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Sleep & Breathing = Schlaf & Atmung Mar 2024Snoring is the most common symptom of obstructive sleep apnea. Various objective methods of measuring snoring are available, and even if the measurement is performed the... (Review)
Review
PURPOSE
Snoring is the most common symptom of obstructive sleep apnea. Various objective methods of measuring snoring are available, and even if the measurement is performed the same way, communication is difficult because there are no common reference values between the researcher and clinician with regard to intensity and frequency, among other variables. In other words, no consensus regarding objective measurement has been reached. This study aimed to review the literature related to the objective measurement of snoring, such as measurement devices, definitions, and device locations.
METHODS
A literature search based on the PubMed, Cochrane, and Embase databases was conducted from the date of inception to April 5, 2023. Twenty-nine articles were included in this study. Articles that mentioned only the equipment used for measurement and did not include individual details were excluded from the study.
RESULTS
Three representative methods for measuring snoring emerged. These include (1) a microphone, which measures snoring sound; (2) piezoelectric sensor, which measures snoring vibration; and (3) nasal transducer, which measures airflow. In addition, recent attempts have been made to measure snoring using smartphones and applications.
CONCLUSION
Numerous studies have investigated both obstructive sleep apnea and snoring. However, the objective methods of measuring snoring and snoring-related concepts vary across studies. Consensus in the academic and clinical communities on how to measure and define snoring is required.
Topics: Humans; Snoring; Polysomnography; Sleep Apnea, Obstructive; Sound; Vibration
PubMed: 37421520
DOI: 10.1007/s11325-023-02865-6 -
European Archives of... Oct 2023Obstructive sleep apnoea (OSA) is an increasing health problem in children. The "gold standard" for OSA diagnosis at the moment is overnight polysomnography (PSG). Some... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive sleep apnoea (OSA) is an increasing health problem in children. The "gold standard" for OSA diagnosis at the moment is overnight polysomnography (PSG). Some researchers think portable monitors (PMs) are promising methods for diagnosing OSA, which make children more comfortable and lower costs. Compared with PSG, our comprehensively evaluated the diagnostic accuracy of PMs for diagnosing OSA in pediatrics.
RESEARCH QUESTION
This study aims to determine whether PMs can replace PSG in pediatric OSA diagnosis.
STUDY DESIGN AND METHODS
The PubMed, Embase, Medline databases Scopus, Web of Science, and Cochrane Library databases were searched systematically for studies published up to December 2022, evaluating the ability of PMs to diagnose OSA in children. For estimating the pooled sensitivity and specificity of the PMs in the included studies, we used a random-effects bivariate model. Studies included in this meta-analysis were evaluated systematically according to QUADAS-2 guidelines for assessing diagnostic accuracy studies. Two independent investigators conducted each stage of the review independently.
RESULTS
A total of 396 abstracts and 31 full-text articles were screened, and 41 full-text articles were chosen for final review. There were 707 pediatric patients enrolled in these twelve studies, and 9 PMs were evaluated. There was a wide range of diagnostic sensitivity and specificity among PM systems as compared to AHI measured by PSG. The pooled sensitivity and specificity in diagnosing pediatric OSA were, respectively, 0.91 [0.86, 0.94] and 0.76 [0.58, 0.88] for PMs. According to the summary receiver operating characteristic (SROC) curve, the AUC of PMs in diagnosing OSA in pediatric population was 0.93 [0.90, 0.95].
INTERPRETATION
PMs were more sensitive but slightly less specific for pediatric OSA. The combination of PMs and questionnaires appeared to be a reliable tool for the diagnosis of pediatric OSA. This test may be used for screening subjects or populations at high risk of OSA when there is a high demand for PSG, but the quantity is limited. No clinical trial was involved in the current study.
Topics: Humans; Child; Polysomnography; Sleep; Sleep Apnea, Obstructive; Sensitivity and Specificity; ROC Curve
PubMed: 37405453
DOI: 10.1007/s00405-023-08095-6 -
Sleep & Breathing = Schlaf & Atmung Mar 2024To compare the anatomical balance and shape of the upper airway in the supine position between adults with positional obstructive sleep apnea (POSA) and adults with...
PURPOSE
To compare the anatomical balance and shape of the upper airway in the supine position between adults with positional obstructive sleep apnea (POSA) and adults with non-positional OSA (NPOSA).
