Journal of Clinical Sleep Medicine最新文献

{"title":"Evaluation of a novel smart mandibular advancement device for nightly monitoring of treatment.","authors":"Anna M Mohammadieh, Benjamin K Tong, Glenn M Stewart, Philip de Chazal, Peter A Cistulli","doi":"10.5664/jcsm.11736","DOIUrl":"https://doi.org/10.5664/jcsm.11736","url":null,"abstract":"<p><strong>Study objectives: </strong>Study Objectives: A current gap in oral appliance therapy, relative to continuous positive airway pressure, in the management of obstructive sleep apnea (OSA) is access to nightly therapy data. The aim of this pilot study was to evaluate the performance of a novel intra-oral, multi-sensory array embedded within a mandibular advancement device (MAD).</p><p><strong>Methods: </strong>Patients established on MAD therapy for OSA underwent two level 2 diagnostic polysomnography (PSG) studies with the smart MAD (sMAD) in situ, under zero protrusion (control) and usual mandibular protrusion (treatment) conditions. The studies occurred within two weeks of one another, and the sequence of studies was randomly allocated. The agreement between sMAD and PSG was assessed using apnea-hypopnea index (AHI), total sleep time (TST), and sleep position. An additional aim was to assess the ability of the device to detect the change in AHI across the two conditions (control vs treatment).</p><p><strong>Results: </strong>Overall, there was a high level of agreement between sMAD and PSG in the treatment condition with regards to the AHI (r = 0.81, p<0.001). Both PSG and sMAD detected a significant change in AHI associated with mandibular advancement in the treatment condition relative to control, and this change was not significantly different between the two (-12.7 ± 13.8 vs -6.9 ± 8.5 events/h for PSG and sMAD respectively, p=0.1). There was a high level of agreement for total sleep time in the combined control and treatment groups (r = 0.80, p<0.001). Sleep position showed high concordance in the lateral position (98%), but supine sleep showed moderate concordance (64%) related to differences in position monitoring between sMAD and PSG (ie. head vs torso).</p><p><strong>Conclusions: </strong>This pilot study demonstrates the feasibility of estimating clinically relevant therapy data with high accuracy from a sensor system within a MAD. The ability to provide clinicians with relevant sleep metrics including AHI, TST, compliance, sleep position and response to MAD therapy on a nightly basis has the potential to enhance clinical uptake of MAD therapy. Further research is required to validate these results in a larger sample over a longer term.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you Zzz during pregnancy? A brief review of Z-drug use and management of insomnia during pregnancy.","authors":"Xinhang Tu, Mithri R Junna, Bhanu Prakash Kolla","doi":"10.5664/jcsm.11740","DOIUrl":"https://doi.org/10.5664/jcsm.11740","url":null,"abstract":"<p><p>Sleep disturbance is highly prevalent during pregnancy, and there are no guidelines clearly appraising pharmacological treatment for insomnia during pregnancy. Furthermore, the data on the efficacy and safety of non-benzodiazepine benzodiazepine receptor agonists in pregnant patients are inconclusive. We present a case of insomnia during pregnancy that was managed with doxylamine and zolpidem and discuss the current evidence examining the efficacy and potential adverse effects of treatment with a focus on the non-benzodiazepine benzodiazepine receptor agonists in the management of insomnia during pregnancy.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of advancement treatments of the stomatognathic system on objective sleepiness in OSA: a systematic review.","authors":"Paul Galvez, Emmanuel d'Incau, Jacques Taillard, Vincent P Martin, Maria Clotilde Carra, Mathilde Fenelon, Virginie Chuy, Julien Coelho, Pierre Philip, Jean-Arthur Micoulaud-Franchi","doi":"10.5664/jcsm.11730","DOIUrl":"https://doi.org/10.5664/jcsm.11730","url":null,"abstract":"<p><strong>Study objectives: </strong>Objective sleepiness is an important outcome requiring rigorous evaluation regarding OSA treatment efficacy, but no systematic review has explored the efficacy of advancement treatments of the stomatognathic system (ATSS), i.e. mandibular advancement device (MAD), hypoglossal nerve stimulation (HNS), and maxillomandibular advancement surgery (MMA), on objective sleepiness in OSA.