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Sleep Medicine Reviews Apr 2024This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism. This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was registered with PROSPERO prior to the accomplishment of the main search. Ten clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. The certainty of the evidence analysis was established by different levels of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. A meta-analysis of diagnostic test accuracy was performed with multiple thresholds per study applying a two-stage random effects model, using the thresholds offered by the studies and based on the number of EMG bruxism events per hour presented by the participants. Five studies were included. The MA indicated that portable EMG diagnostic devices showed a very good diagnostic capacity, although a high variability is evident in the studies with some outliers. Very low quality of evidence due to high risk of bias and high heterogeneity among included studies suggests that portable devices have shown high sensitivity and specificity when diagnosing sleep bruxism (SB) compared to polysomnography. The tests performed in the MA found an estimated optimal cut-off point of 7 events/hour of SB with acceptably high sensitivity and specificity for the EMG portable devices.
Topics: Humans; Sleep Bruxism; Polysomnography; Electromyography
PubMed: 38295573
DOI: 10.1016/j.smrv.2024.101906 -
Pediatric Nephrology (Berlin, Germany) May 2023Nocturnal enuresis (NE) is a multifactorial and complex condition. One less understood factor in its pathophysiology is the enuretic inability to wake up when the... (Review)
Review
BACKGROUND
Nocturnal enuresis (NE) is a multifactorial and complex condition. One less understood factor in its pathophysiology is the enuretic inability to wake up when the bladder is full (impaired arousal).
OBJECTIVE
We aimed to investigate the relationship between sleep and NE in children and adolescents.
METHODS
A systematic review was performed following the PRISMA guidelines, and the electronic databases MEDLINE (via PubMed) and SCOPUS were searched until March 2022. Eligibility criteria were studies that recruited patients aged five-17 years with a diagnosis of NE according to the International Child Continence Society (ICCS), Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), or International Classification Criteria of Sleep Disorders-Third edition (ICSD-3) who had their sleep assessed using validated questionnaires and/or polysomnography. The tool used to analyze the risk of bias in the included studies was the risk of bias in non-randomized studies of exposure.
RESULTS
Of 1582 citations screened, nine were included, giving 1685 participants, 581 with NE. All studies were observational and half had a low risk of bias. Four studies evaluated sleep by questionnaires only; two used questionnaires and polysomnography; two used only polysomnography, and one used sleep logs and actigraphy. Sleep questionnaires showed that children with enuresis had more sleep problems than controls, especially parasomnias, breathing disorders, and daytime sleepiness. Among the polysomnography parameters, the sleep stage architecture and periodic limb movements during sleep had conflicting data between the two studies.
LIMITATIONS
The studies evaluated sleep through heterogeneous tools. They used different questionnaires; even those considered by polysomnography did not record the same channels.
CONCLUSION
It seems that enuretic children and adolescents sleep differently from those who are non-enuretic. More studies are needed to clarify the best way to assess sleep and better understand this relationship. The review protocol was registered with PROSPERO, CRD42021266338. There was no funding.
Topics: Humans; Child; Adolescent; Nocturnal Enuresis; Sleep; Polysomnography; Urinary Bladder; Urinary Incontinence
PubMed: 36427087
DOI: 10.1007/s00467-022-05818-5 -
Journal of Oral Rehabilitation Sep 2017This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of questionnaires, clinical assessment and portable diagnostic devices compared... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of questionnaires, clinical assessment and portable diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism (SB). Two reviewers searched electronic databases for diagnostic test accuracy studies that compared questionnaires, clinical assessment or portable diagnostic devices for SB, with the reference standard method PSG, comprising previous studies from all languages and with no restrictions regarding age, gender or time of publication. Of the 351 articles, eight met the inclusion criteria for qualitative, and seven for quantitative analysis. The methodology of selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The studies were divided and analysed over three groups: three studies evaluating questionnaires, two regarding the clinical assessment of tooth wear and three covering portable diagnostic devices. The MA indicated that portable diagnostic devices showed the best validity of all evaluated methods, especially as far as a four-channel EMG/ECG recording is concerned. Questionnaires and the clinical assessment can be used as screening methods to identify non-SB individuals, although it is not that good in identifying subjects with SB. The quality of evidence identified through GRADEpro, was from very low-to-moderate, due to statistical heterogeneity between studies.
Topics: Electromyography; Humans; Patient Selection; Polysomnography; Reference Standards; Reproducibility of Results; Sensitivity and Specificity; Sleep Bruxism
PubMed: 28477392
DOI: 10.1111/joor.12520 -
Neurological Sciences : Official... Dec 2022Parkinson's disease (PD) patients experience non-motor symptoms (NMS), which may appear before motor manifestations. The most common NMS is depression, affecting about... (Review)
Review
BACKGROUND
Parkinson's disease (PD) patients experience non-motor symptoms (NMS), which may appear before motor manifestations. The most common NMS is depression, affecting about 30-40% of PD patients. Both PD and depression are associated with an increased inflammatory burden, with studies showing elevation of diverse inflammatory markers in patients with both conditions.
