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Medicina (Kaunas, Lithuania) Jul 2023: This study aimed to assess the comparative effectiveness of continuous positive airway pressure (CPAP) therapy and sildenafil pharmacological therapy in improving... (Meta-Analysis)
Meta-Analysis Review
: This study aimed to assess the comparative effectiveness of continuous positive airway pressure (CPAP) therapy and sildenafil pharmacological therapy in improving sexual function among patients with obstructive sleep apnea (OSA) and erectile dysfunction (ED). : Population: Patients affected by OSA and ED; Intervention: CPAP therapy vs. Comparison: Sildenafil pharmacological therapy; Outcomes: Improvement in erectile function, as measured by the International Index of Erectile Function 5 (IIEF-5) scoring system; Time: A systematic review of the literature from the past 20 years; Study Design: Observational studies comparing erectile function improvements after OSA treatment. : A total of eight papers were included in the qualitative summary, involving four hundred fifty-seven patients with ED and OSA. Erectile function improvements were observed in both treatment groups. After sildenafil and CPAP treatment, the mean IIEF-5 domain scores were 37.7 and 27.3, respectively ( < 0.001). Sildenafil 100 mg demonstrated a higher therapeutic impact compared to CPAP treatment. : CPAP therapy significantly improved sexual parameters in most studies for OSA patients with ED. The findings suggest that CPAP therapy effectively alleviates erectile dysfunction symptoms, resulting in improved sexual performance in OSA patients. The comparison of the two treatments indicates that sildenafil has a more substantial therapeutic impact on erectile function than CPAP therapy; however, a combined treatment will provide a cumulative effect.
Topics: Male; Humans; Sildenafil Citrate; Erectile Dysfunction; Continuous Positive Airway Pressure; Sleep Apnea, Obstructive; Sexual Dysfunction, Physiological
PubMed: 37512129
DOI: 10.3390/medicina59071318 -
Sleep Medicine Reviews Jun 2024Sleep is crucial for health and development. Evidence indicates that sleep changes over time and distinct subgroups may experience different longitudinal patterns. This...
Sleep is crucial for health and development. Evidence indicates that sleep changes over time and distinct subgroups may experience different longitudinal patterns. This study systematically reviewed the studies that used latent trajectory modeling to investigate sleep trajectories of children and adolescents aged 0-18 years, and summarized the associated determinants and health-related outcomes. We searched PubMed, Embase, CENTRAL, PsycINFO, and Web of Science, identifying 46 articles that met our criteria. To ensure the reliability of the review, only studies rated as good or fair in terms of methodological quality were included, resulting in a total of 36 articles. Group-based trajectories were identified on several sleep dimensions (i.e., sleep duration, general and specific sleep problems, and bed-sharing behavior) and three or four trajectories were reported in most studies. There was a convergence trend across sleep duration trajectories during the first six years of life. Studies on specific sleep problem (i.e., insomnia, night-waking, and sleep-onset difficulties) typically identified two trajectories: consistent, minimal symptoms or chronic yet fluctuating symptoms. Lower socioeconomic status, maternal depression, and night feeding behaviors were the most frequently reported determinants of sleep trajectories. Membership in a group with certain adverse patterns (e.g., persistent short sleep duration) was associated with increased risks of multiple negative health-related conditions, such as obesity, compromised immunity, neurological problems, substance use, or internalizing/externalizing symptoms. Generally, there is potential to improve the quality of studies in this field. Causality is hard to be inferred within the current body of literature. Future studies could emphasize early life sleep, incorporate more assessment timepoints, use objective measures, and employ experimental design to better understand changes of and mechanisms behind the various sleep trajectories and guide targeted interventions for at-risk subpopulations.
Topics: Adolescent; Child; Child, Preschool; Humans; Infant; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 38461678
DOI: 10.1016/j.smrv.2024.101916 -
Neurotoxicology May 2024Obstructive Sleep Apnea (OSA) is a significant health concern characterized by recurrent upper airway blockages during sleep, causing various health issues. There's... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive Sleep Apnea (OSA) is a significant health concern characterized by recurrent upper airway blockages during sleep, causing various health issues. There's growing evidence of a link between air pollution and OSA, though research results have been inconsistent. This systematic review and meta-analysis aims to consolidate and examine data on the relationship between air pollution and OSA's risk and severity.
