Prevalence of Insomnia and Sleep Habits during the First and Second Wave of COVID-19 in Belgium.

Belgium has one of the highest numbers of COVID-19 cases per 1 million inhabitants. The pandemic has led to significant societal changes with repercussions on sleep and on mental health. We aimed to investigate the effect of the first and the second wave of COVID-19 on the sleep of the Belgian populationWe launched two online questionnaires, one during the first lockdown (7240 respondents) and one during the second (3240 respondents), to test differences in self-reported clinical insomnia (as measured by the Insomnia Severity Index) and sleep habits during the two lockdowns in comparison with the pre-COVID period.

Alogliptin and Heart Failure Outcomes in Patients With Type 2 Diabetes.

In 2016, the FDA issued a warning for saxagliptin and alogliptin regarding an increased risk of heart failure (HF), potentially limiting the use of effective medications in type 2 diabetes. Current data and guideline recommendations regarding HF risk are conflicting, especially with alogliptin. In March 2019, the Memphis Veterans Affairs Medical Center made a formulary change from saxagliptin to alogliptin, creating an opportunity to evaluate a large number of patients receiving alogliptin.

The Risk of Major Bleeding With Apixaban Administration in Patients With Acute Kidney Injury.

Background: Apixaban is eliminated by the kidneys and in acute kidney injury (AKI) there is potential for an increase in apixaban exposure and bleeding events. In one instance, data have shown higher than normal bleed risk in patients with AKI, unless calibrated anti-factor Xa monitoring is used, which is not widely available.

Objective: To evaluate bleeding with apixaban administration to hospitalized patients with an AKI in an unmonitored real-world scenario.

Reversible Verbal Memory Integration Deficits in Obstructive Sleep Apnoea.

When presented with novel but semantically related elements after learning verbal material, healthy participants tend to endorse these items as previously learned. This reflects the normal integration and association of novel verbal information into long-term memory. How obstructive sleep apnoea (OSA) negatively impacts verbal memory performance, and whether deficits are reversible following positive airway pressure (PAP) treatment, remain elusive.

Impact of Beta-Lactam Allergies on Selection of Antimicrobials in an Inpatient Setting Among Veteran Population.

Purpose: Beta-lactam antibiotics are among the most common and widely used antibiotics. However, reported allergy to this class of antibiotics is also common, leading to the use of alternative broad-spectrum antibiotics by healthcare providers. This has led to the emergence of various negative health outcomes.

Sex-Related Differences in Sleep-Related PSG Parameters and Daytime Complaints in a Clinical Population.

Background: Recent research suggested that perception of sleep impairments might present sex-related effects (ie, women appear to be more prone to report fatigue rather than sleepiness). The latter has been evidenced in sleep-related breathing disorders (SRBD). Differently, it has been suggested that sleep-related movement disorders may also be associated to fatigue rather than to sleepiness.

Recruitment dynamics of cognitive control in insomnia.

Study Objectives: Individuals with insomnia disorder (ID) commonly report complaints of cognitive control functioning. Conversely, both behavioral and neurological evidence supporting subjective cognitive control impairments in insomnia remain remarkably scarce and inconclusive. To investigate this discrepancy, the present study used next to behavioral measures, event-related potentials (ERPs) to assess proactive control and reactive control in insomnia.

An Underappreciated and Prolonged Drug Interaction Leads to Ineffective Anticoagulation.

A poorly understood significant drug-drug interaction compounded by ineffective communication among providers at times of care transition most likely contributed to multiple thromboembolic events in an 81-year-old patient. Increased awareness of drug interactions with direct oral anticoagulants (DOACs), as well as improved communication among inpatient and outpatient providers at the time of discharge is essential in maximizing efficacy and safety outcomes in patients requiring chronic anticoagulation. When rifampin is coadministered with apixaban, a reduction in apixaban exposure results in decreased efficacy and increased risk for thromboembolic events.

