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Frontiers in Psychiatry 2023Sleep-related eating disorder (SRED) consists of recurrent episodes of uncontrolled, involuntary eating and drinking 1-3 h after falling asleep with partial or full...
BACKGROUND
Sleep-related eating disorder (SRED) consists of recurrent episodes of uncontrolled, involuntary eating and drinking 1-3 h after falling asleep with partial or full unconsciousness. This condition is diagnosed based on interviews with the patients affected and the diagnostic criteria of the International Classification of Sleep Disorders. However, polysomnography (PSG) is not necessary to confirm this disease. This systematic review aims to evaluate the findings of PSG in SRED patients.
METHODS
For this systematic review, PubMed, Embase, and Scopus databases were searched in February 2023, which resulted in 219 records. After removing duplicates, the articles that included the presentation of PSG results of SRED patients in English were selected. In addition, only original studies were considered. The risk of bias by using case reports and descriptive studies was assessed using the Joanna Briggs Institute critical appraisal tools and the Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Furthermore, a case report of a 66-year-old woman with SRED was included.
RESULTS
A total of 15 papers were selected for further analysis, of which 7 were descriptive studies, 6 were case reports, and 2 were observational studies. The risk of bias in the majority of the studies was moderate or high. Unexpectedly, if the eating episode occurred during PSG, in most cases it was not observed during deep sleep (the N3 sleep stage). Moreover, studies did not report significant deviations in the sleep parameters measured using PSG. Among SRED patients, the prevalence of sleepwalking was much higher than the general population. Our case report presented a potentially life-threatening episode of holding an apple in the mouth that might result in choking, which was captured using PSG.
CONCLUSION
Polysomnography is not necessary for the diagnosis of SRED. However, it could facilitate the diagnosis and differentiation of SRED from other eating disorders. PSG also has limitations in capturing eating episodes and in addition, its cost effectiveness should be considered during the diagnostic process. More studies into the pathophysiology of SRED are needed because classifying SRED as non-rapid eye movement parasomnias can be inappropriate as it does not always occur during deep sleep.
PubMed: 37234216
DOI: 10.3389/fpsyt.2023.1139670 -
Tremor and Other Hyperkinetic Movements... 2023The objective of this review is to provide updated information on the epidemiology, correlating factors and treatment of chronic kidney disease associated restless legs... (Review)
Review
OBJECTIVES
The objective of this review is to provide updated information on the epidemiology, correlating factors and treatment of chronic kidney disease associated restless legs syndrome (CKD-A-RLS) in both adult and pediatric population.
MATERIALS AND METHODS
We have reviewed the Medline search and Google Scholar search up to May 2022, using key words restless legs syndrome, chronic kidney disease and hemodialysis and kidney transplant. The reviewed articles were studied for epidemiology, correlating factors, as well as pharmacologic and non-pharmacologic treatment options.
RESULTS
Our search revealed 175 articles, 111 were clinical trials or cross- sectional studies and 64 were review articles. All 111 articles were retrieved and studied in detail. Of these, 105 focused on adults and 6 on children. A majority of studies on dialysis patients reported a prevalence between 15-30%, which is notably higher than prevalence of RLS in general population (5-10%). The correlation between presence of CKD-A-RLS with age, gender, abnormalities of hemogram, iron, ferritin, serum lipids, electrolytes and parathyroid hormones were also reviewed. The results were inconsistent and controversial. Limited studies have reported on the treatment of CKD-A-RLS. Non-pharmacological treatment focused on the effect(s) of exercise, acupuncture, massage with different oils and infra-red light whereas, pharmacologic treatment options include the effects of dopaminergic drugs, Alpha2-Delta ligands (gabapentin and pregabalin), vitamins E and C, and intravenous iron infusion.
