Increased Daytime Sleepiness Research Articles

The Dynamics of Heart Rate Asymmetry and Situational Sleepiness from Evening to Night: The Role of Daytime Sleepiness.

The relationship between daytime sleepiness and heart rate asymmetry (HRA) during the transition from evening to night is crucial for understanding autonomic regulation and its implications for alertness. This study aims to investigate how daytime sleepiness influences HRA dynamics from evening to night and how situational sleepiness correlates with HRA metrics. HRA metrics were calculated at 8 P.M., 9 P.M., and 10 P.M. in 50 participants, categorized into 'Lower Normal' and 'Higher Normal' daytime sleepiness groups based on Epworth Sleepiness Scale (ESS) scores. Situational sleepiness was assessed using the Karolinska Sleepiness Scale (KSS) and Stanford Sleepiness Scale (SSS). The results demonstrated that individuals with 'Higher Normal' daytime sleepiness exhibited lower HRA metrics at 10 P.M. compared to those with 'Lower Normal' daytime sleepiness, supporting the suggestion that higher daytime sleepiness correlates with reduced parasympathetic activity and diminished autonomic responsiveness. Significant negative correlations between situational sleepiness and HRA metrics were observed in the 'Higher Normal' group, particularly with the SSS. Therefore, increased daytime sleepiness affects HRA dynamics by decreasing parasympathetic activity and altering autonomic regulation at the beginning of the biological night (10 P.M.). These findings suggest potential applications for enhancing drowsiness detection and managing fatigue in safety-critical environments.

Evaluation of wakefulness electroencephalogram in OSA patients.

Obstructive sleep apnea (OSA) has been associated with an elevated cardiovascular risk, increased daytime sleepiness, cognitive decline, and slower electroencephalographic activity (EEG). This study assesses EEG patterns during wakefulness in OSA patients compared to those without sleep-disordered breathing. This retrospective study analyzed 30 OSA patients with an Apnea/Hypopnea Index (AHI) of 15 or higher, as well as 29 individuals without sleep-disordered breathing (AHI of 5 or lower) who underwent hospital polysomnography and met all inclusion criteria. Sociodemographic and EEG data were obtained from the sleep laboratory database. Blinded EEG analysis was conducted by two observers, assessing activity in the frontal, central, and occipital regions. No significant differences were observed in EEG activity between OSA and non-OSA patients. However, a weak correlation was found between decreased C3 EEG frequency and higher AHI (p = 0.033), as well as increased total sleep time and higher O2 EEG frequency (p = 0.038). Lower amplitudes in C3 (p = 0.043) and O1 (p = 0.031) were correlated with reduced average oxygen saturation. Our findings suggest that OSA-related hypoxemia may impact neuronal activity, highlighting the need to address this sleep-disordered breathing in order to potentially prevent the cognitive decline observed in OSA patients.

Exploring Food Insecurity and Perceived Stress on Daytime Sleepiness among Older Adults in New York City.

The growing population of older adults in the U.S. is experiencing increased food insecurity and stress, which are associated with nocturnal sleep quality and consequently excessive daytime sleepiness. This study aimed to investigate the relationship between food insecurity and perceived stress on daytime sleepiness in older adults aged 60 and older living in New York City. This cross-sectional, quantitative study utilized the US Household Food Security Survey Module six-item questionnaire, the Perceived Stress Scale (PSS), and Sleepiness Total to collect data. Participants completed an online survey via Qualtrics. Linear and logistic regression models were used to assess the association between demographic variables and food insecurity, perceived stress, and daytime sleepiness outcomes. Three hundred seventy-eight (378) older adults participated in this study. Food insecurity was associated with age (p = 0.045), education (p = 0.022), and daytime sleepiness (p < 0.001). On average, participants with a BMI of over 30 had an increased daytime sleepiness total relative to a BMI < 25 (p = 0.029), and those with two to three health conditions and those with more than four health conditions had higher daytime sleepiness totals relative to those with zero to one condition (p = 0.007 and 0.007, respectively). Participants who had moderate and high stress, regardless of food security status, had higher daytime sleepiness totals than those with low stress (food secure; p = 0.002; food insecure; p < 0.001). Multifaceted interventions are needed to alleviate food insecurity, manage stress, and reduce excessive daytime sleepiness among older adults.

