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Archives of Cardiovascular Diseases 2024Sacubitril/valsartan has been demonstrated to significantly improve left ventricular performance and remodelling in patients with heart failure. However, its effects on... (Observational Study)
Observational Study
BACKGROUND
Sacubitril/valsartan has been demonstrated to significantly improve left ventricular performance and remodelling in patients with heart failure. However, its effects on the right ventricle in patients with chronic heart failure and sleep-disordered breathing (SDB) have not been studied.
AIM
To investigate the impact of sacubitril/valsartan treatment on right ventricular function in patients with SDB.
METHODS
This was a subanalysis of an observational prospective multicentre study involving 101 patients. At inclusion, patients were evaluated by echocardiography and nocturnal ventilatory polygraphy, which allowed patients to be divided into three groups: "central-SDB"; "obstructive-SDB"; and "no-SDB".
RESULTS
After 3 months of sacubitril/valsartan therapy, a positive impact on right ventricular function was observed. In the general population, tricuspid annular plane systolic excursion increased by +1.32±4.74mm (P=0.024) and systolic pulmonary artery pressure decreased by -3.1±10.91mmHg (P=0.048). The central-SDB group experienced the greatest echocardiographic improvement, with a significant increase in tricuspid annular plane systolic excursion of +2.1±4.9mm (P=0.045) and a significant reduction in systolic pulmonary artery pressure of -8.4±9.7mmHg (P=0.001).
CONCLUSIONS
Sacubitril/valsartan improved right ventricular function in patients with heart failure and SDB after only 3 months of treatment. The greatest improvement in right ventricular function was observed in the central-SDB group.
Topics: Humans; Valsartan; Drug Combinations; Male; Female; Aminobutyrates; Ventricular Function, Right; Prospective Studies; Biphenyl Compounds; Middle Aged; Treatment Outcome; Aged; Heart Failure; Time Factors; Recovery of Function; Sleep Apnea, Central; Angiotensin II Type 1 Receptor Blockers; Tetrazoles; Protease Inhibitors; Polysomnography; Neprilysin; Chronic Disease
PubMed: 38811278
DOI: 10.1016/j.acvd.2024.04.003 -
CoDAS 2024To investigate oropharyngeal structures and functions in a pediatric population with Down Syndrome (DS) and obstructive sleep apnea (OSA) and to correlate with the...
PURPOSE
To investigate oropharyngeal structures and functions in a pediatric population with Down Syndrome (DS) and obstructive sleep apnea (OSA) and to correlate with the apnea/hypopnea index (AHI) and sleep questionnaires.
METHODS
12 Children with DS and OSA, between the age of 4 and 12 years old, underwent polysomnography (PSG); sleep questionnaires, Pediatric Sleep Questionnaire (PSQ) and Obstructive Sleep Apnea-18 (OSA-18); and speech-language evaluation using the Short Evaluation of Orofacial Myofunctional Protocol (ShOM).
RESULTS
There was a positive correlation between ShoM higher scores and the apnea-hypopnea index (AHI) and between ShoM and the number of hypopneas. The orofacial myofunctional alterations observed in the studied group were: oral breathing, alteration in lip tonus and competence, tongue posture at rest and in swallowing, and occlusal alteration. There was also an increased risk for OSA according to the sleep questionnaires, as well as the presence of obesity and overweight, but without correlation with the severity of OSA.
CONCLUSION
All DS children show alterations in orofacial characteristics, higher scores being associated to severe OSA. Orofacial myofunctional evaluation may help to identify different phenotypes in Down syndrome children with Obstructive sleep Apnea, enhancing the need for a multidisciplinary approach.
Topics: Humans; Down Syndrome; Sleep Apnea, Obstructive; Child; Pilot Projects; Polysomnography; Male; Female; Child, Preschool; Surveys and Questionnaires; Severity of Illness Index; Mouth Breathing; Tongue; Facial Muscles; Cross-Sectional Studies
PubMed: 38808857
DOI: 10.1590/2317-1782/20242023119pt -
Otolaryngologia Polska = the Polish... Jun 2024Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres....
INTRODUCTION
Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children's polysomnography call for a reliable and easily accessible screening method.
AIM
The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points.
MATERIAL AND METHODS
Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Mościcki ENT Hospital in Chorzów.
RESULTS
Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures.
CONCLUSIONS
The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.