CONCLUSION
This updated review showed that RLS is two to three times more common in patients with CKD compared to the general population. More patients with CKD-A-RLS demonstrated increased mortality, increased incidence of cardiovascular accident, depression, insomnia and impaired quality of life than those with CKD without RLS. Dopaminergic drugs such as levodopa, ropinirole, pramipexole and rotigotine as well as calcium channel blockers (gabapentin and pregabalin) are helpful for treatment of RLS. High quality studies with these agents are currently underway and hopefully confirm the efficacy and practicality of using these drugs in CKD-A-RLS. Some studies have shown that aerobic exercise and massage with lavender oil can improve symptoms of CKD-A- RLS suggesting that these measures can be useful as adjunct therapy.
Topics: Humans; Child; Gabapentin; Restless Legs Syndrome; Pregabalin; Quality of Life; Dopamine Agents; Renal Insufficiency, Chronic; Iron
PubMed: 37008995
DOI: 10.5334/tohm.752 -
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 Jun 2023To address the hypothesis that periodic leg movements during sleep (PLMS) are more frequent in children with attention-deficit hyperactivity disorder (ADHD) when... (Meta-Analysis)
Meta-Analysis
Time to rest a hypothesis? Accumulating evidence that periodic leg movements during sleep are not increased in children with attention-deficit hyperactivity disorder (ADHD): results of a case-control study and a meta-analysis.
STUDY OBJECTIVES
To address the hypothesis that periodic leg movements during sleep (PLMS) are more frequent in children with attention-deficit hyperactivity disorder (ADHD) when compared with typically developing (TD) children. To that end, we analyzed PLMS in a recent case-control study and conducted a systematic review and meta-analysis of PLMS frequency in children with ADHD and TD children.
METHODS
In our case-control study, we compared the PLMS frequency of 24 children with ADHD (mean age 11 years, 17 males) to that of 22 age-matched typically developing (TD) children (mean age 10 years, 12 males). A subsequent meta-analysis included 33 studies that described PLMS frequency in groups of children with ADHD and/or groups of TD children.
RESULTS
The case-control study did not show any differences in the frequency of PLMS between children with ADHD and TD children, a result that was consistent across a range of different definitions of PLMS, which in turn had a significant and systematic effect on PLMS frequency. The meta-analysis compared the average PLMS indices and the proportion of children with elevated PLMS indices between children with ADHD and TD children and across a number of analyses did not find any meta-analytic results that supported the hypothesis that PLMS are more frequent in children with ADHD.
CONCLUSIONS
Our results suggest that PLMS are not more frequent in children with ADHD compared with TD children. A finding of frequent PLMS in a child with ADHD should therefore be considered a separate disorder and prompt specific diagnostic and therapeutic strategies.
Topics: Male; Humans; Child; Attention Deficit Disorder with Hyperactivity; Leg; Nocturnal Myoclonus Syndrome; Case-Control Studies; Polysomnography; Sleep
PubMed: 36869787
DOI: 10.1093/sleep/zsad046 -
Sleep Medicine Feb 2023Several studies suggest an association between periodic limb movements during sleep (PLMS) and hypertension; however, a systematic evaluation of this relationship is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies suggest an association between periodic limb movements during sleep (PLMS) and hypertension; however, a systematic evaluation of this relationship is lacking.
METHODS
We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio, comparing the risk of hypertension in persons with PLMS (defined by the level of periodic limb movements per hour of sleep depended on individual studies) versus those without PLMS. After assessing heterogeneity and bias, the pooled risk ratio and 95% confidence intervals (CIs) were determined using a random-effect, generic inverse variance method of DerSimonian and Laird.
RESULTS
Out of 572 potentially relevant articles, six eligible studies were included in the data analysis. Studies (6 cross-sectional) included 8949 participants. The statistical heterogeneity of this study was insignificant, with an I of 0%. A funnel plot and Egger's regression asymmetry test showed no publication bias with P-value ≥0.05. The pooled risk ratio of hypertension in patients with PLMS was 1.26 (95% CI, 1.12-1.41).
CONCLUSIONS
Our analysis demonstrates an increased hypertension risk among patients with PLMS. Prospective or interventional studies are needed to confirm this association.
