Management Of Sleep Disorders Research Articles

Diagnosis and management of common sleep disorders during the perinatal period.

The perinatal period is a critical phase in a woman's life characterized by significant physical, emotional, and societal changes. Sleep disorders such as insomnia, restless legs syndrome, obstructive sleep apnea, and poor sleep quality have been observed to increase in prevalence during the perinatal period. Given the harmful impact of sleep disturbances on the health of both mother and newborn, it is crucial to diagnose and treat them promptly. There is a paucity of literature on sleep problems during the perinatal period. This narrative review aimed to summarize the existing evidence and provide suggestions for promptly identifying and managing these disorders.

Decisional Needs of Veterans With Mild Traumatic Brain Injury Initiating Treatment for Insomnia Disorder and Obstructive Sleep Apnea.

We sought to elicit key informant (KI) perspectives regarding decisional needs of Veterans with mild traumatic brain injury (mTBI) who are initiating insomnia disorder and obstructive sleep apnea (OSA) treatment within the Veterans Health Administration (VHA) Polytrauma/TBI System of Care (PSC). Specifically, we sought to understand: (1) information regarding treatment options that Veterans with mTBI require in order to make an informed decision; and (2) values used to guide decision-making (ie, personally meaningful aspects of the decision used to compare treatment options). Nationwide VHA PSC sites. Clinicians included VHA providers and policymakers involved in the management of mTBI and/or sleep disorders in the VHA PSC (n =29). Veterans included those with a clinician-confirmed mTBI who received care for insomnia disorder and/or OSA within the past year (n =20). Semi-structured interviews with the 49 KIs were recorded and transcribed verbatim. Themes were identified using a descriptive and interpretive approach to qualitative analysis. Not applicable. Informational needs identified by both KI groups included information regarding outcomes and downsides of treatment, accessible delivery, treatment candidates, description of diagnosis, and level of commitment. Values used to guide decision-making for both insomnia disorder and OSA treatment included benefits, downsides, and availability of treatments. Values used to decide on insomnia treatments alone included time commitment, intrinsic management of sleep, beliefs regarding mental health treatment, and time course of benefit. Values used to decide on OSA treatment alone included intrusiveness of the treatment, appearance, and impact on bed partners. The current study revealed the decisional needs of Veterans with mTBI who are initiating sleep disorder treatment. Findings can inform the development of decision aids and other efforts aimed at promoting patient-centered management of comorbid mTBI and sleep disorders, thereby improving care quality and clinical outcomes.

Sleep disorders and diabetes mellitus. Literature review and own data

The article presents analysis of current research on sleep disorders in patients with type 2 diabetes mellitus (T2DM). The mechanisms underlying the relationship between insomnia and glycemic control are complex, as both DM can cause sleep disorders and insomnia can worsen the course of diabetes. It is well known that both short (< 6 hours) and long (> 8 hours) sleep durations are associated with an elevated risk of diabetes development. The reported prevalence of sleep disorders in diabetes patients ranges between 28.0% and 59.1%. Our investigation performed in Lviv with the use of Pittsburgh Sleep Quality Index (PSQI) questionnaire, identified that 46.2% of T2DM patients experienced sleep disorders. A comprehensive literature review also unveils association between DM and diverse sleep disorders such as insomnia, circadian rhythm disturbances, obstructive sleep apnea (OSA), and restless legs syndrome (RLS). The article furnishes insights into the classification, diagnostic principles, and treatment modalities for these disorders. Referral of patients to sleep specialists for the management of sleep disorders and the integration of sleep hygiene into diabetes care can effectively mitigate symptoms, forestall DM complications, and enhance patients’ quality of life. Circadian molecules like nobiletin, REV‑ERB agonists, and CRY stabilizers have demonstrated efficacy in preclinical studies and hold potential for the development of novel treatments for conditions associated with circadian dysregulation. Considering the frequency of detection of sleep disorders in T2DM patients according to the modern literary sources and own research, the study of this problem is important for the development of an algorithm for the examination of such patients, namely the need for endocrinologists to pay attention to the sleep status of patients and, if necessary, to refer them to somnologists. Further investigation into the etiology of sleep disorders in T2DM patients and their correlation with carbohydrate metabolism indicators exhibits promise. It is imperative to explore avenues to address these causes by complementing the primary therapy for T2DM.

