{"title":"Impact of COVID-19 pandemic on insomnia and sleep efficiency in parents and caregivers of young children","authors":"N. Jiao, K. Pituch, M. Petrov","doi":"10.3389/frsle.2023.1212784","DOIUrl":"https://doi.org/10.3389/frsle.2023.1212784","url":null,"abstract":"During the COVID-19 pandemic, sleep problems were highly prevalent. However, few studies assess sleep quality among parents and caregivers with young children. This study aimed to describe the impacts of the COVID-19 pandemic on sleep patterns among parents and caregivers with young children (<6 years) and identify the factors associated with insomnia and sleep efficiency.An internet sample of 136 caregivers (age: 35 ± 9.7 y, 70.6% female) were recruited internationally from May 21, 2020 to July 1, 2020. Participants completed the Center for Epidemiological Studies–Depression Scale-10 (CES-D-10), Sleep Hygiene and Practices Scale (SHPS), Coronavirus Impact Scale (CIS), Insomnia Severity Index (ISI), and sleep patterns prior to and during the pandemic. Hierarchical regressions were conducted to examine the factors associated with insomnia and sleep efficiency.Nearly 40% of the caregivers reported household incomes <$10,000. More than half reported clinical levels of depressive symptoms (59.2%) and low sleep efficiency (65.8%). Approximately 90% reported that their sleep-wake routine was altered with delayed bedtime and midpoint, and more naps and nightmares. Almost half (51.5%) were experiencing clinically meaningful insomnia symptoms. Greater insomnia symptom severity was independently associated with lower income, greater depressive symptoms, poor sleep hygiene behaviors, altered sleep-wake routine, and greater COVID-related disruptions in daily life. The predictors associated with poor sleep efficiency during the pandemic were lower income and poor sleep efficiency before the pandemic.The study highlighted the factors associated with insomnia and poor sleep efficiency during the COVID-19 pandemic. Interventions are needed to support caregivers' sleep during global crises.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83079641","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}
S. Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, J. Prowting, Layth Tumah, Abed A. Najjar, H. Khan, Muna Sankari, O. Lasisi, L. Ravelo, P. Peppard, M. Badr, A. Sankari
{"title":"Role of automated detection of respiratory related heart rate changes in the diagnosis of sleep disordered breathing","authors":"S. Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, J. Prowting, Layth Tumah, Abed A. Najjar, H. Khan, Muna Sankari, O. Lasisi, L. Ravelo, P. Peppard, M. Badr, A. Sankari","doi":"10.3389/frsle.2023.1162652","DOIUrl":"https://doi.org/10.3389/frsle.2023.1162652","url":null,"abstract":"Study objectives The objective of this study was to determine whether electrocardiogram (ECG) and heart rate accelerations that occur in the vicinity of respiratory events could predict the severity of sleep-disordered breathing (SDB). Methods De-identified polysomnogram (NPSG) recordings from 2091 eligible participants in the Sleep Heart Health Study (SHHS) were evaluated after developing and validating an automated algorithm using an initial set of recordings from 1,438 participants to detect RR interval (RRI) dips in ECG and heart rate accelerations from pulse rate signal. Within-subject comparisons were made between the apnea-hypopnea index (AHI) and both the total RRI dip index (total RRDI) and total heart rate acceleration index (total HRAI). Results The estimated AHIs using respiratory-related HRAI correlated with NPSG AHI both in the unadjusted and adjusted model (B: 0.83 and 0.81, respectively P < 0.05). Respiratory-related HRAI had a strong agreement with NPSG AHI (intraclass correlation coefficient-ICC: 0.64, whereas respiratory-related RRDI displayed weaker agreement and ICC: 0.38). Further assessment of respiratory-related HRAI (≥5 events/h) showed a strong diagnostic ability (78, 87, 81, and 56% agreement for traditional AHI cutoffs 5, 10, 15, and 30 events/h, respectively). At the AHI cutoff of 5 events/h the receiver operating curves (ROC) revealed an area under the curve (AUCs) of 0.90 and 0.96 for RE RRDI and RE HRAI respectively. Conclusion The automated respiratory-related heart rate measurements derived from pulse rate provide an accurate method to detect the presence of SDB. Therefore, the ability of mathematical models to accurately detect respiratory-related heart rate changes from pulse rate may enable an additional method to diagnose SDB.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78139616","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}
