Sleep & breathing = Schlaf & Atmung最新文献

{"title":"Prestroke sleep and stroke: a narrative review.","authors":"Xiaodong Yuan, Yongshan Fu, Ya Ou, Jing Wang, Cuiping Yan, Baozhu Li, Qi Wu, Pingshu Zhang","doi":"10.1007/s11325-025-03391-3","DOIUrl":"10.1007/s11325-025-03391-3","url":null,"abstract":"<p><strong>Objectives: </strong>This review aims to explore the relationship between poor pre-stroke sleep and stroke.</p><p><strong>Results: </strong>Pre-stroke sleep duration is associated with the risk and mortality of total stroke, exhibiting a 'U-shaped' or 'J-shaped' dose-response relationship. Regarding stroke subtypes, prolonged sleep duration is linked to an increased risk of ischemic stroke, while short sleep duration is associated with hemorrhagic and wake-up strokes. Additionally, poor sleep quality is one of the risk factors for stroke occurrence. Moreover, daytime napping can mitigate the negative consequences of sleep issues, but attention should be paid to the duration and frequency of naps. Finally, disruptions in circadian rhythms, inflammatory responses, endocrine changes, and alterations in the autonomic nervous system may be potential pathogenic mechanisms through which chronic poor sleep leads to stroke.</p><p><strong>Conclusions: </strong>Healthy individuals experiencing poor sleep can be considered susceptible to stroke. It is crucial to further refine stroke risk assessments for these individuals and provide targeted medical advice. Additionally, we should identify the optimal duration and frequency of naps to reduce the risk of stroke. Furthermore, closer attention should be paid to the temporal dimension to address the challenges that modern societal changes pose to circadian rhythms. Lastly, the relationship between chronic poor sleep and sleep disorders should also be closely examined.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"221"},"PeriodicalIF":2.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using DISE to characterize upper airway collapse and ventilatory characteristics in modeling obstructive sleep apnea.","authors":"Kaitlin N Manning, Katherine P Gouldman, Jason L Yu","doi":"10.1007/s11325-025-03380-6","DOIUrl":"10.1007/s11325-025-03380-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate potential insights gained from incorporating ventilatory measures during drug induced sleep endoscopy (DISE) as a model of obstructive sleep apnea (OSA).</p><p><strong>Study design: </strong>Cross-sectional SETTING: Emory University Hospital Midtown METHODS: DISE was performed on OSA patients referred for presurgical evaluation. A CPAP titration was performed under DISE to determine the critical closing pressure (P_crit) and the pharyngeal opening pressure (P_open) of the upper airway. Airflow was captured using a calibrated pneumotachometer and allowed for calculation of the following ventilatory measures: peak airflow (V_max), tidal volume (TV), respiratory rate (RR) and minute ventilation (MV). Comparative analysis was performed exploring differences in ventilatory measures and baseline demographics between high collapsible and low collapsible airways based on a median split of P_open.</p><p><strong>Results: </strong>Between 6/1/2022 and 6/30/2023, 36 patients were enrolled with 31 completing the study. Between the start and completion of DISE CPAP titration, there was a significant improvement in V_max (+16 L/min, [12, 20], p<0.001), TV (+0.29 L, [0.20, 0.37], p<0.001), and MV (4.4 L/min, [3.2, 5.5], p<0.001), while RR was not significantly different (-0.31 breaths/min, [-0.96, 0.35], p=0.3). High P_open patients exhibited significantly greater V_max (35.48 L/min (13.91) vs. 22.24 L/min (7.22), p=0.003) and were younger (55.94 yrs (10.59) vs. 68.87 yrs (8.52), p<0.001).</p><p><strong>Conclusion: </strong>Incorporating quantitative ventilatory measures into DISE provides valuable insights into individualized patterns of airway collapsibility and OSA pathophysiology. This could allow for more targeted approaches to further research and eventually improve management of the disorder.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"220"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the diagnostic accuracy of automatic polygraphy analysis versus manual analysis in obstructive sleep apnea.","authors":"Alejandra Roncero, María Torres, Mariola Bretón, Mª Dolores Ramirez, Jorge Lázaro, Marta Cristeto, José G Pichel, Carlos Ruiz-Martínez","doi":"10.1007/s11325-025-03374-4","DOIUrl":"10.1007/s11325-025-03374-4","url":null,"abstract":"<p><strong>Introduction: </strong>The high prevalence of obstructive sleep apnea (OSA) and limited healthcare resources have led to an increase in automated diagnostic testing in clinical practice. However, there is limited scientific support for this approach, which may pose risks for patients. Previous studies comparing automatic and manual OSA diagnostic methods often involve small sample sizes and lack standardized protocols.