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Sleep
Journal Prestige (SJR): 2.37
Citation Impact (citeScore): 5
Number of Followers: 29  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0161-8105 - ISSN (Online) 1550-9109
Published by Sleep Research Society Homepage  [1 journal]
  • Sleep restriction effects on sleep spindles in adolescents and relation of
           these effects to subsequent daytime sleepiness and cognition

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      First page: zsad071
      Abstract: Study ObjectivesLimiting spindle activity via sleep restriction could explain some of the negative cognitive effects of sleep loss in adolescents. The current study evaluates how sleep restriction affects sleep spindle number, incidence, amplitude, duration, and wave frequency and tests whether sleep restriction effects on spindles change across the years of adolescence. The study determines whether sleep restriction effects on daytime sleepiness, vigilance, and cognition are related to changes in sleep spindles.MethodsIn each year of this 3-year longitudinal study, 77 participants, ranging in age from 10 to 16 years, each completed three different time in bed (TIB) schedules: 7, 8.5, or 10 hours in bed for 4 consecutive nights. A computer algorithm detected and analyzed sleep spindles in night four central and frontal electroencephalogram. Objective and self-reported daytime sleepiness and cognition were evaluated on the day following the 4th night.ResultsFor 7 versus 10 hours TIB average all-night frontal and central spindle counts were reduced by 35% and 32%, respectively. Reducing TIB also significantly decreased spindle incidence in the first 5 hours of non-rapid eye movement sleep, produced small but significant reductions in spindle amplitude, and had little to no effect on spindle duration and spindle wave frequency. Sleep restriction effects did not change with age. The reductions in spindle count and incidence were related to daytime sleepiness on the following day but were not related to working memory.ConclusionsThe sleep loss effects on daytime functioning in adolescents are partially mediated by reduced sleep spindles impacting daytime sleepiness.
      PubDate: Tue, 14 Mar 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad071
      Issue No: Vol. 46, No. 5 (2023)
       
  • Early life postnatal intermittent hypoxia: a case for (Mal)adaptive
           cardiorespiratory plasticity, inflammation, and epigenetics

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      First page: zsad065
      Abstract: NIH10.13039/100000002AG061824Leda J Sears FoundationUniversity of Missouri10.13039/100007165
      PubDate: Wed, 08 Mar 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad065
      Issue No: Vol. 46, No. 5 (2023)
       
  • Solriamfetol improves chronic sleep fragmentation-induced increases in
           sleep propensity and ameliorates explicit memory in male mice

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      First page: zsad057
      Abstract: Obstructive sleep apnea (OSA) is a highly prevalent condition characterized by episodes of partial or complete breath cessation during sleep that induces sleep fragmentation (SF). One of the frequent manifestations of OSA is the presence of excessive daytime sleepiness (EDS) associated with cognitive deficits. Solriamfetol (SOL) and modafinil (MOD) are wake-promoting agents commonly prescribed to improve wakefulness in OSA patients with EDS. This study aimed to assess the effects of SOL and MOD in a murine model of OSA characterized by periodic SF. Male C57Bl/6J mice were exposed to either control sleep (SC) or SF (mimicking OSA) during the light period (06:00 h to 18:00 h) for 4 weeks, which consistently induces sustained excessive sleepiness during the dark phase. Both groups were then randomly assigned to receive once-daily intraperitoneal injections of SOL (200 mg/kg), MOD (200 mg/kg), or vehicle for 1 week while continuing exposures to SF or SC. Sleep/wake activity and sleep propensity were assessed during the dark phase. Novel Object Recognition test, Elevated-Plus Maze Test, and Forced Swim Test were performed before and after treatment. SOL or MOD decreased sleep propensity in SF, but only SOL induced improvements in explicit memory, while MOD exhibited increased anxiety behaviors. Chronic SF, a major hallmark of OSA, induces EDS in young adult mice that is mitigated by both SOL and MOD. SOL, but not MOD, significantly improves SF-induced cognitive deficits. Increased anxiety behaviors are apparent in MOD-treated mice. Further studies aiming to elucidate the beneficial cognitive effects of SOL are warranted.
      PubDate: Thu, 02 Mar 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad057
      Issue No: Vol. 46, No. 5 (2023)
       
