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Sleep disturbances have been shown to result in considerable morbidity and mortality. It is important for dental clinicians to understand the neuroscience behind sleep disorders. The authors conducted a search of the literature published from January 1990 through March 2024 of sleep medicine–related articles, with a focus on neuroscience. The authors prioritized articles about the science of sleep as related to dental medicine. The authors found a proliferation of articles related to sleep neuroscience along with its implications in dental medicine. The authors also found that the intricate neuroscientific principles of sleep medicine are being investigated robustly. The salient features of, and the differences between, central and obstructive sleep apneas have been elucidated. Sleep genes, such as CRY, PER1, PER2, and CLOCK, and their relationship to cancer and neurodegeneration are also additions to this rapidly developing science. The dental clinician has the potential to be the first to screen patients for possible sleep disorders and make prompt referrals to the appropriate medical professionals. This can be lifesaving as well as minimize potential future morbidity for the patient. [ABSTRACT FROM AUTHOR]

Background: Poor sleep is an unrecognized problem among cancer survivors that affects quality of life. However, screening for sleep disorders is not routine in cancer care. To fill this gap, a self-paced online training program was designed for RNs to screen patients for sleep disturbance and provide brief intervention or referral for treatment (Sleep-SBIRT). Method: A three-phase evaluation pilot study included the following steps: (a) develop an online training program with in situ simulation; (b) implement the program with RNs at a comprehensive cancer center; and (c) evaluate module and quiz completion rates and focus group thematic analysis. Results: Of the 22 RNs participating, 17 completed online modules and in situ simulation. The RNs were satisfied (M = 4.74/5, SD = 0.42) and self-confident (M = 4.45/5, SD = 0.45) with the learning. Focus group themes were learning new knowledge, learning online effectively, applying learning to in situ simulation, and intending to implement. Conclusion: The RNs gained knowledge applying Sleep-SBIRT, but future larger studies are warranted. [J Contin Educ Nurs. 2024;55(8):387–392.] [ABSTRACT FROM AUTHOR]

Background: Poor quality of sleep is a widespread issue in modern society, and even children are being diagnosed with sleep disorders nowadays. Sleep disruption in children can lead to poor mental health in the long term. The present study aimed to evaluate the association between sleep disorders and subsequent depression in children and adolescents. Methods: This retrospective cohort study used electronic medical records from the IQVIATM Disease Analyzer database. It included children and adolescents aged 6–16 with an initial diagnosis of a sleep disorder and age- and gender-matched patients without sleep disorders treated by one of 274 office-based pediatricians in Germany between January 2010 and December 2022. The five-year cumulative incidence of depression in the cohorts with and without sleep disorders was studied with Kaplan–Meier curves using the log-rank test. Multivariable Cox regression analyses were used to assess the association between sleep disorders and depression. Results: The present study included 10,466 children and adolescents with and 52,330 without sleep disorder diagnosis (mean age 10 ± 3 years, 48% female). Within five years after the index date, 5% of sleep disorder patients and 2% of the matched non-sleep disorder cohort had been diagnosed with depression. A strong and significant association was observed between sleep disorders and subsequent depression (HR: 2.34; 95% CI: 2.09–2.63). This association was stronger in adolescents (HR: 3.78; 95% CI: 3.13–4.56) than in children. Upon the exclusion of depression diagnoses in the first year after the index date, the association between sleep disorders and depression remained strong and significant (HR: 1.92; 95% CI: 1.68–2.19). Conclusions: This study indicates a strong and significant association between sleep disorders and depression. [ABSTRACT FROM AUTHOR]

Background: Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25–85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. Methods: Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6–14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. Results: Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. Conclusions: Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep. [ABSTRACT FROM AUTHOR]

Introduction: Sleep hygiene education (SHE) consists of environmental and behavioral practices primarily intended to reduce sleep problems. Currently considered ineffective as a stand-alone treatment, the manner in which the education is typically delivered may be ineffective for the acquisition of new knowledge. The purpose of this study was to determine if a more engaging teaching medium may improve the efficacy of sleep hygiene education. This study examined the use of game-based learning to teach SHE to individuals with sleep problems. Methods: 35 participants played the SHE games for 30 days. Differences in preand post-state anxiety and sleep quality measures were examined. Results: Participants had significant improvements in sleep quality and state anxiety after using the app for 30 days, although scores for the majority of patients remained elevated. Discussion: This pilot investigation provides initial evidence for the efficacy of a game-based approach to SHE. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine sleep disturbances and resilience in the first-degree relatives of patients in a tertiary intensive care unit (ICU) and to investigate the relationship between sleep quality and resilience. Materials and Methods: The study included 65 voluntary participants who were the first-degree relatives of critical patients. The Pittsburgh sleep quality index (PSQI) and the resilience scale for adults (RSA) were used. Results: A sleep disorder was found in 34 (52.3%) of the participants in the study. The PSQI values of the participants ranged from 0 to 17, with an average of 6.35±3.586 standard deviation (SD). When the PSQI and the subcomponents of the index were compared according to gender, the proximity of the participants to the patient, educational status of the participants and, marital status of the participants, no statistically significant relationship was found. The average score for the RSA was 123.93±24.093 SD and it was seen that the participants had a good level of resilience. No statistically significant relationship was found between resilience and sleep in the relatives of the patients treated in the tertiary ICU. Conclusion: In this study, the relationship between resilience and sleep quality in the relatives of patients was examined, and no correlation was found. However, it was observed that the ICU patients had significantly impaired sleep quality markers compared to healthy individuals in the community. [ABSTRACT FROM AUTHOR]

Sleep staging has a very important role in diagnosing patients with sleep disorders. In general, this task is very time-consuming for physicians to perform. Deep learning shows great potential to automate this process and remove physician bias from decision making. In this study, we aim to identify recent trends on performance improvement and the causes for these trends. Recent papers on sleep stage classification and interpretability are investigated to explore different modeling and data manipulation techniques, their efficiency, and recent advances. We identify an improvement in performance up to 12% on standard datasets over the last 5 years. The improvements in performance do not appear to be necessarily correlated to the size of the models, but instead seem to be caused by incorporating new architectural components, such as the use of transformers and contrastive learning. [ABSTRACT FROM AUTHOR]

