Sleep最新文献

{"title":"Alteration of sleep architecture in children with obstructive sleep apnea syndrome.","authors":"Plamen Bokov, Benjamin Dudoignon, Karen Spruyt, Christophe Delclaux","doi":"10.1093/sleep/zsad170","DOIUrl":"10.1093/sleep/zsad170","url":null,"abstract":"","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624579","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 clinical effects of digital cognitive behavioral therapy for insomnia in a heterogenous study sample: results from a randomized controlled trial.","authors":"Jennifer Schuffelen, Leonie F Maurer, Noah Lorenz, Alexander Rötger, Reinhard Pietrowsky, Annika Gieselmann","doi":"10.1093/sleep/zsad184","DOIUrl":"10.1093/sleep/zsad184","url":null,"abstract":"<p><strong>Study objectives: </strong>Numerous studies worldwide have reported the beneficial effects of digital cognitive behavioral therapy for insomnia (dCBT-I). However, few focus on real-world study samples that reflect people in regular care. To test whether dCBT-I is suitable within German regular care, we designed a randomized controlled trial recruiting a heterogenous insomnia population.</p><p><strong>Methods: </strong>Participants aged ≥18 who met the criteria for insomnia disorder were randomized to 8-weeks dCBT-I + care-as-usual (CAU) or they were set on a waitlist + CAU. The intervention group was followed-up at 6- and 12-months. The primary outcome was self-reported insomnia severity, assessed with the Insomnia Severity Index (ISI) at 8-weeks post-randomization. A one-way ANCOVA with baseline score as a covariate was fitted to determine group differences. Secondary outcomes included measures of daytime functioning, quality of life, depression, anxiety, dreams, and nightmares.</p><p><strong>Results: </strong>Of the N = 238 participants (67.6% female), age range 19-81 years, n = 118 were randomized to dCBT-I and n = 120 to the control group. At posttreatment, the use of dCBT-I was associated with a large reduction in the ISI (Diffadj = -7.60) in comparison to WLC (d = -2.08). This clinical improvement was also reflected in responder and remission rates. Treatment effects were also observed for daytime functioning, quality of life, symptoms of depression and anxiety (ds = 0.26-1.02) and at long-term follow-up (intervention group only; ds = 0.18-1.65). No effects were found for dream and nightmare frequency.</p><p><strong>Conclusions: </strong>This study showed that dCBT-I reduces insomnia symptoms and improves daytime functioning in a heterogenous insomnia population in Germany with sustained long-term treatment effects in the intervention group. Our results underscore the potential of digital health applications, their suitability within regular care, and their role in facilitating widespread implementation of CBT-I as a first-line treatment for insomnia.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823282","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":"Influence of sex hormone use on sleep architecture in a transgender cohort.","authors":"Margot W L Morssinkhof, Ysbrand D van der Werf, Odile A van den Heuvel, Daan A van den Ende, Karin van der Tuuk, Martin den Heijer, Birit F P Broekman","doi":"10.1093/sleep/zsad249","DOIUrl":"10.1093/sleep/zsad249","url":null,"abstract":"<p><strong>Study objectives: </strong>Sex differences in sleep architecture are well-documented, with females experiencing longer total sleep time, more slow wave sleep (SWS), and shorter Rapid Eye Movement (REM) sleep duration than males. Although studies imply that sex hormones could affect sleep, research on exogenous sex hormones on sleep architecture is still inconclusive. This study examined sleep architecture changes in transgender individuals after 3 months of gender-affirming hormone therapy (GAHT).</p><p><strong>Methods: </strong>We assessed sleep architecture in 73 transgender individuals: 38 transmasculine participants who started using testosterone and 35 transfeminine participants who started using estrogens and antiandrogens. Sleep architecture was measured before GAHT and after 3 months of GAHT for 7 nights using an ambulatory single-electrode sleep EEG device. Changes in sleep architecture were analyzed using linear mixed models, and non-normally distributed outcomes were log-transformed and reported as percentages.