BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-br...BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-brachial dystonic seizures(FBDSs), and hyponatremia. Anti-LGI1 AE has increasingly been considered a primary form of AE. Early identification and treatment of this disease are clearly very important.CASE SUMMARY Here, we report that a male patient developed severe anti-LGI1 encephalitis, which was initially misdiagnosed as a sleep disturbance. He was hospitalized for epileptic seizures and typical FBDSs half a month after he developed sleep disturbances. LGI1 antibodies were detected in his cerebrospinal fluid and serum(1:100 and 1:3.2, respectively), which led to the diagnosis of classic anti-LGI1 AE. No obvious abnormality was observed on brain computed tomography images. T2-weighted fluid-attenuated inversion recovery and T2-weighted scans of brain magnetic resonance imaging(MRI) showed slightly elevated signals within the left basal ganglia area. No tumor was detected within the brain of this patient using MRI. After hormone and antiepileptic drug treatment, the patient’s symptoms improved significantly.CONCLUSION Anti-LGI1 antibody-associated encephalitis has characteristic clinical manifestations, such as cognitive impairment, psychiatric symptoms, seizures, sleep disorders, hyponatremia, and FBDSs. LGI1 antibodies are present in the serum and/or cerebrospinal fluid, but their production is sensitive to immunosuppressants, and this disease has a relatively good prognosis. In particular, we should be aware of the possibility of anti-LGI1 antibody-associated encephalitis in adolescents with sleep disorders to avoid missed diagnoses and misdiagnoses.展开更多
Dementia prevalence has soared due to population aging. In Mild Cognitive Impairment (MCI) as a pre-dementia stage, sleepdisturbances have raised much interest as a factor in a bidirectional relationship with cognitiv...Dementia prevalence has soared due to population aging. In Mild Cognitive Impairment (MCI) as a pre-dementia stage, sleepdisturbances have raised much interest as a factor in a bidirectional relationship with cognitive decline. Thus, this studydeveloped the Sleep and Cognition Enhancement Multimodal Intervention (SCEMI) based on Lazarus’ multimodal approachand conducted a randomized controlled experiment to investigate the effects of the novel program on sleep and cognition inMCI elderly. The participants were 55 MCI elderly with sleep disturbances at two dementia care centers located in S-city,Gyeonggi-do, South Korea (n = 25 in the experimental group and n = 30 in the control group). The study period was fromNovember 01 to December 27, 2022. The experimental group received 8 sessions of SCEMI, 60 min per session once a week.The control group received general education and guidance using a simplified booklet on the sleep and cognitive improvement.For data collection, a self-reported questionnaire was used to investigate sleep quality, presleep arousal, cognitive function,stress, and depression. The results showed that, compared to the control group, the experimental group had significantlyimproved across all variables: sleep quality (U = 109.50, p < 0.001), presleep arousal (U = 11.50, p < 0.001), cognitive function(U = 72.00, p < 0.001), stress (U = 139.00, p < 0.001), and depression (U = 231.50, p = 0.015). Thus, the SCEMI appears topositively affect symptomatic improvement and delays the progression to dementia as an integrated intervention to enhancesleep and cognition in community-dwelling MCI elderly with sleep disturbances.展开更多
Patients diagnosed with cancer often experience sleep disturbance in the form of poor sleep patterns or insomnia that can start on diagnosis and continue until the end of the individual’s life.The aim of this review ...Patients diagnosed with cancer often experience sleep disturbance in the form of poor sleep patterns or insomnia that can start on diagnosis and continue until the end of the individual’s life.The aim of this review is to discuss current definitions and theories of sleep disturbance,its prevalence,the underlying physiological and psychological correlates,measurement scales,and possible intervention and management strategies.Equally important,regular assessment is worthwhile for sleep disturbance and quality of life among cancer patients.Therefore,it is advisable for health‑care professionals to conduct regular assessment of sleep disturbance for cancer patients and provide appropriate management.展开更多