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy of the apnea-hypopnea index (REI) obtained through automatic versus manual polygraphy (PR) analysis and its performance across OSA severity levels.</p><p><strong>Method: </strong>This prospective study included 3,144 subjects who underwent both automatic and manual PR analysis.</p><p><strong>Results: </strong>A low diagnostic concordance (44.52%) was observed between automatic and manual PR analyses, indicating a poor diagnostic capacity of automated analysis. Sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were assessed for OSA diagnosis at different severity levels. While high S and NPV were noted for excluding OSA, E and PPV were low. For mild OSA, S and PPV were particularly low, as were E and PPV. The accuracy was similarly poor for moderate and severe OSA, though severe OSA showed higher E and NPV. Finally, for very severe OSA, S remained low, contrasting with high E, PPV, and NPV.</p><p><strong>Conclusions: </strong>Automated polygraphy shows limited diagnostic accuracy, especially in mild and moderate OSA. Despite good sensitivity to rule out disease, its low specificity may lead to misclassification. Manual analysis remains essential for reliable diagnosis.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"218"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the potential biomarkers between stroke and obstructive sleep apnea by WGCNA and machine learning.","authors":"Lin Zhou, Pengfan Ye, Yiming Wang","doi":"10.1007/s11325-025-03369-1","DOIUrl":"10.1007/s11325-025-03369-1","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke (IS) and obstructive sleep apnea (OSA) are highly prevalent disorders with significant societal and individual burdens. OSA exacerbates stroke outcomes, elevates recurrent stroke risk, and impedes functional recovery. Identifying shared biomarkers and elucidating the molecular mechanisms linking IS and OSA have been critical for developing targeted therapies and improving patient prognosis.</p><p><strong>Methods: </strong>Transcriptomic data for IS and OSA were obtained from the GEO database (GSE58294, GSE135917, GSE38792, and GSE22255). After batch-effect correction, weighted gene co-expression network analysis (WGCNA) and differential expression analysis were performed to identify disease-associated genes. Functional enrichment analysis and a protein-protein interaction network construction were conducted. Advanced machine learning algorithms-Least Absolute Shrinkage and Selection Operator (LASSO) regression and random forests-were applied to screen hub genes, followed by validation of their diagnostic performance. Patients were stratified into high-and low-expression groups based on hub genes levels, and gene set enrichment analysis (GSEA) was performed to characterize pathway activity.</p><p><strong>Results: </strong>Integration of WGCNA and differential expression analysis revealed 112 shared differentially expressed genes (DEGs) significantly associated with IS and OSA. Enrichment analysis implicated these DEGs in critical processes, including protein ubiquitination, fatty acid metabolism, cell proliferation and apoptosis, autophagy, cyclooxygenase pathway, and chromatin remodeling. Machine learning identified DUSP1 as a central hub gene, with significantly elevated expression in both IS and OSA. Diagnostic validation demonstrated robust performance for DUSP1 (AUCs: 1.000 in GSE58294, 0.885 in GSE135917, 0.718 in GSE22255), though variability was observed in GSE38792 (AUC: 0.487). GSEA highlighted distinct pathway signatures: high DUSP1 expression correlated with activation of ribosome, spliceosome, and nucleocytoplasmic transport pathway, while suppressing Ras/Rap1 signaling, platelet activation, PI3K-AKT signaling, IL-17 signaling, and immune-related pathways (e.g., Fc gamma R-mediated phagocytosis, cytokine-cytokine receptor interaction, and B cell receptor signaling pathway).</p><p><strong>Conclusion: </strong>Through integrative bioinformatics and machine learning, this study identifies DUSP1 as a novel hub gene linking IS and OSA. Functional annotation reveal its involvement in shared biological pathways, offering mechanistic insights into disease pathogenesis and highlighting DUSP1 as a potential therapeutic target.