Clinical symptoms and neuroanatomical substrates of daytime sleepiness in Parkinson’s disease

Clinical and neuroanatomical correlates of daytime sleepiness in Parkinson’s disease (PD) remain inconsistent in the literature. Two studies were conducted here. The first evaluated the interrelation between non-motor and motor symptoms, using a principal component analysis, associated with daytime sleepiness in PD. The second identified the neuroanatomical substrates associated with daytime sleepiness in PD using magnetic resonance imaging (MRI). In the first study, 77 participants with PD completed an extensive clinical, cognitive testing and a polysomnographic recording. In the second study, 29 PD participants also underwent MRI acquisition of T1-weighted images. Vertex-based cortical and subcortical surface analysis, deformation-based morphometry, and voxel-based morphometry were performed to assess the association between daytime sleepiness severity and structural brain changes in participants. In both studies, the severity of daytime sleepiness and the presence of excessive daytime sleepiness (EDS; total score >10) were measured using the Epworth Sleepiness Scale. We found that individuals with EDS had a higher score on a component including higher dosage of dopamine receptor agonists, motor symptoms severity, shorter sleep latency, and greater sleep efficiency. Moreover, increased daytime sleepiness severity was associated with a larger surface area in the right insula, contracted surfaces in the right putamen and right lateral amygdala, and a larger surface in the right posterior amygdala. Hence, daytime sleepiness in PD was associated with dopaminergic receptor agonists dosage, motor impairment, and objective sleep measures. Moreover, neuroanatomical changes in cortical and subcortical regions related to vigilance, motor, and emotional states were associated with more severe daytime sleepiness.

Ramadan fasting observance is associated with decreased sleep duration, increased daytime sleepiness and insomnia symptoms among student-athletes

ObjectiveTo examine the relationships between Ramadan fasting observance (RFO) and sleep-wake patterns, daytime sleepiness, and insomnia levels in student-athletes. MethodsSleep was measured using wrist-actigraphy in 25 semi-professional student-athletes (mean ± SD; age = 22 ± 2 years, height = 182.0 ± 5.8 cm, body mass = 81.3 ± 15.2 kg) during seven nights before RFO (academic study period), during the first half of RFO (14 nights, holiday period), and the second half of RFO (14 nights, academic study period). Additionally, participants completed the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires seven days before RFO and on the last day of RFO. ResultsActigraphy results indicated RFO was associated with significant decreases in sleep duration during the second half of RFO vs. before and during the first half of RFO (p < 0.001). However, the first half of RFO was associated with a delay of ⁓ 2.5 h in sleep onset compared to before RFO; this delay persisted during the second half of RFO (p < 0.001). The total PSQI score before RFO (6.6 ± 2.3 AU) and during RFO (8.2 ± 2.3 AU) suggested poor overall sleep quality. ISI and ESS scores were greater during than before RFO (p = 0.002 and p = 0.041, respectively). ConclusionsThe second half of RFO was associated with decreases in objectively assessed sleep duration among student-athletes. RFO was also associated with impaired sleep quality, excessive daytime sleepiness, and increased insomnia symptoms. Personalized interventions to address sleep-related issues in student-athletes during RFO are warranted.

Melatonin hormone level in nurses and factors affecting it; Investigation according to shift working pattern

This study aimed to determine the relationship between melatonin hormone levels, sleep, and factors affecting sleep, psychological resilience, and depression in nurses working with a shift work system. Conducted between February 5–12, 2021, at the Training and Research Hospital in Ağrı province, the descriptive study included 41 night shift nurses and 35 day shift nurses, totaling 76 participants. Blood samples for melatonin analysis were collected and data were gathered using the Sociodemographic Information Form, Epworth Sleepiness Scale, Sleep Disorder Scale Short Form, Brief Psychological Resilience Scale, and Beck Depression Scale Short Form. Melatonin analysis was performed using the ELISA method. Statistical significance was set at p < 0.05. Results showed that sleep disorders were present in all nurses with <7 h of daily sleep. Factors such as the use of sleeping pills, marital status, age, and gender affected sleep disorders. Mean scores for melatonin levels were 67.82 ± 40.20 for night shift nurses and 68.08 ± 39.62 for day shift nurses, with no significant difference between shifts. Similarly, no significant differences were found in daytime sleepiness (7.49 ± 4.47 vs. 7.51 ± 4.65), sleep disturbance (24.71 ± 7.33 vs. 25.23 ± 6.64), psychological resilience (18.42 ± 4.19 vs. 17.89 ± 4.74), or depression (3.22 ± 2.60 vs. 3.49 ± 3.35). Nurses exhibited mild sleep disturbances, low depression tendencies, and moderate psychological resilience. Increased daytime sleepiness and sleep disorders correlated with higher depression tendencies and lower psychological resilience. Hospital management and education units are recommended to conduct interventions on sleep quality, depression, and psychological resilience to raise awareness among nurses.

