BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been compl...Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.展开更多
BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AI...BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.展开更多
In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associ...In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associated with an increased cardiovascular risk,including stroke.Con-tinuous positive airways pressure(CPAP)therapy at night is the most effective treatment forOSA and has been shown to reduce the cardiovascular risk in OSA patients.However,there is nosuitable bedside monitoring method evaluating the recovery of cerebral hemodynamics duringCPAP therapy.Near-infrared spectroscopy(NiRS)is idelly suited for non-invasive monitoringthe cerebral hemodynamics during sleep due to its properties of local measurement,totally sa feapplication and good tolerance to motion.In this pilot study,we monitored cerebral hemody-namics during standard CPAP therapy at night in thre patients with severe OSA using NIRS.We found periodic oscllations in HbO2,HHb,tisue oxygenation index(TO1)and blood volume(BV)associa ted with periodic apnea events without CPAP in all OSA patients.These osillationswere eliminated under the optimal CPAP pressures in all patients.These results sugg ested thatthe recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedsideNIRS measurements in real time during ll night CPAP therapy.NIRS is a usefi bedsidemonitoring tool to evaluate the treatment elicacy of CPAP therapy in patients with OSA.展开更多
This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native th...This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.展开更多
[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders w...[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders were randomly selected and divided into a research group and a control group,with 150 cases in each group.The control group was administered with western medicine,and the research group was treated with acupuncture and medicine to compare their clinical treatment effects.[Results]The total effective rate of treatment in the research group was significantly higher than that in the control group;after treatment,both the PSQI and SAS scores of the two groups were significantly reduced,and the reduction degree of the research group was higher than that of the control group,the difference was statistically significant(P<0.05).[Conclusions]Combined use of acupuncture and medicine to treat sleep disorders in patients with anxiety disorders has better curative effect and fewer adverse reactions,so it has high clinical application value.展开更多
The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral ...The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral developmental processes and the accumulation of new abilities and skills. We review the current research evidence regarding the relationship between sleep (and its various components) and cerebral and physical developmental processes. Although sleep is an everyday physiological necessity, the ability to recognize it as a critical component of development may bring a different view towards sleep by parents, educators, and caregivers. This change might lead to a shift in individual and social attitudes aimed at enabling the necessary time and conditions for adequate sleep in children and adolescents to become the norm. These sets of values will then hopefully extend into adulthood, in which sleep also plays a crucial role in both physical and mental wellbeing.展开更多
BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenien...BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenience of treatments discourage patients from complying with them,leading to chronic insomnia.AIM To investigate the long-term home-practice effects of mindful breathing combined with a sleep-inducing exercise as adjunctive insomnia therapy.METHODS A quasi-experimental design was used in the present work,in which the patients with insomnia were included and grouped based on hospital admission:40 patients admitted between January and April 2020 were assigned to the control group,and 40 patients admitted between May and August 2020 were assigned to the treatment group.The control group received routine pharmacological and physical therapies,while the treatment group received instruction in mindful breathing and a sleep-inducing exercise in addition to the routine therapies.The Pittsburgh Sleep Quality Index(PSQI),Generalized Anxiety Disorder 7-item(GAD-7)scale,and Insomnia Severity Index(ISI)were utilized to assess sleepquality improvement in the patient groups before the intervention and at 1 wk,1 mo,and 3 mo postintervention.RESULTS The PSQI,GAD-7,and ISI scores before the