METHODS
A literature search across PubMed, EMBASE, and Web of Science was conducted until January 10, 2024. The selection criteria targeted studies involving OSA participants or those at risk, with quantitative air pollution assessments. The Nested Knowledge software facilitated screening and data extraction, while the Newcastle-Ottawa Scale was used for quality assessment. Meta-analyses, utilizing random-effects models, computed pooled odds ratios (ORs) for the OSA risk associated with PM2.5 and NO2 exposure, analyzed using R software version 4.3.
RESULTS
The systematic review included twelve studies, four of which were analyzed in the meta-analysis. The meta-analysis revealed diverse results on the association of PM2.5 and NO2 with OSA risk. PM2.5 exposure showed a pooled OR of 0.987 (95 % CI: 0.836-1.138), indicating no substantial overall impact on OSA risk. Conversely, NO2 exposure was linked to a pooled OR of 1.095 (95 % CI: 0.920-1.270), a non-significant increase in risk. Many studies found a relationship between air pollution exposure and elevated Apnea-Hypopnea Index (AHI) levels, indicating a relationship between air pollution and OSA severity.
CONCLUSION
The findings suggest air pollutants, especially NO2, might play a role in worsening OSA risk and severity, but the evidence isn't definitive. This highlights the variability of different pollutants' effects and the necessity for more research. Understanding these links is vital for shaping public health policies and clinical approaches to address OSA amidst high air pollution.
Topics: Sleep Apnea, Obstructive; Humans; Air Pollution; Particulate Matter; Air Pollutants; Severity of Illness Index; Risk Factors; Nitrogen Dioxide; Environmental Exposure
PubMed: 38636605
DOI: 10.1016/j.neuro.2024.04.005 -
Croatian Medical Journal Apr 2024To review the literature data on the prevalence of benzodiazepines abuse and poisoning in older adults; the prevalence of polypharmacy with benzodiazepines in this... (Review)
Review
AIM
To review the literature data on the prevalence of benzodiazepines abuse and poisoning in older adults; the prevalence of polypharmacy with benzodiazepines in this demographic; and determine whether benzodiazepine anxiolytics or hypnotics were more frequently implicated in the cases of abuse and poisoning.
METHODS
We searched PubMed and Scopus for relevant studies published from January 1, 2013, to May 1, 2023. Twelve studies were included in the final selection.
RESULTS
The review highlights the diverse prevalence rates of benzodiazepine abuse and poisoning in the older adult population. Benzodiazepine anxiolytics were more frequently associated with negative outcomes than benzodiazepine hypnotics. Concurrent use of benzodiazepines, benzodiazepine-related medications, and opioids was reported, although these medications were not the only ones commonly used by the elderly.
CONCLUSION
It is essential to increase awareness about adhering to prescribed pharmacological therapies to mitigate issues related to drug abuse and poisoning among older adults.
Topics: Humans; Benzodiazepines; Sleep Initiation and Maintenance Disorders; Aged; Hypnotics and Sedatives; Substance-Related Disorders; Polypharmacy; Prevalence; Aged, 80 and over; Anti-Anxiety Agents
PubMed: 38706240
DOI: 10.3325/cmj.2024.65.146 -
Medicine Oct 2023This systematic review and meta-analysis aimed to assess the efficacy of acupuncture or moxibustion therapy in senile insomnia patients. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This systematic review and meta-analysis aimed to assess the efficacy of acupuncture or moxibustion therapy in senile insomnia patients.
METHODS
A comprehensive literature search was conducted using 7 electronic databases to identify randomized controlled trials reported on the use of acupuncture or moxibustion therapy in insomnia. The time frame was set from database establishment to March 11, 2023. The RevMan (version 5.3) and STATA (version 17.0) software were used to evaluate the quality of the included randomized controlled trials and perform a meta-analysis. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Subgroup analysis was performed based on different intervention methods. The I2 statistic was used to assess heterogeneity among studies.
RESULTS
A total of 20 studies conducted between 2007 and 2022 were included, involving 1677 patients with senile insomnia. In terms of efficacy, acupuncture or moxibustion alone was significantly better than western drugs (RR = 1.12; 95% CI, 1.06-1.20), acupuncture combined with drugs was better than drugs alone (RR = 1.20; 95% CI, 1.12-1.29), and acupuncture combined with cognitive behavior therapy intervention (CBT-I) was significantly better than CBT-I alone (RR = 1.52; 95% CI, 1.07-2.17). In terms of Pittsburgh Sleep Quality Index scores, acupuncture or moxibustion alone was more effective than western drugs (MD = -1.82; 95% CI, -2.37 to -1.26), acupuncture combined with drugs was more effective than drugs alone (MD = -3.10; 95% CI, -4.25 to -1.95), and acupuncture was significantly more effective than sham acupuncture (MD = -4.18; 95% CI, -5.85 to -2.51) and psychological intervention (MD = -3.54; 95% CI, -4.33 to -2.75) in improving sleep quality.
