Journal of Clinical Sleep Medicine最新文献

{"title":"Quality measures for the care of patients with insomnia: 2024 update after measure maintenance.","authors":"Robin M Lloyd, T'Auna Crawford, Ryan Donald, Diedra D Gray, William J Healy, Mithri R Junna, Daniel Lewin, Amee Revana, Sharon Schutte-Rodin","doi":"10.5664/jcsm.11512","DOIUrl":"10.5664/jcsm.11512","url":null,"abstract":"<p><p>Insomnia is highly prevalent and is one of the most common sleep disorders among adults and children in the United States. The American Academy of Sleep Medicine convened the Quality Measures Task Force to perform maintenance on this quality measure set, developed to optimize management and care for patients with insomnia, as the measure set was originally developed and published in 2015. The Quality Measures Task Force reviewed the current medical literature, including updated clinical practice guidelines and systematic literature reviews, existing quality measures, and performance data highlighting gaps or variations in care since implementation of the original quality measure set to inform any potential revisions to the quality measures. The revised quality measures can be used to evaluate and track initial and follow-up performance measures and to implement continuous quality improvement, especially in outcomes associated with diagnosing and managing insomnia for adults and children.</p><p><strong>Citation: </strong>Lloyd RM, Crawford T, Donald R, et al. Quality measures for the care of patients with insomnia: 2024 update after measure maintenance. <i>J Clin Sleep Med</i>. 2025;21(3):565-571.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"565-571"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802794","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 novel method for positive airway pressure delivery: vortical pulsating airflow.","authors":"Liran Oren, Ephraim Gutmark, Ann Romaker","doi":"10.5664/jcsm.11466","DOIUrl":"10.5664/jcsm.11466","url":null,"abstract":"<p><strong>Study objectives: </strong>The primary objective of this study was to determine whether vortical pulsating airflow can achieve therapeutic pharyngeal pressure levels without requiring a tight-sealing mask.</p><p><strong>Methods: </strong>A pilot study included 12 nasal-breathing adults who are currently using positive airway pressure (PAP) for therapy. Patients were awake, and pharyngeal pressures were measured using a miniature pressure probe inserted through their nares. Vortical pulsating airflow was applied via a nasal cannula with a customized valve. The inspiratory flow rate was increased until the pharyngeal pressure matched or exceeded the participant's prescribed PAP level. The expiratory flow rate was maintained at a constant low level of continuous airflow.</p><p><strong>Results: </strong>The study demonstrated that vortical pulsating airflow could generate pharyngeal pressures equivalent to or higher than those achieved with PAP therapy in all participants. The peak inspiratory pressures with vortical pulsating airflow followed an oscillatory pattern matching the pulsation frequency. The mean peak pressure increased linearly with the pulsating flow rate. Compared to a high-flow nasal cannula, vortical pulsating airflow produced significantly higher inspiratory pharyngeal pressures, reaching nearly 20 cmH₂O.</p><p><strong>Conclusions: </strong>Vortical pulsating airflow could be a viable method for delivering PAP therapy to patients with respiratory or sleep disorders without needing a tight-sealing mask. Further research is required to establish whether this method can improve patients' adherence to PAP therapy, assess long-term safety and efficacy, and explore the impact of varying pulsation parameters on treatment outcomes.</p><p><strong>Citation: </strong>Oren L, Gutmark E, Romaker A. A novel method for positive airway pressure delivery: vortical pulsating airflow. <i>J Clin Sleep Med.</i> 2025;21(3):513-518.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"513-518"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570068","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":"Effect of sleep quality on wound healing among patients undergoing emergency laparotomy: an observational study.","authors":"Asish Das, Ravi Gupta, Farhanul Huda, Navin Kumar, Vijay Krishnan, Somprakas Basu","doi":"10.5664/jcsm.11442","DOIUrl":"10.5664/jcsm.11442","url":null,"abstract":"<p><strong>Study objectives: </strong>We aimed to study the association between sleep quality, total sleep duration, and wound healing among adult patients who had good sleep quality at the time of admission to the hospital who underwent laparotomy for various reasons.