METHODS
Adults diagnosed with OSA (apnea-hypopnea index (AHI) > 10 events/h) were assessed for eligibility. POSA was defined as the supine AHI more than twice the AHI in non-supine positions; otherwise, patients were classified as NPOSA. Cone beam computed tomography (CBCT) imaging was performed for every participant while awake in the supine position. The anatomical balance was calculated as the ratio of the tongue size to the maxillomandibular enclosure size. The upper airway shape was calculated as the ratio of the anteroposterior dimension to the lateral dimension at the location of the minimal cross-sectional area of the upper airway (CSAmin-shape).
RESULTS
Of 47 participants (28 males, median age [interquartile range] 56 [46 to 63] years, median AHI 27.8 [15.0 to 33.8]), 34 participants were classified as having POSA (72%). The POSA group tended to have a higher proportion of males and a lower AHI than the NPOSA group (P = 0.07 and 0.07, respectively). After controlling for both sex and AHI, the anatomical balance and CSAmin-shape were not significantly different between both groups (P = 0.18 and 0.73, respectively).
CONCLUSION
Adults with POSA and adults with NPOSA have similar anatomical balance and shape of their upper airway in the supine position.
TRIAL REGISTRATION
This study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR Trial ACTRN12611000409976).
Topics: Male; Adult; Humans; Middle Aged; Supine Position; Polysomnography; Australia; Sleep Apnea, Obstructive; Cone-Beam Computed Tomography
PubMed: 37466758
DOI: 10.1007/s11325-023-02879-0 -
Movement Disorders : Official Journal... Jan 2024Clinical presentation and progression dynamics are variable in patients with Parkinson's disease (PD). Disease course mapping is an innovative disease modelling...
BACKGROUND
Clinical presentation and progression dynamics are variable in patients with Parkinson's disease (PD). Disease course mapping is an innovative disease modelling technique that summarizes the range of possible disease trajectories and estimates dimensions related to onset, sequence, and speed of progression of disease markers.
OBJECTIVE
To propose a disease course map for PD and investigate progression profiles in patients with or without rapid eye movement sleep behavioral disorders (RBD).
METHODS
Data of 919 PD patients and 88 isolated RBD patients from three independent longitudinal cohorts were analyzed (follow-up duration = 5.1; 95% confidence interval, 1.1-8.1] years). Disease course map was estimated by using eight clinical markers (motor and non-motor symptoms) and four imaging markers (dopaminergic denervation).
RESULTS
PD course map showed that the first changes occurred in the contralateral putamen 13 years before diagnosis, followed by changes in motor symptoms, dysautonomia, sleep-all before diagnosis-and finally cognitive decline at the time of diagnosis. The model showed earlier disease onset, earlier non-motor and later motor symptoms, more rapid progression of cognitive decline in PD patients with RBD than PD patients without RBD. This pattern was even more pronounced in patients with isolated RBD with early changes in sleep, followed by cognition and non-motor symptoms and later changes in motor symptoms.
CONCLUSIONS
Our findings are consistent with the presence of distinct patterns of progression between patients with and without RBD. Understanding heterogeneity of PD progression is key to decipher the underlying pathophysiology and select homogeneous subgroups of patients for precision medicine. © 2023 International Parkinson and Movement Disorder Society.
Topics: Humans; REM Sleep Behavior Disorder; Parkinson Disease; Polysomnography; Cognitive Dysfunction; Cognition
PubMed: 38006282
DOI: 10.1002/mds.29662 -
Lancet (London, England) Oct 2023
Topics: Humans; Disorders of Excessive Somnolence; Polysomnography; Primary Health Care
PubMed: 37865466
DOI: 10.1016/S0140-6736(23)01508-8 -
Development and validation of a sleep questionnaire, SNoRE 3.0, to evaluate sleep in companion dogs.Scientific Reports Aug 2023Disturbances in the sleep-wake cycle are a debilitating, yet rather common condition not only in humans, but also in family dogs. While there is an emerging need for...