</p><p><strong>Methods: </strong>We conducted a systematic review of the literature using PubMed, Scopus and Web of Science databases. All clinical studies assessing the efficacy of ATSS on objective sleepiness in adults with OSA, by the maintenance of wakefulness test (MWT), the multiple sleep latency test (MSLT), the Oxford sleep resistance test (OSLER), the psychomotor vigilance task (PVT) or the sustained attention to response task (SART), were included.</p><p><strong>Results: </strong>Among 42 screened studies, 11 were included - 6 randomized controlled trials (RCTs) and 5 prospective studies. Regarding the RCTs, all assessed MAD efficacy and only one RCT found a significant improvement of objective sleepiness for MAD compared with placebo, on the MSLT. In the remaining RCTs, the included participants did not present objective sleepiness at baseline and were mostly with mild/moderate OSA. Regarding the prospective studies, all found a significant improvement of objective sleepiness for each treatment assessed, i.e. MAD, HNS, MMA and submental stimulation. Interestingly, the included participants presented objective sleepiness at baseline and moderate/severe OSA.</p><p><strong>Conclusions: </strong>This systematic review highlighted the lack of RCTs assessing the efficacy of MAD or other ATSS on objective sleepiness in OSA. Further RCTs are needed to address this important outcome taking into account baseline objective sleepiness and OSA severity.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of heart rate reduction during sleep onset in participants with and without insomnia.","authors":"Yan Ma, Peter M Wayne, Janet M Mullington, Gloria Y Yeh","doi":"10.5664/jcsm.11714","DOIUrl":"https://doi.org/10.5664/jcsm.11714","url":null,"abstract":"<p><strong>Study objectives: </strong>Hyperarousal is common in patients with insomnia. Autonomic stress may reflect hyperarousal and distinguish participants with insomnia vs good sleepers. Slope analysis of heart rate reduction during sleep onset might be a promising measure of such autonomic modulation. We aim to explore the potential utility of this measure with data collected from home settings from the Sleep Heart Health Study.</p><p><strong>Methods: </strong>In this secondary analysis with 743 participants, we applied two approaches to compute slopes for heart rate reduction during sleep onset. We compared slopes among participants with and without insomnia symptoms, with short versus long sleep onset latency, with or without difficulty falling asleep during the study night, and with sleep-onset insomnia versus other insomnia subtypes. We also explored correlations between heart rate reduction and sleep outcome measures.</p><p><strong>Results: </strong>We found that the slopes of heart rate reduction during sleep onset were most significantly associated with objectively measured sleep onset latency, followed by subjectively reported sleep onset latency, regardless of the approach used to compute the slopes. Participants with self-reported difficulty falling asleep during the study night had significantly blunted heart rate reduction. The slopes were significantly blunted in participants with self-reported sleep-onset insomnia compared to other types of insomnia.</p><p><strong>Conclusions: </strong>As measures of autonomic activity, the slopes of heart rate reduction may serve as a physiological biomarker to indicate hyperarousal during wakefulness before sleep onset. Tracking changes of heart rate reduction during sleep onset may have potential value in the evaluation of insomnia treatments, especially those targeting sleep onset difficulties.