-
Neurologic Clinics Aug 2019Non-24-hour sleep-wake rhythm disorder is a circadian rhythm sleep-wake disorder characterized by an inability to entrain to the 24-hour environment. Patients present... (Review)
Review
Non-24-hour sleep-wake rhythm disorder is a circadian rhythm sleep-wake disorder characterized by an inability to entrain to the 24-hour environment. Patients present with complaints of insomnia or hypersomnia, with progressive daily shifts of sleep-wake activity on actigraphy or sleep logs. Although first recognized in blind individuals without light perception, it also can be seen in individuals with intact vision. Treatment focuses on timed melatonin in blind individuals, whereas it is more complex in sighted individuals, using multiple time cues, such as light, melatonin, social interactions, feeding, and activity.
Topics: Humans; Sleep Disorders, Circadian Rhythm
PubMed: 31256788
DOI: 10.1016/j.ncl.2019.03.002 -
Journal of Affective Disorders Feb 2023Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and...
BACKGROUND
Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia.
METHODS
Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children.
RESULTS
The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05).
CONCLUSIONS
Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.
Topics: Female; Child; Humans; Child, Preschool; Infant; Male; Cohort Studies; Dyssomnias; Sleep; Sleep Initiation and Maintenance Disorders; Parents
PubMed: 36513160
DOI: 10.1016/j.jad.2022.12.012 -
La Revue de Medecine Interne Jul 2022Sleepiness concerns one in five French people and involves a severe accidental risk. The recent notion of hypersomnolence includes excessive daytime sleepiness and the...
Sleepiness concerns one in five French people and involves a severe accidental risk. The recent notion of hypersomnolence includes excessive daytime sleepiness and the excessive need for sleep. The diagnostic approach to hypersomnolence begins with a clinical exploration by interview and sleep diary in order to specify the symptoms, to compare them with the typology and the patient's individual sleep need to rule out chronic sleep deprivation and a circadian rhythm disorder. In case of poor quality of sleep (or dyssomnia) associated, one must investigate for sleep apnea syndrome or restless legs syndrome with periodic legs movements. Secondary causes include mental or somatic diseases or a toxic origin. The diagnosis of central hypersomnia can be suspected on the characteristics of hypersomnolence or at the end of the diagnostic process. It will require ruling out the most frequent causes of hypersomnolence and the confounding factors for polysomnography interpretation. The causes and consequences associated with hypersomnolence require early detection, precise diagnosis and comprehensive management.
Topics: Disorders of Excessive Somnolence; Humans; Narcolepsy; Polysomnography; Restless Legs Syndrome
PubMed: 35184867
DOI: 10.1016/j.revmed.2022.01.004 -
Respiratory Care Aug 2019Sleep-disordered breathing affects a significant portion of the population worldwide. It is associated with many comorbid conditions, including heart failure and... (Review)
Review
Sleep-disordered breathing affects a significant portion of the population worldwide. It is associated with many comorbid conditions, including heart failure and depression. Advances in the field regarding the diagnosis and treatment of sleep-disordered breathing are occurring on an increasing basis. This review will discuss the latest findings in the field with an emphasis on people who have obstructive sleep apnea.
Topics: Cardiovascular Diseases; Comorbidity; Depression; Disease Management; Humans; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 31346075
DOI: 10.4187/respcare.07063 -
Sleep Medicine Clinics Jun 2020Unlike other reviews written on this topic, the focus of this article is primarily on nonpharmacologic treatments for daytime sleepiness that is not secondary to other... (Review)
Review
Unlike other reviews written on this topic, the focus of this article is primarily on nonpharmacologic treatments for daytime sleepiness that is not secondary to other medical or psychological conditions. To provide an appropriate background on primary excessive daytime sleepiness, what is considered optimal sleep in terms of sleep duration, sleep insufficiency, and sleep need is discussed in detail. This discussion is followed by an examination of the behavioral strategy of banking sleep. After briefly discussing behavioral interventions for sleepiness associated with narcolepsy, a new behavioral method of treating daytime somnolence is proposed and described.
Topics: Behavior Therapy; Disorders of Excessive Somnolence; Humans; Narcolepsy; Sleep; Sleepiness; Wakefulness
PubMed: 32386694
DOI: 10.1016/j.jsmc.2020.02.018 -
Heart (British Cardiac Society) Nov 2023Sleep-disordered breathing (SDB) is common in individuals with established cardiovascular disease (CVD), particularly those with heart failure (HF). There are two main... (Randomized Controlled Trial)
Randomized Controlled Trial
Sleep-disordered breathing (SDB) is common in individuals with established cardiovascular disease (CVD), particularly those with heart failure (HF). There are two main types of SDB, central sleep apnoea (CSA) and obstructive sleep apnoea (OSA) which frequently overlap as mixed SDB. Investigating for SDB could be considered in patients with excessive daytime sleepiness, male sex, high body mass index, low ejection fraction, atrial fibrillation (AF), in patients with no dipping blood pressure pattern, recurrent paroxysms of nocturnal dyspnoea or when an apnoea is witnessed. Excessive daytime sleepiness is less likely to be reported by patients with HF than by the general population. In patients with CVD and OSA, continuous positive airway pressure (CPAP) ventilation for over 4 hours daily reduced the risk of major adverse cardiovascular events, but there was no reduction in mortality. In patients with AF and OSA treated with AF ablation, CPAP use was associated with a reduced risk of recurrence of AF. In patients with HF and OSA, small studies have demonstrated that CPAP improves symptoms, brain natriuretic peptide levels and ejection fraction, but data on survival are lacking. Treatment remains unclear in patients with HF and CSA. The presence of CSA may be a defensive adaptive response to HF, and effectively treating CSA as demonstrated in a randomised clinical trial of adaptive servo-ventilation caused more harm than benefit when compared to optimal medical therapy. Thus, the focus of treating CSA should remain on improving the underlying HF by optimising medical therapy and, if indicated, cardiac resynchronisation therapy.
