Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine

STUDY OBJECTIVES: To examine beliefs about prescription sleep medications (hypnotics) among individuals with insomnia disorder seeking cognitive behavioral therapy for insomnia (CBTI) and predictors of wishing to reduce use. METHODS: Baseline data was collected from 245 adults 50 years and older enrolled in the "RCT of the effectiveness of stepped-care sleep therapy in general practice (RESTING)" study. T-tests compared characteristics of prescription sleep medication users with those of non-users...

STUDY OBJECTIVES: Asian Americans (AAs) report higher rates of insufficient sleep than non-Hispanic Whites (NHWs). It is unclear how sleep outcomes differ among disaggregated Asian subgroups. METHODS: The National Health Interview Survey (NHIS) (2006-2018) was used to analyze self-reported sleep duration and quality measures for AA subgroups (Chinese [n=11,056], Asian Indian [n=11,249], Filipino [n = 13,211], and other Asians [n = 21,767]). Outcomes included hours of sleep per day, the number of days reporting trouble falling asleep, staying asleep, waking up rested, and taking sleep medication in the past week...

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Disorder of arousal (DOA) is a form of nonrapid eye movement (NREM) sleep parasomnia caused by partial or incomplete arousal from deep sleep. Most previous studies of DOA patients analyzed prearousal hypersynchronous delta activity (HSDA), but few studies have described postarousal HSDA. Herein, we report a 23-year-old man with a history of abrupt arousal during sleep, confused behavior and speech since he was 14 years old. During video EEG monitoring (VEEG), he had nine arousal events of getting up, sitting on the bed, looking around or simple arousal, including eyes open, looking at the ceiling or head flexion...

STUDY OBJECTIVES: To evaluate the performance of the 2017 American Academy of Sleep Medicine criteria (AASM2017 ) in screening obstructive sleep apnea (OSA), and compare with three other validated instruments: NoSAS score, STOP-Bang, and GOAL questionnaires. METHODS: From July 2019 to December 2021, 4,499 adults undergoing overnight polysomnography (PSG) were included. The AASM2017 instrument considers an increased high risk for moderate-to-severe OSA in the presence of excessive daytime sleepiness and at least two of the following three criteria: loud snoring; observed apnea, gasping, or choking; and hypertension...

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STUDY OBJECTIVES: Disturbed sleep and 24-hour activity rhythms are linked to adverse cardiometabolic profiles in adults and adolescents, and these associations may originate in early life. We aimed to study associations of sleep and 24-hour rhythms with cardiometabolic risk factors in school-age children. METHODS: This cross-sectional population-based study comprised 894 children aged 8-11 years from the Generation R Study. Sleep (duration, efficiency, number of awakenings, time awake after sleep onset) and 24-hour activity rhythms (social jetlag, interdaily stability, intradaily variability) were assessed using tri-axial wrist actigraphy for nine consecutive nights...

STUDY OBJECTIVES: Social support (SS) is associated with better health outcomes including sleep health. However, the specific sources of SS that benefit sleep are unclear, and whether these associations vary by race/ethnicity or age are unknown. The aim of this study was to examine cross-sectional associations between sources of SS (number of friends, financial, church attendance, and emotional support) and self-reported short sleep duration (< 7 hours) overall and by race/ethnic groups (Black, Hispanic, and White) and age (< 65 vs...

STUDY OBJECTIVES: Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia disorder. The goal of this study was to evaluate clinical benefits of CBT-I to veterans with insomnia disorder during the early months of the COVID-19 pandemic using an uncontrolled observational design. METHODS: A cohort of 63 VA mental health providers delivered CBT-I to 180 veterans as part of an evidence-based psychotherapy training program and captured de-identified treatment outcome data through a data portal...

STUDY OBJECTIVES: Machine learning (ML) models have been employed in the setting of sleep disorders. This review aims to summarize the existing data about the role of ML techniques in the diagnosis, classification, and treatment of sleep related breathing disorders. METHODS: A systematic search in MedLine, EMBASE, and Cochrane databases through January 2022 was performed. RESULTS: Our search strategy revealed 132 studies that were included in the systematic review...

