Journal of Clinical Sleep Medicine最新文献

{"title":"Quantifying the sources of discrepancy between total recording time and total sleep time in home sleep apnea testing: insights from home-based polysomnography.","authors":"Apostolis Nikolopoulos, Konstantinos Tatsis, Charikleia Tselepi, Agni Sioutkou, Athanasios Kostoulas, Georgios Siopis, Konstantinos Kostikas, Athanasios Konstantinidis","doi":"10.5664/jcsm.11632","DOIUrl":"https://doi.org/10.5664/jcsm.11632","url":null,"abstract":"<p><strong>Study objectives: </strong>To quantify the contribution of sleep onset latency (SOL), wake after sleep onset (WASO), and wake after sleep offset (WASF) in the discrepancy between total recording time (TRT) and total sleep time (TST) in home-based polysomnography (PSG) using patient-activated and deactivated monitoring devices.</p><p><strong>Methods: </strong>This observational study enrolled patients with a high pretest probability of obstructive sleep apnea (OSA) who underwent unattended home-based PSG. We measured the duration of SOL, WASO, and WASF to quantify the discrepancy between TRT and TST. TRT was defined as the interval from device activation to deactivation by the patients. SOL represented the time from device activation to the first epoch of any sleep, WASO was the total amount of time spent awake after the sleep onset epoch until the last epoch of any sleep, and WASF was defined as the time from the last epoch of any sleep until the patient-initiated device deactivation. We also assessed differences in apnea-hypopnea index (AHI) between home-based PSG and type 3 sleep studies by reanalyzing home-based PSG recordings as simulated type 3 studies after omitting type 2 signals.</p><p><strong>Results: </strong>A total of 78 patients were included in the study. The mean TRT exceeded the mean TST by 19%, with TRT at 457±78 min and TST at 383±68 min. The mean difference between TRT and TST was 74±53 min, attributed to SOL (30%), WASO (45%), and WASF (25%). There was considerable variability in the difference between TRT and TST among study participants, ranging from as little as 14 minutes to as much as 233 minutes. The mean AHI in simulated type 3 studies (41±29) was, on average, 23% lower than the mean AHI recorded in home-based PSG (53±30, P <.001).</p><p><strong>Conclusions: </strong>There was significant variability in the gap between TRT and TST among patients with a high pretest probability of OSA undergoing unattended home-based PSG. WASO was identified as the largest contributor to this discrepancy, with notable contributions from SOL and WASF. Additionally, simulated type 3 studies underestimated the true AHI compared to type 2 studies.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617755","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":"COVID-19 infection and sleep health: findings from the nationally representative COVID-19 Unequal Racial Burden survey.","authors":"Dana M Alhasan, Symielle A Gaston, Paula D Strassle, Anna María Nápoles, Chandra L Jackson","doi":"10.5664/jcsm.11638","DOIUrl":"https://doi.org/10.5664/jcsm.11638","url":null,"abstract":"<p><strong>Study objectives: </strong>To estimate overall and racial/ethnic-specific associations between COVID-19 infection status and sleep health.</p><p><strong>Methods: </strong>We analyzed online survey data collected from December 2020-February 2021 among Asian, Black, Latino (English and Spanish-speaking), and White adults (n=1000 each), along with American Indian/Alaska Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI), and multiracial adults (n=500). COVID-19 infection (confirmed, probable, suspected), based on self-reported data on symptoms and infected contacts, was classified using World Health Organization definitions. Sleep disturbances were categorized as 'yes' (mild/moderate/severe) versus 'no' (normal). Weighted analyses were used to generate nationally representative estimates within each racial/ethnic group. Adjusting for sociodemographic and health behaviors, Poisson regression with robust variance estimated prevalence ratios (PRs) and confidence intervals (CIs) for sleep disturbances among individuals with a COVID-19 infection vs. not in the overall population and by race/ethnicity, gender, and ability to get healthcare.</p><p><strong>Results: </strong>Among 5,359 eligible participants, 24% had a COVID-19 infection. COVID-19 infection was associated with a 32% higher prevalence of sleep disturbances (PR=1.32 [95% CI: 1.22-1.42]). Associations of COVID-sleep associations were higher among AI/AN (PR=1.64 [1.30-2.08]), NH/PI (PR=1.53 [1.24-1.90]), and English-speaking Latino (PR=1.49 [1.20-1.86]) compared to White adults (PR=1.14 [0.93-1.41]), although confidence intervals overlapped,. The higher prevalence of sleep disturbances among women with COVID-19 (PR=1.32 [1.19-1.45]) was similar to men (PR=1.34 [1.18-1.53]). COVID-19 infection also had a similar association with sleep disturbances among participants who did and did not report being unable to get needed healthcare.