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Sleep Medicine Jan 2021Several observational studies have shown that patients with irritable bowel syndrome (IBS) may have a high risk of restless legs syndrome (RLS). This systematic review... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Several observational studies have shown that patients with irritable bowel syndrome (IBS) may have a high risk of restless legs syndrome (RLS). This systematic review and meta-analysis aimed to comprehensively investigate the bidirectional association between IBS and RLS.
METHODS
All conservational studies on IBS and RLS were searched in MEDLINE (assessed by PubMed), Embase, Web of Science, CINAHL, the Cochrane Library database and Google Scholar from inception to June 14, 2020. The Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality were used to assess the methodological quality of the cohort and cross-sectional studies, respectively. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using Reviewer Manager 5.3.
RESULT
A total of five cross-sectional studies of moderate methodological quality and one cohort study of high methodological quality were included in our review. Four cross-sectional studies and one cohort study involving 86 438 individuals met the criteria of IBS predicating the onset of RLS. Patients with IBS had a nearly three-fold increased odds of RLS compared with controls (OR = 2.60, 95%CI: 2.17-3.12, P < 0.00001; I = 48%, P = 0.11). Three sensitivity analyses confirmed the robustness of the pooled result. Two cross-sectional studies involving 3581 individuals met the criteria of RLS predicating the onset of IBS. RLS patients had a nearly four-fold increased odds of IBS compared with controls without RLS (OR = 3.87, 95%CI: 1.73-8.66, P = 0.0010; I = 77%, P = 0.04).
CONCLUSION
In this systematic review and meta-analysis, we found a substantial bidirectional association between IBS and RLS. More prospective, high-quality, population-based studies are warranted in the future.
Topics: Cohort Studies; Cross-Sectional Studies; Humans; Irritable Bowel Syndrome; Prospective Studies; Restless Legs Syndrome
PubMed: 33348297
DOI: 10.1016/j.sleep.2020.12.002 -
International Journal of Chronic... 2022Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic respiratory disease (CRD) morbidity and mortality.... (Review)
Review
ABSTRACT
Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic respiratory disease (CRD) morbidity and mortality. These behaviours need to be understood in low- and middle-income countries (LMIC) to develop appropriate interventions.
PURPOSE
Where and how have free-living PA, SB and sleep data been collected for adults living with CRD in LMIC? What are the free-living PA, SB and sleep levels of adults living with CRD?
PATIENTS AND METHODS
The literature on free-living PA, SB and sleep of people living with CRD in LMIC was systematically reviewed in five relevant scientific databases. The review included empirical studies conducted in LMIC, reported in any language. Reviewers screened the articles and extracted data on prevalence, levels and measurement approach of PA, SB and sleep using a standardised form. Quality of reporting was assessed using bespoke criteria.
RESULTS
Of 89 articles, most were conducted in Brazil (n=43). PA was the commonest behaviour measured (n=66). Questionnaires (n=52) were more commonly used to measure physical behaviours than device-based (n=37) methods. International Physical Activity Questionnaire was the commonest for measuring PA/SB (n=11). For sleep, most studies used Pittsburgh Sleep Quality Index (n=18). The most common ways of reporting were steps per day (n=21), energy expenditure (n=21), sedentary time (n=16), standing time (n=13), sitting time (n=11), lying time (n=10) and overall sleep quality (n=32). Studies revealed low PA levels [steps per day (range 2669-7490steps/day)], sedentary lifestyles [sitting time (range 283-418min/day); standing time (range 139-270min/day); lying time (range 76-119min/day)] and poor sleep quality (range 33-100%) among adults with CRD in LMIC.
CONCLUSION
Data support low PA levels, sedentary lifestyles and poor sleep among people in LMIC living with CRDs. More studies are needed in more diverse populations and would benefit from a harmonised approach to data collection for international comparisons.
