Journal of Clinical Sleep Medicine最新文献

{"title":"Shared underlying dynamics between sleep disorder and psychiatric disorder: pro-inflammatory state?","authors":"Menguhan Araz Altay","doi":"10.5664/jcsm.11588","DOIUrl":"https://doi.org/10.5664/jcsm.11588","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257153","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":"Community prevalence of positional obstructive sleep apnea.","authors":"Brett L Duce, Antti E Kulkas, Timo T Leppänen, Arie Oksenberg, Juha Töyräs, Craig A Hukins","doi":"10.5664/jcsm.11584","DOIUrl":"https://doi.org/10.5664/jcsm.11584","url":null,"abstract":"<p><strong>Study objectives: </strong>The prevalence of positional obstructive sleep apnea (POSA) in community populations warrants further investigation. Further, more research is needed into the clinical characteristics of its subtypes such as supine predominant OSA (spOSA) and supine isolated OSA (siOSA).</p><p><strong>Methods: </strong>A cross-sectional analysis was performed on 1870 Sleep Heart Health Study participants. OSA was defined by an apnea-hypopnea index (AHI) of five events or more per hour of sleep. Participants with OSA were classified as POSA if the supine AHI was ≥2 times the non-supine AHI. Participants with OSA who did not meet this threshold were classified as non-positional OSA participants (non-POSA). Demographics, polysomnographic data, comorbidities, and medications were all considered. The POSA subtypes spOSA and siOSA were also investigated.</p><p><strong>Results: </strong>POSA participants were slightly older, less obese, and had higher systolic blood pressure than non-POSA subjects, in addition to being more prevalent (62% and 38%, respectively). POSA exhibited higher supine and total AHI. The prevalence of comorbidities or prescription drugs did not differ. In the POSA cohort, spOSA was more prevalent than siOSA (56% vs. 44%). When compared to siOSA, spOSA was associated with more fragmented sleep and higher AHI. Furthermore, when compared to the siOSA group, the spOSA group had a higher prevalence of hypertension and diabetes, as well as more frequently prescribed medications for these comorbidities.</p><p><strong>Conclusions: </strong>In the SHHS population the prevalence of POSA is greater than non-POSA. The spOSA subtype is more prevalent and appears to have worse health consequences than siOSA.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257138","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":"Current knowledge on the pathophysiology of idiopathic hypersomnia and potential mechanisms of action for low-sodium oxybate treatment.","authors":"Logan D Schneider, Alyssa Cairns, Chad Ruoff, Richard K Bogan","doi":"10.5664/jcsm.11566","DOIUrl":"https://doi.org/10.5664/jcsm.11566","url":null,"abstract":"<p><strong>Study objectives: </strong>To elucidate hypotheses for the pathophysiology of idiopathic hypersomnia and discuss the mechanisms by which low-sodium oxybate (LXB) improves idiopathic hypersomnia symptoms.</p><p><strong>Methods: </strong>Published literature on idiopathic hypersomnia sleep abnormalities, symptoms, treatments, and underlying pathophysiology was reviewed.</p><p><strong>Results: </strong>Patients with idiopathic hypersomnia often show sleep architecture alterations, such as increased sleep efficiency and reduced slow-wave sleep, although the literature lacks consensus. The current understanding of pathophysiologic changes in idiopathic hypersomnia is sparse, but several hypotheses have been posited to explain specific symptoms. Long biological sleep clock, hypofunction of default mode network, dysregulated gamma-aminobutyric acid (GABA) signaling, inflammation, reduced physical activity, and immunologic abnormalities have been linked, to varying degrees, with the hallmark symptoms of idiopathic hypersomnia (excessive daytime sleepiness, sleep inertia, brain fog, dysautonomia). Treatment mechanisms may help elucidate pathophysiologic mechanisms. LXB effectively addresses idiopathic hypersomnia symptoms and is the only US-approved therapy for this indication. Oxybate, the active moiety in LXB, acts dose-dependently on GABA and gamma-hydroxybutyrate receptors, inhibits dopamine and noradrenaline signaling, and improves sleep architecture in people with narcolepsy. The effectiveness of LXB, a sleep-inducing treatment, on idiopathic hypersomnia symptoms suggests altered sleep architecture may contribute to this disorder.</p><p><strong>Conclusions: </strong>Idiopathic hypersomnia, a sleep disorder with potentially debilitating symptoms, remains understudied. The underlying pathophysiology of idiopathic hypersomnia needs defining; insights can be gleaned from contextualizing current knowledge about mechanisms of effective treatments, such as LXB.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257140","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":"Achondroplasia and obstructive sleep apnea: surgical outcomes and comparison to general population.","authors":"Claudio Gomez Ascencio, Anna Wani, Ron B Mitchell","doi":"10.5664/jcsm.11574","DOIUrl":"10.5664/jcsm.11574","url":null,"abstract":"<p><strong>Study objectives: </strong>The objective was to compare demographics between children with achondroplasia and OSA with the general pediatric population with OSA, as well as present treatment outcomes for children with achondroplasia.</p><p><strong>Methods: </strong>Retrospective chart review of 22 children with achondroplasia and OSA and 141 children with OSA without achondroplasia. Parameters from polysomnography were analyzed. Values before and after surgery were compared for the achondroplasia group, while baseline values were compared between the control group and achondroplasia group.