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Medicine May 2023Sleep-related problems are debilitating and long-lasting conditions in individuals with stroke. We aimed to estimate the prevalence of poor sleep quality after stroke by... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sleep-related problems are debilitating and long-lasting conditions in individuals with stroke. We aimed to estimate the prevalence of poor sleep quality after stroke by conducting a systematic review and meta-analysis.
METHODS
Five databases (PubMed, Embase, Web of Science, Scopus, and CINHAL) were searched for literature published before November 2022. Studies recruiting participants with stroke, using a validated scale to measure sleep quality and in English were included. We used the Agency for Healthcare Research and Quality Scale and Newcastle-Ottawa Scale to assess the quality of eligible studies. Pooled prevalence and subgroup analyses were performed to understand the variation in sleep quality among studies. We followed the PRISMA checklist to report the study.
RESULTS
Thirteen studies were included for analysis (n = 3886). The pooled prevalence of poor sleep quality was 53% (95% CI 41-65%). Studies using PSQI with a cutoff point of 7 had a prevalence of 49% (95% CI 26-71%), whereas those with a cutoff point of 5 had a higher prevalence of 66% (95% CI 63-69%) (P = .13). Geographical location could explain the prevalence variation between studies. The majority of included studies had a medium level quality of evidence (10/13).
CONCLUSION
Poor sleep quality appears to be common in patients with stroke. Considering its negative impact on health, effective measures should be taken to improve their quality of sleep. Longitudinal studies should be conducted to examine the contributing factors and investigate the mechanisms that lead to poor sleep quality.
Topics: Humans; Sleep Quality; Stroke; Sleep; Sleep Initiation and Maintenance Disorders; Prevalence
PubMed: 37335687
DOI: 10.1097/MD.0000000000033777 -
Nutrients Jul 2023Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social... (Meta-Analysis)
Meta-Analysis Review
Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents' sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents' sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents' health, highlighting the need to examine further the interplay between these variables.
Topics: Adolescent; Humans; Eating; Sleep Initiation and Maintenance Disorders; Feeding Behavior; Sleep; Obesity
PubMed: 37513597
DOI: 10.3390/nu15143179 -
Clinical Cardiology Apr 2023Insomnia has been closely associated with cardiovascular disease (CVD) including myocardial infarction (MI). Our study aims to assess the eligibility of insomnia as a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Insomnia has been closely associated with cardiovascular disease (CVD) including myocardial infarction (MI). Our study aims to assess the eligibility of insomnia as a potential risk factor for MI.
METHODS
PubMed, Scopus, and Web of Science were searched using terms; such as "Insomnia" and "MI." Only observational controlled studies with data on the incidence of MI among insomniacs were included. Revman software version 5.4 was used for the analysis.
RESULTS
Our pooled analysis showed a significant association between insomnia and the incidence of MI compared with noninsomniacs (relative risk [RR] = 1.69, 95% confidence interval [CI] = 1.41-2.02, p < .00001). Per sleep duration, we detected the highest association between ≤5 h of sleep, and MI incidence compared to 7-8 h of sleep (RR = 1.56, 95% CI = 1.41-1.73). Disorders of initiating and maintaining sleep were associated with increased MI incidence (RR = 1.13, 95% CI = 1.04-1.23, p = .003). However, subgroup analysis of nonrestorative sleep and daytime dysfunction showed an insignificant association with MI among both groups (RR = 1.06, 95% CI = 0.91-1.23, p = .46). Analysis of age, follow-up duration, sex, and comorbidities showed a significant association in insomniacs.
CONCLUSION
Insomnia and ≤5 h of sleep are highly associated with increased incidence of MI; an association comparable to that of other MI risk factors and as such, it should be considered as a risk factor for MI and to be incorporated into MI prevention guidelines.
Topics: Humans; Incidence; Sleep Initiation and Maintenance Disorders; Myocardial Infarction; Risk Factors; Sleep
PubMed: 36841256
DOI: 10.1002/clc.23984 -
Sleep Medicine Jun 2022To examine the impact of prostate cancer (PCa) on sleep health for patients and caregivers. We hypothesized that sleep disturbances and poor sleep quality would be... (Review)
Review
Systematic review of sleep and sleep disorders among prostate cancer patients and caregivers: a call to action for using validated sleep assessments during prostate cancer care.
OBJECTIVE/BACKGROUND
To examine the impact of prostate cancer (PCa) on sleep health for patients and caregivers. We hypothesized that sleep disturbances and poor sleep quality would be prevalent among patients with PCa and their caregivers.
