Sleep Position Research Articles

Micrognathia and cleft palate as a cause of obstructive sleep apnoea in infants.

Obstructive sleep apnoea (OSA) is common in Robin sequence (RS). We investigated the significance of micrognathia, cleft palate and sleep positioning on OSA in infants. We analysed our 13-year national reference centre polysomnography (PSG) dataset. PSG was performed as daytime recordings (97%) in the supine-, side- and prone sleeping position at the median age of 5 weeks (interquartile range 3-8 weeks). Our study included 113 infants with RS and cleft palate, 10 infants with RS but intact palate and 32 infants with cleft palate without micrognathia. The degree of OSA in infants with cleft palate without micrognathia was less severe than in infants with RS in terms of obstructive events (median OAHI 4 vs. 32 h-1, respectively), SpO2 desaturations (ODI≥3OAH 0.4 vs. 3 h-1), transcutaneous pCO2 levels (TcCO2P95, 41 vs. 46 mmHg) (p < 0.0001) and work of breathing (p = 0.01). In the RS group, OSA was sleep-position dependent, with fewer obstructive events apparent in the side (18 vs. 24 h-1, p = 0.005) and prone (39 vs. 27 h-1, p = 0.003) sleeping positions than when supine. The degree of OSA in RS infants is more dependent on micrognathia than on cleft palate.

The impact of pillow height on neck muscle activity: a pilot study.

Muscle relaxation in the neck during sleep is crucial for achieving quality sleep, and varying pillow heights can significantly influence the myoelectric activity of the neck muscles. This study aims to investigate the effects of different pillow heights on neck muscle activity, with the goal of providing evidence-based recommendations for pillow selection. A total of 15 asymptomatic participants in this study, aged 18 to 30, were assigned to three groups based on pillow height: height 1 (0.5*Shoulder width), height 2 (1.0*Shoulder width), and height 3 (1.5*Shoulder width). Electromyography (EMG) was employed to measure muscle activity in the sternocleidomastoid and trapezius muscles during lateral sleeping positions. Sleep comfort was evaluated using a 100mm visual analog scale (VAS). Statistical analysis was conducted using ANOVA to assess the differences in muscle activity and comfort levels across the various pillow heights. The muscle activation levels revealed that both the sternocleidomastoid and trapezius muscle exhibited the lowest EMG activity in the height 2 (p < 0.001). In contrast, the sternocleidomastoid muscle recorded the highest activation, demonstrating significantly greater average electromyography (AEMG) and integrated electromyography (iEMG) at height 1 (p < 0.001). Meanwhile, the trapezius muscle showed the highest AEMG at height 3 (p < 0.001). Additionally, height 2 was identified as the most comfortable option when compared to height 1 and 3 (p < 0.001). This study concludes that varying pillow heights are linked to neck muscle activity and sleep comfort. These findings underscore the importance of an appropriate pillow height to maintain a healthy cervical spine and promote restful sleep.

Polysomnographic Phenotype of Positional Obstructive Sleep Apnea

Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by recurrent upper airway obstruction, leading to disrupted sleep and various health complications. Positional OSA (POSA) refers to patients whose OSA severity is significantly influenced by body position, especially when lying supine. This study aimed to evaluate the polysomnographic characteristics of POSA and non-positional OSA (non-POSA) and to assess their clinical implications.Methods: This retrospective study included patients diagnosed with OSA who underwent type 1 polysomnography. Patients were categorized into POSA and non-POSA groups based on whether their apnea-hypopnea index (AHI) in the supine position was at least twice as high as that in the lateral position. We collected and analyzed clinical and polysomnographic parameters, including AHI, oxygen desaturation index, arousal index, nadir peripheral oxygen saturation (SpO&lt;sub&gt;2&lt;/sub&gt;), and sleep position proportions. These were compared across different OSA severity levels—mild, moderate, and severe—to assess differences between the POSA and non-POSA groups.Results: In total, 500 patients with OSA were analyzed, of whom 63.4% were classified as having POSA. Patients with POSA exhibited milder disease severity than those without, with an average AHI of 23.3±15.3/h versus 43.9±27.9/h, respectively, and a higher nadir SpO&lt;sub&gt;2&lt;/sub&gt; of 82.8%±6.6% versus 77.1%±9.8%. POSA was more common in patients with mild OSA (76.5%) and moderate OSA (72.8%), while severe OSA cases were predominantly non-POSA (POSA was 47.4%). Moreover, patients with POSA spent significantly more sleep time in the lateral position (43.8%±22.7%) than non-POSA patients (27.2%±28.2%).Conclusion: Patients with POSA generally exhibited milder disease and more favorable polysomnographic profiles than non-POSA patients. POSA is prevalent in mild-to-moderate OSA, and identifying it via polysomnography may inform tailored treatment strategies.

