Journal of Clinical Sleep Medicine最新文献

{"title":"Sleep efficiency in community-dwelling persons living with dementia: exploratory analysis using machine learning.","authors":"Ji Yeon Lee, Eunjin Yang, Ae Young Cho, YeonKyu Choi, SungHee Lee, Kyung Hee Lee","doi":"10.5664/jcsm.11436","DOIUrl":"10.5664/jcsm.11436","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep disturbances lead to negative health outcomes and caregiver burden, particularly in community settings. This study aimed to investigate a predictive model for sleep efficiency and its associated features in older adults living with dementia in their own homes.</p><p><strong>Methods: </strong>This was an exploratory, observational study. A total of 69 older adults diagnosed with dementia were included in this study. Data were collected via actigraphy for sleep and physical activity for 14 days, a sweat patch for cytokines for 2-3 days, and a survey of diseases, medications, psychological and behavioral symptoms, functional status, and demographics at baseline. Using 730 days of actigraphy, sweat patches, and baseline data, the best prediction model for sleep efficiency was selected and further investigated to explore its associated top 10 features using machine learning analysis.</p><p><strong>Results: </strong>The CatBoost model was selected as the best predictive model for sleep efficiency. In order of importance, the most important features were sleep regularity, number of medications, dementia medication, daytime activity count, instrumental activities of daily living, neuropsychiatric inventory, hypnotics, occupation, tumor necrosis factor-alpha, and waking hour lux.</p><p><strong>Conclusions: </strong>This study established the best sleep efficiency predictive model among community-dwelling older adults with dementia and its associated features using machine learning and various sources, such as the Internet of Things. This study highlights the importance of individualized sleep interventions for community-dwelling older adults with dementia based on associated features.</p><p><strong>Citation: </strong>Lee JY, Yang E, Cho AY, Choi Y, Lee S, Lee KH. Sleep efficiency in community-dwelling persons living with dementia: exploratory analysis using machine learning. <i>J Clin Sleep Med</i>. 2025;21(2):393-400.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"393-400"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559281","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":"Cognitive behavioral therapy for insomnia access and engagement considerations: if we build it, will they access?","authors":"Aaron M Martin, Christina S McCrae","doi":"10.5664/jcsm.11506","DOIUrl":"10.5664/jcsm.11506","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"223-225"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774450","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":"Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia.","authors":"Yoichiro Takei, Hideaki Nakayama, Yuichi Inoue","doi":"10.5664/jcsm.11434","DOIUrl":"10.5664/jcsm.11434","url":null,"abstract":"<p><strong>Study objectives: </strong>Catathrenia has been classified as a sleep-related breathing disorder variant in the third edition of the <i>International Classification of Sleep Disorders</i>, but its validity remains unverified. We analyzed the clinical descriptive variables and polysomnographic findings of catathrenia and discussed the similarities to and differences from those of obstructive sleep apnea, non-rapid eye movement parasomnias, and sleep bruxism (SB).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 47 patients diagnosed with nocturnal groaning through polysomnography. We examined sex, body mass index, age at symptom onset, weekly symptom frequency, and presence/absence of comorbidities, including obstructive sleep apnea, periodic limb movement disorder, non-rapid eye movement parasomnia, and SB. The groaning event index was calculated according to sleep position and sleep stage.</p><p><strong>Results: </strong>The distribution of patients with catathrenia did not show sex differences (male/female = 20:27), body mass index was 20.6 ± 3.0 kg/m², and age of onset was 18.2 ± 7.4 years. The groaning event index was higher in stages N1 and R than in stage N3 and in the supine position than in the lateral position. There were no cases complicated with non-rapid eye movement parasomnia, but the complication of SB was observed in 30% of the participants, and SB events appeared immediately before or during the interictal period of the groaning event episodes in these cases.</p><p><strong>Conclusions: </strong>Given the clinical background, posture- and sleep stage-dependent appearance of groaning events, and the relatively high complication rate of SB, catathrenia pathogenesis may be heterogeneous or comprise elements of different sleep disorders.