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Epilepsia Open Sep 2023This study evaluated sleep and respiratory abnormalities, and their relationship with seizures, in adults with developmental and epileptic encephalopathies (DEEs). We...
This study evaluated sleep and respiratory abnormalities, and their relationship with seizures, in adults with developmental and epileptic encephalopathies (DEEs). We studied consecutive adults with DEEs undergoing inpatient video-EEG monitoring and concurrent polysomnography between December 2011 and July 2022. Thirteen patients with DEEs were included (median age: 31 years, range: 20-50; 69.2% female): Lennox-Gastaut syndrome (n = 6), Lennox-Gastaut syndrome-like phenotype (n = 2), Landau-Kleffner syndrome (n = 1), epilepsy with myoclonic-atonic seizures (n = 1), and unclassified DEEs (n = 3). Sleep architecture was often fragmented by epileptiform discharges and seizures resulting in arousals (median arousal index: 29.0 per h, range: 5.1-65.3). Moderate-to-severe obstructive sleep apnea (OSA) was observed in seven patients (53.8%). Three patients (23.1%) had tonic seizures that frequently occurred with central apnea; one met criteria for mild central sleep apnea. Of the patients with tonic seizures, two had other identifiable seizure manifestations, but in one patient, central apnea was commonly the only discernable seizure manifestation. Polysomnography during video-EEG is an effective diagnostic tool in detecting sleep and seizure-related respiratory abnormalities. Clinically significant OSA may increase the risk of comorbid cardiovascular disease and premature mortality. Treatment of epilepsy may improve sleep quality, and conversely, improved sleep, may decrease seizure burden.
Topics: Female; Male; Humans; Polysomnography; Lennox Gastaut Syndrome; Sleep Apnea, Central; Sleep; Seizures; Electroencephalography; Sleep Apnea, Obstructive
PubMed: 37277988
DOI: 10.1002/epi4.12772 -
Critical Care Nursing Clinics of North... Jun 2021Sleep affects physiologic and psychological recovery throughout critical illness. Patients often describe poor sleep as a major source of distress while hospitalized in... (Review)
Review
Sleep affects physiologic and psychological recovery throughout critical illness. Patients often describe poor sleep as a major source of distress while hospitalized in an intensive care unit. The intensive care unit environment poses unique challenges for sleep assessment and monitoring. The purpose of this literature review is to discuss methods of assessment and monitoring of sleep within the intensive care unit setting. The advantages and disadvantages of physiologic monitoring of sleep (eg, polysomnography, bispectral index, and actigraphy) are compared with those of subjective measures of sleep quality (eg, validated patient-oriented sleep questionnaires, and informal nursing assessments).
Topics: Actigraphy; Critical Illness; Humans; Intensive Care Units; Polysomnography; Sleep; Sleep Wake Disorders
PubMed: 34023079
DOI: 10.1016/j.cnc.2021.01.008 -
Alzheimer's Research & Therapy Dec 2022Increasing evidence has supported a link between obstructive sleep apnea (OSA) and cognition, and blood-brain barrier (BBB) dysfunction which can be reflected by... (Clinical Trial)
Clinical Trial
BACKGROUND
Increasing evidence has supported a link between obstructive sleep apnea (OSA) and cognition, and blood-brain barrier (BBB) dysfunction which can be reflected by paroxysmal slow wave events (PSWEs) may be a potential mechanism. The purpose of our study was to investigate the correlation between the PSWEs and cognitive impairment in patients with OSA, with a focus on the possible mechanism.
METHODS
In total, 339 subjects with subjective snoring complaints from the Sleep Medicine Center underwent magnetic resonance imaging and whole-night polysomnography. OSA was defined as apnea-hypopnea index (AHI) ≥ 5 events/h. MCI was defined as the MoCA < 26 and met the criteria: (1) subjective cognitive impairment; (2) objective impairment in one or more cognitive domains; (3) slightly impaired complex instrumental daily abilities, but independent daily living abilities; and (4) no dementia. The PSWEs calculated by self-developed Python scripts were defined for EEG recordings as a median power frequency of < 6 Hz for more than five consecutive seconds. Serum cyclophilin A (CyPA) and matrix metalloproteinase-9 (MMP-9) levels and amyloid-β 42 levels in neuron-derived exosomes were determined. The participants who received continuous positive airway pressure (CPAP) were followed up and their PSWEs were recalculated after 1 year of treatment.