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumer sleep technologies that self-screen or self-assess risk for OSA: is subclinical OSA (SCOSA) coming to our clinics?","authors":"Sharon Schutte-Rodin, Steven Holfinger, Ambrose A Chiang, Anuja Bandyopadhyay","doi":"10.5664/jcsm.11738","DOIUrl":"https://doi.org/10.5664/jcsm.11738","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual periodic limb movement index after CPAP therapy is associated with hypoxemia.","authors":"Lourdes M DelRosso, Harshill Modi, Viraj Jain, Itzel Vazquez, Daniel L Picchietti","doi":"10.5664/jcsm.11716","DOIUrl":"https://doi.org/10.5664/jcsm.11716","url":null,"abstract":"<p><strong>Study objectives: </strong>Periodic limb movements during sleep (PLMS) frequently coexist with obstructive sleep apnea (OSA), yet the impact of CPAP treatment on PLMS remains unclear. This study investigates factors associated persistence of periodic limb movement index (PLMI) during CPAP therapy.</p><p><strong>Methods: </strong>A retrospective cross-sectional study analyzed data from 107 adult patients who underwent split polysomnographic studies. Participants were classified into four groups based on PLMI changes: normal PLMI throughout (Group 1), persistent elevated PLMI (Group 2), worsened PLMI (Group 3), and resolved PLMI (Group 4). Predictors of PLMI persistence, including sleep architecture, oxygen desaturation, age, and BMI, were assessed using logistic regression analysis.</p><p><strong>Results: </strong>36.1% of patients experienced resolution of elevated PLMI, 16.4% showed worsening, and 47.5% had persistent PLMI despite CPAP therapy. Logistic regression analysis revealed that male sex (OR = 5.38, 95% CI [1.64-17.61], <i>p</i> = 0.005), higher BMI (OR = 1.09, 95% CI [1.01-1.17], <i>p</i> = 0.018), and greater time spent with oxygen saturation ≤88% during the diagnostic portion (OR = 1.034, 95% CI [1.002-1.066], <i>p</i> = 0.035) were significant predictors of residual PLMI. Sleep architecture variables such as total sleep time, sleep efficiency, and sleep stage distribution were not independently associated with residual PLMI.</p><p><strong>Conclusions: </strong>Residual periodic limb movements during CPAP therapy are common and are independently associated with male sex, higher BMI, and greater hypoxemia during the diagnostic portion of sleep.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregivers' outcome prioritization for home positive airway pressure in children: a mixed-methods study.","authors":"Vanessa C Dannenberg, Daniel Ofosu, Ella Milne, Deborah L Olmstead, Mathieu Chalifour, Shannon Scott, Maria L Castro-Codesal","doi":"10.5664/jcsm.11708","DOIUrl":"https://doi.org/10.5664/jcsm.11708","url":null,"abstract":"<p><strong>Study objectives: </strong>To determine caregiver-reported priorities regarding the benefits, challenges, and further insights on home positive airway pressure (PAP) for children.</p><p><strong>Methods: </strong>Mixed-method study analyzing responses to an online survey by parents/caregivers of children (<18 years) using home PAP for at least 3 months. A semi-structured anonymous survey with multiple-choice and open-ended questions was conducted asking for caregivers PAP outcome priorities and their opinion on what should be research priorities. Descriptive analysis summarized caregivers' and children's demographics, and responses to multiple-choice questions. Thematic analysis was used to synthesize the qualitative data.</p><p><strong>Results: </strong>Seventy-three caregivers completed the survey, 82% were mothers. Over 90% of them considered improved sleep, rest, daytime energy levels, and breathing during sleep as very important/important benefits of PAP. Children becoming dependent on PAP to sleep was reported as very important/important challenge by 76% of caregivers. Among the research priorities, improvement in breathing during sleep (77%) and reduction in the frequency of respiratory illness (73%) were the preferred PAP benefits. Mask-related issues (72%) and the child becoming dependent on PAP (57%) were considered priority challenges to research. Four themes emerged from open-ended questions: 1) better nights and days, 2) adapting to home PAP, 3) finding the right mask, and 4) the importance of a team approach.</p><p><strong>Conclusions: </strong>Caregiver's priorities regarding PAP included known respiratory benefits of this therapy, such as improved breathing, but also less reported non-respiratory outcomes, which reflected in benefits for the entire family. Potential challenges of PAP requiring further research should focus on mask-related issues.