Topics: Humans; Male; Female; Child; Retrospective Studies; Pulse Wave Analysis; Polysomnography; Child, Preschool; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Adolescent
PubMed: 38808637
DOI: No ID Found -
Cureus May 2024Obstructive sleep apnea syndrome (OSAS) is a severe condition that is characterized by recurrent partial or complete breathing interruptions during sleep, leading to...
INTRODUCTION
Obstructive sleep apnea syndrome (OSAS) is a severe condition that is characterized by recurrent partial or complete breathing interruptions during sleep, leading to insulin resistance, microvascular complications, and cardiovascular complications. It is of great importance to know the impact of type 2 diabetes mellitus (DM), which is prevalent in the world and in our country, Turkey, leads to significant mortality and morbidity, significantly affects the quality of life, and requires continuous follow-up, on sleep in patients with OSAS and to raise awareness on this issue. In this study, we aimed to determine the effects of diabetes on sleep duration and sleep architecture in patients with OSAS and to investigate the relationship between OSAS severity and DM control.
METHODS
Fifty diabetic and 42 non-diabetic patients diagnosed with OSAS at the Sleep Disorders Center of Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey, between October 2022 and March 2023 were included in the study. Polysomnographic and biochemical parameters of the two groups were compared. The effect of OSAS severity and sleep architecture on diabetes control was investigated.
RESULTS
No significant difference was found between diabetic and non-diabetic patients in terms of total sleep duration, sleep efficiency, and sleep latency, whereas REM (rapid eye movement) latency was prolonged and REM sleep duration and percentage were significantly lower in diabetic patients. The severity of OSAS was found to be greater in diabetic patients and they spent significantly more time below 90% saturation during sleep. No correlation was found between the groups in the glycated hemoglobin (HbA1c) parameter, which we examined in terms of diabetes control, sleep architecture, and OSAS severity.
CONCLUSION
The presence of diabetes aggravates the severity of OSAS, prolongs the transition to REM sleep, and leads to a decrease in REM duration. Sleep is essential for both mental and physical well-being. In this regard, it is of utmost importance to examine diabetic patients for OSAS and to perform polysomnography in appropriate patients.
PubMed: 38807970
DOI: 10.7759/cureus.61215 -
Frontiers in Psychiatry 2024To examine serum concentrations of neurotensin, pannexin-1 and sestrin-2, and their correlations with subjective and objective sleep quality and cognitive function in...
OBJECTIVES
To examine serum concentrations of neurotensin, pannexin-1 and sestrin-2, and their correlations with subjective and objective sleep quality and cognitive function in the patients with chronic insomnia disorder (CID).
METHODS
Sixty-five CID patients were enrolled continuously and fifty-six good sleepers in the same period were served as healthy controls (HCs). Serum levels of neurotensin, pannexin-1 and sestrin-2 were measured by enzyme-linked immunosorbent assays. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and polysomnography, and mood was evaluated by 17-item Hamilton Depression Rating Scale. General cognitive function was assessed with the Chinese-Beijing Version of Montreal Cognitive Assessment and spatial memory was evaluated by Blue Velvet Arena Test (BVAT).
RESULTS
Relative to the HCs, the CID sufferers had higher levels of neurotensin (=5.210, <0.001) and pannexin-1 (=-4.169, <0.001), and lower level of sestrin-2 (=-2.438, =0.015). In terms of objective sleep measures, pannexin-1 was positively associated with total sleep time (=0.562, =0.002) and sleep efficiency (=0.588, =0.001), and negatively with wake time after sleep onset (=-0.590, =0.001) and wake time (=-0.590, =0.001); sestrin-2 was positively associated with percentage of rapid eye movement sleep (=0.442, =0.016) and negatively with non-rapid eye movement sleep stage 2 in the percentage (=-0.394, =0.034). Adjusted for sex, age and HAMD, pannexin-1 was still associated with the above objective sleep measures, but sestrin-2 was only negatively with wake time (=-0.446, =0.022). However, these biomarkers showed no significant correlations with subjective sleep quality (PSQI score). Serum concentrations of neurotensin and pannexin-1 were positively associated with the mean erroneous distance in the BVAT. Adjusted for sex, age and depression, neurotensin was negatively associated with MoCA score (=-0.257, =0.044), pannexin-1 was positively associated with the mean erroneous distance in the BVAT (=0.270, =0.033).
