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American Family Physician Feb 2022Childhood sleep disorders can disrupt family dynamics and cause cognitive and behavior problems. Early recognition and management can prevent these complications....
Childhood sleep disorders can disrupt family dynamics and cause cognitive and behavior problems. Early recognition and management can prevent these complications. Behavior subtypes of childhood insomnias affect 10% to 30% of children and result from inconsistent parental limit-setting and improper sleep-onset association. Behavior insomnias are treated using extinction techniques and parent education. Hypnotic medications are not recommended. Obstructive sleep apnea affects 1% to 5% of children. Polysomnography is required to diagnose obstructive sleep apnea; history and physical examination alone are not adequate. Adenotonsillectomy is the first-line treatment for obstructive sleep apnea. Nasal continuous positive airway pressure is the second-line treatment for children who do not respond to surgery or if adenotonsillectomy is contraindicated. Restless legs syndrome can be difficult to recognize and has an association with attention-deficit/hyperactivity disorder. Management of restless legs syndrome includes treatment of iron deficiency, if identified, and removal of triggering factors. Parasomnias affect up to 50% of children and usually resolve spontaneously by adolescence. Management of parasomnias involves parental education, reassurance, safety precautions, and treating comorbid conditions. Delayed sleep phase syndrome is found during adolescence, manifesting as a night owl preference. Treatment of delayed sleep phase syndrome includes sleep hygiene, nighttime melatonin, and morning bright light exposure. Sleep deprivation is of increasing concern, affecting 68% of people in high school.
Topics: Continuous Positive Airway Pressure; Humans; Parasomnias; Polysomnography; Sleep Apnea, Obstructive; Sleep Wake Disorders
PubMed: 35166510
DOI: No ID Found -
Sleep Nov 2012This evidence-based review provides a systematic and comprehensive review of the literature regarding the utility of polysomnography for the evaluation of... (Review)
Review
OBJECTIVE
This evidence-based review provides a systematic and comprehensive review of the literature regarding the utility of polysomnography for the evaluation of non-respiratory sleep disorders in children including hypersomnias, parasomnias, sleep-related movement disorders, and sleep in other special populations.
METHODS
A task force of pediatric sleep medicine experts performed a systematic review of the literature regarding the use of polysomnography for non-respiratory sleep disorders in children. They identified and graded 76 papers as evidence.
RESULTS
The main results include (1) polysomnography combined with the multiple sleep latency test is useful for evaluating disorders of excessive somnolence to objectively quantify sleepiness. The results have to be interpreted with consideration of the pubertal stage and regularity of the sleep patterns of the child; (2) polysomnography is indicated in children with parasomnias or sleep related movement disorders who have a high likelihood of having obstructive sleep apnea (OSA); (3) polysomnography is not routinely indicated in children with enuresis unless there is a high likelihood of OSA; (4) polysomnography can be helpful in evaluating children with restless legs syndrome (RLS) and when periodic limb movement disorder (PLMD) is suspected.
CONCLUSIONS
These findings suggest that, in children with non-respiratory sleep disorders, polysomnography should be a part of a comprehensive sleep evaluation in selected circumstances to determine the nature of the events in more detail or when the suspicion of OSA is relatively high.
Topics: Child; Evidence-Based Medicine; Humans; Polysomnography; Sleep Apnea, Obstructive; Sleep Wake Disorders
PubMed: 23115394
DOI: 10.5665/sleep.2188 -
Journal of Sleep Research Feb 2019Many studies investigating sleep and memory consolidation have evaluated full-night sleep rather than alternative sleep periods such as daytime naps. This multi-centre...
