Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD...Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.展开更多
Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Dat...Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.展开更多
Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unc...Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unclear. Several prospective studies have reported that specific non-motor symptoms predict a conversion risk of developing a neurodegenerative disease, including olfactory dysfunction, abnormal color vision, autonomic dysfunction, excessive daytime sleepiness, depression, and cognitive impairment. Parkinson＇s disease （PD） with RBD exhibits clinical heterogeneity with respect to motor and non-motor symptoms compared with PD without RBD. In this review, we describe the main clinical and pathogenic features of RBD, focusing on its association with other non-motor symptoms of parkinsonism.展开更多
Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been compl...Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.展开更多
BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AI...BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.展开更多
Objective： To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome （OSAHS）. Methods： We conducted a non-randomized retrospective clinical trial...Objective： To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome （OSAHS）. Methods： We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus （exercising group）. Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale （ESS）, checked patients＇ polysomnography, and took 320- detector computed tomography （CT） before treatment. Six and twelve months later, we made records of apnea hypopnea index （AHI）, lowest arterial oxygen saturation （LSaO2）, body mass index （BMI）, the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment （control group） at the same time. SPSS 10.0 was used to analyze the data. Results： Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group （P〈0.05）. However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups （P〈0.0001）. There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising （P〉0.05）. At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower （P〈0.01） than that before treatment. There was no significant change of BMI in either group. Conclusions： Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure （CPAP） treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.展开更多
In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associ...In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associated with an increased cardiovascular risk,including stroke.Con-tinuous positive airways pressure(CPAP)therapy at night is the most effective treatment forOSA and has been shown to reduce the cardiovascular risk in OSA patients.However,there is nosuitable bedside monitoring method evaluating the recovery of cerebral hemodynamics duringCPAP therapy.Near-infrared spectroscopy(NiRS)is idelly suited for non-invasive monitoringthe cerebral hemodynamics during sleep due to its properties of local measurement,totally sa feapplication and good tolerance to motion.In this pilot study,we monitored cerebral hemody-namics during standard CPAP therapy at night in thre patients with severe OSA using NIRS.We found periodic oscllations in HbO2,HHb,tisue oxygenation index(TO1)and blood volume(BV)associa ted with periodic apnea events without CPAP in all OSA patients.These osillationswere eliminated under the optimal CPAP pressures in all patients.These results sugg ested thatthe recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedsideNIRS measurements in real time during ll night CPAP therapy.NIRS is a usefi bedsidemonitoring tool to evaluate the treatment elicacy of CPAP therapy in patients with OSA.展开更多
An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodi...An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.展开更多
The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral ...The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral developmental processes and the accumulation of new abilities and skills. We review the current research evidence regarding the relationship between sleep (and its various components) and cerebral and physical developmental processes. Although sleep is an everyday physiological necessity, the ability to recognize it as a critical component of development may bring a different view towards sleep by parents, educators, and caregivers. This change might lead to a shift in individual and social attitudes aimed at enabling the necessary time and conditions for adequate sleep in children and adolescents to become the norm. These sets of values will then hopefully extend into adulthood, in which sleep also plays a crucial role in both physical and mental wellbeing.展开更多
This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native th...This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.展开更多
