Journal of Clinical Sleep Medicine最新文献

{"title":"Spinal stenosis as a rare cause of central sleep apnea: a case report.","authors":"Albatol N Rashed, Nora Bedaiwi","doi":"10.5664/jcsm.11726","DOIUrl":"10.5664/jcsm.11726","url":null,"abstract":"<p><p>In this case report we present a rare cause of central sleep apnea secondary to severe cervical stenosis in a young male after excluding all the possible causes of central sleep apnea.</p><p><strong>Citation: </strong>Rashed AN, Bedaiwi N. Spinal stenosis as a rare cause of central sleep apnea: a case report. <i>J Clin Sleep Med</i>. 2025;21(9):1643-1647.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1643-1647"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058850","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":"Integrative treatment of obstructive sleep apnea: principles and practice.","authors":"G Dave Singh, Jamila Battle","doi":"10.5664/jcsm.11694","DOIUrl":"10.5664/jcsm.11694","url":null,"abstract":"<p><p>In the management of obstructive sleep apnea, the integrative concept of care is gathering momentum. This is an encouraging development to prevent deficiencies or errors due to a lack of professional collaboration since risks, benefits and alternatives of various techniques can be discussed candidly. However, while the deployment of a multidisciplinary team is encouraged, a scientific, evidence-based approach needs to be rigorously engendered to encompass the phenotypic heterogeneity of obstructive sleep apnea, including neurologic, metabolic, craniofacial, and myopathic endotypes. This classification helps identify diverse techniques for screening, diagnostics, treatment, and long-term follow-up, while recognizing underlying principles of management, such as the critical airway collapsing pressure, arousal threshold, loop gain, and muscle tone classification. For example, in the craniofacial endotype, recognizing developmental compensation, postural compensation, and decompensation will aid in case selection and indicate the most appropriate treatment protocol to help with clinical, interdisciplinary decision-making and management of obstructive sleep apnea. In fact, emerging techniques indicated to achieve future directions and goals of an integrated approach include the use of novel algorithms, artificial intelligence, and pharmaceuticals for data-driven predictive modeling.</p><p><strong>Citation: </strong>Singh GD, Battle J. Integrative treatment of obstructive sleep apnea: principles and practice. <i>J Clin Sleep Med</i>. 2025;21(9):1591-1596.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1591-1596"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755612","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":"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":"10.5664/jcsm.11730","url":null,"abstract":"<p><strong>Study objectives: </strong>Objective sleepiness is an important outcome requiring rigorous evaluation regarding obstructive sleep apnea (OSA) treatment efficacy, but no systematic review has explored the efficacy of advancement treatments of the stomatognathic system (ie, mandibular advancement device [MAD], hypoglossal nerve stimulation, and maxillomandibular advancement surgery) 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 advancement treatments of the stomatognathic system on objective sleepiness in adults with OSA by the Maintenance of Wakefulness Test, the Multiple Sleep Latency Test, the Oxford Sleep Resistance Test, the Psychomotor Vigilance Task, or the Sustained Attention to Response Task 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 1 RCT found a significant improvement of objective sleepiness for MAD compared with placebo, on the Multiple Sleep Latency Test. In the remaining RCTs, the included participants did not present objective sleepiness at baseline and most had mild/moderate OSA. Regarding the prospective studies, all found a significant improvement of objective sleepiness for each treatment assessed (ie, MAD, hypoglossal nerve stimulation, maxillomandibular advancement surgery, and submental stimulation). Interestingly, the included participants in the prospective studies 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 advancement treatments of the stomatognathic system on objective sleepiness in OSA. Further RCTs are needed to address this important outcome, taking into account baseline objective sleepiness and OSA severity.</p><p><strong>Citation: </strong>Galvez P, d'Incau E, Taillard J, et al. Efficacy of advancement treatments of the stomatognathic system on objective sleepiness in OSA: a systematic review. <i>J Clin Sleep Med.</i> 2025;21(9):1611-1625.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1611-1625"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406832/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cardiac magnetic resonance imaging in obstructive sleep apnea: a systematic scoping review.","authors":"Mustafa Jaafar, Aaryan Godhamgaonkar, Senan Alsanjari, Majd Protty","doi":"10.5664/jcsm.11742","DOIUrl":"10.5664/jcsm.11742","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is a prevalent condition associated with cardiovascular morbidity. Cardiac magnetic resonance imaging (CMR) provides a noninvasive modality for detecting subclinical cardiac changes in OSA, however its role in OSA diagnosis and management remains underexplored.