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STUDY OBJECTIVES: Restless legs syndrome (RLS) is a prevalent sleep disorder with limited treatment options. Bilateral high-frequency noninvasive peroneal nerve stimulation (NPNS) reduces RLS symptoms. Here, we sought to characterize the mechanism of action for NPNS and identify predictors of treatment response. We hypothesized that - similar to voluntary leg movements - NPNS reduces RLS symptoms by activating leg muscles. METHODS: For 20 adults with moderate-severe RLS, we tested this hypothesis by recording surface electromyography (EMG) from the tibialis anterior leg muscle while administering NPNS at varying amplitudes to determine the minimum NPNS amplitude that evoked EMG activity (motor threshold, MT) and maximal NPNS amplitude that was not distracting (therapeutic intensity level, TIL)...

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a risk factor for a major public health problem, car crashes, due to excessive daytime sleepiness (EDS). Commercial vehicle driving (CVD) is a hazardous occupation, having a high fatality rate worldwide. There have been no studies on EDS and OSA in Zambia despite the high rate of annual road traffic accidents (RTAs). We aim to determine the prevalence of EDS and OSA risk among CVDs in Lusaka, Zambia to assess the impact of OSA on high RTA rates...

STUDY OBJECTIVES: The potential sedative effect of dronabinol and the high expression of cannabinoid receptors on the hypoglossal motor nuclei makes this agent a good candidate for obstructive sleep apnea (OSA) pharmacotherapy, to be tested with atomoxetine, a noradrenergic reuptake inhibitor that reduced OSA severity in combination with oxybutynin. Here we tested the effect of atomoxetine 80 mg plus dronabinol (Ato-Dro) at two different doses (5 and 10 mg) vs. baseline and atomoxetine alone in a two-center, open-label, dose-escalating trial...

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STUDY OBJECTIVES: Undiagnosed obstructive sleep apnea (OSA) is associated with increased risk for subsequent cardiovascular events, hospitalizations, and mortality. The primary objective of this study was to determine the association between undiagnosed OSA and subsequent hospitalizations among older adults with pre-existing cardiovascular disease (CVD). A secondary objective was to determine the risk of 30-day hospital readmission associated with undiagnosed OSA among older adults with CVD...

STUDY OBJECTIVES: Sleep-disordered breathing (SDB) is common in patients with congestive heart failure (CHF) and has important implications regarding symptoms and prognosis. However, the burden of SDB on those with heart failure has not been well characterized in developing countries; this includes Mozambique in sub-Saharan Africa. Diagnosing SDB in individuals with CHF is important because treatment of SDB may improve outcomes. METHODS: Between September of 2014 and April of 2017, patients hospitalized in a specialized cardiology unit in Maputo, Mozambique with decompensated congestive heart failure were recruited, utilizing convenience sampling...

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STUDY OBJECTIVES: Several studies have shown that patients with short sleep duration show a poor response to cognitive behavioral therapy for insomnia (CBT-I) but such studies have not included patients with comorbid conditions. The current study was conducted to determine whether pre-treatment sleep duration moderates the response of patients with major depression (MDD) and insomnia (ID) disorders to a combined CBT-I and antidepressant medication treatment. METHODS: This study comprised a secondary analysis of a larger randomized trial that tested combined CBT-I/antidepressant medication treatment of patients with MDD and ID...

STUDY OBJECTIVES: Chronic noncancer pain (CP) commonly co-occurs with obstructive sleep apnea (OSA) and may contribute to greater symptom burden. The study aims were to (1) characterize CP among veterans with OSA; and (2) examine differences in sleepiness (Epworth Sleepiness Scale, ESS), insomnia symptoms (Insomnia Severity Index [ISI]), and quality of life (Short Form Health Survey 20, SF-20) in veterans with OSA with or without pre-existing CP. METHODS: An observational, cross-sectional, study of 111 veterans with newly diagnosed, untreated OSA was conducted...