Sleep in children and adolescents with juvenile idiopathic arthritis: a systematic review and meta-analysis of case-control studies

Abstract Study Objectives Juvenile idiopathic arthritis (JIA) is one of the most common pediatric rheumatic disease. However, sleep alteration associated with this auto-immune disease remain unclear. We aimed in this systematic review and meta-analysis to compare sleep duration, quality, and architecture in JIA subjects with those in their healthy peers. Methods Systematic search performed in PubMed, EMBase, Cochrane, and PsycINFO databases included 19 studies in the qualitative synthesis of which 10 met the inclusion criteria for the meta-analysis. Results Pooled results from subjective methods indicated pronounced sleep disturbances and complaints in youth with JIA compared with their healthy counterparts. This was further confirmed by Increased difficulty maintaining sleep (wake after sleep onset; SMD: −0.69; CI: −1.29; −0.09, p =0.02) and a tendency to increased difficulty initiating sleep (sleep onset latency; SMD: −0.29; CI: −0.60; 0.03, p =0.07). There were no remarkable differences in sleep duration or sleep architecture between JIA patients and healthy controls. High heterogeneity was found for several outcomes. This could be explained by the different methods used as well as associated sleep disorders, medication and comorbidities. Conclusions Although included studies were methodologically diverse, the summarized results of our review and meta-analysis bring evidence that children with JIA present more fragmented sleep compared to healthy peers. Thereby, the implementation of strategies to manage and improve sleep in this population are needed and might have a beneficial effect on the symptoms and functions of JIA.

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What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00616-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Gianfilippo Caggiari ◽

Giuseppe Rocco Talesa ◽

Giuseppe Toro ◽

Eugenio Jannelli ◽

Gaetano Monteleone ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Sleep Quality ◽

Sleep Disturbances ◽

Meta Analysis ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Low Back

AbstractEnergy spent during daily activities is recuperated by humans through sleep, ensuring optimal performance on the following day. Sleep disturbances are common: a meta-analysis on sleep quality showed that 15–30% of adults report sleep disorders, such as sleep onset latency (SOL), insufficient duration of sleep and frequently waking up at night. Low back pain (LBP) has been identified as one of the main causes of poor sleep quality. Literature findings are discordant on the type of mattress that might prevent onset of back pain, resulting in an improved quality of sleep. We conducted a systematic literature review of articles published until 2019, investigating the association of different mattresses with sleep quality and low back pain. Based on examined studies, mattresses were classified according to the European Committee for Standardization (2000) as: soft, medium-firm, extra-firm or mattresses customized for patients affected by supine decubitus. A total of 39 qualified articles have been included in the current systematic review. Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment.

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Efficacy of Micronized Progesterone for Sleep: A Systematic Review and Meta-analysis of Randomized Controlled Trial Data

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa873 ◽

2020 ◽

Author(s):