RESULTS
A total of 339 participants were divided into the OSA+MCI group (n = 157), OSA-MCI group (n = 118), and controls (normal cognitive state without OSA) (n = 64). The total PSWEs and the occurrence per minute of PSWEs at stage REM in the OSA+MCI group were higher than those in the OSA-MCI and control groups. The duration ratio of PSWEs at stage REM in the OSA+MCI group significantly increased. The total PSWEs and PSWEs at the F4-M1, O1-M2, and O2-M1 channels in stage REM were independently associated with cognitive impairment in OSA patients. There were positive correlations between the PSWEs and serum CyPA and MMP-9 levels in patients with OSA. The mediation analysis showed that the relationship between mean SaO and percentage of sleep time spent with oxygen saturation <90% with MoCA scores was mediated by the total PSWEs (proportion of mediation 77.89% and 82.89%). The PSWEs were negatively correlated with global cognitive performance and cognitive subdomains. After 1 year of CPAP treatment, the total PSWEs, PSWEs in stage REM, and serum CyPA and MMP-9 levels decreased significantly, and MoCA scores were improved compared with baseline.
CONCLUSIONS
The PSWEs were implicated in cognitive impairment in patients with OSA, and the mechanisms of cognitive impairment due to hypoxia in OSA patients could be BBB dysfunction. The PSWEs can be used as a marker of cognitive impairment in patients with OSA.
TRIAL REGISTRATION
This trial is registered on the Chinese Clinical Trial Registry, number ChiCTR1900021544. The trial was registered on February 27, 2019.
Topics: Humans; Cognitive Dysfunction; Matrix Metalloproteinase 9; Polysomnography; Sleep; Sleep Apnea, Obstructive
PubMed: 36585689
DOI: 10.1186/s13195-022-01153-x -
Sleep Dec 2023
Topics: Polysomnography; Deep Learning; Sleep; Sleep Stages
PubMed: 37843473
DOI: 10.1093/sleep/zsad268 -
Journal of Healthcare Engineering 2022As a physiological phenomenon, sleep takes up approximately 30% of human life and significantly affects people's quality of life. To assess the quality of night sleep,...
As a physiological phenomenon, sleep takes up approximately 30% of human life and significantly affects people's quality of life. To assess the quality of night sleep, polysomnography (PSG) has been recognized as the gold standard for sleep staging. The drawbacks of such a clinical device, however, are obvious, since PSG limits the patient's mobility during the night, which is inconvenient for in-home monitoring. In this paper, a noncontact vital signs monitoring system using the piezoelectric sensors is deployed. Using the so-designed noncontact sensing system, heartbeat interval (HI), respiratory interval (RI), and body movements (BM) are separated and recorded, from which a new dimension of vital signs, referred to as the coordination of heartbeat interval and respiratory interval (CHR), is obtained. By extracting both the independent features of HI, RI, and BM and the coordinated features of CHR in different timescales, Wake-REM-NREM sleep staging is performed, and a postprocessing of staging fusion algorithm is proposed to refine the accuracy of classification. A total of 17 all-night recordings of noncontact measurement simultaneous with PSG from 10 healthy subjects were examined, and the leave-one-out cross-validation was adopted to assess the performance of Wake-REM-NREM sleep staging. Taking the gold standard of PSG as reference, numerical results show that the proposed sleep staging achieves an averaged accuracy and Cohen's Kappa index of 82.42% and 0.63, respectively, and performs robust to subjects suffering from sleep-disordered breathing.
Topics: Heart Rate; Humans; Polysomnography; Quality of Life; Sleep; Sleep Stages
PubMed: 35844670
DOI: 10.1155/2022/2016598 -
Singapore Medical Journal Apr 2020Sleep is an important component in a child's growth and development. Snoring is common in children and often perceived as benign, but habitual snoring may be an...