The dynamics of cyclic‐periodic phenomena during non‐rapid and rapid eye movement sleep

SummarySleep is a complex physiological state characterized by distinct stages, each exhibiting unique electroencephalographic patterns and physiological phenomena. Sleep research has unveiled the presence of intricate cyclic‐periodic phenomena during both non‐rapid eye movement and rapid eye movement sleep stages. These phenomena encompass a spectrum of rhythmic oscillations and periodic events, including cyclic alternating pattern, periodic leg movements during sleep, respiratory‐related events such as apneas, and heart rate variability. This narrative review synthesizes empirical findings and theoretical frameworks to elucidate the dynamics, interplay and implications of cyclic‐periodic phenomena within the context of sleep physiology. Furthermore, it invokes the clinical relevance of these phenomena in the diagnosis and management of sleep disorders.

Saudi Clinical Psychologists’ Competence in Sleep Disorders Management: A Comprehensive Perspective

Saudi Clinical Psychologists’ Competence in Sleep Disorders Management: A Comprehensive Perspective

Assessment and management of sleep disorders in shift workers: Challenges and considerations for general practice.

Shift work is characterised by displaced sleep opportunities and associated sleep disturbance. Shift workers often report sleepiness and other wake time symptoms associated with poor sleep. However, clinical sleep disorders are also prevalent in shift workers. Although prevalence rates are similar or higher in shift workers compared with the general population, help seeking in shift workers with sleep disorders is low. This article aims to provide general practitioners with a contemporary overview of the prevalence rates for sleep disorders in shift workers, to clarify the existing evidence relating to mental and physical health consequences of sleep disorders in shift workers and to highlight the need to consider undiagnosed sleep disorders before attributing sleep-related symptoms solely to workschedules. Symptoms of sleep loss associated with shift work overlap with symptoms experienced by individuals living with sleep disorders. Although >40% of middle-aged Australians live with a sleep disorder that requires investigation and management, symptoms in shift workers are often attributed to the work schedule and, as a result, might not be investigated for appropriate diagnosis and treatment. We argue that screening for sleep disorders in shift workers with sleep complaints should be a priority.

Sleeping Stage Classification Using CNN

Abstract: Maintaining proper health and mental stability is critical for overall health and well-being. Despite a good deal of research investment, sleep quality continues to be a crucial public challenge. Nowadays, people of all age groups are affected by improper sleep quality. Poor sleep can lead to a variety of neurological disorders. Sleep disorders are common in all subsets of the population, independently of gender. This public health challenge greatly affects quality of life in terms of both physical and mental health. Insomnia, parasomnias, sleep- related breathing difficulties, hypersomnia, bruxism, narcolepsy, and circadian rhythm disorders are some common examples of sleep-related disorders. Some of these disorders can be treated with proper analysis of early symptoms; in such cases, adequate sleep quality is essential for the patient’s recovery. Artificial intelligence has several applications in sleep medicine including sleep and respiratory event scoring in the sleep laboratory, diagnosing and managing sleepdisorders, and population health. While still in its nascent stage, there are several challenges which preclude AI’s generalizability and wide-reaching clinical applications. Artificial intelligence is a powerful tool in healthcare that may improve patient care, enhance diagnostic abilities, and augment the management of sleep disorders. However, there is a need to regulate and standardize existing machine learning algorithms and deep learning algorithm prior to its inclusion in the sleep clinic. In this project, we can develop the framework for sleeping stage classification for both subjective data and ECG data and classify the data using Convolutional neural network algorithm to analyse the multiple sleeping stages.