</p><p><strong>Results: </strong>In transmasculine participants, SWS decreased by 7 minutes (95% CI: -12; -3) and 1.7% (95% CI: -3%; -0.5%), REM sleep latency decreased by 39% (95% CI: -52%; -22%) and REM sleep duration increased by 17 minutes (95% CI: 7; 26) after 3 months of GAHT. In transfeminine participants, sleep architecture showed no significant changes after 3 months of GAHT.</p><p><strong>Conclusions: </strong>Sleep architecture changes after 3 months of masculinizing GAHT in line with sleep in cisgender males, while it shows no changes after feminizing GAHT. The sex-specific nature of these changes raises new questions about sex hormones and sleep. Future research should focus on studying possible underlying neural mechanisms and clinical consequences of these changes.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10268653","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 breathing at the intersection of nightmares and cardiovascular risk.","authors":"Barry Krakow","doi":"10.1093/sleep/zsad171","DOIUrl":"10.1093/sleep/zsad171","url":null,"abstract":"","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10131737","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":"Excessive daytime sleepiness versus sleepiness at the wheel, the need to differentiate global from situational sleepiness to better predict sleep-related accidents.","authors":"Pierre Philip","doi":"10.1093/sleep/zsad231","DOIUrl":"10.1093/sleep/zsad231","url":null,"abstract":"","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10157276","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":"Circadian misalignment alters resting-state functional connectivity of the salience network in rotating shift workers.","authors":"Sun-Young Kim, Kyung Hwa Lee, Ha Young Lee, Jeong Eun Jeon, Cho Won Park, Jiyoon Shin, Min Cheol Seo, Sehyun Jeon, Seog Ju Kim, Yu Jin Lee","doi":"10.1093/sleep/zsad237","DOIUrl":"10.1093/sleep/zsad237","url":null,"abstract":"<p><strong>Study objectives: </strong>This study compared resting-state functional connectivity (rsFC) of the salience network (SN) between rotating shift workers (RSWs) and controls. Furthermore, we examined whether rsFC of the SN was correlated with sleep, emotion, cognition, and attention.</p><p><strong>Methods: </strong>The 60 RSWs and 57 controls enrolled in this study completed self-report questionnaires and sleep diaries to assess subjective sleep quality, and polysomnography and actigraphy to evaluate objective sleep and 24-hour rest-activity rhythm parameters. The participants also underwent resting-state functional magnetic resonance imaging and structural T1 scans. We performed a seed-based rsFC analysis of the SN using the anterior cingulate cortex (ACC) and anterior insula (AI) as seed regions. Furthermore, AI and ACC rsFC were compared in RSWs and controls, and we analyzed correlations between rsFC and variables of interest showing significant group differences.</p><p><strong>Results: </strong>Compared with controls, RSWs showed reduced rsFC between the ACC and right insula, and increased rsFC of the ACC with the left occipital lobe and right superior frontal gyrus extending to the supplementary motor area (SFG/SMA). Moreover, RSWs showed reduced rsFC between the right AI and right superior parietal lobule (SPL). Finally, rsFC between the ACC and right AI was correlated with 24-hour rest-activity rhythmicity.</p><p><strong>Conclusions: </strong>Although RSWs did not show sleep disturbance, emotional distress, cognitive impairment, or attention deficits, alterations of right insula, left occipital lobe, right SFG/SMA, and right SPL rsFC in the SN indicate that impairments in salience detection and top-down attentional control may emerge in shift workers over time.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10173921","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":"Larger hypothalamic volume in narcolepsy type 1.","authors":"Hilde T Juvodden, Dag Alnæs, Martina J Lund, Ingrid Agartz, OIe A Andreassen, Andres Server, Per M Thorsby, Lars T Westlye, Stine Knudsen Heier","doi":"10.1093/sleep/zsad173","DOIUrl":"10.1093/sleep/zsad173","url":null,"abstract":"<p><strong>Study objectives: </strong>Narcolepsy type 1 (NT1) is a neurological sleep disorder. Postmortem studies have shown 75%-90% loss of the 50 000-70 000 hypocretin-producing neurons and 64%-94% increase in the 64 000-120 000 histaminergic neurons and conflicting indications of gliosis in the hypothalamus of NT1 patients. The aim of this study was to compare MRI-based volumes of the hypothalamus in patients with NT1 and controls in vivo.