CP-02. DAYTIME SLEEPINESS AND HEALTH-RELATED QUALITY OF LIFEIN PATIENTS WITH CHILDHOOD-ONSET CRANIOPHARYNGIOMA

Abstract BACKGROUND Adamantinomatous craniopharyngioma (CP) is a rare embryonal malformation originating from remnants of the craniopharyngeal duct and located in the sellar and/or parasellar area. Overall survival rates are high (92%), but frequently quality of life (QoL) is severely impaired in patients with CP involving hypothalamic structures. Tumor- and/or treatment-related hypothalamic lesions result in disturbances of circadian rhythms including increased daytime sleepiness. METHODS After a median follow-up interval of 10 years (range: 1-39 years), 119 patients (63 female/ 56 male) with CP, recruited in KRANIOPHARYNGEOM 2000/2007 and KRANIOPHARYNGEOM Registry 2019 between 2000 and 2022, were analysed for daytime sleepiness by Epworth scale (ES) and for QoL by EORTC QLQ-C30 questionnaire. RESULTS CP patients (n= 85) with pathologically increased ES score (ES score &amp;gt; 12) had worse QoL (p = 0.003), when compared with CP patients with normal ES score (n= 34). Pathologically increased daytime sleepiness (ES score) was negatively correlated with QoL (r= -0.395; p&amp;lt; 0.001). Surgical hypothalamic lesions (71% of patients) were associated with higher ES scores, whereas such impact could not be observed for presurgical hypothalamic involvement of CP (73% of patients). CONCLUSIONS As increased daytime sleepiness plays an important role for QoL in survivors of CP, treatment of disturbances of circadian rhythms with medication such as central stimulating agents is recommended. For prevention of increased daytime sleepiness, hypothalamus-sparing surgical treatment strategies should be considered as state of the art in patients with CP.

The effect of experimentally induced sleep fragmentation and estradiol suppression on neurobehavioral performance and subjective sleepiness in premenopausal women.

Menopause is associated with nighttime sleep fragmentation, declining estradiol, and impaired cognition. In a model of pharmacologically induced estradiol suppression mimicking menopause, we examined the impact of menopause-pattern sleep fragmentation on daytime neurobehavioral performance and sleepiness in premenopausal women. Twenty premenopausal women completed two five-night inpatient studies in the mid-to-late follicular phase (estrogenized) and after pharmacological estradiol suppression (hypo-estrogenized). During each study, participants had an uninterrupted 8-hour sleep opportunity for two nights, followed by three nights where sleep was experimentally fragmented to mimic menopause-pattern sleep disturbance, and during which the sleep opportunity was extended to prevent shortening of the sleep duration. Neurobehavioral performance and subjective sleepiness were measured using the Psychomotor Vigilance Task and Karolinska Sleepiness Scale (KSS). Compared to unfragmented sleep, sleep fragmentation increased attentional lapses (+ 0.6 lapses, p < .05), slowed reaction time (+ 9.4 milliseconds, p < .01), and increased daytime sleepiness (+ 0.5 KSS score, p < .001). Estradiol suppression increased attentional lapses (+ 0.8; p < .001) and reaction time (+ 12.3, p < .01) but did not significantly affect daytime sleepiness. The effect of sleep fragmentation on neurobehavioral performance differed by estradiol state, such that the adverse effects of sleep fragmentation on attentional lapses (+ 0.9, trend p = .06) and reaction time (+ 15, p < .05) were observed only when estrogenized. Menopause-pattern sleep fragmentation and estradiol suppression worsened neurobehavioral performance and daytime sleepiness, even while sleep duration was not reduced. The adverse effects of sleep fragmentation in the context of an adequate sleep duration highlight the importance of sleep continuity as a vital aspect of good sleep health.