Objective:Up to 85.3%of patients with psoriasis experience sleep disturbance(SD).However,SD has not been characterized in Chinese patients with psoriasis,and the factors that affect SD among adult patients with psoria...Objective:Up to 85.3%of patients with psoriasis experience sleep disturbance(SD).However,SD has not been characterized in Chinese patients with psoriasis,and the factors that affect SD among adult patients with psoriasis remain unclear.This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis.Methods:This was a cross-sectional,questionnaire-based,case-control study involving 142 adult participants with psoriasis and 142 healthy controls.The Pittsburgh Sleep Quality Index(PSQI)was administered to assess SD.Mild psoriasis was defined by Psoriasis Area and Severity Index and body surface area cut-offs of<10,and mild to severe psoriasis was determined by Psoriasis Area and Severity Index and body surface area cut-offs of≥10.Logistic regression was performed to investigate the associations.Results:The prevalence of SD(PSQI score of≥6)was 47.9%in adult patients with psoriasis.The mean PSQI score in patients with psoriasis was 6.1±3.7,which was higher than that in the control group(4.9±2.5,P<0.001).The risk of SD in the psoriasis group was 1.669 times higher(95%confidence interval,1.008-2.761;P=0.046)than that in the healthy group.Female sex(adjusted odds ratio,4.130;95%confidence interval,1.306-13.058;P=0.016)was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis,whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis.Conclusion:Patients with psoriasis were more likely than healthy controls to develop SD.In patients with moderate to severe psoriasis,but not in those with mild psoriasis,female sex was associated with a higher likelihood of SD.展开更多
OBJECTIVE: To evaluate the effect of Guizhi Gancao Longgu Muli Tang(GGLMT), a decoction prepared with herbal medicine of Traditional Chinese Medicine, on sleep disturbances in women with menopause.METHODS: Totally 162...OBJECTIVE: To evaluate the effect of Guizhi Gancao Longgu Muli Tang(GGLMT), a decoction prepared with herbal medicine of Traditional Chinese Medicine, on sleep disturbances in women with menopause.METHODS: Totally 162 participants were recruited for the treatment of sleep difficulty from February,2012 to December, 2014. Decoction of 200 mL was taken by every participant twice daily in half an hour after lunch and dinner during two weeks.Sleep quality was assessed by Pittsburg sleep quali-ty index(PSQI) and menopausal symptoms and quality of life were evaluated by the menopause rating scale(MRS) and the Chinese version of World Health Organization quality of life-BREF at the final fellow-up in the fourth weekend after beginning.RESULTS: The average scores of PSQI had reduced from(13.82 ± 4.97) to(8.14 ± 3.19), 95% CI(- 4.87,- 3.05) after 2-week GGLMT treatment in the fourth week. GGLMT improved symptoms in patients with more severe conditions(MRS ≥ 16).Three adverse drug reaction, mouth ulcer, constipation, and folliculitis, might be related with GGLMT and disappeared after withdrawals of the treatment.CONCLUSION: For menopausal women suffering from chronic sleep disturbances, our findings suggest that two weeks treatment of GGLMT was safe and effective.展开更多
Postoperative sleep disturbance is a common occurrence with significant adverse effects on patients including delayed recovery,impairment of cognitive function,pain sensitivity and cardiovascular events.The developmen...Postoperative sleep disturbance is a common occurrence with significant adverse effects on patients including delayed recovery,impairment of cognitive function,pain sensitivity and cardiovascular events.The development of postoperative sleep disturbance is multifactorial and involves the surgical inflammatory response,the severity of surgical trauma,pain,anxiety,the use of anesthetics and environmental factors such as nocturnal noise and light levels.Many of these factors can be managed perioperatively to minimize the deleterious impact on sleep.Pharmacological and non-pharmacological treatment strategies for postoperative sleep disturbance include dexmedetomidine,zolpidem,melatonin,enhanced recovery after surgery(ERAS) protocol and controlling of environmental noise and light levels.It is likely that a combination of pharmacological and non-pharmacological therapies will have the greatest impact;however,further research is required before their use can be routinely recommended.展开更多
Liver cirrhosis represents the end-stage of chronic liver disease and is related to high morbidity and mortality.To date,there is no standard curative method for liver cirrhosis,but there is treatment for common compl...Liver cirrhosis represents the end-stage of chronic liver disease and is related to high morbidity and mortality.To date,there is no standard curative method for liver cirrhosis,but there is treatment for common complications.Therefore,improving the health-related quality of life(HRQoL)of patients with cirrhosis has become a potential therapeutic intervention by limiting its symptoms and complications.Sleep is a complex and rhythmic physiological process and is crucial to human health.Sleep disturbances are commonly encountered in patients with cirrhosis and adversely affect their HRQoL.Recently,sleep disturbances in patients with cirrhosis have received growing attention owing to their reciprocal effects.To better understand the effect of sleep disturbances on patients with cirrhosis,this review provides a comprehensive summary of the epidemiology and underlying mechanisms of sleep disturbances in cirrhosis.We also elaborate on the mutual relationships between sleep disturbances and other complications,such as muscle cramps,malnutrition,frailty,sarcopenia,HRQoL,and hepatic encephalopathy,in the context of cirrhosis.Finally,we discuss the potential management to improve poor sleep quality in patients with cirrhosis.展开更多