[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders w...[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders were randomly selected and divided into a research group and a control group,with 150 cases in each group.The control group was administered with western medicine,and the research group was treated with acupuncture and medicine to compare their clinical treatment effects.[Results]The total effective rate of treatment in the research group was significantly higher than that in the control group;after treatment,both the PSQI and SAS scores of the two groups were significantly reduced,and the reduction degree of the research group was higher than that of the control group,the difference was statistically significant(P<0.05).[Conclusions]Combined use of acupuncture and medicine to treat sleep disorders in patients with anxiety disorders has better curative effect and fewer adverse reactions,so it has high clinical application value.展开更多
BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenien...BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenience of treatments discourage patients from complying with them,leading to chronic insomnia.AIM To investigate the long-term home-practice effects of mindful breathing combined with a sleep-inducing exercise as adjunctive insomnia therapy.METHODS A quasi-experimental design was used in the present work,in which the patients with insomnia were included and grouped based on hospital admission:40 patients admitted between January and April 2020 were assigned to the control group,and 40 patients admitted between May and August 2020 were assigned to the treatment group.The control group received routine pharmacological and physical therapies,while the treatment group received instruction in mindful breathing and a sleep-inducing exercise in addition to the routine therapies.The Pittsburgh Sleep Quality Index(PSQI),Generalized Anxiety Disorder 7-item(GAD-7)scale,and Insomnia Severity Index(ISI)were utilized to assess sleepquality improvement in the patient groups before the intervention and at 1 wk,1 mo,and 3 mo postintervention.RESULTS The PSQI,GAD-7,and ISI scores before the intervention and at 1 wk postintervention were not significantly different between the groups.However,compared with the control group,the treatment group exhibited significant improvements in sleep quality,daytime functioning,negative emotions,sleep latency,sleep duration,sleep efficiency,anxiety level,and insomnia severity at 1 and 3 mo postintervention(P<0.05).The results showed that mindful breathing combined with the sleep-inducing exercise significantly improved the long-term effectiveness of insomnia treatment.At 3 mo,the PSQI scores for the treatment vs the control group were as follows:Sleep quality 0.98±0.48 vs 1.60±0.63,sleep latency 1.98±0.53 vs 2.80±0.41,sleep duration 1.53±0.60 vs 2.70±0.56,sleep efficiency 2.35±0.58 vs 1.63±0.49,sleep disturbance 1.68±0.53 vs 2.35±0.53,hypnotic medication 0.53±0.64 vs 0.93±0.80,and daytime dysfunction 1.43±0.50 vs 2.48±0.51(all P<0.05).The GAD-7 scores were 2.75±1.50 vs 7.15±2.28,and the ISI scores were 8.68±2.26 vs 3.38±1.76 for the treatment vs the control group,respectively(all P<0.05).CONCLUSION These simple,cost-effective,and easy-to-implement practices used in clinical or home settings could have profound significance for long-term insomnia treatment and merit wide adoption in clinical practice.展开更多
PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalen...PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.展开更多
BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime h...BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.展开更多
Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(S...Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(SFHT)and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019(COVID-19).Methods:This case-control study was conducted at shelter hospitals and quarantine hotels in China.A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31,2022,while 2190 uninfected individuals served as healthy controls.Structured questionnaires were used to collect data on demographics,underlying diseases,vaccination status,and use of SFHT.Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score.Subsequently,a conditional logistic regression model was used for data analysis.Results:Overall,7538 eligible subjects were recruited,with an average age of[45.54±16.94]years.The age of COVID-19 patients was significantly higher than that of uninfected individuals([48.25±17.48]years vs[38.92±13.41]years;t=22.437,P<0.001).A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio.The use of SFHT(odds ratio=0.753,95%confidence interval:0.692,0.820)was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.Conclusion:Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection.This is a useful study in the larger picture of COVID-19 management,but data from large-sample multi-center,randomized clinical trial are warranted to confirm the finding.展开更多
基金supported by the National Key R&D Pro-gram of China(No.2021YFC2501500)the National Natural Science Foundation of China(Nos.82271525 and 82071488)the Nanfang Hospital Clinical Research Project of Southern Medical University(No.2021CR009),China。
文摘Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
基金supported by This work was supported by the Ministry of Science and Technology of the People’s Republic of China(STI2030-Major Projects2021ZD0201900)。
文摘Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.
