Sleep Questionnaire Research Articles

Impact of sleep disturbance on longitudinal cognitive performance in patients with transient ischemic attack or mild stroke

IntroductionSleep disturbances including obstructive sleep apnea (OSA) and poor sleep quality are common after stroke, while its association with cognitive changes following transient ischemic attack (TIA) or mild stroke remains unclear. We aim to determine whether sleep duration, OSA parameters, or nocturnal hypoxemia is associated with a greater cognitive decline after stroke. MethodsWe prospectively followed-up patients with acute TIA/mild stroke [National Institute Health Stroke Scale (NIHSS) < 7] who underwent baseline sleep questionnaire [Pittsburgh Sleep Quality Index (PSQI)], and serial cognitive assessments [Montreal Cognitive Assessment (MoCA) 5-min, Stroop Test] at baseline and one-year. We also evaluated apnea-hypopnea index (AHI) and nocturnal hypoxemia by Home Sleep Apnea Test (HSAT) at one-year. Primary outcome was one-year change in MoCA 5-min score. ResultsOne hundred and five patients with TIA/mild stroke (mean age 63 years, 65 % male) were included. Baseline short sleep (< 6 hour/night) and AHI ≥ 20/hour at one-year were independently associated with a decline in the MoCA 5-min total score after covariates adjustment [short sleep: β = −2.36 95 % confidence interval (CI) (−4.13, −0.59), p = 0.009; AHI ≥ 20/hour: β = −1.79 (−3.26, −0.32), p = 0.017; remained significant after multiple comparisons correction]. A lower mean MinSpO2 was associated with a decline in executive function [Stroop interference index: β = 0.29 (0.04, 0.53), p = 0.021], but not with MoCA 5-min score at one-year. Moderation analysis indicated AHI ≥ 20/hour was associated with a pronounced decline in executive function only in men. ConclusionsShort sleep after stroke onset, AHI ≥ 20/hour and nocturnal hypoxemia at one-year contributed to an impaired cognitive trajectory at one-year following stroke in patients with TIA/mild stroke.

Nocturnal Sleep Dynamics Alterations in the Early Stages of Behavioral Variant Frontotemporal Dementia.

Sleep disorders have been recognized as an integral component of the clinical syndrome in several neurodegenerative diseases, including Alzheimer's Disease (AD). However, limited data exists for rarer types of neurodegenerative diseases, such as behavioral variant Frontotemporal Dementia (bvFTD). This study aims to analyze EEG power spectra and sleep stage transitions in bvFTD patients, hypothesizing that bvFTD may show distinctive sleep stage transitions compared to patients with Alzheimer's Disease (AD). Eighteen probable bvFTD patients and eighteen age- and sex-matched probable AD patients underwent overnight polysomnography (PSG) and completed sleep disorders questionnaires. Sleep questionnaires, full-night EEG spectra, and sleep stage transitions indexes were compared between groups. bvFTD patients had higher Insomnia Severity Index (ISI) scores (95%CI: 0, 5) and reported poorer sleep quality than AD patients (p<0.01). Compared to AD, bvFTD patients showed higher N1 percentage (95%CI: 0.1, 6), lower N3 percentage (95%CI: -13.6, -0.6), higher sleep-wake transitions (95%CI: 1.49, 8.86) and N1 sleep-wake transitions (95%CI: 0.32, 6.1). EEG spectral analysis revealed higher spectral power in bvFTD compared to AD patients in faster rhythms, especially sigma rhythm, across all sleep stages. In bvFTD patients, sleep-wake transitions were positively associated with ISI. Patients with bvFTD present higher rates of transitions between wake and sleep than AD patients. The increased frequency of sleep transitions indicates a higher degree of sleep instability in bvFTD, which may reflect an imbalance in sleep-wake promoting systems. Sleep stage transitions analysis may provide novel insights into the sleep alterations of bvFTD patients.

Factors associated with poor sleep in children with drug-resistant epilepsy.

