Search Results (357)

Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic control in this population. Methods: This cross-sectional study utilized data from the El Banco por Salud biobank, including 1685 participants (aged 52.6 ± 14.5 years, BMI: 32.4 ± 7.0 kg/m²) recruited from Federally Qualified Community Health Centers. Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale, while dietary information was obtained via the Brief Dietary Assessment Tool for Hispanics. Primary outcomes included cardiometabolic risk factors and glycated hemoglobin (HbA1c) levels. Results: Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 22.0% of participants and was associated with higher BMI (p < 0.001), larger waist circumference (p = 0.002), poorer diet quality, increased dyslipidemia (p = 0.036), and elevated HbA1c (p = 0.007). Linear regression analyses confirmed that excessive daytime sleepiness was significantly associated with higher HbA1c levels, both in unadjusted (R² = 0.011; p < 0.001) and adjusted for demographic, anthropometric, and socioeconomic factors (R² = 0.107; p = 0.004) models. Conclusions: Excessive daytime sleepiness among Latinos of Mexican ancestry is associated with unhealthy dietary patterns and poor glycemic control, highlighting the need for targeted interventions addressing sleep and dietary habits in this vulnerable population. Full article

Background: People with Parkinson’s disease (PwPD) often experience sleep disturbances and reduced physical activity. Altered sleep behavior and lower daily steps have been linked to disease severity and symptom burden. Although physical activity may influence sleep, few studies have examined the relationship between sleep parameters and daily steps in PD. This scoping review aimed to review current knowledge on sleep parameters and daily steps collected concurrently in PwPD and their potential association. Methods: A systematic search was conducted in five databases, PubMed, Web of Science, Sport Discus, Cochrane Library, and Scopus. Methodological quality was assessed using a customized quality checklist developed by Zanardi and collaborators for observational studies, based on Downs and Black’s work. Results: Out of 1421 records, five studies met the eligibility criteria and were included in the review. Four studies reported wearable-based measurements of both step count and sleep parameters, while one study reported wearable-based measurements of step count and self-reported sleep measures. Two studies examined the association between sleep parameters and step count. One study did not find any correlation between sleep and step count, whereas one study reported a positive correlation between daytime sleepiness and step count. Conclusions: This review highlighted the lack of research investigating the relationship between sleep parameters and step count as an indicator of physical activity in PwPD. Findings are inconsistent with a potential positive correlation emerging between daytime sleepiness and step count. Findings also pointed toward lower step count and reduced sleep duration in PwPD, as measured with wearable devices. Full article

Background/Objectives: Epilepsy and sleep disturbances frequently co-occur, yet the causal nature of this relationship remains uncertain, particularly in relation to epilepsy subtypes and status epilepticus. We investigated potential bidirectional causal associations between sleep-related traits and epilepsy, including subtypes and status epilepticus, using Mendelian randomization (MR). Methods: We conducted two-sample MR using genome-wide association study (GWAS) summary statistics from European ancestry cohorts. Epilepsy, its subtypes, and status epilepticus were analyzed using data from the International League Against Epilepsy Consortium on Complex Epilepsies (ILAE) and the FinnGen study. Nine self-reported sleep-related traits were derived from the UK Biobank-based GWAS. Causal estimates were primarily obtained using inverse variance weighted models with additional MR analysis methods. Pleiotropy and heterogeneity were assessed to enhance the robustness of the finding. Results: Several subtype-specific associations were identified, with direction and statistical significance varying across cohorts and subtypes. After correction for multiple testing and filtering for tests with ≥10 instrumental variables to ensure robust and reliable MR estimates, several consistent and potentially mutually reinforcing associations emerged. In the ILAE cohort, focal epilepsy with hippocampal sclerosis was associated with an increased risk of insomnia, and juvenile myoclonic epilepsy with reduced sleep duration. In the FinnGen cohort, overall epilepsy was associated with increased risk of both insomnia and daytime sleepiness. In reverse MR, daytime sleepiness and napping were associated with increased risk of epilepsy, while daytime napping and frequent insomnia symptoms were linked to elevated risk of status epilepticus. Conclusions: Our findings reveal subtype-specific and bidirectional causal links between epilepsy and sleep-related traits. These results highlight the biological interplay between epileptic networks and sleep regulation and underscore the need for further clinical and mechanistic studies. Full article

