The latest medical research on Sleep Apnoea
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about sleep apnoea gathered by our medical AI research bot.
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Request AccessMagnesium citrate monotherapy improves RLS symptoms and multiple suggested immobilization test scores in an open-label pilot study.
J Clin SleepAn estimated 3% of the population suffers from clinically significant restless legs syndrome. Given the limited pharmacological options in the arsenal, there is a need for a therapeutic agent with a better side effect profile.
Twelve treatment naïve adults (10 women and 2 men with a median age of 41.5 [32-48.5] years) with primary RLS were recruited in our open-label pilot study; magnesium citrate 200 mg was administered daily for eight weeks. Serum magnesium levels, IRLS, Kohnen QOL scale, and multiple suggested immobilization tests were performed before and after supplementation. Paired t-tests and Wilcoxon signed-rank tests were used for data analysis. Pearson and Spearman's analyses assessed the association between magnesium levels and RLS variables.
Participants had a significant reduction in IRLS scores (- 6.67 [2.33-11] p=0.006) and improved Kohnen QOL scores (-8.5 [2.09-14], p=0.014) without notable differences in serum magnesium levels (p=0.3). Average PLMW across all SIT trials (30.40 [5.20, 122.40] to 8.63 [0.32, 17.47] p=0.043) and subjective measures on mSIT also demonstrated improvement. Serum magnesium levels negatively correlated with m-SIT self-reported scores and the PLMW indices.
Despite the limitations of open-label design, our study's positive results indicate the need for a placebo-controlled trial with a larger sample size.
clinicaltrials.gov (NCT04462796).
Sleep deficiency and symptoms of pain, fatigue, and depressed mood in youth with and without childhood systemic lupus erythematosus.
J Clin SleepTo describe and compare sleep deficiency and symptoms of pain, fatigue, and depressed mood in youth with childhood Systemic lupus erythematosus (cSLE) to a healthy comparison group of youth; and to test the associations between sleep and symptoms of pain, fatigue, and depressed mood in youth with cSLE.
Forty-three youth (23 youth with cSLE; 20 age, sex-matched healthy youth) wore actigraphs and completed sleep diaries for 10 days, and completed self-report questionnaires on sleep quality, pain, fatigue, and depressed mood.
On average, both groups had a total sleep time of less than 7 hours. Youth with cSLE had worse sleep efficiency (73.3%) and sleep regularity index scores (55.4) compared to the healthy comparison group of youth (79.2%, 60.1, respectively). Youth with cSLE had worse pain (p = .03) and fatigue (p = .004) compared to the healthy comparison group. Negative associations were found among self-reported sleep quality, sleep satisfaction, and symptoms of pain, fatigue, and depressed mood in youth with cSLE and wake after sleep onset was positively associated with fatigue.
Poor sleep efficiency and sleep irregularity accompanied by symptoms of pain, fatigue, and depressed mood was prevalent in youth with cSLE. Youth with lupus should be encouraged to maintain a regular sleep schedule. Since, this is the first study to incorporate objective sleep and sleep regularity measures in youth with cSLE, additional studies with objective and self-report sleep measures are needed to replicate our findings.
Sleep stage continuity is associated with objective daytime sleepiness in patients with suspected obstructive sleep apnea.
J Clin SleepExcessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA) is poorly explained by standard clinical sleep architecture metrics. We hypothesized that reduced sleep stage continuity mediates this connection independently from standard sleep architecture metrics.
1,907 patients with suspected OSA with daytime sleepiness complaints underwent in-lab diagnostic polysomnography and next-day Multiple Sleep Latency Test (MSLT). Sleep architecture was evaluated with novel sleep-stage continuity quantifications (mean sleep stage duration and probability of remaining in each sleep stage), and conventional metrics (total N1, N2, N3 and REM times; and sleep onset latency). Multivariate analyses were utilized to identify variables associated with moderate EDS (5 ≤ mean daytime sleep latency (MSL) ≤ 10 minutes) and severe EDS (MSL < 5 minutes).
Compared to those without EDS, participants with severe EDS had lower N3 sleep continuity (mean N3 period duration 10.4 vs 13.7 minutes, p<0.05), less N3 time (53.8 vs 76.5 minutes, p<0.05); greater total sleep time (374.0 vs 352.5 minutes, p<0.05) and greater N2 time (227.5 vs 186.8 minutes, p<0.05). After adjusting for standard sleep architecture metrics using multivariate logistic regression, decreased mean wake and N3 period duration, and the decreased probability of remaining in N2 and N3 sleep remained significantly associated with severe EDS, while the decreased probability of remaining in wake and N2 sleep were associated with moderate EDS.