Disturbances in the sleep-wake cycle are a debilitating, yet rather common condition not only in humans, but also in family dogs. While there is an emerging need for easy-to-use tools to document sleep alterations (in order to ultimately treat and/or prevent them), the veterinary tools which yield objective data (e.g. polysomnography, activity monitors) are both labor intensive and expensive. In this study, we developed a modified version of a previously used sleep questionnaire (SNoRE) and determined criterion validity in companion dogs against polysomnography and physical activity monitors (PAMs). Since a negative correlation between sleep time and cognitive performance in senior dogs has been demonstrated, we evaluated the correlation between the SNoRE scores and the Canine Dementia Scale (CADES, which includes a factor concerning sleep). There was a significant correlation between SNoRE 3.0 questionnaire scores and polysomnography data (latency to NREM sleep, ρ = 0.507, p < 0.001) as well as PAMs' data (activity between 1:00 and 3:00 AM, p < 0.05). There was a moderate positive correlation between the SNoRE 3.0 scores and the CADES scores (ρ = 0.625, p < 0.001). Additionally, the questionnaire structure was validated by a confirmatory factor analysis, and it also showed an adequate test-retest reliability. In conclusion the present paper describes a valid and reliable questionnaire tool, that can be used as a cost-effective way to monitor dog sleep in clinical settings.
Topics: Humans; Animals; Dogs; Pets; Reproducibility of Results; Sleep; Polysomnography; Sleep, Slow-Wave; Juniperus; Snoring
PubMed: 37587172
DOI: 10.1038/s41598-023-40048-1 -
Sleep Feb 2024Sleep and physical activity, two important health behaviors, are often studied independently using different accelerometer types and body locations. Understanding...
Sleep and physical activity, two important health behaviors, are often studied independently using different accelerometer types and body locations. Understanding whether accelerometers designed for monitoring each behavior can provide similar sleep parameter estimates may help determine whether one device can be used to measure both behaviors. Three hundred and thirty one adults (70.7 ± 13.7 years) from the Baltimore Longitudinal Study of Aging wore the ActiGraph GT9X Link and the Actiwatch 2 simultaneously on the non-dominant wrist for 7.0 ± 1.6 nights. Total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, number of wake bouts, mean wake bout length, and sleep fragmentation index (SFI) were extracted from ActiGraph using the Cole-Kripke algorithm and from Actiwatch using the software default algorithm. These parameters were compared using paired t-tests, Bland-Altman plots, and Deming regression models. Stratified analyses were performed by age, sex, and body mass index (BMI). Compared to the Actiwatch, the ActiGraph estimated comparable TST and sleep efficiency, but fewer wake bouts, longer WASO, longer wake bout length, and higher SFI (all p < .001). Both devices estimated similar 1-min and 1% differences between participants for TST and SFI (β = 0.99, 95% CI: 0.95, 1.03, and 0.91, 1.13, respectively), but not for other parameters. These differences varied by age, sex, and/or BMI. The ActiGraph and the Actiwatch provide comparable absolute and relative estimates of TST, but not other parameters. The discrepancies could result from device differences in movement collection and/or sleep scoring algorithms. Further comparison and calibration is required before these devices can be used interchangeably.
Topics: Humans; Adult; Wrist; Actigraphy; Longitudinal Studies; Sleep; Polysomnography; Reproducibility of Results
PubMed: 37257489
DOI: 10.1093/sleep/zsad155 -
Science Progress 2023Sleep is essential for a range of physiological and mental functions in professional athletes. There is proof that athletes may experience lower quality and quantity of... (Review)
Review
Sleep is essential for a range of physiological and mental functions in professional athletes. There is proof that athletes may experience lower quality and quantity of sleep. While adequate sleep has been shown to have restorative effects on the immune system and endocrine system, facilitate nervous system recovery and the metabolic cost of wakefulness, and play a significant role in learning, memory, and synaptic plasticity, which can affect sports recovery, injury risk reduction, and performance. Sports performance may suffer significantly from a lack of sleep, especially under maximal and long-term exercise. Due to the potential harm, these factors may do to an athlete's endocrine, metabolic, and nutritional health, sports performance is impacted by reduced sleep quality or quantity. There are several neurotransmitters associated with the sleep-wake cycle that have been discovered. They comprise cholinergic hormone, orexin, melanin, galanin, serotonin, gamma-aminobutyric acid, histamine, and serotonin. Therefore, dietary modifications that affect the neurotransmitters in the brain also may affect sleep; particularly for athletes who require more physical and psychological recovery owing to the tremendous physiological and psychological demands placed on them during training and performance. This review explores the variables that influence the quantity and quality of sleep-in populations of athletes and assesses their possible effects. In addition, several recommendations for improving sleep are presented. Even though there has been much research on variables that impact sleep, future studies may highlight the significance of these aspects for athletes.