Aims: To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings. Design: A qualitative descriptive study. Data were collected via semi‐structured interviews. Methods: In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized. Results: Six themes and 20 sub‐themes were identified. Non‐validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed. Conclusion: Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness. Impacts: The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post‐cardiac event counselling. Reporting Method: Adherence to COREQ guidelines was maintained. Patient or Public Contribution: No Patient or Public Contribution as this study explored health professionals' experiences only. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Many self-reported sleep instruments have been developed and adapted into many languages, including Turkish, and their psychometric properties have been examined. This study aims to present a literature review on self-report instruments adapted into Turkish and used to assess different aspects of sleep in child, adolescent, and adult populations. Terms related to sleep self-report instruments were applied to 4 search engines: PubMed, EMBASE, Scopus, and Google Scholar. The search engines were searched for articles published until October 2023. Assessment instruments whose psychometric properties were not evaluated in Turkish language were excluded from the study. This study defined 27 sleep instruments, including 9 child and adolescent and 18 adult sleep instruments. Increasing the availability of Turkish sleep tools for children and adult will improve the chance of intervention by increasing the identification of sleep disorders. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression are frequently comorbid yet phenotypically distinct. This study identifies differences in the clinically observable phenome across a wide variety of physical and mental disorders comparing patients with diagnoses of depression without anxiety, anxiety without depression, or both depression and anxiety. Methods: Using electronic health records for 14 994 participants with depression and/or anxiety in the Mayo Clinic Biobank, a phenotype-based phenome-wide association study (Phe2WAS) was performed to test for differences between these groups across a broad range of clinical diagnoses observed in the electronic health record. Additional analyses were performed to determine the temporal sequencing of diagnoses. Results: Compared to patients diagnosed only with anxiety, those diagnosed only with depression were more likely to have diagnoses of obesity (OR 1.75; p = 1 × 10−27), sleep apnea (OR 1.71; p = 1 × 10−22), and type II diabetes (OR 1.74; p = 9 × 10−18). Compared to those diagnosed only with depression, those diagnosed only with anxiety were more likely to have diagnoses of palpitations (OR 1.91; p = 2 × 10−25), benign skin neoplasms (OR 1.61; p = 2 × 10−17), and cardiac dysrhythmias (OR 1.45; p = 2 × 10−12). Patients with comorbid depression and anxiety were more likely to have diagnoses of other mental health disorders, substance use disorders, sleep problems, and gastroesophageal reflux relative to isolated depression. Conclusions: While depression and anxiety are closely related, this study suggests that phenotypic distinctions exist between depression and anxiety. Improving phenotypic characterization within the broad categories of depression and anxiety could improve the clinical assessment of depression and anxiety. [ABSTRACT FROM AUTHOR]

Copyright of FACSalud is the property of Revista FACSalud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sleep disturbances are serious issues in individuals with end stage kidney disease because they are associated with worsening kidney function and other negative health outcomes, especially in older adults. Our analysis aimed to provide clinicians with the conceptual clarity required for managing sleep disturbances in older patients who are receiving dialysis. A literature review revealed three attributes that define this population's sleep disturbances: sleep initiation and maintenance difficulties, restless sleep and short sleep, and abnormal breathing during sleep. Con - sidering the serious consequences and correlates of sleep disturbances in older patients who are receiving dialysis, tailored interventions are needed to improve their sleep. Our literature review, concept analysis, and case studies provide key information for designing future mechanistic, clinical-translational, and interventional research. [ABSTRACT FROM AUTHOR]

Aim: Sleep is an essential part of a healthy life. Many people experience insomnia due to their living conditions. Matrix metalloproteinases (MMPs) play an essential role in remodeling the microenvironment. Tissue inhibitors of MMPs (TIMPs) maintain a balance with MMPs. Disruption of the balance causes various pathologies. The aim of the study is to elucidate the effects of sleep disturbance on matrix metalloproteinases and inhibitors by comparing MMP-2/TIMP-2 and MMP-9/TIMP-1 ratio in the serum of patients with chronic insomnia to healthy controls. Materials and Methods: This study included 40 adult males diagnosed with chronic insomnia and 40 healthy individuals as a control group. Blood samples were obtained from the brachial vein and subsequently centrifuged at 2,000 rpm for 15 minutes to collect serum samples. MMP-2, MMP-9, TIMP-1, and TIMP-2 levels were analyzed using commercial Enzyme-linked immunosorbent assay (ELISA) kit protocols with the obtained serum samples. Results: Consequently, in this study it was demonstrated a higher MMP-2/TIMP-2 ratio in chronic insomnia patients when compared to healthy controls, whereas the MMP-9/TIMP-1 ratio remained unchanged. Conclusion: These results suggest that higher MMP2/TIMP2 ratio may potentially contribute to the pathogenesis of diseases associated with sleep deprivation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Appropriate diagnosis of sleep problems is crucial, given the importance of sleep in childhood development. The Sleep Self‐Report Scale (SSRS) is used to assess children's sleep problems in the United States and Spain, and this study aimed to expand the usability of this instrument by evaluating its validity and reliability in Turkish children. Methods: Between March 2019 and December 2019, this methodological, descriptive, correlational study was conducted on 1138 children. The sociodemographic information form and the SSRS were used to collect data. Factor analysis, Cronbach's alpha, and item‐total score analysis were used for data analysis. Results: The scale consists of 23 items and 3 sub‐dimensions. Three sub‐dimensions were observed to explain 58.79% of the total variance. All goodness of fit indices were >0.90 and the root mean square error was <0.08 in the confirmatory factor analysis. For the entire scale, the Cronbach's alpha coefficient is.94. Conclusions: The SSRS was found to be a valid and reliable instrument to identify sleep problems. The factorial structure supported by exploratory and confirmatory analysis examines the most relevant areas of sleep in children. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder characterized by motor and nonmotor symptoms. Neuropsychiatric symptoms include sleep disorders, psychosis, cognitive impairment, depression, and anxiety. Because this neuropsychiatric aspect remains unexplored in such patients, we examined depression and sleep pattern disturbances in such patients. Methodology: All patients with a confirmed PD diagnosis attending an outpatient clinic and a PD support group will participate in this study. After recording the drug name, mechanism of action, frequency and duration of treatment, and examining drug use patterns, patients were assessed on the Hamilton Depression Scale (HAM-D) and the Parkinson's Disease Sleep Scale (PDSS-D). (2) Assess for depression and disturbed sleep patterns. Pearson's correlation test was used for correlations between various variables. Results: Thirty-five patients fulfilling the inclusion criteria and exclusion criteria were enrolled in the study. The mean ± standard deviation age of the patients was 66.46 ± 9.21 years. A total of 6 single drugs and 4 fixed-dose combinations were prescribed in a span of a mean of 6.53 years. Levodopa + carbidopa (125 mg), followed by pramipexole, is the most prescribed drug among the study population. The mean score of the HAM-D Scale of 35 patients was 23.02. The maximum score was 52. The mean score of the PDSS-2 of 35 patients was 22.8 (out of 60) and there was a weak or moderate correlation between the different variables. Conclusion: Major part of the treatment plan in PD patients was levodopa + carbidopa (125 mg). Out of 35 patients, the majority of them were depressed and it could be one of the reasons for nocturnal disturbances based on PDSS-2 scoring. Furthermore, there was a weak correlation between different variables but it was not statistically significant. [ABSTRACT FROM AUTHOR]