Melanie A. Baime, Prem Umang Satyavolu, A. Huhn, J. Ellis
{"title":"Pain catastrophizing moderates the relationship between chronic pain and insomnia severity in persons with opioid use disorder","authors":"Melanie A. Baime, Prem Umang Satyavolu, A. Huhn, J. Ellis","doi":"10.3389/frsle.2023.1111669","DOIUrl":"https://doi.org/10.3389/frsle.2023.1111669","url":null,"abstract":"Study objectives Chronic pain and insomnia commonly co-occur among individuals with opioid use disorder (OUD) and are associated with adverse treatment outcomes and reduced quality of life. Exploring factors that influence these relationships may help identify relevant treatment targets. The present study investigated whether pain catastrophizing moderates the presence of chronic pain and insomnia severity in individuals with OUD. Methods Participants with OUD symptoms (N = 154) were recruited from Amazon's Mechanical Turk, and completed screening measures for chronic pain, insomnia, and pain catastrophizing. Moderation analyses were used to explore whether pain catastrophizing moderated the relationship between chronic pain and insomnia severity. Results Results suggested that chronic pain was only associated with insomnia severity symptoms among individuals with higher levels of pain catastrophizing but was unrelated at lower levels of pain catastrophizing. Conclusions These results suggest that pain catastrophizing may represent a modifiable risk factor among individuals with co-occurring OUD, insomnia, and chronic pain. Future longitudinal and experimental research that examines changes in insomnia, pain severity, and pain catastrophizing over time in OUD may be beneficial.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77268522","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}
E. Arasteh, E. R. de Groot, Demi van den Ende, T. Alderliesten, X. Long, R. de Goederen, M. Benders, J. Dudink
{"title":"Unobtrusive cot side sleep stage classification in preterm infants using ultra-wideband radar","authors":"E. Arasteh, E. R. de Groot, Demi van den Ende, T. Alderliesten, X. Long, R. de Goederen, M. Benders, J. Dudink","doi":"10.3389/frsle.2023.1150962","DOIUrl":"https://doi.org/10.3389/frsle.2023.1150962","url":null,"abstract":"Background Sleep is an important driver of development in infants born preterm. However, continuous unobtrusive sleep monitoring of infants in the neonatal intensive care unit (NICU) is challenging. Objective To assess the feasibility of ultra-wideband (UWB) radar for sleep stage classification in preterm infants admitted to the NICU. Methods Active and quiet sleep were visually assessed using video recordings in 10 preterm infants (recorded between 29 and 34 weeks of postmenstrual age) admitted to the NICU. UWB radar recorded all infant's motions during the video recordings. From the baseband data measured with the UWB radar, a total of 48 features were calculated. All features were related to body and breathing movements. Six machine learning classifiers were compared regarding their ability to reliably classify active and quiet sleep using these raw signals. Results The adaptive boosting (AdaBoost) classifier achieved the highest balanced accuracy (81%) over a 10-fold cross-validation, with an area under the curve of receiver operating characteristics (AUC-ROC) of 0.82. Conclusions The UWB radar data, using the AdaBoost classifier, is a promising method for non-obtrusive sleep stage assessment in very preterm infants admitted to the NICU.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88848502","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}
Anastasija Jemcov, Lindsay Rosenberg, Kim M. Tan-MacNeill, I. Smith, S. Weiss, P. Corkum
{"title":"Short Report: Barriers and facilitators to parents' implementation of a transdiagnostic eHealth sleep intervention for children with neurodevelopmental disorders","authors":"Anastasija Jemcov, Lindsay Rosenberg, Kim M. Tan-MacNeill, I. Smith, S. Weiss, P. Corkum","doi":"10.3389/frsle.2023.1143281","DOIUrl":"https://doi.org/10.3389/frsle.2023.1143281","url":null,"abstract":"Background Insomnia is highly prevalent in children diagnosed with neurodevelopmental disorders (NDDs) and has negative effects on physical and mental health and wellbeing. Lack of evidence-based intervention programs and barriers to treatment (e.g., time/cost) reduce treatment access. To address these problems, the possibility was explored of modifying the Better Nights, Better Days intervention for typically developing (TD) children (BNBD-TD) to make