Evaluating Sleep Challenges in Hospitalized Youth.

To characterize sleep quality and sleep disruptions among youth hospitalized outside of the intensive care unit (ICU). Participants were eligible for the survey-based study if they were 8-17 years old, English-speaking, hospitalized for ≥3 days outside of the ICU, and developmentally able to understand surveys. Survey administration included a sleep diary, the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), and a study-specific Inpatient Sleep Disruptors Questionnaire. The chart review provided additional clinical information. Descriptive and comparative statistics were performed to assess the association between overnight clinical monitoring and daytime sleepiness. Forty-five participants (mean age 13.4 years, 60% female), recruited between May and December 2022, were included in the study. Mean total sleep time (8.2 ± 1.7 hours) and ESS-CHAD score (8.6 ± 4.3) were normal with 79% reporting fair to good sleep the previous night.Participants rated alarms on equipment, vital signs, and noise as most disruptive to sleep. Participants with vital signs every four hours showed higher levels of daytime sleepiness compared with participants with vitals measured every shift (9.3 vs. 6.3; p=0.04). Most participants reported normal sleep, although there was wide variability with a portion with impaired sleep quality and elevated daytime sleepiness. Alarms on equipment, vital signs, and noise were most disruptive, and increased vital sign frequency was also associated with increased daytime sleepiness. In clinically stable pediatric patients, a reduction in vital sign monitoring overnight may be an important change to improve patient sleep.

Changes in sleep patterns in primary care workers during the first wave of the COVID-19 pandemic in 2022 in Shanghai: a cross-sectional study

The coronavirus disease (COVID-19) pandemic has significantly affected the sleep health of healthcare workers (HCWs); however, no studies have assessed this effect in primary HCWs. This cross-sectional, web-based study explored the prevalence and factors associated with sleep disorders among primary HCWs during the first COVID-19 outbreak in Shanghai from 12 July to 15 August 2022. Sociodemographic and work-related characteristics, various sleep dimensions, and exposure to patients with COVID-19 were assessed. They were screened for common mental disorders (depression, burnout, and stress). Overall, 313 primary HCWs were recruited. At least one sleep dimension in 84% of respondents deteriorated compared with that observed pre-pandemic; sleep quality (decline of 66%) and daytime sleepiness (increase of 56%) were the most affected domains. After excluding 145 primary HCWs with pre-pandemic ‘poor sleep’, depression (odds ratio [OR] 3.08; 95% confidence interval [CI] 1.59–5.98), weekly burnout symptoms (OR 2.57; 95% CI 1.32–5.03), and high psychological stress (OR 4.51; 95% CI 2.09–9.72) were associated with poor sleep patterns during the pandemic. After adjusting for significant differences between groups, for every 1-point increase in the Perceived Stress Scale score, an associated 12% increased risk of poor sleep (adjusted OR 1.12; 95% CI 1.05–1.21; p = 0.002) was observed. Most primary HCWs showed significant worsening of sleep quality, with increases in daytime sleepiness during the first wave of the COVID-19 pandemic in Shanghai. HCWs with high stress levels were at greater risks of sleep disorders.

Case report: Nighttime media restriction for pediatric insomnia

This report describes the case of a 13-year-old boy with chronic insomnia and increased daytime sleepiness linked to excessive nocturnal media use. Implementing a restriction on digital device usage after 9 pm led to a significant improvement in the sleep duration with no adverse event. Throughout the 16-week treatment period, the total sleep time of the patient normalized, and the daytime sleepiness problem was resolved. This is an indication that the treatment was effective. This case emphasizes the potential of nighttime screentime restriction in treating pediatric chronic insomnia and highlights the importance of addressing screen time in sleep disorder management.