Objective Several clinical obstructive sleep apnea syndrome(OSAS)phenotypes associated with heterogeneous cardiovascular risk profiles have been recently identified.The purpose of this study was to identify clusters a...Objective Several clinical obstructive sleep apnea syndrome(OSAS)phenotypes associated with heterogeneous cardiovascular risk profiles have been recently identified.The purpose of this study was to identify clusters amongst these profiles that allow for the differentiation of patients.Methods This retrospective study included all moderate-to-severe OSAS patients referred to the sleep unit over a 5-year period.Demographic,symptom,comorbidity,polysomnographic,and continuous positive airway pressure(CPAP)adherence data were collected.Statistical analyses were performed to identify clusters of patients.Results A total of 567 patients were included(67%men,54±13 years,body mass index:32±7 kg/m2,65%Caucasian,32%European African).Five clusters were identified:less severe OSAS(n=172);healthier severe OSAS(n=160);poorly sleeping OSAS patients with cardiometabolic comorbidities(n=87);younger obese men with sleepiness at the wheel(n=94);sleepy obese men with very severe desaturating OSAS and cardiometabolic comorbidities(n=54).Patients in clusters 3 and 5 were older than those in clusters 2 and 4(P=0.034).Patients in clusters 4 and 5 were significantly more obese than those in the other clusters(P=0.04).No significant differences were detected in terms of symptoms and comorbidities.Polysomnographic profiles were very discriminating between clusters.CPAP adherence was similar in all clusters but,among adherent patients,daily usage was more important in cluster 1(less severe patients)than in cluster 5.Conclusion This study highlights that the typical sleepy obese middle-aged men with desaturating events represent only a minority of patients in our multi-ethnic moderate-to-severe OSAS cohort of 33%females.展开更多
AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of patients.METHODS:Prospective cross-sectional study with consecutive sampling in South-East Asian population was performed.Va...AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of patients.METHODS:Prospective cross-sectional study with consecutive sampling in South-East Asian population was performed.Validated questionnaires:the Pittsburg Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were administered prospectively.Subjects with nonglaucomatous optic neuropathy or concomitant retinal pathology were excluded.Glaucoma severity was based on HVF 24-2 perimetry.Binocular single vision was represented based on the better eye.Frequency of and predictive factors for poor sleep quality and excessive daytime sleepiness were compared.RESULTS:A total of 79 primary open angle glaucoma(POAG),27 primary angle-closure glaucoma(PACG)patients,and 89 controls were recruited.PACG patients had higher median PSQI scores(P=0.004)and poorer sleep quality(P<0.001).Compared to controls,PACG patients were 3.34 times more likely to have poor sleep quality(P=0.008),which remained significant after adjustment for demographics(P=0.016)and predictive variables(P=0.013).PACG patients have poorer sleep quality when visual acuity(VA)was 6/15 or worse(P=0.009).Univariate and multivariate analysis of predictive variables for poor sleep quality and daytime sleepiness did not find statistical significance.CONCLUSION:PACG patients have poorer sleep quality but not daytime sleepiness.This is important in South-East Asian population with heavy disease burden.Evaluations on sleep disturbances can be considered to provide more ho istic care.展开更多