PATIENTS/METHODS
A systematic literature search was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines. To be eligible for this systematic review, studies had to include: (1) patients diagnosed with PCa and/or their caregivers; and (2) objective or subjective data on sleep. 2431 articles were identified from the search. After duplicates were removed, 1577 abstracts were screened for eligibility, and 315 underwent full-text review.
RESULTS AND CONCLUSIONS
Overall, 83 articles met inclusion criteria and were included in the qualitative synthesis. The majority of papers included patients with PCa (98%), who varied widely in their treatment stage. Only 3 studies reported on sleep among caregivers of patients with PCa. Most studies were designed to address a different issue and examined sleep as a secondary endpoint. Commonly used instruments included the Insomnia Severity Index and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaires (EORTC-QLQ). Overall, patients with PCa reported a variety of sleep issues, including insomnia and general sleep difficulties. Both physical and psychological barriers to sleep are reported in this population. There was common use of hypnotic medications, yet few studies of behavioral interventions to improve sleep for patients with PCa or their caregivers. Many different sleep issues are reported by patients with PCa and caregivers with diverse sleep measurement methods and surveys. Future research may develop consensus on validated sleep assessment tools for use in PCa clinical care and research to promote facilitate comparison of sleep across PCa treatment stages. Also, future research is needed on behavioral interventions to improve sleep among this population.
Topics: Caregivers; Humans; Male; Prostatic Neoplasms; Quality of Life; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 35489117
DOI: 10.1016/j.sleep.2022.03.020 -
Journal of Clinical Sleep Medicine :... Apr 2022The aim of this study is to evaluate the relationship between the month of birth (MOB) and the risk of narcolepsy. (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
The aim of this study is to evaluate the relationship between the month of birth (MOB) and the risk of narcolepsy.
METHODS
We conducted a systematic review of the electronic databases PubMed, Embase, and Cochrane CENTRAL from their inception to September 30, 2021. We also added data on narcolepsy from the National Health Insurance Research Database in Taiwan. Then we extracted the relative risk (RR) ratios of narcolepsy in each month of birth to those of the general population and transformed them from MOB to season. A random-effects model was used to calculate pooled RR ratios from the meta-analysis and 95% confidence interval (CI).
RESULTS
The meta-analysis analyzed 7 studies and included 3,776 patients from 8 areas (Canada, China, France, Germany, Hong Kong, Netherlands, Taiwan, and United States). The RR ratio was highest in March (1.11; 95% CI, 0.99-1.26) and August (1.11; 95% CI, 0.98-1.26) and lowest in April (0.90; 95% CI, 0.78-1.03). However, none of the MOBs reached statistical significance. Moreover, the narcolepsy risk patterns on the 3 continents (Asia, Europe, and North America) were different. In North America, the highest and lowest significant risks were found in March (1.47; 95% CI, 1.20-1.79) and September (0.75; 95% CI, 0.56-0.99). In Asia, the lowest notable risk was in April (0.80; 95% CI, 0.66-0.97). In Europe, the risk of narcolepsy was not significantly related to any MOB. In terms of seasons, only spring MOBs in North America had a significantly higher risk (1.21; 95% CI, 1.06-1.38).
CONCLUSIONS
The findings indicated that the risk of narcolepsy and MOB differed across the 3 continents. This study indicates the important role of environmental factors in narcolepsy.
SYSTEMATIC REVIEW REGISTRATION
Registry: PROSPERO; Identifier: CRD42020186660.
CITATION
Hsu C-W, Tseng P-T, Tu Y-K, et al. Month of birth and the risk of narcolepsy: a systematic review and meta-analysis. 2022;18(4):1113-1120.
Topics: Hong Kong; Humans; Narcolepsy; Netherlands; Odds Ratio; Seasons
PubMed: 34893148
DOI: 10.5664/jcsm.9816 -
Graefe's Archive For Clinical and... Jan 2024The association of obstructive sleep apnea (OSA) with development of eye diseases is unclear. This current systematic review and meta-analysis attempts to summarize and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The association of obstructive sleep apnea (OSA) with development of eye diseases is unclear. This current systematic review and meta-analysis attempts to summarize and analyze associations between OSA and ocular disorders in the literature.
