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Acta Neurologica Scandinavica Jan 2018We performed a systematic review and meta-analysis to evaluate the proposed association of restless legs syndrome (RLS) with cerebrovascular/cardiovascular outcomes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We performed a systematic review and meta-analysis to evaluate the proposed association of restless legs syndrome (RLS) with cerebrovascular/cardiovascular outcomes.
METHODS
We calculated the corresponding odds ratios on the prevalence of cerebrovascular/cardiovascular risk factors and standardized mean differences on the reported mean age at baseline between RLS patients and controls. We also calculated the corresponding risk ratios and adjusted for potential confounders hazard ratios (HRs ) on the reported outcomes of interest between RLS patients and controls.
RESULTS
We identified 8 eligible studies (644 506 patients, mean age: 60.2 years, 36.2% males; 3.3% with RLS). RLS patients were found to have significantly higher prevalence of hypertension (P = .002), diabetes (P = .003) and hyperlipidemia (P = .010) compared to controls. In the unadjusted analyses of prospective observational studies, RLS patients were found to have significantly higher risk for cerebrovascular ischaemia (P = .01) and all-cause mortality (P = .04) compared to controls during follow-up, while in the adjusted for potential confounders analyses RLS patients were only found to have a higher risk of all-cause mortality (HR adjusted=1.52, 95% CI: 1.17-1.97, P = .002).
CONCLUSIONS
The present report does not provide evidence for an increased risk of cerebrovascular and cardiovascular events in RLS patients, which highlights the vast presence of confounding factors.
Topics: Adult; Cardiovascular Diseases; Cerebrovascular Disorders; Female; Humans; Male; Middle Aged; Prevalence; Restless Legs Syndrome; Risk Factors
PubMed: 28948600
DOI: 10.1111/ane.12848 -
Oral Surgery, Oral Medicine, Oral... Jan 2023To determine the best disocclusion guidance in occlusal splints (OSs) to manage and treat temporomandibular disorder (TMD) and sleep bruxism (SB). (Review)
Review
OBJECTIVE
To determine the best disocclusion guidance in occlusal splints (OSs) to manage and treat temporomandibular disorder (TMD) and sleep bruxism (SB).
STUDY DESIGN
The research was conducted on 7 major electronic databases and 3 gray literature sources. We included randomized trials, nonrandomized clinical trials, and before-and-after studies. The risk of bias (RoB) was assessed by Joanna Briggs Institute of Critical Appraisal Tools. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the certainty of evidence.
RESULTS
Qualitative synthesis included 16 surveys reporting data from 620 participants. Canine guidance (CG) was widely searched. Bilateral balanced occlusion (BBO) and CG significantly decreased pain levels compared with the placebo splint. Comparing between OS and absence of therapy, only CG was assessed and showed significant improvements on mouth opening, pain, sleep quality, and muscle activity. When compared different guide types among themselves, no significant improvement was founded in any evaluated outcome. Three studies presented high RoB, 7 presented moderate RoB, and 6 presented low RoB.
CONCLUSIONS
It is suggested there is not enough evidence to support that there are any specific kind of guidance responsible for improving evaluated outcomes on TMD and SB.
Topics: Humans; Occlusal Splints; Sleep Bruxism; Temporomandibular Joint Disorders; Splints; Pain
PubMed: 36241594
DOI: 10.1016/j.oooo.2022.07.009 -
Archives of Oral Biology Nov 2017The aim of this article was to systematically review the literature to assess the relationship between risk factors and sleep bruxism (SB) in adults (age ≥18 years). (Review)
Review
OBJECTIVE
The aim of this article was to systematically review the literature to assess the relationship between risk factors and sleep bruxism (SB) in adults (age ≥18 years).
DESIGN
A systematic search of the following databases was carried out: PubMed, Embase, Scopus, Cochrane Oral Health Group's Trial Register and Cochrane Register of Controlled Trials, Web of Science, LILACs and SciELO. Nine out of the 4583 initially identified articles were selected. This review was conducted according to the guidelines from the Cochrane Handbook for Systematic Reviews of Interventions, with reporting in agreement to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
RESULTS
Among the nine analyzed articles, associations between SB and gastro-esophageal reflux disease (GERD) (OR=6.6, CI=1.4-30.9) was found in one randomized clinical trial (RCT). Four cross-sectional studies suggested history of SB during childhood (OR=8.1 CI=5.4-12-2), age (OR=3.1, CI=2.3-4.1) and chronic migraine (OR=3.8, C.I=1.8-7.8) as determinant factors for the development of SB. In one case-control study, patients with genetic polymorphisms were more likely to present SB (OR=4.3, CI=1.6-11.3). Smoking (OR=2.8, CI=2.2-3.5) and alcohol intake (OR=1.9, CI=1.2-2.8) showed moderate association in two case-control studies.
CONCLUSIONS
History of SB during childhood, gastro-esophageal reflux disease and genetic polymorphisms seem to be important risk factors associated to SB in adults. Dry mouth on awakening seems to be a protective factor. Association does not infer with causality. Even if the evidence emerged from the considered studies was clinically relevant, further studies are requested to better understand the biological mechanisms behind the described associations.
Topics: Adult; Humans; Risk Factors; Sleep Bruxism
PubMed: 28692828
DOI: 10.1016/j.archoralbio.2017.07.002 -
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 -
Journal of Oral & Facial Pain and... 2014To carry out a systematic review to consolidate current knowledge on the potential association between sleep bruxism (SB) and sleep-disordered breathing (SDB). (Review)
Review
AIMS
To carry out a systematic review to consolidate current knowledge on the potential association between sleep bruxism (SB) and sleep-disordered breathing (SDB).