We aimed to investigate sleep in children with drug-resistant epilepsy (DRE), including developmental and epileptic encephalopathies (DEEs). Next, we examined differences in sleep macrostructure and microstructure and questionnaire outcomes between children with well-controlled epilepsy (WCE) and children with DRE. Furthermore, we wanted to identify factors associated with poor sleep outcome in these children, as some factors might be targets to improve epilepsy and neurodevelopmental outcomes. A cross-sectional study was conducted in children 4 to 18-years-old. Children without epilepsy, with WCE, and with DRE were included. Overnight electroencephalography (EEG), including chin electromyography and electrooculography, to allow sleep staging, was performed. Parents were asked to fill out a sleep questionnaire. Classical five-stage sleep scoring was performed manually, spindles were automatically counted, and slow wave activity (SWA) in the first and last hour of slow wave sleep was calculated. One hundred eighty-two patients were included: 48 without epilepsy, 75 with WCE, and 59 with DRE. We found that children with DRE have significantly lower sleep efficiency (SE%), less time spent in rapid eye movement (REM) sleep, fewer sleep spindles, and a lower SWA decline over the night compared to children with WCE. Subjectively more severe sleep problems were reported by the caregivers and more daytime sleepiness was present in children with DRE. Least absolute shrinkage and selection operator (LASSO) regression showed that multifocal interictal epileptiform discharges (IEDs), benzodiazepine treatment, and longer duration of epilepsy were associated with lower SE% and lower REM sleep time. The presence of multifocal discharges and cerebral palsy was associated with fewer spindles. Benzodiazepine treatment, drug resistance, seizures during sleep, intellectual disability, and older age were associated with lower SWA decline. Both sleep macrostructure and microstructure are severely impacted in children with DRE, including those with DEEs. Epilepsy parameters play a distinct role in the disruption REM sleep, spindle count, and SWA decline.

Which Interventions Are Effective in Treating Sleep Disturbances After THA or TKA? A Systematic Review.

Poor sleep quality is a common complaint after total joint arthroplasty (TJA), and it is associated with reports of higher pain and worse functional outcomes. Several interventions have been investigated with the intent to reduce the incidence of postoperative sleep disturbance with varying effectiveness. An aggregate of the best available evidence, along with an evaluation of the quality of those studies, is needed to provide valuable perspective to physicians and to direct future research. In this systematic review, we asked: (1) What is the reported efficacy of the most commonly studied medications and nonpharmacologic approaches, and (2) what are their side effects and reported complications? This systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search using a combination of controlled vocabulary and keywords was performed utilizing Medline (Ovid), Embase (Ovid), Cochrane Central, and Web of Science databases from database inception to 2023, with the last search occurring October 24, 2023, to identify studies that evaluated a sleep intervention on the effect of patient-reported sleep quality after THA or TKA. Inclusion criteria were clinical trials, comparative studies, and observational studies on adult patients who underwent primary TKA or THA for osteoarthritis and who completed validated sleep questionnaires to assess sleep quality postoperatively. We excluded studies on patients younger than 18 years, patients with sleep apnea, TKA or THA because of trauma or conditions other than osteoarthritis, revision TJA, studies in languages other than English, and studies from nonindexed journals or preprint servers. Two investigators independently screened 1535 studies for inclusion and exclusion criteria and extracted data from the included studies. Ultimately, 14 studies were included in this systematic review, including 12 randomized controlled trials and 2 prospective comparative studies. A total of 2469 participants were included, with a mean ± SD age of 65 ± 7 years and 38% men in control groups and 65 ± 7 years and 39% men in intervention groups. Sleep quality questionnaires utilized included the Pittsburgh Sleep Quality Index, Self-Rating Scale of Sleep, 100-mm VAS - Sleep, Sleep Disturbance Numeric Rating Scale, Likert scales, and one institutionally designed questionnaire. Quality analysis was performed utilizing the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials, where higher scores of 13 indicated a more reliable study, and the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies, where higher scores of 9 indicated a more reliable study and scores < 5 represented a high risk of bias. Two of the randomized controlled trials scored a 12 of 13, and the remaining 10 met every criteria of the JBI checklist. Both comparative studies scored 5 of 9 possible points of the Newcastle-Ottawa Scale. Melatonin and selective cyclooxygenase-2 inhibitor rofecoxib were found to provide a clinically important benefit to sleep quality within the first postoperative week after TJA. However, rofecoxib was withdrawn from the market globally in 2004 over concerns about increased risk of cardiovascular events. Another cyclooxygenase-2 inhibitor, celecoxib, remains available. No other intervention demonstrated a clinical benefit. Side effects of melatonin include dizziness, headache, paresthesia, and nausea, and it is contraindicated in patients with liver failure, autoimmune conditions, or who are receiving warfarin. Long-term adverse effects of rofecoxib include hypertension, edema, and congestive heart failure, and it is contraindicated in patients with renal insufficiency or who are receiving warfarin. Melatonin is considered safe in older patients, but more caution should be taken with rofecoxib. Owing to limited evidence in support of most of the interventions we studied, none of these interventions can be recommended for routine use after TJA. Melatonin and rofecoxib may provide a benefit to sleep quality in some patients, but physicians need to understand the adverse effects and contraindications before recommending these interventions. Additionally, rofecoxib is no longer commercially available. Future investigation is warranted to evaluate the effectiveness of interventions with minimal side effect profiles for providers to be able to make an informed decision about interventions for sleep improvement after TJA. Level III, therapeutic study.