Efficacy of Homeopathic Higher Dilutions in management of Sleep Disorders: A Review

Background: Sleep disorders, including insomnia, have diverse causes and can significantly impact physical and mental health. Homeopathy is explored as an alternative treatment for these disorders, but its efficacy remains uncertain. Aim/Objective: This study reviews clinical research on the efficacy of homeopathic higher dilutions remedies for sleep disorders. The goal is to provide insights into the progress in clinical and preclinical investigations on homeopathy for sleep disorders. Methodology: We conducted a comprehensive database search for original clinical studies on homeopathy and sleep disorders and its related terminology published until September 2023, applying exclusion criteria to select relevant studies. Results: We identified 11 studies meeting our criteria. These studies explored the use of homeopathic remedies for managing sleep disorders with the help of various assessment tools, like Hamilton Anxiety Rating Scale (HAM-A), STAI questionnaire, Jenkins Sleep Scale (JSS), Insomnia Severity Index (ISI), Sleep Diary (SD), Sleep Impairment Index (SII), Visual Analogic Scale (VAS), and Trait of Anxiety Scale (TAS). Findings included reduced anxiety and improved sleep quality with Passiflora Compose, potential benefits of individualized homeopathic treatment for insomnia, and positive outcomes in children and young adults with sleep issues. Homeopathy also showed potential effects on sleep patterns in a rat study. Conclusion: The reviewed studies suggest the potential benefits of homeopathic treatments for sleep-related conditions. Passiflora Compose, individualized homeopathic treatment, and homeopathic similimum demonstrated promise in improving sleep quality and reducing anxiety. More research and larger trials are needed for wider acceptance, but these findings highlight their value for diverse populations.

Comparing the Prevalence of Sleep Disorders Among Underweight, Normal, Overweight, and Obese Adults in Riyadh, Saudi Arabia.

Background Sleep disorders are prevalent worldwide and can have a negative impact on physical and psychological well-being. Numerous studies have explored the reciprocal connection between obesity and sleep disorders. This study aimed to compare the prevalence of sleep disorders among underweight, normal, overweight, and obese adults in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted on 378 adults visiting primary healthcare centers in Riyadh, Saudi Arabia, from August to November 2022. Data werecollected using a self-administered questionnaire that included a section for demographic data and the SLEEP-50 questionnaire in both English and Arabic languages. Results Most of the participants were aged between 25 and 34 years (37.6%), 79.1% were females and 59.5% were either overweight or obese.Most participants (78.3%) had at least one sleep disorder, with narcolepsy being the most frequent disorder (65.1%), and 23% had two combined sleep disorders. Obese and overweight patients were significantly more likely to have sleep disorders (p=0.011), and obese patients were more likely to have all sleep disorders (p=0.049). Conclusion The prevalence of sleep disorders, namely narcolepsy and insomnia, is high among adults in Riyadh, Saudi Arabia. Moreover, sleep disorders are significantly associated with obesity. Evaluation and management of sleep disorders in clinical settings among patient with overweight or obese is important to improve their quality of life and to prevent physical and psychological complications.

The Association Between Heart Rate Variability and Sleep Quality - a Narrative Review

Introduction Heart rate variability (HRV) serves as a non-invasive marker to assess autonomic nervous system (ANS) modulation on cardiac rhythm. Its link with sleep quality, particularly in the context of insomnia, posits HRV as a potential indicator of autonomic state variations during sleep disturbances. The prevalence of insomnia, affecting up to 20% of the general population, emphasizes the need to understand its extensive impact. Material and Methods For this review - 41 relevant titles from 1985 to 2024 were selected Analysis of the Literature: Recent studies highlight a bidirectional relationship between insomnia and ANS function, with increased sympathetic activity indicated by physiological and subjective measures in individuals with insomnia. The role of medications like beta-blockers in disrupting ANS and leading to sleep deprivation further connects measurable and perceived aspects of sleep quality, impacting health negatively. Moreover, HRV's application has expanded beyond professional athletics to daily activity and sleep quality monitoring by the general population, emphasizing its potential in evaluating stress and training intensity. Conclusion: The complex interplay between HRV, insomnia, and health outcomes necessitates further research. However, integrating HRV measurements into clinical and everyday monitoring may offer a promising avenue for improving sleep disorder management and enhancing quality of life.