</p><p><strong>Results: </strong>Pre-intervention in the T&A achondroplasia group, 0 children had mild OSA, 1 had moderate OSA, and 10 had severe OSA. In the comparative group 16 had mild OSA, 11 had moderate OSA, and 114 had severe OSA. The achondroplasia population had a much younger age at T&A compared to the control population - 3.1 versus 6.8 years. When comparing baseline data in the achondroplasia population with respective T&A outcomes, oAHI and SpO₂ were improved. For the adenoidectomy group, there were no significant changes in OSA after surgery. For the Cervicomedullary decompression (CMD) group, there was a decrease in oAHI after surgery.</p><p><strong>Conclusions: </strong>Patients with achondroplasia and OSA have an earlier age of onset compared to children without achondroplasia. For these patients with moderate to severe OSA, treatment with adenotonsillectomy leads to significant improvement. Treatment with adenoidectomy showed no significant change in OSA. CMD also led to an improvement in oAHI.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257136","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":"Intraoperative insights: can wearable devices leverage intraoperative data to advance pediatric OSA diagnostics?","authors":"Eric Cheon, Keith Kilner, Inbal Hazkani BenDror","doi":"10.5664/jcsm.11580","DOIUrl":"https://doi.org/10.5664/jcsm.11580","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191020","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":"OSA diagnosis in context: a comprehensive approach to evaluating novel diagnostic devices.","authors":"Jean-Benoit Martinot, Nhat-Nam Le-Dong","doi":"10.5664/jcsm.11578","DOIUrl":"https://doi.org/10.5664/jcsm.11578","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191041","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":"Embracing the challenge: fostering interest in sleep medicine among internal medicine residents.","authors":"Juan Irizarry-Nieves, Alba Rivera-Diaz, Miriam Padilla-Diaz, Patricia Fernandez-Hawa, Luis Irizarry-Nieves, Lissette Jimenez-Davila, William Rodriguez-Cintrón","doi":"10.5664/jcsm.11564","DOIUrl":"https://doi.org/10.5664/jcsm.11564","url":null,"abstract":"<p><strong>Study objectives: </strong>This study aims to investigate the perception and interest of internal medicine (IM) residents in sleep medicine (SM). The focus is on understanding the current state of knowledge, training adequacy, and the inclination of residents towards pursuing sleep medicine subspecialty training.</p><p><strong>Methods: </strong>We utilized the Indiana University Survey Questionnaire (IUSQ), a validated survey, to assess Internal Medicine residents' perceptions of sleep medicine. The anonymous digital survey was administered to residents at our ACGME-accredited internal medicine training program (IMTP).</p><p><strong>Results: </strong>Of the 61 residents, 52 (85%) participated. The majority recognized the burden of sleep-disordered breathing (SDB) in the population and its importance for training and general practice. However, there was a notable discrepancy in their perception of receiving adequate training in SDB during residency. A significant proportion expressed a neutral stance or disagreement with the idea of pursuing sleep medicine fellowship, citing a lack of interest or comfort in managing sleep disorders.</p><p><strong>Conclusions: </strong>Despite the rising prevalence of sleep-related breathing disorders, there exists a gap in residents' interest in specializing in sleep medicine. This underscores the need for improved sleep medicine education in residency programs. Bridging this educational gap requires curricular enhancements, increased clinical exposure, and mentorship in sleep medicine. Addressing these issues will better equip future physicians to meet the growing demands of sleep medicine and enhance overall patient care.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191015","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":"Early identification of sleep phenotypes in infants by videosomnography: a cross-sectional study.","authors":"Maria Breda, Maristella Lucchini, Natalie Barnett, Oliviero Bruni","doi":"10.5664/jcsm.11576","DOIUrl":"https://doi.org/10.5664/jcsm.11576","url":null,"abstract":"<p><strong>Study objectives: </strong>We propose to identify different sleep phenotypes in infancy, relying on auto-videosomnography metrics.</p><p><strong>Methods: </strong>In this cross-sectional study, objective infant sleep metrics of six hundred twenty-three infants aged 9 to 13 months, recruited among users of Nanit baby-monitor in the United States, were obtained from Nanit auto-videosomnography (1 week of data averaged) in the child's natural sleep environment. A cluster analysis was conducted to group infants based on sleep metrics.</p><p><strong>Results: </strong>Three reproducible and stable sleep phenotypes were identified: Long Sleepers (n.338), Interrupted Sleepers (n.130) and Short Sleepers (n.155). All sleep metrics were statistically significant different in the three groups. Long Sleepers had longer nighttime sleep duration than Interrupted and Short Sleepers. Interrupted Sleepers presented more awakenings than Short and Long Sleepers, and similarly more parental interventions. Short Sleepers presented later bedtimes and earlier wake up times when compared with Long and Interrupted Sleepers. Nighttime sleep efficiency was better in Long Sleepers than in Interrupted and Short Sleepers, but Short Sleepers presented better sleep efficiency than Interrupted Sleepers.