  • Sympathetic dysregulation induced by postnatal intermittent hypoxia

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      First page: zsad055
      Abstract: Study ObjectivesExposure to postnatal chronic intermittent hypoxia (pCIH), as experienced in sleep-disordered breathing, is a risk factor for developing cardiorespiratory diseases in adulthood. pCIH causes respiratory instability and motor dysfunction that persist until adult life. In this study, we investigated the impact of pCIH on the sympathetic control of arterial pressure in rats.Methods and ResultsNeonate male Holtzman rats (P0–1) were exposed to pCIH (6% O2 for 30 seconds, every 10 minutes, 8 h/day) during their first 10–15 days of life, while control animals were maintained under normoxia. In early adult life (P25–40), freely behaving pCIH animals (n = 13) showed higher baseline arterial pressure levels linked to augmented sympathetic-mediated variability than control animals (n = 12, p < 0.05). Using decerebrated in situ preparations, we found that juvenile pCIH rats exhibited a twofold increase in thoracic sympathetic nerve activity (n = 14) and elevated firing frequency of ventromedullary presympathetic neurons (n = 7) compared to control rats (n = 6–7, p < 0.05). This pCIH-induced sympathetic dysregulation was associated with increased HIF-1α (hypoxia-inducible factor 1 alpha) mRNA expression in catecholaminergic presympathetic neurons (n = 5, p < 0.05). At older age (P90–99), pCIH rats displayed higher arterial pressure levels and larger depressor responses to ganglionic blockade (n = 6–8, p < 0.05), confirming the sympathetic overactivity state.ConclusionspCIH facilitates the vasoconstrictor sympathetic drive by mechanisms associated with enhanced firing activity and HIF-1α expression in ventromedullary presympathetic neurons. This excessive sympathetic activity persists until adulthood resulting in high blood pressure levels and variability, which contribute to developing cardiovascular diseases.
      PubDate: Thu, 02 Mar 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad055
      Issue No: Vol. 46, No. 5 (2023)
       
  • Sleep problems in old age: metabotropic glutamate receptor to the rescue

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      First page: zsad044
      Abstract: National Institutes of Health10.13039/100000002R01NS109151R21NS130878
      PubDate: Tue, 28 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad044
      Issue No: Vol. 46, No. 5 (2023)
       
  • Here come the pro/con debates

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      First page: zsad043
      Abstract: One of the goals of the new editorial team for the journal SLEEP is to make the journal a forum to conduct scientific debates on current issues. One part of this strategy is to introduce a new type of article—Pro/Con Debates (Point-Counterpoint). These articles are by invitation, although anybody can email us with suggestions. We very much welcome this.
      PubDate: Tue, 28 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad043
      Issue No: Vol. 46, No. 5 (2023)
       
  • The dim light melatonin onset across ages, methodologies, and sex and its
           relationship with morningness/eveningness

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      First page: zsad033
      Abstract: The onset of melatonin secretion, the dim light melatonin onset (DLMO), is a tool for determining the phase of the circadian timing system. Although small studies have investigated the impacts of age and methods of calculating DLMO, there is no DLMO reference range. In the current study, the saliva DLMO from 3579 participants from 121 published studies and plasma DLMO from 818 healthy controls from 31 studies (aged 3–73 years) were analyzed. In a subset of 53 papers (1749 participants), individual saliva DLMO and Morningness Eveningness Questionaire (MEQ) scores were obtained from authors or mined from publications and a reference range was constructed. Saliva DLMO was earliest in children to 10 years of age and latest around 20 years of age and thereafter advanced with age by 30 min in the oldest participants. Melatonin assay methods and DLMO calculation methods had little effect on the determination of the DLMO. Saliva DLMO was correlated (p < 0.001) with the MEQ score; lower MEQ scores were associated with later DLMO. MEQ scores increased with age, reflecting a tendency toward morningness. An evaluation of 14 saliva DLMO studies of clinically diagnosed patients living with delayed sleep–wake phase disorder (mean ages 20 to 31 years) revealed mean saliva DLMO within the reference range albeit at the late extreme. Peak plasma melatonin levels from 179 studies of healthy participants revealed a high degree of variability within studies and age groups, but only a small decline between the 20 and 50 years and lowest levels after 70 years.
      PubDate: Fri, 17 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad033
      Issue No: Vol. 46, No. 5 (2023)
       