Tagesschläfrigkeit bei Patienten mit unbehandeltem Restless-Legs-Syndrom

Abstract Background Restless legs syndrome (RLS), a disorder characterized by an urge to move one’s legs during sleep or rest, leads to impaired sleep quality. Many patients with RLS report increased daytime sleepiness, but this has seldom been the focus of clinical research. The current study empirically investigated the prevalence and severity of daytime sleepiness in RLS. Methods This prospective study included 29 newly diagnosed treatment-naïve patients with RLS and 31 healthy controls and assessed standardized subjective (tiredness symptom scale [TSS], Stanford Sleepiness Scale [SSS], Epworth Sleepiness Scale [ESS]), cognitive (psychomotor vigilance task [PVT], Mackworth Clock Test [MCT]), and physiological measures (pupillary unrest index [PUI]). RLS symptom severity was assessed, and the effects of RLS on general health aspects and subjective sleep quality (Pittsburgh Sleep Quality Index) were compared to control data. Results Patients had moderate to severe RLS with significant negative effects on general health, quality of life, and sleep quality. Patients with RLS showed more subjective daytime sleepiness (ESS) and current sleepiness (TSS, SSS) than controls. The objective performance of patients in sustained attention tasks (P VT, MCT) was significantly worse than that of controls. Additionally, patients showed higher PUI scores. Conclusion In the present study, RLS was associated with markedly impaired subjective sleep quality and with subjectively and objectively increased daytime sleepiness. Since daytime sleepiness can be a major factor leading to compromised quality of life, assessing and treating sleepiness should be incorporated into standard diagnostics and treatment.

Prevalence of Obstructive Sleep Apnea in Head and Neck Squamous Cell Carcinoma Patients before and after Treatment.

Background and Objectives: Obstructive sleep apnea (OSA) is common not only in the general population but even more so in patients with tumors of the head and neck region. Untreated, it leads to reduced quality of life, increased daytime sleepiness, and other comorbidities. The aim of this study was to determine the difference in the occurrence of OSA in the patient population with head and neck tumors compared with the general population as represented by the Trend cohort of the Study of Health in Pomerania (SHIP), and to assess the influence of tumor treatment. Materials and Methods: Between July 2018 and December 2021, preoperative polysomnography was conducted in 47 patients with histologically confirmed squamous cell carcinoma in the oropharynx, hypopharynx, or larynx. A follow-up polysomnography was performed in 23 patients 2-11 months after completing treatment. The collected data were correlated with tumor treatment and tumor size. Results: Of the included patients, 43 were male and 4 were female. Age ranged from 54 to 90 years. The pretherapeutic measurement found no significant difference in the prevalence of a pathologically elevated apnea-hypopnea index (AHI) in our patients compared with the SHIP Trend cohort. In the follow-up measurement after completion of treartment, a significant deterioration in AHI was observed. Initially, 70% of patients had an AHI > 5; after therapy, this increased to 87% (p = 0.008). The effect was particularly pronounced in the group of patients with advanced tumor stages who had received primary chemoradiation. Conclusions: OSA is a relevant condition in patients with head and neck cancer. Tumor treatment can lead to an increased occurrence of sleep-related breathing disorders, especially in patients with advanced tumor stages undergoing primary chemoradiation. Additional studies are necessary to better understand the exact mechanism involved.

Changes in the pattern of sleep disturbances in healthy subjects under 21-day antiorthostatic hypokinesia

Background. Antiorthostatic hypokinesia (ANOH) reproduces some of the effects of weightlessness on the human body and is used to study adaptation to space flight conditions. It is known that ANOH affects nighttime sleep, but there is no information in the literature on the sequence of occurrence of sleep disorders in ANOH.The aim of the research was to study the dynamics of subjective changes in assessing sleep quality under conditions of antiorthostatic hypokinesia.Materials and methods. Six healthy male volunteers (age from 26 to 34 years) participated in the experiment with 21-day ANOH. They were on a medical bed with a body inclination angle relative to the horizon of –6° for 21 days. To assess sleep quality, a structured questionnaire was used that assessed sleep duration, rate of falling asleep, night awakenings, the presence of daytime sleepiness, and daytime falling asleep.Results. Based on the assessment of the dynamics of the sleep efficiency index (SEI), three stages of adaptation were identified. At the stage of acute adaptation (the first 3 days), there is a decrease in SEI from 96.4 to 91.3 (p &lt; 0.01), a statistically significant prolongation of falling asleep from 17.6 to 33.6 minutes (p &lt; 0.01), an increase duration of night awakenings up to 17.4 minutes, increase in daytime sleepiness by 11 %. In the next 3 days (the “recovery” stage), there is a statistically significant increase in SEI compared to the 1st stage to 94.7 (p &lt; 0.01), but it remains statistically significantly lower than the background values (p &lt; 0.004). The number of complaints about daytime sleepiness increases (up to 42 %), evening bedtime shifts later by 26 minutes. At the 3rd stage (the remaining nights) there is a relative stabilization of the sleep-wake cycle.Conclusion. Under conditions of 21-day ANOH, a gradual change in the pattern of sleep disturbances occurs. The most negative changes in terms of subjective assessment were noted in the first three days. Then there is an improvement in falling asleep, a decrease in night awakenings, combined with an increase in daytime sleepiness and the formation of a schedule with a later bedtime.

