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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 -
Journal of Sleep Research Dec 2023Longitudinal studies observed that individuals suffering from insomnia disorder have a higher vulnerability to develop symptoms of psychopathology compared with good... (Meta-Analysis)
Meta-Analysis Review
Longitudinal studies observed that individuals suffering from insomnia disorder have a higher vulnerability to develop symptoms of psychopathology compared with good sleepers. Particularly, insomnia disorder has been associated with an increased risk for depression. Previous studies indicate relatively stable effects; however, replication is needed as the last meta-analysis on the topic has been published 4 years ago. We conducted a replication of a previous systematic review and meta-analysis evaluating the longitudinal association between insomnia disorder and psychopathology, including original works published between 2018 and 2022. Literature search was conducted from April 2018 to August 2022 using key words identifying longitudinal studies that evaluate individuals with insomnia disorder compared with good sleepers at baseline, and the onset of all possible mental disorders at long-term follow-up. Only one work was added to the previous sample of studies published in 2019 looking at the longitudinal association between insomnia disorder and depression. Meta-analytic results confirmed the previous observation, with an even higher observed effect for the link between insomnia and depression. This again recognizes insomnia disorder as a possible transdiagnostic process in psychopathology, with consequent important clinical implications. Nevertheless, more longitudinal studies are needed evaluating the link between insomnia disorder and mental disorders.
Topics: Humans; Longitudinal Studies; Mental Disorders; Risk Factors; Sleep Initiation and Maintenance Disorders
PubMed: 37211915
DOI: 10.1111/jsr.13930 -
Sleep Medicine Reviews Oct 2016Psoriasis is an immune-mediated chronic inflammatory disorder which manifests as dermatologic lesions, and psoriatic arthritis (PsA) in about 30% of cases. Psoriasis is... (Review)
Review
Psoriasis is an immune-mediated chronic inflammatory disorder which manifests as dermatologic lesions, and psoriatic arthritis (PsA) in about 30% of cases. Psoriasis is associated with multiple comorbidities including metabolic syndrome, hypertension, diabetes, cardiovascular events, obesity and psychiatric disorders, which can all affect the course of sleep disorders. A systematic review of the literature on the relationship between psoriasis, PsA, and formal sleep disorders identified 33 studies. There is an increased prevalence of obstructive sleep apnea (OSA) with 36%-81.8% prevalence in psoriasis versus 2%-4% in the general population. There was also an increase in the prevalence of restless legs syndrome of 15.1%-18% in psoriasis versus 5%-10% in European and North American samples. The wide variety of insomnia criteria used in studies resulted in an insomnia prevalence of 5.9%-44.8% in psoriasis, which is insufficient to show an elevated prevalence when the general population has a 10% prevalence of chronic insomnia and 30-35% prevalence of transient insomnia. There is evidence that symptoms of insomnia in psoriasis are directly mediated by pruritus and pain. Treatments that decrease the cutaneous symptoms in psoriasis were successful in mitigating insomnia, but did not show improvements in OSA where the relationship with psoriasis is multifactorial.
Topics: Comorbidity; Humans; Psoriasis; Restless Legs Syndrome; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 26624228
DOI: 10.1016/j.smrv.2015.09.003 -
Sleep Medicine Dec 2023Sleep disorders, including obstructive sleep apnea (OSA), restless leg syndrome (RLS) and insomnia, are present in chronic obstructive pulmonary disease (COPD) with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sleep disorders, including obstructive sleep apnea (OSA), restless leg syndrome (RLS) and insomnia, are present in chronic obstructive pulmonary disease (COPD) with varied prevalence. The aim of this systematic review and meta-analysis was to investigate prevalence of OSA, RLS and insomnia in patients with COPD and summarize their clinical characteristics.
METHODS
We searched PubMed, Web of Science and Scopus for eligible articles reporting the prevalence of OSA, RLS, and insomnia in COPD patients. The Newcastle‒Ottawa scale was applied for quality assessment. Odds ratios or mean differences with 95 % confidence intervals (CIs) were applied for the overall prevalence calculation and clinical characteristics assessment. Sensitivity analysis, subgroup analysis and meta-regression were conducted to evaluate the heterogeneity of the results.
