Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was e...Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.展开更多
Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applicatio...Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applications.Existing schemes are limited by flexibility,biosafety,and manufacturing costs,which create large barriers for wider applications.Here,we present a novel flexible MNA electrode that can simultaneously achieve flexibility of the substrate to fit a curved body surface,robustness of microneedles to penetrate the skin without fracture,and a simplified process to allow mass production.The compatibility with wearable wireless systems and the short preparation time of the electrodes significantly improves the comfort and convenience of electrophysiological recording.The normalized electrode–skin contact impedance reaches 0.98 kΩcm^(2)at 1 kHz and 1.50 kΩcm^(2)at 10 Hz,a record low value compared to previous reports and approximately 1/250 of the standard electrodes.The morphology,biosafety,and electrical/mechanical properties are fully characterized,and wearable recordings with a high signal-to-noise ratio and low motion artifacts are realized.The first reported clinical study of microneedle electrodes for surface electrophysiological monitoring was conducted in tens of healthy and sleep-disordered subjects with 44 nights of recording(over 8 h per night),providing substantial evidence that the electrodes can be leveraged to substitute for clinical standard electrodes.展开更多
Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclus...Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to a real-MA group(patients=34)and a sham-MA group(patients=33).Patients in the real-MA group were treated on‘Five-shen acupoints’,including Sishencong(四神聪EX-HN 1),Shenting(神庭GV 24),Shendao(神道GV 11),bilateral Benshen(本神GB 13),and bilateral Shenmen(神门HT 7).Though being punctured on the same acupoints,patients in the sham-MA group were treated by a placebo acupuncture approach(Streitberger Placeboneedle).Each group received corresponding interventions every other day,three times a week for total eight weeks.Both polysomnography(PSG)and testing of serum biological markers such as neuropeptide Y(NPY)and substance P(SP)were performed at pre-and post-treatment.Additionally,the global scores of Pittsburgh sleep quality index(PSQI)and the global scores of 17-items Hamilton Depression Rating Scale(HAMD17)were used for assessing the subjective sleep and emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI and global scores of HAMD17 declined significantly(both P<0.05)in the real-MA group but not in the sham-MA group(both P>0.05).According to the parameters of PSG,striking decline were observed in sleep latency(SL)and wake after sleep onset(WASO)and striking climb were observed in total sleep time(TST)and sleep efficiency(SE)in the real-MA group after treatment(P<0.05,respectively)but not in the sham-MA group(P>0.05,respectively).Additionally,there were no significant differences in awakening times(ATs)and rapid eyes movement sleep latency(REM-SL)in both two groups after treatment(both P>0.05).Meanwhile,the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions(both P<0.05)while those indicators only slightly fluctuated in the sham-MA group(P>0.05).No serious adverse event was reported in either real-or sham-MA group.Conclusion:(1)MA may be a potential alternative therapy for improving MDD and comorbid insomnia(particularly in extending total sleep time and shortening wake-up duration and sleep latency)via upregulating the expression of NPY and downregulating the expression of SP;more importantly,this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency.(2)There is insufficient evidence to prove that MA can effectively reduce the number of arousals.展开更多
The EDF+ (European Data Format Plus) is a flexible and open source data format created in order to store and exchange biomedical signals. It is known worldwide and used by a large variety of specialists in the area. E...The EDF+ (European Data Format Plus) is a flexible and open source data format created in order to store and exchange biomedical signals. It is known worldwide and used by a large variety of specialists in the area. EDF+ signals have been subjected to many researches of clinical interest amongst diagnosing and for treatment of diseases related to sleeping disorders. Nevertheless, more complete and user-friendly tools, which use these signals, are yet too few in the market. This paper presents a new tool developed in order to read and analyze EDF+ signals, focusing in the area of sleep disorders. It includes several features, such as organizing