Phytotherapeutic Effects of Ashanti Pepper and Horn of Plenty in Sleep Disorder Management Resulting from Stress-Induced Neurobehavioral Alterations

This investigation explores the potential antidepressant effects arising from the inherent bioactive compounds found in <i>Cnestis ferruguinea</i> and <i>Piper guineense</i>. Both botanical entities contain flavonoids, phenolics, saponins, and tannins, which are known for their anxiolytic, antidepressant, and antioxidant properties. It is worth noting that <i>Cnestis ferruguinea</i> also contains terpenoids, which are recognized for their anxiolytic effects. Given the growing interest in nutritional interventions for neuropsychiatric conditions, our study meticulously examines the antioxidant capacities and anxiolytic properties of these phytochemicals, positioning them as potential regulators of brain health, particularly in the realm of sleep disorders. In response to the increasing demand for therapeutic alternatives with reduced side effects, our inquiry thoroughly examines the antioxidant and anxiolytic profiles of these botanical extracts. Of particular importance, <i>Cnestis ferruguinea</i> exhibits superior antioxidant potential compared to <i>Piper guineense</i>, thus warranting further investigation into its pharmacological utility. Subsequent analysis of the effects of <i>Cnestis ferruguinea</i> on sleep architecture, especially in the context of chronic stress, reveals promising results. The botanical extract significantly prolongs sleep duration in rats exposed to stress, suggesting a potential dual role in mitigating stress-induced neurobehavioral changes and depressive symptoms. Additionally, a noticeable decrease in immobility duration in the forced swim test, along with improvements in acetylcholinesterase levels following <i>Cnestis ferruguinea</i> treatment, provides mechanistic insights into its antidepressant effects. Our findings provide substantial evidence to support the pharmacotherapeutic potential of <i>Cnestis ferruguinea</i>, highlighted by its antioxidant abilities and anxiolytic effects. Further investigations should delve into the intricate molecular pathways underlying these effects, potentially paving the way for innovative botanical-based interventions in neuropsychiatric disorders, particularly those associated with stress-induced neurobehavioral changes and sleep disorders.

Cannabinoids and Sleep: Exploring Biological Mechanisms and Therapeutic Potentials.

The endogenous cannabinoid system (ECS) plays a critical role in the regulation of various physiological functions, including sleep, mood, and neuroinflammation. Phytocannabinoids such as Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), cannabinomimimetics, and some N-acylethanolamides, particularly palmitoyethanolamide, have emerged as potential therapeutic agents for the management of sleep disorders. THC, the psychoactive component of cannabis, may initially promote sleep, but, in the long term, alters sleep architecture, while CBD shows promise in improving sleep quality without psychoactive effects. Clinical studies suggest that CBD modulates endocannabinoid signaling through several receptor sites, offering a multifaceted approach to sleep regulation. Similarly, palmitoylethanolamide (PEA), in addition to interacting with the endocannabinoid system, acts as an agonist on peroxisome proliferator-activated receptors (PPARs). The favorable safety profile of CBD and PEA and the potential for long-term use make them an attractive alternative to conventional pharmacotherapy. The integration of the latter two compounds into comprehensive treatment strategies, together with cognitive-behavioral therapy for insomnia (CBT-I), represents a holistic approach to address the multifactorial nature of sleep disorders. Further research is needed to establish the optimal dosage, safety, and efficacy in different patient populations, but the therapeutic potential of CBD and PEA offers hope for improved sleep quality and general well-being.

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.

Melatonin Use in Pediatrics: A Clinical Review on Indications, Multisystem Effects, and Toxicity.