CONCLUSIONS
This meta-analysis revealed that acupuncture or moxibustion alone or combination with other therapies(drugs, CBT-I or psychological intervention) has high clinical efficacy and can improve the sleep quality of patients with senile insomnia. However, further well-designed studies are warranted to verify these findings.
Topics: Humans; Moxibustion; Sleep Initiation and Maintenance Disorders; Acupuncture Therapy; Treatment Outcome; Acupressure
PubMed: 37861514
DOI: 10.1097/MD.0000000000034842 -
Sleep & Breathing = Schlaf & Atmung Jun 2024Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may... (Meta-Analysis)
Meta-Analysis
PURPOSE
Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may contribute to abnormal orofacial development, leading to increased upper airway resistance and susceptibility to upper airway collapsibility during sleep. Recognizing early indicators, such as a short lingual frenulum, is crucial for prompt intervention. This systematic review aims to evaluate the association between a short lingual frenulum and the risk of obstructive sleep apnea syndrome in children.
METHODS
This systematic review adheres to PRISMA criteria for a quantitative analysis. A comprehensive search was conducted on five databases until January 2024 to identify relevant studies. The selected articles underwent rigorous analysis, considering study design, sample characteristics, lingual frenulum characterization, sleep assessment methods, and key findings.
RESULTS
A total of 239 references were initially identified. Finally, six studies were included in the qualitative synthesis, with four studies eligible for the quantitative synthesis. The Newcastle-Ottawa scale was employed to assess study quality. Meta-analysis, supported by a moderate evidence profile according to the GRADE scale, revealed statistically significant differences, with odds ratios of 3.051 (confidence interval: 1.939 to 4.801) for a short frenulum and 12.304 (confidence interval: 6.141 to 24.653) for a high-arched palate.
CONCLUSION
This systematic review and meta-analysis provide evidence supporting the association between ankyloglossia and obstructive sleep apnea in children. Nevertheless, it is crucial to consider additional factors such as tongue mobility and the presence of a high-arched palate in further evaluations.
Topics: Child; Humans; Ankyloglossia; Sleep Apnea, Obstructive
PubMed: 38478208
DOI: 10.1007/s11325-024-03021-4 -
Cancer Medicine Apr 2024Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological... (Meta-Analysis)
Meta-Analysis Review
Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors.
METHODS
The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia.
RESULTS
A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (-19%) and sleep disturbance (-17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07-0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07-0.49, respectively).
CONCLUSION
RT interventions of 60 minutes per session, performed 2-3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.
Topics: Humans; Resistance Training; Neoplasms; Randomized Controlled Trials as Topic; Cancer Survivors; Sleep Quality; Sleep Wake Disorders; Sleep Initiation and Maintenance Disorders; Male; Female
PubMed: 38650577
DOI: 10.1002/cam4.7179 -
Behavioural Brain Research Oct 2023The modified multi-platform method (MMPM) is used to induce animal models of paradoxical sleep deprivation and impairs memory in rodents. However, variations in MMPM... (Meta-Analysis)
Meta-Analysis Review
The modified multi-platform method (MMPM) is used to induce animal models of paradoxical sleep deprivation and impairs memory in rodents. However, variations in MMPM protocols have contributed to inconsistent conclusions across studies. This meta-analysis aimed to assess the variations of the MMPM and their effects on memory in rats and mice. A comprehensive search identified 60 studies, and 50 were included in our meta-analysis. Overall, the meta-analysis showed that the MMPM significantly reduced the percentage of time spent in target quadrants (I = 54 %, 95 % confidence interval [CI] = [-1.83, -1.18]) and the number of platform-area crossings (I = 26 %, 95 % CI = [-1.71, -1.07]) in the Morris water maze (MWM) and shortened the latency to entering the dark compartment in the passive avoidance task (I = 68 %, 95 % CI = [-1.36, -0.57]), but it increased the number of errors in the radial arm water maze (RAWM) (I = 59 %, 95 % CI = [1.29, 2.07]). Additionally, mice performed worse on the MWM, whereas rats performed worse on the passive avoidance task. More significant memory deficits were found in cross-learning and post-learning MMPM in the MWM and RAWM, respectively. This study provided evidence that the MMPM can be used in preclinical studies of memory deficits induced by paradoxical sleep deprivation.