intervention and at 1 wk postintervention were not significantly different between the groups.However,compared with the control group,the treatment group exhibited significant improvements in sleep quality,daytime functioning,negative emotions,sleep latency,sleep duration,sleep efficiency,anxiety level,and insomnia severity at 1 and 3 mo postintervention(P<0.05).The results showed that mindful breathing combined with the sleep-inducing exercise significantly improved the long-term effectiveness of insomnia treatment.At 3 mo,the PSQI scores for the treatment vs the control group were as follows:Sleep quality 0.98±0.48 vs 1.60±0.63,sleep latency 1.98±0.53 vs 2.80±0.41,sleep duration 1.53±0.60 vs 2.70±0.56,sleep efficiency 2.35±0.58 vs 1.63±0.49,sleep disturbance 1.68±0.53 vs 2.35±0.53,hypnotic medication 0.53±0.64 vs 0.93±0.80,and daytime dysfunction 1.43±0.50 vs 2.48±0.51(all P<0.05).The GAD-7 scores were 2.75±1.50 vs 7.15±2.28,and the ISI scores were 8.68±2.26 vs 3.38±1.76 for the treatment vs the control group,respectively(all P<0.05).CONCLUSION These simple,cost-effective,and easy-to-implement practices used in clinical or home settings could have profound significance for long-term insomnia treatment and merit wide adoption in clinical practice.展开更多
PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalen...PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.展开更多
BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime h...BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.展开更多
Introduction: Sleep is critical to human physiological function, cognitive performance, and emotional regulation. Healthcare personnel, especially physicians, are chronically exposed to long working hours, which are o...Introduction: Sleep is critical to human physiological function, cognitive performance, and emotional regulation. Healthcare personnel, especially physicians, are chronically exposed to long working hours, which are often accompanied by decreased sleep time. Clinical evidence indicates that these conditions affect their cognitive function and professional practice, but researchers in the field have not sufficiently explored the possible effects of reductions in sleep time on social cognition. Objective: The aim of this is to further explore the effects of sleep restriction among medical residents, the specific impairments in social cognition that it produces, and the effects of a sleep hygiene orientation on those impairments. Method: There were 124 medical residents (50 males, 74 females) who completed a daily sleep/work log, a battery of sleep tests/questionnaires, and neuropsychological evaluations. The participants then received a short course (8 hours) on basic concepts of sleep hygiene and sleep psychoeducation. Once the course was completed, participants filled out the questionnaires again. Results: The results indicate that sleep disturbances in medical residents were associated with severe neurocognitive and social cognition impairments. After the sleep hygiene intervention, neuropsychological function and sleep parameters improved, awareness increased, and social cognition performance significantly improved. Conclusion: Using sleep psychoeducation and sleep hygiene intervention in medical residents is a simple strategy to mitigate the effects of sleep restriction.展开更多
目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研...目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研究的发文量、国家/地区、机构、作者、期刊、文献引用、关键词和研究热点进行分析,并进行可视化呈现。结果共检索到798篇文献。以通信作者分析,中国发文199篇,居全球首位,且与多个国家建立了合作关系。美国发文196篇,位列第2。发文量最多的机构是加拿大多伦多大学,共34篇。发文量前10位的作者中5位来自美国密歇根大学,相互合作较密切,其中美国学者Devin L Brown发表文章数量为28篇,被引频次236次,发文量和被引频次均居首位。发文量最多的期刊是Sleep Medicine(74篇),发表文章被引频次最高的期刊是Stroke(3542次)。关键词可视化分析发现卒中与睡眠呼吸暂停出现频次最高。在卒中与睡眠相关性研究领域,研究主题分析提示失眠、抑郁作为基础课题对该领域发展非常重要,卒中预防、功能结局、脑血流主题研究需要努力开发。结论越来越多的研究聚焦于缺血性卒中和睡眠之间的关联性,中国和美国在该领域发表文献较多,睡眠呼吸障碍是主要研究热点。未来在卒中和睡眠领域可探索失眠、抑郁、卒中预防、功能结局、脑血流等主题。展开更多
1.Introduction For athletes,the quality and quantity of sleep are essential elements for optimizing recovery and subsequent performance.1 Unfortunately,athletes frequently face challenges getting sufficient,high-quali...1.Introduction For athletes,the quality and quantity of sleep are essential elements for optimizing recovery and subsequent performance.1 Unfortunately,athletes frequently face challenges getting sufficient,high-quality sleep.2 A recent systematic review and meta-analysis of 81 studies involving 1830 athletes concluded that compared to healthy non-athletes,athletes'sleep duration was shorter with poorer sleep efficiency.展开更多
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
文摘Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.
文摘BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.
基金Supported by Clinic Barmelweid Scientific Foundation.
