Excessive daytime sleepiness (EDS) is common in patients with obstructive sleep apnea (OSA) and continues to persist in many patients despite adequate OSA treatment. EDS in OSA is associated with ...decreased quality of life (QOL) as well as increased societal burden, which may impact health care utilization and costs. However, economic burden is often not the primary focus in the treatment of EDS in OSA. This targeted literature review aimed to examine the published literature on the economic burden of EDS in OSA. This review identified available literature using a targeted PubMed search strategy using search terms related to EDS in OSA in adults. Results demonstrate that there are few studies that detailed the direct costs associated with EDS in OSA, though several studies indicated an association between EDS in OSA and indirect economic burdens, including motor vehicle accidents (MVAs), near misses, work productivity, mood, and QOL. Data from the literature confirmed that persistent EDS in OSA following continuous positive airway pressure persists in 12%–65% of patients. Future studies should further describe the direct costs of EDS in OSA, quantify the cost associated with MVAs and lost work productivity, and detail QOL and social impacts of the condition.
This article presents an up-to-date review of the state-of-the-art knowledge regarding the effect of sleep on the anabolic growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis. This axis is ...involved in learning and memory and neuroprotection at the central level, and in the crosstalk between sleep and the immune system, with respect to its anti-inflammatory properties. We also aim to provide insight into the consequences of sleep loss on cognitive capacities in healthy individuals and patients with obstructive sleep apnea (OSA), regarding the mechanistic association with the GH/IGF-1 axis. Finally, this review examines the inflammatory/endocrine pathways that are affected by sleep loss, and which may consequently interact with the GH/IGF-1 axis.
The deleterious effects of sleep loss include fatigue, and can cause several adverse age-dependent health outcomes. It is therefore important to improve our understanding of the fundamental physiology underlying these effects in order to better apply non-pharmacological countermeasures (e.g., sleep strategies, exercise training, continuous positive airway pressure therapy) as well as pharmacological solutions, so as to limit the deleterious consequences of sleep loss/disorders.
Sleep and exercise: A reciprocal issue? Chennaoui, Mounir; Arnal, Pierrick J; Sauvet, Fabien ...
Sleep medicine reviews,
04/2015, Letnik:
20
Journal Article
Recenzirano
Summary Sleep and exercise influence each other through complex, bilateral interactions that involve multiple physiological and psychological pathways. Physical activity is usually considered as ...beneficial in aiding sleep although this link may be subject to multiple moderating factors such as sex, age, fitness level, sleep quality and the characteristics of the exercise (intensity, duration, time of day, environment). It is therefore vital to improve knowledge in fundamental physiology in order to understand the benefits of exercise on the quantity and quality of sleep in healthy subjects and patients. Conversely, sleep disturbances could also impair a person's cognitive performance or their capacity for exercise and increase the risk of exercise-induced injuries either during extreme and/or prolonged exercise or during team sports. This review aims to describe the reciprocal fundamental physiological effects linking sleep and exercise in order to improve the pertinent use of exercise in sleep medicine and prevent sleep disorders in sportsmen.
Slow-wave sleep: From the cell to the clinic Léger, Damien; Debellemaniere, Eden; Rabat, Arnaud ...
Sleep medicine reviews,
October 2018, 2018-10-00, 20181001, 2018-10, Letnik:
41
Journal Article
Recenzirano
In recent decades, increasing evidence has positioned slow-wave sleep (SWS) as a major actor in neurophysiological phenomena such as glucose metabolism, hormone release, immunity and memory. This ...proposed role for SWS, coupled with observations of impaired SWS in several pathologies as well as in aging, has led some researchers to implement methods that could specifically enhance SWS.
This review aims to gather the current knowledge extending from the cell to the clinic, in order to construct an overview of what is currently known about so-called SWS. We slowly expand the view from the molecular processes underlying SWS to the cell unit and assembly to cortical manifestations. We then describe its role in physiology and cognition to finally assess its association with clinical aspects. Finally, we address practical considerations for several techniques that could be used to manipulate SWS, in order to improve our understanding of SWS and possibly help the development of treatments for SWS clinical disorders.
Societal costs of insomnia Léger, Damien; Bayon, Virginie
Sleep medicine reviews,
12/2010, Letnik:
14, Številka:
6
Journal Article
Recenzirano
Summary Insomnia is the most common sleeping disorder and has been recognized as a major public health issue, associated with a high societal cost. The aim of this review is firstly to understand how ...the socio-demographic and career characteristics of insomniacs may influence the economical consequences of this disease. Secondly, it also tries to explain how patients seek help to cope with their insomnia. The review aims to carefully describe the possible links between insomnia and public health concerns as to point out what are the certitudes and the missing data on the consequences of insomnia on work, economics, accidents, costs and health related quality of life (HrQol).
