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American Family Physician Feb 2022Childhood sleep disorders can disrupt family dynamics and cause cognitive and behavior problems. Early recognition and management can prevent these complications....
Childhood sleep disorders can disrupt family dynamics and cause cognitive and behavior problems. Early recognition and management can prevent these complications. Behavior subtypes of childhood insomnias affect 10% to 30% of children and result from inconsistent parental limit-setting and improper sleep-onset association. Behavior insomnias are treated using extinction techniques and parent education. Hypnotic medications are not recommended. Obstructive sleep apnea affects 1% to 5% of children. Polysomnography is required to diagnose obstructive sleep apnea; history and physical examination alone are not adequate. Adenotonsillectomy is the first-line treatment for obstructive sleep apnea. Nasal continuous positive airway pressure is the second-line treatment for children who do not respond to surgery or if adenotonsillectomy is contraindicated. Restless legs syndrome can be difficult to recognize and has an association with attention-deficit/hyperactivity disorder. Management of restless legs syndrome includes treatment of iron deficiency, if identified, and removal of triggering factors. Parasomnias affect up to 50% of children and usually resolve spontaneously by adolescence. Management of parasomnias involves parental education, reassurance, safety precautions, and treating comorbid conditions. Delayed sleep phase syndrome is found during adolescence, manifesting as a night owl preference. Treatment of delayed sleep phase syndrome includes sleep hygiene, nighttime melatonin, and morning bright light exposure. Sleep deprivation is of increasing concern, affecting 68% of people in high school.
Topics: Continuous Positive Airway Pressure; Humans; Parasomnias; Polysomnography; Sleep Apnea, Obstructive; Sleep Wake Disorders
PubMed: 35166510
DOI: No ID Found -
Arquivos de Neuro-psiquiatria Oct 2020
Topics: Humans; Polysomnography; REM Sleep Behavior Disorder; Sleep, REM
PubMed: 33146234
DOI: 10.1590/0004-282X20200189 -
Frontiers in Endocrinology 2023Obstructive sleep apnea (OSA) is characterized by episodic sleep state-dependent collapse of the upper airway, with consequent hypoxia, hypercapnia, and arousal from... (Review)
Review
Obstructive sleep apnea (OSA) is characterized by episodic sleep state-dependent collapse of the upper airway, with consequent hypoxia, hypercapnia, and arousal from sleep. OSA contributes to multisystem damage; in severe cases, sudden cardiac death might occur. In addition to causing respiratory, cardiovascular and endocrine metabolic diseases, OSA is also closely associated with nonalcoholic fatty liver disease (NAFLD). As the prevalence of OSA and NAFLD increases rapidly, they significantly exert adverse effects on the health of human beings. The authors retrieved relevant documents on OSA and NAFLD from PubMed and Medline. This narrative review elaborates on the current knowledge of OSA and NAFLD, demonstrates the impact of OSA on NAFLD, and clarifies the underlying mechanisms of OSA in the progression of NAFLD. Although there is a lack of sufficient high-quality clinical studies to prove the causal or concomitant relationship between OSA and NAFLD, existing evidence has confirmed the effect of OSA on NAFLD. Elucidating the underlying mechanisms through which OSA impacts NAFLD would hold considerable importance in terms of both prevention and the identification of potential therapeutic targets for NAFLD.
Topics: Humans; Non-alcoholic Fatty Liver Disease; Hypoxia; Sleep Apnea, Obstructive; Sleep; Polysomnography
PubMed: 37850091
DOI: 10.3389/fendo.2023.1254459 -
Sleep Medicine Oct 2023The diagnosis of narcolepsy is based on clinical information, combined with polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT). PSG and the MSLT are...
BACKGROUND
The diagnosis of narcolepsy is based on clinical information, combined with polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT). PSG and the MSLT are moderately reliable at diagnosing narcolepsy type 1 (NT1) but unreliable for diagnosing narcolepsy type 2 (NT2). This is a problem, especially given the increased risk of a false-positive MSLT in the context of circadian misalignment or sleep deprivation, both of which commonly occur in the general population.
AIM
We aimed to clarify the accuracy of PSG/MSLT testing in diagnosing NT1 versus controls without sleep disorders. Repeatability and reliability of PSG/MSLT testing and temporal changes in clinical findings of patients with NT1 versus patients with hypersomnolence with normal hypocretin-1 were compared.
METHOD
84 patients with NT1 and 100 patients with non-NT1-hypersomnolence disorders, all with congruent cerebrospinal fluid hypocretin-1 (CSF-hcrt-1) levels, were included. Twenty-five of the 84 NT1 patients and all the hypersomnolence disorder patients underwent a follow-up evaluation consisting of clinical assessment, PSG, and a modified MSLT. An additional 68 controls with no sleep disorders were assessed at baseline.
CONCLUSION
Confirming results from previous studies, we found that PSG and our modified MSLT accurately and reliably diagnosed hypocretin-deficient NT1 (accuracy = 0.88, reliability = 0.80). Patients with NT1 had stable clinical and electrophysiological presentations over time that suggested a stable phenotype. In contrast, the PSG/MSLT results of patients with hypersomnolence, and normal CSF-hcrt-1 had poor reliability (0.32) and low repeatability.