</p><p><strong>Methods: </strong>We conducted a systematic scoping review to evaluate the utility of CMR in assessing cardiac remodeling and cardiovascular risk in patients with OSA. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, 6 databases (PubMed, Scopus, EMBASE, Google Scholar, Web of Science, and the Cochrane Library) were searched for studies on CMR use in OSA. A total of 21 studies met the inclusion criteria, providing data on left ventricular hypertrophy, myocardial fibrosis, right ventricular function, and pulmonary hypertension.</p><p><strong>Results: </strong>The majority of studies indicated a significant correlation between OSA severity and adverse cardiac outcomes, including left ventricular hypertrophy, myocardial fibrosis, and right ventricular dysfunction. CMR demonstrated superior sensitivity in detecting these changes compared to other imaging modalities. Continuous positive airway pressure therapy was found to reduce left ventricular mass and improve right ventricular function in several studies, and showing the potential reversibility of OSA-related cardiac remodeling.</p><p><strong>Conclusions: </strong>CMR is a valuable tool in identifying early cardiovascular changes in patients with OSA, with implications for earlier intervention and improved management of cardiovascular risk. Further research is warranted to standardize CMR protocols and explore long-term outcomes of CMR-guided interventions in OSA management.</p><p><strong>Citation: </strong>Jaafar M, Godhamgaonkar A, Alsanjari S, Protty M. The role of cardiac magnetic resonance imaging in obstructive sleep apnea: a systematic scoping review. <i>J Clin Sleep Med</i>. 2025;21(9):1627-1638.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1627-1638"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037001","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":"Mechanisms associated with obstructive sleep apnea in achondroplasia.","authors":"G Dave Singh","doi":"10.5664/jcsm.11778","DOIUrl":"10.5664/jcsm.11778","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1649"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121218","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":"Changing outcomes: trauma, disordered sleep, and suicide.","authors":"J F Pagel","doi":"10.5664/jcsm.11818","DOIUrl":"10.5664/jcsm.11818","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1509-1510"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585482","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":"Nightmares and insomnia within the acute aftermath of trauma prospectively predict suicidal ideation.","authors":"Anthony N Reffi, David A Kalmbach, Philip Cheng, David A Moore, Matthew B Jennings, Gregory C Mahr, Grace M Seymour, Lily Jankowiak, Christopher L Drake","doi":"10.5664/jcsm.11744","DOIUrl":"10.5664/jcsm.11744","url":null,"abstract":"<p><strong>Study objectives: </strong>Patients with acute trauma are vulnerable to suicidality following hospitalization. Research suggests nightmares and insomnia may interact to potentiate suicidality, possibly due to nightmares worsening co-occurring insomnia. Nightmares and insomnia are common stress reactions to acute trauma and might compound suicide risk within acutely traumatized patients. We tested the prospective relationship between nightmares and insomnia immediately after trauma on future suicidal ideation (SI).</p><p><strong>Methods: </strong>Patients hospitalized in Detroit, Michigan following traumatic injury (mean_age = 39.53 ± standard deviation 14.31 years, 67.0% male, 67.0% Black) completed surveys at 3 posttrauma timepoints: 1 week (time 1 [T1]; n = 88), 1 month (time 2 [T2]; n = 61), and 2 months (time 3 [T3]; n = 59).</p><p><strong>Results: </strong>Patients with clinically significant nightmares and comorbid insomnia symptoms at T2 reported the highest rates of SI at T3 (42.9%), whereas patients with insomnia alone (8.0%) or neither sleep disturbance (6.7%) had the lowest SI rates (<i>P</i>s < .05). We observed an interaction effect wherein insomnia symptoms at T2 predicted increased SI at T3, but only among patients with comorbid nightmares at T2. This interaction remained after accounting for acute stress symptoms at T2. Post hoc analyses showed nighttime awakenings and total wake time at T2 predicted increased SI at T3 with nightmares also moderating this prospective effect.</p><p><strong>Conclusions: </strong>These novel results suggest clinically significant nightmares strengthen the association between insomnia and suicidality after trauma. As nearly half of acute trauma patients with nightmares and insomnia experience SI 2 months after trauma, early interventions that target both may curb SI rates.</p><p><strong>Citation: </strong>Reffi AN, Kalmbach DA, Cheng P, et al. Nightmares and insomnia within the acute aftermath of trauma prospectively predict suicidal ideation. <i>J Clin Sleep Med</i>. 2025;21(9):1519-1527.