Relationship Between Sleep Position and Glaucoma Progression

&amp;lt;i&amp;gt;Introduction&amp;lt;/i&amp;gt;: Glaucoma, a leading cause of irreversible blindness worldwide, is strongly influenced by intraocular pressure (IOP), with recent studies suggesting that nocturnal IOP fluctuations and body position during sleep may play a critical role in disease progression. The purpose of the study was to explore the relationship between sleep position and glaucoma progression. &amp;lt;i&amp;gt;Aim of the study&amp;lt;/i&amp;gt;: The aim of the study was to evaluate the relationship between sleep position and glaucoma progression. Methods: This cross-sectional observational study was conducted at the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, over a 1-year period from mid-2023 to mid-2024. A total of 40 patients were included. Data were collected retrospectively from medical records, focusing on demographic characteristics, sleep position preferences, and intraocular pressure (IOP) measurements. Descriptive statistics, chi-square tests used for data analysis, with statistical significance set at p &amp;lt; 0.05. &amp;lt;i&amp;gt;Result&amp;lt;/i&amp;gt;: Among the patients, 35.00% were aged 60-70 years, with a significant male predominance (87.50%). The most preferred sleep position was the right lateral decubitus position (LDP), chosen by 45.00% of patients, and it was associated with a mean intraocular pressure (IOP) increase of 1.8 mmHg and a 50.00% progression rate of glaucoma. Notably, patients with higher baseline IOP, representing 30.00% of the sample, experienced a mean IOP increase of 2.0 mmHg. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The study highlights that the right lateral decubitus position is strongly associated with increased intraocular pressure and higher glaucoma progression, emphasizing the need to consider sleep position and individual risk factors in glaucoma management.

Differential effects of sleep position and sleep stage on the severity of obstructive sleep apnea.

This study compared the effects of sleeping in the supine position and rapid eye movement sleep on the severity of obstructive sleep apnea, and investigated the effect of sleep stage on position-dependent obstructive sleep apnea, and of sleep position on rapid eye movement-dependent obstructive sleep apnea. We analysed epoch-labelled polysomnographic readouts of 3843 patients, and calculated the apnea-hypopnea index for each sleep position and sleep stage. Subgroup analyses were performed to evaluate whether the proportion of position-dependent obstructive sleep apnea patients changed during rapid eye movement and non-rapid eye movement sleep, and whether that of rapid eye movement-dependent obstructive sleep apnea patients changed during supine/lateral sleep. The apnea-hypopnea index was highest in the rapid eye movement-supine position (50.7 ± 22.6 events per hr), followed by non-rapid eye movement-supine, rapid eye movement-lateral and non-rapid eye movement-lateral (39.2 ± 25.3, 22.9 ± 24.4, 15.9 ± 21.9 events per hr, respectively; p < 0.001). Patients with position-dependent obstructive sleep apnea had a higher ratio of rapid eye movement sleep, and those with rapid eye movement-dependent obstructive sleep apnea had a higher ratio of sleep time in the supine position (p < 0.001). During rapid eye movement sleep, position-dependent obstructive sleep apnea was not observed in 21.1% of patients who otherwise had position-dependent obstructive sleep apnea. In the lateral position, 36.9% of patients with rapid eye movement-dependent obstructive sleep apnea did not retain rapid eye movement dependency. Although sleeping in the supine position and rapid eye movement sleep were both associated with more frequent respiratory events, this was the first study to demonstrate that the former had a stronger correlation with obstructive sleep apnea severity. Position dependency in patients with obstructive sleep apnea decreased during rapid eye movement sleep, and worsening of rapid eye movement dependency was alleviated in the lateral position, suggesting potential for personalized obstructive sleep apnea management.