Topics: Humans; Polysomnography; Orexins; Sleep Latency; Reproducibility of Results; Narcolepsy; Disorders of Excessive Somnolence
PubMed: 37544279
DOI: 10.1016/j.sleep.2023.07.029 -
American Journal of Respiratory and... Aug 2020
Topics: Humans; Infant; Polysomnography
PubMed: 32510967
DOI: 10.1164/rccm.202005-2036ED -
Respirology (Carlton, Vic.) Mar 2020
Topics: Cheyne-Stokes Respiration; Heart Failure; Heart Failure, Systolic; Humans; Phenotype; Polysomnography; Sleep Apnea, Central
PubMed: 31390110
DOI: 10.1111/resp.13657 -
Biosensors Mar 2023Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth.... (Review)
Review
Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.
Topics: Child; Humans; Polysomnography; COVID-19; Sleep; Wearable Electronic Devices
PubMed: 36979607
DOI: 10.3390/bios13030395 -
Scientific Reports May 2022The adoption of multisensor wearables presents the opportunity of longitudinal monitoring of sleep in large populations. Personalized yet device-agnostic algorithms can...
The adoption of multisensor wearables presents the opportunity of longitudinal monitoring of sleep in large populations. Personalized yet device-agnostic algorithms can sidestep laborious human annotations and objectify cross-cohort comparisons. We developed and tested a heart rate-based algorithm that captures inter- and intra-individual sleep differences in free-living conditions and does not require human input. We evaluated it on four study cohorts using different research- and consumer-grade devices for over 2000 nights. Recording periods included both 24 h free-living and conventional lab-based night-only data. We compared our optimized method against polysomnography, sleep diaries and sleep periods produced through a state-of-the-art acceleration based method. Against sleep diaries, the algorithm yielded a mean squared error of 0.04-0.06 and a total sleep time (TST) deviation of [Formula: see text]2.70 (± 5.74) and 12.80 (± 3.89) minutes, respectively. When evaluated with PSG lab studies, the MSE ranged between 0.06 and 0.11 yielding a time deviation between [Formula: see text]29.07 and [Formula: see text]55.04 minutes. These results showcase the value of this open-source, device-agnostic algorithm for the reliable inference of sleep in free-living conditions and in the absence of annotations.
Topics: Heart Rate; Humans; Polysomnography; Reproducibility of Results; Sleep; Wearable Electronic Devices
PubMed: 35562527
DOI: 10.1038/s41598-022-11792-7 -
The European Respiratory Journal Mar 2023Mechanisms underlying blood pressure changes in obstructive sleep apnoea (OSA) are incompletely understood. Increased respiratory effort is one of the main features of...
BACKGROUND
Mechanisms underlying blood pressure changes in obstructive sleep apnoea (OSA) are incompletely understood. Increased respiratory effort is one of the main features of OSA and is associated with sympathetic overactivity, leading to increased vascular wall stiffness and remodelling. This study investigated associations between a new measure of respiratory effort (percentage of total sleep time spent with increased respiratory effort based on measurement of mandibular jaw movements (MJM): REMOV, %TST) and prevalent hypertension in adults referred for evaluation of suspected OSA.
METHODS
A machine learning model was built to predict hypertension from clinical data, conventional polysomnography (PSG) indices and MJM-derived parameters (including REMOV). The model was evaluated in a training subset and a test subset.
RESULTS
The analysis included 1127 patients: 901 (80%) in the training subset and 226 (20%) in the test subset. The prevalence of hypertension was 31% and 30%, respectively, in the training and test subsets. A risk stratification model based on 18 input features including REMOV had good accuracy for predicting prevalent hypertension (sensitivity 0.75 and specificity 0.83). Using the Shapley additive explanation method, REMOV was the best predictor of hypertension after clinical risk factors (age, sex, body mass index and neck circumference) and time with oxygen saturation <90%, ahead of standard PSG metrics (including the apnoea-hypopnoea index and oxygen desaturation index).
CONCLUSION
The proportion of sleep time spent with increased respiratory effort automatically derived from MJM was identified as a potential new reliable metric to predict prevalent hypertension in patients with OSA.
Topics: Adult; Humans; Sleep; Sleep Apnea, Obstructive; Hypertension; Polysomnography; Risk Factors
PubMed: 36455958
DOI: 10.1183/13993003.01486-2022 -
Psychiatry Research Jun 2023Insomnia and its opposite hypersomnia are part of the diagnostic criteria for major depressive disorder (MDD). However, no study has investigated whether the postulated...
Insomnia and its opposite hypersomnia are part of the diagnostic criteria for major depressive disorder (MDD). However, no study has investigated whether the postulated sleep alterations in clinical subtypes of MDD are reflected in polysomnography (PSG)-derived objective sleep measures. The objective of this study was to establish associations between the melancholic, atypical and unspecified subtypes of MDD and objective PSG-based sleep features. This cross-sectional analysis included 1820 community-dwelling individuals who underwent PSG and a semi-structured psychiatric interview to elicit diagnostic criteria for MDD and its subtypes. Adjusted robust linear regression was used to assess associations between MDD subtypes and PSG-derived objective sleep measures. Current melancholic MDD was significantly associated with decreased absolute delta power and sleep efficiency and with increased wake after sleep onset. Remitted unspecified MDD was significantly associated with increased rapid eye movements density. No other significant associations were identified. Our findings reflect that some PSG-based sleep features differed in MDD subtypes compared with no MDD. The largest number of significant differences were observed for current melancholic MDD, whereas only rapid eye movements density could represent a risk factor for MDD as it was the only sleep measure that was also associated with MDD in remitted participants.
Topics: Humans; Depressive Disorder, Major; Polysomnography; Cross-Sectional Studies; Sleep; Depression
PubMed: 37098299
DOI: 10.1016/j.psychres.2023.115213