文摘In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associated with an increased cardiovascular risk,including stroke.Con-tinuous positive airways pressure(CPAP)therapy at night is the most effective treatment forOSA and has been shown to reduce the cardiovascular risk in OSA patients.However,there is nosuitable bedside monitoring method evaluating the recovery of cerebral hemodynamics duringCPAP therapy.Near-infrared spectroscopy(NiRS)is idelly suited for non-invasive monitoringthe cerebral hemodynamics during sleep due to its properties of local measurement,totally sa feapplication and good tolerance to motion.In this pilot study,we monitored cerebral hemody-namics during standard CPAP therapy at night in thre patients with severe OSA using NIRS.We found periodic oscllations in HbO2,HHb,tisue oxygenation index(TO1)and blood volume(BV)associa ted with periodic apnea events without CPAP in all OSA patients.These osillationswere eliminated under the optimal CPAP pressures in all patients.These results sugg ested thatthe recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedsideNIRS measurements in real time during ll night CPAP therapy.NIRS is a usefi bedsidemonitoring tool to evaluate the treatment elicacy of CPAP therapy in patients with OSA.
文摘This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.
文摘[Objectives]To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders.[Methods]A total of 300 anxiety patients with sleep disorders were randomly selected and divided into a research group and a control group,with 150 cases in each group.The control group was administered with western medicine,and the research group was treated with acupuncture and medicine to compare their clinical treatment effects.[Results]The total effective rate of treatment in the research group was significantly higher than that in the control group;after treatment,both the PSQI and SAS scores of the two groups were significantly reduced,and the reduction degree of the research group was higher than that of the control group,the difference was statistically significant(P<0.05).[Conclusions]Combined use of acupuncture and medicine to treat sleep disorders in patients with anxiety disorders has better curative effect and fewer adverse reactions,so it has high clinical application value.
文摘The early years of life are characterized by significant developmental processes of growth and differentiation in all physical systems and especially the central nervous system. Sleep plays a crucial role in cerebral developmental processes and the accumulation of new abilities and skills. We review the current research evidence regarding the relationship between sleep (and its various components) and cerebral and physical developmental processes. Although sleep is an everyday physiological necessity, the ability to recognize it as a critical component of development may bring a different view towards sleep by parents, educators, and caregivers. This change might lead to a shift in individual and social attitudes aimed at enabling the necessary time and conditions for adequate sleep in children and adolescents to become the norm. These sets of values will then hopefully extend into adulthood, in which sleep also plays a crucial role in both physical and mental wellbeing.
基金the Shengjing Hospital of China Medical University(approval No 2019PS582K).
文摘BACKGROUND Insomnia is the most common sleep disorder.It disrupts the patient’s life and work,increases the risk of various health issues,and often requires long-term intervention.The financial burden and inconvenience of treatments discourage patients from complying with them,leading to chronic insomnia.AIM To investigate the long-term home-practice effects of mindful breathing combined with a sleep-inducing exercise as adjunctive insomnia therapy.METHODS A quasi-experimental design was used in the present work,in which the patients with insomnia were included and grouped based on hospital admission:40 patients admitted between January and April 2020 were assigned to the control group,and 40 patients admitted between May and August 2020 were assigned to the treatment group.The control group received routine pharmacological and physical therapies,while the treatment group received instruction in mindful breathing and a sleep-inducing exercise in addition to the routine therapies.The Pittsburgh Sleep Quality Index(PSQI),Generalized Anxiety Disorder 7-item(GAD-7)scale,and Insomnia Severity Index(ISI)were utilized to assess sleepquality improvement in the patient groups before the intervention and at 1 wk,1 mo,and 3 mo postintervention.RESULTS The PSQI,GAD-7,and ISI scores before the intervention and at 1 wk postintervention were not significantly different between the groups.However,compared with the control group,the treatment group exhibited significant improvements in sleep quality,daytime functioning,negative emotions,sleep latency,sleep duration,sleep efficiency,anxiety level,and insomnia severity at 1 and 3 mo postintervention(P<0.05).The results showed that mindful breathing combined with the sleep-inducing exercise significantly improved the long-term effectiveness of insomnia treatment.At 3 mo,the PSQI scores for the treatment vs the control group were as follows:Sleep quality 0.98±0.48 vs 1.60±0.63,sleep latency 1.98±0.53 vs 2.80±0.41,sleep duration 1.53±0.60 vs 2.70±0.56,sleep efficiency 2.35±0.58 vs 1.63±0.49,sleep disturbance 1.68±0.53 vs 2.35±0.53,hypnotic medication 0.53±0.64 vs 0.93±0.80,and daytime dysfunction 1.43±0.50 vs 2.48±0.51(all P<0.05).The GAD-7 scores were 2.75±1.50 vs 7.15±2.28,and the ISI scores were 8.68±2.26 vs 3.38±1.76 for the treatment vs the control group,respectively(all P<0.05).CONCLUSION These simple,cost-effective,and easy-to-implement practices used in clinical or home settings could have profound significance for long-term insomnia treatment and merit wide adoption in clinical practice.