signal channels through previous montage customizations, sleep stage bars and graphics for analyzing the quality of sleep (hypnograms). It provides easiness in the whole process of interpretation and scoring of sleep events in polysomnography exams. The software development used the C++ language, due to its great versatility and efficiency, using Visual Studio Community 2013? as the Integrated Development Environment (IDE). Moreover, it implements many Digital Signal Processing (DSP) techniques, for instance, its own set of digital filters. This paper presents an application of Polysomnography analysis software and suggests a modification on the way to interpret the EDF+ standard and its usage.展开更多
Objective To assess the effects of sleep deprivation (SD) on the whole night polysomnography (PSG) in healthy young men. Methods The whole night PSG was recorded by using Neurofax-1518K (Nihon Kohden, Japan) system be...Objective To assess the effects of sleep deprivation (SD) on the whole night polysomnography (PSG) in healthy young men. Methods The whole night PSG was recorded by using Neurofax-1518K (Nihon Kohden, Japan) system before and after 38 h of SD among 15 healthy male subjects. Results Compared with PSG before SD, post-SD PSG showed significantly shortened sleep latency (before SD: 19.7±9.3, after SD: 5.6±7.3, P<0.05), decreased stage 1 (S1) non-rapid eye movement (NREM) sleep [before SD: (9.2±1.9)%, after SD: (4.0±1.4)%, P<0.05], and increased stage 4 (S4) NREM sleep [before SD: (10.3±3.7)%, after SD: (26.2±4.3)%, P<0.01]. Conclusion During post-SD sleep, the proportion of S4 NREM sleep was increased as compensation in healthy male. In addition, SD was proved to affect electrophysiological brain activities in normal people.展开更多
Automated sleep stages classification facilitates clinical experts in conducting treatment for sleep disorders,as it is more time-efficient concerning the analysis of whole-night polysomnography(PSG).However,most of t...Automated sleep stages classification facilitates clinical experts in conducting treatment for sleep disorders,as it is more time-efficient concerning the analysis of whole-night polysomnography(PSG).However,most of the existing research only focused on public databases with channel systems incompatible with the current clinical measurements.To narrow the gap between theoretical models and real clinical practice,we propose a novel deep learning model,by combining the vision transformer with supervised contrastive learning,realizing the efficient sleep stages classification.Experimental results show that the model facilitates an easier classification of multi-channel PSG signals.The mean F1-scores of 79.2%and 76.5%on two public databases outperform the previous studies,showing the model’s great capability,and the performance of the proposed method on the children’s small database also presents a high mean accuracy of 88.6%.Our proposed model is validated not only on the public databases but the provided clinical database to strictly evaluate its clinical usage in practice.展开更多
Background：The currently available polysomnography （PSG） equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea （...Background：The currently available polysomnography （PSG） equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea （OSA） patients cannot receive timely diagnosis and treatment,we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG,based on the clinical syndromes and the demographic and anthropometric characteristics.Methods：The nomogram was constructed through an ordinal logistic regression procedure.Predictive accuracy and performance characteristics were assessed with the area under the curve （AUC） of the receiver operating characteristics and calibration plots,respectively.Decision curve analyses were applied to assess the net benefit of the nomogram.Results：Among the 401 patients,73 （18.2%） were diagnosed and grouped as the none OSA （apnea-hypopnea index [AHI] 〈5）,67 （16.7%） the mild OSA （5 ≤ AHI 〈 15）,82 （20.4%） the moderate OSA （15 ≤ AHI 〈 30）,and 179 （44.6%） the severe OSA （AHI ≥ 30）.The multivariable analysis suggested the significant factors were duration of disease,smoking status,difficulty of falling asleep,lack of energy,and waist circumference.A nomogram was created for the prediction of OSA using these clinical parameters and was internally validated using bootstrapping method.The discrimination accuracies of the nomogram for any OSA,moderate-severe OSA,and severe OSA were 83.8%,79.9%,and 80.5%,respectively,which indicated good calibration.Decision curve analysis showed that using nomogram could reduce the unnecessary polysomnography （PSG） by 10% without increasing the false negatives.Conclusions：The established clinical nomogram provides high accuracy in predicting the individual risk of OSA.This tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers.展开更多