Sleep duration has been shown to be associated with individual chronic diseases but its association with multimorbidity, common in older adults, remains poorly understood. We examined whether sleep ...duration is associated with incidence of a first chronic disease, subsequent multimorbidity and mortality using data spanning 25 years.
Data were drawn from the prospective Whitehall II cohort study, established in 1985 on 10,308 persons employed in the London offices of the British civil service. Self-reported sleep duration was measured 6 times between 1985 and 2016, and data on sleep duration was extracted at age 50 (mean age (standard deviation) = 50.6 (2.6)), 60 (60.3 (2.2)), and 70 (69.2 (1.9)). Incidence of multimorbidity was defined as having 2 or more of 13 chronic diseases, follow-up up to March 2019. Cox regression, separate analyses at each age, was used to examine associations of sleep duration at age 50, 60, and 70 with incident multimorbidity. Multistate models were used to examine the association of sleep duration at age 50 with onset of a first chronic disease, progression to incident multimorbidity, and death. Analyses were adjusted for sociodemographic, behavioral, and health-related factors. A total of 7,864 (32.5% women) participants free of multimorbidity had data on sleep duration at age 50; 544 (6.9%) reported sleeping ≤5 hours, 2,562 (32.6%) 6 hours, 3,589 (45.6%) 7 hours, 1,092 (13.9%) 8 hours, and 77 (1.0%) ≥9 hours. Compared to 7-hour sleep, sleep duration ≤5 hours was associated with higher multimorbidity risk (hazard ratio: 1.30, 95% confidence interval = 1.12 to 1.50; p < 0.001). This was also the case for short sleep duration at age 60 (1.32, 1.13 to 1.55; p < 0.001) and 70 (1.40, 1.16 to 1.68; p < 0.001). Sleep duration ≥9 hours at age 60 (1.54, 1.15 to 2.06; p = 0.003) and 70 (1.51, 1.10 to 2.08; p = 0.01) but not 50 (1.39, 0.98 to 1.96; p = 0.07) was associated with incident multimorbidity. Among 7,217 participants free of chronic disease at age 50 (mean follow-up = 25.2 years), 4,446 developed a first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died. Compared to 7-hour sleep, sleeping ≤5 hours at age 50 was associated with an increased risk of a first chronic disease (1.20, 1.06 to 1.35; p = 0.003) and, among those who developed a first disease, with subsequent multimorbidity (1.21, 1.03 to 1.42; p = 0.02). Sleep duration ≥9 hours was not associated with these transitions. No association was found between sleep duration and mortality among those with existing chronic diseases. The study limitations include the small number of cases in the long sleep category, not allowing conclusions to be drawn for this category, the self-reported nature of sleep data, the potential for reverse causality that could arise from undiagnosed conditions at sleep measures, and the small proportion of non-white participants, limiting generalization of findings.
In this study, we observed short sleep duration to be associated with risk of chronic disease and subsequent multimorbidity but not with progression to death. There was no robust evidence of an increased risk of chronic disease among those with long sleep duration at age 50. Our findings suggest an association between short sleep duration and multimorbidity.
Sleep and memory are deeply related, but the nature of the neuroplastic processes induced by sleep remains unclear. Here, we report that memory traces can be both formed or suppressed during sleep, ...depending on sleep phase. We played samples of acoustic noise to sleeping human listeners. Repeated exposure to a novel noise during Rapid Eye Movements (REM) or light non-REM (NREM) sleep leads to improvements in behavioral performance upon awakening. Strikingly, the same exposure during deep NREM sleep leads to impaired performance upon awakening. Electroencephalographic markers of learning extracted during sleep confirm a dissociation between sleep facilitating memory formation (light NREM and REM sleep) and sleep suppressing learning (deep NREM sleep). We can trace these neural changes back to transient sleep events, such as spindles for memory facilitation and slow waves for suppression. Thus, highly selective memory processes are active during human sleep, with intertwined episodes of facilitative and suppressive plasticity.Though memory and sleep are related, it is still unclear whether new memories can be formed during sleep. Here, authors show that people could learn new sounds during REM or light non-REM sleep, but that learning was suppressed when sounds were played during deep NREM sleep.