Patients with OSA with EDS experience lower sleep continuity, noticeable especially during N3 sleep and wake. Sleep-stage continuity quantifications assist in characterizing the sleep architecture and are associated with objective daytime sleepiness highlighting the need for more detailed evaluations of sleep quality.
Insomnia symptoms and increased risk of all-cause mortality by age and sex.
J Clin SleepPrior research suggests that insomnia may increase the risk of death. However, the potential influence of age and sex is unclear. This study aimed to investigate the association of insomnia symptoms with all-cause mortality by age and sex.
This prospective cohort was drawn from the Health and Retirement Study, a survey of Americans older than 50 years and their spouses of any age from 2002 to 2018. Insomnia symptom scores were based on difficulties initiating sleep, difficulty maintaining sleep, waking up too early, and restorative sleep. Cox proportional hazards regression models were employed to investigate the association between insomnia symptoms and all-cause mortality stratified by age and sex.
A total of 33004 participants were included with a mean age of 61.7 years and 56.8% females. Over a mean follow-up of 8.4 years, 8935 (27.1%) deaths were recorded. After adjusting for confounding, males with insomnia symptom scores ranging from 5 to 8 had a 71% increased risk of death (HR=1.71, 95% CI: 1.27, 2.30) compared to their counterparts without insomnia symptoms. Similarly, males aged ≥60, and females aged <60 with insomnia symptoms ranging from 5-8 had an increased risk of death compared to their counterparts without insomnia symptoms (HR=1.15, 95%: 1.02, 1.31, and HR=1.38, 95% CI: 1.00, 1.90, respectively). However, there was no increased risk of death for females aged ≥60 (HR=0.94, 95% CI: 0.84, 1.06).
These findings suggest that insomnia symptoms may serve as predictors of low life expectancy.
A shot in the dark: the impact of online visibility on the search for an effective sleep app.
J Clin SleepDictated by consumer ratings and concealed algorithms, high levels of online visibility are granted to certain sleep apps on mainstream modes of app selection. Yet, it remains unclear to what extent these highly visible apps are evidence-based. The objectives of this review were to identify and describe the apps with the greatest online visibility when searching for a sleep app and to assess the claimed and actual research associated with them.
A keyword search was conducted in Google Play and Google search. Titles of the most visible apps were retrieved. App descriptions were examined to identify research claims made about app effectiveness on sleep and other health-related outcomes. A follow-up search on PubMed and Google Scholar was conducted to verify claims.
The keyword search identified 53 highly visible apps. Examination of app store descriptions found that no reference to research was made for the majority of apps (n = 45, 84.9%). Published research studies were available for just three apps, with most studies evaluating app impact on non-sleep related outcomes. There was some evidence to attesting to the effectiveness of two apps in improving sleep.
This review demonstrates how, when carrying out a typical search for a sleep app, information about the evidence base for the majority of highly visible apps is not available. Results highlight the need for the improvement of mainstream modes of app selection in terms of better consumer-app specificity and increased transparency regarding the access to information about the evidence base for apps.
Persistent combined type sleep-related rhythmic movement disorder into adolescence: a case report.
J Clin SleepSRMD is characterized by repetitive, stereotyped, rhythmic movements of large muscle groups, primarily occurring at the onset of sleep and during s...
Sleep macro-architecture in patients with Parkinson's disease does not change during the first night of neurostimulation in a pilot study.
J Clin SleepA growing body of literature suggests that deep brain stimulation (DBS) to treat motor symptoms of Parkinson's disease (PD) may also ameliorate certain sleep deficits. Many foundational studies have examined the impact of stimulation on sleep following several months of therapy, leaving an open question regarding the time course for improvement. It is unknown whether sleep improvement will immediately follow onset of therapy or accrete over a prolonged period of stimulation. The objective of our study was to address this knowledge gap by assessing the impact of DBS on sleep macro-architecture during the first nights of stimulation.