  • Hypersomnia and narcolepsy in 42 adult patients with craniopharyngioma

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      First page: zsad032
      Abstract: Study ObjectivesTo evaluate sleep, sleepiness, and excessive need for sleep in patients with craniopharyngioma (a suprasellar tumor which can affect sleep–wake systems).MethodsA retrospective study of all adult patients living with craniopharyngioma referred to the sleep clinic, who received a sleep interview, nocturnal polysomnography, multiple sleep latency tests (MSLT), and 18-h bed rest polysomnography. Their sleep measurements were compared with those of age- and sex-matched healthy controls.ResultsOf 54 patients screened with craniopharyngioma, 42 were analyzed, 80% of whom complained of excessive daytime sleepiness. Sleep testing revealed that 6 (14.3%) of them had secondary narcolepsy (including one with cataplexy), and 11 (26.2%) had central hypersomnia associated with a medical disorder. Compared with controls, patients were more frequently obese, had a shorter mean sleep latency on MSLT, and slept longer on the first night. There was a nonsignificant trend for patients with (vs. without) narcolepsy and hypersomnia to be younger, to have a higher body mass index, to be more likely to have received radiation therapy, and to have more severe damage to the hypothalamus after surgery. Treatment with stimulants (modafinil, pitolisant, and methylphenidate) was beneficial in 9/10 patients.ConclusionsNearly half of the patients with craniopharyngioma and sleep disorders have a central disorder of hypersomnolence (narcolepsy and hypersomnia), which should be investigated and lead to considerations beyond sleep apnea syndrome in these obese patients.
      PubDate: Fri, 17 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad032
      Issue No: Vol. 46, No. 5 (2023)
       
  • Exploiting labels from multiple experts in automated sleep scoring

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      First page: zsad034
      Abstract: National Institutes of Health10.13039/100000002R01NS102190R01NS102574R01NS107291RF1AG064312RF1NS120947R01AG073410R01HL161253R01NS126282R01AG073598National Science Foundation10.13039/1000000012014431American Academy of Sleep Medicine Foundation 10.13039/1000139811RF1AG064312
      PubDate: Thu, 16 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad034
      Issue No: Vol. 46, No. 5 (2023)
       
  • Multi-scored sleep databases: how to exploit the multiple-labels in
           automated sleep scoring

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      First page: zsad028
      Abstract: Study ObjectivesInter-scorer variability in scoring polysomnograms is a well-known problem. Most of the existing automated sleep scoring systems are trained using labels annotated by a single-scorer, whose subjective evaluation is transferred to the model. When annotations from two or more scorers are available, the scoring models are usually trained on the scorer consensus. The averaged scorer’s subjectivity is transferred into the model, losing information about the internal variability among different scorers. In this study, we aim to insert the multiple-knowledge of the different physicians into the training procedure. The goal is to optimize a model training, exploiting the full information that can be extracted from the consensus of a group of scorers.MethodsWe train two lightweight deep learning-based models on three different multi-scored databases. We exploit the label smoothing technique together with a soft-consensus (LSSC) distribution to insert the multiple-knowledge in the training procedure of the model. We introduce the averaged cosine similarity metric (ACS) to quantify the similarity between the hypnodensity-graph generated by the models with-LSSC and the hypnodensity-graph generated by the scorer consensus.ResultsThe performance of the models improves on all the databases when we train the models with our LSSC. We found an increase in ACS (up to 6.4%) between the hypnodensity-graph generated by the models trained with-LSSC and the hypnodensity-graph generated by the consensus.ConclusionOur approach definitely enables a model to better adapt to the consensus of the group of scorers. Future work will focus on further investigations on different scoring architectures and hopefully large-scale-heterogeneous multi-scored datasets.
      PubDate: Fri, 10 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad028
      Issue No: Vol. 46, No. 5 (2023)
       
  • Gene-x-environment analysis supports protective effects of eveningness
           chronotype on self-reported and actigraphy-derived sleep duration among
           those who always work night shifts in the UK Biobank

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      First page: zsad023
      Abstract: Previous research has linked having an eveningness chronotype with a higher tolerance for night shift work, suggesting the ability to work nights without health consequences may partially depend upon having a circadian clock optimized for these times. As chronotypes entrain over time to environmental cues, it remains unclear whether higher relative eveningness among healthy night workers reflects a moderating or mediating effect of chronotype on health. We address these concerns conducting a genome-wide association study and utilizing a polygenic score (PGS) for eveningness as a time-invariant measure of chronotype. On a sample of 53 211 workers in the UK Biobank (2006–2018), we focus on the effects of night shift work on sleep duration, a channel through which night shift work adversely affects health. We ask whether a higher predisposition toward eveningness promotes night shift work tolerance. Results indicate that regular night shift work is associated with a 13-minute (3.5%) reduction in self-reported sleep per night relative to those who never work these hours (95% confidence interval [CI] = −17:01, −8:36). We find that eveningness has a strong protective effect on night workers: a one-SD increase in the PGS is associated with a 4-minute (28%) reduction in the night shift work sleep penalty per night (CI = 0:10, 7:04). This protective effect is pronounced for those working the longest hours. Consistent patterns are observed with an actigraphy-derived measure of sleep duration. These findings indicate that solutions to health consequences of night shift work should take individual differences in chronotype into account.
      PubDate: Mon, 06 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad023
      Issue No: Vol. 46, No. 5 (2023)
       