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"219"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific parallels of sleep physiology in the Qur'anic narrative of the Companions of the Cave \"the Cave Sleepers\".","authors":"Wissem Dhahbi, Ahmed S BaHammam, Abdelfatteh El Omri, Ismail Dergaa, Amine Souissi, Anis Ben Dhahbi, Helmi Ben Saad","doi":"10.1007/s11325-025-03377-1","DOIUrl":"10.1007/s11325-025-03377-1","url":null,"abstract":"<p><strong>Background: </strong>The Qur'anic narrative of the Companions of the Cave (Cave Sleepers, in Arabic \"Ashab al-Kahf\") describes young believers who experienced a prolonged, divinely induced sleep in a cave, as recounted in verses 18:9-26 of Sūrah Al-Kahf. This account, while spiritual in nature, presents details that parallel modern scientific concepts in sleep physiology, particularly regarding environmental influences and bodily preservation during extended immobility.</p><p><strong>Objective: </strong>To explore scientific parallels between the Qur'anic description of the Cave Sleepers' prolonged sleep and contemporary sleep physiology, fostering interdisciplinary dialogue.</p><p><strong>Methods: </strong>A comparative analytical descriptive approach was employed, incorporating historical context and established principles for the scientific interpretation of the Qur'an. A comprehensive literature review covered publications from 1970 to July 2024, focusing on sleep physiology, circadian rhythms, and relevant Qur'anic exegesis.</p><p><strong>Results: </strong>The analysis revealed notable correspondences between the Qur'anic narrative and modern sleep science. The emphasis on noise reduction and controlled light exposure aligns with the current understanding of optimal sleep environments and circadian regulation. The narrative's mention of bodily preservation and periodic turning during sleep reflects modern practices to prevent complications from prolonged immobility, such as pressure ulcers and muscle atrophy. Additionally, the described cave environment mirrors conditions known to support hypometabolic states and sleep consolidation.</p><p><strong>Conclusions: </strong>The Qur'anic account of the Cave Sleepers resonates with contemporary sleep physiology, particularly in environmental optimization and bodily maintenance during extended sleep. This interdisciplinary exploration encourages new scientific questions and research directions in sleep biology and human physiology.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"217"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between sleep quality and cardiac autonomic modulation according to physical activity levels in adults: a cross-sectional study.","authors":"Lucas J Onimaru, Diego G D Christofaro, Heloisa B Valente, Isabella C Leoci, Monica L Andersen, Sergio Tufik, Gerson Ferrari, Luiz Carlos M Vanderlei, William R Tebar, Priscila Kalil Morelhão","doi":"10.1007/s11325-025-03388-y","DOIUrl":"10.1007/s11325-025-03388-y","url":null,"abstract":"<p><strong>Background: </strong>Poor sleep quality has been related to various health issues, particularly cardiovascular diseases. This association is partly due to the negative influence that sleep problems have on cardiac autonomic activity, which is often evaluated heart rate variability (HRV). Regular physical activity (PA) has been suggested as an effective strategy to improve HRV and mitigate the adverse effects of sleep disorders. Although some studies have been conducted in this field, further research is warranted to comprehensively understand how PA influences this dynamic.</p><p><strong>Aim: </strong>To analyse the association between cardiac autonomic modulation (CAM) and sleep quality, stratified by physical activity levels.</p><p><strong>Methods: </strong>The sample consisted of 230 participants. CAM was assessed under resting conditions using time- and frequency-domain indices of HRV: RMSSD, SDNN, LF n.u, HF n.u and nonlinear metrics such as SD1 and SD2. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and PA was objectively quantified with an ActiGraph GT3X accelerometer.</p><p><strong>Results: </strong>Among participants classified as insufficiently active, poor sleep quality was significantly associated with lower parasympathetic activity, reflected in reduced RMSSD (β = -12.10; 95% CI: -21.02 to -3.06) and SD1 (β = -8.39; 95% CI: -14.81 to -1.97) values. No significant associations were found in the physically active group.</p><p><strong>Conclusions: </strong>Lower parasympathetic modulation was observed in insufficiently active individuals reporting poor sleep quality, suggesting that PA may mitigate the unfavorable effects of sleep impairment on cardiac autonomic function.