Polysomnograms were recorded for three consecutive nights in 14 patients with advanced PD (10 male, 4 female; age: 53-74 years), with intermittent, unilateral subthalamic nucleus DBS on the final night or two. Sleep scoring was determined manually by a consensus of four experts. Sleep macro-architecture was objectively quantified using the percentage, latency, and mean bout length of wake after sleep onset (WASO) and on each stage of sleep (REM and NREM stages N1, N2, N3).
Sleep was found to be highly disrupted in all nights. Sleep architecture on nights without stimulation was consistent with prior results in treatment naive patients with PD. No statistically significant difference was observed due to stimulation.
These objective measures suggest that one night of intermittent subthreshold stimulation appears insufficient to impact sleep macro-architecture.
Name: Adaptive Neurostimulation to Restore Sleep in Parkinson's Disease; URL: https://clinicaltrials.gov/ct2/show/NCT04620551; Identifier: NCT04620551.
Device-related outcomes following hypoglossal nerve stimulator implantation.
J Clin SleepHypoglossal nerve stimulation (HGNS) has been widely used to treat obstructive sleep apnea in selected patients. Here we evaluate rates of revision and explant related to HGNS implantation and assess types of adverse events contributing to revision and explant.
Post-market surveillance data for HGNS implanted between January 1, 2018 and March 31, 2022, were collected. Event rates and risk were calculated using the post-market surveillance event counts and sales volume over the same period. Indications were categorized for analysis. Descriptive statistics were reported and freedom from explant or revision curves were grouped by year of implantation.
Of the 20,881 HGNS implants assessed, rates of explant and revision within the first year were 0.723% and 1.542%, respectively. The most common indication for explant was infection (0.378%) and for revision was surgical correction (0.680%). Of the 5,820 devices with three-year post-implantation data, the rate of explant was 2.680% and of revision was 3.557%. During this same interval, elective removal (1.478%) was the most common indication, and for revisions, surgical correction (1.134%).
The efficacy of HGNS is comparable in the real world setting to published clinical trial data. Rates of explant and revision are low, supporting a satisfactory safety profile for this technology.
Rest-activity rhythm disruption and metabolic health in schizophrenia: a cross-sectional actigraphy study of community-dwelling people living with schizophrenia and non-psychiatric comparison participants.
J Clin SleepPeople living with schizophrenia (PLWS) have increased physical comorbidities and premature mortality which may be linked to dysregulated rest-activity rhythms (RARs). This study aimed to compare RARs between PLWS and non-psychiatric comparison participants (NCs); examine the relationships of RARs with age, sleep, metabolic and physical health outcomes; and, among PLWS, relationships of RARs with illness-related factors.
The study sample included 26 PLWS and 36 NCs, assessed with wrist-worn actigraphy to compute RAR variables and general sleep variables. Participants completed assessments for clinical symptoms, physical health, sleep quality, medication use, and assays for fasting glycosylated hemoglobin (HbA1c) levels. We examined group differences in RAR and sleep variables, relationships of RAR variables with metabolic and physical health measures, and, among PLWS, relationships between RAR variables and illness-related measures.
PLWS had significantly shorter active periods, lower relative amplitude, and lower mean activity during their most active 10 hours compared to the NCs (Cohen's d=.79, .58, and .62; respectively). PLWS had poorer sleep quality, greater mean percent sleep, less wake after sleep onset, and higher total sleep time (TST) variability compared to NCs. PLWS had higher rates of antidepressant, anxiolytic, and antipsychotic medication use compared to NCs, which may have impacted sleep quality and objective sleep measures. Across both groups, more fragmented and variable RARs were associated with higher HbA1c levels (ηp2=0.10) and worse physical health (ηp2=0.21). Among PLWS, RARs were correlated with TST (rs=.789, p<0.01) and percent sleep (rs=.509, p<0.05), but not with age, sleep quality, or other illness-related factors.
RARs provide unique information about sleep and activity for PLWS and have the potential for targeted interventions to improve metabolic health and mortality.
Sleep-related breathing disorders in infants with spina bifida repaired prenatally and postnatally.
J Clin SleepAdvances in prenatal repair of myelomeningocele (MMC) have improved outcomes involving different organ systems. There is limited data on respiratory outcomes following prenatal surgical repair. We hypothesize there is no difference in respiratory outcomes between spina bifida (SB) patients who have undergone prenatal versus postnatal repair.