Background： Kleine-Levin syndrome （KLS） is a rare sleep disorder characterized by recurrent episodes of hypersomnia. Polysomnographic （PSG） researches of KLS have been reported only in few publications in the pas...Background： Kleine-Levin syndrome （KLS） is a rare sleep disorder characterized by recurrent episodes of hypersomnia. Polysomnographic （PSG） researches of KLS have been reported only in few publications in the past decades. This study aimed to investigate the characteristics of PSG of KLS. Methods： This study, which was conducted from March 2010 to July 2014, included seven patients diagnosed with KLS in the Sleep and Wake Disorder Center of Huashan Hospital, Fudan University （Shanghai, China）. PSG and multiple sleep latency tests （MSLT） were performed during their episodes and the results were evaluated. Results： Five of the seven patients were males, The mean age at KLS onset was 15.6 ：k 3.6 years. The number of episodes ranged from 2 to 7. The duration of episodes lasted from 4 to 11 days. The sleep architecture and proportion were normal in most of the patients. The average value of mean sleep latency was 6.9 4- 4.1 min. No sleep-onset rapid eye movement （SOREM） was detected in three of the patients, whereas one patient experienced one period of SOREM, and such episodes occurred twice in other two patients. Conclusions： We found that sleep architecture and proportion were normal in most KLS patients. However, the results of PSG and MSLT had no specificity for KLS patients.展开更多
Background The most common obstruction sites for obstructive sleep apnea hypopnea syndrome （OSAHS） are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The stud...Background The most common obstruction sites for obstructive sleep apnea hypopnea syndrome （OSAHS） are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography （PSG） after nasopharyngeal tube insertion （NPT-PSG）, and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites. Methods Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place （NP＇r-PSG）. Results of the two PSGs were compared. A NPT-PSG apnea hypopnea index （AHI） greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up. Results After NPT-PSG, patients＇ AHI significantly decreased and lowest oxygen saturation （LaSO2） significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty （UPPP） alone and 32 with UPPP ＋ glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%. Conclusions NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.展开更多
Anumber of therapies have been developed in the past decades.About two thirds of patients can be seizure free with antiepileptic drugs.1 Other patients are drug resistant,some of whom are good candidates for epileptic...Anumber of therapies have been developed in the past decades.About two thirds of patients can be seizure free with antiepileptic drugs.1 Other patients are drug resistant,some of whom are good candidates for epileptic focus resection and become seizure free after surgery.2 The treatment for drug-resistant patients who are not eligible for resection is still challenging.Traditionally,these patients can receive palliative surgery such as callosotomy and multiple subpial transection,3,4 but the long-term outcomes of these procedures are not satisfactory.5-7 In the past decades,neuromodulation techniques have been applied in the treatment of epilepsy.Much evidence has been accumulated about the therapeutic effects of vagus nerve stimulation for epilepsy.In contrast to peripheral nerve stimulation,brain stimulation techniques have also been developed for patients with epilepsy recently.展开更多
D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Cli...D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.展开更多
Obstructive sleep apnea(OSA)is often a lifestyle disease associated with obesity,which is rapidly evolving as a major health concern with diverse multisystemic implications.To prevent and mitigate its adverse effects ...Obstructive sleep apnea(OSA)is often a lifestyle disease associated with obesity,which is rapidly evolving as a major health concern with diverse multisystemic implications.To prevent and mitigate its adverse effects and reduce its burden on society,its aetiopathogeneses must be precisely understood.Numerous studies focusing on the range of diverse anatomic,functional,and lifestyle factors have already been carried out to determine the possible contributory roles of these factors in OSA.Recently,evidence to validate the role of inflammatory pathways and immune mechanisms in the aetiopathogeneses of OSA is being developed.This allows for further research and translation of such knowledge for targeted therapeutic and preventive interventions in patients with or who are at risk of developing OSA.展开更多