Randomized Clinical Study of Nano-Cerium Oxide and its Efficacy in Sciatic Nerve Regeneration: A Histopathological Evaluation

Background: Peripheral nerve damage is a frequent clinical condition. peripheral nerve injuries are variable, and these injuries are mostly caused by trauma. Blunt trauma has many types, including contusion, laceration, stretching, traction, penetrating and perforating injuries, abnormal sleeping positions, external pressure, internal compression, ischemia. Cerium oxide nanoparticles are used widely in the materials field. Besides their material applications. Objective: this study was examining how cerium oxide nanoparticles impact axonal regeneration of the sciatic nerve in rats. Materials and Methods: 24 adult animals used, weighing average (M±SD: 230 ± 20 g). The animals were separated into two group. The first group (control) was left without treatment, The second group (Nano cerium Oxide) was treated orally with 50 mg of Nano cerium oxide daily for 7 days. Right Sciatic nerve was completely transected in all animals. The result evaluated at 4th, 8th and 12th weeks post-operative. Results: The histopathological results, indicated that the high effective result in the second group, then the control group. The control group has a significant nerve damage and some regenerative signs over time. While there are indications of severe damage particularly at 4 and 8 weeks, then presence of almost normal nerve fibers at 12 weeks suggests partial recovery. Conclusion: Nano Cerium Oxide accelerated the regeneration of the peripheral nerves These findings suggest that this nanoparticle could can be seen as a novel therapy for promoting the regeneration of the nervous system.

Association Between Sleep Position, Obesity, and Obstructive Sleep Apnea Severity.

This study examines the relationship between obstructive sleep apnea severity, sleep position, and body weight, particularly focusing on the negative impact of sleeping in a supine position combined with being overweight in a population-based sample. The Apnea-Hypopnea Index (AHI) was utilized as a marker of OSA severity and sleep position from a standardized overnight polysomnography. Participants were categorized by body mass index (BMI) (kg/m2) into normal weight/underweight (<25) and overweight (≥25). The results indicated a higher mean Apnea-Hypopnea Index for those sleeping in the supine position compared to other positions, with overweight individuals experiencing a proportionally greater impact from sleep position than their normal-weight counterparts.

Factors affecting lymphedema after neoadjuvant chemotherapy and axillary dissection in female breast cancer patients: a retrospective cohort study based on the Chinese population.

Breast cancer-related lymphedema (BCRL) is a common complication among breast cancer survivors. Most BCRL studies have focused on patients receiving adjuvant chemotherapy, with relatively little attention paid to BCRL in patients undergoing neoadjuvant chemotherapy (NAC). This study aimed to investigate the risk factors associated with BCRL in Chinese women undergoing NAC and axillary lymph node dissection (ALND). At our institution, this cohort study collected data from 336 women with breast cancer and documented axillary nodal metastasis at diagnosis, who received NAC and ALND surgery between 2015 and 2020. BCRL was assessed through both objective limb circumference measurements and subjective self-reported symptoms. Multivariate logistic regression was employed to identify risk factors for BCRL, considering clinical, demographic, and lifestyle-related characteristics. The cumulative incidence of BCRL within 2.5 years was 43.75%. Factors independently associated with BCRL included radiotherapy (versus no radiotherapy; hazard ratio (HR) = 1.611; P = 0.020), NAC duration of 105 days or shorter (versus 105-143 days; HR = 0.471; P = 0.020), removal of more than 15 lymph nodes (versus 15 or fewer lymph nodes; HR = 1.593; P = 0.036), drainage duration of 20-29 days (versus 10-19 days; HR = 1.568; P = 0.028), and sleeping biased toward the affected arm (versus sleeping biased toward the healthy arm; HR = 2.033; P = 0.019). This study identified several risk factors for BCRL in breast cancer patients following NAC and ALND. Patients presenting with one or more of these factors should be monitored closely for early detection and intervention. Further research is warranted to explore the impact of drainage duration and sleep position on the development of BCRL.