Close association has been established between obstructive sleep apnea (OSA) and adolescent idiopathic scoliosis (AIS), with PSQ being employed as a screening method for OSA. A cross-sectional study was conducted among patients aged from 10 to 16 years who presented to a scoliosis outpatient clinic. Patient demographics, radiological assessments, and PSQ scores were gathered. A total of 299 patients were included in the study, with 28.7% males and 71.2% females. The average Cobb angle was 6.20°. PSQ scores revealed a prevalence of 33.4% for significant obstructive sleep apnea. Patients diagnosed with AIS exhibited a prevalence of 32.9% with positive PSQ results. Among those undergoing adenoid and/or tonsil surgery, 27% had positive PSQ scores. Factors such as genetics, abnormal biomechanical forces, environmental factors including melatonin, and intermittent hypoxia were explored for their potential contribution to AIS etiology. The aim of the study is to underscore the importance of early detection and intervention in OSA cases and highlights the effectiveness of the PSQ, as a screening tool in identifying sleep disorders. The findings underscore the complex relationship between OSA and AIS, and moreover any spinal curvature is in relation with OSA. [ABSTRACT FROM AUTHOR]

Healthy sleep and optimal ventilatory control begin in early development and are crucial for positive child outcomes. This paper summarizes information presented at the Sleep and Ventilatory Control sessions of the National Heart, Lung, and Blood-sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop. These sessions focused on pediatric sleep health, screening for sleep health and sleep disorders in primary care using the electronic health record, infant sleep and ventilatory control, and home sleep testing. Throughout this summary, we discuss key gaps in and barriers to promoting sleep and ventilatory health that were identified during the workshop sessions. We conclude with strategies to address these gaps and barriers and directions for future multidisciplinary research, patient care, and training. [ABSTRACT FROM AUTHOR]

Objective: To investigate correlation between cognitive function, age, and sleep disturbances. Methods: This retrospective clinical study enrolled 78 patients with sleep disorders who were divided into three groups: a group of 24 patients with sleep disorders accompanied by cognitive decline (SD-CD); 54 patients with sleep disorders and no cognitive decline (SD-nCD) was divided into two groups, one of 30 patients aged between 60 and 70 years and another of 24 patients aged >70 years. Polysomnography was used to record patients' sleep indicators throughout night; these included total sleep duration, sleep efficiency (SE), sleep latency, sleep structure and percentage of N1, N2, and N3 stages, rapid eye movement (REM) stage, as well as apnea hypopnea index (AHI), and oxygen saturation (OS). Analysis of variance (ANOVA) for continuous variables and chi-square test for categorical variables were used to analyze variables between different groups. Pearson's correlation was used to analyze correlation between sleep parameters and mini-mental state examination (MMSE). Blood samples were used to determine their Ab, Ab40, Ab42, total tau, phosphorylated tau protein (ptau), ptau181, ptau217, the inflammatory factor IL-1b, vitamin B12 (VB12), and melatonin levels. Results: In the SD-CD group, there was a significant decrease in SE and an increase in N1 stage sleep in older patients and a significant increase in AHI, REM stage AHI, and non-REM stage AHI. In patients with SD-nCD, the minimum OS, minimum OS in the REM period, and minimum OS in the non-REM period were significantly reduced. OS was significantly correlated with cognitive level, as evaluated by the MMSE. The addition of sleep parameters can significantly improve the accuracy of dementia diagnosis. Dementia biomarkers of Ab and tau proteins in blood showed cognition-related differences, while ptau181 was associated with both cognition and age-related differences. Regression models revealed that age was related to higher levels of cognitive decline before (b =0.43, P < 0.001) and after (b = 0.38, P < 0.001) adjustment of gender, BMI, and education level. There was a significant mediation effect of relationship between aging and cognitive function by sleep efficiency and N1 stage sleep. Conclusion: Sleep disorders and low OS are associated with a higher incidence of cognitive decline and dementia. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective & Design: Sleep problems are common and have been linked to health problems, diminished well-being, and impaired performance. Many scales to diagnose clinically relevant sleep problems are time-consuming, complex, and difficult to administer in non-clinical and multi-thematic studies. Through a multi-stage translation (from English to German) and scale testing process, we developed a parsimonious measure of sleep problems and daytime functioning for non-clinical applications based on the Athens Insomnia Scale. Results: Exploratory (NStudy 1 = 25,140) and confirmatory (NStudy 2 = 14,797) factor analyses suggest a two-dimensional structure with the subscales "sleep problems" and "daytime functioning". Internal scale consistency was acceptable. Measurement invariance was found across time, gender, age, and diagnosed sleep disorders. The scale discriminates between people with and without sleep disorders and predicts emerging sleep disorders. Short-term retest reliability was acceptable (NStudy 3 = 78). Convergent validity with other sleep measures and discriminant validity with indicators of well-being were observed (NStudy 4 = 341). After a multi-stage translation to English, we confirmed the factor structure and found measurement invariance across languages (NStudy 5 = 623). Conclusion: Our short 7-item scale has good psychometric properties and is suitable for self-administration, making it useful in measuring sleep problems and daytime functioning efficiently and reliably, especially for large population studies. [ABSTRACT FROM AUTHOR]