</p><p><strong>Conclusions: </strong>COVID-19 infections may lead to sleep disturbances, among racial/ethnic groups.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617750","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 influence of an innovative inspiratory pressure relief accessory on continuous positive airway pressure profiles in a laboratory bench setting.","authors":"Geoffery P Sleeper, Kimber A Catullo, Pai-Lien Chen, Susheel P Patil, Kingman P Strohl, Ambrose A Chiang","doi":"10.5664/jcsm.11624","DOIUrl":"https://doi.org/10.5664/jcsm.11624","url":null,"abstract":"<p><strong>Study objectives: </strong>Despite its efficacy, long-term adherence to continuous positive airway pressure (CPAP) hovers around 50%. The V-com (SleepRes, Murfreesboro, TN), an inspiratory pressure relief (IPR) accessory, claims to improve comfort by decreasing inspiratory pressures. We aim to independently assess its impact on fixed CPAP settings in a laboratory bench model.</p><p><strong>Methods: </strong>An ASL-5000 Breathing simulator (IngMar Medical, Pittsburgh, PA) with normal lung settings was employed. A ResMed AirSense 11 device was connected to ASL-5000 through a React Health Rio II exhalation vent and an elbow adapter. Mean inspiratory and expiratory pressures were measured at fixed CPAP settings (4, 6, 8, 10, 12, 14, 16, 18, and 20 cmH2O) at baseline, one IPR unit, and two IPR units in series, without and with expiratory pressure relief (EPR). Generalized linear models were applied to evaluate changes in pressure across CPAP settings.</p><p><strong>Results: </strong>With one IPR, mean inspiratory pressures decreased significantly from the baseline pressures (p<0.001), with only a marginal reduction of mean expiratory pressures (p=0.239). The inspiratory pressure reduction was consistently greater than the expiratory pressure drop across all settings (P<0.001). Higher CPAP settings resulted in larger reductions in inspiratory and expiratory pressures (p<0.001). Two IPR units in series led to a greater decrease in both pressures (p=0.001). When EPR 3 was combined with IPR, a larger drop in pressure was noted. (P<0.001).</p><p><strong>Conclusions: </strong>This IPR accessory decreases inspiratory pressures but only marginally reduces expiratory pressures in this laboratory bench model. Two IPR units further decrease both inspiratory and expiratory pressures.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617757","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 is associated with reduced sleep apnea severity, but not its endotype traits in those with comorbid insomnia and sleep apnea.","authors":"Elliot J Brooker, Shane A Landry, Pedro R Genta, Gabriel T Abdelmessih, Bradley A Edwards, Sean P A Drummond","doi":"10.5664/jcsm.11636","DOIUrl":"https://doi.org/10.5664/jcsm.11636","url":null,"abstract":"<p><strong>Study objectives: </strong>Cognitive behavioral therapy for insomnia (CBT-I) improves obstructive sleep apnea (OSA) severity in comorbid insomnia and sleep apnea (COMISA), though the mechanisms underlying this change are unstudied. CBT-I, which promotes sleep continuity and reduces hyperarousal, may improve OSA by raising the respiratory arousal threshold. We aimed to investigate the effect of CBT-I on OSA severity and its impact on the arousal threshold and other endotype traits.</p><p><strong>Methods: </strong>In this single-arm trial, 25 patients with COMISA (13F:12M, <i>M_age</i>=53.7, <i>SD_age</i>=8.7 years) completed a seven-week individual CBT-I program. Patients met diagnostic criteria for insomnia and demonstrated an apnea-hypopnea index (AHI) ≥ 10 events/h (<i>M_AHI</i>=35.2, <i>SD_AHI</i>=16.4 events/h). Overnight polysomnography before and after CBT-I measured OSA severity, sleep architecture, and the four OSA endotypes (i.e., collapsibility, muscle compensation, loop gain, arousal threshold).</p><p><strong>Results: </strong>There was a 7.7±10.2 event/h reduction in the AHI from baseline to post treatment (<i>p</i>=.001), however, no change in any of the OSA endotype traits studied (all <i>p</i>>.05). Secondary analyses showed a relationship whereby increases in N3 sleep were associated with decreases in AHI (<i>r</i>²=.19, <i>p</i>=.03). Significant improvements were also found in insomnia severity and sleep diary-based sleep efficiency, sleep onset latency, and wake after sleep onset at post-treatment (all <i>p</i><.001).</p><p><strong>Conclusions: </strong>CBT-I is beneficial in improving insomnia symptoms and we provide further support CBT-I improves OSA severity. Despite no change in the OSA endotype traits, the improvement in the AHI may be associated with increased amounts N3 sleep. These results underscore the importance of managing insomnia in COMISA.</p><p><strong>Clinical trial registration: </strong>Registry: Australian and New Zealand Clinical Trial Registry; Identifier: ACTRN12622000226707.