</p><p><strong>Conclusions: </strong>Cluster analysis based on objective sleep metrics offers a novel multidimensional approach for the early identification of infants' sleep patterns. Phenotyping sleep patterns is extremely important in identifying the risk for developing neurobehavioral disorders since night wakings and reduced sleep duration in infancy might be predictive of the development of emotional and behavioral problems later in childhood.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191014","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":"Prevalence of restless legs and association with patient-reported outcome measures in myasthenia gravis.","authors":"Mohanad AlGaeed, Tarrant McPherson, Ikjae Lee, Michelle Feese, Inmaculada Aban, Gary Cutter, Henry J Kaminski, Elias G Karroum","doi":"10.5664/jcsm.11386","DOIUrl":"10.5664/jcsm.11386","url":null,"abstract":"<p><strong>Study objectives: </strong>Inflammatory and immune mechanisms are considered in restless legs syndrome (RLS) pathophysiology with several autoimmune diseases associated with RLS. There is a paucity of studies examining RLS prevalence in myasthenia gravis (MG), an autoimmune neuromuscular disease. This study investigated RLS prevalence and association with patient-reported measures in a large registry of participants with MG using a validated RLS diagnostic questionnaire.</p><p><strong>Methods: </strong>The Myasthenia Gravis Foundation of America MG Patient Registry is used on a semiannual basis to survey participants with MG. Patients aged ≥ 18 years, living in the United States, and answering \"yes\" to physician diagnosed MG were invited by email to enroll in an RLS-customized web-based survey. Collection of data included demographics, disease variables, patient-reported measures with a simple depression scale, MG-quality of life-15 revised, MG-activities of daily living instruments, and 13-item short-form Cambridge-Hopkins diagnostic questionnaire for RLS. Multivariable logistic regression models explored the association between RLS and MG variables of interest.</p><p><strong>Results: </strong>A total of 630 eligible participants with MG (age: 62.8 ± 13.2; 54.9% female; 91.6% White) completed the survey. The overall prevalence of RLS was 14.8%. The prevalence of clinically significant RLS was 8.4%. The odds of having RLS were increased with higher (worse) MG-activities of daily living, MG-quality of life-15 revised, and depression scores. History of \"thymic tumor with thymectomy\" and \"continuous positive airway pressure therapy\" were also independent predictors of RLS.</p><p><strong>Conclusions: </strong>RLS is common in patients with MG and is associated with worse functional status, quality of life, and depression. The thymus could play a key role in an autoimmune process associating MG with RLS.</p><p><strong>Citation: </strong>AlGaeed M, McPherson T, Lee I, et al. Prevalence of restless legs and association with patient-reported outcome measures in myasthenia gravis. <i>J Clin Sleep Med</i>. 2025;21(2):269-276.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"269-276"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331552","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 microsleeps to estimate sleepiness at the wheel and near-miss accidents in obstructive sleep apnea.","authors":"Pasquale Tondo, Caterina Pronzato, Irene Risi, Carlo Perretti, Luigi De Gennaro, Maria R Bonsignore, Alberto Malovini, Francesco Fanfulla","doi":"10.5664/jcsm.11376","DOIUrl":"10.5664/jcsm.11376","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea is considered a risk factor for sleepiness at the wheel and near-miss accidents (NMA). To date, there are subjective and objective methods such as the Maintenance of Wakefulness Test (MWT) to investigate sleepiness. However, these methods have limitations. Therefore, a new analysis of the MWT was introduced based on the identification of microsleeps (MS). So, we tested MS analysis to improve the discriminative ability of MWT in recognizing individuals at risk for sleepiness at the wheel and NMA in a population with obstructive sleep apnea.</p><p><strong>Methods: </strong>The study was conducted on 100 naïve patients with suspected obstructive sleep apnea referred to our Sleep Medicine Unit. All patients performed a full standard polysomnography and MWT. The MWT was analyzed according to standard criteria, and the presence of MS episodes, the mean MS latency, and the MS density (the mean absolute or relative number of MS) were assessed.</p><p><strong>Results: </strong>MS were observed in 100% of alert or sleepy patients and 47% of the fully alert patients (<i>P</i> < .0001). Almost 90% of patients reporting NMA showed episodes of MS during MWT. The occurrence of NMA was related to excessive daytime sleepiness, MS latency, and MS density (<i>P</i> < .001). The discriminative power for the NMA of MS density measures was higher than that derived from latency analysis, particularly in patients without excessive daytime sleepiness and with a simultaneous mean sleep latency > 33 minutes.</p><p><strong>Conclusions: </strong>MS analysis provides objective evidence of sleepiness and, therefore, could improve the discriminative ability of the MWT in recognizing individuals at high risk for accidents.</p><p><strong>Citation: </strong>Tondo P, Pronzato C, Risi I, et al. The role of microsleeps to estimate sleepiness at the wheel and near-miss accidents in obstructive sleep apnea. <i>J Clin Sleep Med.</i> 2025;21(2):287-295.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"287-295"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331479","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}