Journal of Clinical Sleep Medicine最新文献_第5页

Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1. 1型嗜睡症青少年夜间睡眠紊乱及相关功能结果的特征。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-17 DOI: 10.5664/jcsm.11416

Gillian Heckler, Jennifer Worhach, Grace Wang, Klara Szilagyi, Bo Zhang, Cecilia Diniz Behn, Thomas Scammell, Kiran Maski

{"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":"https://doi.org/10.5664/jcsm.11416","url":null,"abstract":"Study objectives: Disrupted nighttime sleep (DNS) and sleep instability are common in children and adolescents with Narcolepsy Type 1 (NT1), but optimal objective sleep measures have not been determined. We compared self-reported and objective sleep measures between young people with NT1 and healthy controls (HC) and test the hypotheses that the Wake/N1 Index is the best objective measure of perceived nocturnal wakings vs. other DNS measures reported in the literature and is associated with daytime functional problems.Methods: N=26 HC and N=27 NT1 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.Results: Compared to HC, NT1 participants reported more frequent restless sleep, nighttime moaning/groaning/talking, tossing and turning, and nocturnal wakings (all p's < 0.01), 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 SSRI/SNRI use. The Wake/N1 Index was associated with daytime fatigue but no other behavioral or cognitive concerns.Conclusions: DNS is a multi-factorial 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.","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Insights, recommendations, and research priorities for central sleep apnea: report from an expert panel. 中枢性睡眠呼吸暂停的见解、建议和研究重点：专家小组的报告。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-10 DOI: 10.5664/jcsm.11424

Vaishnavi Kundel, Anjali Ahn, Michael Arzt, Jerryll Asin, Ali Azarbarzin, Nancy Collop, Aneesa Das, James C Fang, Rami Khayat, Thomas Penzel, Jean-Louis Pépin, Sunil Sharma, Maria V Suurna, Sudha Tallavajhula, Atul Malhotra

{"title":"Insights, recommendations, and research priorities for central sleep apnea: report from an expert panel.","authors":"Vaishnavi Kundel, Anjali Ahn, Michael Arzt, Jerryll Asin, Ali Azarbarzin, Nancy Collop, Aneesa Das, James C Fang, Rami Khayat, Thomas Penzel, Jean-Louis Pépin, Sunil Sharma, Maria V Suurna, Sudha Tallavajhula, Atul Malhotra","doi":"10.5664/jcsm.11424","DOIUrl":"10.5664/jcsm.11424","url":null,"abstract":"Central sleep apnea (CSA) is commonly encountered among patients with sleep-disordered breathing, however its clinical consequences are less well-characterized. We therefore convened an expert panel to discuss the common presentations of CSA, as well as challenges and knowledge gaps in the diagnosis and management of CSA. The panel identified several key research priorities essential for advancing our understanding of the disorder. Within the diagnostic realm, panel members discussed the utility of multi-night assessments, and importance of the development and validation of novel metrics and automated assessments for differentiating central versus obstructive hypopneas, such that their impact on clinical outcomes and management may be better evaluated. The panel also discussed the current therapeutic landscape for the management of CSA and agreed that therapies should primarily aim to alleviate sleep-related symptoms, after optimizing treatment to address the underlying cause. Most importantly, the panel concluded that there is a need to further investigate the clinical consequences of CSA, as well as the implications of therapy on clinical outcomes, particularly among those who are asymptomatic. Future research should focus on endo-phenotyping central events for a better mechanistic understanding of the disease, validating novel diagnostic methods for implementation in routine clinical practice, as well as the use of combination therapy and comparative effectiveness trials in elucidating the most efficacious interventions for managing CSA.","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394863","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}

引用次数: 0

Passing the torch. 传递火炬

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-10 DOI: 10.5664/jcsm.11426

Nancy A Collop

引用次数: 0

Home sleep apnea testing auto-interpretation. 家庭睡眠呼吸暂停测试自动解读。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-10 DOI: 10.5664/jcsm.11432

Felix Wireko, Timothy I Morgenthaler

引用次数: 0

Public engagement with consumer sleep technology for obstructive sleep apnea screening: implications for equity, access, and practice. 公众参与消费者睡眠技术的阻塞性睡眠呼吸暂停筛查：对公平、获取和实践的影响。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-10 DOI: 10.5664/jcsm.11418