METHODS
A systematic review was conducted in PubMed and PsycINFO databases to investigate what inflammatory markers are associated with PD depression (PDD). Only studies in English that measured inflammatory markers and analyzed against depression scores in PD patients were included.
RESULTS
A total of 1132 articles were retrieved, and 14 entries were found to be eligible. Twelve were cross-sectional studies, one was a cohort, and one was a non-randomized controlled trial. IL-17A was the only marker strongly associated with PDD, while studies assessing sIL-2R and serum amyloid A found a moderate correlation. C-reactive protein, IL-10, tumor necrosis factor-α, monocyte chemoattractant protein-1, and IL-6 yielded conflicting results. Their possible roles in PDD are discussed. PDD was also related to longer disease duration and other NMS, such as anxiety, fatigue, dementia, REM sleep behavior disorder, and autonomic dysfunction.
CONCLUSION
We suggest that these markers may be used for distinguishing isolated depression from that related to neurodegeneration, especially in individuals that concurrently present with other known prodromal symptoms of PD and other α-synucleinopathies. However, future prospective studies are warranted to confirm this hypothesis.
Topics: Humans; Anxiety; Biomarkers; Depression; Parkinson Disease; REM Sleep Behavior Disorder; Synucleinopathies
PubMed: 36040559
DOI: 10.1007/s10072-022-06363-7 -
Fertility and Sterility Jan 2020This literature review presents two unusual and mystifying disorders of penile erection: painful nocturnal erections, alternatively termed sleep-related painful...
This literature review presents two unusual and mystifying disorders of penile erection: painful nocturnal erections, alternatively termed sleep-related painful erections, and idiopathic stuttering priapism, a variant of recurrent ischemic priapism in which no cause is discernible. The disorders are closely related although they are distinct clinically and pathologically. The main subject areas of discussion are recognition, clinical evaluation and management although current concepts surrounding their causes and mechanisms are also addressed. It is acknowledged that despite the perceived rarities of these disorders they are impactful in terms of their disease profiles and consequences. Future advances in their management will require continued development of evidence-based treatments.
Topics: Humans; Male; Penile Erection; Priapism; REM Sleep Parasomnias; Rare Diseases
PubMed: 32033724
DOI: 10.1016/j.fertnstert.2019.11.013 -
Sleep Medicine Clinics Mar 2024Exploding head syndrome (EHS) has historically been viewed as a disorder predominantly affecting older people and being more common in females. Through a comprehensive... (Review)
Review
Exploding head syndrome (EHS) has historically been viewed as a disorder predominantly affecting older people and being more common in females. Through a comprehensive review of data since 2005, this scoping review provides updated evidence from 4082 participants reporting EHS across a variety of study designs on: how EHS presents; key information on comorbidity and correlates of EHS; how EHS is experienced in terms of symptoms and beliefs; causal theories arising from the research reviewed; and evidence-based information on how research has reported on the management of EHS. Since 2005, EHS has attracted increasing research interest; however, there are significant gaps in the research that are hindering a better understanding of EHS that might be helpful for clinicians.
Topics: Humans; Parasomnias
PubMed: 38368060
DOI: 10.1016/j.jsmc.2023.10.007 -
Dental Press Journal of Orthodontics 2014Prevalence of sleep bruxism (SB) in children is subject to discussions in the literature. (Review)
Review
INTRODUCTION
Prevalence of sleep bruxism (SB) in children is subject to discussions in the literature.
OBJECTIVE
This study is a systematic literature review aiming to critically assess the prevalence of SB in children.
METHODS
Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children.
RESULTS
After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB.
CONCLUSION
There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately.
Topics: Child; Child, Preschool; Humans; Prevalence; Sleep Bruxism
PubMed: 25628080
DOI: 10.1590/2176-9451.19.6.054-061.oar -
Neurology Jun 2017To estimate the placebo and nocebo responses in restless legs syndrome (RLS) and explore their determinants. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the placebo and nocebo responses in restless legs syndrome (RLS) and explore their determinants.
METHODS
Databases were searched up to October 2015. Randomized, double-blind, placebo-controlled trials of patients with RLS were included if quantitative data were extractable in the placebo arm. Placebo response was defined as the within-group change from baseline, using any scale measuring RLS severity or disability. Nocebo response was defined as the proportion of patients experiencing adverse events in the placebo arm. Random-effects meta-analysis was used to pool data. Statistical heterogeneity was assessed with statistic. Several predetermined subgroup and sensitivity analysis were performed. PROSPERO registration number is CRD42015027992.