Daytime sleepiness in health-care employees: A cross-sectional study between shift duty and day duty

Background: Shift duty disrupts the sleep-wake cycle, leading to shift work disorder, which is characterized by daytime sleepiness and insomnia. Excessive daytime sleepiness decreases work performance, increases workplace accidents, and impairs neurocognitive function. Sleep disturbance also impacts the employee-patient relationship; thereby, it is necessary to assess the prevalence of daytime sleepiness. Aim and Objective: The aim of the study is to compare the prevalence of daytime sleepiness in healthcare employees working in the daytime versus shift duty. Materials and Methods: Subjects were chosen from the Parent Institute between the ages of 24 and 38. A total of 260 health-care employees were included in the study and were divided into two equal groups, with one working on day duty and the other working on shift duty. To evaluate subjective and objective daytime sleepiness, the Epworth sleepiness scale questionnaire was given to both groups. Results: The parameters were analyzed statistically. There was a significant difference in daytime sleepiness between the two groups. There was increased daytime sleepiness in health-care employees working on shift duty as compared to those working on day duty. Conclusion: Sleep deprivation due to disruption of internal sleep regulation leading to shift work disorder is thought to be an important cause of increased daytime sleepiness in health-care employees working on shift duty.

Quality of life associated with nursing professionals' individual resources and work.

to assess the physical and mental components of nursing professionals' quality of life and associate them with individual, health and work characteristics. cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied. the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness. quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.

Retracted: Assessment and mitigation of sleep disturbances in Egyptian acute care settings

BackgroundSleep disturbances in acute care settings pose challenges to patient recovery and well-being. Acute care facilities provide a unique context to explore these issues due to their diverse patient populations. Understanding the prevalence and nature of sleep disturbances is crucial for developing effective interventions tailored to the acute care setting. AimAssess and mitigate of sleep disturbances in Egyptian Acute Care Settings among patients. MethodsA cross-sectional design was utilized, involving 158 adult patients aged 18 and above with various medical conditions. Sleep assessments utilized the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Berlin Questionnaire, and Insomnia Severity Index (ISI). Statistical analyses, including t-tests and ANOVA, were conducted using SPSS 26. ResultsThe study, encompassed 158 patients, revealed several key findings: heightened sleep latency (p = 0.042) and a substantial increase in the Global PSQI Score (p = 0.018), indicated compromised overall sleep quality. Daytime sleepiness escalated across activities (p < 0.01), hinted at potential sleep-related issues. Additionally, occurrences of snoring, witnessed apnoea's, and daytime sleepiness significantly rose (p < 0.05), suggested the possibility of sleep-disordered breathing. Results from the Insomnia Severity Index (ISI) underscored challenges across various sleep aspects (p < 0.01), highlighted the overall severity of insomnia symptoms (p = 0.001). These findings emphasized the necessity for targeted interventions to address these sleep disturbances ConclusionThe study underscored the significant impact of sleep disturbances on patients within Egyptian Acute Care Settings. With heightened sleep latency, compromised overall sleep quality, and increased daytime sleepiness observed among the patient cohort, there is a pressing need for tailored interventions to mitigate these issues. RecommendationsDevelop interventions tailored to address sleep disturbances, enhance healthcare provider awareness, and incorporate regular sleep assessments into patient care routines. Additionally, future research should evaluate the efficacy of these interventions within acute care environments.