Objectives:The present study aims to assess the prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department(OPD)after the second wave of the coronavirus disease 201...Objectives:The present study aims to assess the prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department(OPD)after the second wave of the coronavirus disease 2019(COVID-19)pandemic.Materials and Methods:A descriptive,cross-sectional study was carried out among 117 OPD nurses between October and December 2021 using a purposive sampling technique.Two self-reported standardized scales,the Smartphone Addiction Scale-ShortVersion and Insomnia Severity Index were used.Kolmogorov–Smirnov test,Mann–Whitney U,and Kruskal–Wallis Htest were used.Pearson’s correlation and Scatter plot were used to determine the relationship between the study variables.A stepwise multiple linear regression analysis was also performed.Results:The majority of participants had slight smartphone addiction(78.6%)and suffered from sub-threshold to severe forms of insomnia(73.5%).A significant mild positive correlation was found between smartphone addiction and insomnia(r=0.195,P<0.05).Stepwise multivariate logistic regression analysis predicted factors such as female gender and exposure to smartphones for more than 5 years influencing smartphone addiction.A strong influence of exposure to the smartphone for more than 5 years was found on insomnia severity.Conclusion:Smartphone addiction and insomnia were identified problems among nurses working in the OPD after the second wave of the COVID-19 pandemic,requiring an urgent need to identify and manage various factors responsible for smartphone addiction and insomnia such as female gender and years of exposure to smartphones.展开更多
BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential the...BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.展开更多
Minimally invasive surgeries,including laparoscopic,endoscopic,and robotic surgeries,have gained great popularity and have gradually replaced conventional open surgeries.Commonly,patients may have perioperative psycho...Minimally invasive surgeries,including laparoscopic,endoscopic,and robotic surgeries,have gained great popularity and have gradually replaced conventional open surgeries.Commonly,patients may have perioperative psychological issues such as anxiety,depression,sleep disturbance,and delirium.A comprehensive literature review was conducted to identify how these psychological issues occur in minimally invasive surgeries and how nurses can take better care of patients to alleviate these issues.Only papers focusing on psychological issues during the perioperative period were included in the re-view,and preexisting issues before the setting of surgical treatment plan were not discussed.Compared to conventional surgeries,the incidence of postoperative anxiety,preoperative depression,and sleep disturbance is lower in minimally invasive surgeries,the incidence of postoperative depression may be higher with limited evidence,and the incidence of preoperative anxiety and delirium is inconclusive.Systematic perioperative nursing programs not only alleviate psychological issues,but also reduce postsurgical complications and accelerate recovery.However,special nursing programs to handle delirium are lacking.展开更多
Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Me...Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Methods:From March 21,2021 to April 31,2021,3927 Chinese women with or without PCOS were recruited online.All participants completed WeChat-based electronic questionnaires.Sleep characteristics were measured using the Pittsburgh sleep quality index.Results:A total of 2871 women were included in the final analysis.Sleep duration(odds ratio[OR],0.857;95%confidence interval[CI],0.763-0.963),sleep midpoint(OR,1.142;95%CI,1.049-1.244),sleep disturbance(OR,1.320;95%CI,0.957-1.146),daytime dysfunction(OR,1.136;95%CI,1.030-1.253),and night shift work(OR,1.628;95%CI,1.264-2.097)were associated with a higher risk of PCOS.After adjusting for confounders,including age,body mass index,smoking status,and coffee and tea drinking status,sleep disturbance(OR,1.314;95%CI,1.111-1.555),daytime dysfunction(OR,1.143;95%CI,1.034-1.264),and night shift work(OR,1.800;95%CI,1.388-2.333)remained associated.In addition,sleep disturbance(OR,1.887;95%CI,1.400-2.542)and subjective sleep quality(OR,1.299;95%CI,1.037-1.627)were associated with infertility in women with PCOS,and sleep disturbance(OR,1.750;95%CI,1.281-2.390)remained significant after adjusting for confounders.Conclusions:Sleep disturbance,daytime dysfunction,and night shift work are significantly associated with PCOS.Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.展开更多
Parkinson’s disease(PD)is a multifaceted disease in which environmental variables combined with genetic predisposition cause dopaminergic(DAergic)neuron loss in the substantia nigra pars compacta.The mutation of leuc...Parkinson’s disease(PD)is a multifaceted disease in which environmental variables combined with genetic predisposition cause dopaminergic(DAergic)neuron loss in the substantia nigra pars compacta.The mutation of leucine-rich repeat kinase 2(Lrrk2)is the most common autosomal dominant mutation in PD,and it has also been reported in sporadic cases.A growing body of research suggests that circadian rhythm disruption,particularly sleep-wake abnormality,is common during the early phase of PD.Our present study aimed to evaluate the impact of sleep deprivation(SD)on motor ability,sleep performance,and PD pathologies in Lrrk2^(G2019S) transgenic mice.After two months of SD,Lrrk2^(G2019S) mice at 12 months of age