Obstructive sleep apnea syndrome and Alzheimer's disease pathology: may continuous positive airway pressure treatment delay cognitive deterioration?

Purpose: The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD).

Methods: This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included.

Sleep disorders and late-onset epilepsy of unknown origin: Understanding new trajectories to brain amyloidopathy.

The intertwining between epilepsy, sleep disorders and beta amyloid pathology has been progressively highlighted, as early identification and stratification of patients at high risk of cognitive decline is the need of the hour. Modification of the sleep-wake activity, such as sleep impairment or excessive daytime sleepiness, can critically affect cerebral beta amyloid levels. Both mice models and human studies have demonstrated a substantial increase in the burden of beta amyloid pathology after sleep-deprivation, with potential negative effects partially restored by sleep recovery.

Dysregulation of the orexin/hypocretin system is not limited to narcolepsy but has far-reaching implications for neurological disorders.

Neuropeptides orexin A and B (OX-A/B, also called hypocretin 1 and 2) are released selectively by a population of neurons which projects widely into the entire central nervous system but is localized in a restricted area of the tuberal region of the hypothalamus, caudal to the paraventricular nucleus. The OX system prominently targets brain structures involved in the regulation of wake-sleep state switching, and also orchestrates multiple physiological functions. The degeneration and dysregulation of the OX system promotes narcoleptic phenotypes both in humans and animals.

Sleep-wake cycle dysregulation in idiopathic REM sleep behaviour disorder.

Alteration of the circadian sleep-wake rhythm has been suggested in patients affected by idiopathic rapid eye movement sleep behaviour disorder. Because actigraphy is the validated instrument to monitor the sleep-wake cycle, the aim of the present study was to investigate the circadian sleep-wake rhythm in patients with idiopathic rapid eye movement sleep behaviour disorder compared with healthy aged controls. Fourteen-day actigraphic recording, a comprehensive sleep interview, and cognitive and behavioural domains were investigated in patients affected by idiopathic rapid eye movement sleep behaviour disorder, and compared with controls similar for age, sex and cognitive performances.

Direct application of an ECG-based sleep staging algorithm on reflective photoplethysmography data decreases performance.

Objective: The maturation of neural network-based techniques in combination with the availability of large sleep datasets has increased the interest in alternative methods of sleep monitoring. For unobtrusive sleep staging, the most promising algorithms are based on heart rate variability computed from inter-beat intervals (IBIs) derived from ECG-data. The practical application of these algorithms is even more promising when alternative ways of obtaining IBIs, such as wrist-worn photoplethysmography (PPG) can be used.

Clusters of sleep apnoea phenotypes: A large pan-European study from the European Sleep Apnoea Database (ESADA).

Background And Objective: To personalize OSA management, several studies have attempted to better capture disease heterogeneity by clustering methods. The aim of this study was to conduct a cluster analysis of 23 000 OSA patients at diagnosis using the multinational ESADA.

Methods: Data from 34 centres contributing to ESADA were used.

Obstructive sleep apnea in people with intellectual disabilities: adherence to and effect of CPAP.

Purpose: Obstructive sleep apnea (OSA) is common in people with intellectual disabilities (ID), but in practice continuous positive airway pressure (CPAP) is often deemed unfeasible. We investigated adherence to and effect of CPAP in patients with ID and OSA.

Methods: Patients with ID were started on CPAP using an intensive training program.

The European Portuguese version of the insomnia severity index.

Insomnia is the most prevalent sleep complaint, but remains largely an unidentified public health issue. The Insomnia Severity Index (ISI) is a brief self-report questionnaire to assess insomnia, long-established both in clinical and research settings. The present study aimed to analyse the reliability, validity, and accuracy of the ISI European Portuguese version.

Continuous positive airway pressure therapy in obstructive sleep apnoea patients with erectile dysfunction-A meta-analysis.

Background: Erectile dysfunction (ED) with obstructive sleep apnoea (OSA) is a relatively common issue for men. A number of clinical studies have demonstrated that continuous positive airway pressure (CPAP) therapy may effectively alleviate ED symptoms from patients with OSA.

Methods: PubMed, MEDLINE, EMBASE and Cochrane Library databases were utilised and searched for the relevant studies up to September 2, 2019.

Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea: The SAMS Randomized Clinical Trial.

Importance: Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated.

Objective: To determine whether combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with OSA when conventional device treatment failed.

Design, Setting, And Participants: Multicenter, parallel-group, open-label randomized clinical trial of upper airway surgery vs ongoing medical management.

COVID-19: dealing with a potential risk factor for chronic neurological disorders.

SARS-CoV2 infection is responsible for a complex clinical syndrome, named Coronavirus Disease 2019 (COVID-19), whose main consequences are severe pneumonia and acute respiratory distress syndrome. Occurrence of acute and subacute neurological manifestations (encephalitis, stroke, headache, seizures, Guillain-Barrè syndrome) is increasingly reported in patients with COVID-19. Moreover, SARS-CoV2 immunopathology and tissue colonization in the gut and the central nervous system, and the systemic inflammatory response during COVID-19 may potentially trigger chronic autoimmune and neurodegenerative disorders.

Heart Rate Variability Parameters During Psychogenic Non-epileptic Seizures: Comparison Between Patients With Pure PNES and Comorbid Epilepsy.