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617746","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":"A case study of acceptance and commitment therapy for central disorders of hypersomnolence: opportunities to improve patient-centered and comprehensive treatment approaches.","authors":"Alicia J Roth, Nancy Foldvary-Schaefer","doi":"10.5664/jcsm.11634","DOIUrl":"https://doi.org/10.5664/jcsm.11634","url":null,"abstract":"<p><p>Beyond daytime sleepiness, central disorders of hypersomnolence (CDH; including narcolepsy types 1 and 2 and idiopathic hypersomnia) affect the fundamental aspects of everyday life, including mental health, negative self-esteem, relationships, social stigma, and occupational/school problems, all of which can lead to disability. Limited scientifically tested behavioral treatments designed to address the psychological, social, and economic devastation associated with hypersomnia exist. This case report reviews one patient's experience with two adjuvant interventions for CDH: group Cognitive Behavioral Therapy for Hypersomnia (CBT-H) and individual Acceptance and Commitment Therapy (ACT) intervention for CDH.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574512","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":"A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study.","authors":"Shumenghui Zhai, Tonya M Palermo, Susan Shenoi, George Demiris, Waylon Howard, Julie Kientz, Weichao Yuwen, Teresa M Ward","doi":"10.5664/jcsm.11610","DOIUrl":"https://doi.org/10.5664/jcsm.11610","url":null,"abstract":"<p><strong>Study objectives: </strong>To describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis (JIA) and their parents.</p><p><strong>Methods: </strong>Fifty children, 8-13 years, with JIA and sleep deficiency, and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7-weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline (T1), immediately post-intervention (T2), and one-month post-intervention (T3). Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews.</p><p><strong>Results: </strong>Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and PROMIS sleep disturbance scores immediately post-intervention and one-month follow up; and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores one-month post-intervention. Parents in the SLEEPSMART group had significant improvements in the PROMIS sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately post-intervention and one-month follow-up; and in their self-efficacy scores one-month post-intervention in comparison to parents in the control group.</p><p><strong>Conclusions: </strong>SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with JIA and their parents.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov, Title: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis (SLEEPMART) Pilot Study, identifier: NCT04066205.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574514","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":"Home sleep apnea testing in patients with continuous flow LVAD: is it feasible?","authors":"Pornthira Mutirangura, Tamas Alexy, Sophia E Airhart, Jenna E Kay, Antonio C Christophy, Dominic Emerson, David Raymer, Andrew W Shaffer, Anthony W Castleberry, Marshall P Hyden, Karol Mudy, Benjamin Sun, Snigdha Pusalavidyasagar","doi":"10.5664/jcsm.11606","DOIUrl":"https://doi.org/10.5664/jcsm.11606","url":null,"abstract":"<p><strong>Study objectives: </strong>The incidence of sleep-related breathing disorder (SRBD) remains unclear in patients with a continuous flow left ventricular assist device (LVAD). Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing (HSAT) a more practical alternative. WatchPat has failed to accurately diagnose SRBD in this population. In contrast, the NOX-T3 utilizes more channels to monitor physiological variables potentially offering improved diagnostic accuracy. Therefore, we aimed to validate the NOX-T3 versus PSG in detecting SRBD in patients with a durable LVAD.</p><p><strong>Methods: </strong>This is a single-center, prospective, observational pilot study. Patients with LVAD who screened positive on the STOP-BANG questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index (AHI) with the PSG and the respiratory event index (REI) using the NOX-T3 were compared as well as time spent with oxygen (O₂) saturation ≤ 88% using Spearman's correlation. P values less than 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Ten patients (8 males, 2 females) were enrolled. The average age was 54±15 years and 9 were implanted with a HeartMate3 device. There was a strong correlation between the AHI obtained from NOX T3 and PSG (R²=0.984) but the time spent with O₂ saturation ≤88% correlated poorly (r=0.168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.</p><p><strong>Conclusions: </strong>Our results suggest that the NOX-T3 HSAT device is a useful tool in the comprehensive evaluation of SRBD in patients with LVAD.