  • Poor sleep quality, impaired cardiac autonomic control, and metabolic
           syndrome: a tricky relationship'

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      First page: zsad022
      Abstract: The occurrence of metabolic syndrome (MetS) is highly favored by a lack of physical activity, a sedentary lifestyle, and an unbalanced diet. The number of cases has been constantly increasing in the last 40 years, affecting up to more than 40% of people over 50 years old in the United States [1]. Although it remains asymptomatic for several years, MetS evolves silently and should be taken very seriously. Indeed, over time, MetS considerably increase the risk of developing serious diseases such as type 2 diabetes, liver, chronic kidney, or cardiovascular diseases [2, 3].
      PubDate: Mon, 06 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad022
      Issue No: Vol. 46, No. 5 (2023)
       
  • Association of sleep behaviors with white matter hyperintensities and
           microstructural injury: a cross-sectional and longitudinal analysis of 26
           354 participants

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      First page: zsad020
      Abstract: Study ObjectivesThis study assessed the associations between sleep behaviors with white matter macro and microstructure.MethodsA total of 26 354 participants in the UK Biobank (mean [standard deviation], age, 63.7 [7.5] years, 53.4% female) were included in this study. A healthy sleep score integrated sleep behaviors including chronotype, insomnia, sleep duration, daytime sleepiness, and snoring. Linear and nonlinear relationships were calculated between individual and aggregate sleep behaviors with white matter hyperintensities (WMH) and microstructural injury.ResultsA “U-shaped” relationship was revealed between sleep duration and WMH, and the lowest WMH was at 7.7 h per night. Four unhealthy sleep behaviors including late chronotype, sleep duration (>8 h or <7 h), excessive daytime sleepiness, and snoring significantly increased WMH impacts. Lower healthy sleep score was linked with increased WMH impacts (β = 0.164, 95% CI = 0.110–0.218), and worse microstructure in association and thalamic white matter tracts. Increased body mass index, glycated hemoglobin A1c, and systolic blood pressure were potential mediators of the relationships between unhealthy sleep behaviors and increased WMH. However, higher BMI and low-density lipoprotein were revealed as protective mediators between snoring and improved white matter integrity including lower MD and higher ICVF.ConclusionsUnhealthy sleep behaviors were associated with increased WMH impacts and worse white matter microstructure in specific tracts across middle and older age. These findings provide the potential to improve white matter integrity by reversing unhealthy sleep behaviors.
      PubDate: Thu, 02 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad020
      Issue No: Vol. 46, No. 5 (2023)
       
  • The role of sleep and heart rate variability in metabolic syndrome:
           evidence from the Midlife in the United States study

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      First page: zsad013
      Abstract: Study ObjectivesPoor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study.MethodsSelf-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses.ResultsPoor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV.ConclusionsTo the best of the author’s knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
      PubDate: Thu, 02 Feb 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad013
      Issue No: Vol. 46, No. 5 (2023)
       
  • Small-molecule screening in aged Drosophila identifies mGluR as a
           regulator of age-related sleep impairment

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      First page: zsad018
      Abstract: As a normal physiological phenomenon, aging has a significant impact on sleep. Aging leads to sleep impairment, including sleep loss, fragmented sleep, and a lower arousal threshold, leading to various diseases. Because sleep regulates memory consolidation, age-dependent sleep impairment also affects memory. However, the mechanisms underlying age-related sleep dysregulation and its impact on memory remain unclear. Using male and female Drosophila as a model, which possesses sleep characteristics similar to those of mammals and exhibits age-dependent sleep impairment, we performed small-molecule screening to identify novel regulators of age-dependent decline in sleep. The screening identified 3,3ʹ-difluorobenzaldazine (DFB), a positive allosteric modulator of the metabotropic glutamate receptor (mGluR) 5, as a novel sleep-promoting compound in aged flies. We found that mutant flies of mGluR, a single mGluR gene in Drosophila, and decreased mGluR expression had significant impairment in sleep and memory due to olfactory conditioning. The decreased sleep phenotype in the mGluR mutants was not promoted by DFB, suggesting that the effects of DFB on age-dependent sleep impairment are dependent on mGluR. Although aging decreases the expression of mGluR and the binding scaffold proteins Homer and Shank, the transient overexpression of mGluR in neurons improves sleep in both young and aged flies. Overall, these findings indicate that age-dependent decreased expression or function of mGluR impairs sleep and memory in flies, which could lead to age-related sleep and memory impairment.
      PubDate: Tue, 31 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad018
      Issue No: Vol. 46, No. 5 (2023)
       