showed an exacerbated PD-like phenotype with motor deficits,a reduced striatal DA level,degenerated DAergic neurons,and altered sleep structure and biological rhythm accompanied by the decreased protein expression level of circadian locomotor output cycles kaput Lrrk2 gene in the brain.All these changes persisted and were even more evident in 18-month-old mice after 6 months of follow-up.Moreover,a significant increase inα-synuclein aggregation was found in SD-treated transgenic mice at 18 months of age.Taken together,our findings indicate that sleep abnormalities,as a risk factor,may contribute to the pathogenesis and progression of PD.Early detection of sleep disorders and improvement of sleep quality may help to delay disease progression and provide long-term clinical benefits.展开更多
文摘BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-brachial dystonic seizures(FBDSs), and hyponatremia. Anti-LGI1 AE has increasingly been considered a primary form of AE. Early identification and treatment of this disease are clearly very important.CASE SUMMARY Here, we report that a male patient developed severe anti-LGI1 encephalitis, which was initially misdiagnosed as a sleep disturbance. He was hospitalized for epileptic seizures and typical FBDSs half a month after he developed sleep disturbances. LGI1 antibodies were detected in his cerebrospinal fluid and serum(1:100 and 1:3.2, respectively), which led to the diagnosis of classic anti-LGI1 AE. No obvious abnormality was observed on brain computed tomography images. T2-weighted fluid-attenuated inversion recovery and T2-weighted scans of brain magnetic resonance imaging(MRI) showed slightly elevated signals within the left basal ganglia area. No tumor was detected within the brain of this patient using MRI. After hormone and antiepileptic drug treatment, the patient’s symptoms improved significantly.CONCLUSION Anti-LGI1 antibody-associated encephalitis has characteristic clinical manifestations, such as cognitive impairment, psychiatric symptoms, seizures, sleep disorders, hyponatremia, and FBDSs. LGI1 antibodies are present in the serum and/or cerebrospinal fluid, but their production is sensitive to immunosuppressants, and this disease has a relatively good prognosis. In particular, we should be aware of the possibility of anti-LGI1 antibody-associated encephalitis in adolescents with sleep disorders to avoid missed diagnoses and misdiagnoses.
文摘Dementia prevalence has soared due to population aging. In Mild Cognitive Impairment (MCI) as a pre-dementia stage, sleepdisturbances have raised much interest as a factor in a bidirectional relationship with cognitive decline. Thus, this studydeveloped the Sleep and Cognition Enhancement Multimodal Intervention (SCEMI) based on Lazarus’ multimodal approachand conducted a randomized controlled experiment to investigate the effects of the novel program on sleep and cognition inMCI elderly. The participants were 55 MCI elderly with sleep disturbances at two dementia care centers located in S-city,Gyeonggi-do, South Korea (n = 25 in the experimental group and n = 30 in the control group). The study period was fromNovember 01 to December 27, 2022. The experimental group received 8 sessions of SCEMI, 60 min per session once a week.The control group received general education and guidance using a simplified booklet on the sleep and cognitive improvement.For data collection, a self-reported questionnaire was used to investigate sleep quality, presleep arousal, cognitive function,stress, and depression. The results showed that, compared to the control group, the experimental group had significantlyimproved across all variables: sleep quality (U = 109.50, p < 0.001), presleep arousal (U = 11.50, p < 0.001), cognitive function(U = 72.00, p < 0.001), stress (U = 139.00, p < 0.001), and depression (U = 231.50, p = 0.015). Thus, the SCEMI appears topositively affect symptomatic improvement and delays the progression to dementia as an integrated intervention to enhancesleep and cognition in community-dwelling MCI elderly with sleep disturbances.
文摘Patients diagnosed with cancer often experience sleep disturbance in the form of poor sleep patterns or insomnia that can start on diagnosis and continue until the end of the individual’s life.The aim of this review is to discuss current definitions and theories of sleep disturbance,its prevalence,the underlying physiological and psychological correlates,measurement scales,and possible intervention and management strategies.Equally important,regular assessment is worthwhile for sleep disturbance and quality of life among cancer patients.Therefore,it is advisable for health‑care professionals to conduct regular assessment of sleep disturbance for cancer patients and provide appropriate management.
基金supported by grants from the National Natural Science Foundation of China(Nos.82073447,81974479,81773329)National key R&D program(No.2018YFC0117004).