it appropriate for children with NDD. Aims The current study's aim was to examine qualitative data from exit interviews conducted during a usability study. Parents of children with NDD used BNBD-TD and reported on barriers and facilitators experienced while implementing the intervention. Methods/procedures Participants were 15 Canadian parents of children aged 4 to 10 years who were formally diagnosed with an NDD. Parents implemented the BNBD-TD intervention with their children and participated in a semi-structured exit interview to provide perspectives on their user experience. Results Based on an inductive thematic analysis, key facilitators included increased self-efficacy, positive outcomes for the family (e.g., improved sleep problems, parent validation), improved sleep related beliefs/attitudes, and increased motivation. Key barriers included time challenges, struggles when trying to improve sleep problems, and psychosocial factors with negative effects on implementation (e.g., burnout, stress, and/or exhaustion). Conclusions/implications Barriers and facilitators identified resulted in recommendations to include more program supports, including helping parents to plan for implementation success.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73329278","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}
C. Barner, Ann-Sophie Werner, Sandra Schörk, Jan Born, S. Diekelmann
{"title":"The effects of sleep and targeted memory reactivation on the consolidation of relevant and irrelevant information","authors":"C. Barner, Ann-Sophie Werner, Sandra Schörk, Jan Born, S. Diekelmann","doi":"10.3389/frsle.2023.1187170","DOIUrl":"https://doi.org/10.3389/frsle.2023.1187170","url":null,"abstract":"Introduction Sleep is assumed to facilitate the consolidation of new memories in an active process of covert reactivation of the underlying memory representations. Recent evidence suggests that this process is selective by favoring memories that are of future relevance, and can be externally triggered by learning-associated sensory cues presented during sleep [i.e., targeted memory reactivation (TMR)]. In the present study, we (1) set out to confirm the preferential sleep effect for relevant information, and then asked whether (2) simultaneous TMR of relevant and irrelevant information facilitates the advantage for relevant information, and (3) whether the preferential benefit of sleep and TMR for relevant information persists over time. Methods To test these questions, participants explicitly learned two sets of picture-location associations, of which one set was instructed (after encoding) to be relevant and the other to be irrelevant for later testing. In Experiment 1, memory was tested after ~12 h of night sleep (n = 28) or daytime wakefulness (n = 28) as well as again after ~1 week. Results Results showed overall better memory retention after sleep compared to wakefulness after 12 h as well as after 1 week. The relevant memories were overall retained better than the irrelevant memories. Interestingly, a trend toward a stronger sleep benefit for the relevant memories emerged after 1 week, although this effect failed to reach significance. In Experiment 2, learning of the relevant and irrelevant picture-location associations took place in the presence of an odor. During subsequent sleep, in the first phase of slow wave sleep (SWS), participants were either presented with the odor again (n = 23) or received an odorless vehicle (n = 20). Memory retention was assessed after the first SWS period (following awakening) as well as after ~one week. As in Experiment 1, relevant memories were overall retained better than irrelevant memories. However, TMR did not differentially affect the retention of relevant and irrelevant memories. Discussion These findings provide tentative evidence that the selective benefit of sleep for relevant memories evolves over time but is not further facilitated by TMR.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84473545","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}
E. Finnsson, Eydís Arnardóttir, Wan-Ju Cheng, Raichel M. Alex, Þ. Sigmarsdóttir, Snorri Helgason, L. Hang, J. Ágústsson, A. Wellman, S. Sands
