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  • 1
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    Isolated dream‐enactment behaviours as a prodromal hallmark of rapid eye movement sleep behaviour disorder
    Wiley ; 2023
    In:  Journal of Sleep Research Vol. 32, No. 3 ( 2023-06)
    Details
    In: Journal of Sleep Research, Wiley, Vol. 32, No. 3 ( 2023-06)
    Abstract: Recurrent dream‐enactment behaviours (DEB) and rapid eye movement (REM) sleep without atonia (RSWA) are two diagnostic hallmarks of REM sleep behaviour disorder (RBD), a specific prodrome of α‐synucleinopathy. Whilst isolated RSWA (without DEB) was suggested as a prodrome of RBD, the implication of ‘isolated’ recurrent DEB remains under‐investigated. In this cross‐sectional study, we sought to investigate neurodegenerative markers amongst the first‐degree relatives (FDRs, aged 〉 40 years) of patients with RBD who underwent clinical assessment for DEB, neurodegenerative markers, and video‐polysomnography assessment. Isolated recurrent DEB was defined as: (i) three or more episodes of DEB, (ii) had a DEB episode in the past 1 year, and (iii) subthreshold RSWA. We identified 29 FDRs (mean [SD] age 53.4 [8.3]  years, 55.2% male) with isolated recurrent DEB and 98 age and sex‐matched FDRs as controls. Isolated DEB was associated with nightmare (27.6% versus 11.2%, p  = 0.02), and the DEB group had a higher rate of current smoking (27.6% versus 3.1%, p  = 0.006), type 2 diabetes mellitus (24.1% versus 10.2%, p  = 0.003), anxiety disorder (24.1% versus 11.2%, p  = 0.02), and constipation (hard lump of stool, 31.0% versus 7.1%, p   〈  0.001) than the control group. The present findings revealed that family relatives of patients with RBD with isolated recurrent DEB have increased risk of RBD and neurodegenerative features, which adds to the emerging data that isolated DEB is a prodromal feature of RBD and α‐synucleinopathy neurodegeneration.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.v32.3
    DOI: 10.1111/jsr.13791
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2007459-1
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  • 2
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    Rest‐Activity Pattern Alterations in Idiopathic REM Sleep Behavior Disorder
    Wiley ; 2020
    In:  Annals of Neurology Vol. 88, No. 4 ( 2020-10), p. 817-829
    Details
    In: Annals of Neurology, Wiley, Vol. 88, No. 4 ( 2020-10), p. 817-829
    Abstract: The purpose of this study was to investigate the differences in actigraphy‐measured rest‐activity patterns (eg, sleep–wake cycle, circadian rest‐activity rhythm, and physical activity) across different stages of α‐synucleinopathy. Methods We compared alterations in 7‐day actigraphy‐measured rest‐activity patterns among patients with clinically diagnosed α‐synucleinopathies (n = 44), and their age‐, sex‐, and body mass index (BMI)‐matched patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, n = 88), and non‐rapid eye movement (REM) sleep behavior disorder (RBD) controls (n = 44) in a case–control study (study 1) and between convertors (n = 22) and their age‐, sex‐, BMI‐, iRBD‐duration, and follow‐up duration‐matched non‐convertors (n = 66) in a prospective nested case–control study (study 2). Results In study 1, there were significant increases (all p values were adjusted by false discovery rate 〈  0.01) in probable napping behaviors (percentage, duration, and episodes), activity fragmentation (estimated by k AR ), and physical inactivity during active periods across controls, and iRBD, to clinically diagnosed α‐synucleinopathies. In study 2, higher levels (all p values were adjusted by false discovery rate 〈  0.05) of baseline objective probable napping, activity fragmentation, and physical inactivity during active periods were associated with the conversion of patients with iRBD into clinically diagnosed α‐synucleinopathies at 2 years of follow‐up with medium to large effect sizes (Cohen's d: 0.56 to 0.80). These findings were further supported by functional linear modeling analyses. Interpretation Rest‐activity pattern alterations, mainly objective probable napping behaviors, activity fragmentation, and physical inactivity during active period, emerge as early as at the stage of iRBD, which serves as early and robust prodromal markers of the conversion of iRBD into clinically diagnosed α‐synucleinopathies. ANN NEUROL 2020;88:817–829
    Type of Medium: Online Resource
    ISSN: 0364-5134 , 1531-8249
    URL: Issue
    URL: Article
    DOI: 10.1002/ana.v88.4
    DOI: 10.1002/ana.25853
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2037912-2
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  • 3
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    The impact of sleep-corrected social jetlag on mental health, behavioral problems, and daytime sleepiness in adolescents
    Elsevier BV ; 2022
    In:  Sleep Medicine Vol. 100 ( 2022-12), p. 494-500
    Details
    In: Sleep Medicine, Elsevier BV, Vol. 100 ( 2022-12), p. 494-500
    Type of Medium: Online Resource
    ISSN: 1389-9457
    URL: Article
    DOI: 10.1016/j.sleep.2022.09.027