Sleep is an important component in a child's growth and development. Snoring is common in children and often perceived as benign, but habitual snoring may be an indication of obstructive sleep apnoea (OSA). OSA can have health, developmental and cognitive consequences. The three common risk factors for paediatric OSA are tonsillar and/or adenoidal hypertrophy, obesity and allergic rhinitis. Primary care providers are well-placed to identify children at risk by screening for habitual snoring and associated OSA risk factors during routine consultations. Physician awareness of OSA symptoms/signs facilitates diagnosis, management and referral decisions. A trial of medical treatment may be considered for habitual snoring with mild symptoms/signs before referral. Overnight polysomnography is the gold standard investigation utilised by paediatric sleep specialists to diagnose OSA. Adenotonsillectomy is the first-line management for OSA with adenotonsillar hypertrophy, but residual/recurrent OSA may occur, so follow-up by primary care providers is important after surgery.
Topics: Adenoidectomy; Child; Child, Preschool; Female; Humans; Male; Polysomnography; Risk Factors; Sleep Apnea, Obstructive; Snoring; Tonsillectomy
PubMed: 32500157
DOI: 10.11622/smedj.2020054 -
Sensors (Basel, Switzerland) Apr 2023A mattress-type non-influencing sleep apnea monitoring system was designed to detect sleep apnea-hypopnea syndrome (SAHS). The pressure signals generated during sleep on...
A mattress-type non-influencing sleep apnea monitoring system was designed to detect sleep apnea-hypopnea syndrome (SAHS). The pressure signals generated during sleep on the mattress were collected, and ballistocardiogram (BCG) and respiratory signals were extracted from the original signals. In the experiment, wavelet transform (WT) was used to reduce noise and decompose and reconstruct the signal to eliminate the influence of interference noise, which can directly and accurately separate the BCG signal and respiratory signal. In feature extraction, based on the five features commonly used in SAHS, an innovative respiratory waveform similarity feature was proposed in this work for the first time. In the SAHS detection, the binomial logistic regression was used to determine the sleep apnea symptoms in the signal segment. Simulation and experimental results showed that the device, algorithm, and system designed in this work were effective methods to detect, diagnose, and assist the diagnosis of SAHS.
Topics: Humans; Arrhythmias, Cardiac; Polysomnography; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 37050735
DOI: 10.3390/s23073675 -
Sleep Jul 2022The mouse-deer or chevrotains are the smallest of the ungulates and ruminants. They are characterized by a number of traits which are considered plesiomorphic for the...
The mouse-deer or chevrotains are the smallest of the ungulates and ruminants. They are characterized by a number of traits which are considered plesiomorphic for the Artiodactyla order. The objective of this study was to examine sleep in the lesser mouse-deer (Tragulus kanchil), which is the smallest in this group (body mass < 2.2 kg). Electroencephalogram, nuchal electromyogram, electrooculogram, and body acceleration were recorded in four adult mouse-deer females using a telemetry system in Bu Gia Map National Park in Vietnam. The mouse-deer spent on average 49.7 ± 3.0% of 24 h in non-rapid eye movement (NREM) sleep. REM sleep occupied 1.7 ± 0.3% of 24 h or 3.2 ± 0.5% of total sleep time. The average duration of REM sleep episodes was 2.0 ± 0.2 min, the average maximum was 5.1 ± 1.1 min, and the longest episodes lasted 8 min. NREM sleep occurred in sternal recumbency with the head held above the ground while 64.7 ± 6.4% of REM sleep occurred with the head resting on the ground. The eyes were open throughout most of the NREM sleep period. The mouse-deer displayed polyphasic sleep and crepuscular peaks in activity (04:00-06:00 and 18:00-19:00). The largest amounts of NREM occurred in the morning (06:00-09:00) and the smallest before dusk (at 04:00-06:00). REM sleep occurred throughout most of the daylight hours (08:00-16:00) and in the first half of the night (19:00-02:00). We suggest that the pattern and timing of sleep in the lesser mouse-deer is adapted to the survival of a small herbivorous animal, subject to predation, living in high environmental temperatures in the tropical forest undergrowth.
