Journal of Clinical Sleep Medicine最新文献

{"title":"Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review.","authors":"Elaine S Barry, Levita D'Souza","doi":"10.5664/jcsm.11164","DOIUrl":"10.5664/jcsm.11164","url":null,"abstract":"<p><strong>Study objectives: </strong>Maternal depressive symptoms (MDS) affect most women during the first year postpartum. Mothers provide most of the nighttime care for infants, so studying the relationship between MDS and infant sleep location (ISL) is highly relevant to understanding maternal mental health over the first year of life and beyond. Infant sleep is studied by anthropologists, health care providers, and psychologists, with very little communication across disciplines. This review aimed to determine whether there is a predictive relationship between MDS and ISL.</p><p><strong>Methods: </strong>This systematic review searched 6 databases with terms related to maternal mood and ISL. Final analysis included 14 published studies, analyzed with narrative synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies directly compared ISL and MDS.</p><p><strong>Results: </strong>Five studies showed no relationship between ISL and MDS, and 1 study found bedsharing reduced MDS. Five studies found cosleeping was related to higher MDS although directionality is mixed or missing, and 3 studies found an association at some ages or for some populations only. Examining studies according to type of infant sleep assessment, study design, age of infant, or breastfeeding status failed to detect consistent patterns.</p><p><strong>Conclusions: </strong>A variety of study designs, types and definitions of variable measures, sample recruitment, and study outcomes prevent detection of a consistent relationship between MDS and ISL. We explore reasons for the elusive nature of a relationship and make recommendations for future research in MDS and ISL, including crossdisciplinary collaborations.</p><p><strong>Citation: </strong>Barry ES, D'Souza L. Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review. <i>J Clin Sleep Med</i>. 2024;20(9):1517-1533.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device-related outcomes following hypoglossal nerve stimulator implantation.","authors":"Annie E Moroco, Zhikui Wei, Israel Byrd, Andrea Rasmussen, Eugene G Chio, Ryan J Soose, Phillip Huyett, Armin Steffen, Clemens Heiser, Maurits S Boon, Colin T Huntley","doi":"10.5664/jcsm.11176","DOIUrl":"10.5664/jcsm.11176","url":null,"abstract":"<p><strong>Study objectives: </strong>Hypoglossal nerve stimulation (HGNS) has been widely used to treat obstructive sleep apnea in selected patients. Here we evaluate rates of revision and explant related to HGNS implantation and assess types of adverse events contributing to revision and explant.</p><p><strong>Methods: </strong>Postmarket surveillance data for HGNS implanted between January 1, 2018 and March 31, 2022, were collected. Event rates and risk were calculated using the postmarket surveillance event counts and sales volume over the same period. Indications were categorized for analysis. Descriptive statistics were reported and freedom from explant or revision curves were grouped by year of implantation.</p><p><strong>Results: </strong>Of the 20,881 HGNS implants assessed, rates of explant and revision within the first year were 0.723% and 1.542%, respectively. The most common indication for explant was infection (0.378%) and for revision was surgical correction (0.680%). Of the 5,820 devices with 3-year postimplantation data, the rate of explant was 2.680% and of revision was 3.557%. During this same interval, elective removal (1.478%) was the most common indication, and for revisions, surgical correction (1.134%).</p><p><strong>Conclusions: </strong>The efficacy of HGNS is comparable in the real world setting to published clinical trial data. Rates of explant and revision are low, supporting a satisfactory safety profile for this technology.</p><p><strong>Citation: </strong>Moroco AE, Wei Z, Byrd I, et al. Device-related outcomes following hypoglossal nerve stimulator implantation. <i>J Clin Sleep Med</i>. 2024;20(9):1497-1503.