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1519-1527"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051115","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":"Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy.","authors":"İbrahim Arslan, Mesut Güneş, Ömer Tarık Selçuk, Hülya Eyigör","doi":"10.5664/jcsm.11772","DOIUrl":"10.5664/jcsm.11772","url":null,"abstract":"<p><strong>Study objectives: </strong>We investigated the diagnostic role of vestibular evoked myogenic potential (VEMP) in detecting potential damage to the otolithic organs and brainstem in patients with obstructive sleep apnea syndrome (OSAS) and evaluated the effect of continuous positive airway pressure therapy on the vestibular system through VEMP measurements.</p><p><strong>Methods: </strong>This single-center, prospective study included 51 patients with severe OSAS (102 ears) and 20 controls without OSAS (40 ears). Cervical and ocular VEMP tests were administered to both groups. For patients with OSAS, VEMP tests were repeated after 3-month continuous positive airway pressure therapy. Pre- and posttreatment VEMP data were compared between the groups.</p><p><strong>Results: </strong>Patients with OSAS had significantly lower response rates of both ocular and cervical VEMP compared to controls (<i>P</i> = .003 and <i>P</i> = .027, respectively). In ocular VEMP, prolonged p1 and n1 latencies, shortened p1-n1 interpeak latencies, and decreased amplitudes were observed (<i>P</i> < .0001 for all). In cervical VEMP, prolonged n1 and p1-n1 interpeak latencies and reduced amplitudes were noted (<i>P</i> < .0001 for all), whereas no significant changes were observed in p1 latency. Significant posttreatment improvements were detected in ocular VEMP parameters, including n1 latency, p1-n1 latency, and amplitudes (<i>P</i> < .0001, <i>P</i> = .001, and <i>P</i> = .001, respectively). Similarly, significant posttreatment improvements were observed in cervical VEMP parameters, namely n1 latency, p1-n1 latency, and amplitudes (<i>P</i> < .0001, <i>P</i> < .0001, and <i>P</i> = .003, respectively). There was no significant change in p1 latency.</p><p><strong>Conclusions: </strong>Subclinical abnormalities in otolithic organs and the brainstem in severe OSAS could be detected early using noninvasive VEMP testing. VEMP tests also revealed that a 3-month continuous positive airway pressure therapy ameliorated these vestibular system abnormalities.</p><p><strong>Citation: </strong>Arslan İ, Güneş M, Selçuk ÖT, Eyigör H. Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy. <i>J Clin Sleep Med.</i> 2025;21(9):1547-1556.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1547-1556"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144266","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":"Artificial intelligence may fill the gap of underdiagnosis in sleep medicine: the role of ChatGPT-4.","authors":"Ram Kishun Verma","doi":"10.5664/jcsm.11820","DOIUrl":"10.5664/jcsm.11820","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1507-1508"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585481","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":"Artificial intelligence in sleep medicine: assessing the diagnostic precision of ChatGPT-4.","authors":"Anshum Patel, Joseph Cheung","doi":"10.5664/jcsm.11732","DOIUrl":"10.5664/jcsm.11732","url":null,"abstract":"<p><strong>Study objectives: </strong>Large language models such as ChatGPT-4 are emerging in medicine, including sleep medicine, where artificial intelligence is used to analyze sleep data and predict treatment outcomes. Effectiveness of large language models in accurately diagnosing sleep disorders based on clinical history has not yet been studied. This study evaluates ChatGPT-4's diagnostic performance using clinical vignettes.</p><p><strong>Methods: </strong>Nineteen clinical vignettes containing patient history, physical examination findings, and diagnostic tests from the <i>Case Book of Sleep Medicine</i> (third edition, 2019, American Academy of Sleep Medicine) were presented to ChatGPT-4. Its differential and final diagnoses were compared to reference diagnoses, with accuracy assessed by (1) the percentage of correct differentials and (2) a 3-tier scoring system (no match, partial match, full match) for final diagnoses.</p><p><strong>Results: </strong>The mean accuracy for differential diagnoses was 63.27% ± 15.61% (standard deviation), ranging from 33.33-100%. The mean number of artificial intelligence-generated differential diagnoses matching the American Academy of Sleep Medicine case differential diagnoses was 2.79 ± 0.71 (standard deviation). For final diagnoses, ChatGPT-4 scored a total of 30 out of a possible 38, resulting in an overall accuracy of 78.95%. The model achieved a mean score of 1.58 ± 0.61 (standard deviation) out of 2, with 68.42% of cases achieving a full match. Performance was higher in cases with fewer differential diagnoses, whereas accuracy decreased in complex cases.</p><p><strong>Conclusions: </strong>ChatGPT-4 demonstrates promising diagnostic potential in sleep medicine, with moderate to high accuracy in identifying differential and final diagnoses, although its variability in more complex cases calls for refinement and clinical validation.</p><p><strong>Citation: </strong>Patel A, Cheung J. Artificial intelligence in sleep medicine: assessing the diagnostic precision of ChatGPT-4. <i>J Clin Sleep Med.</i> 2025;21(9):1511-1517.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1511-1517"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057294","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}