Objective The study aims to identify the prevalence and risk factors for OSA in a group of Egyptian patients with type 2 diabetes. Methods 125 type 2 diabetes mellitus patients visited Mansoura University Hospital (Diabetes Mellitus Outpatient Clinic (OPC) at Specialized Medical Hospital and the Sleep Disordered Breathing Unit of the Chest Department), all of them exposed to history taking, the patients underwent anthropometric measurements (weight, height, body mass index, neck circumference), a test of their tonsillar size, Malampati score, Friedman OSA score, Epworth sleepiness scale (ESS), Berlin questionnaire, STOP BANG questionnaire, full-night polysomnography, fasting, and postprandial blood sugar. Results The study included 125 T2DM Egyptian patients with a mean age of 54.63 ± 9.47 years. Males accounted for 35.2 percent of patients, while females accounted for 64.8%. According to the study of co-morbidity, hypertension constituted 77 (61.1%), ischemic heart disease 28 (22.4%), other cardiac diseases 11 (8.8%), bronchial asthma 6 (4.8%), liver diseases 6 (4.8%), hypothyroidism 3 (2.4%), and renal diseases 3 (2.4%). A total of seven patients (5.6%) had no OSA symptoms, 87 had borderline symptoms, and 31 had positive symptoms. There were 51 (40.8%) normal patients, 12 (9.6%) borderline patients, and 62 (49.6%) sleepy patients on the Epworth scale. According to the Stop-Bang questionnaire, 121 (96.8%) patients answered positively. It was determined that 122 patients (97.6%) were at high risk based on the Berlin questionnaire. There were 17 patients (13.6%) with OSA on polysomnography, of which six were moderate (35.3%) and 11 were severe (64.7%). Among moderate and severe OSA patients, glycosylated hemoglobin levels differed significantly. Multivariate logistic regression analysis for independent predictors of OSA, chronic renal disease patients is the most common associated risk factor (OR = 14.3, CI = 1.2-67) then hypertension (OR = 5.6, CI=1.2-25.5) and heart failure (OR = 4.4). Conclusions OSA affects 13.6% patients with type 2 diabetes patients who are hypertensive are at higher risk of OSA, chronic renal failure is considered another risk factor Furthers studies are needed on a big scale of Egyptian diabetic patients to detect the prevalence of OSA. [ABSTRACT FROM AUTHOR]

Copyright of Veterinarska Stanica is the property of Croatian Veterinary Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sleep-related hypermotor epilepsy (SHE) should be differentiated from NREM parasomnias in terms of a similar clinical presentation. The lack of ictal and/or interictal epileptic encephalographic (EEG) features in SHE complicates the differential diagnosis. Moreover, epileptic paroxysmal arousal (PA) does not present with associated hyperkinetic motor events typical of SHE, and this should be carefully evaluated from confusional arousal (CA), a type of NREM parasomnia. In this term, this paper aims to present three patients referred to the Sleep and Disorders Unit with the prediagnosis of CA but diagnosed as epileptic PA following video-polysomnography (PSG) with multichannel EEG recordings; and aims to discuss the clinical, EEG, and PSG characteristics of these patients on the basis of literature data. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to develop a sleep problems scale and a coping with sleep problems scale for pregnant women and assess their reliability and validity. Design: An empirical research quantitative design. Review Methods: Self‐reported instruments were developed through (1) item generation, (2) preliminary item evaluation and (3) scale refining and evaluation. Item pools were created via literature review, opinions of experts and women with experience in pregnancy sleep. Content, construct and criterion validities were tested. Reliability was assessed using Cronbach's alpha, split‐half reliability and corrected item‐total correlation. Data Sources: Data were collected between January 23 and July 22, 2020, at a hospital's obstetrics polyclinic. In the pilot and main study, 30 and 368 pregnant women (gestational age: 8–42 weeks) were included, respectively. Results: The content validity index was >0.9 for each scale. Factor analysis showed 24 and 18 items in the two scales, both with four subdimensions. The corrected item‐total correlations were acceptable, and Cronbach's alpha coefficient was 0.883 and 0.799, respectively. Conclusion: Both scales developed in this study are valid and reliable for the Turkish society. Implications for the profession and/or patient care/global clinical community: This study's findings may prevent the lack of validated screening instruments to identify pregnancy‐specific sleep features. Impact We developed two scales to assess sleep problems in pregnant women. These were valid and reliable, can be routinely used by health professionals and may guide nurses and midwives in assessing and managing sleep problems during pregnancy. Reporting Method: The study conforms to the COSMIN checklist. Patient or Public Contribution: Data were collected during face‐to‐face surveys. Ten women contributed to the item pool generation, 30 pregnant women participated in the pilot study, and 368 antenatal service users participated in the main study. [ABSTRACT FROM AUTHOR]

Purpose: To describe and compare demographic characteristics and comorbidities of rural and urban Veterans diagnosed with sleep disorders, and to evaluate whether rurality is a disparity for sleep care among Veterans. Methods: Numbers of Veterans with sleep disorders and comorbid conditions were determined using the Department of Veterans Affairs (VA's) Corporate Data Warehouse, a database that contains detailed clinical information for all Veterans who receive VA health care. Comparisons between urban and rural Veterans were conducted for fiscal years (FY) 2010‐2021. Findings: The prevalence of diagnosed sleep disorders was similar among rural and urban Veterans from FY2010 to 2021 and increased for both groups during this time period. The prevalence of chronic pulmonary disease, congestive heart failure, and diabetes mellitus was higher for rural Veterans with sleep disorders compared to their urban counterparts. From 2012 to 2021, the percentage of rural Veterans who received sleep care at VA facilities was lower than the percentage of urban Veterans who received VA sleep care during the same time span. Conclusions: Although rural Veterans exhibited a higher prevalence of 3 comorbid conditions associated with sleep disorders, the prevalence of sleep disorder diagnoses was similar between rural and urban Veterans. Therefore, it is possible that sleep disorders are underdiagnosed among rural Veterans. The fact that rural Veterans received VA sleep care at a lower rate compared to urban Veterans indicates that rurality is a disparity in access to care in this population. VA is addressing this disparity through a variety of programs, including telehealth initiatives. [ABSTRACT FROM AUTHOR]

Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study's questionnaires. The Cronbach's alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study's findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes. [ABSTRACT FROM AUTHOR]