Sleep is not a luxury,but it is a necessity.If people sleep well,they will be more productive and start the morning in an excellent mood.On the other hand,people who do not sleep well,they start their morning very dro...Sleep is not a luxury,but it is a necessity.If people sleep well,they will be more productive and start the morning in an excellent mood.On the other hand,people who do not sleep well,they start their morning very drowsy irrespective of the other effects on their health,such as the disturbance of the circadian rhythm.In this paper,an automatic hybrid algorithm is developed to analyze sleep quality using basically the electroencephalogram(EEG)signal and polysomnographic report.The idea behind this is to perform the EEG signal processing in such a way as to be classified according to the sleep stages.Finally,we check if the subject passed through all the sleep cycles or not.To carry out this work,Python version 3 was used.展开更多
Introduction:Obstructive sleep apnea syndrome(OSAS) is considered a major public health issue due to its high prevalence and severe consequences.Several published studies have revealed that electroacupuncture may reli...Introduction:Obstructive sleep apnea syndrome(OSAS) is considered a major public health issue due to its high prevalence and severe consequences.Several published studies have revealed that electroacupuncture may relieve OSAS symptoms.However,the mechanism of electro-acupuncture in the treatment of patients with OSAS remains unclear.Methods and analysis:We evaluated the efficacy and mechanism of electro-acupuncture in the treatment of patients with OSAS.This was a two-group parallel randomized controlled trial.Sixty patients with OSAS will be randomly divided into an electro-acupuncture or shallow acupuncture group in a proportion of 1:1,and the patients will be administered 36 sessions of electro/shallow acupuncture treatment(three times a week for 12 weeks,20 min for each session).The Epworth Sleepiness Scale(ESS) will be used as the primary outcome.Secondary outcomes will include polysomnography(PSG),sleep quality,emotional state,and cognitive function.In addition,patients will receive neuroimaging scanning before and after the entire acupuncture treatment to evaluate neuroplasticity changes,including gray matter density,white matter integrity,and functional connections.Expected outcomes:We believe that the use of electro-acupuncture will be more effective in patients with mild to moderate OSAS and that the cognitive and emotional status of patients will improve after acupuncture treatment.In addition,we aim to clarify which brain areas can be altered by acupuncture in patients with OSAS.Discussion:This randomized clinical trial aims to explore the curative effect and central mechanism of acupuncture treatment for OSAS.We will explore gray matter density,white matter integrity,and functional connections of the brain using fMRI technology.The results of this study will be significant to the guidelines for clinical OSAS treatment.展开更多
In order to characterize sleep and the cognitive patterns in patients with acute minor thalamic infarction （AMTI）, we enrolled 27 patients with AMTI and 12 mat- ched healthy individuals. Questionnaires about sleep a...In order to characterize sleep and the cognitive patterns in patients with acute minor thalamic infarction （AMTI）, we enrolled 27 patients with AMTI and 12 mat- ched healthy individuals. Questionnaires about sleep and cognition as well as polysomnography （PSG） were performed on days 14 and 90 post-stroke. Compared to heal- thy controls, in patients with AMTI, hyposomnia was more prevalent; sleep architecture was disrupted as indicated by decreased sleep efficiency, increased sleep latency, and decreased non-rapid eye movement sleep stages 2 and 3; more sleep-related breathing disorders occurred; and cog- nitive functions were worse, especially memory. While sleep apnea and long-delay memory recovered to a large extent in the patients, other sleep and cognitive function deficit often persisted. Patients with AMTI are at an increased risk for hyposomnia, sleep structure disturbance, sleep apnea, and memory deficits. Although these abnormalities improved over time, the slow and incomplete improvement suggest that early management should be considered in these patients.展开更多
基金support from Tungs’Taichung Metroharbor Hospital(grant number#TTMHH-109R0048 to Stella Chin-Shaw Tsai).