</p><p><strong>Methods: </strong>In this observational study, consecutive adult patients undergoing emergency laparotomy were followed up until the eighth postoperative day. The primary outcome (wound healing) was assessed using the Southampton Wound Grading System. Sleep quality (assessed by the single-item sleep quality scale) was the primary predictor. Pain was assessed using a visual analog pain scale. We studied the effect of postoperative sleep quality on wound healing on postoperative day 8. Secondary analyses assessed the effect of total sleep time, severity of pain, and markers of systemic inflammation on wound healing.</p><p><strong>Results: </strong>In this study 110 participants were included. The average age of participants was 41.7 ± 16.2 years. On postoperative day 8, 34.5% rated their sleep quality as \"poor to fair\" and the rest as \"good.\" Postoperative poor sleep quality was associated with impaired wound healing, starting from the third postoperative day (<i>P</i> < .001 for each subsequent day). Multiple logistic regression was overall significant (χ² = 118.40; degrees of freedom = 9; <i>P</i> < .001), classified 92.7% cases correctly, and explained 88% variance to the outcome. This model showed that shorter total sleep time (<i>P</i> = .009), higher total leukocyte count (<i>P</i> = .005), presence of comorbidities (<i>P</i> = .01), and poor sleep quality during the postoperative week (odds ratio = 78.14; <i>P</i> = .005) increased the odds for impaired healing of wounds.</p><p><strong>Conclusions: </strong>Poor sleep quality during the healing phase is associated with wound complications, a surrogate marker of impaired wound healing.</p><p><strong>Citation: </strong>Das A, Gupta R, Huda F, Kumar N, Krishnan V, Basu S. Effect of sleep quality on wound healing among patients undergoing emergency laparotomy: an observational study. <i>J Clin Sleep Med.</i> 2025;21(3):503-512.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"503-512"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559276","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":"Consumer sleep technology use in individuals with obstructive sleep apnea: does it have a role in monitoring treatment response?","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.11504","DOIUrl":"10.5664/jcsm.11504","url":null,"abstract":"<p><p>Consumer sleep technology (CST) has an emerging role in monitoring sleep, including screening or surveillance of sleep disorders; however, few data are available on CST in patients with obstructive sleep apnea. We analyzed attitudes toward CST and patterns of CST use among individuals with obstructive sleep apnea. Among 251 respondents (mean age 57.5 years; 58.2% female), 66.5% reported CST use, and 92.0% indicated that monitoring obstructive sleep apnea treatment response would be a useful feature of CST. Individuals with a household income < $30,000 (odds ratio 0.26; <i>P</i> = .008) or identifying as a minority/other race (odds ratio 0.15; <i>P</i> = .021) were less likely to use CST. Older age (beta coefficient 0.05; <i>P</i> < .001), Medicare insurance (beta coefficient 1.26; <i>P</i> = .006), and positive airway pressure use (beta coefficient 1.79; <i>P</i> = .008) were associated with increased nights/wk of CST use. These findings demonstrate a high perceived value of CST for monitoring treatment response among individuals with obstructive sleep apnea but disparate use by sociodemographic and clinical factors.</p><p><strong>Citation: </strong>Lenze NR, Kazemi RJ, Ikeda AK, et al. Consumer sleep technology use in individuals with obstructive sleep apnea: does it have a role in monitoring treatment response? <i>J Clin Sleep Med.</i> 2025;21(3):593-597.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"593-597"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717523","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":"Genetic QT score as a predictor of sudden cardiac death in participants with sleep-disordered breathing in the UK Biobank.","authors":"Amit Arora, Wojciech Zareba, Raymond L Woosley, Yann C Klimentidis, Imran Y Patel, Stuart F Quan, Christopher Wendel, Fadi Shamoun, Stefano Guerra, Sairam Parthasarathy, Salma I Patel","doi":"10.5664/jcsm.11474","DOIUrl":"10.5664/jcsm.11474","url":null,"abstract":"<p><strong>Study objectives: </strong>The goal of this study was to evaluate the association between a polygenic risk score (PRS) for QT prolongation (QTc-PRS), corrected QT intervals (QTc) and sudden cardiac death (SCD) in participants enrolled in the UK Biobank with and without sleep-disordered breathing (SDB).