Objectives: Sleep serves a crucial role in the optimal development of cognitive, emotional, and physical domains. Sleep disturbances and disorders have been reported to frequently occur in many neurodevelopmental conditions, including ADHD and Autism Spectrum Disorder. The connection between dyslexia and sleep, however, is sparsely explored. This community study aimed to enhance knowledge about sleep disturbances in children with dyslexia and explore the potential impact of anxiety. Method: The parents of 160 children aged 7–13 years old with a primary diagnosis of dyslexia completed the Children’s Sleep Habits Questionnaire (CSHQ) and the Spence Children’s Anxiety Scale (SCAS). Results: Sixty-six percent of the children showed pathological levels of sleep disturbances, with clinical scores observed in the subscales of Sleep Onset Delay, Sleep Anxiety, and Daytime Sleepiness. Overall, sleep and anxiety were correlated, but anxiety levels were not elevated and not correlated with Sleep Onset Delay. Conclusions: The current results suggest that the majority of children with dyslexia suffer from sleep disturbances, such as delayed sleep onset and shorter sleep durations, irrespective of the scores given on the anxiety scale. Given the importance of sleep for optimal development, there is an alarming need for more studies to be carried out to explore additional factors that interact with healthy sleep to develop sleep interventions. Full article

Background and Aim: Neuropathic pain leads to a significant deterioration in health-related quality of life (HRQOL). Treating neuromusculoskeletal pain is especially important to prevent and improve physical frailty and the locomotive syndrome. Varied pharmacotherapies could be applicable for neuropathic pain patients, but evidence has been limited for a wide range of neuropathic pain conditions with different etiologies. The aim of this review was to highlight mirogabalin, a novel calcium channel α2δ ligand which was first approved in Japan, and which is effective for various types of neuropathic pain diseases. Methods: We conducted a narrative review of the recent evidence that mirogabalin has significant analgesic potency for varied types of neuropathic pain conditions. Futher, this review highlighted specific advantages over other calcium channel ligands. Results: Analgesic potency of mirogabalin could cover peripheral neuropathic pain conditions including post-herpetic neuralgia, diabetic peripheral neuropathy, cauda equina syndrome caused by lumbar spinal stenosis, radiculopathy caused by cervical spondylosis, and also central neuropathic pain conditions like spinal cord injury. Mirogabalin consistently demonstrated daytime sleepiness and dizziness as adverse effects, but most of these were mild. Conclusions: Mirogabalin is recommended as the first-line drug against most molecular mechanisms that cause neuropathic pain regardless of whether they have a peripheral or central origin. Mirogabalin demonstrates relatively less daytime sleepiness, making it age-friendly in the current global situation where population aging is accelerated. Considering the epidemic of ‘opiophobia’ in Japan and other countries, pharmacotherapy using mirogabalin could treat neuropathic pain associated with cancer and its treatment (e.g., chemotherapy-induced peripheral neuropathy), as well as non-cancer etiologies worldwide. Full article

Background: Chronotype reflects individual variations in daily activity and sleep patterns, influenced by underlying circadian rhythms. While chronotype is often reduced to the morningness–eveningness spectrum, recent evidence suggests more diverse circadian typologies. Chronotype is linked to mental health, frequently associated with psychiatric disorders such as depression and suicide. This study aims to examine differences among six chronotypes (as defined by Single-Item Chronotyping) in mental health outcomes, including depression, anxiety, interpersonal relations, general functioning, suicidal behavior, and suicide acceptance. Methods: The study sample consisted of 306 young adults. Chronotype was determined using the Polish version of Single-Item Chronotyping (SIC). Mental health was assessed with the 30-item General Health Questionnaire (GHQ-30), which evaluates three dimensions: depression and anxiety, interpersonal relations, and general functioning. The Suicide Behavior Questionnaire (SBQ-R) measured past and potential future suicidal tendencies, while the Suicide Acceptance Questionnaire (SAQ) assessed attitudes toward the act of suicide. Results: The “daytime sleepy” and “moderately active” chronotypes were identified as at higher risk for mental health issues. These types exhibited greater levels of depression and anxiety, more general dysfunction, and a higher risk of suicidal behavior. The “daytime sleepy” type also experienced more interpersonal relationship difficulties compared to the “daytime active” type. Conclusions: Recognizing the “daytime sleepy” and “moderately active” types as risk factors highlights the importance of considering chronotype in mental health assessments. The SIC provides a concise method for monitoring circadian rhythm changes during treatment, facilitating tailored interventions such as modifying treatment schedules or lifestyle adjustments in alignment with an individual’s circadian rhythm. Full article