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574516","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":"Nasal biomarker inflammatory profile in response to intranasal corticosteroids in pediatric obstructive sleep apnea syndrome.","authors":"Ambika G Chidambaram, Christopher M Cielo, Inna Chervoneva, Jonathan M Spergel, Ignacio E Tapia","doi":"10.5664/jcsm.11604","DOIUrl":"https://doi.org/10.5664/jcsm.11604","url":null,"abstract":"<p><strong>Study objectives: </strong>Nasopharyngeal inflammation contributes to pediatric obstructive sleep apnea syndrome (OSAS). Intranasal corticosteroids (INCS) are used to treat pediatric OSAS; a randomized controlled trial (RCT) showed an improvement in OSAS symptoms but without polysomnography or neurobehavioral outcome differences. There is a lack of data demonstrating an objective decrease in the nasal inflammatory biomarker profile (NIBP) associated with INCS. Hence, we evaluated the association of NIBP and response to INCS.</p><p><strong>Methods: </strong>Secondary analysis of a RCT of INCS versus placebo in pediatric OSAS (n=134). The difference in intranasal biomarkers (IL-4, IL-13, TNF-alpha) between the groups after 3 and 12 months was evaluated. The association of the NIBP and response to INCS was assessed. Multiple regression analysis was performed to identify clinical predictors of response to INCS.</p><p><strong>Results: </strong>There were no statistically significant differences in the nasal IL-4, IL-13 and TNF-alpha levels between INCS and placebo groups after 3 and 12 months of treatment. Within the INCS group, there was no statistically significant change in the nasal IL-4, IL-13 and TNF-alpha levels after 3 months of therapy based on responder status. However, among those who received INCS, obesity and a higher obstructive apnea-hypopnea index (OAHI) at baseline were clinical predictors of greater OAHI after three months (<i>p</i> = 0.038 and 0.002, respectively).</p><p><strong>Conclusions: </strong>INCS did not affect the NIBP in children with OSAS, including the responders. In addition, INCS is not recommended as a treatment option in children with obesity or high OAHI at baseline.</p><p><strong>Clinical trial registration: </strong>Name: Steroids for Pediatric Apnea Research in Kids (SPARK); URL: https://clinicaltrials.gov/study/NCT02180672; Identifier: NCT02180672.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574520","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 effectiveness of high-flow nasal cannula therapy in comparison with continuous positive airway pressure therapy in patients with obstructive sleep apnea: an open-label randomized crossover trial.","authors":"Siraj Wali, Ghadah Batawi, Ghufran Bin Afeef, Ahmad A Bamagoos, Arwa Jamal, Omar Kanbr, Ranya Alshumrani, Faris Alhejaili, M Safwan Badr","doi":"10.5664/jcsm.11640","DOIUrl":"https://doi.org/10.5664/jcsm.11640","url":null,"abstract":"<p><strong>Study objectives: </strong>Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea (OSA). However, its effectiveness is limited by poor long-term compliance. Few recent studies have investigated the effectiveness of high-flow nasal cannula (HFNC) in treating OSA; however, its role remains uncertain. This study aimed to determine the effectiveness of HFNC, compared with CPAP, in the treatment of patients with OSA.</p><p><strong>Methods: </strong>This prospective open-label randomized crossover trial was conducted on treatment-naïve, newly-diagnosed patients with OSA. Participants underwent a CPAP and a HFNC titration studies in one-of-two crossover sequences. The American Academy of Sleep Medicine guidelines for CPAP titration were followed for titration of both: CPAP and HFNC. The initial flow rate of HFNC was set at 10 L/min, and the flow rate was increased by 10 L/min, up to a maximum of 60 L/min, to eliminate all respiratory events.</p><p><strong>Results: </strong>Sixty-eight participants completed the study. Compared to the diagnostic PSG, the apnea-hypopnea index (AHI) decreased by a median of 52% with HFNC therapy [18-77, p value < 0.001]. Clinically acceptable titration was observed in 48% of patients receiving HFNC therapy, whereas 53% experienced a ≥50% reduction in the AHI. The efficacy of HFNC decreased as OSA severity increased. However, CPAP therapy provided superior control of OSA, with a lower AHI (5.8 vs. 16.6, p values < 0.001). Sleep architecture significantly improved with CPAP; however, declined with HFNC.</p><p><strong>Conclusions: </strong>HFNC serves as a viable option for patients intolerant to CPAP, although careful patient selection is essential.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574522","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":"Perspective: Improving the understanding of sleep deprivation and strategies for fatigue management across the medical education continuum: a call to action.","authors":"Isaac L Alter, Rachel B Kutler, Yi Cai, Ilene M Rosen","doi":"10.5664/jcsm.11502","DOIUrl":"10.5664/jcsm.11502","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"613-616"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717525","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}