Topics: Adult; Developing Countries; Exercise; Humans; Pulmonary Disease, Chronic Obstructive; Sedentary Behavior; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35469273
DOI: 10.2147/COPD.S345034 -
Journal of Sleep Research Dec 2023Comorbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating sleep disorder. Cognitive behavioural therapy for insomnia (CBTi) may be an... (Meta-Analysis)
Meta-Analysis Review
Comorbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating sleep disorder. Cognitive behavioural therapy for insomnia (CBTi) may be an appropriate treatment for COMISA; however, no previous study has systematically reviewed and meta-analysed literature reporting on the effect of CBTi in people with COMISA. A systematic literature search was conducted across PsychINFO and PubMed (n = 295). In all, 27 full-text records were independently reviewed by at least two authors. Forward- and backward-chain referencing, and hand-searches were used to identify additional studies. Authors of potentially eligible studies were contacted to provide COMISA subgroup data. In total, 21 studies, including 14 independent samples of 1040 participants with COMISA were included. Downs and Black quality assessments were performed. A meta-analysis including nine primary studies measuring the Insomnia Severity Index indicated that CBTi is associated with a large improvement in insomnia severity (Hedges' g = -0.89, 95% confidence interval [CI] -1.35, -0.43). Subgroup meta-analyses indicated that CBTi is effective in samples with untreated obstructive sleep apnoea (OSA) (five studies, Hedges' g = -1.19, 95% CI -1.77, -0.61) and treated OSA (four studies, Hedges' g = -0.55, 95% CI -0.75, -0.35). Publication bias was evaluated by examining the Funnel plot (Egger's regression p = 0.78). Implementation programmes are required to embed COMISA management pathways in sleep clinics worldwide that currently specialise in the management of OSA alone. Future research should investigate and refine CBTi interventions in people with COMISA, including identifying the most effective CBTi components, adaptations, and developing personalised management approaches for this highly prevalent and debilitating condition.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Cognitive Behavioral Therapy; Sleep; Sleep Apnea, Obstructive; Comorbidity
PubMed: 36872072
DOI: 10.1111/jsr.13847 -
Sensors (Basel, Switzerland) Nov 2019Sleep apnea is a sleep related disorder that significantly affects the population. Polysomnography, the gold standard, is expensive, inaccessible, uncomfortable and an... (Review)
Review
Sleep apnea is a sleep related disorder that significantly affects the population. Polysomnography, the gold standard, is expensive, inaccessible, uncomfortable and an expert technician is needed to score. Numerous researchers have proposed and implemented automatic scoring processes to address these issues, based on fewer sensors and automatic classification algorithms. Deep learning is gaining higher interest due to database availability, newly developed techniques, the possibility of producing machine created features and higher computing power that allows the algorithms to achieve better performance than the shallow classifiers. Therefore, the sleep apnea research has currently gained significant interest in deep learning. The goal of this work is to analyze the published research in the last decade, providing an answer to the research questions such as how to implement the different deep networks, what kind of pre-processing or feature extraction is needed, and the advantages and disadvantages of different kinds of networks. The employed signals, sensors, databases and implementation challenges were also considered. A systematic search was conducted on five indexing services from 2008-2018. A total of 255 papers were found and 21 were selected by considering the inclusion and exclusion criteria, using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach.
Topics: Deep Learning; Humans; Neural Networks, Computer; Sleep Apnea Syndromes
PubMed: 31726771
DOI: 10.3390/s19224934 -
Journal of Sleep Research Feb 2022The outbreak of the novel coronavirus disease 2019 (COVID-19) changed lifestyles worldwide and subsequently induced individuals' sleep problems. Sleep problems have been... (Meta-Analysis)
Meta-Analysis Review
The outbreak of the novel coronavirus disease 2019 (COVID-19) changed lifestyles worldwide and subsequently induced individuals' sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID-19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta-analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID-19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and Newcastle-Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta-analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%-29%) for female participants and 27% (95% CI 24%-30%) for male participants. Although in both gender subgroups, patients with COVID-19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta-regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.
Topics: COVID-19; Communicable Disease Control; Female; Humans; Male; Pandemics; SARS-CoV-2; Sleep Initiation and Maintenance Disorders; Sleep Quality
PubMed: 34245055
DOI: 10.1111/jsr.13432 -
Complementary Therapies in Medicine Aug 2023To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer.
DESIGN
Systematic review and meta-analysis of randomized controlled trials (RCTs).
METHODS
Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs.