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"216"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of digital cognitive behavioral therapy treatment for perioperative sleep disorders in patients undergoing total knee arthroplasty.","authors":"Yanan Wang, Juan Shao, Peixia Yu, Yanan Li, Xiulin Huo, Qingkai Li, Li Song, Qiujun Wang, Xiaojuan Qie","doi":"10.1007/s11325-025-03387-z","DOIUrl":"10.1007/s11325-025-03387-z","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing total knee arthroplasty (TKA) may suffer from perioperative sleep disorders (PSD), and their management is challenging. The aim of this study was to assess the efficiency of digital cognitive behavioral therapy (dCBT) in the management of PSD after TKA.</p><p><strong>Methods: </strong>From December 2022 to August 2023, a total of 114 patients undergoing primary, unilateral TKA under general anaesthesia were included. The primary outcome was the Athens Insomnia Scale (AIS) score. Other outcome parameters included sleep quality, pain scores (NRS scores), mental disorders (hospital anxiety and depression scale scores and MMSE scores) and recovery quality (quality of recovery-40 questionnaire).</p><p><strong>Results: </strong>There was no significant difference in AIS score, sleep quality, pain score or mental status between the two groups immediately after admission. The AIS scores of the dCBT group and control group were 3 (2) andvs. 3 (2.25) (P < 0.05) on the first postoperative day, 3 (1) vs. 3 (3) (P < 0.05) on the third postoperative day, and 1 (1) vs. 2 (2) (P < 0.05) on the 15th postoperative day, respectively. Compared with those in the control group, the sleep quality, anxiety scores and recovery quality in the early stage significantly improved in the dCBT group. However, the pain scores and cognitive function of the two groups were not significantly different.</p><p><strong>Conclusion: </strong>dCBT can decrease the severity of PSD and improve recovery quality in the early stage after TKA surgery. Furthermore, dCBT can relieve anxiety and thereby promote postoperative recovery.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"215"},"PeriodicalIF":2.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor sleep quality is a predictor of severe hypoglycemia during comprehensive diabetes care in type 1 diabetes.","authors":"Prapai Dejkhamron, Thipaporn Tharavanij, Supawadee Likitmaskul, Petch Rawdaree, Jeerunda Santiprabhob, Chaicharn Deerochanawong, Wannee Nitiyanant, Sirimon Reutrakul","doi":"10.1007/s11325-025-03385-1","DOIUrl":"10.1007/s11325-025-03385-1","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances is common in type 1 diabetes (T1D) and can be associated with poor glycemic control, and possibly hypoglycemia. This study aims to investigate whether poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), was associated with glycemic control or severe hypoglycemia in T1D individuals.</p><p><strong>Methods: </strong>This one-year prospective cohort study included 221 (148 F/63 M) T1D participants (aged ≥ 13 years), receiving intensive insulin therapy. A1C levels were obtained at baseline and during the 12-month follow-up. Incidences of diabetic ketoacidosis (DKA) and severe hypoglycemia were collected.</p><p><strong>Results: </strong>The mean age of participants was 21.4 ± 8.9 years, with a baseline A1C of 9.27 ± 2.61%. Poor sleep quality was reported in 33.0% of participants. A1C levels improved over the one-year follow-up, but there was no significant difference in A1C reduction between those with good vs. poor sleep quality (-0.42 ± 1.73 vs. -0.42 ± 1.67, P = 0.835), nor in DKA incidence (P = 0.466). However, participants with poor sleep quality experienced more SH episodes (6.53 (2.45-17.41) vs. 0 per 100-person year, P = 0.01). After adjusting for age, body mass index, and glucose monitoring, each one-point increase in PSQI score was associated with a higher severe hypoglycemia risk (OR 1.31, 95%CI 1.13-1.52). Poor sleep quality predicted an increased risk of severe hypoglycemia (OR 24.54, 95%CI 1.31-459.29).</p><p><strong>Conclusion: </strong>Poor sleep quality is common in T1D individuals and is a risk factor for incident SH. These findings highlight the importance of incorporating sleep assessment into routine T1D diabetes care and the need of targeted interventions to improve sleep quality in T1D individuals. These findings support the importance of addressing sleep quality in T1D management, particularly in relation to hypoglycemia risk.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"214"},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of PRECEDE-PROCEED model on enhancing neonatal sleep safety practices.","authors":"Ying Li, Yue-Ping Ma, Xue-Qin Lu, Rui-Hua Wang, Yan-Qing Zhu","doi":"10.1007/s11325-025-03386-0","DOIUrl":"10.1007/s11325-025-03386-0","url":null,"abstract":"<p><strong>Objective: </strong>The neonatal period is the most vulnerable stage of life, and safe sleep practices are crucial in preventing asphyxia and sudden infant death syndrome. The PRECEDE-PROCEED model is a comprehensive evaluation framework for assessing health needs for designing and implementing health programs. This study aimed to explore the application and effectiveness of an intervention based on the PRECEDE-PROCEED model in improving neonatal sleep safety caregiving behaviors.