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JNCI Cancer Spectrum Apr 2024Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown.
METHODS
A Preferred Reporting Items for Systematic Review and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology-compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, posttraumatic stress, and insomnia in this population. MEDLINE, Web of Science, Cochrane Central Register, KCI Korean Journal database, SciELO, Russian Science Citation Index, and Ovid-PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyses and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors.
RESULTS
A total of 208 studies (n = 654 413; median age = 60.7 years; 25.5% women) were identified. Among the patients, 19.5% reported depressive symptoms (95% confidence interval [CI] = 17% to 21%), 17.8% anxiety symptoms (95% CI = 14% to 21%), 34.3% distress (95% CI = 29% to 39%), 17.7% posttraumatic symptoms (95% CI = 6% to 41%), and 43.8% insomnia symptoms (95% CI = 35% to 52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95% CI = 7% to 13%), 5.6% anxiety (95% CI = 2% to 10%), 9.6% insomnia (95% CI = 1% to 40%), and 1% posttraumatic stress (95% CI = 0% to 84.5%). Suicide pooled incidence was 161.16 per 100 000 individuals per year (95% CI = 82 to 239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared with surgery and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress.
CONCLUSIONS
Patients with head and neck cancer presented notable prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential.
Topics: Humans; Head and Neck Neoplasms; Depression; Anxiety; Stress Disorders, Post-Traumatic; Mental Health; Sleep Initiation and Maintenance Disorders; Suicide; Female; Male; Prevalence; Middle Aged; Psychological Distress; Incidence; Aged
PubMed: 38702757
DOI: 10.1093/jncics/pkae031 -
Sleep Medicine Jul 2024The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults.... (Meta-Analysis)
Meta-Analysis
The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.
Topics: Aged; Female; Humans; Male; Middle Aged; Global Health; Independent Living; Prevalence; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 38669835
DOI: 10.1016/j.sleep.2024.03.040 -
Cancer Medicine Apr 2024Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological... (Meta-Analysis)
Meta-Analysis Review
Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors.
METHODS
The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia.
RESULTS
A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (-19%) and sleep disturbance (-17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07-0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07-0.49, respectively).
CONCLUSION
RT interventions of 60 minutes per session, performed 2-3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.
Topics: Humans; Resistance Training; Neoplasms; Randomized Controlled Trials as Topic; Cancer Survivors; Sleep Quality; Sleep Wake Disorders; Sleep Initiation and Maintenance Disorders; Male; Female
PubMed: 38650577
DOI: 10.1002/cam4.7179 -
Hand Surgery & Rehabilitation Jun 2024The most common symptom and reason patients seek treatment for carpal tunnel syndrome is lack of sleep. Our purpose was to determine how much sleep-related symptoms of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The most common symptom and reason patients seek treatment for carpal tunnel syndrome is lack of sleep. Our purpose was to determine how much sleep-related symptoms of carpal tunnel syndrome improve after carpal tunnel release using validated patient-reported outcome measures (PROMs) and objective sleep data as primary measures of interest.
METHODS
A PRISMA-guided literature search was conducted using Ovid MEDLINE, PubMed, Cochrane, and ClinicalTrials.gov. Only interventional clinical trials that examined primary outcome measures of interest were included. Patient-reported outcome measures underwent meta-analysis to determine how much scores improved following carpal tunnel release.
RESULTS
The Pittsburgh Sleep Quality Index improved significantly after carpal tunnel release, by 4.43 points and 6.02 points at 1-3 and 6-12 months postoperatively, respectively, and continued to improve up to 2 years. Improvement on the Insomnia Severity Index after carpal tunnel release was also significant, with improvement up to 1 year postoperatively, by 8.54 points and 9.05 points at 1-3 and 6-12 months, respectively. Insomnia Severity Index scores improved significantly after splinting as well.
CONCLUSIONS
The present meta-analysis determined to what extent patients can expect their sleep to improve after operative and non-operative intervention, as measured by various patient-reported outcome measures that assess sleep. The Pittsburgh Sleep Quality Index and Insomnia Severity Index correlated very well between studies and across hundreds of patients with carpal tunnel syndrome. Data are lacking to define the minimal clinically important difference and assess whether patients achieve a minimal clinically important difference for sleep questionnaires; more information on this topic is needed.
LEVEL OF EVIDENCE
III.