Restless legs syndrome (or Willis-Ekbom) presents with an overwhelming need for movement of the lower limbs in order to eliminate the unpleasant sensations in them, which appear during rest and sleep. The unpleasant sensations are described as "tingling, pulling or pain" in the knees, ankles, or through the entire lower limbs. Periodic limb movement syndrome presents with involuntary movements of the lower limbs or the body during sleep, for which the patient has no recollection, unlike in those in restless leg syndrome. In most cases they present with four or more successive movements of dorsal flection of the toes and ancles with partial flection of the knees and hips divided into five to 90 second intervals. A 44-year-old man, a taxi driver, is admitted in a neurological clinic with complaints of a headache, dizziness, exhaustion, which he associates with difficulty falling asleep and maintaining a sleeping state after an ischemic stroke in the right middle cerebral artery four months earlier. The conducted polysomnography reveals an increased sleep latency, periodic limb movement syndrome and multiple arousals before entering REM sleep. [ABSTRACT FROM AUTHOR]

»Den Patienten reskalieren. Zur Diagnose schlafbezogener Probleme im Schlaflabor«. The sleep laboratory has become the key site for the study and clinical diagnosis of sleep disorders, with polysomnography (PSG) being the analytical procedure of choice. In this article we argue that, first, during the overall process of being diagnosed at the sleep laboratory, a constant "doing patient" takes place. Second, we show how a constant "re-scaling" of the patient is performed. The patient shifts on a scale between personhood and a physical body, but without ever fully achieving either of these states. The art of successfully performing and creating the patient role collaboratively is precisely one of carefully navigating between these poles and rescaling the patient. With this in mind, we claim that the "body" and the "person" are not just constitutive and predefined entities, but processual units of construction through ongoing interactions. The rescaling of the patient is bound temporally to the (mini-)phases of the overall process of being diagnosed at the sleep laboratory and spatially to various settings within it. This rescaling also differs socially regarding interaction with the complementary roles of the hospital personnel. Even in situations that appear to reduce patients to bodily objects, there are strategies used that maintain the ascription of personhood, shield them against the impact of the loss of being a person, and facilitate the re-transformation of bodies into persons. [ABSTRACT FROM AUTHOR]

Objective: This study was done to investigate the causal links between malocclusion, tongue tone, and jaw structure and the initiation of apneic/hypopneic events during sleep. Structural causes of strain on the lips and downstream tongue collapse were tested using physical models. Methods: Distinct models were used to break down the sequence of apneic events. First, the establishment of the lips as a resting closure mechanism of the mouth was tested. Next, a tongue tone model was used to determine the force required to prevent collapse into the pharynx. Finally, a pharyngeal model was used to evaluate differential negative pressure zones during collapse. Results: The lips may be the primary closure structure of the mouth due to mechanical advantage. The least radial strain placed on the lips permitted better mouth closure. There is a threshold that is required to maintain oral position of the tongue without collapse and resultant buildup of pharyngeal negative pressure. Conclusions: Apneic/hypopneic events can be simplified to 3 steps: (1) failure of mouth closure due to strain upon the lips, (2) release of tongue restraint by oral compression or intrinsic tongue tone causes collapse, and (3) partial or complete tongue collapse into the pharynx causes a distal negative pressure surge. [ABSTRACT FROM AUTHOR]

Background: Sleep is vital for adolescents' physical and emotional development; however, sleep disturbances and disorders frequently occur in this age group and affect their health and well-being. In this review, we investigated the prevalence, etiology, diagnosis, clinical characteristics, and treatment of sleep disorders observed among adolescents. Current Concepts: The diagnostic criteria for insomnia disorder among adolescents include difficulties in falling asleep, maintaining sleep, or waking up too early and feeling unrefreshed, which are observed at least 3 days per week over 3 or more months. Cognitive-behavioral therapy for insomnia typically includes identifying and addressing negative thoughts and behaviors associated with sleep and establishing a consistent sleep-wake schedule. Delayed sleep phase syndrome is diagnosed in individuals in whom sleep onset and wake times are persistently delayed by 2 or more hours beyond the desired or existing sleep schedule, which leads to excessive daytime sleepiness or impaired functioning. Behavioral interventions comprise sleep hygiene education, relaxation techniques, and phototherapy. Symptoms such as pronounced snoring, apnea observed by others, and gasping or pauses in breathing during sleep may indicate sleep apnea. Continuous positive airway pressure therapy is an effective treatment strategy for sleep apnea. A history of excessive daytime sleepiness and cataplexy suggests narcolepsy, and treatment options include pharmacotherapy, behavior modification, and lifestyle adjustments. Restless leg syndrome treatments include behavioral therapy, as well as anticonvulsant and dopamine receptor agonist administration. Discussion and Conclusion: Addressing sleep disorders is important to promote optimal health and well-being of adolescents and requires a multidisciplinary approach. Early detection, accurate diagnosis, and individualized treatment improve sleep and overall health outcomes and promote academic and social success. [ABSTRACT FROM AUTHOR]

AASM guidelines are the result of decades of efforts aiming at standardizing sleep scoring procedure, with the final goal of sharing a worldwide common methodology. The guidelines cover several aspects from the technical/digital specifications, e.g., recommended EEG derivations, to detailed sleep scoring rules accordingly to age. Automated sleep scoring systems have always largely exploited the standards as fundamental guidelines. In this context, deep learning has demonstrated better performance compared to classical machine learning. Our present work shows that a deep learning-based sleep scoring algorithm may not need to fully exploit the clinical knowledge or to strictly adhere to the AASM guidelines. Specifically, we demonstrate that U-Sleep, a state-of-the-art sleep scoring algorithm, can be strong enough to solve the scoring task even using clinically non-recommended or non-conventional derivations, and with no need to exploit information about the chronological age of the subjects. We finally strengthen a well-known finding that using data from multiple data centers always results in a better performing model compared with training on a single cohort. Indeed, we show that this latter statement is still valid even by increasing the size and the heterogeneity of the single data cohort. In all our experiments we used 28528 polysomnography studies from 13 different clinical studies. [ABSTRACT FROM AUTHOR]