Many studies investigating sleep and memory consolidation have evaluated full-night sleep rather than alternative sleep periods such as daytime naps. This multi-centre study followed up on, and was compared with, an earlier full-night study (Schabus et al., 2004) investigating the relevance of daytime naps for the consolidation of declarative and procedural memory. Seventy-six participants were randomly assigned to a nap or wake group, and performed a declarative word-pair association or procedural mirror-tracing task. Performance changes from before to after a 90-min retention interval filled with sleep or quiet wakefulness were evaluated between groups. Associations between performance changes, sleep architecture, spindles, and slow oscillations were investigated. For the declarative task we observed a trend towards stronger forgetting across a wake period compared with a nap period, and a trend towards memory increase over the full-night. For the procedural task, accuracy was significantly decreased following daytime wakefulness, showed a trend to increase with a daytime nap, and significantly increased across full-night sleep. For the nap protocol, neither sleep stages, spindles, nor slow oscillations predicted performance changes. A direct comparison of day and nighttime sleep revealed that daytime naps are characterized by significantly lower spindle density, but higher spindle activity and amplitude compared with full-night sleep. In summary, data indicate that daytime naps protect procedural memories from deterioration, whereas full-night sleep improves performance. Given behavioural and physiological differences between day and nighttime sleep, future studies should try to characterize potential differential effects of full-night and daytime sleep with regard to sleep-dependent memory consolidation.
Topics: Adult; Female; Humans; Male; Polysomnography; Sleep; Wakefulness; Young Adult
PubMed: 29271015
DOI: 10.1111/jsr.12649 -
Journal of Sleep Research Aug 2019Actigraphy is increasingly used in practice and research studies because of its relative low cost and decreased subject burden. How multiple nights of at-home actigraphy...
Actigraphy is increasingly used in practice and research studies because of its relative low cost and decreased subject burden. How multiple nights of at-home actigraphy compare to one independent night of in-laboratory polysomnography (PSG) has not been examined in people with insomnia. Using event markers (MARK) to set time in bed (TIB) compared to automatic program analysis (AUTO) has not been systematically evaluated. Subjects (n = 30) meeting DSM-5 criteria for insomnia and in-laboratory PSG sleep efficiency (SE) of <85% were studied. Subjects were free of psychiatric, sleep or circadian disorders, other chronic conditions and medications that effect sleep. Subjects had an in-laboratory PSG, then were sent home for 7 nights with Philips Actiwatch Spectrum Plus. Data were analysed using Philips Actiware version 6. Using the mean of seven nights, TIB, total sleep time (TST), SE, sleep-onset latency (SOL) and wake after sleep onset (WASO) were examined. Compared to PSG, AUTO showed longer TIB and TST and less WASO. MARK only differed from PSG with decreased WASO. Differences between the PSG night and the following night at home were found, with better sleep on the first night home. Actigraphy in people with insomnia over seven nights is a valid indicator of sleep compared to an independent in-laboratory PSG. Event markers increased the validity of actigraphy, showing no difference in TIB, TST, SE and SOL. AUTO was representative of SE and SOL. Increased SE and TST without increased TIB suggests possible compensatory sleep the first at night home after in-laboratory PSG.
Topics: Actigraphy; Female; Humans; Male; Middle Aged; Polysomnography; Sleep Initiation and Maintenance Disorders
PubMed: 30941838
DOI: 10.1111/jsr.12854 -
Journal of Medical Internet Research Sep 2022American Academy of Sleep Medicine guidelines suggest that clinical prediction algorithms can be used to screen patients with obstructive sleep apnea (OSA) without... (Review)
Review
BACKGROUND
American Academy of Sleep Medicine guidelines suggest that clinical prediction algorithms can be used to screen patients with obstructive sleep apnea (OSA) without replacing polysomnography, the gold standard.
OBJECTIVE
We aimed to identify, gather, and analyze existing machine learning approaches that are being used for disease screening in adult patients with suspected OSA.
METHODS
We searched the MEDLINE, Scopus, and ISI Web of Knowledge databases to evaluate the validity of different machine learning techniques, with polysomnography as the gold standard outcome measure and used the Prediction Model Risk of Bias Assessment Tool (Kleijnen Systematic Reviews Ltd) to assess risk of bias and applicability of each included study.