</p><p><strong>Methods: </strong>The QTc-PRS was calculated using allele copy number and previously reported effect estimates for each single nuclear polymorphism. Competing-risk regression models adjusting for age, sex, body mass index, QT prolonging medication, race, and comorbid cardiovascular conditions were used for SCD analyses.</p><p><strong>Results: </strong>A total of 500,584 participants were evaluated (56.5 ± 8 years, 54% female, 1.4% diagnosed with sleep apnea). A higher QTc-PRS was independently associated with the increased QTc interval duration (<i>P</i> < .0001). The mean QTc for the top QTc-PRS quintile was 15 msec longer than the bottom quintile (<i>P</i> < .001). SDB was found to be an effect modifier in the relationship between QTc-PRS and SCD. The adjusted hazard ratio per 5-unit change in QTc-PRS for SCD was 1.64 (95% confidence interval 1.16-2.31, <i>P</i> = .005) among those with SDB and 1.04 (95% confidence interval 0.95-1.14, <i>P</i> = .44) among those without SDB (<i>P</i> for interaction = .01). Black participants with SDB had significantly elevated adjusted risk of SCD (hazard ratio = 9.6, 95% confidence interval 1.24-74, <i>P</i> = .03).</p><p><strong>Conclusions: </strong>In the UK Biobank population, the QTc-PRS was associated with SCD among participants with SDB but not among those without SDB, indicating that SDB is a significant modifier of the genetic risk. Black participants with SDB had a particularly high risk of SCD.</p><p><strong>Citation: </strong>Arora A, Zareba W, Woosley RL, et al. Genetic QT score as a predictor of sudden cardiac death in participants with sleep-disordered breathing in the UK Biobank. <i>J Clin Sleep Med</i>. 2025;21(3):549-557.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"549-557"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717524","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 impact of screen time and parental habits on children's sleep quality.","authors":"Deisi Ferrari, Priscila Kalil Morelhão, Gustavo A Moreira, Sergio Tufik, Monica Levy Andersen","doi":"10.5664/jcsm.11470","DOIUrl":"10.5664/jcsm.11470","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"609-610"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631950","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":"Update to quality measures for the care of adult patients with obstructive sleep apnea.","authors":"Robin Lloyd","doi":"10.5664/jcsm.11514","DOIUrl":"10.5664/jcsm.11514","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"611"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802943","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-disordered breathing in a multiethnic cohort of preterm adolescents and adults: assessment of neonatal and subsequent risk factors.","authors":"Nataly J Sanchez-Solano, Gregory P Barton, Tanya Martinez-Fernandez, MinJae Lee, Kara N Goss","doi":"10.5664/jcsm.11440","DOIUrl":"10.5664/jcsm.11440","url":null,"abstract":"<p><strong>Study objectives: </strong>Determine whether preterm-born adolescents and adults have sleep-disordered breathing, as documented by abnormal overnight oximetry.</p><p><strong>Methods: </strong>This single-center cross-sectional study prospectively enrolled adolescents and adults born moderately to extremely preterm (≤ 32 weeks gestation or < 1,500-g birth weight) or full term to complete a study visit, STOP-Bang questionnaire, and overnight oximetry. Oxygen desaturation index (ODI) was compared in preterm vs term with Poisson regression models. Subgroup analyses in preterm participants evaluated associations of neonatal risk factors with ODI.