Topics: Humans; Male; Cardiovascular Diseases; Sleep Apnea Syndromes; Sleep Apnea, Central; Sleep Apnea, Obstructive; Heart Failure; Atrial Fibrillation; Disorders of Excessive Somnolence
PubMed: 37607811
DOI: 10.1136/heartjnl-2019-316375 -
Seminars in Respiratory and Critical... Jun 2023Insufficient sleep syndrome, shift work disorder, and obstructive sleep apnea (OSA) not only significantly impact the health of affected individuals, but also pose a...
Insufficient sleep syndrome, shift work disorder, and obstructive sleep apnea (OSA) not only significantly impact the health of affected individuals, but also pose a threat to public safety. This article describes the clinical manifestations and impact of these sleep disorders, particularly as they pertain to workers' health and those with safety-sensitive positions. Sleep deprivation, circadian rhythm disruptions, and excessive daytime sleepiness-hallmarks of insufficient sleep, shift work disorder, and OSA, respectively-all lead to a series of cognitive deficits and impaired concentration that affect workers in a wide variety of fields. We describe the health consequences of these disorders along with treatment strategies, with a focus on current regulatory standards and the under-recognition of OSA in commercial drivers. Given its large scale, there is a need for improved guidelines and regulations for the screening, diagnosis, treatment, and long-term follow-up of OSA in commercial motor vehicle drivers. Increased recognition of the ways in which these sleep disorders impact workers will pave the way for significant improvements in occupational health and safety.
Topics: Humans; Automobile Driving; Risk Factors; Sleep Wake Disorders; Sleep Apnea, Obstructive; Disorders of Excessive Somnolence
PubMed: 37072022
DOI: 10.1055/s-0043-1767787 -
Zhonghua Jie He He Hu Xi Za Zhi =... Feb 2023In the past year, some important progress has been made in the field of sleep medicine, especially in the diagnosis, classification, evaluation, complications, and... (Review)
Review
In the past year, some important progress has been made in the field of sleep medicine, especially in the diagnosis, classification, evaluation, complications, and individualized treatment of obstructive sleep apnea (OSA). This article briefly introduced the latest progress and research results in the field of sleep medicine at home and abroad from 1 October 2021 to 30 September 2022, hoping to provide more ideas on the diagnosis and treatment of OSA and future research directions.
Topics: Humans; Polysomnography; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 36740381
DOI: 10.3760/cma.j.cn112147-20221031-00860 -
Sleep Medicine Clinics Mar 2022Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF). Untreated obstructive sleep apnea (OSA) and central sleep apnea (CSA) in... (Review)
Review
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF). Untreated obstructive sleep apnea (OSA) and central sleep apnea (CSA) in patients with HF are associated with worse outcomes. Detailed sleep history along with polysomnography (PSG) should be conducted if SDB is suspected in patients with HF. First line of treatment is the optimization of medical therapy for HF and if symptoms persist despite optimization of the treatment, positive airway pressure (PAP) therapy will be started to treat SDB. At present, there is limited evidence to prescribe any drugs for treating CSA in patients with HF. There is limited evidence for the efficacy of continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV) in improving mortality in patients with heart failure with reduced ejection fraction (HFrEF). There is a need to perform well-designed studies to identify different phenotypes of CSA/OSA in patients with HF and to determine which phenotype responds to which therapy. Results of ongoing trials, ADVENT-HF, and LOFT-HF are eagerly awaited to shed more light on the management of CSA in patients with HF. Until then the management of SDB in patients with HF is limited due to the lack of evidence and guidance for treating SDB in patients with HF.
Topics: Heart Failure; Humans; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Central; Stroke Volume
PubMed: 35216764
DOI: 10.1016/j.jsmc.2021.10.007 -
European Respiratory Review : An... Sep 2019Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere... (Review)
Review
Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere coincidence, it appears that they share clinical features and that they may aggravate each other as a result of reciprocally adverse pathogenetic mechanisms. Comorbidity between chronic insomnia disorder and OSA is a clinically relevant condition that may confront practitioners with serious diagnostic and therapeutic challenges. Current data, while still scarce, advocate an integrated and multidisciplinary approach that seems superior over the isolated treatment of each sleep disorder alone.
Topics: Comorbidity; Humans; Lung; Respiration; Risk Factors; Sleep; Sleep Apnea Syndromes; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 31597675
DOI: 10.1183/16000617.0080-2019