RESULTS
Sixty articles reporting the prevalence of sleep disorders in patients with COPD were included, and the prevalence of OSA, RLS, and insomnia reached 29.1 %(95%CI 27.2%-30.9 %), 21.6 %(95%CI 11.8%-33.3 %) and 29.5 %(95%CI 16.9%-44.0 %), respectively. COPD patients with OSA were characterized by male sex (OR 1.631 95 % CI: 1.231-2.161), obesity(kg/m) (MD 4.435, 95 % CI 3.218-5.652), higher Epworth Sleepiness Scale (MD: 3.741, 95 % CI: 0.655-6.828, p = 0.018), better pulmonary function (MD 5.66, 95 % CI 3.546-7.774) and higher risks of hypertension (OR 1.933 95 % CI 1.382-2.70) and diabetes (OR 1.898 95 % CI 1.264-2.849). COPD patients with RLS were associated with a higher Epworth sleepiness scale (ESS) score (MD 3.444, 95 % CI 1.880-5.008) and a longer COPD duration(year) (MD: 3.656, 95 % CI: 2.209-5.103). COPD patients with insomnia were characterized by female sex(OR 0.556, 95%CI 0.545,0.567, p < 0.001).
CONCLUSION
Our study suggests that OSA, RLS and insomnia are common in COPD patients with specific clinical characteristics. Further studies are needed to explore the interactions between COPD and sleep disorders.
Topics: Humans; Male; Female; Sleep Initiation and Maintenance Disorders; Prevalence; Sleepiness; Pulmonary Disease, Chronic Obstructive; Sleep Apnea, Obstructive; Sleep Wake Disorders; Restless Legs Syndrome
PubMed: 37950939
DOI: 10.1016/j.sleep.2023.10.034 -
Hormones (Athens, Greece) Dec 2023PURPOSE : Obstructive sleep apnea (OSA) is a chronic, sleep-related breathing disorder which leads to increased cardiovascular risks. Vitamin D deficiency is... (Meta-Analysis)
Meta-Analysis
UNLABELLED
PURPOSE : Obstructive sleep apnea (OSA) is a chronic, sleep-related breathing disorder which leads to increased cardiovascular risks. Vitamin D deficiency is associated with various cardiometabolic complications, including increased cardiovascular morbidity and mortality. We aimed to analyze the difference in serum 25-hydroxyvitamin D (25-OHD) level, prevalence of vitamin D insufficiency and deficiency, and the effect of CPAP treatment on serum 25-OHD levels among adult patients with OSA.
METHODS
We pooled data from 18 observational studies involving 5592 individuals. Baseline parameters that might have contributed to the significant differences observed were also analyzed.
RESULTS
Patients with OSA had significantly lower serum 25-OHD levels (pooled d + - 0.74 [95% CI: - 1.19 to - 0.28], p < 0.01) and higher prevalence of vitamin D deficiency (pooled log (odds ratio) 0.98 [95% CI: 0.30 to 1.67], p < 0.01) compared to those without OSA. Subgroup analysis demonstrated that these differences were significant only in moderate OSA and severe OSA. Neither age nor BMI nor geographical latitude contributed significantly to the differences observed in serum 25-OHD levels. The use of CPAP did not lead to significant changes in serum 25-OHD levels.
CONCLUSION
Patients with OSA have lower serum 25-OHD levels with a higher prevalence of vitamin D deficiency, regardless of age or BMI, pointing to an independent association between vitamin D and OSA.
Topics: Adult; Humans; Vitamin D; Vitamin D Deficiency; Sleep Apnea, Obstructive; Vitamins
PubMed: 37704922
DOI: 10.1007/s42000-023-00481-3 -
Sleep Medicine Reviews Jun 2023This systematic review aims to assess the association between attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS) in accordance with the... (Meta-Analysis)
Meta-Analysis Review
This systematic review aims to assess the association between attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for original articles that reported prevalence data on ADHD and RLS until January 24th, 2023. Two independent reviewers evaluated the quality of the articles using the National Institutes of Health assessment tool. Among the 208 articles identified between 1996 and 2022, 29 were included. In large general population studies, 2.6-15.3% of participants met the RLS criteria, of which 3.2-17.4% presented with ADHD. In the ADHD group, RLS symptoms ranged from 11 to 42.9% in children and 20-33.0% in adults. This suggests a strong co-occurrence between RLS and ADHD. A common characteristic of these conditions is sleep fragmentation, as discussed in the reviewed papers. Although large-scale studies with comparable diagnostic criteria across the lifespan are required, our findings may advocate a possible common physiological pathway, including sleep fragmentation and dopaminergic system impairment.
Topics: Child; Adult; Humans; Restless Legs Syndrome; Attention Deficit Disorder with Hyperactivity; Sleep Deprivation; Longevity; Dopamine
PubMed: 36924608
DOI: 10.1016/j.smrv.2023.101770 -
Cephalalgia : An International Journal... Sep 2014Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine.
METHODS
We conducted a systematic review and meta-analysis of studies investigating RLS in headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations.