RESULTS
Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance.
CONCLUSIONS
Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.
Topics: Adult; Humans; Mind-Body Therapies; Yoga; Meditation; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Neoplasms
PubMed: 37244384
DOI: 10.1016/j.ctim.2023.102954 -
Medicina (Kaunas, Lithuania) Aug 2023: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving... (Meta-Analysis)
Meta-Analysis Review
: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving functional outcomes with good compliance rates. Herein, we aimed to perform a meta-analysis comparing clinical outcomes between OSA children treated with dental appliances versus controls. : The study was registered with PROSPERO. A systematic search was performed for all comparative studies examining outcomes in pediatric patients who underwent treatment of OSA with oral appliances versus controls. Data was extracted and analyzed using a random effects model via Rev Man 5.3. : Six studies including 180 patients were analyzed split into two groups: patients treated with dental appliances (n = 123) and the controls (n = 119). Therapy with dental appliances was shown to significantly improve the apnea-hypopnea index ( = 0.009) and enlarge the superior posterior airway space ( = 0.02). Maxilla-to-mandible measurements were not significantly different between the two groups, nor was the mean SO ( = 0.80). : This is the most updated meta-analysis assessing the role of dental appliances for OSA in children; it shows that such devices can improve functional outcomes by decreasing the apnea-hypopnea index.
Topics: Humans; Child; Patient Compliance; Sleep Apnea, Obstructive
PubMed: 37629737
DOI: 10.3390/medicina59081447 -
Neuroepidemiology 2022Narcolepsy is a chronic neurological disorder. The diagnostic criteria of narcolepsy evolve from clinical symptoms to molecular biomarkers, along with the understanding...
INTRODUCTION
Narcolepsy is a chronic neurological disorder. The diagnostic criteria of narcolepsy evolve from clinical symptoms to molecular biomarkers, along with the understanding of its clinical nature and pathogenesis. Estimates of incidence and prevalence of narcolepsy vary between studies, while the contribution of changing diagnostic criteria to the variation remains unclear. We aimed to explore sources of heterogeneity in estimates of incidence and prevalence, with a particular focus on diagnostic criteria.
METHODS
We searched 5 databases for observational studies on the incidence or prevalence of narcolepsy published before October 14, 2021. Subgroup analyses and meta-regression were used to assess the impact of diagnostic criteria on incidence/prevalence of narcolepsy after adjusting for age-group, region, study period, vaccination status, index date, and type of narcolepsy.
RESULTS
Thirty-five studies were selected from 2,833 articles. The estimates of incidence and prevalence were wide-ranging with high heterogeneity (incidence I2 = 99.8%; prevalence I2 = 99.7%), from 0.06 to 6.56 per 100,000 person-years for incidence and from 1.05 to 79.40 per 100,000 population for prevalence, respectively. Totally 10 diagnostic criteria were used, including the 1st revised edition of International Classification of Diseases (ICSD-1), ICSD-2, ICSD-3, the 8th revision of International Classification of Diseases (ICD-8), ICD-9, ICD-10, Brighton collaboration case definition (Brighton), Mayo classification, the Ullanlinna Narcolepsy Scale, and clinical symptoms with the multiple sleep latency test. ICD tended to provide higher estimates of incidence/prevalence than Brighton (incidence odds ratio [OR] 1.38, [95% CI: 1.02, 1.86]; prevalence OR 1.50, [95% CI: 1.04, 2.39]). No significant difference was found in estimates of two rates between ICSD and Brighton. The incidence was higher for children than adults (OR 1.61, [95% CI: 1.25, 2.07]) and for individuals vaccinated with Pandemrix than those unvaccinated (OR 6.49, [95% CI: 3.86, 10.91]).
CONCLUSIONS
Estimates of incidence/prevalence of narcolepsy could not be pooled reliably with substantial heterogeneity. Incidence/prevalence studies using ICSD and Brighton provided lower estimates than studies using ICD and other criteria. Diagnostic criteria should be standardized when comparing or pooling the incidence/prevalence to understand the epidemiology of narcolepsy. Future studies are needed to focus on the at-risk population for the etiology investigation of narcolepsy.