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2041737-8
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  • 4
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    Prevalence and correlates of REM sleep behaviour disorder in patients with major depressive disorder: a two-phase study
    BMJ ; 2022
    In:  Journal of Neurology, Neurosurgery & Psychiatry Vol. 93, No. 9 ( 2022-09), p. 1010-1017
    Details
    In: Journal of Neurology, Neurosurgery & Psychiatry, BMJ, Vol. 93, No. 9 ( 2022-09), p. 1010-1017
    Abstract: To investigate the prevalence and clinical correlates of video polysomnography (vPSG)-confirmed rapid eye movement sleep behaviour disorder (RBD) in patients with major depressive disorder (MDD). Methods This is a clinic-based two-phase epidemiological study. In phase 1, patients with MDD were screened by a validated questionnaire, RBD Questionnaire-Hong Kong (RBDQ-HK). In phase 2, a subsample of both the screen-positive (RBDQ-HK 〉 20) and screen–negative patients with MDD underwent further clinical and sleep assessment (vPSG) to confirm the diagnosis of RBD (MDD+RBD). Poststratification weighting method was used to estimate the prevalence of MDD+RBD. The total likelihood ratio and the probability of prodromal Parkinson’s disease (PD) were calculated from prodromal markers and risk factors, as per the Movement Disorder Society research criteria. Results A total of 455 patients with MDD were screened (median age (IQR)=52.66 (15.35) years, 77.58% woman, 43.74% positive). Eighty-one patients underwent vPSG and 12 of them were confirmed MDD+RBD. The prevalence of MDD+RBD was estimated to be 8.77% (95% CI: 4.33% to 16.93%), with possibly male predominance. MDD+RBD were associated with colour vision and olfaction deficit and a higher probability for prodromal PD. Conclusions Almost 9% of patients with MDD in the psychiatric outpatient clinic has vPSG-confirmed RBD. Comorbid MDD+RBD may represent a subtype of MDD with underlying α-synucleinopathy neurodegeneration. Systematic screening of RBD symptoms and necessity of vPSG confirmation should be highlighted for capturing this MDD subtype with a view to enhance personalised treatment and future neuroprotection to prevent neurodegeneration.
    Type of Medium: Online Resource
    ISSN: 0022-3050 , 1468-330X
    URL: Article
    DOI: 10.1136/jnnp-2021-327460
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1480429-3
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  • 5
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    Residual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow‐up Study
    Wiley ; 2020
    In:  Movement Disorders Vol. 35, No. 11 ( 2020-11), p. 2077-2085
    Details
    In: Movement Disorders, Wiley, Vol. 35, No. 11 ( 2020-11), p. 2077-2085
    Abstract: The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injurious symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear. Objective The objective of this study was to determine the rate and correlates of RIS and its association with the risk of neurodegenerative diseases in patients with iRBD. Methods This was a retrospective cohort study. RIS was defined by the RBD Questionnaire–Hong Kong (RBDQ‐HK) as the presence of residual sleep‐related injuries or potential injurious behaviors for at least once a month after at least 1 year of treatment. Results A total of 15 out of 133 (11.3%) patients with iRBD (age at diagnosis = 66.5 ± 7.3 years, 77.4% male) had RIS after 2.7 years of treatment. Patients with RIS were younger at both onset and polysomnography‐confirmed diagnosis of iRBD (years, mean ± standard deviation, 56.3 ± 6.9 vs. 61.8 ± 7.6, P = 0.01; 61.2 ± 4.2 vs. 67.2 ± 7.4, P   〈  0.001, respectively), had more severe behavioral symptoms at diagnosis (both RBDQ‐HK total score and behavioral subscore, P = 0.01), and used a higher maximum dose of clonazepam (mg; median [interquartile range], 1.5 [1.0] vs. 1.0 [1.0], P = 0.01). RIS was probably associated with a higher risk of developing dementia with Lewy bodies (adjusted hazard ratio [95% confidence interval], 5.47 [1.71–17.46] , adjusted for onset age of RBD), but not Parkinsons's disease in the follow‐up. Conclusion RIS is not uncommon in patients with iRBD despite long‐term medication treatment. An earlier onset and more severe clinical profile are associated with RIS. The prediction of RIS toward dementia with Lewy bodies but not PD suggests that RIS may probably help to identify the specific risk of different subtypes of α‐synucleinopathy. © 2020 International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v35.11
    DOI: 10.1002/mds.28210
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2041249-6
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  • 6
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    School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial
    MDPI AG ; 2023
    In:  Healthcare Vol. 11, No. 13 ( 2023-06-26), p. 1853-
    Details
    In: Healthcare, MDPI AG, Vol. 11, No. 13 ( 2023-06-26), p. 1853-
