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Sleep Medicine Reviews Jun 2021The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional... (Meta-Analysis)
Meta-Analysis Review
The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional association between these behaviors. The daily associations between sleep and physical activity have been examined in observational or interventional contexts. The primary goal of the current systematic review and meta-analysis was to summarize existing evidence about daily associations between sleep and physical activity outcomes at inter- and intra-individual level in adults. A systematic search of records in eight databases from inception to July 2019 identified 33 peer-reviewed empirical publications that examined daily sleep-physical activity association in adults. The qualitative and quantitative analyses of included studies did not support a bidirectional daily association between sleep outcomes and physical activity. Multilevel meta-analyses showed that three sleep parameters were associated with physical activity the following day: sleep quality, sleep efficiency, and wake after sleep onset. However, the associations were small, and varied in terms of direction and level of variability (e.g., inter- or intra-individual). Daytime physical activity was associated with lower total sleep time the following night at an inter-person level with a small effect size. From a clinical perspective, care providers should monitor the effects of better sleep promotion on physical activity behaviors in their patients. Future studies should examine sleep and physical activity during a longer period and perform additional sophisticated statistical analyses. SYSTEMATIC REVIEW REGISTRATION: https://osf.io/w6uy5/.
Topics: Adult; Exercise; Humans; Motor Activity; Polysomnography; Sleep
PubMed: 33571893
DOI: 10.1016/j.smrv.2021.101426 -
Journal of Sleep Research Jan 2024Insufficient sleep is a growing global problem, with poor sleep associated with many negative health and performance outcomes. Previous reviews investigating the effect... (Review)
Review
Insufficient sleep is a growing global problem, with poor sleep associated with many negative health and performance outcomes. Previous reviews investigating the effect of diet on sleep have highlighted the amino acid tryptophan as a promising sleep-promoting nutrient, with the richest food source of tryptophan, ⍺-lactalbumin, requiring further investigation. Therefore, this systematic review aimed to review the existing evidence of association between ⍺-lactalbumin and sleep. Four electronic databases (CINAHL Complete, Embase, MEDLINE Complete, and SPORTDiscus with Full Text) were searched from database inception to March 2023, with primary research articles included if they contained α-lactalbumin as an independent variable, an outcome measure of sleep or sleepiness, and participants were ≥ 18 years old. Eight studies were reviewed, with four studies recruiting athletic populations (50%) and four recruiting healthy participants (50%). Sleep or sleepiness was measured objectively in six studies (75%), with two studies employing polysomnography and four utilizing actigraphy to assess sleep. Across the studies, 20-60 g of ⍺-lactalbumin was supplemented, with five studies (63%) observing a positive association between α-lactalbumin and sleep. Sleep-onset latency was the primary sleep metric improved following evening supplementation of α-lactalbumin (≤ 3.5 hr pre-sleep), with no studies observing any negative associations with sleep. Data from this review suggest that individuals that have difficulty initiating sleep may benefit most from pre-sleep α-lactalbumin supplementation. Further research is required to establish the effect that α-lactalbumin has on sleep architecture, through the use of more comprehensive sleep analysis tools such as portable electroencephalography or polysomnography, in combination with stringent dietary controls.
PubMed: 38185736
DOI: 10.1111/jsr.14141 -
Sleep Medicine Jul 2023This study explores the polysomnographic differences between amyotrophic lateral sclerosis (ALS) patients and healthy controls. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study explores the polysomnographic differences between amyotrophic lateral sclerosis (ALS) patients and healthy controls.
METHODS
An electronic literature search was conducted in MEDLINE, EMBASE, All EBM databases, Web of Science, and CNKI from inception to Oct 2022.
RESULTS
Meta-analyses revealed significant reductions in sleep efficiency, total sleep time, N2%, slow wave sleep percentage, minimum SpO, and mean SpO, and increases in wake time after sleep onset and N1%, sleep latency, rapid eye movement sleep latency, time spent with SpO < 90%, oxygen desaturation index, and apnea hypopnea index in ALS patients compared with controls. Sensitivity analyses showed that some heterogeneity was explained by excluding patients taking medications impacting sleep, whether studies employed an adaptation night, and the use of different PSG scoring rules.
CONCLUSIONS
Significant polysomnographic abnormalities are present in ALS. Our findings underscore the need for a comprehensive PSG assessment of sleep changes in ALS patients. When performing PSG examinations in ALS, whether the patients are taking medication impacting sleep and the scoring system used should be considered.
Topics: Humans; Amyotrophic Lateral Sclerosis; Polysomnography; Sleep; Sleep, REM; Sleep Latency
PubMed: 37163838
DOI: 10.1016/j.sleep.2023.04.014 -
Frontiers in Neurology 2023Stroke is the second leading cause of death worldwide, and improving sleep quality in post-stroke insomnia is beneficial to the recovery of stroke. Acupuncture is widely...