Pediatric Obstructive Sleep Apnea: Clinical Manifestations and Consequences

Obstructive sleep apnea (OSA) significantly impacts the quality of life in children, affecting their physical and mental health. The pathophysiology involves a complex interaction between anatomical factors (such as enlarged tonsils, adenoids, and structural abnormalities) and obesity, along with neuromuscular compensations. Clinical manifestations include loud snoring, breathing pauses, restless sleep, unusual sleeping positions, and frequent awakenings. OSA can lead to enuresis, growth impairment, poor academic performance, and neurocognitive and behavioral difficulties. Long-term consequences are cardiovascular morbidity, metabolic dysfunction, and neurocognitive impairment. Many studies have explored these associations and the impact of adenotonsillectomy. This review provides an overview of clinical manifestations and consequences of OSA, aiming to enhance diagnosis and treatment strategies for pediatric OSA.

Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia.

Catathrenia has been classified as a sleep-related breathing disorder variant in the third edition of the International Classification of Sleep Disorders, but its validity remains unverified. We analyzed the clinical descriptive variables and polysomnographic findings of catathrenia and discussed the similarities and differences to those of obstructive sleep apnea (OSA), non-REM parasomnias, and sleep bruxism (SB). A retrospective analysis was conducted on 47 patients diagnosed with nocturnal groaning through polysomnography. We examined sex, body mass index, age at symptom onset, weekly symptom frequency, and presence/absence of comorbidities, including OSA, periodic limb movement disorder, non-REM parasomnia, and SB. The groaning event (GE) index was calculated according to sleep position and sleep stage. The distribution of patients with catathrenia did not show sex difference (male/female = 20:27), body mass index was 20.6 ± 3.0 kg/m2, and age of onset was 18.2 ± 7.4 years. The GE index was higher in stages N1 and R than in stage N3 and in the supine position than in the lateral position. There were no cases complicated with non-REM parasomnia, but the complication of SB was observed in 30% of the participants, and SB events appeared immediately before or during the interictal period of the GE episodes in these cases. Given the clinical background, posture- and sleep stage-dependent appearance of GEs, and the relatively high complication rate of SB, catathrenia pathogenesis may be heterogeneous or comprise elements of different sleep disorders.

Sudden death of a two-month-old infant: A case report emphasizing safe sleep practices

A rare case of sudden cardiopulmonary arrest in a two-month-old infant during overnight breastfeeding is presented in this case report. The infant's respiratory distress prompted an emergency response, highlighting the complexities of managing critical situations in neonates. The report provides a comprehensive overview of the clinical presentation, resuscitation efforts, and laboratory findings. It emphasizes the importance of continuous education on safe sleep practices, breastfeeding techniques, and cultural factors that influence sleep safety. The aim is to raise awareness, foster understanding, and emphasize the necessity of a holistic approach to preventing adverse events in the vulnerable neonatal population. The case emphasizes the importance of establishing a safe sleeping environment by avoiding risk factors such as prone sleeping positions and soft bedding. It also highlights the need for culturally sensitive education. Additionally, the case addresses the challenges related to maternal alertness during night feeds and the controversial practice of bed-sharing. The report highlights the importance of healthcare providers in sharing information, conducting research, and involving communities to encourage a culture of sleep safety that protects the well-being of infants. Continuous education and awareness are crucial in this joint effort to safeguard the most vulnerable members of society.

Arousal burden is highest in supine sleeping position and during light sleep.

Arousal burden (AB) is defined as the cumulative duration of arousals during sleep divided by the total sleep time. However, in-depth analysis of AB related to sleep characteristics is lacking. Based on previous studies addressing the arousal index (ArI), we hypothesized that the AB would peak in the supine sleeping position and during non-rapid eye movement stage 1 (N1) and show high variability between scorers. Nine expert scorers analyzed polysomnography recordings of 50 participants, the majority with an increased risk for obstructive sleep apnea. AB was calculated in different sleeping positions and sleep stages. A generalized estimating equation was utilized to test the association between AB and sleeping positions, sleep stages, and scorers. The correlation between AB and ArI was tested with Spearman's rank-order correlation. AB significantly differed between sleeping positions (p<0.001). The median AB in the supine sleeping position was 47-62% higher than in the left and right position. The AB significantly differed between the sleep stages (p<0.001); the median AB was more than 200% higher during N1 than during other sleep stages. In addition, the AB differed significantly between scorers (p<0.001) and correlated strongly with ArI (r=0.935, p<0.001). AB depends on the sleeping position, sleep stage, and scorer as hypothesized. AB behaved similarly as the ArI, but the high variability in the ABs between scorers indicates a potential limitation caused by subjective manual scoring. Thus, the development of more accurate techniques for scoring arousals is required before AB can be reliably utilized.