</p><p><strong>Results: </strong>Ninety-six preterm and 44 term participants completed study procedures. Preterm participants more often reported snoring (25% vs 9%; <i>P</i> = .03) and excessive fatigue (62% vs 40%; <i>P</i> = .02), and had higher body mass index, leading to higher STOP-Bang scores (2 ± 1 vs 1 ± 1; <i>P</i> < .001). Preterm participants had 40% higher ODI (incidence rate ratio: 1.40; 95% confidence interval [1.07,1.83]; <i>P</i> = .02). However, after adjusting for classic risk factors for sleep-disordered breathing including age and STOP-Bang score in a multivariable model, history of preterm birth did not predict additive risk for sleep-disordered breathing. Among neonatal factors, a patent ductus arteriosus was associated with a higher ODI (incidence rate ratio 1.99; 95% confidence interval [1.37,2.91]; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Preterm-born adolescents and adults in this study have higher rates of snoring, daytime fatigue, and nocturnal desaturations compared to those term-born. However, the risk of elevated ODI is best attributed to obesity in this cohort and not the history of prematurity. Additionally, a history of a patent ductus arteriosus increased risk for sleep-disordered breathing.</p><p><strong>Citation: </strong>Sanchez-Solano NJ, Barton GP, Martinez-Fernandez T, Lee M, Goss KN. Sleep-disordered breathing in a multiethnic cohort of preterm adolescents and adults: assessment of neonatal and subsequent risk factors. <i>J Clin Sleep Med</i>. 2025;21(3):519-528.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"519-528"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570085","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 sleep promotion program for insufficient sleep among adolescents: a pilot feasibility randomized controlled trial.","authors":"Jessica C Levenson, Tina R Goldstein, Meredith L Wallace, Rachel Witt, Allison G Harvey, Daniel Buysse, Dana L Rofey, Brian Suffoletto, Elizabeth Miller","doi":"10.5664/jcsm.11456","DOIUrl":"10.5664/jcsm.11456","url":null,"abstract":"<p><strong>Study objectives: </strong>We examined the feasibility, acceptability, and impact of a sleep promotion program (SPP).</p><p><strong>Methods: </strong>This pilot trial randomly assigned adolescents (13-15 years of age) with insufficient sleep duration and irregular sleep timing to SPP-continuation (n = 24; SPP in month 1, continuation treatment in month 2) or monitoring-SPP (n = 20; monitoring in month 1, SPP in month 2). SPP included 1 clinician session and at-home delivery of web-based reports of each youth's sleep diary data with accompanying intervention questions that prompt youth to engage in sleep behavior change. Attrition rate primarily measured feasibility. Program satisfaction measured acceptability. Total sleep time, sleep timing, and sleep timing regularity were measured via sleep diary at baseline, Follow-up 1, and Follow-up 2 (each ∼1 month apart). Linear mixed-effects models compared treatment arms on changes in sleep from baseline to Follow-up 1 (month 1). We also compared changes in sleep during month 1 to changes in sleep during month 2 among SPP-continuation participants.</p><p><strong>Results: </strong>Attrition rate was 8.5%, and 96.5% of participants rated the quality of care received as good or excellent. In month 1, SPP-continuation youth showed a significantly greater increase in mean total sleep time than monitoring-SPP youth (0.57 vs -0.38 hours; contrast = 0.95; confidence interval = 0.14, 1.76; <i>P</i> = .024). SPP-continuation participants showed an increase in total sleep time during month 1 (0.51 hours) but a decrease during month 2 (-0.74 hours; contrast = -1.24; confidence interval = -2.06, -0.42; <i>P</i> = .005). No other significant effects were observed.</p><p><strong>Conclusions: </strong>SPP is highly feasible, acceptable, and associated with a significant increase in total sleep time early in treatment.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Targeted Intervention for Insufficient Sleep among Typically-Developing Adolescents; URL: https://clinicaltrials.gov/ct2/show/NCT04163003; Identifier: NCT04163003.</p><p><strong>Citation: </strong>Levenson JC, Goldstein TR, Wallace ML, et al. A sleep promotion program for insufficient sleep among adolescents: a pilot feasibility randomized controlled trial. <i>J Clin Sleep Med.</i> 2025;21(3):529-541.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"529-541"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591970","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":"Inspiratory positive pressure modulation to minimize respiratory control instability.","authors":"Robert Joseph Thomas","doi":"10.5664/jcsm.11548","DOIUrl":"10.5664/jcsm.11548","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"455-456"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916099","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}