Sleep and circadian disturbances in children with neurodevelopmental disorders.

Sleep is essential for brain development and overall health, particularly in children with neurodevelopmental disorders (NDDs). Sleep disruptions can considerably impact brain structure and function, leading to dysfunction of neurotransmitter systems, metabolism, hormonal balance and inflammatory processes, potentially contributing to the pathophysiology of NDDs. This Review examines the prevalence, types and mechanisms of sleep disturbances in children with NDDs, including autism spectrum disorder, attention-deficit hyperactivity disorder and various genetic syndromes.

What are the important risk factors for excessive daytime sleepiness in a population-based cohort?

Excessive daytime sleepiness (EDS) is a common complaint in the general population and is associated with cardiovascular disease and increased mortality. We aimed to investigate whether sleep duration is related to excessive daytime sleepiness in the general population, both in itself and in combination with other factors. We performed a cross-sectional analysis in the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort (n = 27,976; 14,436 females; aged 50-64 years) to assess how sleep-related factors along with anthropometric, lifestyle, socioeconomic factors as well as somatic disease and psychological distress, were related with EDS assessed by the Epworth sleepiness scale (ESS).

Systematic review: REM sleep, dysphoric dreams and nightmares as transdiagnostic features of psychiatric disorders with emotion dysregulation - Clinical implications.

Background: Fragmented rapid eye movement (REM) sleep disrupts the overnight resolution of emotional distress, a process crucial for emotion regulation. Emotion dysregulation, which is common across psychiatric disorders, is often associated with sleep disturbances. This systematic review explores how REM sleep and nightmares affect emotion processing and regulation in individuals with psychiatric disorders where emotion dysregulation is a key concern, suggesting novel sleep-related treatment pathways.

Context-aware analysis enhances autoscoring accuracy of home sleep apnea testing.

Study Objectives: Home sleep apnea testing based on peripheral arterial tonometry (P-HSAT) is increasingly being deployed because of its ability to test for multiple nights. However, P-HSATs do not have access to modalities such as airflow and cortical arousals and instead rely on alternative sources of information to detect respiratory events. This results in an a-priori performance disadvantage.

Duration of major depressive episodes and sleep architecture: an exploratory study.

Growing evidence supports sleep-wake disruption as a mechanism involved in mood disorders pathogenesis. Duration of depressive episodes varies widely, and longer depressive episodes have been connected to worse outcomes. We aimed to explore if the length of depressive episodes is related to objective modifications of sleep features.

Comparative analysis of sleep physiology using qualitative and quantitative criteria for insomnia symptoms.

Despite decades of research, defining insomnia remains challenging due to its complex and variable nature. Various diagnostic systems emphasize the chronic nature of insomnia and its impact on daily functioning, relying heavily on patient self-reporting due to limitations in objective measures like polysomnography (PSG). Discrepancies between subjective experiences and objective PSG results highlight the need for more nuanced approaches, such as electroencephalogram (EEG) spectral analysis, which reveals distinct patterns of high-frequency activity in individuals with insomnia.

Nocturnal short-term HRV reflects impaired daytime vigilance better than overnight HRV in suspected OSA patients.

In obstructive sleep apnea (OSA), heart rate variability (HRV) decreases and performance in psychomotor vigilance task (PVT) worsens with more severe hypoxic load. Nevertheless, the association between HRV and PVT performance is poorly understood. Thus, we hypothesize that nocturnal short-term HRV is better related to daytime psychomotor vigilance compared to overnight HRV.

Trends and variation in issuance of high-cost narcolepsy drugs by NHS England organisations and regions from 2019 to 2022.

Clinicians and people with narcolepsy report varied access to higher-cost narcolepsy treatments in England associated with variations in national and local commissioning. There are no publicly available data quantifying use of these drugs to support policy decisions. We therefore aimed to describe national, regional and local prescribing trends for higher-cost narcolepsy drugs using new national databases.

Semi automatic quantification of REM sleep without atonia in natural sleep environment.

Polysomnography, the gold standard diagnostic tool in sleep medicine, is performed in an artificial environment. This might alter sleep and may not accurately reflect typical sleep patterns. While macro-structures are sensitive to environmental effects, micro-structures remain more stable.

Interconnection between adolescents' and family members' sleep.