Association between self-reported sleep apnea and biomarkers of liver injury: Evidence from National Health and Nutrition Examination Survey.

The community population based studies on the relationship between obstructive sleep apnea and liver injury are limited. The study aimed to clarify the association between sleep apnea (SA) and liver injury by using the data in The National Health and Nutrition Examination Survey. SA was assessed by the sleep questionnaire and liver injury was evaluated by liver function test, hepatic steatosis index, and fibrosis-4. Weighted multivariable linear regression was performed to examine the association between SA and liver injury. Subgroup analyses and sensitivity analysis were also conducted. A total of 19,362 eligible participants were included in the study. After adjusting for confounders, the presence of SA was significantly associated with increased levels of lnALT, lnAST/alanine aminotransferase, lnGGT, and lnHSI (all P values < .05), but not with lnFIB-4 (P > .05). There is a dose-response relationship between the severity of SA and increased levels of lnALT, lnGGT, and decreased levels of lnAST/alanine aminotransferase (test for trend, all P values < .05). Subgroup analyses revealed that the positive association between SA and liver function, liver steatosis showed a tendency to exist in nonobese, younger, non-Hispanic Black, and male populations. Sensitive analysis showed the relationship between SA and liver injury was stable. Self-reported SA was independently associated with elevated liver enzymes and liver steatosis among US population. The association was more pronounced among nonobese, younger, non-Hispanic Black, and male populations.

Comparison between twin block appliance and mandibular advancement on clear aligners in the improvement of airway dimension: incremental versus maximum bite advancement.

The aim of the present retrospective study was to compare the changes resulting from treatment using the MA and the TB with special regard to the oro-and naso-pharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions and positive history of Sleep Disorder Breathing (SDB) diagnosed through the Pediatric Sleep Questionnaire (PSQ). This retrospective study involved 2 groups of subjects: patients treated with Twin Block (TB group: n = 22, 10 males, 12 females; mean age 12.0 ± 1.3 years) and patients treated with Mandibular Advancement (MA group: n = 23, 11 males, 12 females; mean age 12.2 ± 1.1 years). Pretreatment (T1) and posttreatment (T2) lateral cephalograms were analyzed. All patients underwent the PSQ to diagnose SDB. In both treated groups there was an increase in the airways dimensions and an improvement in symptoms related SDB. The statistical comparison of the changes between T1 and T2 in the TB group showed a significant increment in upper airway size (PNS-AD2, +1.50 mm + -3.30; McNamara's upper pharynx dimension, +2.21 + -4.21) after active treatment. The MA group showed similar results during active treatment with a significant increase in both upper (PNS-AD2, +2.72 + -2.65; McNamara's upper pharynx dimension, +2.97 + -3.07) and lower (PNS-AD1, +2.17 mm + -3.54) airway size. Despite the different structure of these two devices and the different advancement protocols, both appliances were valuable as a suitable treatment option for Class II patients with respiratory disorders, inducing an increase of upper and lower airway size and a significant reduction in diurnal symptoms.