  • Pro: can physiological risk factors for obstructive sleep apnea be
           determined by analysis of data obtained from routine polysomnography'

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      First page: zsac310
      Abstract: pathophysiologyendotypesprecision medicine
      PubDate: Sat, 28 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsac310
      Issue No: Vol. 46, No. 5 (2023)
       
  • Association between indoor noise level at night and objective/subjective
           sleep quality in the older population: a cross-sectional study of the
           HEIJO-KYO cohort

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      First page: zsac197
      Abstract: Study objectivesNoise exposure could be an important risk factor for low sleep quality; however, evidence on indoor noise in large-scale populations is limited. We evaluate the association between indoor noise at night and objective and subjective sleep quality in the older population.MethodsIn this cross-sectional study of 1076 participants (≥60 years), we measured indoor noise at night (A-weighted equivalent noise from bedtime to rising time [LAeq]) using a portable noise level meter set in bedrooms and sleep quality using actigraphy and a questionnaire for 2 nights. Using multivariable linear regression models, we examined the associations between indoor noise at night and objective and subjective sleep parameters independent of potential confounders such as age, body mass index, and sleep medication.ResultsIncreased indoor noise at night by 1 dB of LAeq was significantly associated with lower objective sleep quality, such as lower sleep efficiency (regression coefficient [β], −0.19%; 95% confidence interval [95% CI], −0.26 to −0.12; p < 0.001), longer log-transformed sleep onset latency (β, 0.02 log min; 95% CI 0.01 to 0.03; p< 0.001) and wake after sleep onset (β, 0.66 min; 95% CI 0.40 to 0.92; p < 0.001), and higher log-transformed fragmentation index (β, 0.01; 95% CI 0.008 to 0.017; p < 0.001). These results remained consistent in the analysis using noise-event rate (≥45 dB) as an independent variable.ConclusionThis study revealed the quantitative association between indoor noise at night and objective and subjective sleep quality in the older population. Reducing noise and improving sleep quality may prevent fatal diseases.
      PubDate: Fri, 27 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsac197
      Issue No: Vol. 46, No. 5 (2023)
       
  • Muscle injury induces an increase in total and non-rapid eye movement
           sleep time

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      First page: zsad012
      Abstract: Study ObjectivesThis study describes macro- and micro-sleep responses to a myotoxic skeletal muscle injury and investigates possible mechanisms.MethodsWe recorded the electroencephalogram (EEG)/electromyogram (EMG) of 24 Wistar rats before and after induction of tibialis anterior muscle injury (n = 8 per group: control, control + buprenorphine and injured). A top-down analysis of sleep characteristics was processed from total sleep time (TST), sleep stages, sleep stability, spectral analysis, and spindles. To further investigate the mechanisms involved, we analyzed the protein level of sleep regulatory molecules including tumor necrosis factor- α (TNF-α), interleukin-1β (IL-1β), insulin-like growth factor-1 (IGF-1), and brain and muscle ARNT-like 1 (BMAL1) in plasma, frontal cortex, hippocampus, and tibialis anterior, collected at day +2 after injury from non-EEG/EMG implanted rats.ResultsMuscle injury induces a significant increase in TST at 48 and 72 h post-injury, specific to non-rapid eye movement (NREM) sleep. These increases occur during the dark period and are associated with the higher stability of sleep over 24 h, without change in the different power/frequency spectral bands of NREM/REM sleep. There was no corresponding sleep increase in slow-wave activity or spindle density, nor were there changes in brain levels of the sleep-regulating proinflammatory cytokine IL-1β, which is otherwise involved in the local response to injury. Conversely, decreased protein levels of brain IGF-1 and muscle BMAL1, a core circadian clock gene, after injury may play a role in increased sleep time.ConclusionMuscle injury induces an increase in total sleep time at 48- and 72-h post-injury, specific to NREM sleep during the dark period in rats and is associated with higher sleep stability over 24 h.
      PubDate: Mon, 23 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad012
      Issue No: Vol. 46, No. 5 (2023)
       