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic insights from sleep endoscopy related to oronasal mask failures: a case report.","authors":"Tice R Harkins, Everett Seay, Alan R Schwartz, Eric Thuler, Raj C Dedhia","doi":"10.5664/jcsm.11214","DOIUrl":"10.5664/jcsm.11214","url":null,"abstract":"<p><p>A 71-year-old male with severe obstructive sleep apnea and nasal septal deviation presented to a positive airway pressure (PAP) alternatives clinic due to persistent obstructive events on both continuous PAP and bilevel PAP therapy delivered via oronasal mask. He underwent drug-induced sleep endoscopy with PAP titration to determine the mechanism of oronasal mask failure. A nasal mask was also applied and titrated for comparison. Drug-induced sleep endoscopy with PAP showed tongue base collapse which resolved at low pressure using a nasal mask. Application of an oronasal mask increased minimum therapeutic PAP level. Tightening the mask worsened tongue base collapse, which was not resolved by increasing the PAP level. Following nasal surgery, the patient was able to tolerate nasal continuous PAP at low therapeutic pressure, which resulted in both objective and self-reported improvement is his obstructive sleep apnea. This case highlights the ability of drug-induced sleep endoscopy with PAP to determine the mechanistic cause of oronasal mask failure.</p><p><strong>Citation: </strong>Harkins TR, Seay E, Schwartz AR, Thuler E, Dedhia RC. Mechanistic insights from sleep endoscopy related to oronasal mask failures: a case report. <i>J Clin Sleep Med</i>. 2024;20(9):1551-1554.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational video demonstrating collapsibility of the upper airway during sleep improves initial acceptance of CPAP in patients with severe obstructive sleep apnea: a retrospective study.","authors":"Charikleia Tselepi, Georgios Tsirves, Konstantinos Exarchos, Christos Chronis, Christos Kyriakopoulos, Konstantinos Tatsis, Konstantinos Kostikas, Athanasios Konstantinidis","doi":"10.5664/jcsm.11166","DOIUrl":"10.5664/jcsm.11166","url":null,"abstract":"<p><strong>Study objectives: </strong>We investigated whether an audiovisual educational video demonstrating collapsibility of the upper airway during sleep would influence initial continuous positive airway pressure (CPAP) acceptance among patients with severe obstructive sleep apnea.</p><p><strong>Methods: </strong>Between January 2017 and December 2018, a single-center retrospective study was conducted. We implemented an educational video demonstrating upper airway collapsibility during sleep in February 2018. We analyzed the medical records from 145 consecutive patients diagnosed with severe obstructive sleep apnea who underwent in-laboratory polysomnography both before and after implementing the educational video. Among them, 76 patients received standard care before the video's introduction (standard care group), and another 69 patients were managed after its implementation (video group).</p><p><strong>Results: </strong>Baseline characteristics including age, body mass index, educational level, occupation category, comorbidities, Mallampati score, Epworth Sleepiness Scale score, apnea-hypopnea index, and sleep time with SpO₂ below 90% were not significantly different between the 2 groups. Acceptance of CPAP following an in-laboratory overnight titration study was significantly higher in the video group (80%) than in the standard care group (57%) (<i>P</i> = .003). Multivariate regression analyses revealed that watching the video was a strong predictor of initial CPAP acceptance (odds ratio, 4.162; 95% confidence interval, 1.627-10.646; <i>P</i> = .004). Both sleep time with SpO₂ below 90% (odds ratio, 1.020; 95% confidence interval, 1.002-1.038; <i>P</i> = .029) and sleep efficiency (odds ratio, 1.052; 95% confidence interval, 1.023-1.083; <i>P</i> < .001) were weak predictors for initial CPAP acceptance. At 12 months, adherence among those who accepted the CPAP treatment was similar between the 2 groups (78% vs 74%; <i>P</i> = .662). However, within the initial cohorts, a significantly higher proportion of patients in the video group (62%) were using CPAP at 12 months compared with the standard care group (42%) (<i>P</i> = .015).</p><p><strong>Conclusions: </strong>Among patients with severe obstructive sleep apnea, an educational video demonstrating upper airway collapsibility during sleep improved initial CPAP acceptance rates when compared with standard care.