RESULTS
We included 85 randomized controlled trials (5,046 participants). Pooled placebo response effect size was -1.41 (95% confidence interval [CI] -1.56 to -1.25, 64 trials, = 88.1%), corresponding to -6.58 points in the International RLS Study Group Scale (IRLS). Pooled nocebo response was 45.36% (95% CI 40.47%-50.29%, 72 trials; = 89.8%). The placebo and nocebo responses were greater in trials with longer duration, evaluating pharmacologic interventions and idiopathic RLS, and in industry-funded and unpublished studies. The placebo response was considerably smaller in objective as compared to subjective outcomes. In addition, the nocebo response increases proportionally with the placebo response, and has the same predictors.
CONCLUSIONS
The magnitude of the placebo response in RLS is above the threshold of minimal clinical important difference, and the frequency of adverse events is also considerable. These results are relevant to inform the design and interpretation of future clinical trials.
Topics: Humans; Placebo Effect; Randomized Controlled Trials as Topic; Restless Legs Syndrome
PubMed: 28490647
DOI: 10.1212/WNL.0000000000004004 -
European Journal of Neurology Jul 2021The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis-Ekbom disease is relatively frequent, but its prevalence has shown a high... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis-Ekbom disease is relatively frequent, but its prevalence has shown a high variability across studies. In addition, several reports have shown data suggesting the presence of PN in patients with idiopathic RLS.
METHODS
A search was undertaken using the PubMed, Embase and Web of Science Databases, from 1966 to 6 December 2020, crossing the search term 'restless legs syndrome' with 'neuropathy', 'polyneuropathy' (PNP) and 'peripheral neuropathy', and the references of interest for this topic were identified; a meta-analysis was performed, according to PRISMA guidelines, and a calculation of pooled prevalences, where appropriate, was made using standard methods.
RESULTS
Restless legs syndrome has been reported in 5.2%-53.7% of patients with PN (average 21.5%; 95% confidence interval 18.6%-24.5%), and PN has been reported in 0%-87.5% of patients with RLS (average 41.8%; 95% confidence interval 39.9%-43.6%), both being significantly more frequent than in controls. The heterogeneity across studies could be due to differences in the diagnostic criteria used for both RLS and PN. RLS is a frequent clinical complaint in patients with PN of different aetiologies, mainly diabetic PN, uraemic PNP, familial amyloid PNP, Charcot-Marie-Tooth disease and chronic dysimmune inflammatory PNP. Recent neurophysiological findings suggest the presence of small sensory fibre loss in patients diagnosed with idiopathic RLS, but it remains to be determined whether RLS associated with small sensory fibre loss and idiopathic RLS are different clinical entities.
CONCLUSIONS
Future studies including clinical and neurophysiological assessment and skin biopsy involving a large series of patients with PN and RLS are needed for a better understanding of the association between these two entities.
Topics: Amyloid Neuropathies, Familial; Charcot-Marie-Tooth Disease; Diabetic Neuropathies; Humans; Polyneuropathies; Restless Legs Syndrome
PubMed: 33772991
DOI: 10.1111/ene.14840 -
Arquivos de Neuro-psiquiatria Apr 2022Sleep disorders are commonly observed in children with Down syndrome (DS) and can lead to significant behavioral and cognitive morbidities in these individuals.
BACKGROUND
Sleep disorders are commonly observed in children with Down syndrome (DS) and can lead to significant behavioral and cognitive morbidities in these individuals.
OBJECTIVE
To perform a systematic review evaluating sleep disorders in individuals with DS.
METHODS
Search strategies were based on combinations of keywords: "Down syndrome"; "trisomy 21"; "sleep disorders"; "dyssomnias"; "sleep apnea"; "obstructive"; "sleeplessness"; "insomnia"; "parasomnias"; and "excessive daytime sleepiness". PubMed and Science Direct were used. Only original studies and retrospective reviews in English published between January 2011 and March 2021 were included.
RESULTS
52 articles were included, most of them involving children and adolescents under 18 years of age. The main sleep disorder associated with DS was obstructive sleep apnea (OSA). Some studies reported the presence of cognitive dysfunction in patients with DS and sleep-disordered breathing, and few have been found about parasomnia, insomnia, and daytime sleepiness in these patients. Movement disorders and unusual postures during sleep may be related to disordered sleep breathing in DS. The main treatment options for OSA are continuous positive airway pressure therapy (CPAP), surgery, and weight control. Computational modeling associated with MRI has been used to plan surgical interventions in these patients.
CONCLUSIONS
Individuals with DS are at high risk of developing sleep-related breathing disorders. The main sleep disorder associated with DS was OSA. The presence of sleep-disordered breathing contributes to a worsening of cognitive function in patients with DS.
Topics: Adolescent; Child; Disorders of Excessive Somnolence; Down Syndrome; Humans; Retrospective Studies; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 35293557
DOI: 10.1590/0004-282X-ANP-2021-0242