Brendan J Nolan ◽

Bonnie Liang ◽

Ada S Cheung

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Effect Size ◽

Meta Analysis ◽

Sleep Onset ◽

Sleep Time ◽

Controlled Trials ◽

Sleep Onset Latency ◽

Randomized Controlled ◽

Micronized Progesterone

Abstract Context Preclinical data has shown progesterone metabolites improve sleep parameters through positive allosteric modulation of the γ-aminobutyric acid type A receptor. We undertook a systematic review and meta-analysis of randomized controlled trials to assess micronized progesterone treatment on sleep outcomes. Evidence Acquisition Using preferred reporting items for systematic review and meta-analysis guidelines, we searched MEDLINE, Embase, PsycInfo, and the Cochrane Central Register of Controlled Trials for randomized controlled trials of micronized progesterone treatment on sleep outcomes up to March 31, 2020. This study is registered with the International Prospective Register of Systematic Reviews, number CRD42020165981. A random effects model was used for quantitative analysis. Evidence Synthesis Our search strategy retrieved 9 randomized controlled trials comprising 388 participants. One additional unpublished trial was found. Eight trials enrolled postmenopausal women. Compared with placebo, micronized progesterone improved various sleep parameters as measured by polysomnography, including total sleep time and sleep onset latency, though studies were inconsistent. Meta-analysis of 4 trials favored micronized progesterone for sleep onset latency (effect size, 7.10; confidence interval [CI] 1.30, 12.91) but not total sleep time (effect size, 20.72; CI -0.16, 41.59) or sleep efficiency (effect size, 1.31; CI -2.09, 4.70). Self-reported sleep outcomes improved in most trials. Concomitant estradiol administration and improvement in vasomotor symptoms limit conclusions in some studies. Conclusions Micronized progesterone improves various sleep outcomes in randomized controlled trials, predominantly in studies enrolling postmenopausal women. Further research could evaluate the efficacy of micronized progesterone monotherapy using polysomnography or validated questionnaires in larger cohorts.

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Behavioral interventions for sleep disturbances in children with neurological and neurodevelopmental disorders: a systematic review and meta-analysis of randomized controlled trials

SLEEP ◽

10.1093/sleep/zsaa040 ◽

2020 ◽

Vol 43 (9) ◽

Author(s):

Natalie L Phillips ◽

Teleri Moore ◽

Arthur Teng ◽

Naomi Brookes ◽

Tonya M Palermo ◽

...

Keyword(s):

Systematic Review ◽

Neurodevelopmental Disorders ◽

Functional Outcomes ◽

Behavioral Interventions ◽

Sleep Disturbances ◽

Meta Analysis ◽

Sleep Onset ◽

Controlled Trials ◽

Randomized Controlled

Abstract Study Objectives Sleep disturbances are common and associated with negative functional and health consequences in children with neurological and neurodevelopmental disorders (NNDDs) and represent an important potential target for behavioral interventions. This systematic review examined the efficacy of behavioral sleep interventions (BSIs) for children with NNDDs and comorbid sleep disturbances. Methods A systematic search of MEDLINE, EMBASE, PsychINFO, and CENTRAL was conducted in April 2019. Randomized controlled trials (RCTs) of BSI for children with NNDDS were included. Meta-analysis and GRADE quality ratings were performed on sleep and secondary functional outcomes (cognition, academics, and behavior). Results Nine RCTs were identified (n = 690; Mage = 8.39 ± 2.64years; 71.11% male). The quality of the evidence was predominantly rated as moderate. Posttreatment improvements in sleep were found on self-reported sleep disturbances (total sleep disturbance [standardized mean difference, i.e. SMD = 0.89], night wakings [SMD = 0.52], bedtime resistance [SMD = 0.53], parasomnias [SMD = 0.34], sleep anxiety [SMD = 0.50]) and self-reported sleep patterns (sleep duration [SMD = 0.30], sleep onset duration [SMD = 0.75]) and (2) objectively measured actigraphic sleep patterns (total sleep time [MD = 18.09 min; SMD = 0.32], sleep onset latency [MD = 11.96 min; SMD = 0.41]). Improvements in sleep (self-reported, not actigraphy) were maintained at follow-up, but few studies conducted follow-up assessments resulting in low-quality evidence. Reduction in total behavioral problems (SMD = 0.48) posttreatment and attention/hyperactivity (SMD = 0.28) at follow-up was found. Changes in cognition and academic skills were not examined in any studies. Conclusions BSIs improve sleep, at least in the short term, in children with NNDDs. Benefits may extend to functional improvements in behavior. More rigorous RCTs involving placebo controls, blinded outcome assessment, longer follow-up durations, and assessment of functional outcomes are required.