Exogenous melatonin is typically used for sleep regulation in the context of insomnia either in healthy children or those with neurodevelopmental disabilities. It is also used for the management of circadian rhythm sleep disorders in pediatric and adolescent patients. There are also many other possible indications that we will discuss in this paper beyond the role of melatonin for sleep regulation, including its potential use for various areas of medicine such as inflammatory conditions. Since melatonin is unregulated in the United States, distributed over the counter and perceived to be natural and safe, it has become available in many forms in the last two decades. With increasing sleep disturbances and mental health problems after the COVID-19 pandemic, melatonin has become even more popular and studies have shown a dramatic increase in use as well as resulting side effects, including melatonin overdose. As melatonin is generally viewed by physicians as a benign medication, we hope to increase awareness of melatonin's properties as well as negative side effects to optimize its use in the pediatric population.

Factors Influencing Adherence to Insomnia and Obstructive Sleep Apnea Treatments among Veterans with Mild Traumatic Brain Injury

ABSTRACT Objective To understand factors influencing adherence to recommended treatment for insomnia and obstructive sleep apnea (OSA) among Veterans with mild traumatic brain injury (mTBI). Method Semi-structured interviews (n = 49) with 29 clinical stakeholders and 20 Veterans were conducted. Clinical stakeholders included Veterans Health Administration providers and policymakers involved in the management of mTBI and/or sleep disorders. Veterans included those with a clinician-confirmed mTBI with a recent history of insomnia disorder and/or OSA treatment. Themes were identified using a Descriptive and Interpretive approach. Results Barriers to sleep disorder treatment adherence included factors associated with the patient (e.g., negative appraisal of treatment benefit), intervention (e.g., side effects), health conditions (e.g., cognitive challenges), health care system (e.g., limited availability of care), and socioeconomic status (e.g., economic instability). Similarly, facilitators of adherence included patient- (e.g., positive appraisal of treatment benefit), intervention- (e.g., flexible delivery format), condition- (e.g., accommodating cognitive impairments), health care system- (e.g., access to adherence support), and socioeconomic-related factors (e.g., social support). Conclusions Interviews revealed the multi-faceted nature of factors influencing adherence to sleep disorder treatment among Veterans with mTBI. Findings can inform the development of novel interventions and care delivery models that meet the complex needs of this population.

Sleep disorders and cancer incidence: examining duration and severity of diagnosis among veterans.

Sleep disruption affects biological processes that facilitate carcinogenesis. This retrospective cohort study used de-identified data from the Veterans Administration (VA) electronic medical record system to test the hypothesis that patients with diagnosed sleep disorders had an increased risk of prostate, breast, colorectal, or other cancers (1999-2010, N=663,869). This study builds upon existing evidence by examining whether patients with more severe or longer-duration diagnoses were at a greater risk of these cancers relative to those with a less severe or shorter duration sleep disorder. Incident cancer cases were identified in the VA Tumor Registry and sleep disorders were defined by International Classification of Sleep Disorder codes. Analyses were performed using extended Cox regression with sleep disorder diagnosis as a time-varying covariate. Sleep disorders were present among 56,055 eligible patients (8% of the study population); sleep apnea (46%) and insomnia (40%) were the most common diagnoses. There were 18,181 cancer diagnoses (41% prostate, 12% colorectal, 1% female breast, 46% other). The hazard ratio (HR) for a cancer diagnosis was 1.45 (95% confidence interval [CI]: 1.37, 1.54) among those with any sleep disorder, after adjustment for age, sex, state of residence, and marital status. Risks increased with increasing sleep disorder duration (short [<1-2 years] HR: 1.04 [CI: 1.03-1.06], medium [>2-5 years] 1.23 [1.16-1.32]; long [>5-12 years] 1.52 [1.34-1.73]). Risks also increased with increasing sleep disorder severity using cumulative sleep disorder treatments as a surrogate exposure; African Americans with more severe disorders had greater risks relative to those with fewer treatments and other race groups. Results among patients with only sleep apnea, insomnia, or another sleep disorder were similar to those for all sleep disorders combined. The findings are consistent with other studies indicating that sleep disruption is a cancer risk factor. Optimal sleep and appropriate sleep disorder management are modifiable risk factors that may facilitate cancer prevention.

