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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 -
Brain and Behavior Nov 2023Obstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive... (Review)
Review
BACKGROUND AND OBJECTIVE
Obstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients.
METHODS
We searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits.
RESULTS
We included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings.
CONCLUSIONS
We found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.
Topics: Humans; Diffusion Tensor Imaging; Sleep Apnea, Obstructive; Brain; Magnetic Resonance Imaging; Biomarkers; Neuropsychological Tests
PubMed: 37743582
DOI: 10.1002/brb3.3262 -
Sleep Medicine Reviews Apr 2018This systematic review and meta-analysis aimed to determine the size of the placebo effect for insomnia symptoms when comparing placebo treatment with no treatment.... (Review)
Review
This systematic review and meta-analysis aimed to determine the size of the placebo effect for insomnia symptoms when comparing placebo treatment with no treatment. PsycINFO, MEDLINE, and CINAHL databases were systematically searched for studies allocating participants with insomnia symptoms (diagnosed or self-reported) to receive a placebo that they were led to believe was an active treatment or to a no treatment control group. Thirteen independent studies (n = 566) met inclusion criteria. Meta-analysis indicated a reliable placebo effect whereby placebo treatment led to improved perceived sleep onset latency (SOL; Hedges g = 0.272), total sleep time (TST; Hedges g = 0.322), and global sleep quality (GSQ; Hedges' g = 0.581), when compared with no treatment. There was no effect on objective assessment of SOL, however only a few studies reported this outcome and there were insufficient sample sizes to meta-analyse other objective outcomes. Moderator analysis indicated that the placebo effect for perceived insomnia symptoms was quite consistent across different variables. The present findings provide strong evidence for placebo effects for perceived insomnia symptoms, but not on the only objective measurement with sufficient sample size to meta-analyse, namely objective SOL. This has important implications for the treatment of insomnia symptoms and the design and interpretation of clinical trials for insomnia symptoms.
Topics: Humans; Placebo Effect; Self Report; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 28554719
DOI: 10.1016/j.smrv.2017.03.006 -
Sleep & Breathing = Schlaf & Atmung Dec 2015The aim of this study is to evaluate the association between periodontal disease and obstructive sleep apnea (OSA). (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this study is to evaluate the association between periodontal disease and obstructive sleep apnea (OSA).
METHODS
Electronic search using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Central Trial Registry, Cochrane Database of Systematic Reviews, Scopus, and Embase was carried out for randomized controlled trials, longitudinal, cohort, case-control, and epidemiological studies on humans, published until October 2014. Manual searches were also performed. The participants considered were adult subjects with OSA and chronic periodontitis. The authors reviewed all articles and extracted data using a customized data abstraction sheet. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale.
RESULTS
Six studies met the inclusion criteria set for this review. They evaluated the association between periodontal disease and OSA and the efficacy of periodontal interventions on OSA occurrence and severity. The periodontal disease outcome measures included clinical attachment loss, periodontal pocket depth, oral hygiene indices, radiographic alveolar bone loss, and salivary cytokines. Meta-analysis of four studies revealed a statistically significant association between periodontal disease and OSA (pooled odds ratio = 1.65, 95 % confidence interval (CI) = 1.11, 2.46, P = 0.01). There is insufficient evidence on the efficacy of periodontal disease interventions.
CONCLUSIONS
There is some evidence to a plausible association between periodontal disease and OSA. Evidence on the efficacy of periodontal disease interventions is insufficient. The causal-effect relationship of periodontal disease and OSA is debatable. Further research with case-control studies is warranted.
Topics: Humans; Odds Ratio; Periodontitis; Randomized Controlled Trials as Topic; Sleep Apnea, Obstructive; Statistics as Topic; Treatment Outcome
PubMed: 25801281
DOI: 10.1007/s11325-015-1160-8 -
Schizophrenia Research Jan 2016Risk factors for obstructive sleep apnea (OSA) are common in people with schizophrenia. Identification and treatment of OSA may improve physical health in this... (Review)
Review
BACKGROUND
Risk factors for obstructive sleep apnea (OSA) are common in people with schizophrenia. Identification and treatment of OSA may improve physical health in this population; however there are no guidelines to inform screening and management.
OBJECTIVES
Systematic review to determine, in people with schizophrenia and related disorders: the prevalence of OSA; the prevalence of OSA compared to general population controls; the physical and psychiatric correlates of OSA, associations between antipsychotic medications and OSA; the impact of treatment of OSA on psychiatric and physical health; and the diagnostic validity of OSA screening tools.
DATA SOURCES
Medline, EMBASE, ISI Web of Science and PsycINFO electronic databases. Cohort, case-control and cross-sectional studies and RCTs reporting on prevalence of OSA in subjects with schizophrenia and related disorders were reviewed.
RESULTS
The prevalence of OSA varied between 1.6% and 52%. The prevalence of OSA was similar between people with schizophrenia and population controls in two studies. Diagnosis of OSA was associated with larger neck circumference, BMI>25, male sex and age>50years. There were no data on physical or psychiatric outcomes following treatment of OSA. The diagnostic utility of OSA screening tools had not been investigated.
CONCLUSION
OSA may be prevalent and potentially under-recognized in people with schizophrenia. Further research is required to determine utility of OSA screening tools, the relationships between antipsychotic medications and OSA and any benefits of treating OSA. We propose a strategy for the identification of OSA in people with schizophrenia and related disorders.