EXPLORING THE ASSOCIATION OF SLEEP WITH COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA

Abstract People living with dementia (PWD) commonly experience sleep disruptions, which impacts mental alertness, increases daytime sleepiness, and results in poorer quality of life. While sleep preserves cognitive function among PWD, the relationship between sleep and different cognitive domains is unclear. Our objective was to explore the association between sleep and cognition domains among PWD. Twenty-three PWD completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test (TMT), Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test (BJLO); language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test) at two residential care facilities. Participants wore a motion watch on their wrist for 7 days to monitor sleep. Participants were primarily male (74%), white (87%), and 48% had unspecified dementia. The average number of hours of sleep per night was 4.6±1.2 hours. The overall regression model for sleep was significant (R2=0.80, F(10,12)=4.68, RMSE=42.32, p&amp;lt; 0.05). More sleep was associated with better perception and orientation (BJLO:β=0.57, p=0.03), greater sleep efficiency (β=0.93, p=0.01), longer wake after sleep onset (β=1.19, p 0.002), and there was a trend for better executive function (TMT:β=-0.34, p=0.09). PWD have inadequate sleep. Greater amounts of sleep seem to preserve perception and orientation and may play a protective role for executive function, but more evidence is needed. Regularly assessing sleep may be useful in screening and monitoring cognitive changes among PWD in residential care facilities.

Assessment of oropharyngeal respiratory volume and sleep apnoea scores using peripheral arterial tonometry may improve diagnosis and treatment planning of combined dysgnathia therapy approaches.

Increased daytime sleepiness is a frequently reported symptom in patients with pronounced dysgnathia. This study investigated possible correlations using home peripheral arterial tonometry (PAT) and oropharyngeal airway volume determination in patients with dysgnathia and daytime sleepiness. Twenty patients (13 male, median age 27.6 ± 6.8 years) with abnormal sleep history and 10 skeletal neutral configured controls (6 male, median age 29.5 ± 4.2 years) with normal sleep history were examined. Patients and controls were evaluated for apnoea-hypopnoea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), snoring volume (dB), total sleep time (TST) and REM-percentage (REM). Airway volumetry was measured via CBCT. Individual user experience for PAT was assessed using the User Experience Questionnaire (UEQ). Patients had significantly higher respiratory scores than controls. AHI increased 4.6-fold (p = .006), RDI 2.5-fold (p = .008) and ODI 6.4-fold (p < .001). Oropharyngeal volumes showed a 30% decrease (p = .003). dB, TST and REM showed no significant differences. AHI (r = -.51; p = .005), ODI (r = -.60; p < .001) and RDI (r = -.45; p = .016) correlated negatively with pharyngeal volume. Wits appraisal correlated negatively with oropharyngeal volume (r = -.47; p = .010) and positively with AHI (r = .41; p = .03) and ODI (r = .49; p = .007). dB and TST (r = -.49; p = .008) and REM and RDI (r = -.43; p = .02) correlated negatively. UEQ-KPI (2.17 ± 0.24) confirmed excellent usability of PAT. Patients with mandibular retrognathia and abnormal sleep history showed significantly higher respiratory indices and smaller oropharyngeal volumes than neutrally configured controls. The dygnathia severity directly influenced the risk of obstructive sleep apnoea.

Comparison of sleep characteristics between Parkinson's disease with and without freezing of gait: A systematic review

Parkinson's disease (PD) is a neurodegenerative disorder characterized by a range of motor and non-motor symptoms. Among the motor complaints, freezing of gait (FOG) is a common and disabling phenomenon that episodically hinders patients' ability to produce efficient steps. Concurrently, sleep disorders are prevalent in PD and significantly impact the quality of life of affected individuals. Numerous studies have suggested a bidirectional relationship between FOG and sleep disorders. Therefore, our objective was to systematically review the literature and compare sleep outcomes in PD patients with FOG (PD + FOG) and those without FOG (PD-FOG). By conducting a comprehensive search of the PubMed and Web of Science databases, we identified 20 eligible studies for inclusion in our analysis. Our review revealed that compared to PD-FOG, PD + FOG patients exhibited more severe symptoms of rapid eye movement sleep behavior disorder in nine studies, increased daytime sleepiness in eight studies, decreased sleep quality in four studies, and more frequent and severe sleep disturbances in four studies. These findings indicate that PD + FOG patients generally experience worse sleep quality, higher levels of daytime sleepiness, and more disruptive sleep disturbances compared to those without FOG (PD-FOG). The association between sleep disturbances and FOG highlights the importance of evaluating and monitoring these symptoms in PD patients and open the possibility for future studies to assess the impact of managing sleep disturbances on the severity and occurrence of FOG, and vice versa.