Abstract P308: High Prevalence of Secondary Hypertension with Prospective Systematic Screening

Introduction: A systematic screening of hypertensive patients for secondary arterial hypertension (SHT) is generally held to be not justified by the low prevalence of SHT but improved knowledge and diagnostic tools might change this view. Hypothesis: To challenge the notion that the prevalence of SHT is low, we prospectively submitted consenting hypertensive patients presenting between 2017 and 2023 to a systematic search for SHT. Methods: The systematic search for SHT entailed, besides history and full physical examination, renal Doppler ultrasound assessment, a sleep questionnaire, and measurement of serum Na + , K + , ionized Ca 2+ , plasma active renin (DRC), aldosterone concentration (PAC), the aldosterone-renin ratio (ARR), PTH, TSH, and 24-h urinary/plasma Na + , K + , Ca 2+ , phosphate, and metanephrine and normetanephrine excretion. Cure or prominent improvement of hypertension after target treatment was used to confirm SHT. Results: In 494 consecutive patients (median age 62 years, 50% women) who completed the work-up, we found that 11.5% of these patients had isolated systolic hypertension. The overall prevalence of SHT among those with systo-diastolic HT was 72.3%: 25.5% had primary aldosteronism; 13.4% obstructive sleep apnea, 7.9% hypothyroidism, 6.5% renovascular hypertension and 19.0% rarer causes of SHT. Of all patients, only 14% were referred by their general practitioner or other specialists and 85% were self-presenting. Conclusions: Only a small minority of consecutive hypertensive patients seen in a specialized center were referred by their doctors, thus calling for implementation of broad strategies to increase the awareness of SHT. The fact that a systematic screening showed that SHT is far more common than currently believed supports this conclusion.

The effect of itching on sleep quality and comfort in patients with hemodialysis and renal transplantation: A multi-center cross-sectional study

BackgroundThe aim of this study was to determine the effect of itching on sleep quality and comfort in hemodialysis (HD) and renal transplant (Tx) patients with itching. MethodsThis descriptive, correlational seeking and cross-sectional study was conducted in four hospitals affiliated with a private health group in Istanbul between April and June 2021. The sample of the study consisted of 42 patients receiving HD treatment and 49 patients with renal transplantation. Data were collected using the Patient Information Form, 5-D Itch Scale, Richards-Campbell Sleep Questionnaire and General Comfort Questionnaire. ResultsThere was a significant difference between the HD and renal transplantation groups in the Direction (p = 0.01) and Disability dimension (p = 0.002) of the 5- D Itch scale in favor of the renal transplant group. The mean sleep quality and comfort scores of the groups were similar and moderate. Itching negatively affects sleep quality in patients receiving HD treatment, and 22 % of the change in sleep quality is explained by disability of itching (R2 = 0.22; p = 0.002). Itching negatively affects comfort in both groups. Itching explains 27 % of the change in comfort level in the HD group (R2 = 0.27; p = 0.002) and 25 % of the change in comfort level in the renal transplantation group (R2 = 0.25; p = 0.001). ConclusionsAccording the study results during the hemodialysis treatment process, itching is more intense in terms of distribution and disability and affects the quality of sleep of patients. Itching has a significant impact on patients' perception of comfort. Patients experience itching both during HD treatment and after renal transplantation, which significantly impairs their comfort. Therefore, itching should be carefully monitored during renal replacement therapy and its effects on patients should be evaluated.

Factors Related to the Sleep Duration of 3-Month-Old Infants.

Objective To identify the factors related to sleep duration in 3-month-old infants. Materials and Methods From 2021 to 2023, we conducted a cross-sectional study in the city of Araraquara, Brazil, involving 140 mothers and their respective 3-month-old infants. Maternal socioeconomic, demographic, obstetric, and nutritional characteristics, as well as nutritional and morbidity characteristics of the respective infants, were evaluated. Sleep duration was determined by the Brief Infant Sleep Questionnaire (BISQ). Multivariate linear regression analysis was used to assess the associations of maternal, newborn, and infant factors with sleep duration at three months. Results The nighttime sleep duration of the infants was of 9 hours. There were negative associations between nighttime sleep duration and prone sleep position ( p = 0.011), falling asleep between 8:30 pm and 11:00 pm ( p = 0.032), falling asleep after 11:00 pm ( p < 0.001), respiratory infection ( p = 0.011), dermatitis ( p = 0.002), and the presence of children under 9 years of age in the household ( p = 0.013). Discussion In the present study, factors such as infant morbidity, the presence of other children in the household, and sleeping habits were associated with a decrease in sleep duration in 3-month-old infants. Therefore, we emphasize the importance of early diagnosis of morbidity in the first months of life and of promoting healthy habits such as regulating the time to go to sleep, providing an adequate sleep environment, and other practices that help improve the quality and duration of sleep.