Topics: Humans; Polysomnography; Serotonin; Sleep; Athletes; Athletic Performance; Immune System; Neurotransmitter Agents
PubMed: 37990537
DOI: 10.1177/00368504231206265 -
Sleep Health Dec 2023To evaluate an automatic sleep scoring algorithm against manual polysomnography sleep scoring.
Performance evaluation of the open-source Yet Another Spindle Algorithm sleep staging algorithm against gold standard manual evaluation of polysomnographic records in adolescence.
GOAL AND AIMS
To evaluate an automatic sleep scoring algorithm against manual polysomnography sleep scoring.
FOCUS METHOD/TECHNOLOGY
Yet Another Spindle Algorithm automatic sleep staging algorithm.
REFERENCE METHOD/TECHNOLOGY
Manual sleep scoring.
SAMPLE
327 nights (151 healthy adolescents), from the NCANDA study.
DESIGN
Participants underwent one-to-three overnight polysomnography recordings, one consisting of an event-related-potential paradigm.
CORE ANALYTICS
Epoch by Epoch and discrepancy analyses (Bland Altman plots) were conducted on the overall sample.
ADDITIONAL ANALYTICS AND EXPLORATORY ANALYSES
Epoch by Epoch and discrepancy analysis were repeated separately on standard polysomnography nights and event-related potential nights. Regression models were estimated on age, sex, scorer, and site of recording, separately on standard polysomnography nights and event-related potential nights.
CORE OUTCOMES
The Yet Another Spindle Algorithm sleep scoring algorithm's average sensitivity of 93.04% for Wake, 87.67% for N2, 84.46% for N3, 86.02% for rapid-eye-movement, and 40.39% for N1. Specificity was 96.75% for Wake, 97.31% for N1, 88.87% for N2, 97.99% for N3, and 97.70% for rapid-eye-movement. The Matthews Correlation Coefficient was highest in rapid-eye-movement sleep (0.85) while lowest in N1 (0.39). Cohen's Kappa mirrored Matthews Correlation Coefficient results. In Bland-Altman plots, the bias between Yet Another Spindle Algorithm and human scoring showed proportionality to the manual scoring measurement size.
IMPORTANT ADDITIONAL OUTCOMES
Yet Another Spindle Algorithm performance was reduced in event-related-potential/polysomnography nights for N3 and rapid-eye-movement. According to the Matthews Correlation Coefficient, the Yet Another Spindle Algorithm performance was affected by younger age, male sex, recording sites, and scorers.
CORE CONCLUSION
Results support the use of Yet Another Spindle Algorithm to score adolescents' polysomnography sleep records, possibly with classification outcomes supervised by an expert scorer.
Topics: Humans; Male; Adolescent; Reproducibility of Results; Sleep Stages; Sleep; Polysomnography; Algorithms
PubMed: 37709595
DOI: 10.1016/j.sleh.2023.07.019 -
Sleep Medicine Feb 2024Many components of sleep are disrupted in patients with narcolepsy, including sleep quality, sleep architecture, and sleep stability (ie, frequent awakenings/arousals... (Review)
Review
Many components of sleep are disrupted in patients with narcolepsy, including sleep quality, sleep architecture, and sleep stability (ie, frequent awakenings/arousals and frequent shifts from deeper to lighter stages of sleep). Sodium oxybate, dosed twice nightly, has historically been used to improve sleep, and subsequent daytime symptoms, in patients with narcolepsy. Recently, new formulations have been developed to address the high sodium content and twice-nightly dosing regimen of sodium oxybate: low-sodium oxybate and once-nightly sodium oxybate. To date, no head-to-head trials have been conducted to compare the effects of each oxybate product. This review aims to give an overview of the existing scientific literature regarding the impact of oxybate dose and regimen on sleep architecture and disrupted nighttime sleep in patients with narcolepsy. Evidence from 5 key clinical trials, as well as supporting evidence from additional studies, suggests that sodium oxybate, dosed once- and twice-nightly, is effective in improving sleep, measures of sleep architecture, and disrupted nighttime sleep in patients with narcolepsy. Direct comparison of available efficacy and safety data between oxybate products is complicated by differences in trial designs, outcomes assessed, and statistical analyses; future head-to-head trials are needed to better understand the advantage and disadvantages of each agent.
Topics: Humans; Sodium Oxybate; Polysomnography; Sleep; Narcolepsy; Sleep Quality
PubMed: 38244463
DOI: 10.1016/j.sleep.2023.12.015