</p><p><strong>Citation: </strong>Takei Y, Nakayama H, Inoue Y. Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia. <i>J Clin Sleep Med.</i> 2025;21(2):377-381.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"377-381"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479575","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":"Sleep disturbances are associated with multiple definitions of long COVID.","authors":"Stuart F Quan, Matthew D Weaver, Mark É Czeisler, Lauren A Booker, Melinda L Jackson, Rebecca Robbins, Mark E Howard, Prerna Varma, Shantha M W Rajaratnam","doi":"10.5664/jcsm.11448","DOIUrl":"10.5664/jcsm.11448","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"445-446"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512088","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":"Multicenter comparative study of polysomnography outcomes in children with the monogenic disorder sickle cell disease.","authors":"Ammar Saadoon Alishlash, Anis Rabbani Nourani, Jeffrey Lebensburger, Jennifer A Rothman, Tarig Ali-Dinar, Dima Ezmigna","doi":"10.5664/jcsm.11372","DOIUrl":"10.5664/jcsm.11372","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep-disordered breathing is prevalent in children with sickle cell disease (SCD) and is associated with worse outcomes. This study aimed to compare the outcomes of polysomnography (PSG) performed for pediatric patients with SCD at 3 US centers.</p><p><strong>Methods: </strong>We included patients with SCD aged 0-21 years who underwent PSG at 3 American Academy of Sleep Medicine-accredited centers, the University of Alabama at Birmingham, the University of Florida, and Duke University Hospital, between 2012 and 2022. Descriptive statistics were used as appropriate to compare the baseline characters and PSG outcomes among the different centers.</p><p><strong>Results: </strong>A total of 210 children with SCD from the 3 centers were included, with comparable sex, SCD genotypes, hemoglobin, hematocrit levels, and chronic transfusion. Children from the different centers exhibited variations in age (<i>P</i> < .001), body mass index (<i>P</i> < .05), mean corpuscular volume (<i>P</i> < .05), and hydroxyurea usage (<i>P</i> < .05) at the time of the PSG. Overall, the 3 centers showed significantly different PSG outcomes. Patients from the University of Florida had worse obstructive sleep apnea, oxygenation, and periodic leg movement events, together with lower hydroxyurea usage, and those from Duke University Hospital showed higher hypoventilation and arousal indices.</p><p><strong>Conclusions: </strong>This multicenter study underscores variations in PSG outcomes among pediatric SCD patients at different centers in the southeastern United States. These findings emphasize the need for standardized approaches to screen for sleep-disordered breathing, refer to PSG, and interpret the results in children with SCD. These conclusions may apply to other genetic disorders associated with an increased risk of sleep-disordered breathing.</p><p><strong>Citation: </strong>Alishlash AS, Nourani AR, Lebensburger J, Rothman JA, Ali-Dinar T, Ezmigna D. Multicenter comparative study of polysomnography outcomes in children with the monogenic disorder sickle cell disease. <i>J Clin Sleep Med.</i> 2025;21(2):297-304.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"297-304"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331550","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":"Optimizing wearable single-channel electroencephalography sleep staging in a heterogeneous sleep-disordered population using transfer learning.","authors":"Jaap F van der Aar, Merel M van Gilst, Daan A van den Ende, Pedro Fonseca, Bregje N J van Wetten, Hennie C J P Janssen, Elisabetta Peri, Sebastiaan Overeem","doi":"10.5664/jcsm.11380","DOIUrl":"10.5664/jcsm.11380","url":null,"abstract":"<p><strong>Study objectives: </strong>Although various wearable electroencephalography devices have been developed, performance evaluation of the devices and their associated automated sleep stage classification models is mostly limited to healthy participants. A major barrier for applying automated wearable electroencephalography sleep staging in clinical populations is the need for large-scale data for model training. We therefore investigated transfer learning as a strategy to overcome limited data availability and optimize automated single-channel electroencephalography sleep staging in people with sleep disorders.</p><p><strong>Methods: </strong>We acquired 52 single-channel frontopolar headband electroencephalography recordings from a heterogeneous sleep-disordered population with concurrent polysomnography (PSG). We compared 3 model training strategies: \"pretraining\" (ie, training on a larger dataset of 901 conventional PSGs), \"training-from-scratch\" (ie, training on wearable headband recordings), and \"fine-tuning\" (ie, training on conventional PSGs, followed by training on headband recordings). Performance was evaluated on all headband recordings using 10-fold cross-validation.