Psychogenic non-epileptic seizures (PNES) may resemble epileptic seizures. There are few data about ictal ANS activity alterations induced by PNES in patients with pure PNES (pPNES) compared to PNES with comorbid epilepsy (PNES/ES). We aimed to compare heart rate variability (HRV) parameters and hence autonomic regulation in PNES in epileptic and non-epileptic patients.

Effects of long-term sleep disruption on cognitive function and brain amyloid-β burden: a case-control study.

Background: Recent evidence indicates that disrupted sleep could contribute to the development of Alzheimer's disease by influencing the production and/or clearance of the amyloid-β protein. We set up a case-control study to investigate the association between long-term work-induced sleep disruption, cognitive function, and brain amyloid-β burden.

Methods: Nineteen male maritime pilots (aged 48-60 years) with chronic work-related sleep disruption and a sex-, age-, and education-matched control sample (n = 16, aged 50-60 years) with normal sleep completed the study.

Risk factors for anxiety of otolaryngology healthcare workers in Hubei province fighting coronavirus disease 2019 (COVID-19).

Purpose: To ensure the mental health of the otolaryngology healthcare workers in the fight against coronavirus disease 2019 (COVID-19), it is important to know their mental status and to identify possible risk factors. In this study, we investigated the risk factors for the anxiety in the otolaryngology healthcare workers in Hubei province under the COVID-19 epidemic.

Methods: The otolaryngology healthcare workers in Hubei Province were surveyed using an online questionnaire in which anxiety was measured against the Zung Self-rating Anxiety Scale.

Wearable monitoring of sleep-disordered breathing: estimation of the apnea-hypopnea index using wrist-worn reflective photoplethysmography.

A large part of the worldwide population suffers from obstructive sleep apnea (OSA), a disorder impairing the restorative function of sleep and constituting a risk factor for several cardiovascular pathologies. The standard diagnostic metric to define OSA is the apnea-hypopnea index (AHI), typically obtained by manually annotating polysomnographic recordings. However, this clinical procedure cannot be employed for screening and for long-term monitoring of OSA due to its obtrusiveness and cost.

Shift-work-related sleep disruption and the risk of decline in cognitive function: The CRUISE Study.

Acute total sleep deprivation and partial sleep deprivation have negative impacts on cognitive performance. Studies in subjects who regularly experience sleep loss, however, are rare and often restricted to examination of internal sleeping disorders. To address this issue, we set up a pilot study to explore the effects of a week characterized by sleep disruption on cognitive functioning, using a case-control setting in a maritime pilot group with chronic exposure to intermittent extrinsic, work-related sleep disruption.

Correction to: Sleep dysregulation, memory impairment, and CSF biomarkers during different levels of neurocognitive functioning in Alzheimer's disease course.

An amendment to this paper has been published and can be accessed via the original article.

PAP use in mild cognitive impairment to delay progression to dementia.

Maestri M, Liguori C, Bonanni E, Guarnieri B. PAP use in mild cognitive impairment to delay progression to dementia. .

The Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review.

Objectives: Intermittent hypoxemia is a risk factor for developing complications in obstructive sleep apnea (OSA) patients. The objective of this systematic review was to identify articles evaluating the accuracy of the oxygen desaturation index (ODI) as compared with the apnea-hypopnea index (AHI) and then provide possible values to use as a cutoff for diagnosing adult OSA.

Study Design: Systematic Review of Literature.

Automatic sleep staging using heart rate variability, body movements, and recurrent neural networks in a sleep disordered population.

Study Objectives: To validate a previously developed sleep staging algorithm using heart rate variability (HRV) and body movements in an independent broad cohort of unselected sleep disordered patients.

Methods: We applied a previously designed algorithm for automatic sleep staging using long short-term memory recurrent neural networks to model sleep architecture. The classifier uses 132 HRV features computed from electrocardiography and activity counts from accelerometry.

Perampanel in chronic insomnia.

Objectives: Insomnia is the most prevalent sleep disorder in the general population, and one of the most frequent reasons for consultation in the Sleep Units. Perampanel is an antiepileptic also effective on the structure of sleep, and in restless legs syndrome. We describe the first study that evaluates perampanel in patients with chronic insomnia.

Sleep-Wake Cycle in Alzheimer's Disease Is Associated with Tau Pathology and Orexin Dysregulation.

Background: Alzheimer's disease (AD) is the most common form of dementia. It is mainly characterized by a progressive deterioration of cognition, but sleep-wake cycle disturbances frequently occur. Irregular sleep-wake cycle, insomnia, and daytime napping usually occur in patients with AD in the course of the disease.

Lying Awake at Night: Cardiac Autonomic Activity in Relation to Sleep Onset and Maintenance.

Insomnia, i.e., difficulties initiating and/or maintaining sleep, is one of the most common sleep disorders.

Sleep dysregulation, memory impairment, and CSF biomarkers during different levels of neurocognitive functioning in Alzheimer's disease course.

Background: Alzheimer's disease (AD) is frequently accompanied by sleep impairment, which can induce AD-related neurodegeneration. We herein investigated the sleep architecture, cognition, and cerebrospinal fluid (CSF) biomarkers (tau proteins and β-amyloid) during AD progression from subjective cognitive impairment (SCI) to mild cognitive impairment (MCI) and eventually to AD dementia, and compared the results with cognitively normal (CN) subjects.

Methods: We included patients affected by SCI, MCI, mild AD, and moderate-to-severe AD in our study along with CN subjects as controls.