Preparing for Mars: human sleep and performance during a 13 month stay in Antarctica.

Study Objectives: Manned spaceflights from Earth to Mars will likely become reality within the next decades. Humans will be exposed to prolonged isolation, confinement, and altered photoperiods under artificial atmospheric conditions, with potential adverse effects on sleep and performance. On Earth, polar environments serve as space analogs to study human adaptation; yet, few studies include polysomnography due to operational constraints.

The added value of cognitive behavioral therapy for insomnia to current best evidence physical therapy for chronic spinal pain: protocol of a randomized controlled clinical trial.

Background: Insomnia is a highly prevalent and debilitating comorbidity that is often not addressed in therapy for chronic spinal pain (CSP). Given the close interaction between insomnia and CSP severity and related disability, targeting sleep problems during therapy could improve treatment outcomes in these patients.

Objective: Can cognitive behavioral therapy for insomnia (CBT-I) combined with the modern neuroscience approach (i.

Effect of sleep bruxism duration on perceived sleep quality in middle-aged subjects.

Sleep-related bruxism may directly impact sleep quality. This study aims to evaluate potential relationships between sleep bruxism events and related daytime symptoms. We investigated 22 patients (42.

First Successful Mechanical Splint for Obstructive Sleep Apnea With an Orally Administrable Pharyngeal Stenting Device.

We report the case of obstructive sleep apnea in a 19-year-old, otherwise healthy male presenting with persistent daytime sleepiness and nonrestorative sleep after velo- and uvuloplasty. An individually tailored prototype of an orally inserted pharyngeal stenting device was proposed in the framework of a first clinical feasibility trial. The noninvasive, easily self-administered device is mounted on a simple inferior dental guard.

Can positional therapy be simple, effective and well tolerated all together? A prospective study on treatment response and compliance in positional sleep apnea with a positioning pillow.

Purpose: Until now, there is no clear consensus on optimal care for mild sleep-related breathing disorders (SRBD) in general or for positional obstructive sleep apnea (POSA) in particular. Most proposed treatment options are either invasive and/or expensive. Positional therapy (PT) may therefore present as a valuable first-line intervention in POSA.

Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice.

Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain.

The Brugmann Fatigue Scale: An Analogue to the Epworth Sleepiness Scale to Measure Behavioral Rest Propensity.

: While often confused, fatigue (as opposed to sleepiness) mostly requires rest, not sleep, to recover from. Clinical evaluations of fatigue mainly rely on assessments of symptom intensity, however without taking into account the need to engage in behavioral countermeasures. We therefore developed an 8-item 4-point Likert scale (the Brugmann Fatigue Scale; BFS) sharing a similar conceptual background with the Epworth Sleepiness Scale (ESS), assessing mental and physical fatigue and focusing specifically on rest propensity.

While Isolated Periodic Limb Movement Disorder Significantly Impacts Sleep Depth and Efficiency, Co-Morbid Restless Leg Syndrome Mainly Exacerbates Perceived Sleep Quality.

Background: Restless leg syndrome (RLS) and periodic limb movement (PLM) disorder (PLMD) can affect sleep quality and interfere with daytime functioning. Whether the co-morbidity of RLS further worsens daytime symptoms, sleep architecture and quality in patients with PLMs, is not yet fully clarified.

Methods: Sleep (polysomnography) and daytime symptoms of 47 drug-free patients, assigned to isolated PLMD or co-morbid RLS subgroups, were compared to controls in a retrospective cohort-study (n = 501).

Tired of blunt tools? Sharpening the clinical assessment of fatigue and sleepiness.

Fatigue and sleepiness are ubiquitous symptoms in various conditions and are frequently associated to impaired sleep quality. While separate fatigue and sleepiness scales exist, both constructs are often confused. Unraveling this issue requires estimating the instruments' measurement properties, potential scale recalibration and re-evaluation of symptom intensities on a comparable basis.

Individual differences in subjective circadian flexibility.