Topics: Carpal Tunnel Syndrome; Humans; Patient Reported Outcome Measures; Sleep Quality; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Decompression, Surgical
PubMed: 38641062
DOI: 10.1016/j.hansur.2024.101698 -
Neurotoxicology May 2024Obstructive Sleep Apnea (OSA) is a significant health concern characterized by recurrent upper airway blockages during sleep, causing various health issues. There's... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive Sleep Apnea (OSA) is a significant health concern characterized by recurrent upper airway blockages during sleep, causing various health issues. There's growing evidence of a link between air pollution and OSA, though research results have been inconsistent. This systematic review and meta-analysis aims to consolidate and examine data on the relationship between air pollution and OSA's risk and severity.
METHODS
A literature search across PubMed, EMBASE, and Web of Science was conducted until January 10, 2024. The selection criteria targeted studies involving OSA participants or those at risk, with quantitative air pollution assessments. The Nested Knowledge software facilitated screening and data extraction, while the Newcastle-Ottawa Scale was used for quality assessment. Meta-analyses, utilizing random-effects models, computed pooled odds ratios (ORs) for the OSA risk associated with PM2.5 and NO2 exposure, analyzed using R software version 4.3.
RESULTS
The systematic review included twelve studies, four of which were analyzed in the meta-analysis. The meta-analysis revealed diverse results on the association of PM2.5 and NO2 with OSA risk. PM2.5 exposure showed a pooled OR of 0.987 (95 % CI: 0.836-1.138), indicating no substantial overall impact on OSA risk. Conversely, NO2 exposure was linked to a pooled OR of 1.095 (95 % CI: 0.920-1.270), a non-significant increase in risk. Many studies found a relationship between air pollution exposure and elevated Apnea-Hypopnea Index (AHI) levels, indicating a relationship between air pollution and OSA severity.
CONCLUSION
The findings suggest air pollutants, especially NO2, might play a role in worsening OSA risk and severity, but the evidence isn't definitive. This highlights the variability of different pollutants' effects and the necessity for more research. Understanding these links is vital for shaping public health policies and clinical approaches to address OSA amidst high air pollution.
Topics: Sleep Apnea, Obstructive; Humans; Air Pollution; Particulate Matter; Air Pollutants; Severity of Illness Index; Risk Factors; Nitrogen Dioxide; Environmental Exposure
PubMed: 38636605
DOI: 10.1016/j.neuro.2024.04.005 -
Sleep Medicine Reviews Jun 2024This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers' careers. Shift work adversely impacts new workers' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.
Topics: Humans; Health Status; Mental Health; Shift Work Schedule; Sleep; Sleep Disorders, Circadian Rhythm; Work Schedule Tolerance
PubMed: 38626702
DOI: 10.1016/j.smrv.2024.101927 -
PloS One 2024Stroke is a serious threat to human life and health, and post-stroke insomnia is one of the common complications severely impairing patients' quality of life and... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIM
Stroke is a serious threat to human life and health, and post-stroke insomnia is one of the common complications severely impairing patients' quality of life and delaying recovery. Early understanding of the relationship between stroke and post-stroke insomnia can provide clinical evidence for preventing and treating post-stroke insomnia. This study was to investigate the prevalence of insomnia in patients with stroke.
METHODS
The Web of Science, PubMed, Embase, and Cochrane Library databases were used to obtain the eligible studies until June 2023. The quality assessment was performed to extract valid data for meta-analysis. The prevalence rates were used a random-efect. I2 statistics were used to assess the heterogeneity of the studies.
RESULTS
Twenty-six studies met the inclusion criteria for meta-analysis, with 1,193,659 participants, of which 497,124 were patients with stroke.The meta-analysis indicated that 150,181 patients with stroke developed insomnia during follow-up [46.98%, 95% confidence interval (CI): 36.91-57.18] and 1806 patients with ischemic stroke (IS) or transient ischemic attack (TIA) developed insomnia (47.21%, 95% CI: 34.26-60.36). Notably, 41.51% of patients with the prevalence of nonclassified stroke developed insomnia (95% CI: 28.86-54.75). The incidence of insomnia was significantly higher in patients with acute strokes than in patients with nonacute strokes (59.16% vs 44.07%, P < 0.0001).Similarly, the incidence of insomnia was significantly higher in the patients with stroke at a mean age of ≥65 than patients with stroke at a mean age of <65 years (47.18% vs 40.50%, P < 0.05). Fifteen studies reported the follow-up time. The incidence of insomnia was significantly higher in the follow-up for ≥3 years than follow-up for <3 years (58.06% vs 43.83%, P < 0.05). Twenty-one studies used the Insomnia Assessment Diagnostic Tool, and the rate of insomnia in patients with stroke was 49.31% (95% CI: 38.59-60.06). Five studies used self-reporting, that the rate of insomnia in patients with stroke was 37.58% (95% CI: 13.44-65.63).
