SleepPub Date : 2024-09-23DOI: 10.1093/sleep/zsae222
Dimple Goel, Ivan Ling, Nigel McArdle
{"title":"\"Why are we not working to prevent OSA?\"","authors":"Dimple Goel, Ivan Ling, Nigel McArdle","doi":"10.1093/sleep/zsae222","DOIUrl":"https://doi.org/10.1093/sleep/zsae222","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295975","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}
SleepPub Date : 2024-09-20DOI: 10.1093/sleep/zsae219
Teitur Óli Kristjánsson, Katie L Stone, Helge B D Sorensen, Andreas Brink-Kjaer, Emmanuel Mignot, Poul Jennum
{"title":"Mortality Risk Assessment Using Deep Learning-Based Frequency Analysis of EEG and EOG in Sleep.","authors":"Teitur Óli Kristjánsson, Katie L Stone, Helge B D Sorensen, Andreas Brink-Kjaer, Emmanuel Mignot, Poul Jennum","doi":"10.1093/sleep/zsae219","DOIUrl":"https://doi.org/10.1093/sleep/zsae219","url":null,"abstract":"<p><strong>Study objectives: </strong>To assess whether the frequency content of electroencephalography (EEG) and electrooculography (EOG) during nocturnal polysomnography (PSG) can predict all-cause mortality.</p><p><strong>Methods: </strong>Power spectra from PSGs of 8,716 participants, included from the MrOS Sleep Study and the Sleep Heart Health Study (SHHS), were analyzed in deep learning-based survival models. The best-performing model was further examined using SHapley Additive Explanation (SHAP) for data-driven sleep-stage specific definitions of power bands, which were evaluated in predicting mortality using Cox Proportional Hazards models.</p><p><strong>Results: </strong>Survival analyses, adjusted for known covariates, identified multiple EEG frequency bands across all sleep stages predicting all-cause mortality. For EEG, we found an all-cause mortality hazard ratio (HR) of 0.90 (CI95% 0.85-0.96) for 12-15 Hz in N2, 0.86 (CI95% 0.82-0.91) for 0.75-1.5 Hz in N3, and 0.87 (CI95% 0.83-0.92) for 14.75-33.5 Hz in REM sleep. For EOG, we found several low-frequency effects including an all-cause mortality HR of 1.19 (CI95% 1.11-1.28) for 0.25 Hz in N3, 1.11 (CI95% 1.03-1.21) for 0.75 Hz in N1, and 1.11 (CI95% 1.03-1.20) for 1.25-1.75 Hz in Wake. The gain in the concordance index (C-index) for all-cause mortality is minimal, with only a 0.24% increase: The best single mortality predictor was EEG N3 (0-0.5 Hz) with C-index of 77.78% compared to 77.54% for confounders alone.</p><p><strong>Conclusion: </strong>Spectral power features, possibly reflecting abnormal sleep microstructure, are associated with mortality risk. These findings add to a growing literature suggesting that sleep contains incipient predictors of health and mortality.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295978","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}
SleepPub Date : 2024-09-20DOI: 10.1093/sleep/zsae204
Stephanie A Ward, Elsdon Storey, Matthew T Naughton, Rory Wolfe, Garun S Hamilton, Meng Law, Ryo Kawasaki, Walter P Abhayaratna, Katherine L Webb, Fergal J O'Donoghue, Danijela Gasevic, Nigel P Stocks, Ruth E Trevaks, Liubov D Robman, Scott Kolbe, Sharyn M Fitzgerald, Suzanne G Orchard, Tien Wong, John McNeil, Christopher M Reid, Ben Sinclair, Robyn L Woods
{"title":"Obstructive Sleep Apnea and Cerebral Small Vessel disease in Community-based Older People: An ASPREE Imaging Substudy.","authors":"Stephanie A Ward, Elsdon Storey, Matthew T Naughton, Rory Wolfe, Garun S Hamilton, Meng Law, Ryo Kawasaki, Walter P Abhayaratna, Katherine L Webb, Fergal J O'Donoghue, Danijela Gasevic, Nigel P Stocks, Ruth E Trevaks, Liubov D Robman, Scott Kolbe, Sharyn M Fitzgerald, Suzanne G Orchard, Tien Wong, John McNeil, Christopher M Reid, Ben Sinclair, Robyn L Woods","doi":"10.1093/sleep/zsae204","DOIUrl":"https://doi.org/10.1093/sleep/zsae204","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) may increase risk of dementia. A potential pathway for this risk is through cerebral small vessel disease (CSVD). In the context of an existing randomized trial of aspirin for primary prevention, we aimed to investigate OSA's impact on CSVD imaging measures and explore whether aspirin effects these measures over 3 years that differ in the presence or absence of OSA.</p><p><strong>Methods: </strong>A sub-study of the ASPirin in Reducing Events in the Elderly randomized placebo-controlled trial of low-dose aspirin. Community-dwelling participants aged 70 years and above, without cognitive impairment, cardiovascular disease or known OSA completed an unattended limited-channel sleep study that calculated the oxygen desaturation index and apnea-hypopnea index. At baseline and 3 years later, volumes of white matter hyperintensities (WMH) and silent brain infarctions (SBI) were measured on 1.5 Tesla brain magnetic resonance imaging, and retinal vessel calibers were calculated from retinal vascular imaging.