文摘Objective:Up to 85.3%of patients with psoriasis experience sleep disturbance(SD).However,SD has not been characterized in Chinese patients with psoriasis,and the factors that affect SD among adult patients with psoriasis remain unclear.This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis.Methods:This was a cross-sectional,questionnaire-based,case-control study involving 142 adult participants with psoriasis and 142 healthy controls.The Pittsburgh Sleep Quality Index(PSQI)was administered to assess SD.Mild psoriasis was defined by Psoriasis Area and Severity Index and body surface area cut-offs of<10,and mild to severe psoriasis was determined by Psoriasis Area and Severity Index and body surface area cut-offs of≥10.Logistic regression was performed to investigate the associations.Results:The prevalence of SD(PSQI score of≥6)was 47.9%in adult patients with psoriasis.The mean PSQI score in patients with psoriasis was 6.1±3.7,which was higher than that in the control group(4.9±2.5,P<0.001).The risk of SD in the psoriasis group was 1.669 times higher(95%confidence interval,1.008-2.761;P=0.046)than that in the healthy group.Female sex(adjusted odds ratio,4.130;95%confidence interval,1.306-13.058;P=0.016)was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis,whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis.Conclusion:Patients with psoriasis were more likely than healthy controls to develop SD.In patients with moderate to severe psoriasis,but not in those with mild psoriasis,female sex was associated with a higher likelihood of SD.
基金Science Project of Traditional Chinese Medicine Bureau in Jiangsu Province of China:Analysis on Differences of Platelet Protein Under Syndrome of Cold-phlegm Blocking Heart Vessel And Targeted Intervention Mechanism of Furostanol Saponins of Allium Macrostemon Bunge for Coronary Heart Disease(No.YB2015180)Chinese Medicine Teaching center of Southeast University
文摘OBJECTIVE: To evaluate the effect of Guizhi Gancao Longgu Muli Tang(GGLMT), a decoction prepared with herbal medicine of Traditional Chinese Medicine, on sleep disturbances in women with menopause.METHODS: Totally 162 participants were recruited for the treatment of sleep difficulty from February,2012 to December, 2014. Decoction of 200 mL was taken by every participant twice daily in half an hour after lunch and dinner during two weeks.Sleep quality was assessed by Pittsburg sleep quali-ty index(PSQI) and menopausal symptoms and quality of life were evaluated by the menopause rating scale(MRS) and the Chinese version of World Health Organization quality of life-BREF at the final fellow-up in the fourth weekend after beginning.RESULTS: The average scores of PSQI had reduced from(13.82 ± 4.97) to(8.14 ± 3.19), 95% CI(- 4.87,- 3.05) after 2-week GGLMT treatment in the fourth week. GGLMT improved symptoms in patients with more severe conditions(MRS ≥ 16).Three adverse drug reaction, mouth ulcer, constipation, and folliculitis, might be related with GGLMT and disappeared after withdrawals of the treatment.CONCLUSION: For menopausal women suffering from chronic sleep disturbances, our findings suggest that two weeks treatment of GGLMT was safe and effective.
文摘Postoperative sleep disturbance is a common occurrence with significant adverse effects on patients including delayed recovery,impairment of cognitive function,pain sensitivity and cardiovascular events.The development of postoperative sleep disturbance is multifactorial and involves the surgical inflammatory response,the severity of surgical trauma,pain,anxiety,the use of anesthetics and environmental factors such as nocturnal noise and light levels.Many of these factors can be managed perioperatively to minimize the deleterious impact on sleep.Pharmacological and non-pharmacological treatment strategies for postoperative sleep disturbance include dexmedetomidine,zolpidem,melatonin,enhanced recovery after surgery(ERAS) protocol and controlling of environmental noise and light levels.It is likely that a combination of pharmacological and non-pharmacological therapies will have the greatest impact;however,further research is required before their use can be routinely recommended.
基金National Key Research and Development Program of China,Grant/Award Number:2019YFB1311505Tianjin Health Science and Technology Project,Grant/Award Number:TJWJ2021MS005。
文摘Liver cirrhosis represents the end-stage of chronic liver disease and is related to high morbidity and mortality.To date,there is no standard curative method for liver cirrhosis,but there is treatment for common complications.Therefore,improving the health-related quality of life(HRQoL)of patients with cirrhosis has become a potential therapeutic intervention by limiting its symptoms and complications.Sleep is a complex and rhythmic physiological process and is crucial to human health.Sleep disturbances are commonly encountered in patients with cirrhosis and adversely affect their HRQoL.Recently,sleep disturbances in patients with cirrhosis have received growing attention owing to their reciprocal effects.To better understand the effect of sleep disturbances on patients with cirrhosis,this review provides a comprehensive summary of the epidemiology and underlying mechanisms of sleep disturbances in cirrhosis.We also elaborate on the mutual relationships between sleep disturbances and other complications,such as muscle cramps,malnutrition,frailty,sarcopenia,HRQoL,and hepatic encephalopathy,in the context of cirrhosis.Finally,we discuss the potential management to improve poor sleep quality in patients with cirrhosis.
