AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of live...AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.展开更多
Sleep disturbance related symptoms are common in patients with long-term oxygen therapy (LTOT). Essentially, there were only few previous reports about the sleep architecture in patients with respiratory disease, such...Sleep disturbance related symptoms are common in patients with long-term oxygen therapy (LTOT). Essentially, there were only few previous reports about the sleep architecture in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD). This study aims to clarify the objective sleep state and the elements that affect sleep architecture in Chronic Respiratory Failure (CRF) patients with focus on clinical cases of chronic hypercapnia. 13 subjects with chronic respiratory failure were enrolled in the study. All the subjects were pre-evaluated by pulmonary function test and Arterial blood gas analysis (ABG) including exercise testing. Polysomnography (PSG) test was performed in each subject with supplemental oxygen. The estimated base line PaCO2 value that reflects overall PaCO2 including sleep period was calculated using equation of PaCO2[2.4×(HCOˉ3)-22]from obtained ABG value just before PSG test. 6 subjects were classified as hypercapnic group (base line PaCO2 ≥ 45 mmHg) and 7 subjects were non-hypercapnic group (base line PaCO2 < 45 mmHg). Latency persistent sleep of PSG data was significant higher in patients with hypercapnic than non-hypercapnic (p < 0.01). Periodic Limb Movement was seen in 23.6% of the subjects, however there was no contribution for arousals. Other PSG data include mean SpO2 were no significant difference. This study suggests that patients with estimated hypercapnia had more disturbed sleep architecture especially significant loss of sleep latency than non-hypercapnic patient with chronic respiratory failure under LTOT. Nocturnal PaCO2 level or ventilatory function may contribute to sleep disturbance in patients with estimated hypercapnia during LTOT.展开更多
AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorder...AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.展开更多
The periodic congestion and decongestion of the nasal venous sinuses and an alternation of airflow from one side of the nose to the other are known in literature as “nasal cycle”. It is established that nasal cycle ...The periodic congestion and decongestion of the nasal venous sinuses and an alternation of airflow from one side of the nose to the other are known in literature as “nasal cycle”. It is established that nasal cycle during 24-hours registration contains from 4 to 8 time full periods, length of which varies from 0.80 h to 5.75 h. The mean length of all full periods is 2.80 ± 0.17 h. The mean length of full periods of left nostril is 3.07 h and the mean length of periods of right nostril is 2.43 h. The result suggests that there is any asymmetry in length of periods of airflow trough left and right nostrils about 40 min. The longer periods of left nostril can be connected with higher metabolic and functional activity of brain and human organism during active work.展开更多
目的探讨个性化针对性护理干预在老年慢性阻塞性肺疾病稳定期患者中的应用效果及对微小RNA-146a、微小RNA-146b的影响。方法选取2021年1月—2022年12月收治的80例老年慢性阻塞性肺疾病稳定期患者作为研究对象,按照组间基线资料可比的原...目的探讨个性化针对性护理干预在老年慢性阻塞性肺疾病稳定期患者中的应用效果及对微小RNA-146a、微小RNA-146b的影响。方法选取2021年1月—2022年12月收治的80例老年慢性阻塞性肺疾病稳定期患者作为研究对象,按照组间基线资料可比的原则将其分对照组和观察组,各40例。对照组接受常规护理,观察组在对照组基础上接受综合护理干预,比较两组患者负性情绪、肺功能指标、微小RNA-146a、微小RNA-146b、睡眠质量等。结果护理干预前,两组患者SAS、SDS评分比较差异无统计学意义(P>0.05);护理干预后,观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05)。护理干预后,观察组用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced ecpiratory volume in the first second,FEV1)、FEV1/FVC高于对照组,差异有统计学意义(P<0.05);观察组患者情感负担、经济负担、照顾负担评分低于对照组,差异有统计学意义(P<0.05);观察组患者匹兹堡睡眠质量量表(Pittsburgh sleep quality scale,PSQI)低于对照组,差异有统计学意义(P<0.05);护理干预后,观察组患者miR-146a及miR-146b水平高于对照组,差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病稳定期患者接受综合护理干预,能让其保持积极心态接受诊治,降低其自我感受负担,改善肺功能,保持良好的睡眠质量。展开更多