</p><p><strong>Results: </strong>Mild and moderate/severe OSA was detected in 48.9% and 29.9%, respectively, of the 311 participants, who had a mean age of 73.7 years (SD 3.4 years), 38.6% female. OSA of any severity did not associate with WMH volumes, SBI, nor with retinal vessel calibers at baseline, nor with change in these measures in the 277 participants with repeated measures acquired after 3 years. OSA of any severity did not interact with aspirin on change in these measures over 3 years.</p><p><strong>Conclusion: </strong>In healthy older adults undiagnosed OSA was not associated with retinal vascular calibers and neuroimaging measures of CSVD.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295979","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}
SleepPub Date : 2024-09-19DOI: 10.1093/sleep/zsae218
Nataliia Kozhemiako, Chenguang Jiang, Yifan Sun, Zhenglin Guo, Sinéad Chapman, Guanchen Gai, Zhe Wang, Lin Zhou, Shen Li, Robert G Law, Lei A Wang, Dimitrios Mylonas, Lu Shen, Michael Murphy, Shengying Qin, Wei Zhu, Zhenhe Zhou, Robert Stickgold, Hailiang Huang, Shuping Tan, Dara S Manoach, Jun Wang, Mei-Hua Hall, Jen Q Pan, Shaun M Purcell
{"title":"A spectrum of altered non-rapid eye movement sleep in schizophrenia.","authors":"Nataliia Kozhemiako, Chenguang Jiang, Yifan Sun, Zhenglin Guo, Sinéad Chapman, Guanchen Gai, Zhe Wang, Lin Zhou, Shen Li, Robert G Law, Lei A Wang, Dimitrios Mylonas, Lu Shen, Michael Murphy, Shengying Qin, Wei Zhu, Zhenhe Zhou, Robert Stickgold, Hailiang Huang, Shuping Tan, Dara S Manoach, Jun Wang, Mei-Hua Hall, Jen Q Pan, Shaun M Purcell","doi":"10.1093/sleep/zsae218","DOIUrl":"10.1093/sleep/zsae218","url":null,"abstract":"<p><p>Multiple facets of sleep neurophysiology, including electroencephalography (EEG) metrics such as non-rapid eye movement (NREM) spindles and slow oscillations, are altered in individuals with schizophrenia (SCZ). However, beyond group-level analyses, the extent to which NREM deficits vary among patients is unclear, as are their relationships to other sources of heterogeneity including clinical factors, ageing, cognitive profiles and medication regimens. Using newly collected high-density sleep EEG data on 103 individuals with SCZ and 68 controls, we first sought to replicate our previously reported group-level differences between patients and controls (original N=130) during N2 stage. Then in the combined sample (N=301 including 175 patients), we characterized patient-to-patient variability. We replicated all group-level mean differences and confirmed the high accuracy of our predictive model (AUC=0.93 for diagnosis). Compared to controls, patients showed significantly increased between-individual variability across many (26%) sleep metrics. Although multiple clinical and cognitive factors were associated with NREM metrics, collectively they did not account for much of the general increase in patient-to-patient variability. Medication regimen was a greater contributor to variability. Some sleep metrics including fast spindle density showed exaggerated age-related effects in SCZ, and patients exhibited older predicted biological ages based on the sleep EEG; further, among patients, certain medications exacerbated these effects, in particular olanzapine. Collectively, our results point to a spectrum of N2 sleep deficits among SCZ patients that can be measured objectively and at scale, with relevance to both the etiological heterogeneity of SCZ as well as potential iatrogenic effects of antipsychotic medication.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295976","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":"Expiratory Muscle Strength Training Reduces Oxidative Stress and Systemic Inflammation in Men with Obstructive Sleep Apnea Syndrome: A Double-Blinded, Randomized Parallel Trial","authors":"Nurel Erturk, Adem Celik, Sevim Kahraman Yaman, Huseyin Yaman, Ferhat Unal, Ebru Calik Kutukcu","doi":"10.1093/sleep/zsae221","DOIUrl":"https://doi.org/10.1093/sleep/zsae221","url":null,"abstract":"Study Objectives This study aimed to evaluate and compare the effects of high and low-intensity expiratory muscle strength training (EMST) on disease severity, systemic inflammation, oxidative stress, respiratory muscle strength, exercise capacity, symptoms, daytime sleepiness, fatigue severity, and sleep