</p><p><strong>Results: </strong>Highest performance for 5-stage classification was achieved with fine-tuning (κ = .778), significantly higher than with pretraining (κ = .769) and with training-from-scratch (κ = .733). No significant differences or systematic biases were observed with clinically relevant sleep parameters derived from PSG. All sleep disorder categories showed comparable performance.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of leveraging larger available datasets through deep transfer learning to optimize performance with limited data availability. Findings indicate strong similarity in data characteristics between conventional PSG and headband recordings. Altogether, results suggest the combination of the headband, classification model, and training methodology can be viable for sleep monitoring in the heterogeneous clinical population.</p><p><strong>Citation: </strong>van der Aar JF, van Gilst MM, van den Ende DA, et al. Optimizing wearable single-channel electroencephalography sleep staging in a heterogeneous sleep-disordered population using transfer learning. <i>J Clin Sleep Med.</i> 2025;21(2):315-323.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"315-323"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331551","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":"Transient radiation-induced severe obstructive sleep apnea.","authors":"Vinicius M Palma, Pedro O T Silva, Gilberto G S Formigoni, Luiz U Sennes, Michel B Cahali","doi":"10.5664/jcsm.11382","DOIUrl":"10.5664/jcsm.11382","url":null,"abstract":"<p><p>Radiotherapy for head and neck cancer can trigger or worsen obstructive sleep apnea (OSA) due to factors such as neurological impairment, muscle atrophy, edema, and xerostomia. We present a case in which a patient developed severe OSA 3 months after undergoing radiochemotherapy and neck dissection for squamous cell carcinoma of the right lingual tonsil with regional metastasis. Polysomnography confirmed severe OSA. Unfortunately, the patient did not adhere to the recommended treatment. The symptoms persisted for 6 months but then, unexpectedly, resolved completely. A follow-up polysomnography conducted 1 year after radiotherapy showed no evidence of OSA. This case suggests that a recent diagnosis of OSA following head and neck radiotherapy may not be permanent and should not necessarily lead to a lifelong prognosis of sleep-related breathing disorders.</p><p><strong>Citation: </strong>Palma VM, Silva POT, Formigoni GGS, Sennes LU, Cahali MB. Transient radiation-induced severe obstructive sleep apnea. <i>J Clin Sleep Med</i>. 2025;21(2):427-429.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"427-429"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331480","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":"The effect of botulinum toxin in the masticatory and constrictor musculature of the pharynx as an option in the treatment of obstructive sleep apnea: a case report.","authors":"Ana Carolina Xavier Ottoline, Alonço da Cunha Viana, Debora Petrungaro Migueis","doi":"10.5664/jcsm.11400","DOIUrl":"10.5664/jcsm.11400","url":null,"abstract":"<p><p>The botulinum toxin (BT) is United States Food and Drug Administration-approved for therapeutic applications in different medical conditions. However, BT is not considered an obstructive sleep apnea therapy. Obstructive sleep apnea is characterized by recurrent airway collapse during sleep, leading to intermittent hypoxia, hypercapnia, and arousal. The application of BT in pharyngeal and masticatory musculature can reduce its constrictive activity, attenuating the obstructions. We present the first case report of a 38-year-old man with severe obstructive sleep apnea syndrome who underwent a BT infiltration in palatoglossal, stylohyoid, and masseter muscles bilaterally to treat obstructive sleep apnea itself. He had significant clinical and polysomnographic improvement during the muscle afferent block by intramuscular injection of BT, without adverse effects.</p><p><strong>Citation: </strong>Ottoline ACX, da Cunha Viana A, Migueis DP. The effect of botulinum toxin in the masticatory and constrictor musculature of the pharynx as an option in the treatment of obstructive sleep apnea: a case report. <i>J Clin Sleep Med</i>. 2025;21(2):431-434.