</p><p><strong>Methods: </strong>In this randomized controlled trial, neonatal caregivers from the obstetrics department of a tertiary hospital in Jiangsu Province, China, were recruited between May and August 2024. Using the PRECEDE-PROCEED model as a guiding framework, the study assessed caregivers' baseline knowledge and practices concerning neonatal sleep safety and identified barriers to effective neonatal sleep safety. In the PRECEDE phase, the current state of neonatal caregivers' knowledge, behaviors, and barriers was analyzed. These barriers were categorized into predisposing factors (e.g., caregivers' knowledge, awareness, and motivation), enabling factors (e.g., access to resources and external support), and reinforcing factors (e.g., feedback from others). Targeted interventions were then implemented accordingly. In the PROCEED phase, the effectiveness of the intervention was evaluated, feedback was collected, and the intervention strategy was continuously adjusted and optimized. Lastly, data were gathered through questionnaires and direct on-site observations, and a comparative analysis was conducted to evaluate changes in caregivers' knowledge, practices, and perceived self-efficacy before and after the intervention.</p><p><strong>Results: </strong>Following the intervention, neonatal caregivers exhibited a significant improvement in their knowledge of neonatal sleep safety compared to the control group (P < 0.05). Their caregiving practices became more standardized, with notably higher accuracy rates in sleep posture selection and sleep environment arrangement, in contrast to the control group (P < 0.05). Additionally, caregivers also exhibited a significant increase in self-efficacy scores after the intervention (P < 0.05).</p><p><strong>Conclusion: </strong>The PRECEDE-PROCEED model proved effective in identifying barriers to caregiving practices and facilitated the development of targeted interventions, resulting in substantial improvements in caregivers' knowledge and adherence to best practices for neonatal sleep safety. Additionally, the model contributed to enhancing caregivers' self-efficacy. These outcomes are crucial for the ongoing improvement of caregiving practices and the promotion of neonatal sleep safety. Lastly, the use of this model may contribute to a decrease in the risk of sudden infant death syndrome.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"213"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proposition of hybrid healthcare pathway to screen and diagnose obstructive sleep apnea: exploratory analysis of retrospective observational data.","authors":"AbdelKebir Sabil, Alice De Sanctis, Robin Ohannessian, Jean Arthur Micoulaud-Franchi","doi":"10.1007/s11325-025-03381-5","DOIUrl":"10.1007/s11325-025-03381-5","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to evaluate an integrated hybrid healthcare pathway that combines a digital screening questionnaire, teleconsultations (TC) with sleep physicians and home sleep apnea testing (HSAT), for the screening and diagnosis of obstructive sleep apnea (OSA) in France.</p><p><strong>Methods: </strong>This exploratory retrospective study was performed on data from the SleepDoctor platform collected between July 2022 to April 2024. The OSA screening pathway included a digital Berlin Questionnaire (BQ), followed by an offer of teleconsultation for patients at risk of OSA with a registered nurse, a sleep physician and a home sleep apnea test (HSAT) when needed. Demographic data and risk scores were compared between high and low-risk subjects, with or without teleconsultation and with or without HSAT.</p><p><strong>Results: </strong>Of 45,099 patients included (63.3% women, mean age = 43.6 ± 13.5 years and mean BMI = 28.1 ± 65 kg/m²), 26,440 (58.6%) were at high risk of OSA (60.4% female, mean age = 45.1 ± 12.5 years and mean BMI = 30.3 ± 6.7 kg/m²). Of these, 944 booked a TC with a sleep physician among whom 579 had a HSAT. Although more women were at high risk of OSA, they were less likely to have booked a TC (42.5%) and have had a HSAT (41.6%) than men (p < 0.0001).</p><p><strong>Conclusion: </strong>These findings highlight the need for further optimization of the proposed hybrid pathway, particularly in engaging at-risk individuals to complete the full screening and diagnosis process.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"212"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}