  • Aging impairs the temporal clustering of sleep spindles

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      First page: zsad011
      Abstract: During the second half of our lives and starting already within our forties, our sleeping patterns change. These changes might initially not appear as dramatic as the reorganization of sleep during infancy and early childhood, but they can greatly affect our self-reported quality of life. On the one hand, these alterations occur on the macro scale of overall sleep architecture and might entail a general fragmentation of sleep, a higher number of arousals, and reduced amounts of slow-wave sleep. On the other hand, age impacts sleep on the microscale such that the overall frequency composition, cross-frequency coupling as well as the occurrence of sleep oscillations in the Electroencephalography (EEG) signal are affected. For instance, it has been shown that with aging slow oscillations display reduced amplitudes, a flatter slope, and lower densities [1, 2] and that sleep spindles are reduced in number and duration [3].
      PubDate: Sat, 21 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsad011
      Issue No: Vol. 46, No. 5 (2023)
       
  • Con: can physiological risk factors for obstructive sleep apnea be
           determined by analysis of data obtained from routine polysomnography'

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      First page: zsac158
      Abstract: endotypesarousal thresholdloop gainairway collapsibility
      PubDate: Mon, 09 Jan 2023 00:00:00 GMT
      DOI: 10.1093/sleep/zsac158
      Issue No: Vol. 46, No. 5 (2023)
       
  • Objective multi-night sleep monitoring at home: variability of sleep
           parameters between nights and implications for the reliability of sleep
           assessment in clinical trials

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      First page: zsac319
      Abstract: Study ObjectivesIn-laboratory polysomnography is the current gold standard for objective sleep measurements in clinical trials, but this does not capture night-to-night variability in sleep parameters. This study analyzed variability in sleep parameters recorded over multiple nights of sleep in an ecological setting using a portable sleep monitor and then estimated the minimum sample sizes required to reliably account for inter- and intra-individual variability in sleep parameters.MethodsParticipants were males who self-reported the absence of sleep disorders, and used a sleep monitoring device (Dreem Headband, Dreem, France) over multiple nights of sleep. Night-to-night variability of sleep parameters was determined over five consecutive weeknights using coefficients of variation (CV), and the minimal number of individuals and nights needed to reliably determine each sleep parameter was assessed.ResultsNight-to-night variability for the whole group (n = 94; 470 nights) was high (CV 0.44–0.58) for N2, N3, sleep onset and persistent sleep latencies, and wake after sleep onset (WASO), medium (CV 0.22–0.28) for N1 and N3 percentage, awakenings and REM latency, and low (CV 0.04–0.19) for sleep efficiency, N2 and REM percentages, total sleep time (TST) and micro-arousal index. Minimum sample sizes for reliable assessment of TST and WASO were 2 nights with 10 participants and 4 nights with 50 participants, respectively.ConclusionsNight-to-night variability of sleep parameters is underestimated and under-recognized. These data on variability in commonly used sleep parameters will facilitate better estimation of sample sizes and number of nights required in clinical trials based on the outcomes of interest.
      PubDate: Fri, 30 Dec 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac319
      Issue No: Vol. 46, No. 5 (2022)
       
  • Sleep and neurocognitive outcome in primary school children with Robin
           Sequence

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      First page: zsac317
      Abstract: Study objectivesTo investigate neurocognitive and behavioral outcomes at primary school age in relation to obstructive sleep apnea (OSA) in children with Robin sequence (RS) treated with the Tuebingen palatal plate in infancy and to assess the impact of OSA in these patients.MethodsForty-two primary school-aged children (n = 21 with RS, n = 21 age- and sex-matched controls) underwent polysomnography, intelligence testing (“Wechsler Intelligence Scale for Children—Fifth Edition” [WISC-V]), and anthropometrics. Families completed a 7-day sleep diary and questionnaires on sleep and behavior (Children’s Sleep Habits Questionnaire [CSHQ] and the Child Behavior Checklist [CBCL]).ResultsIn children with RS (17 non-syndromic, four syndromic; median age 9.7 [8.5–10.8] years), the obstructive apnea-hypopnea index (OAHI) was significantly higher than in controls (1.3 [0.4–2.7]/h vs. 0.4 [0.1–0.6]/h). Two syndromic children with RS were already on nocturnal respiratory support for OSA prior to our study, and one non-syndromic child was diagnosed with severe OSA (OAHI 57/h) despite an unremarkable medical history and questionnaire. The overall intelligence quotient in children with RS was within the normal range and did not differ between children with RS and healthy peers (102 vs. 108, p = .05). However, children with RS had values in the at-risk clinical range for externalizing behavior.ConclusionsThese children with RS showed an increased risk of OSA and behavioral problems, suggesting regular screening for OSA throughout childhood. Neurocognitive scores in children with RS were within the normal range after adequate treatment of OSA during infancy.
      PubDate: Sun, 25 Dec 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac317
      Issue No: Vol. 46, No. 5 (2022)
       