文摘Objective Several clinical obstructive sleep apnea syndrome(OSAS)phenotypes associated with heterogeneous cardiovascular risk profiles have been recently identified.The purpose of this study was to identify clusters amongst these profiles that allow for the differentiation of patients.Methods This retrospective study included all moderate-to-severe OSAS patients referred to the sleep unit over a 5-year period.Demographic,symptom,comorbidity,polysomnographic,and continuous positive airway pressure(CPAP)adherence data were collected.Statistical analyses were performed to identify clusters of patients.Results A total of 567 patients were included(67%men,54±13 years,body mass index:32±7 kg/m2,65%Caucasian,32%European African).Five clusters were identified:less severe OSAS(n=172);healthier severe OSAS(n=160);poorly sleeping OSAS patients with cardiometabolic comorbidities(n=87);younger obese men with sleepiness at the wheel(n=94);sleepy obese men with very severe desaturating OSAS and cardiometabolic comorbidities(n=54).Patients in clusters 3 and 5 were older than those in clusters 2 and 4(P=0.034).Patients in clusters 4 and 5 were significantly more obese than those in the other clusters(P=0.04).No significant differences were detected in terms of symptoms and comorbidities.Polysomnographic profiles were very discriminating between clusters.CPAP adherence was similar in all clusters but,among adherent patients,daily usage was more important in cluster 1(less severe patients)than in cluster 5.Conclusion This study highlights that the typical sleepy obese middle-aged men with desaturating events represent only a minority of patients in our multi-ethnic moderate-to-severe OSAS cohort of 33%females.
文摘AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of patients.METHODS:Prospective cross-sectional study with consecutive sampling in South-East Asian population was performed.Validated questionnaires:the Pittsburg Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were administered prospectively.Subjects with nonglaucomatous optic neuropathy or concomitant retinal pathology were excluded.Glaucoma severity was based on HVF 24-2 perimetry.Binocular single vision was represented based on the better eye.Frequency of and predictive factors for poor sleep quality and excessive daytime sleepiness were compared.RESULTS:A total of 79 primary open angle glaucoma(POAG),27 primary angle-closure glaucoma(PACG)patients,and 89 controls were recruited.PACG patients had higher median PSQI scores(P=0.004)and poorer sleep quality(P<0.001).Compared to controls,PACG patients were 3.34 times more likely to have poor sleep quality(P=0.008),which remained significant after adjustment for demographics(P=0.016)and predictive variables(P=0.013).PACG patients have poorer sleep quality when visual acuity(VA)was 6/15 or worse(P=0.009).Univariate and multivariate analysis of predictive variables for poor sleep quality and daytime sleepiness did not find statistical significance.CONCLUSION:PACG patients have poorer sleep quality but not daytime sleepiness.This is important in South-East Asian population with heavy disease burden.Evaluations on sleep disturbances can be considered to provide more ho istic care.
文摘Objectives:The present study aims to assess the prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department(OPD)after the second wave of the coronavirus disease 2019(COVID-19)pandemic.Materials and Methods:A descriptive,cross-sectional study was carried out among 117 OPD nurses between October and December 2021 using a purposive sampling technique.Two self-reported standardized scales,the Smartphone Addiction Scale-ShortVersion and Insomnia Severity Index were used.Kolmogorov–Smirnov test,Mann–Whitney U,and Kruskal–Wallis Htest were used.Pearson’s correlation and Scatter plot were used to determine the relationship between the study variables.A stepwise multiple linear regression analysis was also performed.Results:The majority of participants had slight smartphone addiction(78.6%)and suffered from sub-threshold to severe forms of insomnia(73.5%).A significant mild positive correlation was found between smartphone addiction and insomnia(r=0.195,P<0.05).Stepwise multivariate logistic regression analysis predicted factors such as female gender and exposure to smartphones for more than 5 years influencing smartphone addiction.A strong influence of exposure to the smartphone for more than 5 years was found on insomnia severity.Conclusion:Smartphone addiction and insomnia were identified problems among nurses working in the OPD after the second wave of the COVID-19 pandemic,requiring an urgent need to identify and manage various factors responsible for smartphone addiction and insomnia such as female gender and years of exposure to smartphones.