A policy analysis of sleep-related legislation for Canadian licensed childcare facilities

BackgroundNational legislative guidelines for sleep and rest are lacking in the Canadian licensed childcare sector. No review of Canadian legislation for licensed childcare facilities has focused on sleep. This paper provides a review of the Canadian provincial and territorial legislative landscape, regarding sleep, rest, and naps in licensed childcare centers.MethodsChildcare statutes and regulations for each province and territory were identified and downloaded on a particular date. Statutes and regulations were reviewed focusing on sections articulating licensed childcare facility mandates governing sleep, rest, naps, and sleep equipment. An excel file was used to facilitate systematic data retrieval and comparisons across provinces and territories. Two authors developed and discussed themes that summarized data from the documents.ResultsNo statutes indicated recommendations for sleep, rest, or naps. Only one regulation defined rest (Alberta). Our analysis of regulations identified four themes representing sleep, rest, and naps: programming (general programming, daily programming); space (dedicated space, amount of space, age-specific space); equipment (developmental appropriateness, acceptable sleep equipment, age-specific equipment); and safety (staffing during sleep/rest, sleep position, sleep monitoring, sleep equipment safety, prohibited practices). In Canada, minimal regulatory consistency is evident in required sleep programming, space, acceptability of sleep equipment, and sleep safety considerations. Most jurisdictions’ regulations indicated necessity for developmentally appropriate rest or sleep areas and equipment, in particular for infants, but there was minimal consistency in defining infant age groups.ConclusionsAlthough we identified themes related to sleep across regulations, childcare regulations differ in their definitions of infants and specifications for children’s sleep and rest in licensed Canadian childcare facilities. Without adequate definitions in legislative components of appropriate sleep duration linked to children’s developmental stages, childcare facilities lack guidance to support healthy sleep for children in their care. Future research can examine translation of healthy sleep guidelines into government legislation and mandates for sleep, rest, and naps among young children in licensed childcare.

Classification of Sleeping Position Using Enhanced Stacking Ensemble Learning.

Sleep position recognition plays a crucial role in enhancing individual sleep quality and addressing sleep-related disorders. However, the conventional non-invasive technology for recognizing sleep positions tends to be limited in its widespread application due to high production and computing costs. To address this issue, an enhanced stacking model is proposed based on a specific air bag mattress. Firstly, the hyperparameters of the candidate base model are optimized using the Bayesian optimization algorithm. Subsequently, the entropy weight method is employed to select extreme gradient boosting (XGBoost), support vector machine (SVM), and deep neural decision tree (DNDT) as the first layer of the enhanced stacking model, with logistic regression serving as the meta-learner in the second layer. Comparative analysis with existing machine learning techniques demonstrates that the proposed enhanced stacking model achieves higher classification accuracy and applicability.

A Position Modification Device for the Prevention of Supine Sleep During Pregnancy: A Randomised Crossover Trial.

To assess the effectiveness and acceptability of a pillow-like position modification device to reduce supine sleep during late pregnancy, and to determine the impacts on the severity of sleep-disordered breathing (SDB) and foetal well-being. Randomised cross-over study. Individuals in the third trimester of pregnancy receiving antenatal care at a tertiary maternity hospital in Australia. Participants used their own pillow for a control week and an intervention pillow for a week overnight, in randomised order. Sleep position and total sleep time for each night of both weeks were objectively monitored, with a sleep study and foetal heart rate monitoring performed on the last night of each week. Primary outcome = percentage of sleep time in the supine position; secondary outcomes = apnoea-hypopnoea index, foetal heart rate decelerations and birthweight centile. Forty-one individuals were randomised with data collected on 35 participants over 469 nights. There was no difference in percentage of total sleep time in the supine position overnight between the control or intervention pillow week (13.0% [6.1, 25.5] vs. 16.0% [5.6, 27.2], p = 0.81 with a mean difference of 2.5% [95% CI] = -0.7, 5.6, p = 0.12), and no difference in the severity of SDB or foetal heart rate decelerations across weeks. However, increased supine sleep was significantly related to a higher apnoea-hypopnoea index (rs = 0.37, p = 0.003), lower birthweight (rs = -0.45, p = 0.007) and lower birthweight centile (rs = -0.45, p = 0.006). The proportion of supine sleep each night of the week varied widely both within and across participants, despite awareness of side-sleeping recommendations. We found no evidence to suggest that the adoption of a pillow designed to discourage supine sleep was effective in late pregnancy, with women spending an average of 1 h per night supine. Alternative devices should be investigated, incorporating lessons learnt from this study to inform trials of supine sleep minimisation in pregnancy. Clinical Trial: (Australia New Zealand Clinical Trials Registry): ACTRN12620000371998.