  • A randomized-controlled trial of a digital, small incentive-based
           intervention for working adults with short sleep

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      First page: zsac315
      Abstract: Study ObjectivesWe evaluated the efficacy of a digitally delivered, small and scalable incentive-based intervention program on sleep and wellbeing in short-sleeping, working adults.MethodsA 22-week, parallel-group, randomized-controlled trial was conducted on 21–40 y participants gifted with FitbitTM devices to measure sleep for ≥2 years, as part of a broader healthy lifestyle study. About 225 short sleepers (141 males; average time-in-bed, TIB < 7h) were randomly assigned in a 2:1 ratio to Goal-Setting or Control groups. The Goal-Setting group received health vouchers (~USD 0.24) for meeting each sleep goal (i.e. increasing weeknight TIB by 30 min/sleeping before midnight).The study spanned three phases: (1) 2-week Baseline, (2) 10-week Intervention, and (3) 10-week Follow-Up. Wellbeing questionnaires were administered on Weeks 1–2, 11–12, and 21–22.ResultsBaseline weeknight TIB (mean ± SD) was 387 ± 43 min (Goal-Setting) and 399 ± 44 min (Control), while bedtime was 00:53 ± 01:13 (Goal-Setting), and 00:38 ± 00:56 (Control). No difference in sleep outcomes was observed at study endpoints, but exploratory week-by-week analysis showed that on Weeks 3–5, TIB in the Goal-Setting group increased (9–18 min; ps < 0.05) while on Week 5, bedtimes shifted earlier (15 min; p < 0.01) compared to Baseline. Morning sleepiness was reduced in the Goal-Setting group (mean[SEM] = −3.17(1.53); p = 0.04) compared to Baseline, although between-group differences were not significant (p = 0.62). Main barriers to sleeping longer were work hours (35%), followed by leisure activities (23%) and family commitments (22%).ConclusionOur program resulted in encouraging subjective sleep improvements and short-term sleep extension, but sustained transformation of sleep will probably require structural measures to overcome significant obstacles to sleep.Trial RegistrationClinicalTrials.gov Identifier: NCT04878380 (hiSG Sleep Health Study (hiSG-SHS); https://clinicaltrials.gov/ct2/show/NCT04878380)
      PubDate: Wed, 21 Dec 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac315
      Issue No: Vol. 46, No. 5 (2022)
       
  • Insufficient sleep predicts poor weight loss maintenance after 1 year

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      First page: zsac295
      Abstract: Study ObjectivesInsufficient sleep may attenuate weight loss, but the role of sleep in weight loss maintenance is unknown. Since weight regain after weight loss remains a major obstacle in obesity treatment, we investigated whether insufficient sleep predicts weight regain during weight loss maintenance.MethodsIn a randomized, controlled, two-by-two factorial study, 195 adults with obesity completed an 8-week low-calorie diet and were randomly assigned to 1-year weight loss maintenance with or without exercise and liraglutide 3.0 mg/day or placebo. Sleep duration and quality were measured before and after the low-calorie diet and during weight maintenance using wrist-worn accelerometers (GENEActiv) and Pittsburgh Sleep Quality Index (PSQI). To test associations between insufficient sleep and weight regain, participants were stratified at randomization into subgroups according to sleep duration (</≥6 h/night) or sleep quality (PSQI score ≤/>5).ResultsAfter a diet-induced 13.1 kg weight loss, participants with short sleep duration at randomization regained 5.3 kg body weight (p = .0008) and had less reduction in body fat percentage compared with participants with normal sleep duration (p = .007) during the 1-year weight maintenance phase. Participants with poor sleep quality before the weight loss regained 3.5 kg body weight compared with good quality sleepers (p = .010). During the weight maintenance phase, participants undergoing liraglutide treatment displayed increased sleep duration compared with placebo after 26 weeks (5 vs. −15 min/night) but not after 1 year. Participants undergoing exercise treatment preserved the sleep quality improvements attained from the initial weight loss.ConclusionsShort sleep duration or poor sleep quality was associated with weight regain after weight loss in adults with obesity.
      PubDate: Tue, 06 Dec 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac295
      Issue No: Vol. 46, No. 5 (2022)
       
