnia, such as cognitive behavioral therapy, is essential for suicide prevention.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133058","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":"One size fits null: attentional brain responses differ depending on insomnia subtype.","authors":"Wenrui Zhao, Eus J W Van Someren, Glenn J M van der Lande, Sjors van de Ven, Frank J van Schalkwijk, Tessa F Blanken, Jennifer R Ramautar, Roy Cox","doi":"10.1093/sleep/zsaf056","DOIUrl":"10.1093/sleep/zsaf056","url":null,"abstract":"<p><strong>Study objectives: </strong>Event-related potential (ERP) studies on attentional brain processes in insomnia disorder (ID) have yielded inconsistent findings. Such inconsistencies may relate to small sample sizes, limited corrections for multiple comparisons, and the possibility of heterogeneity within the clinical population. We aimed to overcome these limitations by studying ERP responses both across and within subtypes in a larger sample of ID.</p><p><strong>Methods: </strong>ERPs were recorded in 201 participants with ID and 70 normal sleeper controls (NS) with an auditory oddball task. Participants with ID were subtyped using a validated multivariate trait profile. Analyses evaluated subtype-specific and nonspecific deviations using both conventional ERP components as well as cluster-based permutation tests.</p><p><strong>Results: </strong>All five subtypes were well-represented in the ID sample (subtypes 1-5 respectively N = 31, 83, 28, 29 and 19). ERP component analyses with false discovery rate corrections revealed no evidence for differences between the heterogeneous ID group and NS. However, subtype-specific analyses revealed that ERPs were significantly altered, but in different ways for different subtypes. Specifically, ERP component analyses revealed stronger N100 amplitudes for standards and deviants both in subtypes 2 and 3, and a lower P300 amplitude and longer P300 latency for deviants in subtype 3. Cluster-based permutation tests on ERPs corroborated the P300 amplitude effect for deviants in subtype 3, with subtype 3 and 4 additionally showing a smaller difference between deviant and standard P300 amplitudes.</p><p><strong>Conclusion: </strong>Our findings indicate that ID is a heterogeneous disorder. Ignoring subtype identity dilutes ERP alterations occurring only in specific insomnia subtypes.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120893","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":"Spectral and network investigation reveals distinct power and connectivity patterns between phasic and tonic REM sleep.","authors":"Tamir Avigdor, Laure Peter-Derex, Alyssa Ho, Katharina Schiller, Yingqi Wang, Chifaou Abdallah, Edouard Delaire, Kassem Jaber, Vojtech Travnicek, Christophe Grova, Birgit Frauscher","doi":"10.1093/sleep/zsaf133","DOIUrl":"https://doi.org/10.1093/sleep/zsaf133","url":null,"abstract":"<p><p>Although rapid eye movement (REM) sleep is often thought of as a singular state, it consists of two substates, phasic and tonic REM, defined by the presence (respectively absence) of bursts of rapid eye movements. These two substates have distinct EEG signatures and functional properties. However, whether they exhibit regional specificities remains unknown. Using intracranial EEG recordings from 31 patients, we analyzed expert labeled segments from tonic and phasic REM and contrasted them with wakefulness segments. We assessed the spectral and connectivity content of these segments using Welch's method to estimate power spectral density and the phase locking value to assess functional connectivity. Overall, we found a widespread power gradient between low and high frequencies (p < 0.05, Cohen's d = 0.17± 0.20), with tonic REM being dominated by lower frequencies (p < 0.01, d = 0.18 ± 0.08), and phasic REM by higher frequencies (p < 0.01, d = 0.18 ± 0.19). However, some regions such as the occipito-temporal areas as well as medial frontal regions exhibit opposite trends. Connectivity was overall higher in all bands except in the low and high ripple frequency band in most networks during tonic REM (p < 0.01, d = 0.08 ± 0.09) compared to phasic REM. Yet, functional connections involving the visual network were always stronger during phasic REM when compared to tonic REM. These findings highlight the spatiotemporal heterogeneity of REM sleep which is consistent with the concept of focal sleep in humans.