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American Journal of Orthodontics and... Aug 2023The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related...
INTRODUCTION
The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related parameters (ie, sleep quality and quantity) were associated with patients' compliance during the orthodontic treatment.
METHODS
The study protocol was based on a prospective longitudinal quasi-experimental design. Participants (n = 26; 9 males; mean age, 12.4 ± 1.68 years) were patients in the Postgraduate Orthodontic Clinic, National and Kapodistrian University of Athens. All patients received treatment with a cervical headgear having an embedded TheraMon microsensor. Sleep was assessed by wrist-worn actigraphy for 59 ± 19 days. The Epworth Sleepiness Scale was used to assess average daytime sleepiness, whereas we used the Athens Insomnia Scale for insomnia symptoms. Oral health-related quality of life (OHRQOL) was assessed by the Oral Health Impact Profile (OHIP-14).
RESULTS
Patients slept on average 7.35 ± 0.42 h/d. Compared with the lowest sleep duration recommended for their age group, patients had an average chronic sleep deficit of 1.40 ± 0.49 h/d. Patients wore the headgear 90.9% of the days for 10.40 ± 4.17 h/d. However, only 7 (28%) patients reached or exceeded the wear-time recommendation of 12 h/d. In contrast, 2 (8%) patients wore headgear <5 h/d, 11 (44%) 5-10 h/d, and 12 (48%) patients wore headgear >10 h/d. Aggregated by participants, the median Epworth Sleepiness Scale score during the study was 3.40 (interquartile range [IQR], 4.85; range, 0.2-13.6), the median Athens Insomnia Scale score was 3.00 (IQR, 4.25; range, 0-7), and the median Oral Health Impact Profile score was 1.40 (IQR, 4.17; range, 0.0-20.8). Compared with patients who wore the orthodontic appliance >7.8 h/d, patients who wore it <7.8 h/d had worse average daytime sleepiness (P = 0.050) and worse OHRQOL (P = 0.019).
CONCLUSIONS
Orthodontic treatment with cervical headgear has no substantive negative effect on sleep attributes (quantity and quality), average daytime sleepiness and OHRQOL. However, poor compliance with orthodontic treatment seems to be associated with higher levels of daytime sleepiness.
Topics: Male; Humans; Child; Adolescent; Sleep Initiation and Maintenance Disorders; Prospective Studies; Quality of Life; Sleepiness; Sleep; Disorders of Excessive Somnolence
PubMed: 37002113
DOI: 10.1016/j.ajodo.2022.12.017 -
Epilepsia Sep 2023Seizures are common in critically ill children and neonates, and these patients would benefit from intravenous (IV) antiseizure medications with few adverse effects. We... (Observational Study)
Observational Study
OBJECTIVE
Seizures are common in critically ill children and neonates, and these patients would benefit from intravenous (IV) antiseizure medications with few adverse effects. We aimed to assess the safety profile of IV lacosamide (LCM) among children and neonates.
METHODS
This retrospective multicenter cohort study examined the safety of IV LCM use in 686 children and 28 neonates who received care between January 2009 and February 2020.
RESULTS
Adverse events (AEs) were attributed to LCM in only 1.5% (10 of 686) of children, including rash (n = 3, .4%), somnolence (n = 2, .3%), and bradycardia, prolonged QT interval, pancreatitis, vomiting, and nystagmus (n = 1, .1% each). There were no AEs attributed to LCM in the neonates. Across all 714 pediatric patients, treatment-emergent AEs occurring in >1% of patients included rash, bradycardia, somnolence, tachycardia, vomiting, feeling agitated, cardiac arrest, tachyarrhythmia, low blood pressure, hypertension, decreased appetite, diarrhea, delirium, and gait disturbance. There were no reports of PR interval prolongation or severe cutaneous adverse reactions. When comparing children who received a recommended versus a higher than recommended initial dose of IV LCM, there was a twofold increase in the risk of rash in the higher dose cohort (adjusted incidence rate ratio = 2.11, 95% confidence interval = 1.02-4.38).