quality in male patients with obstructive sleep apnea syndrome (OSAS). Methods Thirty-one male patients diagnosed with moderate OSAS were included in this double-blind, randomized, parallel study. Patients were randomized into two groups: High-EMST and Low-EMST groups. EMST was used at home 7 days/week, once a day, for 25 breaths, 12 weeks. Respiratory muscle strength was measured using a mouth pressure device. Disease severity (Apne Hipopne Index-AHI) and, respiratory sleep events by polysomnography, total oxidant level(TOS), total antioxidant level(TAS), oxidative stress index (OSI), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels by blood serum were evaluated. Results The percentage of AHI change in the High-EMST group(50.8%) was significantly higher than in the Low-EMST group(6.3%) (p=0.002, d=1.31). In general, as MEP increased by one unit, AHI decreased by 0.149 points (b=-0.149; CR=-3.065; p=0.002), and as AHI increased by one unit, ODI increased by 0.746 points (b=0.746; CR=10.604; p&lt;0.001). TOS, OSI, TNF-α and IL-6 levels decreased at similar rates in both groups. Conclusion EMST significantly reduces systemic inflammation and oxidative stress while improving expiratory muscle strength in male patients with moderate OSAS. High-EMST is more effective in enhancing the severity of disease than Low-EMST. EMST is a practical, effective, and promising treatment for pulmonary rehabilitation in patients with moderate OSAS.","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247436","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}
SleepPub Date : 2024-09-18DOI: 10.1093/sleep/zsae220
Mark E Howard,William J Horrey
{"title":"The benefits and pitfalls of advanced driver assistance systems for mitigating drowsy driving crashes.","authors":"Mark E Howard,William J Horrey","doi":"10.1093/sleep/zsae220","DOIUrl":"https://doi.org/10.1093/sleep/zsae220","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247393","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}
SleepPub Date : 2024-09-16DOI: 10.1093/sleep/zsae217
Aboud Tahanis, Vera Hashem, William Ondo
{"title":"Serum Alpha-synuclein in Restless Legs Syndrome.","authors":"Aboud Tahanis, Vera Hashem, William Ondo","doi":"10.1093/sleep/zsae217","DOIUrl":"https://doi.org/10.1093/sleep/zsae217","url":null,"abstract":"<p><strong>Study objectives: </strong>To determine any correlation between serum alpha-synuclein (α-syn) concentrations and restless legs syndrome (RLS), and to explore the impact of intravenous iron supplementation on serum α-syn levels.</p><p><strong>Methods: </strong>We collected clinical data on 113 RLS patients in whom serum α-syn levels were quantified using an ELISA kit and compared to a group of 45 age matched controls. A subset of 9 RLS patients who received intravenous (IV) iron underwent pre- and post-treatment blood sampling to assess α-syn and ferritin response.</p><p><strong>Results: </strong>Family history of RLS was reported by 62.8% of patients, and current dopaminergic augmentation was observed in 31.0%. Low serum ferritin levels below 75 μg/L were seen in 39.8%. Serum α-syn levels were found to be significantly decreased in RLS patients (mean: 7.7 ng/ml) compared to controls (mean: 10.7 ng/ml,), p<0.05. Stratification based on sex, age and age of onset, did not reveal significant differences in α-syn levels. In 9 RLS patients who received IV iron treatment, a linear correlation between fold change in α-syn and ferritin was observed (R: 0.7, p <0.05). The temporal relation between serum α-syn and IV iron treatment showed a gradual decline of α-syn and ferritin by time correlation (p = 0.023, R: -0.739).</p><p><strong>Conclusion: </strong>In our study of 113 RLS subjects, serum α-syn levels were decreased in RLS patients compared to healthy controls and increased in the 9 patients who received IV iron treatment in correlation with ferritin. This correlation could suggest a mechanism for reduced dopamine transmission in RLS.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295980","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}
SleepPub Date : 2024-09-16DOI: 10.1093/sleep/zsae216
Ian G Campbell, Courtney A Kurinec, Zoey Y Zhang, Alejandro Cruz-Basilio, Jessica G Figueroa, Vincent B Bottom, Paul Whitney, John M Hinson, Hans P A Van Dongen