Topics: Animals; Artiodactyla; Female; Polysomnography; Sleep; Sleep, REM
PubMed: 34370021
DOI: 10.1093/sleep/zsab199 -
Clinical Oral Investigations Jun 2022To validate a new diagnostic method (DIABRUX) for quantifying sleep bruxism (SB) activity using the current gold standard, polysomnography (PSG), as a criterion in an...
OBJECTIVES
To validate a new diagnostic method (DIABRUX) for quantifying sleep bruxism (SB) activity using the current gold standard, polysomnography (PSG), as a criterion in an adequate sample size investigation.
MATERIALS AND METHODS
For SB diagnosis, each participant received a two-night ambulatory PSG including audio-video recordings. The 0.5-mm-thick sheet is produced in a thermoforming process. After diagnosis via PSG, each subject wore the diagnostic sheet for five consecutive nights. The resulting total abrasion on the surface was automatically quantified in pixels by a software specially designed for this purpose.
RESULTS
Forty-five participants (10 SB and 35 non-SB subjects) were included. The difference of the mean pixel score between the SB (M = 1,306, SD = 913) and the non-SB group (M = 381, SD = 483; 3.4 times higher for SB) was statistically significant (p < 0.001). The receiver operator characteristic (ROC) analysis revealed a value of 507 pixels as the most appropriate cut-off criterion with a sensitivity of 1.0, a specificity to 0.8, and an area under the curve (AUC) of 0.88. The positive and negative predictive value accounted for 0.59 and 1.0.
CONCLUSIONS
The present data confirm that the new diagnostic method is valid and user-friendly that may be used for therapeutic evaluation, and for the acquisition of larger sample sizes within sophisticated study designs.
CLINICAL RELEVANCE
The verified properties of the new diagnostic method allow estimating SB activity before damages occur due to long-standing bruxism activity. Therefore, it might be utilized for preventive dentistry.
TRIAL REGISTRATION NUMBER
NC T03325920 (September 22, 2017).
Topics: Electromyography; Humans; Polysomnography; Predictive Value of Tests; Sleep Bruxism
PubMed: 35195761
DOI: 10.1007/s00784-022-04398-w -
Sleep Jun 2022Sleep plays a significant role in the mental and physical development of children. Emerging evidence in animals and human adults indicates a relationship between sleep...
Sleep plays a significant role in the mental and physical development of children. Emerging evidence in animals and human adults indicates a relationship between sleep and the gut microbiota; however, it is unclear whether the sleep of preschoolers during a key developmental period, associates with features of their gut microbiota. The objective of this study was to assess the relationship between sleep and gut microbiota in preschool-aged children (4.37 ± 0.48 years, n = 143). Sleep measures included total night-time sleep (TST), sleep efficiency (SE), and wake-time after sleep onset (WASO) assessed using actigraphy. Beta-diversity differences between children with low and high TST (p = .048) suggest gut microbiota community differences. Particularly, relative abundance of Bifidobacterium was higher in the high TST group and Bacteroides, was higher in children who had greater SE and less WASO (LDA score >2). In contrast, some Lachnospiraceae members including Blautia and Coprococcus 1 were associated with shorter night-time sleep duration and less efficiency, respectively. We also found a group of fecal metabolites, including specific neuroactive compounds and immunomodulating metabolites were associated with greater sleep efficiency and less time awake at night. Notably, tryptophan and its metabolizing products were higher in children who had higher SE or lower WASO (LDA score >2); concentration of propionate was higher in children with less WASO (p = .036). Overall, our results reveal a novel association between sleep and gut microbiota in preschool-aged children. Longer night-time sleep and greater sleep efficiency were associated with specific commensal bacteria that may regulate sleep through modulating neurotransmitter metabolism and the immune system.
Topics: Actigraphy; Child, Preschool; Gastrointestinal Microbiome; Humans; Polysomnography; Sleep; Wakefulness
PubMed: 35037059
DOI: 10.1093/sleep/zsac020