Deficient sleep has been linked to a broad range of physical, cognitive and mental health impacts, in particular during adolescence. It is thus essential to understand its underlying mechanisms, including family factors. The goal of our study was to assess through combined subjective and objective assessments, how family members' daily variations in sleep are interconnected, between parents and siblings of adolescents.

Ventilatory response to head-down-tilt in healthy human subjects.

Postural fluid shifts may directly affect respiratory control via a complex interaction of baro- and chemo-reflexes, and cerebral blood flow. Few data exist concerning the steady state ventilatory responses during head-down tilt. We examined the cardiorespiratory responses during acute 50° head-down tilt (HDT) in 18 healthy subjects (mean [SD] age 27 [10] years).

Remote monitoring to improve low adherence in non-invasive ventilation: a protocol for a randomised controlled clinical trial (READ-NIV trial).

Background: Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder. Non-invasive ventilation (NIV) is essential for managing hypercapnic respiratory failure in patients with obesity hypoventilation syndrome (OHS) and those with co-existing OSA, where continuous positive airway pressure (CPAP) alone is insufficient. However, adherence to NIV can be challenging, with substantial non-compliance occurring due to factors such as discomfort and phobia.

Retrospective validation of automatic sleep analysis with grey areas model for human-in-the-loop scoring approach.

State-of-the-art automatic sleep staging methods have demonstrated comparable reliability and superior time efficiency to manual sleep staging. However, fully automatic black-box solutions are difficult to adapt into clinical workflow due to the lack of transparency in decision-making processes. Transparency would be crucial for interaction between automatic methods and the work of sleep experts, i.

The evaluation of a novel single-lead biopotential device for home sleep testing.

Study Objectives: This paper reports on the clinical evaluation of the sleep staging performance of a novel single-lead biopotential device.

Methods: 133 patients suspected of obstructive sleep apnea were included in a multi-site cohort. All patients underwent polysomnography and received the study device, a single-lead biopotential measurement device attached to the forehead.

Effect of CPAP therapy on blood pressure in patients with obstructive sleep apnoea: a worldwide individual patient data meta-analysis.

Background: Obstructive sleep apnoea (OSA) is associated with hypertension, and OSA treatment can reduce systolic blood pressure (SBP) and diastolic blood pressure (DBP), but with a modest mean effect size and vast heterogeneity among studies. The aim of this individual patient data (IPD) meta-analysis was to understand which OSA phenotypes could benefit the most in terms of BP reduction.

Methods: A systematic review of randomised controlled trials that compared continuous positive airway pressure (CPAP) with either passive or active treatment was conducted.

Dreaming conundrum.

Dreaming, a common yet mysterious cognitive phenomenon, is an involuntary process experienced by individuals during sleep. Although the fascination with dreams dates back to ancient times and gained therapeutic significance through psychoanalysis in the early twentieth century, its scientific investigation only gained momentum with the discovery of rapid eye movement (REM) sleep in the 1950s. This review synthesises current research on the neurobiological and psychological aspects of dreaming, including factors influencing dream recall and content, neurophysiological correlates, and experimental models, and discusses the implications for clinical practice.

Comparative efficacy, safety and benefit/risk of alerting agents for excessive daytime sleepiness in patients with obstructive sleep apnoea: a network meta-analysis.

Background: Obstructive sleep apnoea (OSA) is a common chronic respiratory disease associated with a high burden of disabilities related to sleepiness and reduced quality of life. Despite first-line treatment with continuous positive airway pressure (CPAP) therapy, many patients experience residual excessive daytime sleepiness (EDS). The aim of this study is to compare the relative efficacy and safety of medications authorised for this indication in Europe and/or the United States (modafinil/armodafinil, solriamfetol, and pitolisant) for OSA.

Baseline Characteristics Associated with Hypoglossal Nerve Stimulation Treatment Outcomes in Patients with Obstructive Sleep Apnea: A Systematic Review.

Hypoglossal nerve stimulation (HGNS) has emerged as an effective treatment for obstructive sleep apnea (OSA). Identifying baseline characteristics that prospectively could predict treatment outcomes even better is crucial for optimizing patient selection and improving therapeutic success in the future. A systematic review was conducted following PRISMA guidelines.