The aim of this study was to evaluate individual differences in the subjective flexibility of the circadian system in a community sample, with respect to age, gender, chronotype, and sleepiness perceptions. An online questionnaire containing the Circadian Type Inventory, the Composite Scale of Morningness, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale was administered. In addition, participants performed a visuo-verbal judgment task to determine time-of-day variations in estimated sleepiness.

Complex sleep apnea at auto-titrating CPAP initiation: prevalence, significance and predictive factors.

Introduction: Obstructive sleep apnea (OSA) patients may develop central respiratory events under continuous positive airway pressure (CPAP), referred to as complex sleep apnea (CompSA).

Objective: We aimed to assess prevalence and predictive factors of complex apnea and to evaluate treatment response to CPAP.

Methods: Within a retrospective cohort study, we assessed clinical data of OSA patients, attending the sleep lab during a 15-months period.

Slow wave sleep in the chronically fatigued: Power spectra distribution patterns in chronic fatigue syndrome and primary insomnia.

Objectives: To investigate slow wave sleep (SWS) spectral power proportions in distinct clinical conditions sharing non-restorative sleep and fatigue complaints without excessive daytime sleepiness (EDS), namely the chronic fatigue syndrome (CFS) and primary insomnia (PI). Impaired sleep homeostasis has been suspected in both CFS and PI.

Methods: We compared perceived sleep quality, fatigue and sleepiness symptom-intensities, polysomnography (PSG) and SWS spectral power distributions of drug-free CFS and PI patients without comorbid sleep or mental disorders, with a good sleeper control group.

Dimensions of pure chronic fatigue: psychophysical, cognitive and biological correlates in the chronic fatigue syndrome.

Objectives: To investigate associated dimensions of fatigue regarding cognitive impairment, psychomotor performances, muscular effort power and circulating cytokine levels and their relations to symptom intensity in a sample of pure chronic fatigue syndrome (CFS) patients without overlapping objective sleepiness or sleep disorders.

Methods: 16 CFS patients were compared to 14 matched controls. We assessed structured symptom-scales, polysomnography, multiple sleep latency tests, attention (Zazzo-Cancellation ZCT, digit-symbol-substitution DSST), psychomotor vigilance and speed (PVT, finger tapping test, FTT), dynamometer handgrip force (tonic and phasic trials) and circulating cytokines (IFN-γ, IL-1b, IL-6, IL-8, IL-10, TNF-α).

Non-REM sleep EEG power distribution in fatigue and sleepiness.

Objectives: The aim of this study is to contribute to the sleep-related differentiation between daytime fatigue and sleepiness.

Methods: 135 subjects presenting with sleep apnea-hypopnea syndrome (SAHS, n=58) or chronic fatigue syndrome (CFS, n=52) with respective sleepiness or fatigue complaints and a control group (n=25) underwent polysomnography and psychometric assessments for fatigue, sleepiness, affective symptoms and perceived sleep quality. Sleep EEG spectral analysis for ultra slow, delta, theta, alpha, sigma and beta power bands was performed on frontal, central and occipital derivations.

Rapid eye movement and non-rapid eye movement sleep contributions in memory consolidation and resistance to retroactive interference for verbal material.

Study Objectives: To test the hypothesis that rapid eye movement (REM) sleep contributes to the consolidation of new memories, whereas non-rapid eye movement (NREM) sleep contributes to the prevention of retroactive interference.

Design: Randomized, crossover study.

Setting: Two sessions of either a morning nap or wakefulness.

Rapid eye movement sleep does not seem to unbind memories from their emotional context.

Sleep unbinds memories from their emotional learning context, protecting them from emotional interference due to a change of mood between learning and recall. According to the 'sleep to forget and sleep to remember' model, emotional unbinding takes place during rapid eye movement sleep. To test this hypothesis, we investigated emotional contextual interference effects after early versus late post-learning sleep periods, in which slow wave and rapid eye movement sleep, respectively, predominate.