文摘Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.
基金supported by the China Capital Health Research and Development of Special (No. 2018-14111)the National Natural Science Foundation of China (grant No. 62004007 and No. 82027805)the China Postdoctoral Science Foundation Grant (No. 2021M700258)
文摘Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applications.Existing schemes are limited by flexibility,biosafety,and manufacturing costs,which create large barriers for wider applications.Here,we present a novel flexible MNA electrode that can simultaneously achieve flexibility of the substrate to fit a curved body surface,robustness of microneedles to penetrate the skin without fracture,and a simplified process to allow mass production.The compatibility with wearable wireless systems and the short preparation time of the electrodes significantly improves the comfort and convenience of electrophysiological recording.The normalized electrode–skin contact impedance reaches 0.98 kΩcm^(2)at 1 kHz and 1.50 kΩcm^(2)at 10 Hz,a record low value compared to previous reports and approximately 1/250 of the standard electrodes.The morphology,biosafety,and electrical/mechanical properties are fully characterized,and wearable recordings with a high signal-to-noise ratio and low motion artifacts are realized.The first reported clinical study of microneedle electrodes for surface electrophysiological monitoring was conducted in tens of healthy and sleep-disordered subjects with 44 nights of recording(over 8 h per night),providing substantial evidence that the electrodes can be leveraged to substitute for clinical standard electrodes.
基金Supported by TCM Science and Technology Innovation Project of Shanghai Health and Family Planning Commission:Mobile internet-based guidance platform of‘Preventive Treatment of Insomnia’(chronic disease management)(No.ZYKC20161016)Special Project for Clinical Research,Shanghai Municipal Health Commission(No.20174Y0009).
文摘Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to a real-MA group(patients=34)and a sham-MA group(patients=33).Patients in the real-MA group were treated on‘Five-shen acupoints’,including Sishencong(四神聪EX-HN 1),Shenting(神庭GV 24),Shendao(神道GV 11),bilateral Benshen(本神GB 13),and bilateral Shenmen(神门HT 7).Though being punctured on the same acupoints,patients in the sham-MA group were treated by a placebo acupuncture approach(Streitberger Placeboneedle).Each group received corresponding interventions every other day,three times a week for total eight weeks.Both polysomnography(PSG)and testing of serum biological markers such as neuropeptide Y(NPY)and substance P(SP)were performed at pre-and post-treatment.Additionally,the global scores of Pittsburgh sleep quality index(PSQI)and the global scores of 17-items Hamilton Depression Rating Scale(HAMD17)were used for assessing the subjective sleep and emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI and global scores of HAMD17 declined significantly(both P<0.05)in the real-MA group but not in the sham-MA group(both P>0.05).According to the parameters of PSG,striking decline were observed in sleep latency(SL)and wake after sleep onset(WASO)and striking climb were observed in total sleep time(TST)and sleep efficiency(SE)in the real-MA group after treatment(P<0.05,respectively)but not in the sham-MA group(P>0.05,respectively).Additionally,there were no significant differences in awakening times(ATs)and rapid eyes movement sleep latency(REM-SL)in both two groups after treatment(both P>0.05).Meanwhile,the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions(both P<0.05)while those indicators only slightly fluctuated in the sham-MA group(P>0.05).No serious adverse event was reported in either real-or sham-MA group.Conclusion:(1)MA may be a potential alternative therapy for improving MDD and comorbid insomnia(particularly in extending total sleep time and shortening wake-up duration and sleep latency)via upregulating the expression of NPY and downregulating the expression of SP;more importantly,this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency.(2)There is insufficient evidence to prove that MA can effectively reduce the number of arousals.