Introduction In order to better treat obstructive sleep apnea (OSA) in a more efficient and cost-effective way, a joint program between dental clinics and the sleep medicine clinic was piloted at Fort Hood, Texas. Obstructive sleep apnea negatively affects soldier readiness and deployability, leading to the need to establish a successful and proven workflow to treat these patients with oral appliance therapy (OAT). Materials and Methods We performed a retrospective review of a de-identified data set which included 288 patients from July 2016 to July 2020. Projected cost data were obtained from routinely collected sleep clinic positive airway pressure (PAP) data. Data were analyzed to determine treatment success and potential cost savings using OAT versus continuous positive airway pressure (CPAP). Patient workflow including successes and challenges with the program is summarized. Results About 85.5% of patients met criteria for successful control of their OSA using OAT as treatment. Five patients did not tolerate OAT and switched back to CPAP. A higher (less severe) O2 nadir on diagnostic polysomnography is moderately correlated with OAT success. Diagnostic Apnea–Hypopnea Index was inversely and weakly correlated with success. Two of the major challenges noted in the program were (1) loss of follow-up and (2) the length of time from oral appliance referral to fitting the oral appliance. If this program was successfully implemented at other Defense Health Agency (DHA) medical treatment facility (MTF) markets nationwide, a potential cost savings of over $500,000/year/MTF could be achieved. Conclusions Oral appliance therapy has the potential to increase both readiness and deployability for active duty soldiers. Using baseline O2 nadir can help predict success with OAT patients, determining which patients will benefit from this joint program between the dental and medical sleep clinics. Future studies can aim to establish an evidence-based pathway for clinic testing and follow-up. If this patient workflow is implemented properly, there can be significant cost savings army-wide. This all helps The United States Medical Command (MEDCOM) align with the DHA's Quadruple Aim of increased readiness, better health, better care, and lower cost. [ABSTRACT FROM AUTHOR]

Various physiological systems and behaviors such as the sleep-wake cycle, vigilance, body temperature, and the secretion of certain hormones are governed by a 24-hour cycle called the circadian system. While there are many external stimuli involved the regulation of circadian rhythm, the most powerful environmental stimulus is the daily light-dark cycle. Blind individuals with no light perception develop circadian desynchrony. This leads to non-24-hour sleep-wake rhythm disorder, which is associated with sleep-wake disorders, as well as mood disorders and loss of appetite and gastrointestinal disturbances due to disrupted circadian hormone regulation. As the diagnosis is often delayed because of under-recognition in clinical practice, patients must cope with varying degrees of social and academic dysfunction. Most blind individuals report that non-24-hour sleep-wake rhythm disorder affects them more than blindness. In the treatment of totally blind patients suffering from non-24-hour sleep-wake rhythm disorder, the first-line management is behavioral approaches. Drug therapy includes melatonin and the melatonin agonist tasimelteon. Diagnosing blind individuals' sleep disorders is also relevant to treatment because they can be improved with the use of melatonin and its analogues or by phototherapy if they have residual vision. Therefore, assessing sleep problems and planning treatment accordingly for individuals presenting with blindness is an important issue for ophthalmologists to keep in mind. [ABSTRACT FROM AUTHOR]

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. Objective: The aim of this study was to present comprehensive and short‐form adaptations of Axis I and Axis II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings. Methods: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children. Results: The proposed adaptation is suitable for children aged 6–9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, (ii) adding anxiety and depression assessments that have been validated in children and (iii) adding three constructs (stress, catastrophising and sleep disorders) to assess psychosocial functioning in children. Conclusion: The recommended DC/TMD, including Axis I and Axis II, for children aged 6–9 years, is appropriate for use in clinical and research settings. This adapted the first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation. [ABSTRACT FROM AUTHOR]

Sleep problems are common clinical considerations in older adults, though their interface with substance use disorders has received scant attention in the geriatric age group. This review aims to provide an overview of the relation of sleep problems and substance use disorder in older adult population. This was a narrative review conducted through electronic searchers. The studies of relevance were referred to, and the findings were synthesized under the headings of prevalence and etiology, assessment, and management. Literature suggests that sleep problems may be more common among substance users (particularly alcohol users) who have higher age. The pathophysiology of sleep issues in older adults is often multifactorial, and the individual contribution of substance use disorders needs to be teased out through thorough assessment. Management of sleep issues in older adults should include nonpharmacological approaches in addition to the pharmacological ones. Adequate management of sleep problems in older adult substance users remains a challenge, which can be addressed by careful consideration on a case-to-case basis. Further research is required on the different aspects of sleep issues in older adults with substance use disorders. [ABSTRACT FROM AUTHOR]

Herein the major accomplishments, trials and tribulations, and epiphanies experienced by James M. Krueger over the course of his career in sleep research are presented. They include the characterization of a) the supranormal EEG delta waves occurring during NREMS post sleep loss, b) Factor S as a muramyl peptide, c) the physiological roles of cytokines in sleep regulation, d) multiple other sleep regulatory substances, e) the dramatic changes in sleep over the course of infectious diseases, and f) sleep initiation within small neuronal/glial networks. The theory that the preservation of brain plasticity is the primordial sleep function is briefly discussed. These accomplishments resulted from collaborations with many outstanding scientists including James M. Krueger's mentors (John Pappenheimer and Manfred Karnovsky) and collaborators later in life, including Charles Dinarello, Louis Chedid, Mark Opp, Ferenc Obal jr. Dave Rector, Ping Taishi, Linda Toth, Jeannine Majde, Levente Kapas, Eva Szentirmai, Jidong Fang, Chris Davis, Sandip Roy, Tetsuya Kushikata, Fabio Garcia-Garcia, Ilia Karatsoreos, Mark Zielinski, and Alok De, plus many students, e.g. Jeremy Alt, Kathryn Jewett, Erika English, and Victor Leyva-Grado. [ABSTRACT FROM AUTHOR]

Study Objectives To determine the trajectory of: (i) objective sleep parameters and (ii) caregiver-reported sleep questionnaire scores over 3 years in children with Smith-Magenis syndrome (SMS) compared to age-matched typically developing (TD) controls. We also aimed to (iii) describe individual profiles of change in sleep parameters over time. Methods Week-long, overnight actigraphy and questionnaire data from 13 children with SMS and 13 age-matched TD children were collected at Time 1 and Time 2 (3 years later). Independent samples t -tests, paired samples t -tests, and Bayesian analyses were used to compare sleep parameters and sleep questionnaire scores between groups at each time point and compare data within groups to assess change over time. Results Sleep parameters were consistently more disrupted in the SMS group than the TD group, with significantly reduced sleep efficiency, increased wake after sleep onset and earlier get up times at both time points. This was mirrored in the questionnaire data, with children with SMS evidencing higher scores for overall sleep disturbance, night waking, and daytime sleepiness. While TD sleep parameters demonstrated expected developmental changes over 3 years, in the SMS group sleep parameters and variability between and within children remained largely stable. However, some children with SMS showed substantial variation in sleep parameters over time. Questionnaire scores remained stable over 3 years in both groups. Conclusions Overall, sleep disturbance appears to be a stable feature of SMS, indicative of a divergent sleep trajectory compared to TD peers. Proactive intervention approaches should be considered for poor sleep in SMS. [ABSTRACT FROM AUTHOR]

