Perspectives: Investigating the appropriateness of referrals to the Dental Sleep Clinic at Guy’s Hospital
Related Articles
A continuous approach to explain insomnia and subjective-objective sleep discrepancy
Understanding insomnia is crucial for improving its diagnosis and treatment. However, many subjective complaints about insomnia do not align with objective measures of sleep quality, as is the case in subjective-objective sleep discrepancy (SOSD). We address this discrepancy by measuring sleep intrusions and instability in polysomnographic recordings from a large clinical database. Using machine learning, we develop personalized models to infer hypnodensities—a continuous and probabilistic measure of sleep dynamics—, and analyze them via information theory to measure intrusions and instability in a principled way. We find that insomnia with SOSD involves sleep intrusions during intra-sleep wakefulness, while insomnia without SOSD shows wake intrusions during sleep, indicating distinct etiologies. By mapping these metrics to standard sleep features, we provide a continuous and interpretable framework for measuring sleep quality. This approach integrates and values subjective insomnia complaints with physiological data for a more accurate view of sleep quality and its disorders.
Simulating microgravity with 60 days of 6 degree head-down tilt bed rest compromises sleep
Astronauts in space often experience sleep loss. In the AGBRESA (Artificial Gravity Bed Rest) study, we examined 24 participants (mean age ± SD, 33 ± 9 years) during two months of 6o head-down tilt (HDT) bed rest, which is a well-established spaceflight analogue. Polysomnography was recorded during baseline (BDC-9), HDT (nights 1, 8, 30 and 58) and recovery (R, nights 1 and 12). Mixed ANOVAs with post-hoc step-down Bonferroni adjustment indicated that compared to BDC-9, arousals were increased, while sleep duration, N3, and sleep efficiency were all decreased during HDT. Significant quadratic associations between sleep duration and quality with time into HDT did not indicate adaptive improvements during the course of HDT. While sleep duration recovered quickly after the end of bed rest, participants still displayed protracted sleep fragmentation. We conclude that physiological changes caused by exposure to microgravity may contribute to persistent sleep deficits experienced during real space missions.
EEG-based headset sleep wearable devices
The rise of wearable technology has led to EEG-based sleep monitoring devices that use electrodes placed on the forehead, ear, or neck. These devices offer promising applications in clinical and healthy populations by comparing sleep patterns, monitoring intervention responses, and examining the relationship between sleep and lifestyle factors. Despite their potential, challenges like validation against polysomnography, regulatory hurdles, data privacy, and usability hinder clinical adoption. This review explores these devices, their applications, and integration challenges in clinical practice.
The impact of exercise on sleep and sleep disorders
Regular exercise provides a variety of health benefits, including enhanced sleep quality and reduced symptoms of sleep disorders. The complex interaction between sleep and physical activity involves various physiological and psychological processes. Exercise has a positive effect on sleep, but factors such as age, sex, and fitness level, and specific exercise aspects such as intensity, duration, and timing play crucial roles. Understanding these dynamic interactions is essential to gaining insight into how exercise benefits sleep in both healthy individuals and those with sleep disorders. Given the positive effects of moderate exercise on sleep and its potential as a therapeutic option, this narrative review highlights the extensive benefits of exercise on sleep and underscores its important role in overall health and wellness.
Dual orexin receptor antagonists as promising therapeutics for Alzheimer’s disease
We examine the relationship between sleep, glymphatics and Alzheimer’s disease (AD), and recent work questioning glymphatic clearance during sleep. We highlight a need for understanding glymphatic and/or other mechanism of clearance during sleep, and review glymphatic flow measurement methods. Further, we explore dual orexin receptor antagonists (DORAs) potential to mitigate AD sleep disturbances and enhance clearance. Further research could elucidate a linkage between DORAs, improved sleep and reducing AD pathophysiology.
Responses