Journal of Clinical Sleep Medicine最新文献

{"title":"Evaluating the impact of different message strategies about OSA employed in the American Academy of Sleep Medicine Count on Sleep campaign.","authors":"Rebecca Robbins, Sameh S W Morkous, Sarah Honaker, Christina V Darby, Lourdes M DelRosso","doi":"10.5664/jcsm.11394","DOIUrl":"10.5664/jcsm.11394","url":null,"abstract":"<p><p>Health campaigns hold promise for promoting general awareness about obstructive sleep apnea. In 2023, the American Academy of Sleep Medicine developed a series of messages as part of their \"Count on Sleep\" campaign. Three distinct messaging strategies were employed in posts disseminated on Facebook: (1) positive outcome (benefits of obstructive sleep apnea treatment); (2) negative outcome (consequences of untreated obstructive sleep apnea); and (3) partner-focused. We evaluated Facebook analytics to explore which of the 3 strategies was most impactful. The impressions were highest for the positive outcome message (n = 120,062), followed by the negative outcome (n = 12,286) and partner-focused (n = 10,259) messages. Female users were more likely to engage with positive (39% vs 28%) and negative (34% vs 25%) message than males, but sexes were quite balanced in engagement with the partner-focused message (36% vs 36%). There was more engagement from older adults (65 years and older) than from younger adults across all message types.</p><p><strong>Citation: </strong>Robbins R, Morkous SSW, Honaker S, Darby CV, DelRosso LM. Evaluating the impact of different message strategies about OSA employed in the American Academy of Sleep Medicine Count on Sleep campaign. <i>J Clin Sleep Med.</i> 2025;21(2):417-419.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"417-419"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331548","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":"Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1.","authors":"Gillian Heckler, Jennifer Worhach, Grace Wang, Klara Szilagyi, Bo Zhang, Cecilia Diniz Behn, Thomas Scammell, Kiran Maski","doi":"10.5664/jcsm.11416","DOIUrl":"10.5664/jcsm.11416","url":null,"abstract":"<p><strong>Study objectives: </strong>Disrupted nighttime sleep and sleep instability are common in children and adolescents with narcolepsy type 1, but optimal objective sleep measures have not been determined. We compared self-reported and objective sleep measures between young people with narcolepsy type 1 and healthy controls and test the hypotheses that the wake/non-rapid eye movement sleep stage 1 (N1) index is the best objective measure of perceived nocturnal wakings vs other disrupted nighttime sleep measures reported in the literature and is associated with daytime functional problems.</p><p><strong>Methods: </strong>n = 26 healthy controls and n = 27 narcolepsy type 1 participants ages 8-21 years completed a 15-item habitual sleep quality survey and an in-lab polysomnogram. We compared group survey responses and performed stepwise regression of sleep quality and instability measures with a survey question (\"During the night, I wake more than once\"). Last, we used logistic regression to identify associations between the wake/N1 index with daytime functional concerns across groups.</p><p><strong>Results: </strong>Compared to healthy controls, narcolepsy type 1 participants reported more frequent restless sleep, nighttime moaning/groaning/talking, tossing and turning, and nocturnal wakings (all <i>P</i> values < .01), but no greater difficulties in falling asleep or returning back to sleep. Across groups, self-reported waking from sleep was associated with increased wake/N1 index and selective serotonin reuptake inhibitor/selective norepinephrine re-uptake inhibitor use. The wake/N1 index was associated with daytime fatigue but no other behavioral or cognitive concerns.</p><p><strong>Conclusions: </strong>Disrupted nighttime sleep is a multifactorial complaint that differs from insomnia. We believe the wake/N1 index is a useful sleep instability measure that should be helpful in research and as a treatment target in clinical practice, especially for fatigue concerns.</p><p><strong>Citation: </strong>Heckler G, Worhach J, Wang G, et al. Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1. <i>J Clin Sleep Med</i>. 2025;21(2):355-363.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"355-363"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479576","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":"Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy.","authors":"Anna L MacKinnon, Katherine Silang, Dana Watts, Jasleen Kaur, Makayla Freeman, Kyle Dewsnap, Elizabeth Keys, Joshua W Madsen, Gerald F Giesbrecht, Tyler Williamson, Amy Metcalfe, Tavis Campbell, Kelly J Mrklas, Lianne M Tomfohr-Madsen","doi":"10.5664/jcsm.11396","DOIUrl":"10.5664/jcsm.11396","url":null,"abstract":"<p><strong>Study objectives: </strong>Insomnia and sleep problems are common in pregnancy and have potentially negative impacts on both parental and infant health. This study examined the Sleeping for Two adaptation of cognitive behavioral therapy for insomnia (CBT-I) in pregnancy.