ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To evaluate the effectiveness ofradiofrequency volumetric tissue reduction （RFVTR） in the treatment of sleep disordered breathing （SDB ）. Methods We searched The Cochrane Central Register of Controlled Trials （Issue 1, 2005）, MEDLINE （1966 to Apr. 2005）, EMBASE （1989 to Apr. 2005）, CINAHL （1982 to Dec. 2000）, VIP （1989 to Dec. 2004） , CJFD （1979 to 2005）, WANFANG DATA （1977 to 2004） , and CBMdisc （1978 to 2005）. The bibliographies of all papers retrieved in full text form and relevant narrative reviews were searched for additional publications. All randomized controlled clinical trials （RCT） or quasi-randomized controlled trials （quasi-RCT） or prospective cohort studies of RFVTR alone or in combination with other treatments compared with placebo or other treatments were included. Data were extracted independently from the trial reports by the two authors. Meta-analysis was performed using RevMan software. Results There were 11 studies including 540 patients met the inclusion criteria for this review, among which five were RCTs, six were prospective cohort studies, and all trials were of lower methodological quality. RFVTR showed benefit over placebo in apnea index （AI）, but this benefit was not seen in other polysorrmography （PSG） parameters, symptom and quality of life, psychomotor vigilance pain, swallowing difficulty and adverse events. Compared with continuous positive airway pressure （CPAP）, uvulopalatopharyngoplasty （UPPP） and laser assisted uvulopalatoplasty （LAUP） , RFVTR was more effective in psychomotor vigilance pain and swallowing difficulty, but this effect was not seen in PSG parameters, symptom and quality of life. Conclusions RFVTR is more effective than placebo in AI improvement and other treatments in decreasing postoperative pain and other adverse events ; but this benefit was not seen in improving quality of sleeping and life. More well-designed randomized trials need to be conducted to identify the effectiveness and the influence on effectiveness of severity and frequency of treatment.
目的:探讨健康教育对高血压伴阻塞性睡眠呼吸暂停综合征（OSAS）的影响。方法:选择我院住院患者60例，随机分为二组，一组为实验组（入院后给予针对性健康教育），另一组为对照组（只给予一般健康教育）。结果:实验组3例患者病情控制快，血压、血脂、胆固醇控制良好，血氧饱和度恢复正常，与对照组相比，P＜0.05，有统计学意义。结论:加强对高血压伴OSAS患者的健康教育，将有助于改善其健康水平，提高治疗率及生活质量。
Objective To investigate the correlation between serum level of visfatin and obesity in patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty-seven patients with OSAHS and 20 healthy controls were recruited in this study. Polysomnography was performed in all subjects to detect apnea-hypopnea index ( AHI) . The serumlevels of cisfatin, C-reactive protein ( CRP) , TNF-α, and IL-6 were measured by enzyme linked immunosorbent assay. The body mass inex ( BMI) was calculated.The level of cisfatin was compared between the OSAHS patients with different severity and the controls, and its relationship with the levels of AHI, BMI, CRP, TNF-α, and IL-6 was analyzed. Results The serumlevel of visfatin in the OSAHS patients was higher significantly than that in the controls ( P lt;0. 01) and increased by the severity of OSAHS. There were positive correlations between the serum level of visfatin and AHI,BMI, CRP, TNF-α, IL-6 in the OSAHS patients ( P lt;0. 05) . Conclusion The expression of visfatin may play an important role in the pathogenesis of OSAHS.