BACKGROUND
Stroke is the second leading cause of death worldwide, and improving sleep quality in post-stroke insomnia is beneficial to the recovery of stroke. Acupuncture is widely used for the treatment of post-stroke insomnia in China. Therefore, this systematic review and meta-analysis were performed to explore the efficacy and safety of acupuncture for post-stroke insomnia.
METHODS
Eight databases were searched from their inception to 12 September 2022. Two reviewers independently performed the study screening and data extraction. The outcomes include Pittsburgh Sleep Quality Index (PSQI), objective sleep data measured by polysomnography (PSG), long-term efficacy and adverse events. The quality of the trials was assessed by the Cochrane risk of bias tool 2.0. The RevMan 5.4 and Stata 15.1 were used for data synthesis.
RESULTS
Among 3,233 participants from 41 studies were included. Pooled results indicated that acupuncture was superior to control group (CG) in improving PSQI total score (standardized mean difference () = -1.03, 95% confidence interval (CI): -1.32, -0.74, < 0.00001), increasing sleep efficiency ( = 0.65, 95% CI: 0.37 to 0.92) and total sleep time ( = 0.54, 95% CI: 0.22 to 0.86). The favorable results in improving PSQI total score ( = 0.65, 95% CI: 0.37 to 0.92), reduced sleep latency ( = 1.84, 95% CI: 0.31 to 3.38) and increased total sleep time ( = -0.73, 95% CI: -1.15 to -0.31) were also observed in comparisons of acupuncture plus CG vs. CG. As of long-term efficacy and safety, the effects of acupuncture were long-term and robustness, however, due to limited safety information, reliable safety conclusions cannot be drawn. Subgroup analysis showed that acupuncture plus CG was superior to CG for post-infarction patients, but the efficacy of acupuncture alone compared to non-BZDs or other hypnotics needs further research. The GRADE assessment demonstrated that the level of evidence was mostly low or very low given the flaws in the study design and considerable heterogeneity among the included studies.
CONCLUSION
Acupuncture could improve sleep quality, has long-term efficacy and without serious adverse events. However, the findings should be treated with caution owing to the existence of methodological quality issues. More studies with rigorous designs are warranted for validation and explored the safety of acupuncture.
PubMed: 37441610
DOI: 10.3389/fneur.2023.1164604 -
Journal of Gastrointestinal Cancer Dec 2023Obstructive sleep apnea (OSA), characterised by recurrent episodes of upper airway collapse, intermittent hypoxia (IH) and sleep fragmentation (SF), has been associated... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive sleep apnea (OSA), characterised by recurrent episodes of upper airway collapse, intermittent hypoxia (IH) and sleep fragmentation (SF), has been associated with carcinogenesis in pre-clinical models. The relationship between OSA and colorectal cancer (CRC) in clinical studies is controversial.
AIM
The objective of this meta-analysis was to assess the association between OSA and CRC.
METHODS
Two independent investigators searched studies indexed in CINAHL, MEDLINE, EMBASE, the Cochrane Database and clinicaltrials.gov that were randomised controlled trials (RCT) or observational studies evaluating the relationship between OSA and CRC. Studies were included if they had available odds ratios (OR) and relative risks (RR) or if hazard ratios (HR) with 95% confidence intervals (CI) were available and a reference group composed of participants who did not have OSA. OR and 95% CI were calculated using a random-effect, generic inverse variance method.
RESULTS
We included four observational studies out of 85 records, comprising a combined cohort of 5,651,662 identified patients in the data analysis. Three studies used polysomnography to identify OSA. The pooled OR of CRC in patients with OSA was 1.49 (95% CI, 0.75 to 2.97). The statistical heterogeneity was high with I of 95%.
CONCLUSIONS
Our study is unable to conclusively point towards OSA being a risk factor in the development of CRC, despite the plausible biological mechanisms for this. Further well-designed prospective RCT assessing the risk of CRC in patients with OSA and the impact of OSA treatments on the incidence and prognosis of CRC are needed.
Topics: Humans; Sleep Apnea, Obstructive; Polysomnography; Risk Factors; Incidence; Colorectal Neoplasms
PubMed: 36813984
DOI: 10.1007/s12029-023-00919-2 -
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 -
Neuroscience and Biobehavioral Reviews Aug 2022We conducted the first systematic review and series of meta-analyses to assess the efficacy and tolerability of melatonin in children/adolescents or adults with sleep or... (Meta-Analysis)
Meta-Analysis Review
We conducted the first systematic review and series of meta-analyses to assess the efficacy and tolerability of melatonin in children/adolescents or adults with sleep or mental health disorders, using the same set of criteria across disorders and ages. Based on a pre-registered protocol (PROPSPERO: CRD42021289827), we searched a broad range of electronic databases up to 02.02.2021 for randomized control trials (RCTs) of melatonin. We assessed study quality using the Risk of Bias tool, v2. We included a total of 34 RCTs (21 in children/adolescents: N = 984; 13 in adults: N = 1014). We found evidence that melatonin significantly improved sleep onset latency and total sleep time, but not sleep awaking, in children and adolescents with a variety of neurodevelopmental disorders, and sleep onset latency (measured by diary) as well as total sleep time (measured with polysomnography) in adults with delayed sleep phase disorder. No evidence of significant differences between melatonin and placebo was found in terms of tolerability. We discuss clinical and research implications of our findings.