Topics: Humans; Nocturnal Myoclonus Syndrome; Prospective Studies; Cross-Sectional Studies; Polysomnography; Sleep; Hypertension
PubMed: 36701831
DOI: 10.1016/j.sleep.2023.01.008 -
Journal of Clinical Sleep Medicine :... Apr 2023Periodic limb movements during sleep (PLMS) are a frequent finding in restless legs syndrome, but their impact on sleep is still debated, as well the indication for... (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
Periodic limb movements during sleep (PLMS) are a frequent finding in restless legs syndrome, but their impact on sleep is still debated, as well the indication for treatment. We systematically reviewed the available literature to describe which drug categories are effective in suppressing PLMS, assessing their efficacy through a meta-analysis, when this was possible.
METHODS
The review protocol was preregistered on PROSPERO (CRD42021175848), and the systematic search was conducted on and EMBASE (last searched on March 2020). We included original human studies, which assessed PLMS modification on drug treatment with a full-night polysomnography, through surface electrodes on each tibialis anterior muscle. When at least 4 studies were available on the same drug or drug category, we performed a random-effect model meta-analysis.
RESULTS
Dopamine agonists like pramipexole and ropinirole resulted the most effective, followed by l-dopa and other dopamine agonists. Alpha2delta ligands are moderately effective as well opioids, despite available data on these drugs are much more limited than those on dopaminergic agents. Valproate and carbamazepine did not show a significant effect on PLMS. Clonazepam showed contradictory results. Perampanel and dypiridamole showed promising but still insufficient data. The same applies to iron supplementation.
CONCLUSIONS
Dopaminergic agents are the most powerful suppressors of PLMS. However, most therapeutic trials in restless legs syndrome do not report objective polysomnographic findings, there is a lack of uniformity in presenting results on PLMS. Longitudinal polysomnographic interventional studies, using well-defined and unanimous scoring criteria and endpoints on PLMS are needed.
CITATION
Riccardi S, Ferri R, Garbazza C, Miano S, Manconi M. Pharmacological responsiveness of periodic limb movements in patients with restless legs syndrome: a systematic review and meta-analysis. . 2023;19(4):811-822.
Topics: Humans; Restless Legs Syndrome; Dopamine Agonists; Nocturnal Myoclonus Syndrome; Movement; Dopamine Agents
PubMed: 36692194
DOI: 10.5664/jcsm.10440 -
Journal of Oral Rehabilitation May 2023It is important for dentists to know if the presence of snoring is associated with the presence of other dental sleep conditions (e.g. obstructive sleep apnea [OSA],... (Review)
Review
BACKGROUND
It is important for dentists to know if the presence of snoring is associated with the presence of other dental sleep conditions (e.g. obstructive sleep apnea [OSA], sleep bruxism [SB], gastroesophageal reflux disease [GERD], xerostomia and oro-facial pain). If so, dentists could play a significant role in the early recognition and management of these conditions.
OBJECTIVES
This systematic review aimed to: (i) investigate the associations between the presence of snoring and the presence of other dental sleep conditions; and (ii) determine if it is clinically relevant that dentists assess snoring in their population.
METHODS
The literature search was performed in PubMed and Embase.com in collaboration with a medical librarian. Studies were eligible if they employed regression models to assess whether snoring was associated with other dental sleep conditions, and/or investigated the incidence of snoring in patients with other dental sleep conditions and vice versa.
RESULTS
Of the 5299 retrieved references, 36 eligible studies were included. The available evidence indicates that the presence of snoring is associated with higher probabilities of OSA, GERD and headache. Due to limited evidence and conflicting findings, the currently available articles are not indicative of associations between the presence of snoring and the presence of SB and oral dryness.
CONCLUSION
Within the limitations of this study, it can be concluded that the presence of snoring is associated with higher probabilities of OSA, GERD and headache. Therefore, it is clinically relevant that dentists assess snoring in their patient population.