文摘PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.
文摘BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.
文摘Introduction: Sleep is critical to human physiological function, cognitive performance, and emotional regulation. Healthcare personnel, especially physicians, are chronically exposed to long working hours, which are often accompanied by decreased sleep time. Clinical evidence indicates that these conditions affect their cognitive function and professional practice, but researchers in the field have not sufficiently explored the possible effects of reductions in sleep time on social cognition. Objective: The aim of this is to further explore the effects of sleep restriction among medical residents, the specific impairments in social cognition that it produces, and the effects of a sleep hygiene orientation on those impairments. Method: There were 124 medical residents (50 males, 74 females) who completed a daily sleep/work log, a battery of sleep tests/questionnaires, and neuropsychological evaluations. The participants then received a short course (8 hours) on basic concepts of sleep hygiene and sleep psychoeducation. Once the course was completed, participants filled out the questionnaires again. Results: The results indicate that sleep disturbances in medical residents were associated with severe neurocognitive and social cognition impairments. After the sleep hygiene intervention, neuropsychological function and sleep parameters improved, awareness increased, and social cognition performance significantly improved. Conclusion: Using sleep psychoeducation and sleep hygiene intervention in medical residents is a simple strategy to mitigate the effects of sleep restriction.
文摘目的分析2013—2023年缺血性卒中和睡眠相关性研究的现状及研究热点。方法在Web of Science核心合集中检索2013年1月1日—2023年12月31日缺血性卒中和睡眠相关性研究的文献。使用RStudio的bibliometrix软件包和VOSviewer软件对该领域研究的发文量、国家/地区、机构、作者、期刊、文献引用、关键词和研究热点进行分析,并进行可视化呈现。结果共检索到798篇文献。以通信作者分析,中国发文199篇,居全球首位,且与多个国家建立了合作关系。美国发文196篇,位列第2。发文量最多的机构是加拿大多伦多大学,共34篇。发文量前10位的作者中5位来自美国密歇根大学,相互合作较密切,其中美国学者Devin L Brown发表文章数量为28篇,被引频次236次,发文量和被引频次均居首位。发文量最多的期刊是Sleep Medicine(74篇),发表文章被引频次最高的期刊是Stroke(3542次)。关键词可视化分析发现卒中与睡眠呼吸暂停出现频次最高。在卒中与睡眠相关性研究领域,研究主题分析提示失眠、抑郁作为基础课题对该领域发展非常重要,卒中预防、功能结局、脑血流主题研究需要努力开发。结论越来越多的研究聚焦于缺血性卒中和睡眠之间的关联性,中国和美国在该领域发表文献较多,睡眠呼吸障碍是主要研究热点。未来在卒中和睡眠领域可探索失眠、抑郁、卒中预防、功能结局、脑血流等主题。
文摘1.Introduction For athletes,the quality and quantity of sleep are essential elements for optimizing recovery and subsequent performance.1 Unfortunately,athletes frequently face challenges getting sufficient,high-quality sleep.2 A recent systematic review and meta-analysis of 81 studies involving 1830 athletes concluded that compared to healthy non-athletes,athletes'sleep duration was shorter with poorer sleep efficiency.