</p><p><strong>Citation: </strong>Tselepi C, Tsirves G, Exarchos K, et al. Educational video demonstrating collapsibility of the upper airway during sleep improves initial acceptance of CPAP in patients with severe obstructive sleep apnea: a retrospective study. <i>J Clin Sleep Med.</i> 2024;20(9):1423-1433.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute encephalitis induced Kleine-Levin syndrome with episodic vertical gaze dysfunction during hypersomnia episodes.","authors":"Hui Lv, Xiaoyan Long, Yefan Lv, Jinxia Zhou","doi":"10.5664/jcsm.11242","DOIUrl":"10.5664/jcsm.11242","url":null,"abstract":"<p><p>Kleine-Levin syndrome (KLS) is a rare, recurring sleep disorder that easily ignored. Episodic upward-gaze palsy is an uncommon manifestation observed in patients of KLS, which further complicates this disorder. Although peripheral microbial infection have been recognized as most common triggers for KLS, the underlying pathophysiology of this disorder remains unclear. We reported a unique case of KLS elicited by acute encephalitis, which was confirmed by pleocytosis of cerebrospinal fluid at the early stage. The cerebrospinal fluid returned to normal over time while the attacks continued to recur frequently. Episodic upward-gaze palsy was observed during attacks and clinical symptoms were exacerbated following a subsequent COVID-19 infection. This report presents a classic KLS case with distinctive characteristics, which should facilitate more accurate and earlier diagnosis for clinicians. Furthermore, it provides a new perspective for understanding the pathogenesis of this rare disease.</p><p><strong>Citation: </strong>Lv H, Long X, Lv Y, Zhou J. Acute encephalitis induced Kleine-Levin syndrome with episodic vertical gaze dysfunction during hypersomnia episodes. <i>J Clin Sleep Med</i>. 2024;20(9):1555-1556.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rest-activity rhythm disruption and metabolic health in schizophrenia: a cross-sectional actigraphy study of community-dwelling people living with schizophrenia and nonpsychiatric comparison participants.","authors":"Zanjbeel Mahmood, Arren Ramsey, Neha Kidambi, Alexa Hernandez, Hayden Palmer, Jinyuan Liu, Xin M Tu, Sonia Ancoli-Israel, Atul Malhotra, Stephen Smagula, Ellen E Lee","doi":"10.5664/jcsm.11192","DOIUrl":"10.5664/jcsm.11192","url":null,"abstract":"<p><strong>Study objectives: </strong>People living with schizophrenia (PLWS) have increased physical comorbidities and premature mortality which may be linked to dysregulated rest-activity rhythms (RARs). This study aimed to compare RARs between PLWS and nonpsychiatric comparison participants (NCs) and to examine the relationships of RARs with age, sleep, metabolic, and physical health outcomes and, among PLWS, relationships of RARs with illness-related factors.</p><p><strong>Methods: </strong>The study sample included 26 PLWS and 36 NCs, assessed with wrist-worn actigraphy to compute RAR variables and general sleep variables. Participants completed assessments for clinical symptoms, physical health, sleep quality, medication use, and assays for fasting glycosylated hemoglobin (hemoglobin A1c) levels. We examined group differences in RAR and sleep variables, relationships of RAR variables with metabolic and physical health measures, and, among PLWS, relationships between RAR variables and illness-related measures.</p><p><strong>Results: </strong>PLWS had significantly shorter active periods, lower relative amplitude, and lower mean activity during their most active 10 hours compared to the NCs (Cohen's d = 0.79, 0.58, and 0.62, respectively). PLWS had poorer sleep quality, greater mean percent sleep, less wake after sleep onset, and higher total sleep time variability compared to NCs. PLWS had higher rates of antidepressant, anxiolytic, and antipsychotic medication use compared to NCs, which may have impacted sleep quality and objective sleep measures. Across both groups, more fragmented and variable RARs were associated with higher HbA1c levels (η_p² = .10) and worse physical health (η_p² = .21). Among PLWS, RARs were correlated with total sleep time (<i>r_s</i> = .789, <i>P</i> < .01) and percent sleep (<i>r_s</i> = .509, <i>P</i> < .05), but not with age, sleep quality, or other illness-related factors.