METHODS
PubMed, EMBASE, Google Scholar, Web Of Science, and Scopus databases were searched from 1901 to July 2022 in accordance with the Preferred Reporting in Systematic Review & Meta-Analysis (PRISMA). Our primary outcome assessed the association between OSA and the odds of developing floppy eyelid syndrome (FES), glaucoma, non-arteritic anterior ischemic optic neuropathy (NAION), retinal vein occlusion (RVO), keratoconus (KC), idiopathic intracranial hypertension (IIH), age-related macular degeneration (AMD), and central serous chorioretinopathy (CSR) through odds ratio calculated at the 95% confidence interval.
RESULTS
Forty-nine studies were included for systematic review and meta-analysis. The pooled OR estimate was highest for NAION [3.98 (95% CI 2.38, 6.66)], followed by FES [3.68 (95% CI 2.18, 6.20)], RVO [2.71(95% CI 1.83, 4.00)], CSR [2.28 (95% CI 0.65, 7.97)], KC [1.87 (95% CI 1.16, 2.99)], glaucoma [1.49 (95% CI 1.16, 1.91)], IIH [1.29 (95% CI 0.33, 5.01)], and AMD [0.92 [95% CI 0.24, 3.58] All observed associations were significant (p < 0.001) aside from IIH and AMD.
CONCLUSION
OSA is significantly associated with NAION, FES, RVO, CSR, KC, and glaucoma. Clinicians should be informed of these associations so early recognition, diagnosis, and treatment of eye disorders can be addressed in at-risk groups, and early referral to ophthalmic services is made to prevent vision disturbances. Similarly, ophthalmologists seeing patients with any of these conditions should consider screening and referring patients for assessment of possible OSA.
Topics: Humans; Eyelid Diseases; Glaucoma; Keratoconus; Optic Neuropathy, Ischemic; Retinal Vein Occlusion; Sleep Apnea, Obstructive
PubMed: 37227479
DOI: 10.1007/s00417-023-06103-3 -
Journal of Sport and Health Science Jul 2023There is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.
METHODS
A systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model.
RESULTS
The analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD) = 0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMD = 0.38, 95%CrI: -0.05 to 0.81) and role function (SMD = 0.48, 95%CrI: -0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMD = 0.69, 95%CrI: -0.07 to 1.50) and effective in alleviating fatigue (SMD = -0.77, 95%CrI: -1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMD = -1.20, 95%CrI: -2.40 to 0.06), depression (SMD = -0.51, 95%CrI: -1.50 to 0.45), and anxiety (SMD = -0.45, 95%CrI: -1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (-0.87 to -5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMD = -0.33, 95%CrI: -1.70 to 1.00), physical health (SMD = -0.18, 95%CrI: -1.30 to 0.90), and role function (SMD = -1.20, 95%CrI: -2.50 to 0.11).
CONCLUSION
This study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.
Topics: Adult; Humans; Quality of Life; Network Meta-Analysis; Sleep Initiation and Maintenance Disorders; Exercise; Digestive System Neoplasms; Fatigue; Randomized Controlled Trials as Topic
PubMed: 36528289
DOI: 10.1016/j.jshs.2022.12.008 -
European Journal of Medical Research Mar 2023There is a great association between the prevalence of obstructive sleep apnea (OSA) and asthma. Nonetheless, whether OSA impacts lung function, symptoms, and control in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is a great association between the prevalence of obstructive sleep apnea (OSA) and asthma. Nonetheless, whether OSA impacts lung function, symptoms, and control in asthma and whether asthma increases the respiratory events in OSA are unknown. This meta-analysis aimed to examine the relationship between obstructive sleep apnea and asthma severity and vice versa.
METHODS
We carried out a systematic search of PubMed, EMBASE, and Scopus from inception to September 2022. Primary outcomes were lung function, parameters of polysomnography, the risk of OSA in more severe or difficult-to-control asthmatic patients, and the risk of asthma in patients with more severe OSA. Heterogeneity was examined with the Q test and I statistics. We also performed subgroup analysis, Meta-regression, and Egger's test for bias analysis.
RESULTS
34 studies with 27,912 subjects were totally included. The results showed that the comorbidity of OSA aggravated lung function in asthmatic patients with a consequent decreased forced expiratory volume in one second %predicted (%FEV1) and the effect was particularly evident in children. %FEV1 tended to decrease in adult asthma patients complicated with OSA, but did not reach statistical significance. Interestingly, the risk of asthma seemed to be slightly lower in patients with more severe OSA (OR = 0.87, 95%CI 0.763-0.998). Asthma had no significant effect on polysomnography, but increased daytime sleepiness assessed by the Epworth Sleepiness Scale in OSA patients (WMD = 0.60, 95%CI 0.16-1.04). More severe asthma or difficult-to-control asthma was independently associated with OSA (odds ratio (OR) = 4.36, 95%CI 2.49-7.64).