Postoperative Supine Sleeping Position Following Total Knee Arthroplasty Decreases Knee Flexion Contractures

Background Total knee arthroplasty (TKA) is an orthopaedic operation that improves quality of life and reduces pain in patients with disabling arthritis of the knee. One commonly recognized postoperative complication is flexion contracture of the knee. While early physical therapy and range of motion (ROM) exercises have helped improve ROM postoperatively, flexion contractures still remain a significant postoperative complication of TKA. This study evaluated postoperative sleeping position and its effect on terminal knee extension and ROM following primary TKA. We hypothesized that patients who slept in the supine position would achieve earlier knee extension and ROM when compared to those in the lateral recumbent position. Methods A total of 150 consecutive primary total knee arthroplasties (TKAs) were conducted by a single surgeon (JMC). Prospective data collection included assessments of preoperative range of motion (ROM), postoperative ROM, patient-reported outcome measures, and sleeping positions. Functional outcomes and patient-reported measures were compared between pre- and postoperative phases, as well as across different sleeping position groups. Results Postoperative follow up was a mean of 29.6 days. Mean postoperative terminal extension ROM at one month was 2.98 degrees in the supine group versus 6.03 degrees in the lateral group (P &lt; 0.001). Overall, there was significant improvement in patient reported outcome measures (WOMAC, Oxford, and pain) after surgery, but no difference existed between sleeping groups. For knee extension, a two-way ANOVA revealed that there was a statistically significant interaction between the effects of surgery and sleep position (p = 0.0053). Conclusions Our results demonstrate that sleeping position does affect initial postoperative knee terminal extension; however, there is no effect on patient reported outcomes. We found a statistically significant difference in extension when comparing patients in the supine versus lateral group. Patients who slept in the lateral position lacked 6.03 degrees of extension which is greater than the 5 degrees threshold needed for normal gait mechanics. Conversely, those in the supine group only lacked 2.98 degrees of extension, allowing for normal gait mechanics. This study identifies an easy, effective means of increasing patient knee range of motion following TKA.

Sleep disruption and sleep position: Increased wake frequency in supine predicts lateral position preference.

Little is known about the physiological and biomechanical factors that determine individual preferences in lying posture during sleep. This study investigated relationships between position preference and position-specific arousals, awakenings, limb movements and limb movement arousals to explore the mechanisms by which biomechanical factors influence position preference. Forty-one mature-aged adults underwent 2 nights of at-home polysomnography ~2 weeks apart, on a standardised firm foam mattress, measuring nocturnal sleep architecture and position. The lateral supine ratio and restlessness indices specific to lateral and supine positions including limb movement index, limb movement arousal index, arousal index, wake index, respiratory arousal index and apnea-hypopnea index were calculated and analysed via linear mixed-effects regression. In the supine position, all restlessness indices were significantly increased compared with the lateral position, including a 379% increase in respiratory arousals (β = 7.0, p < 0.001), 108% increase in arousal index (β = 10.3, p < 0.001) and 107% increase in wake index (β = 2.5, p < 0.001). Wake index in the supine position increased significantly with more lateral sleep (β = 1.9, p = 0.0013), and significant correlation between lateral supine ratio polysomnography 1 and lateral supine ratio polysomnography 2 (β = 0.95, p < 0.001) indicated strong consistency in sleep preference. Overall, the findings suggest that some individuals have low tolerance to supine posture, represented by a comparatively high wake index in the supine position, and that these individuals compensate by sleeping a greater proportion in the lateral position.