</p><p><strong>Conclusions: </strong>RARs provide unique information about sleep and activity for PLWS and have the potential for targeted interventions to improve metabolic health and mortality.</p><p><strong>Citation: </strong>Mahmood Z, Ramsey A, Kidambi N, et al. Rest-activity rhythm disruption and metabolic health in schizophrenia: a cross-sectional actigraphy study of community-dwelling people living with schizophrenia and nonpsychiatric comparison participants. <i>J Clin Sleep Med</i>. 2024;20(9):1505-1516.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era of ambulatory sleep measurement.","authors":"Patricia L Haynes, Ryan Marmis","doi":"10.5664/jcsm.11220","DOIUrl":"10.5664/jcsm.11220","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do weighted blankets improve sleep among children with a history of maltreatment? A randomized controlled crossover trial.","authors":"Anthony B Cifre, Alyssa Vieira, Carter Baker, Annika Myers, Megan E Rech, Jinu Kim, Yuexin Zhang, Candice A Alfano","doi":"10.5664/jcsm.11152","DOIUrl":"10.5664/jcsm.11152","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep disruption is prevalent and persistent among children who experience maltreatment/interpersonal trauma. Weighted blankets have gained popularity in recent years as a potential nonpharmacological intervention for improving sleep in various populations, but their efficacy has not been examined among maltreated children. The current study used a randomized, within-subjects, crossover design to examine whether the use of a weighted blanket improves objective and/or subjective indices of sleep among 30 children, ages 6-15 years (mean = 9.7, standard deviation = 2.9) adopted from foster care.</p><p><strong>Methods: </strong>Participants used a weighted blanket for 2 weeks and their usual (unweighted) blanket for 2 weeks in a counterbalanced order. Sleep outcomes were measured using actigraphy and subjective sleep diaries.</p><p><strong>Results: </strong>No differences in actigraphy-based or subjective estimates of total sleep time, sleep onset latency, wake after sleep onset, or sleep quality ratings were found based on blanket type. Child age, biological sex, timing of participation (school year vs summer months), and maltreatment/trauma history did not impact outcomes.</p><p><strong>Conclusions: </strong>Although we did not find evidence that weighted blankets improve sleep among children with a history of maltreatment/interpersonal trauma, additional well-controlled studies using larger samples of children are needed.</p><p><strong>Citation: </strong>Cifre AB, Vieira A, Baker C, et al. Do weighted blankets improve sleep among children with a history of maltreatment? A randomized controlled crossover trial. <i>J Clin Sleep Med</i>. 2024;20(9):1405-1413.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and optimization of low-sodium oxybate in participants with narcolepsy switching from a high-sodium oxybate: data from the Substitution of Equal Grams of Uninterrupted Xyrem to Xywav study.","authors":"Wayne Macfadden, Eileen B Leary, Douglas S Fuller, M Todd Kirby, Asim Roy","doi":"10.5664/jcsm.11182","DOIUrl":"10.5664/jcsm.11182","url":null,"abstract":"<p><strong>Study objectives: </strong>Low-sodium oxybate (LXB; calcium, magnesium, potassium, and sodium oxybates; Xywav) contains the same active moiety as high-sodium oxybates (SXBs; SXB [Xyrem] and fixed-dose SXB [Lumryz]), with 92% less sodium, and is approved in the United States for treatment of cataplexy or excessive daytime sleepiness in patients 7 years of age and older with narcolepsy, and idiopathic hypersomnia in adults. Patients with narcolepsy have increased cardiovascular risk relative to people without narcolepsy. LXB's lower sodium content is recognized by the United States Food and Drug Administration in the narcolepsy population as clinically meaningful in reducing cardiovascular morbidity compared with SXBs. The Substitution of Equal Grams of Uninterrupted Xyrem to Xywav study (NCT04794491) examined the transition experience of patients with narcolepsy switching from SXB to LXB.</p><p><strong>Methods: </strong>Eligible participants were aged 18-80 years with narcolepsy type 1 or 2 on a stable SXB dose/regimen. After 2 weeks, participants transitioned gram-per-gram to LXB for 6 weeks, with opportunity for subsequent titration. Assessments included the Epworth Sleepiness Scale, Patient Global Impression of change, Ease of Switching Medication Scale, and Forced Preference Questionnaire.