</p><p><strong>Methods: </strong>A parallel (1:1) randomized controlled trial evaluated CBT-I (<i>n</i> = 32) compared to a treatment as usual waitlist (<i>n</i> = 32) among pregnant individuals from Alberta, Canada experiencing insomnia. Five weekly individual sessions of CBT-I pivoted from in-person delivery to telehealth due to the COVID-19 pandemic physical distancing regulations. Insomnia symptom severity (primary outcome), insomnia diagnosis by structured interview, self-reported sleep problems, as well as sleep parameters measured by diary and actigraphy were assessed pretreatment at 12-28 weeks gestation, 1-week posttreatment, and 6 months postpartum. Birth information (secondary outcomes) were collected via delivery record and parent report of infant sleep (exploratory outcome) was taken at 6 months postpartum.</p><p><strong>Results: </strong>Multilevel modeling using an intention-to-treat approach showed that CBT-I was associated with a decrease in insomnia symptoms and improved sleep quality across time compared to treatment as usual. The CBT-I group had fewer diagnoses of insomnia posttreatment, but the difference did not reach statistical significance until 6 months postpartum. Participants with worse sleep quality at baseline benefitted substantially more from CBT-I vs treatment as usual waitlist.</p><p><strong>Conclusions: </strong>CBT-I delivered in pregnancy can reduce symptoms of insomnia and improve sleep quality, which could in turn minimize risk of negative consequences for birthing parent and infant health.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Sleeping for Two: RCT of CBT-Insomnia in Pregnancy; URL: https://www.clinicaltrials.gov/study/NCT03301727; Identifier: NCT03918057.</p><p><strong>Citation: </strong>MacKinnon AL, Silang K, Watts D, et al. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy. <i>J Clin Sleep Med</i>. 2025;21(2):365-376.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"365-376"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479579","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 5 faces of flow in asynchronous hypoglossal nerve stimulation.","authors":"Tice R Harkins, Leonard J M Soh, Everett G Seay, Eric Thuler, Alan R Schwartz, Raj C Dedhia","doi":"10.5664/jcsm.11450","DOIUrl":"10.5664/jcsm.11450","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"439-441"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570092","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":"Supervised machine learning on electrocardiography features to classify sleep in noncritically ill children.","authors":"Eris van Twist, Anne M Meester, Arnout B G Cramer, Matthijs de Hoog, Alfred C Schouten, Sascha C A T Verbruggen, Koen F M Joosten, Maartje Louter, Dirk C G Straver, David M J Tax, Rogier C J de Jonge, Jan Willem Kuiper","doi":"10.5664/jcsm.11358","DOIUrl":"10.5664/jcsm.11358","url":null,"abstract":"<p><strong>Study objectives: </strong>Despite frequent sleep disruption in the pediatric intensive care unit, bedside sleep monitoring in real time is currently not available. Supervised machine learning applied to electrocardiography data may provide a solution, because cardiovascular dynamics are directly modulated by the autonomic nervous system during sleep.</p><p><strong>Methods: </strong>This retrospective study used hospital-based polysomnography recordings obtained in noncritically ill children between 2017 and 2021. Six age categories were defined: 6-12 months, 1-3 years, 3-5 years, 5-9 years, 9-13 years, and 13-18 years. Features were derived in time, frequency, and nonlinear domain from preprocessed electrocardiography data. Sleep classification models were developed for 2, 3, 4, and 5 states using logistic regression, random forest, and XGBoost classifiers during 5-fold nested cross-validation. Models were additionally validated across age categories.</p><p><strong>Results: </strong>A total of 90 noncritically ill children were included with a median (Q1, Q3) recording length of 549.0 (494.8, 601.3) minutes. The 3 models obtained an area under the receiver operator characteristic curve of 0.72-0.78 with minimal variation across classifiers and age categories. Balanced accuracies were 0.70-0.72, 0.59-0.61, 0.50-0.51, and 0.41-0.42 for 2, 3, 4, and 5 states, respectively. Generally, the XGBoost model obtained the highest balanced accuracy (<i>P</i> < .05), except for 5 states for which logistic regression excelled (<i>P</i> = .67).</p><p><strong>Conclusions: </strong>Electrocardiography-based machine learning models are a promising and noninvasive method for automated sleep classification directly at the bedside of noncritically ill children aged 6 months-18 years. Models obtained moderate-to-good performance for 2- and 3-state classification.</p><p><strong>Citation: </strong>van Twist E, Meester AM, Cramer ABG, et al. Supervised machine learning on electrocardiography features to classify sleep in noncritically ill children. <i>J Clin Sleep Med.</i> 2025;21(2):261-268.