Matcha Does Not Affect Electroencephalography during Sleep but May Enhance Mental Well-Being: A Randomized Placebo-Controlled Clinical Trial.

Although theanine in matcha improves sleep quality and cognitive function, the caffeine in green tea is thought to worsen sleep quality. Therefore, this study investigated the factors behind the observed improvements in subjective sleep quality in matcha. A placebo-controlled randomized double-blind parallel-group study was conducted on healthy Japanese men and women aged 27-64 years. After 4 weeks of consuming 2.7 g of matcha daily (containing 50.3 mg theanine, 301.4 mg catechins, and 71.5 mg caffeine), no significant differences were observed between the control and matcha groups on total sleep time, sleep latency, wake after sleep onset, or sleep efficiency measured by electroencephalography (EEG). However, the sleep questionnaire Oguri-Shirakawa-Azumi Sleep Inventory, the Middle-age and Aged version (OSA-MA), administered immediately after waking showed a trend toward increased satisfaction with sleep time (p < 0.1), and EEG measurements indicated significantly shortened wake-up times after waking with matcha intake (p < 0.05). The Beck Depression Inventory-II scores also tended to decrease (p < 0.1). The continuous intake of matcha may offer improved subjective sleep quality and emotional stability despite not offering significant changes in objective sleep parameters.

Adicción a los videojuegos, calidad de sueño y malestar psicológico en adolescentes y jóvenes adultos

The present research took levels of video game addiction and tested a model of structural structures to determine whether videogame addiction predicted sleep quality and psychological distress. A sample of 612 young male adults was constituted, with a mean age of 21 years (SD = 2.95) of residents of Greater Buenos Aires and 40% in the Federal Capital. They answered a demographic questionnaire, the GASA questionnaire, a sleep questionnaire and the DASS-21 that measures anxiety, depression, and stress. The results indicated high levels of video game addiction and that age introduced differences. The structural model presented a good fit and addiction predicted greater sleep difficulties and less psychological well-being. The discussion will review the implications of this research and provide suggestions for future research.

Preventing postoperative moderate- and high-risk pressure injuries with artificial intelligence-powered smart decompression mattress on in middle-aged and elderly patients: a retrospective cohort analysis.

Aims/Background Artificial intelligence technology has attained rapid development in recent years. The integration of artificial intelligence applications into pressure reduction mattresses, giving rise to artificial intelligence-powered pressure reduction mattresses, is expected to provide personalised intelligent pressure reduction solutions, through automatic user's data-based adjustment of the patient's local pressure condition to prevent pressure injury. The purpose of this study was to investigate the effectiveness of artificial intelligence-powered smart decompression in the prevention of postoperative medium- and high-risk pressure injury in middle-aged and elderly patients. Methods A total of 400 middle-aged and elderly patients admitted to our hospital from June 2021 to December 2023 were selected as study subjects. Patients were categorised into observation and control groups according to the medical record system. General demographic data of the patients were collected. The propensity score matching method was used to balance the baseline data of the two groups of patients. The incidence, severity, complications and sleep quality in the matched study subjects were also compared. Results After matching, there were 96 patients in the two groups, and the differences in baseline data between the two groups were not statistically significant. Pressure injury and the total incidence of complications in the observation group were significantly lower than those in the control group (p < 0.05). Before treatment, there was no difference in the scores of all aspects of the Richards Campbell Sleep Questionnaire between the two groups (p > 0.05). After treatment, the scores of all aspects of Richards Campbell Sleep Questionnaire in the observation group were significantly lower than those in the control group (p < 0.05). Conclusion The artificial intelligence-powered smart decompression mattress can significantly prevent moderate- and high-risk pressure injury, effectively reducing the incidence of pressure injury and complications in postoperative long-term bedridden patients, alleviating the severity of pressure injury, relieving the pressure on various parts, and improving the sleep quality of patients.