</p><p><strong>Results: </strong>The study enrolled 62 participants at baseline; 60 transitioned to LXB and 54 completed the study. At baseline and end of the LXB intervention/early discontinuation, respectively, mean total doses were 8.0 and 8.0 g/night; mean Epworth Sleepiness Scale scores were 9.4 and 8.8. Most participants reported improvement (45%) or no change (48%) in narcolepsy symptoms on the Patient Global Impression of change, reported the transition to LXB was \"easy\" (easy, extremely easy, not difficult at all; 93%) on the Ease of Switching Medication Scale, and preferred LXB compared with SXB (79%) on the Forced Preference Questionnaire, most commonly due to the lower sodium content.</p><p><strong>Conclusions: </strong>Most participants switched from SXB to LXB with minimal modifications of dose/regimen and reported the transition process was easy. Effectiveness of oxybate treatment was maintained on LXB, and most participants preferred LXB to SXB. No new safety or tolerability issues were identified.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: An Interventional Safety Switch Study (Segue Study) of XYWAV in Narcolepsy; URL: https://classic.clinicaltrials.gov/ct2/show/NCT04794491; Identifier: NCT04794491.</p><p><strong>Citation: </strong>Macfadden W, Leary EB, Fuller DS, Kirby MT, Roy A. Effectiveness and optimization of low-sodium oxybate in participants with narcolepsy switching from a high-sodium oxybate: data from the Substitution of Equal Grams of Uninterrupted Xyrem to Xywav study. <i>J Clin Sleep Med</i>. 2024;20(9):1467-1477.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and rehabilitation of tongue motor skills with myofunctional therapy in obstructive sleep apnea: a systematic review and meta-analysis.","authors":"William Poncin, Ambre Willemsens, Lucile Gely, Olivier Contal","doi":"10.5664/jcsm.11074","DOIUrl":"10.5664/jcsm.11074","url":null,"abstract":"<p><strong>Study objectives: </strong>The first objective of this study was to compare tongue motor skills between patients with obstructive sleep apnea (OSA) and healthy participants. Second, the effect of oropharyngeal myofunctional therapy (MFT) on the tongue muscular qualities of patients with OSA was evaluated.</p><p><strong>Methods: </strong>Searches were conducted in 5 electronic databases up to July 2023. Risk of bias was assessed via the Joanna Briggs Institute appraisal checklist for cross-sectional studies (aim number 1) and the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials (aim number 2). Pooled standardized mean differences and 95% confidence intervals were calculated using a random-effects model.</p><p><strong>Results: </strong>Thirteen studies including 520 adults and one study including 92 children addressed aim number 1. Compared to healthy adults, individuals with OSA had no significant difference in tongue protrusion strength (9 studies, n = 366; standardized mean difference [95% confidence interval], -0.00 [-0.45, 0.44]) or endurance (5 studies, n = 125; 0.31 [-0.26, 0.88]) but presented a lower tongue elevation strength (6 studies, n = 243; 1.00 [0.47, 1.53]) and elevation endurance (3 studies, n = 98; 0.52 [0.11, 0.94]). In children, tongue elevation strength was lower but elevation endurance was higher in those with OSA than in healthy children. Two randomized controlled trials (28 adults, 54 children) addressed aim number 2 and were of poor methodological quality. In these studies, myofunctional therapy improved tongue motor skills in patients with OSA.</p><p><strong>Conclusions: </strong>Tongue elevation motor skills are decreased in adults with OSA, whereas tongue protrusion motor skills seem preserved. Very few data are available in children. There are also too few data about the impact of myofunctional therapy on tongue motor skills.</p><p><strong>Citation: </strong>Poncin W, Willemsens A, Gely L, Contal O. Assessment and rehabilitation of tongue motor skills with myofunctional therapy in obstructive sleep apnea: a systematic review and meta-analysis. <i>J Clin Sleep Med</i>. 2024;20(9):1535-1549.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}