{"title":"Sleep apnea endotypes: from the physiological laboratory to scalable polysomnographic measures","authors":"E. Finnsson, Eydís Arnardóttir, Wan-Ju Cheng, Raichel M. Alex, Þ. Sigmarsdóttir, Snorri Helgason, L. Hang, J. Ágústsson, A. Wellman, S. Sands","doi":"10.3389/frsle.2023.1188052","DOIUrl":"https://doi.org/10.3389/frsle.2023.1188052","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway obstruction during sleep. Despite the availability of continuous positive airway pressure (CPAP) as the gold standard treatment, it is not well tolerated by all patients. Accordingly, research has increasingly focused on developing methods for OSA endotyping, which aims to identify underlying pathophysiological mechanisms of the disorder to help guide treatment for CPAP-intolerant individuals. Four key endotypic traits have been identified, namely: collapsibility, upper airway muscle compensation, arousal threshold and loop gain. However, most methods for extracting these traits require specialized training and equipment not available in a standard sleep clinic, which has hampered the ability to assess the full impact of these traits on OSA outcomes. This paper aims to provide an overview of current methods for OSA endotyping, focusing on the Endo-Phenotyping Using Polysomnography (PUP) method and its cloud-based extension, PUPpy, which offer scalable and accessible ways to estimate endotypic traits from standard polysomnography. We discuss the potential for these methods to facilitate precision medicine for OSA patients and the challenges that need to be addressed for their translation into clinical practice.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"81A 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72951619","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}
R. Valji, M. Castro-Codesal, Melanie Lewis, J. MacLean
{"title":"Comparison of non-invasive ventilation use and outcomes in children with Down syndrome and other children using this technology","authors":"R. Valji, M. Castro-Codesal, Melanie Lewis, J. MacLean","doi":"10.3389/frsle.2023.1169236","DOIUrl":"https://doi.org/10.3389/frsle.2023.1169236","url":null,"abstract":"Rationale Children with Down syndrome (DS) make up a substantial portion of long-term non-invasive ventilation (LT-NIV) users though it is unclear if their unique features alter LT-NIV efficacy or use. The aim of this study is to compare the use and outcomes of LT-NIV for children with DS and a matched comparison (MCG). Methods This is a sub-study of a 10-year retrospective review of children initiated on LT-NIV in Alberta, Canada (N = 622). Children with DS (n = 106) were matched in a 1:2 ratio with other children using LT-NIV based on age and therapy start date. Data was collected from medical and sleep laboratory records. Results Upper airway disease was the most common indication for LT-NIV in both groups, though was higher in children with DS (DS: 90% vs. MCG: 50%, OR 8.64 [95% CI 4.38–17.04]). Sleep and respiratory parameters, at the baseline diagnostic sleep study and the change from baseline to treatment study, did not differ between groups. Nasal masks were the predominant mask type in both children with DS (55%) and the MCG (66%) with more children with DS, compared to the MCG, using full face masks (DS: 45 vs. MCG: 33%, p < 0.05). Continuous positive airway pressure was used more often in children with DS (93.3% vs. 69.2%, p < 0.001) while bilevel-positive airway pressure was more common in the MCG (DS: 6.7% vs. MCG 30.8%, p < 0.001). Children with DS were followed longer than children in the MCG (DS: 2.4 [IQR 2.8] vs. MCG: 1.8 [IQR 2.7] years, p < 0.05). Adherence was lower in children with DS at both 6–12 month follow-up and most recent visit with a similar decrease in adherence in both groups over the follow-up period (0.0 [IQR 1.4] vs. −0.3 [IQR 2.0]. Despite this, 66% and 49% of children with DS used LT-NIV for more than 4 h/night at the 6–12 month and most current visit, respectively. Discontinuation of LT-NIV and mortality did not differ between groups. Conclusion LT-NIV is a common and efficacious treatment in children with DS used predominantly for upper airway obstruction. While adherence is lower, the majority of children with DS are successful at using LT-NIV.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80846262","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}
Paul Féghali, Brooke K. Iwamoto, Olivia Triplett, Nicholas J. Rockwood, Timothy D. Nelson, T. V. Van Dyk