Topics: Humans; Snoring; Sleep; Sleep Apnea, Obstructive; Gastroesophageal Reflux; Sleep Bruxism; Headache; Sleep Wake Disorders; Xerostomia
PubMed: 36691754
DOI: 10.1111/joor.13422 -
Lasers in Medical Science Jan 2023The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of... (Review)
Review
The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of acupuncture points for the relief of different signs and symptoms related to the stomatognathic system. In dentistry, some studies in pediatric dentistry have demonstrated the benefit of LLLT therapies in the management of dental anxiety in children. This systematic review aimed to analyze previous clinical studies on the application of LLLT at acupoints among pediatric dental patients. This systematic review was conducted according to the Cochrane Collaboration guidelines and the population, intervention, comparison, and outcome strategy. A broad literature search up to June 17, 2022, was performed using four electronic databases (PubMed, Scopus, Embase, and Google Scholar). The risk of bias in randomized clinical trials was assessed using the RoB 2 tool. A total of four studies using LLLT for photobiomodulation were included (n = 4). The most common wavelengths used were in the infrared range (variation between 716 nm and 980 nm). There were little variations in the application time (14 s to 1 min) and exposure dose (1 to 5 joules). LLLT acted positively on different acupuncture points. LLLT provided various benefits and optimized dental practice by reducing the gag reflex during radiography and impression taking, preanesthetic pain, and symptoms of sleep bruxism in the pediatric dental population. Only one of the evaluated studies had a high risk of bias. The LLLT at acupuncture points is associated with positive results on sleep bruxism, preanesthetic pain, and gag reflex in pediatric dentistry. Future research studies should prioritize standardization of the study design and the methods of analysis.
Topics: Humans; Child; Acupuncture Points; Pediatric Dentistry; Sleep Bruxism; Pain; Low-Level Light Therapy; Lasers
PubMed: 36690781
DOI: 10.1007/s10103-023-03720-6 -
Sleep Medicine Reviews Apr 2023The possible role of inflammatory factors in the pathogenesis of restless legs syndrome (RLS) is not well understood. Because several inflammatory diseases have shown an... (Meta-Analysis)
Meta-Analysis Review
The possible role of inflammatory factors in the pathogenesis of restless legs syndrome (RLS) is not well understood. Because several inflammatory diseases have shown an association with the risk for RLS, the measurement of serum/plasma levels of inflammatory factors has been a matter of a scarce number of studies. We performed a systematic review and a meta-analysis to assess the possible association of serum/plasma levels of inflammatory markers with the risk for RLS. Our results showed a significant trend towards higher serum/plasma C reactive protein (CRP) levels and higher neutrophil-to-lymphocyte (NLR) ratio in patients diagnosed with RLS than in controls, although statistical significance disappeared after applying the random-effects model. Further studies are needed to confirm the suggested possible role of inflammatory factors in the pathogenesis of RLS.
Topics: Humans; Restless Legs Syndrome; Prevalence
PubMed: 36634410
DOI: 10.1016/j.smrv.2022.101744 -
F1000Research 2022. Bruxism is a topic of much controversy and is continually debated in the field of dentistry due to the multifaceted clinical relationship that results in painful...
. Bruxism is a topic of much controversy and is continually debated in the field of dentistry due to the multifaceted clinical relationship that results in painful conditions and consequences to patients. The aim of this review was to determine the effectiveness of a smartphones app in monitoring awake bruxism. PROSPERO (registration number: CRD42021271190). The eligibility criteria were as followed: observational studies, case-control studies, studies that reported odds ratios, and studies on awake bruxism. The following keywords were searched: [smartphones apps] AND [apps] AND [awake bruxism], OR [sleep bruxism], OR [sleep hygiene], OR [parasomnias], AND [habits]. . All the included studies found that the use of the smartphone app allows controlled awake bruxism monitoring. The results also show that the slepp bruxism and awake bruxism are interactive, having negative synergism and substantially increasing the risks of temporomandibular joint pain and temporomandibular disorders. . In the awake bruxims it was possible to identify 70% symptoms through the different frequencies of behavior provided by the App, within the present technological tools have become daily in young and adult population. The app is effective and easy to use by patients, effectively limiting biases the time of evaluation.
Topics: Adult; Humans; Mobile Applications; Wakefulness; Sleep Bruxism; Temporomandibular Joint Disorders; Habits
PubMed: 36606116
DOI: 10.12688/f1000research.110673.2