Sleep Disorders Reduce Health-Related Quality of Life in Multiple Sclerosis (Nottingham Health Profile Data in Patients with Multiple Sclerosis)

Quality of Life (QoL) is decreased in multiple sclerosis (MS), but studies about the impact of sleep disorders (SD) on health-related quality of Life (HRQoL) are lacking. From our original cohort, a cross-sectional polysomnographic (PSG) study in consecutive MS patients, we retrospectively analysed the previously unpublished data of the Nottingham Health Profile (NHP). Those MS patients suffering from sleep disorders (n = 49) showed significantly lower HRQoL compared to MS patients without sleep disorders (n = 17). Subsequently, we classified the patients into four subgroups: insomnia (n = 17), restless-legs syndrome, periodic limb movement disorder and SD due to leg pain (n = 24), obstructive sleep apnea (n = 8) and patients without sleep disorder (n = 17). OSA and insomnia patients showed significantly higher NHP values and decreased HRQoL not only for the sleep subscale but also for the “energy” and “emotional” area of the NHP. In addition, OSA patients also showed increased NHP values in the “physical abilities” area. Interestingly, we did not find a correlation between the objective PSG parameters and the subjective sleep items of the NHP. However, this study demonstrates that sleep disorders can reduce HRQoL in MS patients and should be considered as an important confounder in all studies investigating HRQoL in MS.     

基于X线的成人OSA计算机辅助诊断综述

阻塞性睡眠呼吸暂停（Obstructive Sleep Apnea,OSA）是成年人较为常见的呼吸类疾病之一,该疾病的特点是睡眠过程中频繁出现上气道完全或部分塌陷,严重影响人们的睡眠质量以及身体健康。阻塞性睡眠呼吸暂停综合征的诊断主要依靠多导睡眠监测,但这种方法无法满足目前大量的诊断需求。随着人工智能的出现及发展,假设深度学习可以有效地协助医生进行诊断该综合征。主要从阻塞性睡眠呼吸暂停的临床诊断方式出发,介绍了颅面侧位片作为诊断数据集的优势,以及人工智能诊断OSA的现状,提出了人工智能辅助医师诊断OSA的技术路线,分析了目前该诊断系统仍然存在的问题和挑战。     

基于深度学习的自动睡眠分期研究综述

睡眠分期是为了分析多导睡眠图记录而进行的重要过程,在睡眠监测和睡眠障碍诊疗中发挥着关键作用。传统的手动睡眠分期需要专业知识,繁琐且耗时;而深度学习通过模拟人脑解释信息的机制来构建模型,具有强大的自动特征提取及特征表达功能。将深度学习方法应用于睡眠分期研究,不依赖于手工特征设计,能够实现睡眠分期的自动化。本文着眼于2017年以来的一些典型的自动睡眠分期研究,重点从单视图和多视图输入两个方面系统回顾了应用于自动睡眠分期中的深度学习模型,并分析了多视图模型存在的难点,指出了其具有的潜在研究价值。最后,对自动睡眠分期未来的研究方向进行了探讨。     

Preserved Sleep for the Same Level of Respiratory Disturbance in Children with Prader-Willi Syndrome

Debate remains as to how to balance the use of recombinant human growth hormone (rhGH) as an important treatment in Prader-Willi syndrome (PWS) with its potential role in obstructive sleep apnea. This single-center, retrospective study assessed differences in overnight polysomnography results between children with and without PWS and changes in respiratory parameters before and after the initiation of rhGH treatment in those with PWS. Compared with age-, sex-, and body-mass-index-matched controls (n = 87), children with PWS (n = 29) had longer total sleep time (434 ± 72 vs. 365 ± 116 min; p < 0.01), higher sleep efficiency (86 ± 7 vs. 78 ± 15%; p < 0.05), and lower arousal events (8.1 ± 4.5 vs. 13.0 ± 8.9 events/h; p < 0.05). Mean oxygen saturation was lower in PWS children (94.3 ± 6.0 vs. 96.0 ± 2.0%; p < 0.05), with no other differences in respiratory parameters between groups. Eleven children with PWS (38%) met the criteria for further analyses of the impact of rhGH; polysomnography parameters did not change with treatment. Compared with other children undergoing polysomnography, children with PWS had more favorable markers of sleep continuity and lower oxygen saturation for the same level of respiratory disturbance. rhGH administration was not associated with changes in respiratory parameters in PWS.     

Disruption of Circadian Rhythm Genes in Obstructive Sleep Apnea Patients—Possible Mechanisms Involved and Clinical Implication

Obstructive sleep apnea (OSA) is a chronic condition characterized by recurrent pauses in breathing caused by the collapse of the upper airways, which results in intermittent hypoxia and arousals during the night. The disorder is associated with a vast number of comorbidities affecting different systems, including cardiovascular, metabolic, psychiatric, and neurological complications. Due to abnormal sleep architecture, OSA patients are at high risk of circadian clock disruption, as has been reported in several recent studies. The circadian clock affects almost all daily behavioral patterns, as well as a plethora of physiological processes, and might be one of the key factors contributing to OSA complications. An intricate interaction between the circadian clock and hypoxia may further affect these processes, which has a strong foundation on the molecular level. Recent studies revealed an interaction between hypoxia-inducible factor 1 (HIF-1), a key regulator of oxygen metabolism, and elements of circadian clocks. This relationship has a strong base in the structure of involved elements, as HIF-1 as well as PER, CLOCK, and BMAL, belong to the same Per-Arnt-Sim domain family. Therefore, this review summarizes the available knowledge on the molecular mechanism of circadian clock disruption and its influence on the development and progression of OSA comorbidities.