  • Age-related changes in fast spindle clustering during non-rapid eye
           movement sleep and their relevance for memory consolidation

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      First page: zsac282
      Abstract: Sleep plays a crucial role in memory consolidation. Recent data in rodents and young adults revealed that fast spindle band power fluctuates at a 0.02-Hz infraslow scale during non-rapid eye movement (NREM) sleep. These fluctuations result from a periodic temporal clustering of spindles and may modulate sleep maintenance and memory consolidation. With age, sleep undergoes substantial changes but age-related changes in spindle clustering have never been investigated. Polysomnography data were collected in 147 older (mean age ± SD: 69.3 ± 4.1 years) and 32 young-middle aged (34.5 ± 10.9 years) adults. Sleep-dependent memory consolidation was assessed in a subsample of 57 older adults using a visuospatial memory task. We analyzed power fluctuations in fast spindle frequency band, detected fast spindles, and quantified their clustering during the night separating encoding and retrieval. Fast spindle band power fluctuated at a 0.02-Hz infraslow scale in young-middle aged and older adults. However, the proportion of clustered fast spindles decreased non-linearly with age (p < .001). This effect was not mediated by NREM sleep fragmentation. The clustering level of fast spindles modulated their characteristics (p < .001). Finally, the mean size of spindle clusters was positively associated with memory consolidation (p = .036) and negatively with NREM sleep micro-arousal density (p = .033). These results suggest that clusters of fast spindles may constitute stable sleep periods promoting off-line processes such as memory consolidation. We emphasize the relevance of considering spindle dynamics, obviously impaired during aging, to understand the impact of age-related sleep changes on memory.Clinical Trial Information: Name: Study in Cognitively Intact Seniors Aiming to Assess the Effects of Meditation Training (Age-Well). URL: https://clinicaltrials.gov/ct2/show/NCT02977819'term=Age-Well&draw=2&rank=1. See STROBE_statement_AGEWELL.doc in supplementary material. Registration: EudraCT: 2016-002441-36; IDRCB: 2016-A01767-44; ClinicalTrials.gov Identifier: NCT02977819.
      PubDate: Sat, 26 Nov 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac282
      Issue No: Vol. 46, No. 5 (2022)
       
  • Obesity in children with narcolepsy: metabolic and endocrine comorbidities

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      First page: zsac281
      Abstract: Study ObjectivesNarcolepsy with cataplexy is associated with obesity in children. We proposed to assess whether metabolic complications were linked to narcolepsy regardless of obesity. The second aim of the study was to compare endocrine comorbidities in obese children with narcolepsy and control patients.MethodsWe performed a case-control study in Pediatric Sleep Unit and Pediatric Endocrinology Unit of Woman Mother Child Hospital (Lyon, France) comparing 22 children with narcolepsy with 22 sex-, pubertal stage-, and BMI-matched non-syndromic obese patients. Clinical examination, biological measurements including an oral glucose tolerance test, and abdominal ultrasound were performed.ResultsNo difference regarding glucidic, lipid profile, hepatic, respiratory, and cardiovascular parameters were found between narcoleptic and control participants. Insulin sensitivity did not differ between the two groups. Control patients had more first-degree family history of overweight or obesity than children with narcolepsy (83% vs. 50%, p = .05). Prevalence of precocious puberty in children with narcolepsy was not higher than in control participants, but all the cases of advanced puberty involved children with narcolepsy who were diagnosed before 11 years old. All cases of central hypothyroidism belong to the narcoleptic group, who presented lower thyroid-stimulating hormone and fTA values compared to control children (respectively p = .03 and p = .001).ConclusionsNo difference regarding metabolic complications was found between children with narcolepsy and control participants. Thus, metabolic disorders may be related to weight gain rather than a narcolepsy-specific risk. The presence of hypothyroidism and advanced puberty suggests a global involvement of hypothalamic structures in children with narcolepsy.
      PubDate: Sat, 26 Nov 2022 00:00:00 GMT
      DOI: 10.1093/sleep/zsac281
      Issue No: Vol. 46, No. 5 (2022)
       
 
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