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

STUDY OBJECTIVES: Connecting resident physician work hours and sleep deprivation to adverse outcomes has been difficult. Our study explores clinical reasoning rather than outcomes. Diagnostic errors are a leading cause of medical error and may result from deficits in clinical reasoning. We used simulated cases to explore relationships between sleep duration and diagnostic reasoning. METHODS: Residents were recruited for a 2-month study (inpatient/outpatient). Each participant's sleep was tracked (sleep diary/actigraphy)...

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Over the past few years, artificial intelligence (AI) has emerged as a powerful tool used to efficiently automate several tasks across multiple domains. Sleep medicine is perfectly positioned to leverage this tool due to the wealth of physiological signals obtained through sleep studies or sleep tracking devices and abundance of accessible clinical data through electronic medical records. However, caution must be applied when utilizing AI, due to intrinsic challenges associated with novel technology. The Artificial Intelligence in Sleep Medicine committee of the American Academy of Sleep Medicine (AASM) reviews advancements in AI within the sleep medicine field...

STUDY OBJECTIVES: Randomized controlled trials have shown that combining norepinephrine reuptake inhibitors and antimuscarinics can ameliorate the severity of obstructive sleep apnea (OSA). This article explores whether the effectiveness and safety of combining norepinephrine reuptake inhibitors with antimuscarinic agents surpass monotherapy for treating OSA. METHODS: We searched the randomized controlled trials (RCTs) with adult patients of OSA who received combination and monotherapy in eight databases from inception until April 5, 2023, next evaluated the included studies' quality, and conducted a meta-analysis and systematic review...

STUDY OBJECTIVES: Despite its widespread use in patients with isolated rapid eye movement sleep behavior disorder (iRBD), the cognitive effect of clonazepam is uncertain. This study aimed to investigate effect of cumulative clonazepam on cognitive function in patients with iRBD. METHODS: Demographic characteristics, baseline cognitive test, and most recent cognitive test information were collected retrospectively. Based on cumulative clonazepam doses, patients were classified into four subgroups: group 1 < 365 mg (1 mg * 1 year); 365 mg ≤ group 2 < 1,095 mg (1 mg * 3 years); 1,095 mg ≤ group 3 < 2,190 mg (1 mg * 6 years); and group 4 ≥ 2,190 mg...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

STUDY OBJECTIVES: We examined the association between pulse transit time (PTT) and obstructive sleep apnea (OSA) in children with syndromic craniosynostosis (SCS), where OSA is a common problem and may cause cardiorespiratory disturbance. METHODS: Retrospective study of children (age <18 years) with SCS and moderate-to-severe OSA (i.e., obstructive apnea-hypopnea index [oAHI] ≥ 5), or no OSA (oAHI < 1) who underwent overnight polysomnography (PSG). Children without SCS and normal PSG were included as controls...

STUDY OBJECTIVES: Supportive co-parenting between couples has been shown to have positive effects on the dyadic relationship, child development, and parental and child sleep. This study aimed to investigate the association between paternal involvement in nighttime childcare and child and maternal sleep, while exploring relationship satisfaction, and maternal competence about child sleep as mediators. METHODS: The sample consisted of 290 mothers ( Mage ± SD =34...

A 39-year-old male with a medical history significant for migraine, psoriatic arthritis, postural orthostatic tachycardia syndrome (POTS), vitamin D deficiency and hypoglycemia presented with a two-year history of sleep-related painful erections (SRPE). Since the reported prevalence is low, there is limited understanding of the possible etiologies of the disorder and little published clinical data on treatment algorithms. Thus, he had tried multiple therapies. Baclofen was effective but not tolerated. Pelvic physiotherapy and tadalafil were ineffective...

STUDY OBJECTIVES: Observational data suggest pediatric intensive care unit-related sleep and circadian disruption (PICU-SCD) affects many critically ill children. Multi-center trials exploring PICU-SCD have been impractical as measuring sleep in this setting is challenging. This study validates a questionnaire for caregivers to describe children's sleep in the PICU. METHODS: This prospective, multi-center, case-control study enrolled caregivers of children in four PICUs or in a hospital-based sleep lab (controls)...

STUDY OBJECTIVES: Wearable devices, monitoring sleep stages and heart rate (HR), bring the potential for longitudinal sleep monitoring in patients with neurodegenerative diseases. Sleep quality reduces with disease progression in Huntington's disease (HD). However, the involuntary movements characteristic of HD may affect the accuracy of wrist-worn devices. This study compares sleep stage and heart rate data from the Fitbit Charge 4 (FB) against polysomnography (PSG) in participants with HD...

STUDY OBJECTIVES: To characterize the incidence of pediatric narcolepsy diagnosis, subsequent care, and potential sociodemographic disparities in a large US claims database. METHODS: Merative MarketScan insurance claims (n=12,394,902) were used to identify youth (6-17 years) newly diagnosed with narcolepsy (ICD-10 codes). Narcolepsy diagnosis and care 1-year post-diagnosis included polysomnography (PSG) with Multiple Sleep Latency Test (MSLT), pharmacological care, and clinical visits...

Hypoglossal nerve stimulation (HNS) is indicated for obstructive sleep apnea (OSA) but is ineffective in treating central sleep apnea (CSA). We describe two patients implanted with HNS after being diagnosed with OSA at outside sleep labs and failing a trial of continuous positive airway pressure (CPAP) therapy. Despite successful HNS implantation, the patients continued to have persistent symptoms with residual apnea-hypopnea indices above 25 events/h. Although OSA was the presenting diagnosis, we discovered a significant CSA component in the original diagnostic sleep data upon careful review...

Wolfram syndrome (WS) is a rare autosomal recessive disorder affecting approximately 1:500,000 individuals. The disorder is most commonly caused by mutations in the WFS1 gene, which encodes an endoplasmic reticulum (ER) protein, wolframin, which is thought to protect against ER stress-related apoptosis. The major clinical findings of WS are diabetes mellitus and optic atrophy, both of which usually appear before 16 years of age. Common additional findings include sensorineural hearing impairment, central diabetes insipidus, non-autoimmune hypothyroidism, delayed puberty, neurogenic bladder, cerebellar ataxia, and psychiatric disorders...

STUDY OBJECTIVES: A 2021 survey by the World Health Organization showed that 27% of the global population suffers from sleep problems and that middle-aged and older adults are more likely to have sleep disorders. Sleep deprivation increases cardiovascular disease risk. This study aimed to assess the effects of aerobic exercise (AE), resistance exercise (RE), combined training (CBT) and yoga on the quality of sleep in middle-aged and older adults through their effects on the Pittsburgh sleep quality index (PSQI) and its components...

STUDY OBJECTIVES: Daylight saving time (DST) constitutes a natural quasi-experiment to examine the influence of mild sleep loss and circadian misalignment. We investigated the acute effects of spring transition into DST and the chronic effects of DST (compared to standard time) on medical malpractice claims in the United States over three decades. METHODS: We analyzed 288,432 malpractice claims from the National Practitioner Data Bank. To investigate the acute effects of spring DST transition, we compared medical malpractice incidents/decisions one week before spring DST transition, one week following spring DST transition, and the rest of the year...

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