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0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment

SLEEP ◽

10.1093/sleep/zsaa056.006 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A3-A3

Author(s):

E Mann ◽

C Sagong ◽

A Cuamatzi Castelan ◽

M Singh ◽

T Roth ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Disturbances ◽

Night Shift ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Shift Workers ◽

Circadian Misalignment ◽

Daytime Sleep ◽

Falling Asleep ◽

Dim Light

Abstract Introduction Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers. Methods Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables. Results CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02). Conclusion These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep. Support Support for this study was provided to PC by the NHLBI (K23HL138166)

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Evidence for human-to-human transmission of hantavirus: a systematic review

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab461 ◽

2021 ◽

Author(s):

Joao Toledo ◽

Michelle M Haby ◽

Ludovic Reveiz ◽

Leopoldo Sosa Leon ◽

Rodrigo Angerami ◽

...

Keyword(s):

Systematic Review ◽

Comparative Studies ◽

Data Extraction ◽

Meta Analysis ◽

Hantavirus Infection ◽

Inclusion Criteria ◽

Case Control Studies ◽

Level Of Evidence ◽

Interpersonal Contact ◽

Andes Virus

Abstract Background Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain – Andes virus (ANDV) – can cause human-to-human transmission of the disease. The aim of this systematic review was to assess the evidence for human-to-human transmission of hantavirus. Methods We searched PubMed (inception to 28 February 2021), Cochrane CENTRAL, Embase, LILACS and SciELO (inception to 3 July 2020) and other sources. We included studies that assessed whether interpersonal contact with a person with laboratory-confirmed hantavirus infection led to human-to-human transmission. Two reviewers conducted screening, selection, data extraction, and risk of bias (RoB) assessment. Results Twenty-two studies met the inclusion criteria. Meta-analysis was not possible due to heterogeneity. With the exception of one prospective cohort study of ANDV in Chile with serious RoB, evidence from comparative studies (strongest level of evidence available) does not support human-to-human transmission of hantavirus infection. Non-comparative studies with a critical RoB suggest that human-to-human transmission of ANDV may be possible. Conclusions The balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations.

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Survival of Women Previously Diagnosed of Melanoma with Subsequent Pregnancy: A Systematic Review and Meta-Analysis and a Single-Center Experience

Journal of Clinical Medicine ◽

10.3390/jcm11010083 ◽

2021 ◽

Vol 11 (1) ◽

pp. 83

Author(s):

Nieves Martínez-Campayo ◽

Sabela Paradela de la Morena ◽

Sonia Pértega-Díaz ◽

Luisa Iglesias Pena ◽

Pia Vihinen ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Heterogeneous Data ◽

Subsequent Pregnancy ◽

Inclusion Criteria ◽

Case Control Studies ◽

Childbearing Age ◽

Single Center Experience ◽

Melanoma Diagnosis ◽

Observational Cohort

Melanoma incidence has increased over the last few decades. How the prognosis of a previously diagnosed melanoma may be affected by a woman’s subsequent pregnancy has been debated in the literature since the 1950s, and the outcomes are essential to women who are melanoma survivors in their childbearing years. The main objective of this systematic review is to improve the understanding of whether the course of melanoma in a woman may be altered by a subsequent pregnancy and to help clinicians’ diagnosis. Eligible studies for the systematic review were clinical trials, observational cohort studies and case-control studies that compared prognosis outcomes for non-pregnant patients with melanoma, or pregnant before melanoma diagnosis, versus pregnant patients after a diagnosis of melanoma. The search strategy yielded 1101 articles, of which 4 met the inclusion criteria for the systematic review. All the studies were retrospective non-randomised cohorts with patients with melanomas diagnosed before pregnancy. According to our findings, a subsequent pregnancy was not a significant influence on the outcome of a previous melanoma. However, given the small number of identified studies and the heterogeneous data included, it is recommended to approach these patients with caution, and counselling should be given by known prognostic factors. We also reviewed the medical records of 84 patients of childbearing age (35.8 ± 6.3 years, range 21–45 years) who were diagnosed with cutaneous invasive melanoma in our hospital between 2008 and 2018 (N = 724). Of these, 11 (13.1%) had a pregnancy after melanoma diagnosis (age at pregnancy: 35.6 ± 6.3 years). No statistical differences in outcome were detected.