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health advisory: infant sleep safety in childcare settings.","authors":"Amy Licis, Jocelyn Y Cheng, Tammy Wong, Muhammad Adeel Rishi","doi":"10.5664/jcsm.11724","DOIUrl":"https://doi.org/10.5664/jcsm.11724","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do children living with a chronic disease have more disturbed sleep than their healthy peers?","authors":"Cecilie Paulsrud, Steffen U Thorsen, Pernille Helms, Mia Sofie F Weis, Ajenthen G Ranjan, Poul J Jennum, Nanette Mol Debes, Jannet Svensson","doi":"10.5664/jcsm.11686","DOIUrl":"https://doi.org/10.5664/jcsm.11686","url":null,"abstract":"<p><strong>Study objectives: </strong>Living with a chronic disease (LCD) may impact sleep in children. We aimed to compare sleep in children LCD and healthy peers.</p><p><strong>Methods: </strong>Design: Prospective study. Children and adolescents aged 6-17 years old answered the Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) twice and wore actigraphy (AG) for seven nights and at-home polysomnography (PSG) for one night. Statistics: Unpaired two-sampled t-tests and correlation tests.</p><p><strong>Results: </strong>We included 65 LCD and 63 healthy age-matched children. Compared to the healthy peers, the 6-12-year-olds LCD showed a clear tendency towards shorter total sleep time (TST): AG:16.1 min, [95% CI -0.3; 32.6], SSQ-CA: 19.9 min [-0.7-40.5], later chronotype and chronotype score: AG: 00:25, [-00:07; 00:57] and significantly longer objectively measured sleep latency (p=0.02). Except for a higher sleep and feeling safe subscale score, no major differences in either SSQ-CA or AG measures were seen between the adolescent groups (13-17-year-olds). In children with type 1 diabetes, inverse correlations between TST and glycated hemoglobin (HbA1c) (AG: r=-0.49, p=0.01; SSQ-CA: r=-0.40, p=0.01) were evident. Further, in children with tension-type headache, a strong inverse correlation between TST and monthly headache attacks (AG: r=-0.79, p=0.04) was also found.</p><p><strong>Conclusions: </strong>Children LCD present more sleep disturbances than healthy peers, especially in the 6-12-year-olds. Sleep evaluation should be considered as part of the clinical evaluation.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between sleep apnea and dizziness: a scoping review.","authors":"Eunjin Kim, Dahee Wi, Yoonjung Kim, Jiae Lee","doi":"10.5664/jcsm.11710","DOIUrl":"https://doi.org/10.5664/jcsm.11710","url":null,"abstract":"<p><strong>Study objectives: </strong>Dizziness in people with sleep apnea remains relatively underrecognized, despite accumulating evidence of this relationship from recent studies. This scoping review aimed to summarize evidence from existing research on the relationship between sleep apnea and dizziness.</p><p><strong>Methods: </strong>We used Arksey and O'Malley's five-stage framework to structure and guide this scoping review. We searched the Embase, PubMed, CINAHL, and Cochrane Library databases, along with a hand search.</p><p><strong>Results: </strong>A total of 21 studies were finally included in this scoping review. Studies encompassed case reports, cross-sectional studies, retrospective cohort studies, and quasi-experimental studies. This review identified both a higher incidence of dizziness among people with sleep apnea and a greater prevalence of sleep apnea among people with dizziness, compared with their healthy counterparts. Additionally, across the majority of included studies, significant associations were found between the degree of dizziness and sleep apnea or its related parameters. Studies consistently reported that continuous positive airway pressure treatment led to either complete or partial resolution of dizziness in people with sleep apnea.</p><p><strong>Conclusions: </strong>Overall, evidence from existing articles collectively indicates that sleep apnea is related to dizziness. However, many of the included studies were limited by their cross-sectional design and relatively small sample size. This scoping review suggests that it may be beneficial to consider the potential relationship between sleep apnea and dizziness while evaluating patients. Further research is needed to validate a causal effect of sleep apnea on dizziness.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}