文摘The EDF+ (European Data Format Plus) is a flexible and open source data format created in order to store and exchange biomedical signals. It is known worldwide and used by a large variety of specialists in the area. EDF+ signals have been subjected to many researches of clinical interest amongst diagnosing and for treatment of diseases related to sleeping disorders. Nevertheless, more complete and user-friendly tools, which use these signals, are yet too few in the market. This paper presents a new tool developed in order to read and analyze EDF+ signals, focusing in the area of sleep disorders. It includes several features, such as organizing signal channels through previous montage customizations, sleep stage bars and graphics for analyzing the quality of sleep (hypnograms). It provides easiness in the whole process of interpretation and scoring of sleep events in polysomnography exams. The software development used the C++ language, due to its great versatility and efficiency, using Visual Studio Community 2013? as the Integrated Development Environment (IDE). Moreover, it implements many Digital Signal Processing (DSP) techniques, for instance, its own set of digital filters. This paper presents an application of Polysomnography analysis software and suggests a modification on the way to interpret the EDF+ standard and its usage.
基金Supported by National High Technology Research and Development Program of China (863 Program, No.2007AA02Z420 and No.2008AA02Z412)Joint Key Project of New Frontier Technology in Shanghai Municipal Hospitals (No.SHDC12006105)+1 种基金Foundation of the National Natural Science Foundation of China (No.30770772)the Municipal Committee of Shanghai Science and Technology (No.09411968200)
文摘Objective To assess the effects of sleep deprivation (SD) on the whole night polysomnography (PSG) in healthy young men. Methods The whole night PSG was recorded by using Neurofax-1518K (Nihon Kohden, Japan) system before and after 38 h of SD among 15 healthy male subjects. Results Compared with PSG before SD, post-SD PSG showed significantly shortened sleep latency (before SD: 19.7±9.3, after SD: 5.6±7.3, P<0.05), decreased stage 1 (S1) non-rapid eye movement (NREM) sleep [before SD: (9.2±1.9)%, after SD: (4.0±1.4)%, P<0.05], and increased stage 4 (S4) NREM sleep [before SD: (10.3±3.7)%, after SD: (26.2±4.3)%, P<0.01]. Conclusion During post-SD sleep, the proportion of S4 NREM sleep was increased as compensation in healthy male. In addition, SD was proved to affect electrophysiological brain activities in normal people.
基金the National Natural Science Foundation of China(No.52375254)the Interdisciplinary Program of Shanghai Jiao Tong University(No.21X010301670)the Open Project Program of SJTU-Pinghu Institute of Intelligent Optoelectronics(No.2022SPIOE104)。
文摘Automated sleep stages classification facilitates clinical experts in conducting treatment for sleep disorders,as it is more time-efficient concerning the analysis of whole-night polysomnography(PSG).However,most of the existing research only focused on public databases with channel systems incompatible with the current clinical measurements.To narrow the gap between theoretical models and real clinical practice,we propose a novel deep learning model,by combining the vision transformer with supervised contrastive learning,realizing the efficient sleep stages classification.Experimental results show that the model facilitates an easier classification of multi-channel PSG signals.The mean F1-scores of 79.2%and 76.5%on two public databases outperform the previous studies,showing the model’s great capability,and the performance of the proposed method on the children’s small database also presents a high mean accuracy of 88.6%.Our proposed model is validated not only on the public databases but the provided clinical database to strictly evaluate its clinical usage in practice.