Nicholas R Lenze, Ruby J Kazemi, Allison K Ikeda, Punithavathy Vijayakumar, Cathy A Goldstein, Jeffrey J Stanley, Michael J Brenner, Paul T Hoff

{"title":"Public engagement with consumer sleep technology for obstructive sleep apnea screening: implications for equity, access, and practice.","authors":"Nicholas R Lenze, Ruby J Kazemi, Allison K Ikeda, Punithavathy Vijayakumar, Cathy A Goldstein, Jeffrey J Stanley, Michael J Brenner, Paul T Hoff","doi":"10.5664/jcsm.11418","DOIUrl":"https://doi.org/10.5664/jcsm.11418","url":null,"abstract":"Study objectives: To characterize public practices and perspectives on the use of consumer sleep technology (CST) and evaluate perspectives on using CST as a screening tool for obstructive sleep apnea (OSA).Methods: We designed a survey instrument incorporating content from validated instruments (STOP-BANG and the Epworth Sleepiness Scale) and hypothesis-generated questions. Survey development involved multidisciplinary collaboration among three board-certified sleep medicine experts, researchers, and consumers. The survey was disseminated across a national sample of adults living in the United States via an online platform.Results: Among 897 respondents, the mean (SD) age was 47.5 (16.9) years; 73.1% were female, 81.8% were White, and 505 respondents (56.3%) reported having tracked sleep using CS. Factors associated with decreased odds of CST use included household income <$30,000 (OR 0.47, 95% CI 0.28-0.79; p=0.004), Medicaid insurance (OR 0.43, 95% CI 0.26-0.69; p=0.001), Medicare insurance (OR 0.59, 95% CI 0.41-0.84; p=0.004), and lack of a primary care physician (OR 0.55, 95% CI 0.33-0.91; p=0.021). Most respondents (91.1%) agreed or strongly agreed that screening for OSA would be a useful feature of CST, but respondents reporting an education of high school diploma or less (OR 0.48, 95% CI 0.29-0.79; p=0.004) were less likely to agree with this statement.Conclusions: Attitudes toward and use of CST differed based on demographic and socioeconomic factors. Further study is needed to understand and address barriers to CST adoption and to characterize implications for equitable access to care for sleep disorders.","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394865","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}

引用次数: 0

Arousal burden is highest in supine sleeping position and during light sleep. 仰卧位和浅睡眠时唤醒负担最重。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-04 DOI: 10.5664/jcsm.11398

Minna Pitkänen, Juho Huovinen, Marika Rissanen, Henna Pitkänen, Samu Kainulainen, Thomas Penzel, Francesco Fanfulla, Ulla Anttalainen, Tarja Saaresranta, Ludger Grote, Jan Hedner, Richard Staats, Brett Duce, Juha Töyräs, Arie Oksenberg, Timo Leppänen

{"title":"Arousal burden is highest in supine sleeping position and during light sleep.","authors":"Minna Pitkänen, Juho Huovinen, Marika Rissanen, Henna Pitkänen, Samu Kainulainen, Thomas Penzel, Francesco Fanfulla, Ulla Anttalainen, Tarja Saaresranta, Ludger Grote, Jan Hedner, Richard Staats, Brett Duce, Juha Töyräs, Arie Oksenberg, Timo Leppänen","doi":"10.5664/jcsm.11398","DOIUrl":"https://doi.org/10.5664/jcsm.11398","url":null,"abstract":"Study objectives: Arousal burden (AB) is defined as the cumulative duration of arousals during sleep divided by the total sleep time. However, in-depth analysis of AB related to sleep characteristics is lacking. Based on previous studies addressing the arousal index (ArI), we hypothesized that the AB would peak in the supine sleeping position and during non-rapid eye movement stage 1 (N1) and show high variability between scorers.Methods: Nine expert scorers analyzed polysomnography recordings of 50 participants, the majority with an increased risk for obstructive sleep apnea. AB was calculated in different sleeping positions and sleep stages. A generalized estimating equation was utilized to test the association between AB and sleeping positions, sleep stages, and scorers. The correlation between AB and ArI was tested with Spearman's rank-order correlation.Results: AB significantly differed between sleeping positions (p<0.001). The median AB in the supine sleeping position was 47-62% higher than in the left and right position. The AB significantly differed between the sleep stages (p<0.001); the median AB was more than 200% higher during N1 than during other sleep stages. In addition, the AB differed significantly between scorers (p<0.001) and correlated strongly with ArI (r=0.935, p<0.001).Conclusions: AB depends on the sleeping position, sleep stage, and scorer as hypothesized. AB behaved similarly as the ArI, but the high variability in the ABs between scorers indicates a potential limitation caused by subjective manual scoring. Thus, the development of more accurate techniques for scoring arousals is required before AB can be reliably utilized.","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373425","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}