CONCLUSIONS
Stroke may be a predisposing factor for insomnia. Insomnia is more likely to occur in acute-phase stroke, and the prevalence of insomnia increases with patient age and follow-up time. Further, the rate of insomnia is higher in patients with stroke who use the Insomnia Assessment Diagnostic Tool.
Topics: Humans; Aged; Sleep Initiation and Maintenance Disorders; Quality of Life; Stroke; Ischemic Attack, Transient; Ischemic Stroke
PubMed: 38598535
DOI: 10.1371/journal.pone.0297941 -
Sleep Medicine Jun 2024Clinical Practice Guidelines (CPGs) are crucial in standardizing the management of obstructive sleep apnea (OSA) in adults. However, there has been insufficient... (Review)
Review
OBJECTIVE
Clinical Practice Guidelines (CPGs) are crucial in standardizing the management of obstructive sleep apnea (OSA) in adults. However, there has been insufficient evaluation of the overall quality of CPGs for adult OSA. This review aimed to comprehensively assess the overall quality of CPGs in the field of adult OSA.
METHODS
A systematic search was conducted on various literature databases, guideline-related databases, and academic websites from January 2013 to December 2023 to select CPGs relevant to adult OSA. The methodological and reporting quality of the eligible CPGs were thoroughly appraised by three reviewers using the AGREE II instrument and RIGHT checklist, respectively.
RESULTS
This review included 44 CPGs, consisting of 42 CPGs in English and 2 CPGs in Chinese. The assessment of methodological quality revealed that four domains attained an average standardized score above 60%. Among the domains, "clarity of presentation" received the highest standardized score of 85.10%, while the lowest standardized score was observed in the "rigor of development" domain with the value of 56.77%. The evaluation of reporting quality indicated an overall reporting rate of 51.30% for the eligible CPGs, with only three domains achieving an average reporting rate higher than 50%. The domain with the highest reporting rate was "basic information" at 60.61%, while the domain with the lowest reporting rate was "review and quality assurance" at 15.91%. Furthermore, a significantly positive correlation was found between the AGREE II standardized scores and the RIGHT reporting rates (r = 0.808, P < 0.001).
CONCLUSIONS
The overall quality of the currently available guidelines for adult OSA demonstrated considerable variability. Researchers should prioritize the utilization of evidence-based methods and adhere to the items listed in the RIGHT checklist when developing CPGs to enhance efficient clinical decision-making and promote the translation of evidence into practice.
Topics: Humans; Sleep Apnea, Obstructive; Practice Guidelines as Topic; Adult
PubMed: 38581804
DOI: 10.1016/j.sleep.2024.03.045 -
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 -
Journal of Oral Rehabilitation Jul 2024Obstructive sleep apnoea syndrome (OSAS) has garnered increasing attention in recent years due to its potential association with cancer. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive sleep apnoea syndrome (OSAS) has garnered increasing attention in recent years due to its potential association with cancer. This systematic review and meta-analysis aimed to assess the prevalence of OSAS in cancer patients through a comprehensive analysis of existing literature.
METHODS
This systematic review and meta-analysis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, aimed to evaluate the prevalence of OSAS in cancer patients. A comprehensive search of electronic databases was performed to identify relevant studies published up to September 2021. Eligible studies reporting on the prevalence of OSAS in cancer patients, encompassing various study designs, were included in the analysis. Pooled estimates of the odds ratios (OR) with 95% confidence intervals (CIs) were calculated using a random effects model. Heterogeneity among the studies was assessed using the I statistic.
RESULTS
Seventeen studies fulfilled the inclusion criteria and were subsequently included in the review. The prevalence of OSAS in cancer patients was estimated to have an overall OR of 0.80 (95% CI: 0.75-0.85). In comparison with non-cancer patients, cancer patients had a statistically significant greater risk of OSAS, as indicated by the total estimated RR for the prevalence of OSAS in cancer patients, which was 0.89 (95% CI: 0.86-0.92). Nonetheless, there was a significant amount of heterogeneity (I = 96%) among the studies.
CONCLUSION
The overall data analysed in this review indicates that patients with cancer had far reduced likelihood of developing OSAS than individuals without cancer. However, the significant variation across the included studies highlights the need for additional investigation to fully clarify the complex association between OSAS and cancer incidence. These results emphasise how critical it is to identify OSAS as a possible comorbidity in cancer patients, one that should be taken into account for clinical management and ongoing research.
Topics: Humans; Sleep Apnea, Obstructive; Neoplasms; Prevalence; Risk Factors
PubMed: 38528326
DOI: 10.1111/joor.13681