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Olfactory and Gustatory Symptoms of Coronavirus Disease 2019: A Systematic Review and Meta-analysis

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45714.14565 ◽

2021 ◽

Author(s):

Sivakumar Pradeep ◽

Kalpa Pandya ◽

Vinayak Kamath ◽

Sivakumar Vidhyadharan ◽

Naveen Hedne

Keyword(s):

Systematic Review ◽

Severe Acute Respiratory Syndrome ◽

Meta Analysis ◽

Screening Tools ◽

Case Control Studies ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Search Terms ◽

Pooled Prevalence ◽

Quantitative Synthesis

Introduction: There is increasing anecdotal evidence that olfactory and gustatory dysfunction may be associated with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Aim: The aim of this systematic review and meta-analysis was to find the association of olfactory and gustatory symptoms with Coronavirus Disease-19 (COVID-19) and estimate their pooled prevalence. Materials and Methods: PubMed, Embase, EBSCO and Cochrane databases were searched for cross-sectional, cohort and case-control studies evaluating olfactory and gustatory symptoms in patients with COVID-19. The search terms included COVID-19, severe acute respiratory syndrome coronavirus-2, coronavirus, olfaction disorders, anosmia, hyposmia, dysgeusia and ageusia. Random effects model was used to calculate a pooled Odds Ratio (OR) and pooled prevalence. Results: Total 14 studies were included in qualitative synthesis and 13 studies were incorporated in quantitative synthesis, involving 3,125 patients. The pooled OR was 15.59 reflecting that smell and taste disorders were strongly associated with COVID-19. The pooled prevalence of olfactory and gustatory dysfunction was 56% and 44%, respectively. Conclusion: It can be concluded that there is a significant association between olfactory and gustatory symptoms and COVID-19. Majority of the studies support the use of these symptoms as screening tools for COVID-19.

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Use of virtual consultations in an orthopaedic rehabilitation setting: how do changes in the work of being a patient influence patient preferences? A systematic review and qualitative synthesis

BMJ Open ◽

10.1136/bmjopen-2019-036197 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036197 ◽

Cited By ~ 1

Author(s):

Anthony W Gilbert ◽

Jeremy Jones ◽

Anju Jaggi ◽

Carl R May

Keyword(s):

Systematic Review ◽

Communication Technology ◽

Patient Preferences ◽

Meta Analysis ◽

Research Question ◽

Final Analysis ◽

Successful Implementation ◽

Inclusion Criteria ◽

Qualitative Synthesis ◽

Technology Changes

ObjectivesTo systematically review qualitative studies reporting the use of virtual consultations within an orthopaedic rehabilitation setting and to understand how its use changes the work required of patients.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, we conducted a systematic review of papers to answer the research question ‘How do changes in the work of being a patient when using communication technology influence patient preferences?’ Electronic databases were searched for studies meeting the inclusion criteria in April 2020.ResultsThe search strategy identified 2057 research articles from the database search. A review of titles and abstracts using the inclusion criteria yielded 21 articles for full-text review. Nine studies were included in the final analysis. Six studies explored real-time video conferencing and three explored telephone consultations. The use of communication technology changes the work required of patients. Such changes will impact on expectations for care, resources required of patients, the environment of receiving care and patient–clinician interactions. This adjustment of the work required of patients who access orthopaedic rehabilitation using communication technology will impact on their experience of receiving care. It is proposed that changes in the work of being a patient will influence preferences for or against the use of communication technology consultations for orthopaedic rehabilitation.ConclusionWe found that the use of communication technology changes the work of being a patient. The change in work required of patients can be both burdensome (it makes it harder for patients to access their care) and beneficial (it makes it easier for patients to access their care). This change will likely to influence preferences. Keeping the concept of patient work at the heart of pathway redesign is likely to be a key consideration to ensure successful implementation.PROSPERO registration numberCRD42018100896.

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