引用次数: 0

Promoting sustained access to cognitive behavioral therapy for insomnia in Australia: a system-level implementation program. 促进澳大利亚失眠患者持续获得认知行为疗法：系统级实施方案。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-04 DOI: 10.5664/jcsm.11374

Alexander Sweetman, R Doug McEvoy, Michael S Frommer, Robert Adams, Ching Li Chai-Coetzer, Sallie Newell, Vivienne Moxham-Hall, Sally Redman

{"title":"Promoting sustained access to cognitive behavioral therapy for insomnia in Australia: a system-level implementation program.","authors":"Alexander Sweetman, R Doug McEvoy, Michael S Frommer, Robert Adams, Ching Li Chai-Coetzer, Sallie Newell, Vivienne Moxham-Hall, Sally Redman","doi":"10.5664/jcsm.11374","DOIUrl":"https://doi.org/10.5664/jcsm.11374","url":null,"abstract":"Study objectives: Insomnia is a highly prevalent and debilitating disorder. Cognitive behavioral therapy for insomnia (CBTi) is the recommended 'fist line' treatment, but is accessed by a minority of people with insomnia. This paper describes a system-level implementation program to improve access to CBTi in Australia to inform CBTi implementation in other locations.Methods: From 2019 to 2023, we conducted a program of work to promote sustained change in access to CBTi in Australia. Three distinct phases included 1) Scoping and mapping barriers to CBTi access, 2) Analysis and synthesis of barriers and facilitators to devise change goals, and 3) Structured promotion and coordination of change. We used a system-level approach, knowledge brokerage, and co-design, and drew on qualitative, quantitative, and implementation science methods.Results: We identified barriers to CBTi access from the perspectives of people with insomnia, primary care clinicians, and the health system. A stakeholder advisory committee was convened to co-design change goals, identify modifiable barriers, devise program logic and drive change strategies. We commenced a program to promote system-level change in CBTi access via; improved awareness and education of insomnia among primary care clinicians, self-guided interventions, and advocating to Government for additional CBTi funding mechanisms.Conclusions: This implementation program made significant progress toward improving access to CBTi in Australia. Ongoing work is required to continue this program, as long-term system-level change requires significant and sustained time, effort and resources from multiple stakeholders. This program may be used to inform CBTi implementation activities in other locations.","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373426","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}

引用次数: 0

Agrypnia excitata: a clinical biomarker of acute relapse in anti-NMDAr encephalitis. 兴奋姬蛙：抗 NMDAr 脑炎急性复发的临床生物标志物。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-04 DOI: 10.5664/jcsm.11402

Lina Jeantin, Louis Cousyn, Vincent Navarro, Vi-Huong Nguyen Michel

引用次数: 0

A new perspective after facing the crucible of an FDA class 1 recall. 面对 FDA 一级召回的严峻考验后的新视角。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-03 DOI: 10.5664/jcsm.11408

Colleen G Lance, Kathryn Hansen

引用次数: 0

REM sleep-related bradyarrhythmia syndrome. 快速动眼期睡眠相关心律失常综合征。

IF 3.5 3区医学

Journal of Clinical Sleep Medicine Pub Date : 2024-10-03 DOI: 10.5664/jcsm.11406

Karolina Perez, Misty Shah, Aadhavi Sridharan, Stuart F Quan, Talal Moukabary, Imran Patel, Salma I Patel

引用次数: 0