基金Supported by National Institute of Mental Health,No.5R34MH91338-03 and No.K23 MH103394(to Zalta AK)
文摘BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.
基金funded by the Medical Health Science and Technology Project of Hangzhou Municipal Health Commission to Kehua Yang(A20200709).
文摘Minimally invasive surgeries,including laparoscopic,endoscopic,and robotic surgeries,have gained great popularity and have gradually replaced conventional open surgeries.Commonly,patients may have perioperative psychological issues such as anxiety,depression,sleep disturbance,and delirium.A comprehensive literature review was conducted to identify how these psychological issues occur in minimally invasive surgeries and how nurses can take better care of patients to alleviate these issues.Only papers focusing on psychological issues during the perioperative period were included in the re-view,and preexisting issues before the setting of surgical treatment plan were not discussed.Compared to conventional surgeries,the incidence of postoperative anxiety,preoperative depression,and sleep disturbance is lower in minimally invasive surgeries,the incidence of postoperative depression may be higher with limited evidence,and the incidence of preoperative anxiety and delirium is inconclusive.Systematic perioperative nursing programs not only alleviate psychological issues,but also reduce postsurgical complications and accelerate recovery.However,special nursing programs to handle delirium are lacking.
文摘Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Methods:From March 21,2021 to April 31,2021,3927 Chinese women with or without PCOS were recruited online.All participants completed WeChat-based electronic questionnaires.Sleep characteristics were measured using the Pittsburgh sleep quality index.Results:A total of 2871 women were included in the final analysis.Sleep duration(odds ratio[OR],0.857;95%confidence interval[CI],0.763-0.963),sleep midpoint(OR,1.142;95%CI,1.049-1.244),sleep disturbance(OR,1.320;95%CI,0.957-1.146),daytime dysfunction(OR,1.136;95%CI,1.030-1.253),and night shift work(OR,1.628;95%CI,1.264-2.097)were associated with a higher risk of PCOS.After adjusting for confounders,including age,body mass index,smoking status,and coffee and tea drinking status,sleep disturbance(OR,1.314;95%CI,1.111-1.555),daytime dysfunction(OR,1.143;95%CI,1.034-1.264),and night shift work(OR,1.800;95%CI,1.388-2.333)remained associated.In addition,sleep disturbance(OR,1.887;95%CI,1.400-2.542)and subjective sleep quality(OR,1.299;95%CI,1.037-1.627)were associated with infertility in women with PCOS,and sleep disturbance(OR,1.750;95%CI,1.281-2.390)remained significant after adjusting for confounders.Conclusions:Sleep disturbance,daytime dysfunction,and night shift work are significantly associated with PCOS.Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.
基金We thank Liaoning Provincial Center for Clinical Research on Neurological Diseases,the First Affiliated Hospital,and Dalian Medical University for the research infrastructure and support.This work was supported by the National Natural Science Foundation of China(81771521).
文摘Parkinson’s disease(PD)is a multifaceted disease in which environmental variables combined with genetic predisposition cause dopaminergic(DAergic)neuron loss in the substantia nigra pars compacta.The mutation of leucine-rich repeat kinase 2(Lrrk2)is the most common autosomal dominant mutation in PD,and it has also been reported in sporadic cases.A growing body of research suggests that circadian rhythm disruption,particularly sleep-wake abnormality,is common during the early phase of PD.Our present study aimed to evaluate the impact of sleep deprivation(SD)on motor ability,sleep performance,and PD pathologies in Lrrk2^(G2019S) transgenic mice.After two months of SD,Lrrk2^(G2019S) mice at 12 months of age showed an exacerbated PD-like phenotype with motor deficits,a reduced striatal DA level,degenerated DAergic neurons,and altered sleep structure and biological rhythm accompanied by the decreased protein expression level of circadian locomotor output cycles kaput Lrrk2 gene in the brain.All these changes persisted and were even more evident in 18-month-old mice after 6 months of follow-up.Moreover,a significant increase inα-synuclein aggregation was found in SD-treated transgenic mice at 18 months of age.Taken together,our findings indicate that sleep abnormalities,as a risk factor,may contribute to the pathogenesis and progression of PD.Early detection of sleep disorders and improvement of sleep quality may help to delay disease progression and provide long-term clinical benefits.