基金supported by the National Natural Science Foundation of China (91649114)the Jiangsu Provincial Special Program of Medical Science, China (BL2014042)+3 种基金a Jiangsu Provincial Medical Key Discipline Projectthe Suzhou Clinical Research Center of Neurological Disease (Szzx201503)Jiangsu Province Ordinary University Professional Degree Graduate Practice Innovation, China (SJZZ16-0242)the Priority Academic Program Development of Jiangsu Higher Education Institutions, China
文摘Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unclear. Several prospective studies have reported that specific non-motor symptoms predict a conversion risk of developing a neurodegenerative disease, including olfactory dysfunction, abnormal color vision, autonomic dysfunction, excessive daytime sleepiness, depression, and cognitive impairment. Parkinson＇s disease （PD） with RBD exhibits clinical heterogeneity with respect to motor and non-motor symptoms compared with PD without RBD. In this review, we describe the main clinical and pathogenic features of RBD, focusing on its association with other non-motor symptoms of parkinsonism.
文摘Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.
文摘BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.
基金supported by the Social Development of Science and Technology Program of Ningbo City(No.2010C50031)the Ningbo Natural Science Foundation(No.2013A610261),China
文摘Objective： To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome （OSAHS）. Methods： We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus （exercising group）. Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale （ESS）, checked patients＇ polysomnography, and took 320- detector computed tomography （CT） before treatment. Six and twelve months later, we made records of apnea hypopnea index （AHI）, lowest arterial oxygen saturation （LSaO2）, body mass index （BMI）, the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment （control group） at the same time. SPSS 10.0 was used to analyze the data. Results： Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group （P〈0.05）. However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups （P〈0.0001）. There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising （P〉0.05）. At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower （P〈0.01） than that before treatment. There was no significant change of BMI in either group. Conclusions： Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure （CPAP） treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.
基金Supported by Clinic Barmelweid Scientific Foundation.
文摘In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associated with an increased cardiovascular risk,including stroke.Con-tinuous positive airways pressure(CPAP)therapy at night is the most effective treatment forOSA and has been shown to reduce the cardiovascular risk in OSA patients.However,there is nosuitable bedside monitoring method evaluating the recovery of cerebral hemodynamics duringCPAP therapy.Near-infrared spectroscopy(NiRS)is idelly suited for non-invasive monitoringthe cerebral hemodynamics during sleep due to its properties of local measurement,totally sa feapplication and good tolerance to motion.In this pilot study,we monitored cerebral hemody-namics during standard CPAP therapy at night in thre patients with severe OSA using NIRS.We found periodic oscllations in HbO2,HHb,tisue oxygenation index(TO1)and blood volume(BV)associa ted with periodic apnea events without CPAP in all OSA patients.These osillationswere eliminated under the optimal CPAP pressures in all patients.These results sugg ested thatthe recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedsideNIRS measurements in real time during ll night CPAP therapy.NIRS is a usefi bedsidemonitoring tool to evaluate the treatment elicacy of CPAP therapy in patients with OSA.
文摘An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.
文摘The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral developmental processes and the accumulation of new abilities and skills. We review the current research evidence regarding the relationship between sleep (and its various components) and cerebral and physical developmental processes. Although sleep is an everyday physiological necessity, the ability to recognize it as a critical component of development may bring a different view towards sleep by parents, educators, and caregivers. This change might lead to a shift in individual and social attitudes aimed at enabling the necessary time and conditions for adequate sleep in children and adolescents to become the norm. These sets of values will then hopefully extend into adulthood, in which sleep also plays a crucial role in both physical and mental wellbeing.
文摘This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.
文摘[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders were randomly selected and divided into a research group and a control group,with 150 cases in each group.The control group was administered with western medicine,and the research group was treated with acupuncture and medicine to compare their clinical treatment effects.[Results]The total effective rate of treatment in the research group was significantly higher than that in the control group;after treatment,both the PSQI and SAS scores of the two groups were significantly reduced,and the reduction degree of the research group was higher than that of the control group,the difference was statistically significant(P<0.05).[Conclusions]Combined use of acupuncture and medicine to treat sleep disorders in patients with anxiety disorders has better curative effect and fewer adverse reactions,so it has high clinical application value.