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111962","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":"CON: CBT-I for insomnia treatment can be delivered by a range of healthcare providers.","authors":"Christina S McCrae, Ashley F Curtis, Melanie A Stearns","doi":"10.1093/sleep/zsaf123","DOIUrl":"https://doi.org/10.1093/sleep/zsaf123","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111925","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":"PRO: CBT-I for insomnia treatment can be delivered by a range of healthcare providers.","authors":"Colin A Espie, Michael A Grandner, Christopher L Drake","doi":"10.1093/sleep/zsaf124","DOIUrl":"https://doi.org/10.1093/sleep/zsaf124","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111927","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":"A Comparative Analysis Of Automatic And Manual Scoring Methods In Polysomnography.","authors":"Turgay Dolek, Deniz Akpinar, Semai Bek, Fulden Cantas Turkis, Gulnihal Kutlu","doi":"10.1093/sleep/zsaf137","DOIUrl":"https://doi.org/10.1093/sleep/zsaf137","url":null,"abstract":"<p><p>The objective of this study was to compare twenty-six polysomnography (PSG) parameters between the groups utilizing automatic scoring (AS) software and manual scoring (MS) technique. Two MS groups, each comprising technicians with sleep scoring experience ranging from 5 to 8 years, were established. One group consisted of three technicians while the other included four technicians. PSG record of three hundred sixty-nine was initially scored by the first MS group and subsequently rescored by the second MS group. Finally, the PSG records were automatically scored once using the Embla RemLogic version 3.4 PSG Software (Embla Systems, Natus Medical Incorporated). All PSG records were evaluated three times independently and compared across the three groups: AS, MS group 1, and MS group 2. No significant differences were identified among the MS groups for any of the PSG parameters. AS differs from the two MS groups in many PSG parameters, including sleep stages and the apnea-hypopnea index. (p < 0.05). A strong agreement was noted between MS group 1 and MS group 2 for almost all variables (p < 0.001, Kendall's tau-B (τb) = 0.747-0.922). The AS had a poor correlation with both MS groups regarding total apnea and hypopnea counts. As a result, AS methods yield imprecise results for numerous PSG parameters and should not be regarded as the exclusive scoring approach until more sophisticated artificial intelligence algorithms are developed. PSG scoring conducted by a technician with a minimum of five years of experience is both sufficient and dependable.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111923","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 prevalence, incidence and burden of narcolepsy and idiopathic hypersomnia in Taiwan: comparison between the National Health Insurance Research Claims Database and a hospital cohort database.","authors":"Yu-Shu Huang, Wei-Chih Chin, I-Hang Chung, Tsun-Yi Roan, Chee-Jen Chang, Hsiao-Ting Juang, Shu-Chen Chang, Somraj Ghosh, Stephen Crawford, Huang-Li Lin","doi":"10.1093/sleep/zsaf132","DOIUrl":"https://doi.org/10.1093/sleep/zsaf132","url":null,"abstract":"<p><strong>Study objectives: </strong>We investigated the prevalence and incidence of narcolepsy (type 1 and 2) and idiopathic hypersomnia (IH) in Taiwan using the National Health Insurance Research Database (NHIRD), and compared disease burden with patients identified from a \"gold-standard\" hospital database.</p><p><strong>Methods: </strong>This study employed retrospective cohort and cross-sectional designs, to analyze data from the NHIRD and the hospital database cohort between 2009 and 2019. Analyses comprised prevalence and incidence of narcolepsy and IH, with diagnoses validated against the hospital database, and comparison of demographics, prescriptions, comorbidities, healthcare utilization, and costs with a control cohort. Categorical variables were analyzed using the chi-squared test; continuous variables were assessed via analysis of variance or Kruskal-Wallis tests.</p><p><strong>Results: </strong>From both databases, 24  317 patients were identified as having narcolepsy or IH. The diagnosed prevalence of narcolepsy was 9.98 per 100 000 individuals. Annual increases in prevalence and incidence were observed, particularly in young adults (aged 21-30 years). Patients with narcolepsy and IH exhibited higher rates of comorbidities and received more psychotropics compared with controls. However, fewer patients from the NHIRD received treatment for hypersomnolence than those from the hospital cohort. Healthcare utilization and costs were higher among patients with narcolepsy and IH compared with controls.</p><p><strong>Conclusions: </strong>Increased narcolepsy prevalence over time was observed, particularly among young adults, but the overall prevalence in Taiwan appears to be lower than in other countries, potentially indicating underdiagnosis or inadequate treatment. High comorbidity rates and healthcare utilization underscore the substantial disease burden in patients with central hypersomnia.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102737","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}