Topics: Adolescent; Child; Humans; Melatonin; Neurodevelopmental Disorders; Sleep; Sleep Wake Disorders
PubMed: 35691474
DOI: 10.1016/j.neubiorev.2022.104723 -
Sleep Health Aug 2023Sleep is often severely disturbed in hospitalized patients due to multiple factors such as noise, pain, and an unfamiliar environment. Since sleep is important for... (Meta-Analysis)
Meta-Analysis Review
Sleep is often severely disturbed in hospitalized patients due to multiple factors such as noise, pain, and an unfamiliar environment. Since sleep is important for patient recovery, safe strategies to improve sleep in hospitalized patients are warranted. Music interventions have been found to improve sleep in general, and the aim of this systematic review is to assess the effect of music on sleep among hospitalized patients. We searched 5 databases to identify randomized controlled trials evaluating the effect of music interventions on sleep in hospitalized patients. Ten studies including a total of 726 patients matched the inclusion criteria. The sample sizes ranged from 28 to 222 participants per study. The music interventions varied in how the music was chosen as well as duration and time of day. However, in most studies, participants in the intervention group listened to soft music for 30 minutes in the evening. Our meta-analysis showed that music improved sleep quality compared to standard treatment (standardized mean difference 1.55 [95% CI 0.29-2.81], z = 2.41; p = 0.0159). Few studies reported other sleep parameters, and only one study used polysomnography for objective sleep measurement. No adverse events were reported in any of the trials. Hence, music may constitute a safe and low-cost adjunctive intervention to improve sleep in hospitalized patients. Prospero registration number: CRD42021278654.
Topics: Humans; Music; Music Therapy; Sleep; Polysomnography; Pain
PubMed: 37380591
DOI: 10.1016/j.sleh.2023.03.004 -
Sleep Medicine Reviews Jun 2021This systematic review and meta-analysis aims to assess and quantify putative differences in sleep architecture, sleep efficiency, sleep timing and broadly-defined sleep... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aims to assess and quantify putative differences in sleep architecture, sleep efficiency, sleep timing and broadly-defined sleep difficulties between children with and without epilepsy. Databases were searched systematically, and studies identified in PubMed, EMBASE, PsychINFO and Medline. The meta-analysis included 19 studies comparing a total of 901 children with epilepsy to 1470 healthy children. Relative to healthy children, children with epilepsy experienced reduced sleep time, sleeping on average 34 mins less across self-report, actigraphy, 24-h video-EEG and polysomnography measures. They had more sleep difficulties specifically in the domains of night waking, parasomnias and sleep disordered breathing. The analysis also revealed a significantly increased percentage of N2 sleep and decreased sleep efficiency in children with epilepsy compared to healthy children. These results illustrate that children with epilepsy are vulnerable to more sleep difficulties compared to healthy children. This suggests that screening for sleep difficulties should be an integral part in a diagnosis of epilepsy to ensure that clinically relevant sleep difficulties are identified and treated. Such an approach may ultimately aid in the development of treatment strategies which can contribute to improvements in both developmental and diagnostic outcomes for children with epilepsy.
Topics: Adolescent; Child; Electroencephalography; Epilepsy; Humans; Polysomnography; Sleep; Sleep Apnea Syndromes
PubMed: 33561679
DOI: 10.1016/j.smrv.2021.101416 -
Sleep Medicine Reviews Jun 2022A meta-analysis exploring polysomnography (PSG) differences between narcolepsy type 1 (NT1)/type 2 (NT2) and idiopathic hypersomnia (IH), particularly one that... (Meta-Analysis)
Meta-Analysis Review
A meta-analysis exploring polysomnography (PSG) differences between narcolepsy type 1 (NT1)/type 2 (NT2) and idiopathic hypersomnia (IH), particularly one that stratifies the analysis by IH with and without long sleep time (LST), could provide information useful for appropriately re-classifying the central disorders of hypersomnolence. An electronic literature search was conducted in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO inception to May 2021. Meta-analysis of 26 studies revealed that the effect sizes of differences in some PSG parameters between NT1 and IH were different from those between NT2 and IH. Specifically, there were significant increases in wake time after sleep onset (WASO), arousal index (AI), and N1 percentage, and significant decreases in sleep efficiency, sleep latency, and N2 percentage in NT1 compared with IH, but no differences for these sleep parameters between NT2 and IH. With the exception of rapid eye movement (REM) sleep percentage and REM latency, there were no significant differences in other PSG variables between NT2 and IH without LST. The findings suggest that, NT1, rather than NT2, showed shallower and more fragmented sleep compared with IH. Sleep macrostructure features are very similar between NT2 and IH without LST.
Topics: Disorders of Excessive Somnolence; Humans; Idiopathic Hypersomnia; Narcolepsy; Polysomnography; Sleep Latency
PubMed: 35278894
DOI: 10.1016/j.smrv.2022.101610