</p><p><strong>Methods: </strong>We used a segmentation tool based on deep learning included in Freesurfer and computed the volume of the whole hypothalamus, left/right part of the hypothalamus, and 10 hypothalamic subregions. We included 54 patients with post-H1N1 NT1 (39 females, mean age 21.8 ± 11.0 years) and 114 controls (77 females, mean age 23.2 ± 9.0 years). Group differences were tested with general linear models using permutation testing in Permutation Analysis of Linear Models and evaluated after 10 000 permutations, yielding two-tailed P-values. Furthermore, a stepwise Bonferroni correction was performed after dividing hypothalamus into smaller regions.</p><p><strong>Results: </strong>The analysis revealed larger volume for patients compared to controls for the whole hypothalamus (Cohen's d = 0.71, p = 0.0028) and for the left (d = 0.70, p = 0.0037) and right part of the hypothalamus (d = 0.65, p = 0.0075) and left (d = 0.72, p = 0.0036) and right tubular-inferior (d = 0.71, p = 0.0037) hypothalamic subregions.</p><p><strong>Conclusions: </strong>In conclusion, patients with post-H1N1 NT1 showed significantly larger hypothalamic volume than controls, in particular in the tubular-inferior subregions which could reflect several processes as previous studies have indicated neuroinflammation, gliosis, and changes in the numbers of different cell types.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822006","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":"Strained face during sleep in multiple system atrophy: not just a bad dream.","authors":"Lecca Rosamaria, Figorilli Michela, Bouniol Emma, Marques Ana, Pereira Bruno, Derost Philippe, Debilly Bérangère, Ferri Raffaele, Puligheddu Monica, Durif Franck, Fantini Maria Livia","doi":"10.1093/sleep/zsad180","DOIUrl":"10.1093/sleep/zsad180","url":null,"abstract":"<p><strong>Study objectives: </strong>Patients with Parkinson's disease and multiple system atrophy may be subject to sleep state dissociation. Motivated by the fortuitous observation of prominent facial muscle activity during video-polysomnography in patients with multiple system atrophy, we assessed facial motor activity and chin muscle tone during sleep in multiple system atrophy compared to Parkinson's disease and controls.</p><p><strong>Methods: </strong>A sleep expert blinded to pathology and sleep stage retrospectively analyzed facial activity in 62 video-polysomnography (11 multiple system atrophy, 38 Parkinson's disease, and 13 controls). Facial movements were classified into six categories: \"Eyes closing/opening,\" \"Eyebrows frowning,\" \"Raising eyebrows,\" \"Smiling,\" \"Other mouth movements,\" and \"Strained face,\" an expression involving both the superior and inferior parts of the face. Chin electromyography activity was quantified during Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep using the atonia index, a validated algorithm.</p><p><strong>Results: </strong>Multiple system atrophy patients had an increased number of all facial movements compared to controls during NREM. \"Strained face\" was significantly more frequent in multiple system atrophy compared to Parkinson's disease, even after adjusting for the presence of REM sleep behavior disorder (RBD). Atonia index was lower in multiple system atrophy compared to controls and Parkinson's disease during REM and NREM sleep. This difference remained significant compared to Parkinson's disease in NREM sleep during N1 and N2 after adjusting for the presence of RBD.</p><p><strong>Conclusions: </strong>Facial movements during sleep are frequent in multiple system atrophy, \"strained face\" appears to be a hallmark of this condition. The presence of increased facial activity and elevated muscle tone during all stages of sleep in multiple system atrophy may be a manifestation of sleep state dissociation, reflecting more severe neurodegeneration.