The social profile of reluctant responders is even more worrying: this attitude was more prevalent among low-income people (37%), who are generally more exposed to infectious diseases,4 among young ...women (aged 18–35 years; 36%), who play a crucial role regarding childhood vaccination,5 and among people aged older than 75 years (22%), who are probably at an increased risk for severe illness from COVID-19. When this dimension has been studied, researchers have often found a connection between political beliefs and attitudes to vaccines.6 They highlight a crucial issue for public health interventions: how can we assure the public that recommendations reflect the state of scientific knowledge rather than political interests? Public authorities are setting up fast-track approval processes for a putative vaccine against SARS-CoV-2.9 It is crucial to communicate early and transparently on these processes to avoid vaccines becoming part of political debates.
The COVID-19 pandemic has produced unprecedented changes in social, work, and leisure activities, which all have had major impact on sleep and psychological well-being. This study documented the ...prevalence of clinical cases of insomnia, anxiety, and depression and selected risk factors (COVID-19, confinement, financial burden, social isolation) during the first wave of the pandemic in 13 countries throughout the world.
International, multi-center, harmonized survey of 22 330 adults (mean age = 41.9 years old, range 18–95; 65.6% women) from the general population in 13 countries and four continents. Participants were invited to complete a standardized web-based survey about sleep and psychological symptoms during the first wave of the COVID-19 pandemic from May to August 2020.
Clinical insomnia symptoms were reported by 36.7% (95% CI, 36.0–37.4) of respondents and 17.4% (95% CI, 16.9–17.9) met criteria for a probable insomnia disorder. There were 25.6% (95% CI, 25.0–26.2) with probable anxiety and 23.1% (95% CI, 22.5–23.6) with probable depression. Rates of insomnia symptoms (>40%) and insomnia disorder (>25%) were significantly higher in women, younger age groups, and in residents of Brazil, Canada, Norway, Poland, USA, and United Kingdom compared to residents from Asian countries (China and Japan, 8% for disorder and 22%–25% for symptoms) (all Ps < 0.01). Proportions of insomnia cases were significantly higher among participants who completed the survey earlier in the first wave of the pandemic relative to those who completed it later. Risks of insomnia were higher among participants who reported having had COVID-19, who reported greater financial burden, were in confinement for a period of four to five weeks, and living alone or with more than five people in same household. These associations remained significant after controlling for age, sex, and psychological symptoms.
Insomnia, anxiety, and depression were very prevalent during the first wave of the COVID-19 pandemic. Public health prevention programs are needed to prevent chronicity and reduce long-term adverse outcomes associated with chronic insomnia and mental health problems.
•High rates of insomnia symptoms (36.7%) and disorder (17.4%) associated with COVID-19.•High rates of anxiety (25.6%) and depression (23.1%) associated with COVID-19.•People in confinement, living alone or with five or more people, at higher risk for insomnia.•Sleep health education needed to prevent chronic insomnia and adverse health consequences.
Many scientific fields now use machine-learning tools to assist with complex classification tasks. In neuroscience, automatic classifiers may be useful to diagnose medical images, monitor ...electrophysiological signals, or decode perceptual and cognitive states from neural signals. However, such tools often remain black-boxes: they lack interpretability. A lack of interpretability has obvious ethical implications for clinical applications, but it also limits the usefulness of these tools to formulate new theoretical hypotheses.
We propose a simple and versatile method to help characterize the information used by a classifier to perform its task. Specifically, noisy versions of training samples or, when the training set is unavailable, custom-generated noisy samples, are fed to the classifier. Multiplicative noise, so-called “bubbles”, or additive noise are applied to the input representation. Reverse correlation techniques are then adapted to extract either the discriminative information, defined as the parts of the input dataset that have the most weight in the classification decision, and represented information, which correspond to the input features most representative of each category.
The method is illustrated for the classification of written numbers by a convolutional deep neural network; for the classification of speech versus music by a support vector machine; and for the classification of sleep stages from neurophysiological recordings by a random forest classifier. In all cases, the features extracted are readily interpretable.
Quantitative comparisons show that the present method can match state-of-the art interpretation methods for convolutional neural networks. Moreover, our method uses an intuitive and well-established framework in neuroscience, reverse correlation. It is also generic: it can be applied to any kind of classifier and any kind of input data.
We suggest that the method could provide an intuitive and versatile interface between neuroscientists and machine-learning tools.
•The heuristics of black-box classifiers can be probed with noisy inputs.•The relevant features can be visualised in the input representation space.•The method applies to any kind of data such as 2D images or 1D time series.•It applies to any classifier such as deep neural networks, support vector machines, random forests.
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