基金the Shengjing Hospital of China Medical University(approval No 2019PS582K).
文摘BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenience of treatments discourage patients from complying with them,leading to chronic insomnia.AIM To investigate the long-term home-practice effects of mindful breathing combined with a sleep-inducing exercise as adjunctive insomnia therapy.METHODS A quasi-experimental design was used in the present work,in which the patients with insomnia were included and grouped based on hospital admission:40 patients admitted between January and April 2020 were assigned to the control group,and 40 patients admitted between May and August 2020 were assigned to the treatment group.The control group received routine pharmacological and physical therapies,while the treatment group received instruction in mindful breathing and a sleep-inducing exercise in addition to the routine therapies.The Pittsburgh Sleep Quality Index(PSQI),Generalized Anxiety Disorder 7-item(GAD-7)scale,and Insomnia Severity Index(ISI)were utilized to assess sleepquality improvement in the patient groups before the intervention and at 1 wk,1 mo,and 3 mo postintervention.RESULTS The PSQI,GAD-7,and ISI scores before the intervention and at 1 wk postintervention were not significantly different between the groups.However,compared with the control group,the treatment group exhibited significant improvements in sleep quality,daytime functioning,negative emotions,sleep latency,sleep duration,sleep efficiency,anxiety level,and insomnia severity at 1 and 3 mo postintervention(P<0.05).The results showed that mindful breathing combined with the sleep-inducing exercise significantly improved the long-term effectiveness of insomnia treatment.At 3 mo,the PSQI scores for the treatment vs the control group were as follows:Sleep quality 0.98±0.48 vs 1.60±0.63,sleep latency 1.98±0.53 vs 2.80±0.41,sleep duration 1.53±0.60 vs 2.70±0.56,sleep efficiency 2.35±0.58 vs 1.63±0.49,sleep disturbance 1.68±0.53 vs 2.35±0.53,hypnotic medication 0.53±0.64 vs 0.93±0.80,and daytime dysfunction 1.43±0.50 vs 2.48±0.51(all P<0.05).The GAD-7 scores were 2.75±1.50 vs 7.15±2.28,and the ISI scores were 8.68±2.26 vs 3.38±1.76 for the treatment vs the control group,respectively(all P<0.05).CONCLUSION These simple,cost-effective,and easy-to-implement practices used in clinical or home settings could have profound significance for long-term insomnia treatment and merit wide adoption in clinical practice.
文摘PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.
文摘BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.
基金supported by the fund of COVID-19 Prevention and Treatment from Administration of Traditional Chinese Medicine (No. XGYJKY2022-09 and No. 2022ZYLCYJ05-10)the Threeyear Action Plan for Promoting Clinical Skills and Innovation Ability of Municipal Hospitals (No. SHDC2022CRS039)+2 种基金the Shanghai Natural Science Foundation (No.23ZR1464000 and No.23ZR1463900)Medical Innovation Research Special Project of the Shanghai ‘‘Science and Technology Innovation Action Plan”(No.21Y11922500 and No.21Y11922400)the Talent Fund of Longhua Hospital (No. LH001.007)
文摘Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(SFHT)and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019(COVID-19).Methods:This case-control study was conducted at shelter hospitals and quarantine hotels in China.A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31,2022,while 2190 uninfected individuals served as healthy controls.Structured questionnaires were used to collect data on demographics,underlying diseases,vaccination status,and use of SFHT.Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score.Subsequently,a conditional logistic regression model was used for data analysis.Results:Overall,7538 eligible subjects were recruited,with an average age of[45.54±16.94]years.The age of COVID-19 patients was significantly higher than that of uninfected individuals([48.25±17.48]years vs[38.92±13.41]years;t=22.437,P<0.001).A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio.The use of SFHT(odds ratio=0.753,95%confidence interval:0.692,0.820)was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.Conclusion:Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection.This is a useful study in the larger picture of COVID-19 management,but data from large-sample multi-center,randomized clinical trial are warranted to confirm the finding.