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"431-434"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479580","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":"Prevalence and associations of insomnia after COVID-19 infection.","authors":"Alexandra Kadl, Eric M Davis, Samuel F Oliver, Samuel A Lazoff, John Popovich, Amr A E Atya, Kyle B Enfield, Mark Quigg","doi":"10.5664/jcsm.11420","DOIUrl":"10.5664/jcsm.11420","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep disturbances in \"long COVID\" are common, but the associations between the severity of sleep problems and the severity of COVID infection are unclear. We evaluated the prevalence, persistence, comorbidities, and clinical effects of insomnia following recovery from acute COVID-19 infection in a COVID-specific clinic.</p><p><strong>Methods: </strong>Inpatients discharged after COVID infection and outpatients referred for persistent post-COVID symptoms were surveyed on insomnia severity (Insomnia Severity Index), other neuropsychological symptoms, cardiopulmonary symptoms and physiological functions (6-minute walk distance and others), and functional outcome and quality of life. Multivariable regression models evaluated the severity of Insomnia Severity Index against independent variables.</p><p><strong>Results: </strong>A total of 280 patients met criteria at the initial visit. The prevalence of significant insomnia at the initial visit was 50% and 42% at the subsequent visit (obtained in 78 of the 280 patients). Lower age, female sex, non-White race, and non-Hispanic ethnicity were significantly associated with worse initial Insomnia Severity Index scores. More severe symptoms of anxiety and depression were strong correlates with worse Insomnia Severity Index scores. Interval improvements in insomnia severity correlated with improvements in anxiety and posttraumatic stress disorder scores. Physiological sequelae of infection did not correlate with insomnia at any stage.</p><p><strong>Conclusions: </strong>Initial and persistent insomnia is common in long COVID. Treatment for insomnia with the use of evidence-based approaches (such as cognitive behavioral therapy for insomnia) may best suit this particular post-COVID symptom.</p><p><strong>Citation: </strong>Kadl A, Davis EM, Oliver SF, et al. Prevalence and associations of insomnia after COVID-19 infection. <i>J Clin Sleep Med</i>. 2025;21(2):383-391.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"383-391"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479577","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":"Obstructive sleep apnea illness perception relative to other common chronic conditions.","authors":"Tania Zamora, Brandon Nokes, Atul Malhotra, Carl Stepnowsky","doi":"10.5664/jcsm.11360","DOIUrl":"10.5664/jcsm.11360","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is a common chronic medical condition that results in impaired daytime functioning. While the link between OSA and cardiovascular disease is important, there has been increasing recognition of the impact of OSA on daytime functioning and experience. Better insight into illness perceptions can help better understand how to initiate and maintain treatment.</p><p><strong>Methods: </strong>Data from 2 OSA clinical trials were examined. The baseline respiratory event index was obtained from diagnostic sleep testing. The Brief Illness Perception Questionnaire assesses the cognitive and emotional representation of illness and was administered at baseline along with the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index.</p><p><strong>Results: </strong>A total of 523 patients diagnosed with OSA were studied. The sample had a mean age of 51.1 ± 16.6, mean respiratory event index of 28.6 ± 17.9 events/h, and mean body mass index of 32.8 ± 15.5 kg/m². The mean Brief Illness Perception Questionnaire total score at baseline was 43.3 ± 11.3. Brief Illness Perception Questionnaire scores were significantly correlated with sleepiness and sleep quality but not with respiratory event index. Relative to other common chronic conditions with major comorbidities, Brief Illness Perception Questionnaire scores for patients with OSA were higher on consequences, identity, concern, and emotional representation dimensions.</p><p><strong>Conclusions: </strong>The study shows that veterans with OSA report elevated illness perceptions across several dimensions at levels as high, or higher, than other common chronic conditions. Implications for clinical practice are that it is important to ask patients about their understanding of illness across several dimensions to appreciate better patient needs and preferences.</p><p><strong>Citation: </strong>Zamora T, Nokes B, Malhotra A, Stepnowsky C. Obstructive sleep apnea illness perception relative to other common chronic conditions. <i>J Clin Sleep Med</i>. 2025;21(2):229-235.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"229-235"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299875","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}