Objective To investigate the pathological mechanism of epileptic comorbid sleep disorder by analyzing the changes of cerebral white matter diffusion tensor in patients with sleep disorder with negative magnetic resonance imaging (MRI) epilepsy based on the method of tract-based spatial statistics (TBSS). Methods MRI negative epilepsy patients comorbid sleep disorder who were epileptic patients treated l in China-Japan Union Hospital of Jilin University from January 2020 to December 2022 completed the Epworth sleepiness scale (ESS) and Pittsburgh sleep quality index (PSQI) tests, and those who complained of sleep disorder and PSQI index ≥11 were monitored by nighttime polysomnography (PSG) and those with objective sleep disorder confirmed by PSG were included in the epilepsy comorbid sleep disorder group. Healthy volunteers with matching gender, age, education were included in the health control group. Diffusion tensor image ( DTI) was collected for all subjects by using a 3.0T magnetic resonance scanner. Diffusion parameters were compared between the two groups using TBSS. Results This study included 36 epilepsy patients comorbid sleep disorder and 35 healthy volunteers. epilepsy patients comorbid sleep disorder showed significantly lower fraction anisotropy (FA) (P<0.05) and significantly higher mean diffusivity (MD) (P<0.05) than the health control group . Brain regions with statistical differences in FA reduction included middle peduncle of cerebellum, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum, anterior corona radiata, external capsule and right posterior thalamic radiation.Brain regions with statistical differences in MD degradation included genu of corpus callosum, body of corpus callosum, anterior limb of internal capsule, anterior corona radiata, superior corona radiata, external capsule and right posterior limb of internal capsul. Conclusion Patients with epilepsy comorbidities with sleep disorders have widespread and symmetric white matter damage.The white matter damage is concentrated in the front of the brain.
The incidence of perioperative sleep disorders in patients with cervical spondylosis is high, which affects the physiological and psychological rehabilitation effect of patients after surgery. The expert consensus (preliminary draft) was prepared by summarizing expert experience and recommendations. After expert review and revision, the consensus was formed. The consensus was developed based on existing evidence-based medical evidence and expert clinical experience, which is scientific and practical and can provide a basis for clinical medical personnel to prevent and treat perioperative sleep disorders in patients with cervical spondylosis.
【摘要】 目的 了解和分析玉树地震伤员急性应激期睡眠问题。 方法 2010年4月，对90例玉树地震伤员的急性应激反应采用创伤后应激障碍症状清单平民版(PCL-C)17项量表进行筛查评估，并应用SPSS 17.0软件进行统计学分析。 结果 在PCL-C 17个条目中，提示睡眠障碍的条目2和条目13发生率分别为61.10%、63.30%，分别排列第5位、第3位，其得分分别与PCL-C总得分、闪回症状得分、回避症状得分及高警觉性症状得分均呈正相关(P值均lt;0.01)。 结论 睡眠障碍是地震伤员急性应激反应中的常见问题，需高度重视，并进行积极有效的处理。【Abstract】 Objective To learn and analyze the sleep disorders in acute stress of the wounded persons in Yushu earthquake. Methods The acute stress reaction of 90 wounded persons in Yushu earthquake were screened with post-traumatic stress disorder (PTSD) Checklist-Civilian (PCL-C) version-17 in April 2010. Sleep disorders were statistically analyzed with SPSS 17.0. Results In the 17 items of PCL-C, the incidences of the second and the thirteenth item which were related to sleep disorders were respectively 61.10% ranking at the fifth and 63.30% ranking at the third. Both scores of these two items had significant positive correlation with the total score of PCL-C and the scores of the flashback symptom, the avoidance symptom and the heightened alertness symptom (Plt;0.01). Conclusion Sleep disorder is a common problem in acute stress reaction of wounded persons in earthquakes, which needs high attention to be treated positively.