基金Supported by Grants from the Associao Fundo de Incentivo a Pesquisa and FAPESP-CEPID-Proc. 95/14303-3
文摘AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
文摘Sleep disturbance related symptoms are common in patients with long-term oxygen therapy (LTOT). Essentially, there were only few previous reports about the sleep architecture in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD). This study aims to clarify the objective sleep state and the elements that affect sleep architecture in Chronic Respiratory Failure (CRF) patients with focus on clinical cases of chronic hypercapnia. 13 subjects with chronic respiratory failure were enrolled in the study. All the subjects were pre-evaluated by pulmonary function test and Arterial blood gas analysis (ABG) including exercise testing. Polysomnography (PSG) test was performed in each subject with supplemental oxygen. The estimated base line PaCO2 value that reflects overall PaCO2 including sleep period was calculated using equation of PaCO2[2.4×(HCOˉ3)-22]from obtained ABG value just before PSG test. 6 subjects were classified as hypercapnic group (base line PaCO2 ≥ 45 mmHg) and 7 subjects were non-hypercapnic group (base line PaCO2 < 45 mmHg). Latency persistent sleep of PSG data was significant higher in patients with hypercapnic than non-hypercapnic (p < 0.01). Periodic Limb Movement was seen in 23.6% of the subjects, however there was no contribution for arousals. Other PSG data include mean SpO2 were no significant difference. This study suggests that patients with estimated hypercapnia had more disturbed sleep architecture especially significant loss of sleep latency than non-hypercapnic patient with chronic respiratory failure under LTOT. Nocturnal PaCO2 level or ventilatory function may contribute to sleep disturbance in patients with estimated hypercapnia during LTOT.
基金Supported by The National Natural Science Foundation of China,Nos.81470456 and 81170160The priority Academic Program Development of Jiangsu Higher Education Institutions
文摘AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.
文摘The periodic congestion and decongestion of the nasal venous sinuses and an alternation of airflow from one side of the nose to the other are known in literature as “nasal cycle”. It is established that nasal cycle during 24-hours registration contains from 4 to 8 time full periods, length of which varies from 0.80 h to 5.75 h. The mean length of all full periods is 2.80 ± 0.17 h. The mean length of full periods of left nostril is 3.07 h and the mean length of periods of right nostril is 2.43 h. The result suggests that there is any asymmetry in length of periods of airflow trough left and right nostrils about 40 min. The longer periods of left nostril can be connected with higher metabolic and functional activity of brain and human organism during active work.
文摘目的探讨个性化针对性护理干预在老年慢性阻塞性肺疾病稳定期患者中的应用效果及对微小RNA-146a、微小RNA-146b的影响。方法选取2021年1月—2022年12月收治的80例老年慢性阻塞性肺疾病稳定期患者作为研究对象,按照组间基线资料可比的原则将其分对照组和观察组,各40例。对照组接受常规护理,观察组在对照组基础上接受综合护理干预,比较两组患者负性情绪、肺功能指标、微小RNA-146a、微小RNA-146b、睡眠质量等。结果护理干预前,两组患者SAS、SDS评分比较差异无统计学意义(P>0.05);护理干预后,观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05)。护理干预后,观察组用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced ecpiratory volume in the first second,FEV1)、FEV1/FVC高于对照组,差异有统计学意义(P<0.05);观察组患者情感负担、经济负担、照顾负担评分低于对照组,差异有统计学意义(P<0.05);观察组患者匹兹堡睡眠质量量表(Pittsburgh sleep quality scale,PSQI)低于对照组,差异有统计学意义(P<0.05);护理干预后,观察组患者miR-146a及miR-146b水平高于对照组,差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病稳定期患者接受综合护理干预,能让其保持积极心态接受诊治,降低其自我感受负担,改善肺功能,保持良好的睡眠质量。