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822007","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 unrefreshing naps associated with nocturnal sleep architecture specificities in idiopathic hypersomnia?","authors":"Samantha Mombelli, Anne-Sophie Deshaies-Rugama, Hélène Blais, Zoran Sekerovic, Cynthia Thompson, Alex Desautels, Jacques Montplaisir, Milan Nigam, Julie Carrier, Nadia Gosselin","doi":"10.1093/sleep/zsad175","DOIUrl":"10.1093/sleep/zsad175","url":null,"abstract":"<p><strong>Study objectives: </strong>Unrefreshing naps are supportive clinical features of idiopathic hypersomnia (IH) and are reported by more than 50% of IH patients. They are, however, not mandatory for the diagnosis, and their pathophysiological nature is not understood. This study aimed at verifying whether IH patients with and without unrefreshing naps constitute two subtypes of IH based on their demographic/clinical characteristics, and sleep architecture.</p><p><strong>Methods: </strong>One hundred twelve IH patients underwent a polysomnography (PSG) followed by a multiple sleep latency test (MSLT). They completed questionnaires on excessive daytime sleepiness, mood, and sleep quality. They were met by sleep medicine physicians who conducted a semi-structured clinical interview and questioned them on refreshing aspects of their naps. Patients who reported unrefreshing naps were compared to patients reporting refreshing naps on questionnaires, MSLT and PSG variables, with age as a covariable. As sensitivity analyses, we performed the same comparisons in participants presenting objective markers of IH and those diagnosed with IH based only on clinical judgment (subjective IH), separately.</p><p><strong>Results: </strong>In the whole sample, 61% of patients reported unrefreshing naps. These participants had less awakenings, a lower percentage of N1 sleep, less sleep stage transitions, and a higher percentage of REM sleep on the nighttime PSG compared to the refreshing naps subgroup. When subjective and objective IH patients were tested separately, more group differences were observed on PSG for subjective IH patients.</p><p><strong>Conclusions: </strong>Patients with unrefreshing naps have less fragmented sleep compared to those with refreshing naps. Future studies should investigate whether this group difference indicates a weaker arousal drive.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9718684","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":"Myopia and sleep in children-a systematic review.","authors":"Xiao Nicole Liu, Thomas John Naduvilath, Padmaja R Sankaridurg","doi":"10.1093/sleep/zsad162","DOIUrl":"10.1093/sleep/zsad162","url":null,"abstract":"<p><p>Worldwide, approximately one in three people are myopic or short-sighted. Myopia in children is of particular concern as younger onset age implies a higher risk of progression, and consequently greater risk of developing vision-threatening complications. The importance of sleep in children's health has long been acknowledged, but evidence for its role in childhood myopia is fairly new and mixed results were presented across studies. To facilitate better understanding of this relationship, a broad literature search, up to and including October 31, 2022, was performed using three databases (PubMed, Embase, and Scopus). Seventeen studies were included in the review, covering four main aspects of sleep, namely duration, quality, timing, and efficiency, and their associations with myopia in children. The present literature review discussed these studies, revealed potential limitations in their methodologies, and identified gaps that need to be addressed in the future. The review also acknowledges that current evidence is insufficient, and the role of sleep in childhood myopia is far from being fully understood. Future studies that primarily, objectively, and accurately assess sleep and myopia, taking other characteristics of sleep beyond duration into consideration, with a more diverse sample in terms of age, ethnicity, and cultural/environmental background, and control for confounders such as light exposure and education load are much needed. Although more research is required, myopia management should be a holistic approach and the inclusion of sleep hygiene in myopia education targeting children and parents ought to be encouraged.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10639155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9693791","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}