SIGNIFICANCE
This large observational study provides novel evidence demonstrating the tolerability of IV LCM in children and neonates.
Topics: Infant, Newborn; Humans; Child; Lacosamide; Anticonvulsants; Cohort Studies; Child, Hospitalized; Bradycardia; Sleepiness; Acetamides; Treatment Outcome; Retrospective Studies
PubMed: 37287398
DOI: 10.1111/epi.17676 -
International Journal of Clinical... Aug 2023Dyspnea is a prevalent symptom that significantly reduces quality of life of cancer patients. Palliative treatment is necessary when the symptoms do not respond to... (Meta-Analysis)
Meta-Analysis Review
Dyspnea is a prevalent symptom that significantly reduces quality of life of cancer patients. Palliative treatment is necessary when the symptoms do not respond to treatment for their cause. Opioids are widely used as pharmacological therapy, but evidence for individual agents is inconsistent. The purpose of this study was to evaluate the efficacy and safety of opioids for dyspnea in cancer patients. We searched the CENTRAL, MEDLINE, EMBASE, and ICHUSHI for studies using opioids for dyspnea in adult cancer patients reported by September 2019. Screening of the retrieved literature and assessment of risk of bias and outcomes were performed by two independent authors. A meta-analysis was performed on the primary endpoint, relief of dyspnea, and secondary endpoints including quality of life, somnolence as a side effect, and serious adverse events. Twelve randomized controlled trials were evaluated regarding relief of dyspnea. Somnolence and serious adverse events were evaluated in seven and four randomized controlled trials, respectively, but no randomized controlled trials were evaluable for quality of life. Overall, opioids were more effective than placebo for dyspnea (standardized mean difference - 0.43, 95% confidence interval [CI] - 0.75 to - 0.12). Although significant difference was found between systemic morphine and placebo in the drug-specific analysis, no significant difference could be detected in the other analyses. Systemic administration of opioids is more effective than placebo in relieving dyspnea in cancer patients. Robust evidence on the efficacy and safety of opioids on dyspnea in cancer patients is lacking, and further studies are needed.
Topics: Adult; Humans; Analgesics, Opioid; Sleepiness; Quality of Life; Dyspnea; Neoplasms
PubMed: 37338727
DOI: 10.1007/s10147-023-02362-6 -
Heliyon Sep 2023Indonesia is among the countries with the highest accident rates in the world. Fatigue and drowsiness are among the main causes of the increased risks of accidents in...
Indonesia is among the countries with the highest accident rates in the world. Fatigue and drowsiness are among the main causes of the increased risks of accidents in the road transport sector. Sleep-related factors (quality and quantity, time of day) and work-related factors significantly affect the development of fatigue. The EEG signal indicator is often referred to as the gold standard for measuring fatigue and drowsiness. However, previous studies focused primarily on the trends of EEG signals under certain conditions but overlooking the development of drowsiness indicators based on EEG signals. Furthermore, existing studies still do not agree on what parameters in the EEG signal indicator are best at detecting drowsiness. Thus, this study aims to design an EEG signal-based drowsiness indicator under simulated driving conditions. Drowsy drivers were monitored through EEG signal indicators and subjective assessments. The methods used in this study include statistical significance tests, logistic regression, and support vector machine. The results showed that sleep deprivation had a significant effect on increasing alpha, beta, and theta waves. In addition, driving duration significantly increased the theta power and all EEG ratios and decreased the beta power in the alert group. The ratio of (θ + α)/β and θ/β in the SD group also showed a considerable increase in the end of driving. Furthermore, sleep status and driving duration both influenced subjective sleepiness. EEG signals combined with sleep status and driving duration factors generated acceptable model accuracies (77.1% and 90.2% in training and testing, respectively), with 90.5% sensitivity and 90% specificity in data test. Support vector machine showed better classification than that of logistics regression, with the linear kernel as the best classifier. Theta power had the highest effect in the model compared with other EEG signals.