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"261-268"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331477","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":"Sleep and long COVID.","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.5664/jcsm.11410","DOIUrl":"10.5664/jcsm.11410","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"443"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367272","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":"Positional therapy: is it ready for prime time?","authors":"Shalini Manchanda, Ninotchka Liban Sigua","doi":"10.5664/jcsm.11510","DOIUrl":"10.5664/jcsm.11510","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"221-222"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774461","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":"Prospective crossover trial of positional and CPAP therapy for the treatment of mild-to-moderate positional obstructive sleep apnea.","authors":"Malcolm R Wilson, Robert Carroll, Stephen Kinder, Alexander Ryan, Craig A Hukins, Brett Duce, Claire M Ellender","doi":"10.5664/jcsm.11378","DOIUrl":"10.5664/jcsm.11378","url":null,"abstract":"<p><strong>Study objectives: </strong>We evaluated the efficacy of vibrotactile positional therapy (PT) compared to standard continuous positive airway pressure (CPAP) therapy in mild-to-moderate positional obstructive sleep apnea.</p><p><strong>Methods: </strong>We conducted a prospective crossover randomized controlled trial of adult patients with treatment-naïve, symptomatic, mild-to-moderate positional obstructive sleep apnea, defined as ≥ 5 total apnea-hypopnea index < 30 with supine-to-nonsupine apnea-hypopnea index ratio ≥ 2. Participants were randomized to in-laboratory treatment initiation polysomnography with either PT or CPAP on sequential nights before an 8-week trial of each therapy. The primary end point was symptomatic improvement (Epworth Sleepiness Scale; ΔESS). Secondary end points included patient preference, usage, sleep architecture, and quality of life measures.</p><p><strong>Results: </strong>A total of 52 participants were enrolled and completed both arms of the study. Participants were symptomatic with a median ESS score of 12 (interquartile range, 10-14). Treatment resulted in a significant (<i>P</i> < .001) symptomatic improvement with both PT and CPAP (ΔESS 4; interquartile range, 6-11) without a significant difference between treatment arms (<i>P =</i> .782). PT was effective at restricting supine sleep and demonstrated improved sleep efficiency compared with CPAP, although no better than baseline. Both therapies were effective at reducing apnea-hypopnea index, although CPAP demonstrated superior apnea-hypopnea index reduction. There were otherwise no clinically significant differences in sleep architecture, usage, or secondary outcomes including overall patient preference.</p><p><strong>Conclusions: </strong>In this cohort, treatment with PT or CPAP resulted in clinically significant symptomatic improvement (ΔESS) that was not significantly different between treatment arms. No real difference was seen in other secondary outcome measures. This study provides further evidence to support the use of PT as an alternative first-line therapy with CPAP in appropriately selected patients with positional obstructive sleep apnea.</p><p><strong>Clinical trial registration: </strong>Registry: Australian New Zealand Clinical Trials Registry; Name: Prospective crossover trial of Positional and Continuous positive airway pressure Therapy for the treatment of mild-to-moderate positional obstructive sleep apnea; URL: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377221&isReview=true; Identifier: ACTRN12619000475145.</p><p><strong>Citation: </strong>Wilson MR, Carroll R, Kinder S, et al. Prospective crossover trial of positional and CPAP therapy for the treatment of mild-to-moderate positional obstructive sleep apnea. <i>J Clin Sleep Med.</i> 2025;21(2):305-313.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"305-313"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331553","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":"Central sleep apnea: realignment required.","authors":"Winfried Randerath, Esther Irene Schwarz","doi":"10.5664/jcsm.11476","DOIUrl":"10.5664/jcsm.11476","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"227-228"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677656","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":"Unveiling the hidden risks of CPAP device innovations and the necessity of patient-centric testing.","authors":"Gimbada Benny Mwenge, Giuseppe Liistro, Charlotte Smetcoren, Charlotte Debaille","doi":"10.5664/jcsm.11384","DOIUrl":"10.5664/jcsm.11384","url":null,"abstract":"<p><p>A 72-year-old patient had a severe sleep apnea syndrome well controlled for many years through continuous positive airway pressure therapy. When switching to a newer device with upgraded functions, therapy completely failed. A video recording performed by the patient's wife showed high-frequency mask movements suggesting inability to maintain a therapeutic pressure with high-frequency pressure fluctuations, confirmed afterwards during full night polysomnography and in a bench study. Continuous positive airway pressure therapy manufacturers may put on the market new devices with supposedly better algorithms that in fact may have escaped serious premarketing evaluation and that may jeopardize the efficacy of a well proven treatment. We suggest that better evaluations are necessary before marketing therapeutic devices, and that postmarketing assessment of unanticipated side effects should become the norm.</p><p><strong>Citation: </strong>Mwenge GB, Liistro G, Smetcoren C, Debaille C. Unveiling the hidden risks of CPAP device innovations and the necessity of patient-centric testing. <i>J Clin Sleep Med</i>. 2025;21(2):421-425.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"421-425"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331483","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}