We performed a retrospective study of 46 infants <1 year with SB seen at Children's Hospital Los Angeles from 2004-2022. Demographic data, timing of closure, neonatal course, Chiari II malformation (CIIM), ventriculoperitoneal shunt (VPS), polysomnography (PSG) results, and need for supplemental oxygen were collected. Unpaired t-test and Chi-square Test were used to analyze results.
31/46 had prenatal repair of MMC; average age at repair was 27 weeks post-conception (PCA). Average age at postnatal repair was 37 PCA. There was no difference in age at PSG. There was no difference in CIIM presence (p=0.61). 60% of patients with postnatal repair and 23% in the prenatal group underwent VPS placement (p=0.01).
There was no difference in PSG findings between the two groups: CAI (p=0.11), OAHI (p=0.64), average SpO2 baseline (p=0.91), average SpO2 nadir (p=0.17), average PETCO2 baseline (p=0.87), and average PETCO2 maximum (p=0.54). There were no significant differences in the proportion of patients on supplemental O2 (p=0.25), CSA or OSA between groups.
Patients with SB who've undergone closure of neural tube defect have persistent central apneas, obstructive apneas, and significant hypoxemia. There were no differences in the frequency or severity of sleep-disordered breathing in those with prenatal repair versus postnatal repair.
Changed sleep according to weighted blanket adherence in a 16-week sleep intervention among children with attention-deficit/hyperactivity disorder.
J Clin SleepTo examine differences in sample characteristics and longitudinal sleep outcomes according to weighted blanket adherence.
Children with attention-deficit/hyperactivity disorder (ADHD) (n =94), mean age 9.0 (sd 2.2, range 6-14) participated in a 16-week sleep intervention with weighted blankets (WB). Children were classified as WB adherent (use of WB ≥ 4 nights/week) or non-adherent (use of WB ≤ 3 nights/week). Changes in objectively measured sleep by actigraphy, parent-reported sleep problems (Children's Sleep Habits Questionnaire (CSHQ)) and child-reported Insomnia Severity Index (ISI) were evaluated according to adherence with mixed effect models. Gender, age, and ADHD subtype were examined as potential moderators.
Children adherent to WBs (48/94) showed an early response in sleep outcomes and an acceptance of the WB after four weeks of use as well as a decrease in parent- (CSHQ) (-5.73, P = .000) and child-reported sleep problems (ISI) (-4.29, P = .005) after 16 weeks. The improvement in sleep was larger among WB adherent vs. non-adherent (between-group difference: CSHQ: -2.09, P = .038; ISI: -2.58, P =.007). Total sleep time was stable for children adherent to WB but decreased for non-adherent (between-group difference: +16.90, P = .019).
An early response in sleep and acceptance of the WB predicted later adherence to WBs. Improvements in sleep were more likely among WB adherents vs. non-adherents. Children with ADHD may thus benefit from using WBs to handle their sleep problems.
Microstructural brain abnormalities and associated neurocognitive dysfunction in obstructive sleep apnea: a pilot study with diffusion kurtosis imaging.
J Clin SleepTo assess the possible brain abnormalities in adult patients with moderate and severe obstructive sleep apnea (OSA) using the mean kurtosis (MK) from diffusion kurtosis imaging (DKI) and analyze the correlation between MK and cognitive function.
A total of 30 patients with moderate and severe OSA and 30 healthy controls (HCs) evaluated by the Montreal Cognitive Assessment (MoCA) scale were enrolled. All subjects underwent DKI and 3D T1-weighted imaging (T1WI) on a 3.0T MR scanner. The MK values of gray and white matter brain regions were compared. Partial correlation analysis was used to analyze the correlation between respiratory sleep parameters/cognitive score and MK values in different brain regions.
Compared with the HCs, the MK of 20 brain regions (13 after false discovery rate (FDR) correction) and cognitive scores in the OSA group were significantly lower. In the OSA group, the apnea-hypopnea index (AHI) was negatively correlated with the MK in the white matter of the right occipital lobe; the LSpO2 was positively correlated with the MK in the bilateral parietal, precentral, and right postcentral cortex; the total score of MoCA scale was positively correlated with MK in the left hippocampus; the language function was positively correlated with MK in the white matter of left parietal lobe, and the delayed recall was positively correlated with the MK in right insula cortex and bilateral cingulate. After FDR correction, only the correlations of LSpO2 with right precentral gyrus cortex, and bilateral parietal cortex were significant.
MK values of DKI imaging may provide valuable information in assessing the neurological impacts of obstructive sleep apnea.