PubMed: 37810083
DOI: 10.1016/j.heliyon.2023.e19499 -
Cureus Dec 2023We must remember that there are many subclinical cases of obstructive sleep apnea (OSA), even if the patient or family members typically become aware of it through... (Review)
Review
We must remember that there are many subclinical cases of obstructive sleep apnea (OSA), even if the patient or family members typically become aware of it through symptoms such as snoring and excessive daytime sleepiness (EDS). EDS is a common symptom among hypertensive patients. This interesting and remarkable systematic review aims to comprehensively survey the current literature on the prevalence and association of EDS among hypertensive patients. PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI (Rayyan Systems Inc., Cambridge, MA) was employed throughout this comprehensive process. This review included nine studies with a total of 58,517 patients, and 34,398 (58.8%) were males. EDS prevalence among hypertensive patients ranged from 12.1% to 88.3%. This review stated that individuals with hypertension (HTN) had EDS that was worse than that of patients with normotension. In one of the studies included in this analysis, sympathovagal imbalance was noted alongside EDS and HTN. Older age, primary education, being overweight, working, obesity, depression, and having had the condition for longer are all associated with EDS in HTN patients.
PubMed: 38234944
DOI: 10.7759/cureus.50716 -
Frontiers in Nutrition 2024Plant-rich diets (PRDs), also referred to as plant based diets, have been shown to have beneficial effects on various chronic diseases and all-cause mortality. However,... (Review)
Review
Plant-rich diets (PRDs), also referred to as plant based diets, have been shown to have beneficial effects on various chronic diseases and all-cause mortality. However, limited data are available on the effect of such diets on sleep and sleep disorders. In this review article, we explore existing evidence and potential mechanisms by which PRDs may impact sleep and sleepiness. High-fat diets are associated with drowsiness, while fiber-rich diets improve sleep quality. Anti-inflammatory diets may benefit patients with sleep disturbances, and diets rich in tryptophan and serotonin precursors may improve sleep quality. Isoflavones and polyphenols present in PRDs may also have a positive impact on sleep. Furthermore, diets rich in plants may reduce the risk of obstructive sleep apnea and associated daytime sleepiness. Overall, the current knowledge about PRDs in sleep and sleep disorders is limited, and further research is needed to explore the potential advantages of this dietary approach in sleep disorders.
PubMed: 38379547
DOI: 10.3389/fnut.2024.1239580 -
CNS Drugs Nov 2023Solriamfetol (SUNOSI) is an oral selective dopamine and norepinephrine reuptake inhibitor approved in the EU and the USA for improving wakefulness in adults with... (Review)
Review
Solriamfetol (SUNOSI) is an oral selective dopamine and norepinephrine reuptake inhibitor approved in the EU and the USA for improving wakefulness in adults with excessive daytime sleepiness (EDS) associated with narcolepsy or obstructive sleep apnoea (OSA). In phase III studies, 12 weeks' therapy with solriamfetol within the recommended dosage range for narcolepsy (75 mg or 150 mg once daily) or OSA (37.5 mg, 75 mg or 150 mg once daily) provided early and sustained reductions in excessive sleepiness and improvements in wakefulness relative to placebo. These effects were generally sustained through 52 weeks. The drug's effectiveness in adults with EDS associated with narcolepsy is supported by results from real-world studies. Solriamfetol demonstrated a consistent safety and tolerability profile across clinical studies, with commonly reported adverse reactions generally occurring within 2 weeks of treatment initiation and mostly resolving within 2 weeks. Thus, solriamfetol represents a useful treatment option for adults with EDS associated with narcolepsy or OSA.