{"title":"Sleep restriction and age effects on distinct aspects of cognition in adolescents.","authors":"Ian G Campbell, Courtney A Kurinec, Zoey Y Zhang, Alejandro Cruz-Basilio, Jessica G Figueroa, Vincent B Bottom, Paul Whitney, John M Hinson, Hans P A Van Dongen","doi":"10.1093/sleep/zsae216","DOIUrl":"https://doi.org/10.1093/sleep/zsae216","url":null,"abstract":"<p><p>Insufficient sleep negatively impacts scholastic performance in children and adolescents. Here we use a dose response time in bed (TIB) restriction study to evaluate associations between sleep loss and multiple aspects of cognition. We evaluated changes in cognitive measures across ages 10 to 23 years and determined whether the effects of sleep loss changed across this age range. A younger cohort (n=77, age range 9.9 to 16.2 years) was studied annually for 3 years. An older cohort study (n=82, age range 15 to 22.8 years) was interrupted by the COVID pandemic with 25 participants completing multiple years. Annually participants completed each of three TIB conditions: four consecutive nights with 7, 8.5, or 10 h in bed. A day of cognitive testing followed the fourth night. Restricting TIB to 7 h was associated with impaired top-down attentional control and cognitive flexibility, but performance did not differ between the 8.5 and 10 h TIB conditions. Psychomotor vigilance test performance decreased as TIB was restricted from 10 to 8.5 h and decreased further with restriction to 7 h. Sternberg test measures of working memory were not significantly affected by TIB restriction. The effects of sleep loss on these cognitive measures did not change significantly with age, but age-related improvement in many of the measures may compensate for some sleep loss effects. The findings here do not indicate an adolescent decrease in sleep need; however, the minimal duration of sleep needed for optimal performance appears to differ depending on the cognitive measure.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142295981","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}
SleepPub Date : 2024-09-14DOI: 10.1093/sleep/zsae212
Michele Lastella,Mitch J Duncan,Grace E Vincent
{"title":"Golden Years, Golden Sleep: The Impact of Physical Activity on Older Adults' Sleep Quality.","authors":"Michele Lastella,Mitch J Duncan,Grace E Vincent","doi":"10.1093/sleep/zsae212","DOIUrl":"https://doi.org/10.1093/sleep/zsae212","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247395","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}
SleepPub Date : 2024-09-14DOI: 10.1093/sleep/zsae215
Stephen P Becker, G Leonard Burns, Juan José Montaño, Mateu Servera
{"title":"Psychometric Examination of the PROMIS Parent Proxy Pediatric Sleep Measures from Early Childhood to Adolescence in a Nationally Representative Spanish Sample","authors":"Stephen P Becker, G Leonard Burns, Juan José Montaño, Mateu Servera","doi":"10.1093/sleep/zsae215","DOIUrl":"https://doi.org/10.1093/sleep/zsae215","url":null,"abstract":"Study Objectives To use a nationally representative sample to (1) evaluate the factor structure of the PROMIS parent proxy pediatric sleep scales (Spanish translation), (2) examine the invariance of these scales across sex and across different developmental periods of childhood and adolescence, (3) confirm the information and precision of the scales using item response theory (IRT), and (4) provide age-based normative information. Methods Parents of a nationally representative sample of 5,525 Spanish children and adolescents ages 5-16 years (56.1% boys) completed the Spanish translation parent proxy short versions of the Sleep Disturbance and Sleep-Related Impairment scales. We conducted confirmatory factor analyses (CFA), invariance analyses, and graded response IRT analyses. Results CFAs conducted separately on males and females within three age groups (early childhood: ages 5-8 years; middle childhood: ages 9-12 years; adolescence: ages 13-16 years) indicated all items had a substantial loading with one exception (the sleep continuity item [“my child slept through the night”] had a substantially lower loading and was removed for subsequent analyses). The scores on the two scales demonstrated invariance across sex within each age group. Using IRT analyses, both scales showed a high degree of information and precision from slightly below the trait means to slightly above two standard deviations above the trait means. Conclusions The strong psychometric properties of the short versions of the parent proxy PROMIS pediatric sleep disturbance and sleep-related impairment scales, coupled with age-based norms, suggests these scales are likely to be useful for research and clinical applications.","PeriodicalId":22018,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247438","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}