Topics: Adult; Child; Humans; Incidence; Prevalence; Narcolepsy; International Classification of Diseases; Regression Analysis
PubMed: 35820399
DOI: 10.1159/000525282 -
European Respiratory Review : An... Sep 2023Obstructive sleep apnoea is a highly prevalent chronic disorder and has been shown to be associated with disturbed glucose metabolism and type 2 diabetes. However, the... (Meta-Analysis)
Meta-Analysis Review
Effects of continuous positive airway pressure therapy on glucose metabolism in patients with obstructive sleep apnoea and type 2 diabetes: a systematic review and meta-analysis.
Obstructive sleep apnoea is a highly prevalent chronic disorder and has been shown to be associated with disturbed glucose metabolism and type 2 diabetes. However, the evidence from individual clinical trials on the effect of continuous positive airway pressure (CPAP) treatment on glycaemic control in patients with co-existing obstructive sleep apnoea and type 2 diabetes remains controversial. A systematic review of randomised controlled trials assessing the effect of CPAP on glycaemic control in patients with obstructive sleep apnoea and type 2 diabetes was conducted using the databases MEDLINE, Embase, Cochrane and Scopus up to December 2022. Meta-analysis using a random-effect model was performed for outcomes that were reported in at least two randomised controlled trials. From 3031 records screened, 11 RCTs with a total of 964 patients were included for analysis. CPAP treatment led to a significant reduction in haemoglobin A1c (HbA1c) (mean difference -0.24%, 95% CI -0.43- -0.06%, p=0.001) compared to inactive control groups. Meta-regression showed a significant association between reduction in HbA1c and hours of nightly CPAP usage. CPAP therapy seems to significantly improve HbA1c and thus long-term glycaemic control in patients with type 2 diabetes and obstructive sleep apnoea. The amount of improvement is dependent on the hours of usage of CPAP and thus optimal adherence to CPAP should be a primary goal in these patients.
Topics: Humans; Continuous Positive Airway Pressure; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Sleep Apnea, Obstructive; Glucose
PubMed: 37673425
DOI: 10.1183/16000617.0083-2023 -
Medicina (Kaunas, Lithuania) Mar 2024Insomnia and circadian rhythm disorders are increasingly common in modern society and lead to significant challenges for people's health and well-being. Some studies... (Review)
Review
Insomnia and circadian rhythm disorders are increasingly common in modern society and lead to significant challenges for people's health and well-being. Some studies suggests that men and women differ in neurohormonal secretion, biological processes, and brain morphology. Thus, such differences may affect the etiology, manifestation, and course of sleep disorders, including insomnia and circadian rhythm. This systematic review aims to synthesize the existing literature on sex differences in insomnia and circadian rhythm disorders. PubMed, MEDLINE, Epistemonikos, and Cochrane databases were searched for articles published from inception until 5 September 2023, not older than five years. We performed a systematic search using MESH and non-MESH queries: (sex differences) or (male and female differences) or (men and women differences) or (men and women) AND (insomnia) or (sleep wake disorder*) or (sleep wake rhythm disorder*) or (circadian rhythm disorder*) or (sleep cycle disruption) or (sleep cycle disorder*). Out off 2833 articles screened, 11 studies were included. The prevalence of insomnia is higher among women, and their sleep is more regular and stable compared to men. Studies evaluating the impact of the stressful situation associated with the lockdown on women's and men's insomnia present discordant results concerning sex differences. Women's circadian rhythm was found to be more stable and less fragmented than men's. However, the progression of peak activity time with age was more pronounced in men. The current literature suggests that risk factors for insomnia and circadian rhythm disorders affect men and women differently. These include cerebrovascular and cardiometabolic factors, shift work, and infections. The long-term effects of insomnia seem to be more relevant for the male sex, shortening lifespan more than in women. By summarizing and analyzing existing studies, we highlight the need for further research to improve understanding of the interaction between sex and sleep.
Topics: Female; Male; Humans; Sleep Initiation and Maintenance Disorders; Sleep Disorders, Circadian Rhythm; Sex Characteristics; Sleep; Chronobiology Disorders; Sleep Wake Disorders
PubMed: 38541200
DOI: 10.3390/medicina60030474