Topics: Adult; Humans; Narcolepsy; Disorders of Excessive Somnolence; Carbamates; Sleep Apnea, Obstructive
PubMed: 37847434
DOI: 10.1007/s40263-023-01040-5 -
Actas Espanolas de Psiquiatria Feb 2024This is a narrative review of sleep disorders, especially chronic insomnia, as a primary diagnosis or as a comorbid diagnosis associated with different psychiatric and... (Review)
Review
This is a narrative review of sleep disorders, especially chronic insomnia, as a primary diagnosis or as a comorbid diagnosis associated with different psychiatric and organic diseases. The epidemiological evidence is reviewed, the diagnostic criteria most frequently used in clinical practice are examined, and a series of therapeutic recommendations for the correct treatment of this pathology is presented. Sleep disorders are very prevalent in the general population (one-third experiences difficulty with sleep initiation/maintenance at least once a week, and about 6-15% meet the criteria for insomnia disorders), but remain relatively poorly understood and frequently overlooked by healthcare professionals. Prevalence estimates of insomnia disorder vary between 5% and 20%. Sleep disorders co-exist with psychiatric and medical conditions with an interactive and bidirectional relationship. About 70-80% of psychiatric patients show some sleep disturbance and there is a correlation between the severity of the sleep disturbance and the severity of the psychopathology. Untreated sleep disorders increase the risk of cardiovascular events, cognitive impairment, motor vehicle accidents, obesity, diabetes, and efficiency and safety at work, leading to increased all-cause healthcare utilization and being a strong predictor of sick leave or disability pension and poor quality of life. Sleep disorders can cause drowsiness or excessive daytime sleepiness, which can lead to functional impairment in 15% of the general adult population. Sleep quality should be a routine target in the evaluation of patients with psychiatric and non-psychiatric diseases to ensure sleep health based on early diagnosis and adequate therapeutic approaches.
Topics: Adult; Humans; Sleep Initiation and Maintenance Disorders; Quality of Life; Sleep Wake Disorders; Disorders of Excessive Somnolence; Comorbidity
PubMed: 38454895
DOI: No ID Found -
Computer Methods in Biomechanics and... Sep 2023Electroencephalography (EEG) is a complex signal that may require several years of training, advanced signal processing, and feature extraction methodologies to...
Electroencephalography (EEG) is a complex signal that may require several years of training, advanced signal processing, and feature extraction methodologies to interpret correctly. Recently, many methods have been used to extract and classify EEG data. This study reviews 62 papers that used EEG signals to detect driver drowsiness, published between January 2018 and 2022. We extract trends and highlight interesting approaches from this large body of literature to inform future research and formulate recommendations. To find relevant papers published in scientific journals, conferences, and electronic preprint repositories, researchers searched major databases covering the domains of science and engineering. For each investigation, many data items about (1) the data, (2) the channels used, (3) the extraction and classification procedure, and (4) the outcomes were extracted. These items were then analyzed one by one to uncover trends. Our analysis reveals that the amount of EEG data used across studies varies. We saw that more than half the studies used simulation driving experimental. About 21% of the studies used support vector machine (SVM), while 19% used convolutional neural networks (CNN). Overall, we can conclude that drowsiness and fatigue impair driving performance, resulting in drivers who are more exposed to risky situations.
Topics: Electroencephalography; Signal Processing, Computer-Assisted; Neural Networks, Computer; Computer Simulation; Support Vector Machine
PubMed: 35983784
DOI: 10.1080/10255842.2022.2112574 -
Brain Research Jun 2024Sleep is a daily experience across humans and other species, yet our understanding of how and why we sleep is presently incomplete. This is particularly prevalent in... (Review)
Review
Sleep is a daily experience across humans and other species, yet our understanding of how and why we sleep is presently incomplete. This is particularly prevalent in research examining the neurophysiological measurement of sleepiness in humans, where several electroencephalogram (EEG) phenomena have been linked with prolonged wakefulness. This leaves researchers without a solid basis for the measurement of homeostatic sleep need and complicates our understanding of the nature of sleep. Recent theoretical and technical advances may allow for a greater understanding of the neurobiological basis of homeostatic sleep need: this may result from increases in neuronal excitability and shifts in excitation/inhibition balance in neuronal circuits and can potentially be directly measured via the aperiodic component of the EEG. Here, we review the literature on EEG-derived markers of sleepiness in humans and argue that changes in these electrophysiological markers may actually result from neuronal activity represented by changes in aperiodic markers. We argue for the use of aperiodic markers derived from the EEG in predicting sleepiness and suggest areas for future research based on these.
PubMed: 38879143
DOI: 10.1016/j.brainres.2024.149088