    Abstract: Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups. The sleep education group included a town hall seminar, small class teaching, leaflets, brochures, and a painting competition for children. Parents and teachers were invited to participate in a one-off sleep health workshop. Parental/caregiver-reported questionnaires were collected at baseline and 1-month follow-up. A total of 3769 children were included in the final analysis. There were no significant improvements observed in the sleep-wake patterns, daytime functioning, and insomnia symptoms between the two groups at follow-up, whereas the intervention group had significantly improved parental sleep knowledge than the controls (paternal: adjusted mean difference: 0.95 [95% confidence interval (CI): 0.18 to 1.71]; maternal: adjusted mean difference: 0.87 [95% CI: 0.17 to 1.57] ). In addition, children receiving the intervention had a lower persistence rate of excessive beverage intake (adjusted odds ratio: 0.49 [95% CI: 0.33 to 0.73]), and experienced greater reductions in conduct problems (adjusted mean difference: 0.12 [95% CI: 0.01 to 0.24] ) compared with the controls at 1-month of follow-up. Moreover, a marginally significant reduction for emotional problems in the intervention group was also observed (adjusted mean difference: 0.16 [95% CI: −0.00 to 0.32]). These findings demonstrated that school-based sleep education was effective in enhancing parental sleep knowledge and improving behavioral outcomes in children, but not sufficient in altering the children’s sleep-wake patterns and sleep problems.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare11131853
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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  • 7
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    A Prevention Program for Insomnia in At-risk Adolescents: A Randomized Controlled Study
    American Academy of Pediatrics (AAP) ; 2021
    In:  Pediatrics Vol. 147, No. 3 ( 2021-03-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 147, No. 3 ( 2021-03-01)
    Abstract: To prevent the future development of insomnia in at-risk adolescents. METHODS: A randomized controlled trial comparing 4 weekly insomnia prevention program with a nonactive control group. Subjects were assessed at baseline, postintervention, and 6 and 12 months after intervention. Assessors were blinded to the randomization. Analyses were conducted on the basis of the intention-to-treat principles. RESULTS: A total of 242 adolescents with family history of insomnia and subthreshold insomnia symptoms were randomly assigned to an intervention group (n = 121; mean age = 14.7 ± 1.8; female: 51.2%) or control group (n = 121; mean age = 15.0 ± 1.7; female: 62.0%). There was a lower incidence rate of insomnia disorder (both acute and chronic) in the intervention group compared with the control group (5.8% vs 20.7%; P = .002; number needed to treat = 6.7; hazard ratio = 0.29; 95% confidence interval: 0.12–0.66; P = .003) over the 12-month follow-up. The intervention group had decreased insomnia symptoms (P = .03) and reduced vulnerability to stress-related insomnia (P = .03) at postintervention and throughout the 12-month follow-up. Decreased daytime sleepiness (P = .04), better sleep hygiene practices (P = .02), and increased total sleep time (P = .05) were observed at postintervention. The intervention group also reported fewer depressive symptoms at 12-month follow-up (P = .02) compared with the control group. CONCLUSIONS: A brief cognitive behavioral program is effective in preventing the onset of insomnia and improving the vulnerability factors and functioning outcomes.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2020-006833
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2021
    detail.hit.zdb_id: 1477004-0
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  • 8
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    625 The association between circadian rhythms and psychosocial functioning in children with attention deficit hyperactivity disorder
    Oxford University Press (OUP) ; 2021
    In:  Sleep Vol. 44, No. Supplement_2 ( 2021-05-03), p. A245-A245
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2021-05-03), p. A245-A245
    Abstract: Circadian rhythm disturbances, including delayed circadian rhythm and increased motor activity, are commonly seen in attention-deficit hyperactivity disorder (ADHD). Previous research suggested a link between circadian rhythm disturbances and poor psychosocial functioning in children, but such a relationship has not been examined in children with ADHD. This study aimed at examining the association between circadian-related parameters and psychosocial functioning in children with ADHD. Methods Seventy-nine children with ADHD were recruited into this study (age range: 6–12 years, 75.9% male). They were assessed by parent-report questionnaires on sleep problems (Children’s Sleep Habits Questionnaire, CSHQ), ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale, SWAN), and psychosocial functioning (Strengths and Difficulties Questionnaire, SDQ). Actigraphic data collected for seven consecutive days were analyzed using parametric and nonparametric methods. The