Introducing a sleep disorder screening and management strategy for workers with future shift work requirements: a feasibility and acceptability study

Sleep disorders are common, and largely undiagnosed in early-career workers. The combination of sleep disorders and shift work has implications for mental health, workplace safety, and productivity. Early identification and management of sleep disorders is likely to be beneficial to workers, employers and the community more broadly. We assessed the feasibility and acceptability of a tailored sleep disorder screening and management pathway for individuals with future shift work requirements. Paramedic students were invited to complete an online sleep health survey, which included validated sleep disorder screening questionnaires for insomnia, obstructive sleep apnea and restless legs syndrome. Participants were able to express interest in participating in a sleep monitoring and management study. Participants at risk for a sleep disorder were identified, contacted by the study physician (RJA), notified of their sleep disorder screening results and provided with information regarding management options. Feasibility of the screening and management pathways were determined by completion of the 12 week follow-up, and ability to engage with health services for diagnostic testing or treatment. Acceptability of these pathways was assessed with a semi-structured interview on completion of the study at 12 weeks. Screening was completed in thirty participants (mean age 22.5 ± 6.7, 63% female), 17 of whom were ‘at-risk’ for a sleep disorder and offered a management pathway. All participants engaged with the study physician (RJA), with 16 completing the study (94% completion rate). Three participants with excessive daytime sleepiness received feedback from the study physician (RJA) and no further care required. Of the remaining 14 participants, 11 (78%) engaged with health services after speaking with the study physician (RJA). Those who engaged with diagnostic and management services reported that a structured pathway with online screening was convenient and easy to follow. Facilitating screening and management of sleep disorders in students with future shift work requirements is both feasible and acceptable. These findings can inform the development of a preventive strategy for sleep disorders and ideally, a health services feasibility trial for future shift workers.

Clinical assessment and striatal dopaminergic activity in healthy controls and patients with Parkinson's disease: a Bayesian approach.

We aimed to evaluate correlations between striatal dopamine transporter (DAT) uptake and clinical assessments in both patients with Parkinson's disease (PD) and healthy controls. This study enrolled 193 healthy controls, and 581 patients with PD. They underwent various clinical assessments and 123I-FP-CIT SPECT scans. After reconstruction, attenuation correction, and normalization of SPECT images, counts were measured from the bilateral caudate and putamen, and the occipital cortex for reference. Count densities for each region were extracted and used to calculate striatal binding ratios (SBRs) for each striatal region. SBR is calculated as (target region/reference region)-1. After logarithmic transformation of striatal SBRs, we analyzed the effects of clinical assessments on striatal SBRs using Bayesian hierarchical modeling. MDS-UPDRS total score, part I, part II, part III, Epworth Sleepiness Scale, REM sleep behavior disorder screening questionnaire, SCOPA-AUT total score were negatively associated with striatal SBR in patients with PD. Also, HVLT recognition discrimination was positively associated with striatal SBR in both healthy controls and patients with PD. In healthy control, MDS-UPDRS part II, MOCA, SCOPA-AUT total score were positively associated with striatal SBR. We demonstrated that motor symptom, sleep disturbance, autonomic symptom, and cognition of patients with PD were associated with striatal dopaminergic activity. In healthy controls, motor symptoms, autonomic symptom, and cognition were associated with striatal dopaminergic activity, some of which showing the opposite direction with patients with PD. This result might provide new insight to underlying mechanism of dopamine system with motor and non-motor assessments.

Translation and validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P)

PurposeThis study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep problems in preschoolers. MethodsThe cross-cultural adaptation of JSQ-P into Thai version of JSQ-P (TH-JSQ-P) was performed including forward translation, reconciliation, backward translation, and final approval by the original creator. Children aged 2–6 years from community and clinical settings were enrolled. The TH-JSQ-P was completed by parents of preschool children twice within 10–14 days to assess its reliability and validity. Six validity tests including face validity, content validity, structural validity, construct validity, criterion validity and predictive validity were assessed. Demographic data, Epworth sleepiness scale (ESS), medical and behavior problems, and socioeconomic status were collected for analysis. ResultsA total of 2613 participants completed the TH-JSQ-P, with 1207 completing it twice to assess test-retest reliability. The TH-JSQ-P had good internal consistency reliability and test-retest ability with Cronbach's alpha value of 0.898 and intraclass correlation coefficient of 0.814. The content validity was acceptable. The ESS had correlation with sleep problems in almost all subscales except for sleep habit. ConclusionsThe TH-JSQ-P is a valid and reliable instrument for evaluating sleep problems in preschool children in Thailand. It has the potential to be extensively utilized to screen for sleep problems, thereby enabling healthcare professionals to identify them early and implement prompt management.