CONCLUSION
OSA was associated with more severe or difficult-to-control asthma with decreased %FEV in children. The effect of OSA on lung function in adult patients should be further confirmed. Asthma increased daytime sleepiness in OSA patients. More studies are warranted to investigate the effect of asthma on OSA severity and the impact of different OSA severity on the prevalence of asthma. It is strongly recommended that people with moderate-to-severe or difficult-to-control asthma screen for OSA and get the appropriate treatment.
Topics: Adult; Child; Humans; Sleep Apnea, Obstructive; Asthma; Comorbidity; Polysomnography; Disorders of Excessive Somnolence
PubMed: 36998095
DOI: 10.1186/s40001-023-01097-4 -
Frontiers in Public Health 2023This systematic review and meta-analysis was conducted to analyze the effectiveness of a mindfulness-based program on sleep quality in healthy non-institutionalized... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review and meta-analysis was conducted to analyze the effectiveness of a mindfulness-based program on sleep quality in healthy non-institutionalized older people.
METHODS
This study was conducted following the PRISMA (Preferred Reporting Items For Systematic Reviews And Meta-Analyses) guidelines. The search was conducted during May and June 2023 using four databases: Pubmed, Scopus, Web of Science, and CINAHL. Different keywords combined with Boolean operators were used. Only 10 articles of the initial 177 were included. In the study, the standardized mean difference (SMD) was used along with a 95% confidence interval to measure the effect. Heterogeneity among the studies, assessed using Cochran's -test and the statistic was found to be low, leading to the use of a fixed-effects model in the analysis. The effect size was expressed as Hedge'g. Furthermore, a subgroup analysis was conducted, taking into account the various tools used to assess sleep conditions.
RESULTS
Mindfulness was found to reduce poor sleep quality in people with both long-term and short-term sleep disorders. Weighting effect model Hedge'g = -0.344 with a 95% confidence interval ranging from -0.425 to -0.263. In all cases, statistically significant results were observed, as well as moderate and negative effect sizes according to the Hedge's g index: -0.326 for Insomnia Severity Index (ISI), -0.343 for Pittsburgh Sleep Quality Index (PSQI), and -0.28 for Sleep Onset Latency (SOL).
CONCLUSION
This systematic review and meta-analysis found that mindfulness can be used to remedy poor sleep quality in older people, so it could be a viable treatment option for insomnia or other problems related to poor sleep quality in this population.
Topics: Aged; Humans; Cognitive Behavioral Therapy; Mindfulness; Sleep Initiation and Maintenance Disorders; Sleep Quality; Sleep Wake Disorders
PubMed: 38179560
DOI: 10.3389/fpubh.2023.1242868 -
Sleep Medicine Reviews Jun 2021Understanding salient environmental determinants of pediatric sleep is essential for informing interventions and public health initiatives. Emerging evidence suggests... (Review)
Review
Understanding salient environmental determinants of pediatric sleep is essential for informing interventions and public health initiatives. Emerging evidence suggests that the neighborhood environment can impact pediatric sleep, but this evidence has not yet been systematically reviewed. We conducted a systematic review of the scientific literature on associations between neighborhood environments and sleep in young children (0-5 y), school-aged children (6-12 y) and adolescents (13-18 y). We reviewed 85 articles published between 2003 and 2020. The most commonly examined neighborhood exposure was low socioeconomic status (40 studies), which was associated with sleep outcomes in 58% of studies (primarily shorter sleep duration, later sleep timing, or obstructive sleep apnea). Evidence was stronger for neighborhood safety/crime/violence (21 studies), with 86% of studies reporting associations with sleep outcomes (primarily self- or caregiver-reported sleep problems). Fewer studies examined associations of neighborhood physical environment exposures, including noise (15 studies), the built environment (seven studies), and air pollution (six studies). Limitations of the current body of evidence include 1) limited examination of neighborhood exposures other than socioeconomic status or safety, 2) use of primarily cross-sectional observational study designs, 3) lack of objective sleep outcome assessment, and 4) limits of current exposure assessment methods.
Topics: Adolescent; Child; Child, Preschool; Cross-Sectional Studies; Humans; Observational Studies as Topic; Residence Characteristics; Sleep; Sleep Apnea, Obstructive; Social Class
PubMed: 33827031
DOI: 10.1016/j.smrv.2021.101465