CONCLUSIONS
The CID patients had increased neurotensin and pannexin-1 and decreased sestrin-2 in the serum levels, indicating neuron dysfunction, which could be related to poor sleep quality and cognitive dysfunction measured objectively.
PubMed: 38803679
DOI: 10.3389/fpsyt.2024.1360305 -
PeerJ 2024Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When the Great East Japan Earthquake occurred, cardboard beds were provided to evacuees. However, there were concerns about lower back pain and sleep disturbances, as cardboard beds offer insufficient pressure distribution. This study aimed to compare the effects of cardboard beds with those of foldable camp cots on sleep quality.
METHODS
A randomized controlled crossover study involving 20 healthy participants aged 18-45 years was conducted between June 2022 and January 2023. Participants were asked to sleep for one night on a camp cot and for another night on a cardboard bed, with a minimum three-day washout period between the two nights. Body pressure distribution and sleep metrics obtained from polysomnography (PSG) and questionnaires were compared between the two-bed types ( < 0.05).
RESULTS
The camp cot exhibited better body pressure distribution than a cardboard bed, leading to improved sleep satisfaction, bedding comfort, and reduced morning sleepiness. Nevertheless, polysomnography revealed no notable differences in sleep metrics or sleep architecture between the two types of beds.
CONCLUSIONS
Our findings indicate that cardboard beds have lower pressure dispersion capabilities than camp cots, leading to an increased number of position changes during sleep. Additionally, subjective sleep quality, such as alertness on waking, sleep comfort, and sleep satisfaction, was lower for cardboard beds, suggesting that camp cots might offer a more comfortable bedding option for evacuees. However, there were no discernible differences between the two-bed types in terms of objective sleep metrics derived from PSG. The potential for sleep disturbances caused by lower back pain from a hard mattress has been noted, and it is possible that a single night's experience in healthy individuals might not be enough for sleep issues to manifest.
Topics: Humans; Cross-Over Studies; Adult; Male; Female; Beds; Bedding and Linens; Young Adult; Middle Aged; Sleep Quality; Polysomnography; Adolescent; Japan; Earthquakes; Equipment Design; Surveys and Questionnaires
PubMed: 38803581
DOI: 10.7717/peerj.17392 -
Frontiers in Neuroinformatics 2024Polysomnographic recordings are essential for diagnosing many sleep disorders, yet their detailed analysis presents considerable challenges. With the rise of machine...
INTRODUCTION
Polysomnographic recordings are essential for diagnosing many sleep disorders, yet their detailed analysis presents considerable challenges. With the rise of machine learning methodologies, researchers have created various algorithms to automatically score and extract clinically relevant features from polysomnography, but less research has been devoted to how exactly the algorithms should be incorporated into the workflow of sleep technologists. This paper presents a sophisticated data collection platform developed under the Sleep Revolution project, to harness polysomnographic data from multiple European centers.
METHODS
A tripartite platform is presented: a user-friendly web platform for uploading three-night polysomnographic recordings, a dedicated splitter that segments these into individual one-night recordings, and an advanced processor that enhances the one-night polysomnography with contemporary automatic scoring algorithms. The platform is evaluated using real-life data and human scorers, whereby scoring time, accuracy, and trust are quantified. Additionally, the scorers were interviewed about their trust in the platform, along with the impact of its integration into their workflow.
RESULTS
We found that incorporating AI into the workflow of sleep technologists both decreased the time to score by up to 65 min and increased the agreement between technologists by as much as 0.17 .
DISCUSSION
We conclude that while the inclusion of AI into the workflow of sleep technologists can have a positive impact in terms of speed and agreement, there is a need for trust in the algorithms.
PubMed: 38803523
DOI: 10.3389/fninf.2024.1379932 -
ENeuro Jun 2024Sleep's contribution to affective regulation is insufficiently understood. Previous human research has focused on memorizing or rating affective pictures and less on...