Sensory processing in typically developing toddlers with and without sleep problems

This study investigates the sensory processing of typically developing toddlers with and without sleep problems. The research group consisted of typically developing toddlers with sleep problems (n = 110, mean age=18.35 ± 3.4 months), while the control group included typically developing toddlers without sleep problems (n = 110, mean age=18.67 ± 3.5 months) and their mothers. Toddlers were assigned to the research and control groups based on their sleep problems, as determined by the Brief Infant Sleep Questionnaire. The sensory processing of the toddlers was evaluated using the Infant/Toddler Sensory Profile 2. Sensory patterns and sensory processing sub-parameters of the research and control groups were compared. The sensory processing of the research group showed atypical behavioral responses in low registration (low awareness or indifferent attitude to sensory stimuli), sensory sensitivity (distracted or irritable attitude, intensely stimulated by sensory stimuli), and sensory avoiding (intentional avoidance of sensory stimuli or attitudes that produce out-of-norm responses) patterns compared to the control group (p < 0.05). Behavioral responses were similar in the sensory seeking (disturbing or dangerous attitude to the environment in search of sensory stimuli) pattern (p > 0.309). Statistically significant differences were observed in all sub-parameters of sensory processing compared to the control group. Our findings indicate that toddlers with sleep problems are at risk for sensory processing issues. Toddlers with sleep problems exhibit atypical sensory responses related to sensory sensitivity, low registration, and sensory avoiding. It should be considered that toddlers with sleep problems may show sensitivity to different sensory stimuli, avoidance or may not be able to recognize sensory stimuli. These findings suggest that the inclusion of sensory profile assessments in interdisciplinary care for toddlers with sleep problems may contribute to parent-infant well-being.

Drug-Induced Sleep Endoscopy Predicts Subjective Outcomes of Adenotonsillectomy.

Persistent obstructive sleep apnea (OSA) after adenotonsillectomy (AT) has been reported in 20%-30% of children. The aim of this study was to determine the predictive value of drug-induced sleep endoscopy (DISE) at the time of AT on subjective AT outcomes. This was a prospective cohort study of children aged 2-18 years being treated with AT for sleep disordered breathing (SDB) with one or more risk factors for AT failure: age >7 years, obesity, severe baseline OSA, Black race. All underwent DISE at the time of AT. Potential predictors of subjective AT outcome included age, sex, obesity, and DISE patterns. Multivariable linear regression was used to model predictors of post-AT Pediatric Sleep Questionnaire (PSQ) and OSA-18 outcomes. Pre- and post-AT PSQ/OSA-18 responses were available from 194 children. Mean age was 9.3 ± 3.5 years, with 59% obese, 50% female, and 67% White. After AT, mean PSQ score decreased from 0.60 ± 0.19 to 0.28 ± 0.22, p < 0.001 and mean OSA-18 score decreased from 66 ± 21 to 37 ± 18, p < 0.001. The most frequent sites of obstruction were the tonsils (92%), nasal airway (77%), adenoids (64%), and velopharynx (65%). Multivariable regression modeling demonstrated worse outcomes with obesity, male gender, and multilevel obstruction that included the nasal airway and tongue base in addition to adenotonsillar obstruction. Persistent OSA and symptom burden after AT was common in this population. Obesity, male gender, and multilevel obstruction during DISE were all associated with worse subjective outcomes. 3 Laryngoscope, 2024.

Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial

Objective/BackgroundSleep problems challenge overall wellbeing. Magnesium has been implicated to benefit sleep, although the clinical evidences varied based on the magnesium source used. Magnesium L-threonate (MgT) is a promising intervention due to its brain bioavailability and effects on cognition, memory and mood. We investigated MgT supplementation on sleep quality and daily function. Patients/methodsEighty 35–55-year-olds with self-assessed sleep problems participated in a randomized, double-blind, placebo-controlled, parallel-arm study, taking 1 g/day of MgT or placebo for 21 days. Sleep and daily behaviors were measured subjectively using standardized questionnaires including the Insomnia Severity Index, Leeds Sleep Evaluation Questionnaire, and Restorative Sleep Questionnaire, and objectively using an Oura ring. The Profile of Mood States questionnaire and a daily diary were used to evaluate mood, energy and productivity, and record any safety concerns. ResultsThe MgT group maintained good sleep quality and daytime functioning, while placebo declined. From objective Oura ring measurements, MgT significantly (p < 0.05) improved vs placebo deep sleep score, REM sleep score, light sleep time, and activity and readiness parameters activity score, activity daily movement score, readiness score, readiness activity balance, and readiness sleep balance. From subjective questionnaires, MgT significantly (p < 0.05) improved vs placebo behavior upon awakening, energy and daytime productivity, grouchiness, mood and mental alertness. MgT was safe and well tolerated. ConclusionsThis showed MgT improved sleep quality, especially deep/REM sleep stages, improved mood, energy, alertness, and daily activity and productivity. These are consistent with how MgT works in neuron cells and animal models, suggesting broader positive impacts on overall brain health.