The body of research that reports the relevance of sleep in high-performance sports is growing steadily. While the identification of sleep cycles and diagnosis of sleep disorders are limited to lab-based assessment via polysomnography, the development of activity-based devices estimating sleep patterns provides greater insight into the sleep behavior of athletes in ecological settings. Generally, small sleep quantity and/or poor quality appears to exist in many athletic populations, although this may be related to training and competition context. Typical sleep-affecting factors are the scheduling of training sessions and competitions, as well as impaired sleep onset as a result of increased arousal prior to competition or due to the use of electronic devices before bedtime. Further challenges are travel demands, which may be accompanied by jet-lag symptoms and disruption of sleep habits. Promotion of sleep may be approached via behavioral strategies such as sleep hygiene, extending nighttime sleep, or daytime napping. Pharmacological interventions should be limited to clinically induced treatments, as evidence among healthy and athletic populations is lacking. To optimize and manage sleep in athletes, it is recommended to implement routine sleep monitoring on an individual basis. [ABSTRACT FROM AUTHOR]

• Consumer sleep technologies (CSTs) are the numerous software and hardware products that claim to monitor and even enhance sleep. • At this time, CSTs cannot be used for the diagnosis or treatment of sleep problems. • Orthosomnia is the name for a CST-driven obsession with getting the best possible sleep. [ABSTRACT FROM AUTHOR]

Objectives: Telemedicine was increasingly adopted in otolaryngology as a result of the COVID-19 pandemic, but how it compares to in-person visits over the longitudinal course of the pandemic has not been characterized. This study compares telemedicine visits to in-person visits on measures of clinical efficiency and patient satisfaction. Methods: We examined all in-person and telemedicine encounters that occurred during the 13-month period from April 1, 2020 to April 30, 2021 at a pediatric otolaryngology clinic associated with a large tertiary care children's hospital. We compared patient demographics, primary encounter diagnoses, completions, cancellations, no-shows, cycle time, and patient satisfaction. Results: A total of 19 541 (90.5%) in-person visits and 2051 (9.5%) telemedicine visits were scheduled over the study period. There was no difference in patient age or gender between the visit types. There was a difference in race (75% White or Caucasian for in-person and 73% for telemedicine, P =.007) and average travel distance (53.3 miles for in-person vs 71.0 for telemedicine, P =.000). The most common primary diagnosis was Eustachian tube dysfunction for in-person visits (11.8%) and sleep disordered breathing for telemedicine visits (13.7%). Completion rate was greater for telemedicine visits (52.4% in-person vs 62.5% telemedicine). Cancellations were greater for in-person visits (42.6% in-person vs 24.2% telemedicine), but no-shows were greater for telemedicine (5.0% in-person vs 13.3% telemedicine, all P =.000). Average cycle time was shorter for telemedicine visits (56.5 minutes in-person vs 47.6 minutes telemedicine, P =.000). Patient satisfaction with provider interactions and overall care experience was high for both visit types. Conclusions: Telemedicine was utilized more during months of heightened COVID-19 cases, with higher completion rates, fewer cancellations, shorter cycle times, saved travel distance, and comparable patient satisfaction to in-person visits. Telemedicine has the potential to remain an efficient mode of care delivery in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Purpose: Identify the predictors of common mental disorders (CMD) and psychiatric medication use by faculty members in different teaching units of a public university. Design and Methods: A cross‐sectional study on 253 faculty. Findings: Being single, not having children, and not practicing physical activity were identified as predictors of CMD. Relative to psychiatric medication use, the predictors were the following: being homosexual, teaching classes in the biological sciences field, using medication for the urinary tract and sexual hormones, presenting mental disorder/sleep disorder diagnoses, and being positive for CMD. Practice Implications: The findings of this study may subsidize more effective interventions aimed toward protecting the health and preventing aggravation in these professionals, as well as measures for promoting changes in the university work context. Design and Methods: A cross‐sectional study on 253 faculty. Findings: Being single, not having children, and not practicing physical activity were identified as predictors of CMD. Relative to psychiatric medication use, the predictors were the following: being homosexual, teaching classes in the biological sciences field, using medication for the urinary tract and sexual hormones, presenting mental disorder/sleep disorder diagnoses, and being positive for CMD. Practice Implications: The findings of this study may subsidize more effective interventions aimed toward protecting the health and preventing aggravation in these professionals, as well as measures for promoting changes in the university work context. [ABSTRACT FROM AUTHOR]

Background Periodic limb movement during sleep (PLMS) could exist with patients diagnosed as obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the most competent therapy for OSA. However, its effect on PLM remains controversial. Aim To evaluate PLMS prevalence in OSA patients and the impact of CPAP titration on PLM outcome. Patients and methods Patients with history suggestive of OSA underwent full attended diagnostic and CPAP titration sleep study. On baseline polysomnography, OSA patients with PLM less than 5 were considered pure OSA and those with periodic limb-movement index more than or equal to 5 were considered combined group. Post-CPAP titration, patients were considered CPAP responders, CPAP persistent, CPAP emergent, or non-PLM group according to response of PLM. Results Out of 100 included OSA patients, the combined group was found in 53 patients. CPAP responder group was reported in 27 patients, while 25 and 24 patients were considered CPAP persistent and CPAP emergent, respectively. CPAP-emergent group showed significantly higher apnea–hypopnea index (AHI) than non-PLM group on baseline polysomnography. On the other hand, AHI was comparable in CPAP-persistent and responder group, despite normalization of AHI in both groups after titration. On multivariate regression analysis, old age was found to be an independent predictor for both persistence and emergence of PLM and higher AHI was an independent predictor in CPAP-emergent group. Conclusion PLMS can coexist with OSA in old-age patients, which may persist after CPAP titration. Elderly patients, especially those with baseline higher AHI, may also present with CPAP-emergent PLMS. [ABSTRACT FROM AUTHOR]