RESULTS
Our search retrieved 5479 articles, of which 63 (1.15%) articles were included. We found 23 studies performing diagnostic model development alone, 26 with added internal validation, and 14 applying the clinical prediction algorithm to an independent sample (although not all reporting the most common discrimination metrics, sensitivity or specificity). Logistic regression was applied in 35 studies, linear regression in 16, support vector machine in 9, neural networks in 8, decision trees in 6, and Bayesian networks in 4. Random forest, discriminant analysis, classification and regression tree, and nomogram were each performed in 2 studies, whereas Pearson correlation, adaptive neuro-fuzzy inference system, artificial immune recognition system, genetic algorithm, supersparse linear integer models, and k-nearest neighbors algorithm were each performed in 1 study. The best area under the receiver operating curve was 0.98 (0.96-0.99) for age, waist circumference, Epworth Somnolence Scale score, and oxygen saturation as predictors in a logistic regression.
CONCLUSIONS
Although high values were obtained, they still lacked external validation results in large cohorts and a standard OSA criteria definition.
TRIAL REGISTRATION
PROSPERO CRD42021221339; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221339.
Topics: Adult; Bayes Theorem; Humans; Machine Learning; Neural Networks, Computer; Polysomnography; Sleep Apnea, Obstructive
PubMed: 36178720
DOI: 10.2196/39452 -
Respiratory Care Jan 2010For many years the greatest barrier to the diagnosis and treatment of obstructive sleep apnea (OSA) was recognizing the disease. That obstacle is now fading as more... (Review)
Review
For many years the greatest barrier to the diagnosis and treatment of obstructive sleep apnea (OSA) was recognizing the disease. That obstacle is now fading as more physicians of all types are aware of the high prevalence of OSA and the consequences of untreated OSA. Sleep-laboratory polysomnography has long been considered the accepted standard for OSA diagnosis and has become a lucrative practice. This, unfortunately, has led to a concentration on diagnosis rather than on management of OSA. Although several brands of portable polysomnograph have been approved for home polysomnography, obstacles to reimbursement (primarily from government, but also from private payers) have prevented widespread home polysomnography. Over the last 2 decades many scientific studies have supported a strong correlation between the findings from home polysomnography and sleep-laboratory polysomnography. However, limited data are available from good outcomes-oriented studies, so controversy surrounds home polysomnography in the diagnosis of OSA. We review the evidence and debate whether sleep studies are appropriately done in the home.
Topics: Humans; Monitoring, Ambulatory; Polysomnography; Risk Factors; Sleep Apnea, Obstructive
PubMed: 20040125
DOI: No ID Found -
Clinical Oral Investigations Jun 2022To validate a new diagnostic method (DIABRUX) for quantifying sleep bruxism (SB) activity using the current gold standard, polysomnography (PSG), as a criterion in an...
OBJECTIVES
To validate a new diagnostic method (DIABRUX) for quantifying sleep bruxism (SB) activity using the current gold standard, polysomnography (PSG), as a criterion in an adequate sample size investigation.
MATERIALS AND METHODS
For SB diagnosis, each participant received a two-night ambulatory PSG including audio-video recordings. The 0.5-mm-thick sheet is produced in a thermoforming process. After diagnosis via PSG, each subject wore the diagnostic sheet for five consecutive nights. The resulting total abrasion on the surface was automatically quantified in pixels by a software specially designed for this purpose.
RESULTS
Forty-five participants (10 SB and 35 non-SB subjects) were included. The difference of the mean pixel score between the SB (M = 1,306, SD = 913) and the non-SB group (M = 381, SD = 483; 3.4 times higher for SB) was statistically significant (p < 0.001). The receiver operator characteristic (ROC) analysis revealed a value of 507 pixels as the most appropriate cut-off criterion with a sensitivity of 1.0, a specificity to 0.8, and an area under the curve (AUC) of 0.88. The positive and negative predictive value accounted for 0.59 and 1.0.