文摘Background：The currently available polysomnography （PSG） equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea （OSA） patients cannot receive timely diagnosis and treatment,we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG,based on the clinical syndromes and the demographic and anthropometric characteristics.Methods：The nomogram was constructed through an ordinal logistic regression procedure.Predictive accuracy and performance characteristics were assessed with the area under the curve （AUC） of the receiver operating characteristics and calibration plots,respectively.Decision curve analyses were applied to assess the net benefit of the nomogram.Results：Among the 401 patients,73 （18.2%） were diagnosed and grouped as the none OSA （apnea-hypopnea index [AHI] 〈5）,67 （16.7%） the mild OSA （5 ≤ AHI 〈 15）,82 （20.4%） the moderate OSA （15 ≤ AHI 〈 30）,and 179 （44.6%） the severe OSA （AHI ≥ 30）.The multivariable analysis suggested the significant factors were duration of disease,smoking status,difficulty of falling asleep,lack of energy,and waist circumference.A nomogram was created for the prediction of OSA using these clinical parameters and was internally validated using bootstrapping method.The discrimination accuracies of the nomogram for any OSA,moderate-severe OSA,and severe OSA were 83.8%,79.9%,and 80.5%,respectively,which indicated good calibration.Decision curve analysis showed that using nomogram could reduce the unnecessary polysomnography （PSG） by 10% without increasing the false negatives.Conclusions：The established clinical nomogram provides high accuracy in predicting the individual risk of OSA.This tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers.
文摘Background： Kleine-Levin syndrome （KLS） is a rare sleep disorder characterized by recurrent episodes of hypersomnia. Polysomnographic （PSG） researches of KLS have been reported only in few publications in the past decades. This study aimed to investigate the characteristics of PSG of KLS. Methods： This study, which was conducted from March 2010 to July 2014, included seven patients diagnosed with KLS in the Sleep and Wake Disorder Center of Huashan Hospital, Fudan University （Shanghai, China）. PSG and multiple sleep latency tests （MSLT） were performed during their episodes and the results were evaluated. Results： Five of the seven patients were males, The mean age at KLS onset was 15.6 ：k 3.6 years. The number of episodes ranged from 2 to 7. The duration of episodes lasted from 4 to 11 days. The sleep architecture and proportion were normal in most of the patients. The average value of mean sleep latency was 6.9 4- 4.1 min. No sleep-onset rapid eye movement （SOREM） was detected in three of the patients, whereas one patient experienced one period of SOREM, and such episodes occurred twice in other two patients. Conclusions： We found that sleep architecture and proportion were normal in most KLS patients. However, the results of PSG and MSLT had no specificity for KLS patients.
文摘Background The most common obstruction sites for obstructive sleep apnea hypopnea syndrome （OSAHS） are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography （PSG） after nasopharyngeal tube insertion （NPT-PSG）, and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites. Methods Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place （NP＇r-PSG）. Results of the two PSGs were compared. A NPT-PSG apnea hypopnea index （AHI） greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up. Results After NPT-PSG, patients＇ AHI significantly decreased and lowest oxygen saturation （LaSO2） significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty （UPPP） alone and 32 with UPPP ＋ glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%. Conclusions NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.
基金This study was supported by the grants from the National Natural Science Foundation of China （No. 81271480 and No. 81372122）, the Emerging Advanced Technology Projects from Shanghai Hospital Development Center （SHDC 12013116）, and Projects of Promotion of Advanced Appropriate Technology in Health Service in Shanghai （No. 2013SY069）.
文摘Anumber of therapies have been developed in the past decades.About two thirds of patients can be seizure free with antiepileptic drugs.1 Other patients are drug resistant,some of whom are good candidates for epileptic focus resection and become seizure free after surgery.2 The treatment for drug-resistant patients who are not eligible for resection is still challenging.Traditionally,these patients can receive palliative surgery such as callosotomy and multiple subpial transection,3,4 but the long-term outcomes of these procedures are not satisfactory.5-7 In the past decades,neuromodulation techniques have been applied in the treatment of epilepsy.Much evidence has been accumulated about the therapeutic effects of vagus nerve stimulation for epilepsy.In contrast to peripheral nerve stimulation,brain stimulation techniques have also been developed for patients with epilepsy recently.
基金University of Alabama Birmingham Institutional Review Board approval was obtained,IRB Project Number 300012208.
文摘D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.