Sleep's contribution to affective regulation is insufficiently understood. Previous human research has focused on memorizing or rating affective pictures and less on physiological affective responsivity. This may result in overlapping definitions of affective and declarative memories and inconsistent deductions for how rapid eye movement sleep (REMS) and slow-wave sleep (SWS) are involved. Literature associates REMS theta (4-8 Hz) activity with emotional memory processing, but its contribution to social stress habituation is unknown. Applying selective sleep stage suppression and oscillatory analyses, we investigated how sleep modulated affective adaptation toward social stress and retention of neutral declarative memories. Native Finnish participants ( = 29; age, = 25.8 years) were allocated to REMS or SWS suppression conditions. We measured physiological (skin conductance response, SCR) and subjective stress response and declarative memory retrieval thrice: before laboratory night, the next morning, and after 3 d. Linear mixed models were applied to test the effects of condition and sleep parameters on emotional responsivity and memory retrieval. Greater overnight increase in SCR toward the stressor emerged after suppressed SWS (intact REMS) relative to suppressed REMS (20.1% vs 6.1%; = 0.016). The overnight SCR increase was positively associated with accumulated REMS theta energy irrespective of the condition ( = 0.601; = 0.002). Subjectively rated affective response and declarative memory recall were comparable between the conditions. The contributions of REMS and SWS to habituation of social stress are distinct. REMS theta activity proposedly facilitates the consolidation of autonomic affective responses. Declarative memory consolidation may not have greater dependence on intact SWS relative to intact REMS.
Topics: Humans; Male; Female; Adult; Stress, Psychological; Sleep, REM; Young Adult; Affect; Galvanic Skin Response; Mental Recall; Polysomnography; Sleep, Slow-Wave
PubMed: 38802242
DOI: 10.1523/ENEURO.0453-23.2024 -
Frontiers in Neuroscience 2024Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep-related breathing disorder that significantly impacts the daily lives of patients. Currently, the...
INTRODUCTION
Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep-related breathing disorder that significantly impacts the daily lives of patients. Currently, the diagnosis of OSAHS relies on various physiological signal monitoring devices, requiring a comprehensive Polysomnography (PSG). However, this invasive diagnostic method faces challenges such as data fluctuation and high costs. To address these challenges, we propose a novel data-driven Audio-Semantic Multi-Modal model for OSAHS severity classification (i.e., ASMM-OSA) based on patient snoring sound characteristics.
METHODS
In light of the correlation between the acoustic attributes of a patient's snoring patterns and their episodes of breathing disorders, we utilize the patient's sleep audio recordings as an initial screening modality. We analyze the audio features of snoring sounds during the night for subjects suspected of having OSAHS. Audio features were augmented via PubMedBERT to enrich their diversity and detail and subsequently classified for OSAHS severity using XGBoost based on the number of sleep apnea events.
RESULTS
Experimental results using the OSAHS dataset from a collaborative university hospital demonstrate that our ASMM-OSA audio-semantic multimodal model achieves a diagnostic level in automatically identifying sleep apnea events and classifying the four-class severity (normal, mild, moderate, and severe) of OSAHS.
DISCUSSION
Our proposed model promises new perspectives for non-invasive OSAHS diagnosis, potentially reducing costs and enhancing patient quality of life.
PubMed: 38800571
DOI: 10.3389/fnins.2024.1336307 -
Cureus Apr 2024Apnea-hypopnea index (AHI) and nadir oxygen saturation (SpO2) are the indexes used to measure the severity of obstructive sleep apnea (OSA). Obesity, measured by body...
BACKGROUND
Apnea-hypopnea index (AHI) and nadir oxygen saturation (SpO2) are the indexes used to measure the severity of obstructive sleep apnea (OSA). Obesity, measured by body mass index (BMI), is one of the main contributing factors to the onset and severity of OSA in patients. This study was conducted to find the association between BMI and OSA severity indexes, mainly AHI and nadir SpO2 levels.
METHODS
Polysomnography reports of patients with diagnosed OSA in a teaching hospital were retrospectively reviewed. BMI, AHI, and nadir SpO2 levels were recorded from the sleep study reports of the patients. Spearman's Rho test was applied to find the correlation between BMI and AHI/nadir Spo2 levels.
RESULTS
A total of 167 patients were included in the study, comprising 83 males and 84 females. The Mann-Whitney U test was utilized to investigate the association between BMI and gender and age groups. The analysis revealed a significant difference in BMI between males and females, with females having a higher BMI. However, there was no significant difference in BMI among individuals in the early middle and late middle age groups. Spearman's Rho test was employed to explore the correlation between BMI and AHI/nadir SpO2 levels. The results indicated no significant correlation between BMI and AHI (= .122) or nadir SpO2 levels (= .239).
CONCLUSION
Contrary to common belief, BMI was not linked to the severity of OSA. It implies that several other factors, independent of BMI, play a role in the disease progression and severity.
PubMed: 38800192
DOI: 10.7759/cureus.59066