CONCLUSIONS
The present data confirm that the new diagnostic method is valid and user-friendly that may be used for therapeutic evaluation, and for the acquisition of larger sample sizes within sophisticated study designs.
CLINICAL RELEVANCE
The verified properties of the new diagnostic method allow estimating SB activity before damages occur due to long-standing bruxism activity. Therefore, it might be utilized for preventive dentistry.
TRIAL REGISTRATION NUMBER
NC T03325920 (September 22, 2017).
Topics: Electromyography; Humans; Polysomnography; Predictive Value of Tests; Sleep Bruxism
PubMed: 35195761
DOI: 10.1007/s00784-022-04398-w -
Journal of the American Board of Family... 2015Obstructive sleep apnea (OSA) is a fairly common condition that, if left untreated, can lead to complications such as high blood pressure and heart disease.... (Review)
Review
Obstructive sleep apnea (OSA) is a fairly common condition that, if left untreated, can lead to complications such as high blood pressure and heart disease. Polysomnography (PSG) is the most accurate method for diagnosing OSA, but it is a cumbersome and expensive test. A well-validated, easier to perform and less expensive alternative is the home sleep test (HST). The purpose of this review is to educate the primary care provider about the important differences between PSG and HSTs, the advantages and limitations of both modalities, identifying patients who are appropriate candidates for the HST, identifying patients in whom the HST should not be performed, and further evaluation of patients who have a negative HST.
Topics: Algorithms; Clinical Decision-Making; Decision Support Techniques; Humans; Polysomnography; Primary Health Care; Sleep Apnea, Obstructive
PubMed: 26152443
DOI: 10.3122/jabfm.2015.04.140266 -
Sensors (Basel, Switzerland) Apr 2023A mattress-type non-influencing sleep apnea monitoring system was designed to detect sleep apnea-hypopnea syndrome (SAHS). The pressure signals generated during sleep on...
A mattress-type non-influencing sleep apnea monitoring system was designed to detect sleep apnea-hypopnea syndrome (SAHS). The pressure signals generated during sleep on the mattress were collected, and ballistocardiogram (BCG) and respiratory signals were extracted from the original signals. In the experiment, wavelet transform (WT) was used to reduce noise and decompose and reconstruct the signal to eliminate the influence of interference noise, which can directly and accurately separate the BCG signal and respiratory signal. In feature extraction, based on the five features commonly used in SAHS, an innovative respiratory waveform similarity feature was proposed in this work for the first time. In the SAHS detection, the binomial logistic regression was used to determine the sleep apnea symptoms in the signal segment. Simulation and experimental results showed that the device, algorithm, and system designed in this work were effective methods to detect, diagnose, and assist the diagnosis of SAHS.
Topics: Humans; Arrhythmias, Cardiac; Polysomnography; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 37050735
DOI: 10.3390/s23073675 -
Croatian Medical Journal Dec 2022To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the... (Review)
Review
AIM
To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the current understanding of this topic.
METHODS
A scoping review of available evidence on dreams and dreamlike mentation in NREM parasomnias was conducted in accordance with the PRISMA-ScR guidelines. We searched peer-reviewed literature using Google Scholar, PubMed, Ovid (Embase), Ovid Medline®, Global Health, and APA Psych Info. The Mixed Method Appraisal Tool (MMAT) was used to appraise the quality of selected articles.
RESULTS
The final analysis included 16 studies. All of the studies were from high-income countries. The studies reported on dreams and dreamlike mentation in NREM parasomnias, but there was scarcity of literature for sexsomnia, sleep-related eating disorder, and confusional arousal. All of the studies had the highest quality as shown by the MMAT (76%-100%). Emotions such as apprehension and misfortune were associated with sleepwalking and sleep terrors.
CONCLUSION
Sleep studies involving collection of dream content immediately following NREM parasomnia could significantly minimize reporting bias and improve dream data quality.
Topics: Humans; Parasomnias; Polysomnography; Emotions
PubMed: 36597564
DOI: 10.3325/cmj.2022.63.525