Topics: Mice; Rats; Animals; Sleep Deprivation; Learning; Memory Disorders; Methacrylates
PubMed: 37652237
DOI: 10.1016/j.bbr.2023.114652 -
European Respiratory Review : An... Jan 2024Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the... (Meta-Analysis)
Meta-Analysis Review
Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the first-line treatment but is limited by poor adherence. Nocturnal oxygen therapy may be an alternative treatment for obstructive sleep apnoea but its effects remain unclear. This meta-analysis evaluates the effects of nocturnal oxygen therapy on both obstructive sleep apnoea severity and blood pressure.A literature search was performed based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed, randomised studies that compared the effect of nocturnal oxygen therapy to sham in obstructive sleep apnoea patients were included. The main outcomes were the apnoea-hypopnoea index and systolic and diastolic blood pressure.The search strategy yielded 1295 citations. Nine studies with 502 participants were included. When nocturnal oxygen therapy was compared to sham/air, it significantly reduced the apnoea-hypopnoea index (mean difference (MD) -15.17 events·h, 95% CI -19.95- -10.38 events·h, p<0.00001). Nocturnal oxygen therapy had no significant effect on blood pressure at follow-up without adjustment for baseline values, but did, where available, significantly attenuate the change in blood pressure from baseline to follow-up for both systolic blood pressure (MD -2.79 mmHg, 95% CI -5.45- -0.14 mmHg, p=0.040) and diastolic blood pressure (MD -2.20 mmHg, 95% CI -3.83- -0.57 mmHg, p=0.008).Nocturnal oxygen therapy reduced the apnoea-hypopnoea index severity and the change in (but not absolute) systolic and diastolic blood pressure, compared to sham. This suggests that nocturnal oxygen therapy may be a treatment option for obstructive sleep apnoea. Further studies with longer-term follow-up and standardised measurements are needed.
Topics: Humans; Sleep Apnea, Obstructive; Continuous Positive Airway Pressure; Hypoxia; Oxygen Inhalation Therapy; Oxygen; Randomized Controlled Trials as Topic
PubMed: 38508665
DOI: 10.1183/16000617.0173-2023 -
How much does sleep deprivation impair endurance performance? A systematic review and meta-analysis.European Journal of Sport Science Jul 2023We conducted a systematic review and meta-analysis to investigate the effect of sleep deprivation on endurance performance, as well as possible effect-modifying factors.... (Meta-Analysis)
Meta-Analysis
We conducted a systematic review and meta-analysis to investigate the effect of sleep deprivation on endurance performance, as well as possible effect-modifying factors. Searches were done in Pubmed, Web of Science, Embase, and Scopus on 12 July 2022. We additionally searched the bibliographic references and citations on Google Scholar of the papers whose full text was analyzed. Eligible studies were randomized and non-randomized controlled trials that compared sleep deprivation and habitual-sleep night effects on endurance performance in healthy humans. The studies' quality was examined by the Cochrane Collaboration's risk of bias tool. We calculated the pooled standardized mean differences (pooled SMD) and 95% confidence interval (95%CI) by a random-effects model. A mixed-effects model analyzed subgroups. Thirty-one studies were analyzed (n = 478), generating 38 effect sizes in full. The overall risk of bias was low in 8% of the studies, unclear in 74%, and high in 18%. Sleep deprivation in general had a moderate negative effect on endurance performance (polled SMD [95%CI] = -0.52 [-0.67; -0.38]). Training status, sleep deprivation magnitude, assessment time, exercise mode, and endpoint type did not influence the sleep deprivation effect, whereas longer exercises (>30 min) were more affected by sleep deprivation than shorter ones ( = 0.035). Therefore, the available evidence supports that sleep deprivation's deleterious effect on endurance performance is of moderate size and depends on exercise duration. This information can be useful to estimate the performance decrement of endurance exercise practitioners under sleep deprivation in training routines and competitions.PROSPERO registration number CRD42021229717.
Topics: Humans; Sleep Deprivation; Exercise; Exercise Therapy; Health Status; Nutritional Status
PubMed: 36472094
DOI: 10.1080/17461391.2022.2155583