Background/Objectives: This study aimed to investigate the effect of age at symptom onset on rapid eye movement (REM) sleep latency and sleep-onset REM period (SOREMP) distribution in multiple sleep latency tests (MSLTs) in patients with narcolepsy. Methods: This was a retrospective multicenter chart review of 135 newly diagnosed drug-naïve patients with narcolepsy who underwent MSLT and fulfilled the diagnostic criteria for narcolepsy. The age at onset was defined as the first occurrence of excessive daytime sleepiness or cataplexy. We investigated sleep onset latency, REM sleep latency, and the presence of SORMEP in each nap trial of the MSLT. The clinical, polysomnography, and MSLT findings were compared between the early- and late-onset groups. Correlation and linear regression analyses were used to assess the effect of age at onset as a continuous variable, and survival analyses confirmed its impact on the MSLT parameters. Results: The mean age at onset was 18.3 ± 8.8 years. Patients with early onset had a higher rate of SOREMPs than late-onset patients in the first MSLT nap (81.9% vs. 63.3%, p = 0.031). However, the severity of the narcolepsy symptoms did not differ between the groups. In linear regression analysis, age at onset was significantly associated with MSLT REM sleep latency (β = 0.049, p = 0.033) after adjusting for confounders. Survival analysis confirmed that an early onset of narcolepsy was associated with a higher probability of SOREMPs in the first MSLT nap (hazard ratio 0.955, p = 0.001). Conclusions: A younger age at narcolepsy onset was associated with shorter REM sleep latency and higher SOREMP probability in MSLT. These findings indicate that the early onset of narcolepsy may be linked to greater disease severity in terms of REM sleep dysregulation. Full article

In practice, many patients receive APAP treatment for the simple reason that it provides increased comfort and is easier for patients to accept and tolerate. Reality has proven that we have very many patients diagnosed with OSAS on APAP treatment, under which AHI has normalized, but patients continue to have remaining symptoms. Thus the question was born: is the persistence of remnant symptomatology under APAP related to the mode of ventilation in patients with normalized AHI? The target group was young obese men presenting to the urology service for nocturnal pollakiuria without urologic cause. After performing nocturnal ventilatory polygraphy, the patients were recommended APAP treatment for three months, subsequently, the patients were switched to CPAP treatment for another three months, thus comparing the results obtained. After 6 months of treatment, 71.4% of the subjects would opt to continue CPAP treatment. While a clear option for APAP treatment was expressed by 10.2%. Our research, suggests that we should not be misled by the normalization of AHI under APAP therapy, but to evaluate the patients also with the help of available and standardized questionnaires. Full article

Poor sleep quality and excessive daytime sleepiness are commonly reported by individuals with cystic fibrosis. The potential impact of comorbid sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), has not been extensively studied in the CF population. At present, there are no specific recommendations available to help clinicians identify patients with CF who are at increased risk of sleep disorders. Home sleep apnea testing using a validated peripheral arterial tonometry (PAT) device may offer an accurate diagnosis of OSA in a more convenient and low-cost method than in-lab polysomnography. In this single-center study of 19 adults with CF, we found an increased prevalence of OSA among individuals with CF compared to general population estimates. Although associations with an FEV < 70% predicted and a modified Mallampati score ≥ 3 were observed, these odds ratios did not reach statistical significance, likely reflecting limited power in this small pilot sample. There was no association found between the self-reported presence of nocturnal cough or snoring and OSA. We also found no association between OSA and abnormal scores on commonly used, validated sleep questionnaires, suggesting that CF-specific scales may be needed for effective screening in the CF clinic. Full article

Background/Objectives: Excessive daytime sleepiness (EDS) has been suggested to negatively affect academic performance and behavior. Malocclusion is reportedly a risk factor for sleep-disordered breathing and may be associated with daytime sleepiness. This study investigated the age and sex of patients with malocclusion who are at increased risk of EDS and collected data for future EDS screening. Methods: We analyzed 556 patients with malocclusion aged 6–29 years to identify age- and sex-specific differences in the risk of EDS. Adults were surveyed using the Epworth Sleepiness Scale (ESS), and non-adults were surveyed using the Epworth Sleepiness Scale for Children and Adolescents. Results: The mean ESS score was 4.1 ± 4.1, and the median score was 3. The mean score tended to increase significantly with age. In adolescents, ESS scores increased gradually. In adolescents and young adults, ESS scores were significantly higher in females than in males, and the prevalence of EDS in young adults was 16.7% in men and 32.1% in women, with a marked sex-related difference. Conclusions: In patients with malocclusion, daytime sleepiness may gradually increase from adolescence to young adulthood and be more pronounced in females. The prevalence of EDS in young adults seems higher in women than in men. Our findings could aid in the early identification of EDS and facilitate multidisciplinary cooperation between dentists and sleep specialists. Early identification of sleep problems and prompt intervention during the high-risk period for developing EDS could improve the quality of life for many adolescents and contribute to improved public health. Full article