The Relationships of Specific Cognitive Control Abilities with Objective and Subjective Sleep Parameters in Mild Cognitive Impairment: Revealing the Association between Cognitive Planning and Sleep Duration.

This study aimed to examine the associations between specific sleep parameters and specific aspects of cognitive functioning in individuals diagnosed with mild cognitive impairment (MCI), compared with healthy controls (HCs) by using cognitive, subjective, and objective sleep measures. A total of 179 participants were enrolled, all aged ≥ 65 years (mean age = 70.23; SD = 4.74) and with a minimum of six years of education (mean = 12.35; SD = 3.22). The sample included 46 HCs (36 females), 75 individuals with amnestic MCI (aMCI) (51 females), and 58 individuals with non-amnestic MCI (naMCI) (39 females). Inhibition, cognitive flexibility as a combined application of inhibitory control and set shifting or task/rule switching, and planning were examined. The following D-KEFS subtests were administered for their evaluation: Verbal Fluency Test, Color-Word Interference Test, and Tower Test. Self-reported sleep questionnaires (Athens Insomnia Scale, Stop-Bang questionnaire, and Pittsburg Sleep Quality Index) were used for subjective sleep assessments. Actigraphy was used for objective sleep measurements. Mixed-measures ANOVA, MANOVA, and one-way ANOVA, as well as the Scheffe post hoc test, were applied to the data. The results showed that the three groups exhibited statistically significant differences in the Tower Test (total achievement score, total number of administered problems, and total rule violations). As regards objective sleep measurements, the total sleep time (TST) was measured using actigraphy, and indicated that there are significant differences, with the HC group having a significantly higher mean TST compared to the naMCI group. The relationships evaluated in the TST Tower Test were found to be statistically significant. The findings are discussed in the context of potential parameters that can support the connection between sleep duration, measured as TST, and cognitive planning, as measured using the Tower Test.

Investigating the acute effect of low and moderate intensity aerobic exercise on whole-body task learning and cognition in young adults.

Recent studies have shown that a single bout of exercise has acute improvements on various forms of memory, including procedural motor learning, through mechanisms such as the plasticity-promoting effect. This study aimed to examine (1) the acute effects of timing and intensity of aerobic exercise on the acquisition and retention of motor learning in healthy adults, (2) the effect of sleep quality of the night before and after acquisition on motor learning, and (3) the acute effects of low and moderate-intensity aerobic exercise on cognitive functions. Seventy-five healthy adults were divided into five groups: Two groups performed low or moderate intensity aerobic exercise before motor practice; two groups performed low or moderate intensity aerobic exercise after motor practice; the control group only did motor practice. Low- and moderate-intensity exercises consisted of 30 min of running at 57%-63% and 64%-76% of the maximum heart rate, respectively. Motor learning was assessed using a golf putting task. The sleep quality of the night before and after the acquisition was evaluated using the Richard Campbell Sleep Questionnaire. Cognitive function was assessed before and after aerobic exercise using the Paced Auditory Serial Acquisition Task test. Results indicated that all groups demonstrated acquisition, 1-day and 7-day retention at a similar level (p > 0.05). Regression analysis revealed no significant relationship between sleep quality on the night before the experimental day and total acquisition (p > 0.05). However, a positive correlation was found between the sleep quality on the night of the experimental day and both 1-day and 7-day retention (p < 0.05). A single bout of low or moderate acute exercise did not modify motor skill acquisition and retention. Other results showed the importance of night sleep quality on the retention and proved that a single bout of moderate intensity exercise was associated with improved cognitive function.