{"title":"A daily-level, within-person examination of emotion regulation as a mediator of the relationship between sleep and behavior in youth","authors":"Paul Féghali, Brooke K. Iwamoto, Olivia Triplett, Nicholas J. Rockwood, Timothy D. Nelson, T. V. Van Dyk","doi":"10.3389/frsle.2023.1154638","DOIUrl":"https://doi.org/10.3389/frsle.2023.1154638","url":null,"abstract":"Objective Youth who experience behavioral and emotional problems are at risk for sleep disturbance, while sleep disturbance also perpetuates behavioral and emotional problems. While the relationship between sleep and psychopathology in clinical mental health samples is well-established, exploration of the underlying mechanisms maintaining this relationship is limited. The purpose of this study is to explore within-person variability in emotion regulation as a mechanism of the relationship between sleep and psychopathology in a clinical youth sample. Methods Using a within-person design, 25 children (ages 6–11; 64% male; 44% non-Hispanic White) presenting to outpatient behavioral health treatment with mental health concerns were recruited to participate in a 14-day study. Daily reports of objective sleep duration via actigraphy, self-reported subjective sleepiness, and parent-reported internalizing and externalizing problems and emotion regulation were collected. Multilevel mediation analyses were used to examine the mediating effect of emotion regulation on the daily-level relationship between sleep and behavior problems. Results At the within-person level, emotion dysregulation was a significant mediator of the relationships between objective sleep duration and both externalizing [MCCI (0.0005–0.0063)] and internalizing problems [MCCI (0.0001–0.0025)]. Contrary to hypotheses, when youth slept more than usual, internalizing and externalizing problems were worse through the indirect effect of increased emotion dysregulation. Conclusions Inconsistencies in schedules and routines, even if in a positive direction, may have short-term negative consequences for youth with emotional and behavioral concerns. Future research should look to address sleep variability and how deviations in routine may impact behavior more broadly, through the indirect effects of emotion regulation.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84014785","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":"Mandibular jaw movements as a non-invasive measure of respiratory effort during sleep: application in clinical practice","authors":"J. Martinot, J. Pépin","doi":"10.3389/frsle.2023.1145620","DOIUrl":"https://doi.org/10.3389/frsle.2023.1145620","url":null,"abstract":"Assessment of respiratory effort (RE) is key for characterization of respiratory events. The discrimination between central and obstructive events is important because these events are caused by different physio-pathological mechanisms and require different treatment approaches. Many of the currently available options for home sleep apnea testing either do not measure RE, or RE signal recording is not always reliable. This is due to a variety of factors, including for instance wrong placement of the respiratory inductance plethysmography (RIP) sensors leading to artifacts or signal loss. Monitoring of mandibular jaw movements (MJM) provides the ability to accurately measure RE through a single point of contact sensor placed on the patient's chin. The inertial unit included in the capturing technology and overnight positional stability of the sensor provide a robust MJM bio-signal to detect sleep-disordered breathing (SDB). Many of the pharyngeal muscles are attached to the mandible directly, or indirectly via the hyoid bone. The motor trigeminal nerve impulses to contract or relax these muscles generate discrete MJM that reflect changes in RE during sleep. Indeed, the central drive utilizes the lower jaw as a fine-tuning lever to stiffen the upper airway musculature and safeguard the patency of the pharynx. Associations between the MJM bio-signal properties and both physiological and pathological breathing patterns during sleep have been extensively studied. These show a close relationship between changes in the MJM bio-signal as a function of RE that is similar to levels of RE measured simultaneously by the reference bio-signals such as esophageal pressure or crural diaphragmatic electromyography. Specific waveforms, frequencies, and amplitudes of these discrete MJM are seen across a variety of breathing disturbances that are recommended to be scored by the American Academy of Sleep Medicine. Moreover, MJM monitoring provides information about sleep/wake states and arousals, which enables total sleep time measurement for accurate calculation of conventional hourly indices. The MJM bio-signal can be interpreted and its automatic analysis using a dedicated machine learning algorithm delivers a comprehensive and clinically informative study report that provides physicians with the necessary information to aid in the diagnosis of SDB.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85210093","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}