METHODS
For this systematic review, articles were retained only if they reported studies using full ambulatory polysomnography as "the gold standard" reference test to determine SDB and the international diagnostic criteria proposed by the American Association of Sleep Medicine to determine SB. Detailed individual search strategies from MEDLINE, PubMed, Embase, the Cochrane Library, and LILACS databases were developed. The references cited in the selected articles were also checked, and a partial literature search was undertaken. The selection was completed independently by two reviewers in two phases. The methodology of selected studies was evaluated using the seven-item quality-assessment tool for experimental bruxism studies.
RESULTS
During the initial search, 333 different citations were identified across the six electronic databases. After a comprehensive evaluation of the abstracts, and the full papers when considered necessary, only one study was finally selected for the qualitative/quantitative synthesis. This study did not support the putative association between SB and SDB, since SB was not observed during or in temporal conjunction with snoring or apneic events in any of the evaluated patients. In addition, masseter activity was not observed during apneic episodes.
CONCLUSION
There is not sufficient scientific evidence either to confirm or discredit the association between SB and SDB.
Topics: Humans; Polysomnography; Sleep Apnea Syndromes; Sleep Bruxism; Snoring
PubMed: 25347164
DOI: 10.11607/ofph.1294 -
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 -
CNS Spectrums Apr 2024We aim to assess the relationship between validated smoking cessation pharmacotherapies and electronic cigarettes (e-cigarettes) and insomnia and parasomnia using a... (Meta-Analysis)
Meta-Analysis Review
We aim to assess the relationship between validated smoking cessation pharmacotherapies and electronic cigarettes (e-cigarettes) and insomnia and parasomnia using a systematic review and a network meta-analysis. A systematic search was performed until August 2022 in the following databases: PUBMED, COCHRANE, CLINICALTRIAL. Randomized controlled studies against placebo or validated therapeutic smoking cessation methods and e-cigarettes in adult smokers without unstable or psychiatric comorbidity were included. The primary outcome was the presence of "insomnia" and "parasomnia." A total of 1261 studies were selected. Thirty-seven studies were included in the quantitative analysis (34 for insomnia and 23 for parasomnia). The reported interventions were varenicline (23 studies), nicotine replacement therapy (NRT, 10 studies), bupropion (15 studies). No studies on e-cigarettes were included. Bayesian analyses found that insomnia and parasomnia are more frequent with smoking cessation therapies than placebo except for bupropion. Insomnia was less frequent with nicotine substitutes but more frequent with bupropion than the over pharmacotherapies. Parasomnia are less frequent with bupropion but more frequent with varenicline than the over pharmacotherapies. Validated smoking cessation pharmacotherapies can induce sleep disturbances with different degrees of frequency. Our network meta-analysis shows a more favorable profile of nicotine substitutes for insomnia and bupropion for parasomnia. It seems essential to systematize the assessment of sleep disturbances in the initiation of smoking cessation treatment. This could help professionals to personalize the choice of treatment according to sleep parameters of each patient. Considering co-addictions, broadening the populations studied and standardizing the measurement are additional avenues for future research.
Topics: Adult; Humans; Smoking Cessation; Bupropion; Electronic Nicotine Delivery Systems; Nicotine; Varenicline; Nicotinic Agonists; Network Meta-Analysis; Sleep Initiation and Maintenance Disorders; Bayes Theorem; Tobacco Use Cessation Devices; Parasomnias
PubMed: 38433577
DOI: 10.1017/S1092852924000087 -
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 -
Sleep Medicine Reviews Apr 2018Restless legs syndrome (RLS) is defined as an irresistible urge to move the legs, which is usually accompanied by paresthesias or dysesthesias at least twice weekly, and... (Review)
Review
Restless legs syndrome (RLS) is defined as an irresistible urge to move the legs, which is usually accompanied by paresthesias or dysesthesias at least twice weekly, and affects 2%-4% of adults in Europe and North America. This systematic review assesses the current complementary and alternative options for RLS and the potential benefits of those treatments on sleep quality, mood disorder, and quality of life. A systematic search of the PubMed, Embase, Cochrane, and Web of Science databases was conducted. Eighteen studies met the inclusion criterion, which included the use of the international RLS study group criteria. Complementary and alternative therapies have been found to be effective in both primary and secondary RLS. The severity of primary RLS symptoms can be significantly ameliorated by exercise training, transcutaneous spinal direct current stimulation, pneumatic compression devices, light therapy, repetitive transcranial magnetic stimulation, and acupuncture. Pneumatic compression devices and yoga also improve RLS-related disorders. Exercise training is highly efficacious in the reduction of symptom severity in uremic RLS and related effects such as poor quality of life. Endovenous laser ablation may be a good choice for patients with concurrent RLS and superficial venous insufficiency.
Topics: Complementary Therapies; Depression; Exercise; Humans; Quality of Life; Restless Legs Syndrome; Sleep
PubMed: 28886918
DOI: 10.1016/j.smrv.2017.06.003 -
Journal of Psychopharmacology (Oxford,... Aug 2019This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A... (Meta-Analysis)
Meta-Analysis
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
Topics: Chronobiology Disorders; Consensus; Evidence-Based Medicine; Humans; London; Parasomnias; Psychopharmacology; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders
PubMed: 31271339
DOI: 10.1177/0269881119855343