Background: Sleep-disordered breathing (SDB), particularly Cheyne–Stokes respiration (CSR), is highly prevalent among patients hospitalized with acute decompensated heart failure (ADHF) and is associated with worse clinical outcomes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in heart failure, but their effects on nocturnal respiratory parameters remain underexplored. Objectives: This study aims to evaluate the impact of SGLT2i therapy on key respiratory and cardiac indices including CSR burden, oxygenation, and right heart function in patients with ADHF and reduced left ventricular ejection fraction. Methods: In this single-center prospective cohort study, 60 patients with ADHF, LVEF < 40%, and a baseline apnea–hypopnea index (AHI) > 5 were assessed before and three months after the initiation of SGLT2i therapy. Sleep respiratory parameters were measured using home polygraphy (ApneaLink^TM), while cardiac and renal indices were evaluated by echocardiography, NT-proBNP, and the estimated glomerular filtration rate (eGFR). Structural and functional echocardiographic changes were analyzed both at baseline and following the 3-month treatment period. Patient-reported outcomes were assessed using the Epworth Sleepiness Scale (ESS) and Kansas City Cardiomyopathy Questionnaire (KCCQ). Results: After 3 months of SGLT2i therapy, significant improvements were observed in daytime sleepiness (ESS: −2.68 points; p < 0.001), CSR index (−5.63 events/h; p < 0.001), AHI (−3.07 events/h; p < 0.001), ODI (−6.11 events/h; p < 0.001), and mean nocturnal SpO₂ (+1.95%; p < 0.001). KCCQ scores increased by 9.16 points (p < 0.001), indicating improved quality of life. Cardiac assessments revealed reductions in NT-proBNP (−329.6 pg/mL; p < 0.001) and E/e′ ratio (−1.08; p < 0.001), with no significant change in LVEF or chamber dimensions. Right ventricular function improved, as evidenced by the increased TAPSE/sPAP ratio (+0.018; p < 0.001). Renal function remained stable, with a non-significant upward trend in eGFR. Conclusions: This exploratory study suggests that SGLT2 inhibitors may be associated with the attenuation of Cheyne–Stokes respiration and an improvement in right heart function in patients with ADHF, warranting further investigation in controlled trials. These findings highlight the potential of SGLT2is to address overlapping cardio-respiratory dysfunction in this high-risk population. Full article

Background: Narcolepsy type 1 (NT1) is a rare neurological sleep disorder characterized by excessive daytime sleepiness and cataplexy. NT1 is thought to be caused by the loss of hypocretin-producing neurons in the hypothalamus due to autoimmunity. Since cerebrospinal fluid hypocretin testing is invasive and not always feasible in clinical practice, there is a critical need for less invasive biomarkers to improve diagnostic accuracy and accessibility. Very few studies have explored serum-based biomolecules that could serve as biomarkers for NT1. Methods: This study examines the differential abundance of serum metabolites in patients with NT1 using an LC-MS/MS-based comprehensive metabolomics approach. Results: An untargeted analysis identified a total of 1491 metabolites, 453 of which were differentially abundant compared to the control cohort. Ingenuity pathway analysis revealed that key pathways, such as the inflammatory response (p-value of 0.01, activation z-score of 0.5), generation and synthesis of reactive oxygen species (p-value of 0.0008, z-score of 1.3), and neuronal cell death (p-value of 0.04, z-score of 0.4), are predicted to be activated in NT1. A targeted analysis using parallel reaction monitoring validated 49 metabolites, including important downregulated metabolites such as uridine (fold change (FC) of 0.004), epinephrine (FC of 0.05), colchicine (FC of 0.2), corticosterone (FC of 0.3), and arginine (FC of 0.6), as well as upregulated metabolites such as p-cresol sulfate (FC of 2601.7), taurine (FC of 1315.4), inosine (FC of 429.7), and malic acid (FC of 7.9). Conclusions: Understanding the pathways identified in this study and further investigating the differentially abundant metabolites associated with them may pave the way for gaining insight into disease pathogenesis and developing novel therapeutic interventions. Full article