Introduction  Obstructive sleep apnea (OSA) syndrome is a highly prevalent problem in children. Unfortunately sleep disorders in children remain largely unreported and underdiagnosed due to various reasons. Overnight in-laboratory polysomnography (PSG) is the gold standard diagnostic method for OSA; however, it has several drawbacks. Hence there is a need for simple alternative diagnostic methods, such as biomarkers. Children with OSA seem to have an inflammatory aspect to its pathophysiology; thus the rationale for evaluating inflammatory biomarkers. Objective  This narrative review aimed to evaluate the existing knowledge regarding inflammatory biomarkers for children with sleep disorders. Materials and Methods  An extensive search of all literature linked to the topic was performed in PubMed, Medline, EBSCOhost, Cochrane library database CENTRAL, and Google Scholar search engine. Keywords used in the search included combinations of the following: inflammation, sleep disorders, children, and biomarkers. Studies in the list of references of relevant literature were also included. A total of 155 articles published in the period from 1997 to 2021 were initially included in this review. Selected articles comprised original research, meta-analysis, and systematic reviews. Results  Studies have mainly centered their investigations on serum inflammatory biomarkers, namely interleukin-6, tumor necrosis factor-α, and C-reactive protein. Very few studies investigated salivary inflammatory biomarkers in children. Conclusion  Evidence suggests that children with sleep disorders have elevated levels of salivary as well as serum inflammatory biomarkers in comparison to normal healthy children. Also increased levels of these biomarkers correlate with disease severity. However, more studies are needed to determine the sensitivity and specificity of salivary inflammatory biomarkers for children with sleep disorders. [ABSTRACT FROM AUTHOR]

Acute SARS-CoV-2 infections in children and adolescents are usually mild. However, they can suffer from ongoing symptoms, generally referred to as long COVID. Sleep disorders are one of the most frequent complaints in long COVID although precise data are missing. We assessed the sleep behavior of children and adolescents who presented at our outpatient clinic between January 2021 and May 2022 with the Children's Sleep Habits Questionnaire (CSHQ-DE). We compared the sleep behavior at three different time points: pre-COVID-19; post-COVID-19 at the initial presentation; and post-COVID-19 at re-presentation. Data from 45 patients were analyzed. Of those, 64% were female and the median age was 10 years (range: 0–18 years). Asymptomatic or mild COVID-19 disease was experienced in 89% of patients; 11% experienced moderate disease. The initial presentation occurred at a median of 20.4 weeks (6 weeks–14 months) after the infection. The CSHQ-DE score increased significantly from pre-COVID-19 (45.82 ± 8.7 points) to post-COVID-19 (49.40 ± 8.3 points; p ≤ 0.01). The score then normalized at re-presentation (46.98 ± 7.8; p = 0.1). The greatest changes were seen in the CSHQ-DE subscale score "daytime sleepiness". Our data showed that children and adolescents with long COVID often suffer from sleep disturbances. For most children and adolescents, these sleep disorders decreased over time without any further medical intervention aside from a basic sleep consultation. [ABSTRACT FROM AUTHOR]

Background. Sleep disorders affect an individual's mental and physical health and vice versa. Sleep medicine is underrecognized as a specialty; therefore, many sleep disorders go undiagnosed. This study is aimed at assessing the knowledge of medical students toward circadian neuroscience and sleep disorder based on biomedical diagnosis. Methods. This cross-sectional study was conducted in both male and female medical colleges from the third to the sixth year. A self-administered structured questionnaire consisting of sociodemographic data and the Assessment of Sleep Knowledge in Medical Education (ASKME) survey assessed the students' general knowledge and attitude towards sleep disorder and sleep medicine. Chi-square/Fisher exact tests were used to analyse the participants' knowledge level toward specific sociodemographic data. Also, for two-level continuous variables, the Wilcoxon two-sample test was used. Results. The total number of participants was 296, with 154 female and 142 male participants. The prevalence of inadequate knowledge was considerable with 96.62% of students, compared to adequate knowledge with only 3.38%. The students' attitude to sleep medicine was negative 14.53% and positive among 85.47%. We found that gender was significantly associated with attitude with a p value = 0.0057. The specific interest in sleep medicine had a significant association with knowledge and attitude, p value of 0.0522 and 0.0059, respectively. Conclusion. This study concluded that medical students possess inadequate knowledge regarding sleep medicine, yet they have a positive attitude towards it. [ABSTRACT FROM AUTHOR]

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) domains for sleep disturbance, anxiety, and dyspnea have been under-reported for total joint arthroplasty (TJA). The aims of this study were to report postoperative differences for these domains based on TJA location and chronic pain state. We also investigated whether these domains were associated with physical function and pain interference outcomes. Methods: This was a retrospective, observational study of patients who underwent hip, knee, or shoulder TJA (primary and revision surgeries) at a single academic tertiary referral center. A subset of these patients completed an email-based survey for chronic pain grade (Chronic Pain Grade Scale-Revised) and sleep disturbance, anxiety, dyspnea, physical function, and pain interference (PROMIS short forms). Pre-operative and operative data were extracted from the electronic health record. Data analysis investigated PROMIS domains for differences in TJA location and chronic pain grade. Hierarchical linear regression determined associations of these domains with physical function and pain interference. Results: A total of 2638 individuals provided informed consent and completed the email survey. In the ANOVA models for sleep disturbance, anxiety, and dyspnea, there was no location by chronic pain grade interaction (p > 0.05) and no difference based on TJA location (p > 0.05). There were differences for chronic pain grade (p < 0.01). The poorest postoperative outcome score for each domain was associated with high impact chronic pain. Furthermore, sleep disturbance and dyspnea had the strongest associations with physical function and pain interference (p < 0.01). Conclusions: Sleep disturbance, anxiety, and dyspnea did not vary based on TJA location, but were associated with postoperative chronic pain grade. Sleep disturbance and dyspnea were strongly associated with commonly reported outcomes of physical function and pain interference. These findings provide guidance for those interested in expanding TJA outcome assessment to include sleep disturbance, anxiety, and/or dyspnea. [ABSTRACT FROM AUTHOR]