Topics: Humans; Schizophrenia; Sleep Apnea, Obstructive
PubMed: 26621003
DOI: 10.1016/j.schres.2015.11.014 -
Sleep Medicine Reviews Feb 2024Sleep disordered breathing is extremely common in pregnancy and is a risk factor for maternal complications. Animal models demonstrate that intermittent hypoxia causes... (Meta-Analysis)
Meta-Analysis Review
Sleep disordered breathing is extremely common in pregnancy and is a risk factor for maternal complications. Animal models demonstrate that intermittent hypoxia causes abnormal fetal growth. However, there are conflicting data on the association between maternal sleep disordered breathing and offspring growth in humans. We investigated this association by conducting a systematic review and meta-analysis. Sixty-three manuscripts, and total study population of 67, 671, 110 pregnant women were included. Thirty-one studies used subjective methods to define sleep disordered breathing, 24 applied objective methods and eight used international codes. Using a random effects model, habitual snoring, defined by subjective methods, and obstructive sleep apnea, diagnosed by objective methods, were associated with an increased risk for large for gestational age (OR 1.46; 95%CI 1.02-2.09 and OR 2.19; 95%CI 1.63-2.95, respectively), while obstructive sleep apnea, identified by international codes, was associated with an increased risk for small for gestational age newborns (OR 1.28; 95%CI 1.02-1.60). Our results support that maternal sleep disordered breathing is associated with offspring growth, with differences related to the type of disorder and diagnostic methods used. Future studies should investigate underlying mechanisms and whether treatment of sleep disordered breathing ameliorates the neonatal growth.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Fetus; Pregnancy Complications; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Snoring
PubMed: 37956482
DOI: 10.1016/j.smrv.2023.101868 -
Journal of Neurology Mar 2023Changes in the cognitive function of patients with restless legs syndrome is a growing area of research. Although several studies have been performed to investigate the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Changes in the cognitive function of patients with restless legs syndrome is a growing area of research. Although several studies have been performed to investigate the association between restless legs syndrome (RLS) and cognitive function, the outcomes are still controversial. The meta-analysis aimed to elucidate the relationship between RLS and cognition, including global cognition and various cognitive domains including memory, attention, executive function, and spatial cognition.
METHODS
We searched the MEDLINE, EMBASE, and Web of Science databases from inception to November 2022 to screen eligible records. The means and standard deviations of cognitive test scores were obtained to calculate the standard mean difference and 95% confidence intervals.
RESULTS
A total of 1437 records were collected from the initial search and 16 records involving 4635 individuals were ultimately included in the systematic review and meta-analysis. Our data suggest negative associations between RLS and global cognition (SMD, - 0.42; 95% CI - 0.72 to - 0.11; I = 76.6%) and attention (SMD, - 0.43; 95% CI - 0.73 to - 0.12; I = 85.3%). No significant differences in memory (SMD, - 0.01; 95% CI - 0.31 to 0.28; I = 68.0%), executive function (SMD, - 0.10; 95% CI, - 0.30 to 0.11; I = 52.1%), or spatial cognition (SMD, - 0.17; 95% CI - 0.38 to 0.03; I = 58.5%) were observed between the RLS and control groups. Moreover, the strength of the results was modified by age but not by sex or region.
CONCLUSIONS
Our findings suggest that RLS is negatively correlated with cognitive function, particularly global cognition and attention. However, the causal relationship, considering more confounders, is worthy of further exploration.
Topics: Humans; Adult; Restless Legs Syndrome; Cognition; Executive Function; Attention
PubMed: 36472687
DOI: 10.1007/s00415-022-11484-2 -
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 -
European Journal of Neurology Apr 2013Restless legs syndrome (RLS) has been reported to occur more frequently in patients with multiple sclerosis (MS) than in people without MS. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Restless legs syndrome (RLS) has been reported to occur more frequently in patients with multiple sclerosis (MS) than in people without MS.
METHODS
Systematic review and meta-analysis of studies investigating RLS in patients with MS published through April 2012. We calculated the prevalences and 95% confidence intervals (CIs) of RLS in patients with MS and people without MS as well as odds ratios (ORs) and 95% CIs of the association between MS and RLS based on data from the publications. We then calculated pooled effect estimates for the association between MS and RLS.
RESULTS
We identified 24 studies. RLS prevalence amongst patients with MS ranged from 12.12% to 57.50% and from 2.56% to 18.33% amongst people without MS. Heterogeneity amongst studies was high (RLS prevalence in patients with MS I(2) =94.4%; RLS prevalence amongst people without MS I(2) =82.2%). Hence, we did not pool the prevalence data for meta-analysis. Heterogeneity amongst studies investigating the association between MS and RLS was moderate (I(2) =53.6%). Pooled analysis indicates that MS is associated with a fourfold increased odds for RLS (pooled OR=4.19, 95% CI 3.11-5.66). This association was smaller amongst studies published as full papers (pooled OR=3.94, 95% CI 2.81-5.54) than amongst studies published as abstracts only (pooled OR=6.23, 95% CI 3.25-11.95).
CONCLUSION
This systematic review indicates that RLS prevalence amongst patients with MS ranges from 12.12% to 57.50% in different populations. Pooled analysis further indicates that the odds of RLS amongst patients with MS are fourfold higher compared to people without MS.
Topics: Case-Control Studies; Cross-Sectional Studies; Data Interpretation, Statistical; Humans; Multiple Sclerosis; Odds Ratio; Prevalence; Restless Legs Syndrome
PubMed: 23078359
DOI: 10.1111/j.1468-1331.2012.03873.x