Objective: Positive airway pressure (PAP) therapy effectively treats obstructive sleep apnea (OSA), yet adherence to the therapy presents significant challenges. This study identifies demographic and sleep study factors that influence short-term adherence to PAP therapy among patients with OSA by comparing data from adherent and non-adherent groups. Methods: Patients diagnosed with OSA via polysomnography who commenced PAP therapy after titration were divided into adherent and non-adherent groups. We employed propensity score matching in a 1:1 ratio based on age, gender, and body mass index (BMI), including a total of 150 patients in the analysis. Logistic regression analyses were conducted on all pertinent variables, excluding those with high multicollinearity. Non-significant variables were omitted from the final model, whose performance was evaluated using a receiver operating characteristic (ROC) curve, calculating the area under the curve (AUC). Results: Data from 150 participants (mean age 49.56 ± 14.31 years, 79% males, mean BMI 28.96 ± 5.11) were analyzed. Significant predictors of adherence included smoking status (odds ratio [OR] 0.267; 95% confidence interval [CI], 0.116–0.580; p = 0.001), Epworth sleepiness scale (OR 1.080; 95% CI, 1.004–1.166; p = 0.042), oxygen desaturation index (ODI) during titration (OR 0.906; 95% CI, 0.829–0.975, p = 0.015), and optimal PAP levels (OR 1.240; 95% CI, 1.007–1.119; p = 0.029). The ROC curve analysis indicated an AUC of 0.765, confirming the model’s effectiveness in distinguishing between adherent and non-adherent patients. Conclusions: Adherence is negatively affected by smoking, whereas higher daytime sleepiness, optimal PAP levels, and a lower ODI during titration are associated with better adherence, underscoring the importance of personalized treatment approaches. Full article

This study aimed to compare 4 weeks of cranial electrotherapy stimulation (CES) versus cognitive behavioral therapy for insomnia (CBT-I) in athletes with poor sleep quality pre-competition as measured by changes in daily mood state and physiologic parameters of sleep. Athletes with poor sleep quality in their pre-competition phase were recruited. Four weeks of CES and CBT-I were used to compare the effects on daily mood state and physiologic parameters of sleep. The participants were divided into a CES and a CBT-I group. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Profile of Mood States (POMS), nighttime heart rate variability (HRV), and sleep architecture of cardiopulmonary coupling (CPC) analyses were assessed before and after the interventions. Twenty-four participants (time to competition = 46.71 ± 11.21 days) completed the study. Decreases in PSQI and ESS scores were observed in both groups. A decrease in confusion and tension scores and improvement of sleep efficiency were noted after CBT-I (p < 0.05). Changes in light sleep (stages S1 and S2) and deep sleep (stages S3 and S4) were observed (p < 0.05), accompanied by alterations in HRV (p < 0.05). Both interventions for athletes experiencing poor sleep quality before competition had efficacy in improving sleep quality and reducing daytime sleepiness. CES could cause alterations in sleep architecture and autonomic nervous regulation, and CBT-I contributed to a reduction in negative mood states. This study is tiny and limited by the absence of a control group, which may introduce psychological bias, and future research should include control conditions and extended follow-up assessments to validate these findings. Full article

Background: Excessive daytime sleepiness (EDS) and fatigue are two impactful symptoms, frequently associated with sleep disorders, which can worsen the quality of life. Due to overlapping features and patient-report ambiguity a clear-cut distinction between EDS and fatigue can become a challenging issue. We aimed to investigate the prevalence and consequences of these two conditions in several sleep pathologies, examining their social, psychological, and dietary impact, with a focus on gender-related differences and occupational status. Methods: We prospectively recruited for an online survey 136 adult outpatients (60 females) affected by various sleep disorders and admitted to our Sleep Disorders Center in Parma, Italy. Patients were asked to complete the following tests: Epworth Sleepiness Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Difficulties in Emotion Regulation Scale, Depression Anxiety Stress Scale-21, Hyperarousal Scale, the Addiction-like Eating Behaviors Scale, Work Productivity and Activity Impairment Questionnaire, MEDI-Lite, and EQ-5D Health Questionnaire. Results:Fatigue was the primary daily symptom leading to serious repercussions on social/emotional and psychological well-being, while daytime sleepiness showed a less relevant role. Women reported higher levels of fatigue, sleep disturbances, emotional dysregulation, hyperarousal, and work productivity impairments. Unemployed people experienced a higher degree of fatigue, with multi-level negative consequences. Conclusions: We suggest sleep clinicians place a greater emphasis on the assessment of fatigue during clinical interviews, keeping in mind the greater vulnerability of females, experiencing disproportionate consequences. Further studies should expand our findings, exploring a wider range of gender identities and recruiting larger samples of patients. Full article