文摘Obstructive sleep apnea(OSA)is often a lifestyle disease associated with obesity,which is rapidly evolving as a major health concern with diverse multisystemic implications.To prevent and mitigate its adverse effects and reduce its burden on society,its aetiopathogeneses must be precisely understood.Numerous studies focusing on the range of diverse anatomic,functional,and lifestyle factors have already been carried out to determine the possible contributory roles of these factors in OSA.Recently,evidence to validate the role of inflammatory pathways and immune mechanisms in the aetiopathogeneses of OSA is being developed.This allows for further research and translation of such knowledge for targeted therapeutic and preventive interventions in patients with or who are at risk of developing OSA.
文摘Sleep is not a luxury,but it is a necessity.If people sleep well,they will be more productive and start the morning in an excellent mood.On the other hand,people who do not sleep well,they start their morning very drowsy irrespective of the other effects on their health,such as the disturbance of the circadian rhythm.In this paper,an automatic hybrid algorithm is developed to analyze sleep quality using basically the electroencephalogram(EEG)signal and polysomnographic report.The idea behind this is to perform the EEG signal processing in such a way as to be classified according to the sleep stages.Finally,we check if the subject passed through all the sleep cycles or not.To carry out this work,Python version 3 was used.
基金Supported by National Natural Science Foundation of China (82004197)Project for New Teachers of Beijing University of Chinese Medicine (2020-JYB-XJSJJ-046)。
文摘Introduction:Obstructive sleep apnea syndrome(OSAS) is considered a major public health issue due to its high prevalence and severe consequences.Several published studies have revealed that electroacupuncture may relieve OSAS symptoms.However,the mechanism of electro-acupuncture in the treatment of patients with OSAS remains unclear.Methods and analysis:We evaluated the efficacy and mechanism of electro-acupuncture in the treatment of patients with OSAS.This was a two-group parallel randomized controlled trial.Sixty patients with OSAS will be randomly divided into an electro-acupuncture or shallow acupuncture group in a proportion of 1:1,and the patients will be administered 36 sessions of electro/shallow acupuncture treatment(three times a week for 12 weeks,20 min for each session).The Epworth Sleepiness Scale(ESS) will be used as the primary outcome.Secondary outcomes will include polysomnography(PSG),sleep quality,emotional state,and cognitive function.In addition,patients will receive neuroimaging scanning before and after the entire acupuncture treatment to evaluate neuroplasticity changes,including gray matter density,white matter integrity,and functional connections.Expected outcomes:We believe that the use of electro-acupuncture will be more effective in patients with mild to moderate OSAS and that the cognitive and emotional status of patients will improve after acupuncture treatment.In addition,we aim to clarify which brain areas can be altered by acupuncture in patients with OSAS.Discussion:This randomized clinical trial aims to explore the curative effect and central mechanism of acupuncture treatment for OSAS.We will explore gray matter density,white matter integrity,and functional connections of the brain using fMRI technology.The results of this study will be significant to the guidelines for clinical OSAS treatment.
基金supported by the Health Industry Key Research Project of Tianjin Municipality,China(12KG132)the Science and Technology Plan Project of Tianjin Municipality,China(13ZCZDSY01900)
文摘In order to characterize sleep and the cognitive patterns in patients with acute minor thalamic infarction （AMTI）, we enrolled 27 patients with AMTI and 12 mat- ched healthy individuals. Questionnaires about sleep and cognition as well as polysomnography （PSG） were performed on days 14 and 90 post-stroke. Compared to heal- thy controls, in patients with AMTI, hyposomnia was more prevalent; sleep architecture was disrupted as indicated by decreased sleep efficiency, increased sleep latency, and decreased non-rapid eye movement sleep stages 2 and 3; more sleep-related breathing disorders occurred; and cog- nitive functions were worse, especially memory. While sleep apnea and long-delay memory recovered to a large extent in the patients, other sleep and cognitive function deficit often persisted. Patients with AMTI are at an increased risk for hyposomnia, sleep structure disturbance, sleep apnea, and memory deficits. Although these abnormalities improved over time, the slow and incomplete improvement suggest that early management should be considered in these patients.