Sleep disorder is related to many comorbidities, such as diabetes, obesity, cardiovascular diseases, and hypertension. Because of its increasing prevalence rate, it has become a global problem that seriously threatens people’s health. Various forms of sleep disorder can cause increased insulin resistance and/or decreased sensitivity, thus affecting the occurrence, development and prognosis of diabetes. However, sleep health has not been paid attention to in recent years. Therefore, this article summarizes the findings of the correlation between sleep disorder and diabetes mellitus in recent years, by elaborating the relationship between various types of sleep disorder (including sleep apnea syndrome) and diabetes mellitus, as well as their mechanisms and intervention measures, in order to enhance the attention of clinical workers to sleep health, and to provide basis for reducing the risk of diabetes.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.
Objective To investigate the effect of postoperative sleep disturbance by infusion of low dose esketamine during ambulatory laparoscopic cholecystectomy. Methods Patients undergoing ambulatory laparoscopic cholecystectomy under general anesthesia in General Hospital of Northern Theater Command between August and November 2024 were selected. They were randomly divided into esketamine group and control group based on a random number generator. Patients in the esketamine group received a continuous infusion of esketamine [0.3 mg/(kg·h)] during the operation. Patients in the control group received the equivalent volume of saline. The scores of the Athens Insomnia Scale on the first day before surgery, the first day after surgery, and the third day after surgery, the incidence of sleep disturbance and the Hospital Anxiety and Depression Scale score on the first day and the third day after surgery, mean artial pressure and heart rate during surgery, operation time, anesthesia time, recovery time, total dosage of remifetanil and vasoactive drug, postoperative adverse reactions, and the Visual Analogue Scale score on the day of surgery and the first day after surgery were compared between the two groups. Results A total of 105 patients were included, including 52 in the control group and 53 in the esketamine group. The differences were statistically significant in the incidence of sleep disorders on the first day after surgery (22.64% vs. 46.15%; χ2=6.440, P=0.011), the Athens Insomnia Scale score on the first day after surgery [4 (1.5, 5) vs. 5 (4, 7); Z=−2.933, P=0.003] , the cumulative amount of remifentanil used during surgery [884 (600, 1 112) vs. 572 (476, 872) μg; Z=−2.774, P=0.006], and the Visual Analogue Scale score on the day of surgery [2 (2, 3) vs. 3 (2, 3); Z=−2.488, P=0.013] between the esketamine group and the control group. There was no significant difference in mean arterial pressure, heart rate, operation time, anesthesia time, recovery time, vasoactive drug dosage, Hospital Anxiety and Depression Scale score or incidence of postoperative adverse reactions between the two groups (P＞0.05). Conclusion Continuous intraoperative infusion of low dose esketamine can improve postoperative sleep disturbance, without increasing the incidence of postoperative adverse reactions in patients undergoing ambulatory laparoscopic cholecystectomy.
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.
Objectives To study the characteristics and influencing factors of sleep disorder in patients with epilepsy. Methods One hundred and eighty-four patients with epilepsy who were admitted to the outpatient department and the epilepsy center in the Second Affiliated Hospital of Zhejiang University from October 2016 to October 2017 were enrolled. Their clinical data were collected in detail and their sleep related scales were evaluated. Sleep related assessment tools: Chinese version of the Pittsburgh sleep quality index scale (PSQI), the Epworth sleepiness scale (ESS), Berlin Questionnaire (BQ), Quality Of Life In People With Epilepsy-31 (QOLIE-31), Beck Anxiety Inventory (BAI) and Beck Depression Inventory(BDI). Results Among the 184 cases of patients with epilepsy, 100 cases were male (54.3%), 84 cases were female (45.7%), 35 cases (19.0%) had sleep disorders, 89 cases (48.4%) with poor quality of life, 23 cases (12.5%) with anxiety, 47 cases (25.5%) with depression, 59 cases (32.1%) had daytime sleepiness, and 30 cases (16.3%) with OSAS. there were statistically significant differences in age, history of hypertension, seizure frequency, quality of life , anxiety and depression in epilepsy patients with sleep disorder compared those without sleep disorder (P<0.05). The seizure frequency, quality of life, anxiety and depression were analyzed by logistic regression analysis, suggesting that seizure frequency (P=0.011) and depression (P<0.001) are independent risk factors of sleep disorders. Conclusions Epileptic patients with sleep disorder have higher frequency of seizures, poorer quality of life, and are more likely to be associated with anxiety and depression, and the frequency and depression are independent risk factors of sleep disorder in patients with epilepsy.