RESULTS
We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07-5.71; I (2) = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14-1.30; I (2) = 0.0%).
CONCLUSION
Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
Topics: Case-Control Studies; Migraine Disorders; Prevalence; Restless Legs Syndrome
PubMed: 25142142
DOI: 10.1177/0333102414537725 -
Journal of Pediatric Psychology Sep 2014To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia.
METHODS
Meta-analysis of 16 controlled trials and qualitative analysis of 12 within-subject studies were conducted (total n = 2,560).
RESULTS
Meta-analysis found significant effects for four specified sleep outcomes: sleep-onset latency, number of night wakings, and duration of night wakings, and sleep efficiency, with small to large effect sizes across the controlled clinical trials involving typical children. No significant effects were found for the two studies conducted with special needs populations. Finally, within-subjects studies demonstrated significant effects for all sleep outcomes with large effect sizes. Risk of bias assessment and GRADE ratings of the quality of the evidence are described.
CONCLUSION
Moderate-level evidence supports behavioral interventions for pediatric insomnia in young children. However, low evidence for children, adolescents, and those with special needs (due to a lack of studies that met inclusion criteria) highlights the need for future research.
Topics: Adolescent; Behavior Therapy; Child; Female; Humans; Male; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 24947271
DOI: 10.1093/jpepsy/jsu041 -
Sleep Medicine Reviews Feb 2024Obstructive sleep apnea (OSA) is one of the most common sleep disorders; however, there are inconsistent results about the connection and occurrence of primary and... (Meta-Analysis)
Meta-Analysis Review
Obstructive sleep apnea (OSA) is one of the most common sleep disorders; however, there are inconsistent results about the connection and occurrence of primary and secondary headaches in OSA. Therefore, the primary objectives were to estimate the prevalence and potential relationship between all types of headaches and OSA. A systematic review was conducted according to PRISMA 2020 guidelines. Studies were searched in PubMed, Embase, and Web of science up to July 2023. The Joanna Briggs Institute tool assessed the risk of bias. 1845 articles were identified, and 23 studies describing 15,402 patients were included. Pooled prevalence of all headaches in OSA was 33% (95% CI: 0.25-0.41), 33% for morning headaches (95% CI: 0.24-0.45), 25% for sleep apnea headaches (95% CI: 0.18-0.34), 19% for tension-type headache (95% CI: 0.15-0.23), and 16% for migraine (95% CI: 0.09-0.26). Relative risk for the occurrence of headache in OSA patients compared to the non-OSA people was 1.43 (95% CI: 0.92-2.25). OSA females and males had morning headaches with similar frequency. The prevalence of headaches in OSA was moderate. OSA did not increase the risk of headache. There is a need to conduct further studies focused on bidirectional connections between sleep disorders and headaches.
Topics: Female; Humans; Male; Headache; Prevalence; Risk; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 38056382
DOI: 10.1016/j.smrv.2023.101889 -
Brazilian Journal of Otorhinolaryngology 2022Sleep is fundamental for both health and wellness. The advent of "on a chip" and "smartphone" technologies have created an explosion of inexpensive, at-home applications... (Review)
Review
OBJECTIVE
Sleep is fundamental for both health and wellness. The advent of "on a chip" and "smartphone" technologies have created an explosion of inexpensive, at-home applications and devices specifically addressing sleep health and sleep disordered breathing. Sleep-related smartphone Applications and devices are offering diagnosis, management, and treatment of a variety of sleep disorders, mainly obstructive sleep apnea. New technology requires both a learning curve and a review of reliability. Our objective was to evaluate which app have scientific publications as well as their potential to help in the diagnosis, management, and follow-up of sleep disordered breathing.
METHODS
We search for relevant sleep apnea related apps on both the Google Play Store and the Apple App Store. In addition, an exhaustive literature search was carried out in MEDLINE, EMBase, web of science and Scopus for works of apps or devices that have published in the scientific literature and have been used in a clinical setting for diagnosis or treatment of sleep disordered breathing performing a systematic review.
RESULTS
We found 10 smartphone apps that met the inclusion criteria.
CONCLUSIONS
The development of these apps and devices has a great future, but today are not as accurate as other traditional options. This new technology offers accessible, inexpensive, and continuous at home data monitoring of obstructive sleep apnea, but still does not count with proper testing and their validation may be unreliable.
Topics: Humans; Mobile Applications; Reproducibility of Results; Sleep Apnea, Obstructive; Smartphone; Sleep Apnea Syndromes
PubMed: 35210182
DOI: 10.1016/j.bjorl.2022.01.004