relationship between circadian parameters and psychosocial functioning was analyzed using multiple regression while controlling for age, sex, ADHD medication, total sleep time, and CSHQ total score. Results Later acrophase was significantly associated with higher scores on SDQ emotional problems (St. β = 0.30, p = 0.03) and SWAN inattention subscale (St. β = 0.27, p = 0.043). Lower relative amplitude was associated with higher scores on SDQ hyperactivity symptoms (St. β = -0.29, p = 0.045) and SDQ total difficulties (St. β = -0.31, p = 0.036). Higher levels of mean activity level during the least active 5-h period (L5) were related to higher scores on SDQ peer problems (St. β = 0.38, p = 0.021), SDQ internalizing problems (St. β = 0.38, p = 0.020) and SDQ total difficulties (St. β = 0.33, p = 0.036). Later onset of L5 was associated with increased SDQ emotional problems (St. β = 0.26, p = 0.046). Conclusion Circadian rest-activity rhythm disturbances (delayed phase, blunted rest-activity rhythms, higher level of nocturnal activity, and later onset of nocturnal rest) were associated with poor psychosocial functioning in children with ADHD. Further longitudinal studies are needed to examine the effects of circadian disruption on psychosocial functioning in children with ADHD. Support (if any) This work was supported by the Health and Medical Research Fund (Project No.: 30160604).
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsab072.623
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2056761-3
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  • 9
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    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
    Springer Science and Business Media LLC ; 2021
    In:  Intensive Care Medicine Vol. 47, No. 2 ( 2021-02), p. 160-169
    Details
    In: Intensive Care Medicine, Springer Science and Business Media LLC, Vol. 47, No. 2 ( 2021-02), p. 160-169
    Type of Medium: Online Resource
    ISSN: 0342-4642 , 1432-1238
    URL: Article
    DOI: 10.1007/s00134-020-06234-9
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1459201-0
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  • 10
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    624 The association of circadian rhythms with cognitive functioning in children with attention-deficit hyperactivity disorder
    Oxford University Press (OUP) ; 2021
    In:  Sleep Vol. 44, No. Supplement_2 ( 2021-05-03), p. A245-A245
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2021-05-03), p. A245-A245
    Abstract: Disrupted circadian rhythms is associated with impaired cognitive function. Although circadian rhythm disturbances are commonly seen in individuals with attention-deficit hyperactivity disorder (ADHD), whether their cognitive functioning is thus affected remains unclear. This study aimed to examine the associations of circadian-related parameters with different cognitive abilities in children with ADHD. Methods Fifty-seven children with ADHD were recruited into this study (age range: 6–12 years, 66.7% male). They were assessed by parent-report questionnaires on sleep problems (Children’s Sleep Habits Questionnaire, CSHQ), and ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale). Actigraphic data collected for seven consecutive days were analyzed using parametric and nonparametric methods. Cognitive functioning was assessed with Continuous Performance Test (CPT) for sustained attention, Letter-digit test for processing speed, Digit Span test and N-back task for working memory, Tower of London test for planning skills and Bergs Card Sorting Test for set-shifting ability. The relationship between circadian parameters and cognitive performance was analyzed using multiple regression while controlling for age, sex, ADHD medication, the day of cognitive assessment (school days vs non-school days), total sleep time, and CSHQ total score. Results Increased activity during the most active 10-h period of the day (St. β = 0.39, p = 0.012) was related to more omission errors on CPT, and later onset of the least active 5-h period of the day (St. β = 0.44, p = 0.004) was associated with longer correct reaction time on CPT. Lower relative amplitude was associated with poorer performance on Digit Span (St. β = 0.33, p = 0.042). No significant associations were found between the circadian-related parameters and the performance on other tasks measuring processing speed and executive functions. Conclusion Circadian rest-activity rhythms (blunted rest-activity rhythms, higher daytime activity, and later onset of nocturnal rest) were associated with cognitive functioning in ADHD children. Future longitudinal studies are needed to explore the long-term impact of circadian rhythm disturbances and the effects of circadian-focused intervention on cognitive functioning in ADHD children. Support (if any) This work was supported by the Health and Medical Research Fund (Project No.: 30160604).
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsab072.622
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2056761-3
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