Leveraging Attention-reinforced UWB Signals to Monitor Respiration during Sleep

The respiration state during overnight sleep is an important indicator of human health. However, existing contactless solutions for sleep respiration monitoring either perform in controlled environments and have low usability in practical scenarios or only provide coarse-grained respiration rates, being unable to accurately detect abnormal events in patients. In this article, we propose Respnea, a non-intrusive sleep respiration monitoring system using an ultra-wideband device. Particularly, we propose a profiling algorithm, which can locate the sleep positions in non-controlled environments and identify different subject states. Further, we construct a deep learning model that adopts a multi-head self-attention mechanism and learns the patterns implicit in the respiration signals to distinguish sleep respiration events at a granularity of seconds. To improve the generalization of the model, we propose a contrastive learning strategy to learn a robust representation of the respiration signals. We deploy our system in hospital and home scenarios and conduct experiments on data from healthy subjects and patients with sleep disorders. The experimental results show that Respnea achieves high temporal coverage and low errors (a median error of 0.27 bpm) in respiration rate estimation and reaches an accuracy of 94.44% on diagnosing the severity of sleep apnea-hypopnea syndrome.

Relationship between sleep position and otitis media in infants: The Japan environment and children's study

ObjectiveOtitis media is a disease that commonly occurs in infants. Various risk factors have been reported. Sleep position has been reported to be associated with various diseases. There is no report on the relationship between otitis media and sleep position. We examined the incidence of otitis media and sleep position in infants. MethodsWe used data from the Japan Environment Children's Study. We used multivariate logistic analysis to examine the relationship between sleep position and the incidence of otitis media in infants aged up to 6 months. In addition, we conducted a stratified analysis based on whether the child was able to turn over in bed at 6 months of age. ResultsThe study population comprised 85,731 participants. The incidence of otitis media by sleep position was significantly higher when the infant was in the prone position compared to any other position (adjusted odds ratio, 1.206; 95 %CI, 1.038–1.401). Stratified analysis of turning showed that otitis media was more common in the prone position in all groups. ConclusionIn the current study, infants aged 6 months or younger who slept in the prone position were more likely to have otitis media. Sleep position interview and guidance on changing sleep position may be useful for the prevention of otitis media.

Positional Regulation, Sucking Reflex and Incidence When Given Nutrition Through OGT in High-Risk Infants with Low Birth Weight Infants in the Nicu Room: A Case Study of Waled Hospital

High-risk babies are babies born at 32 – 36 weeks of gestation/prematurely, babies whose mothers suffer from Diabetes Mellitus, babies with a history of apnea, babies with seizures, sepsis, asphyxia, babies with bleeding disorders or breathing problems. Problems that often arise in cases of LBW babies include unstable body temperature, breathing problems, digestive and nutritional disorders, liver immaturity, anaemia, intraventricular bleeding, seizures, infections, hypoglycemia, hyperglycemia and hypocalcemia. This study aims to provide nursing care to babies at high risk in the Nicu Room at Waled Hospital, Cirebon Regency, on 27 December 2023. Examination of the sucking reflex is recommended as a screening that shows intact motor neuron function in neonates. The sucking reflex is well-developed in normal babies and is coordinated with breathing. Inhibition of the sucking reflex in the first hours of life will affect the ability to suck at the beginning of life and will directly hinder the nutritional intake received by the baby. Arranging sleeping positions for newborn babies is the role of the neonatal nurse in providing routine daily care. Positioning, especially for premature babies, is not easy. Positioning errors can result in changes in physiological status (increased respiratory rate, pulse frequency, and decreased oxygen saturation), disturbed comfort and quality of sleep, drinking intolerance, hip joint deformity, and bleeding in the brain. The issues affecting all three clients have not been resolved. However, interventions such as positioning, assessing sucking reflexes in high-risk babies, and providing nutrition through OGT are ongoing, with efforts to set the supine sleep position during enteral nutrition. While the problems faced by the high-risk infants in this study are not yet resolved, ongoing nursing interventions are crucial in managing their care. Continued attention to proper positioning, monitoring of sucking reflexes, and nutritional support through OGT is vital for improving the health outcomes of these vulnerable infants.