ObjectiveTo systematically review the association between chronotype and quality of life in adolescents. MethodsPubMed, EMbase, Cochrane Library, Web of Science, CBM, WBM, VIP, WanFang Data and CNKI databases were electronically searched to collect studies on the association between chronotype and quality of life in adolescents from inception to April 21, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. A qualitative systematic review was then performed. ResultsA total of 7 studies were included. The results of systematic review suggested that the association between chronotype and quality of life in adolescents was statistically significant. Moreover, chronotype completely affected quality of life via insomnia symptoms, sleep related irrational cognition and general self-efficacy. ConclusionCurrent evidence shows that chronotype is associated with quality of life in adolescents. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
睡眠呼吸暂停低通气综合征( OSAHS) 是一种常见的全身性慢性疾病, 主要表现为呼吸暂停和低通气, 反复发生低氧血症、高碳酸血症和睡眠结构紊乱, 导致白天嗜睡、情绪异常、神经认知功能障碍、心脑血管疾病等。这些异常对患者的日常生活、社会功能、工作效率及认知功能等方面都有不同程度的损害, 使患者生活质量明显下降。多项研究提示 OSAHS患者生活质量与抑郁、白天嗜睡、社会支持等密切相关, OSAHS 相关的生活质量评估量表不仅能关注多导睡眠图( PSG) 无法反映的主观症状如嗜睡、困倦等, 而且反映OSAHS 导致的器官功能损害及其严重程度。本文主要就用于评价OSAHS患者生活质量主要的相关量表及其应用, 以及目前一些治疗措施对生活质量的影响作一综述。
Objective To investigate the changes and clinical relationship of plasma adrenomedullin( ADM) , atrial natriuretic polypeptide( ANP) , and heart rate variability( HRV) in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Seventy-five inpatients with OSAHS were enrolled in this study. According to the apnea hypopnea index ( AHI) by polysomnography, the subjects were divided into a mild group, a moderate group, and a severe group. Meanwhile, HRV was screened bydynamic electrocardiogram in sleep laboratory. HRV parameters were obtained including LF ( low frequency power) , HF( high frequency power) , pNN50( percentage of NN50 in the total number of N-N intervals) ,SDNN( standard deviation of the N-N intervals) , rMSSD( square root of the mean squared differences of successive N-N intervals ) . Plasma levels of ADM/ANP were measured by radioimmunoassay. Results The levels of SDNN ( P lt;0. 05) , rMSSD, pNN50, LF ( P lt; 0. 05) and HF were gradually reduced, and the levels of ADM ( P lt;0. 05) and ANP ( P lt; 0. 05) were increased with increasing severity of OSAHS. Linear correlation analysis demonstrated that SDNN was negatively correlated with ADM( r = - 0. 423, P lt;0. 05)and ANP( r = - 0. 452, P lt; 0. 05) , and LF was also negatively correlated with ADM( r = - 0. 348, P lt;0. 05) . Conclusion Lower HRV is associated with more sever OSAHS, and it may be modulated neurohumorally by ADM and ANP.
Habitual snoring can occur in both children and adults. If it is physiological snoring, it usually does not require special intervention. If it is pathological snoring, such as snoring caused by central diseases and obstructive diseases, it needs to be treated as soon as possible. Habitual snoring has more harm to children, such as causing sleep structure disorders, slow growth and development. During the snoring process, children’s sleep fragmentation and hypoxia state lead to changes in the transmission of neurochemicals in the brain’s precortex, causing adverse effects on brain function and inducing attention deficit hyperactivity disorder. This article reviews relevant research in recent years to further elucidate the relationship between children’s habitual snoring and attention deficit hyperactivity disorder, and provide a basis for future clinical research and intervention.
ObjectiveTo analyze the risk factors for electrical status epilepticus during sleep (ESES) in patients with self-limited epilepsy with centrotemporal spikes (SeLECTs) and to construct a nomogram model. MethodsThis study selected 174 children with SeLECTs who visited the Third Affiliated Hospital of Zhengzhou University from March 2017 to March 2024 and had complete case data as the research subjects. According to the results of video electroencephalogram monitoring during the course of the disease, the children were divided into non-ESES group (88 cases) and ESES group (86 cases). Multivariate logistic regression analysis was used to identify the risk factors for the occurrence of ESES in SeLECTs patients. ResultsThe multifactor Logistic regression analysis demonstrated that the EEG discharges in bilateral cerebral areas,types of seizure, epileptic seizures after initial treatment were the independent risk factors for the occurrence of ESES in SeLECTs. ConclusionBilateral distribution of electroencephalogram discharges before treatment, emergence of new seizure forms, and epileptic seizures after initial treatment are risk factors for the ESES in SeLECTs patients. The nomogram model constructed based on the above risk factors has a high degree of accuracy.