Respiratory Analysis with Electrocardiogram Data: Evaluation of Pan-Tompkins Algorithm and Cubic Curve Interpolation Method

Advancements in bioinstrumentation have facilitated the easier monitoring of biometric signals such as electrocardiogram (ECG) and respiration. This development is particularly crucial for the diagnosis and management of various conditions like stress and sleep disorders. Two commonly used features in heart rate variability (HRV) analysis derived from ECG data are standard deviation and serial correlation coefficients of R-R intervals (the time durations between heartbeats). The former utilizes the fundamental components of QRS complexes, while the latter is designed to extract relationships between respiration and heart rate. In the proposed methodology, R-R wave detection is performed on processed ECG data using the Pan-Tompkins algorithm, and the respiration duration for each R-R interval from respiration data is selected. Additionally, missing respiration data for selected R-R intervals is interpolated based on the interpolation method. The results of this study are compared with the standard interpolation and cubic spline interpolation models to assess the effectiveness of the proposed method and its ability to capture temporal fluctuations. Since standard interpolation fails to accurately detect respiration data from R-R intervals and cannot precisely handle missing R-R intervals in short samples, cubic spline interpolation is recommended as a replacement and its results are presented. The obtained results provide insights into the effectiveness and application of the Pan-Tompkins algorithm, FFT (fast fourier transform) implementation, and cubic spline interpolation in the selection of respiration and R-wave features. According to the findings of the study, in the analysis conducted on 2-second samples with a 1000 Hz sampling frequency created from each participant's respiratory data set, missing respiratory data were successfully reconstructed from the R-R intervals of the EKG data using standard and cubic curve interpolation methods. Upon examination of RMSE (Root mean square error) values, it was observed that for 30% of the participants, as RMSE values increased, completion counts for standard interpolation increased, while completion counts for cubic curve interpolation decreased. Conversely, when RMSE values decreased, 60% of the participants showed a decrease in completion counts for standard interpolation and an increase in completion counts for cubic curve interpolation. A 10% participant group was identified where there was no apparent relationship between RMSE values and interpolation method. This indicates that in 90% of the participants, there is a linear relationship between the study's interpolation method, RMSE values, and completion counts for missing R-R intervals.

Sleep quality and psychological disorders in breast cancer female patients receiving radiotherapy at a tertiary oncology center in West Saudi Arabia.

Breast cancer is the most prevalent type of cancer among women worldwide. Many recently diagnosed and treated breast cancer patients complain about sleep disorders, depression, anxiety, stress, and fatigue. This study aimed to evaluate sleep quality among breast cancer patients and to assess its association with psychological disorders, and socio-demographic and clinical characteristics of patients. This cross-sectional study was conducted among women who received radiotherapy for breast cancer (stage 1-3) at King Abdul-Aziz Medical City-Jeddah from January to August 2021. Each participant completed a personal information form, the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire (IPAQ). Clinical data were collected from the medical records to evaluate certain risk factors. Descriptive statistics were used for participant characteristics, and analyses of variance were used to assess associations between the qualitative variables. Fifty-six women with a mean age of 50.1years and an average of 10months after cancer diagnosis were included. Poor sleep quality was present in 58% of respondents. Symptomatic depression, anxiety, and stress were found in 34%, 32%, and 30% of women, respectively. Poor sleep quality was associated with depression (p = 0.031), anxiety (p = 0.03), and stress (p = 0.024) and was independently associated with hot flashes. In multivariate analysis, patients with depression or withcancer for more than 6months were less likely to have good sleep after controlling other variables (21.74 and 14.71 times, respectively). Poor sleep quality was present in 58% of women with breast cancer receiving radiotherapy and was significantly associated with depression, anxiety, stress, and hot flashes. Depression level and cancer duration were significant predictors of sleep quality. Early identification and proper management of psychological and sleep disorders are necessary to improve the quality of life and survival of breast cancer patients.

Management of fatigue and sleep disorders in patients with chronic liver disease.

Management of fatigue and sleep disorders in patients with chronic liver disease.

Multidisciplinary management of sleep disorders in young age male patients after craniocerebral injuries

Multidisciplinary management of sleep disorders in young age male patients after craniocerebral injuries