Poor sleep quality is negatively associated with low cognitive performance in general population independent of self-reported sleep disordered breathing

Background Sleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB). Methods In this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB. Results Finally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P < 0.001). Poor sleepers revealed 1.26 (95%CI: 1.16,1.36), 1.26 (1.08,1.46) and 1.25 (1.14,1.37) fold odds for low cognitive performance in general population and in subjects with and without self-reported SDB respectively. Stratified by age and SDB, the association was observed in young and middle-aged group without SDB (OR = 1.44, 95%CI: 1.30,1.59) and in the elderly group with SDB (OR = 1.30, 95%CI: 1.07,1.58). Conclusions Sleep quality is in a negative association with cognitive performance in general population independent of SDB, implying improvement of sleep disturbances is a potential objective of intervention strategies for cognitive protection at population level.

Sleep Disordered Breathing, Obesity and Atrial Fibrillation: A Mendelian Randomisation Study

It remains unclear whether the association between obstructive sleep apnoea (OSA), a form of sleep-disordered breathing (SDB), and atrial fibrillation (AF) is causal or mediated by shared co-morbidities such as obesity. Existing observational studies are conflicting and limited by confounding and reverse causality. We performed Mendelian randomisation (MR) to investigate the causal relationships between SDB, body mass index (BMI) and AF. Single-nucleotide polymorphisms associated with SDB (n = 29) and BMI (n = 453) were selected as instrumental variables to investigate the effects of SDB and BMI on AF, using genetic association data on 55,114 AF cases and 482,295 controls. Primary analysis was conducted using inverse-variance weighted MR. Higher genetically predicted SDB and BMI were associated with increased risk of AF (OR per log OR increase in snoring liability 2.09 (95% CI 1.10–3.98), p = 0.03; OR per 1-SD increase in BMI 1.33 (95% CI 1.24–1.42), p < 0.001). The association between SDB and AF was not observed in sensitivity analyses, whilst associations between BMI and AF remained consistent. Similarly, in multivariable MR, SDB was not associated with AF after adjusting for BMI (OR 0.68 (95% CI 0.42–1.10), p = 0.12). Higher BMI remained associated with increased risk of AF after adjusting for OSA (OR 1.40 (95% CI 1.30–1.51), p < 0.001). Elevated BMI appears causal for AF, independent of SDB. Our data suggest that the association between SDB, in general, and AF is attributable to mediation or confounding from obesity, though we cannot exclude that more severe SDB phenotypes (i.e., OSA) are causal for AF.

Validation Study of a Contactless Monitoring Device for Vital Signs During Sleep and Sleep Architecture in Adults With Sleep-Disordered Breathing

Background and Objective Few clinical studies have investigated the accuracy of non-contact monitoring devices for vital signs during sleep and sleep architecture in adults with sleep-disordered breathing (SDB). The purpose of this study was to assess the accuracy of a contactless monitoring device for 1) heart rate, respiratory rate, and body temperature during sleep and 2) sleep architecture in adults with SDB.Methods Thirty-five consecutive adults, who visited a tertiary university hospital due to suspected SDB, underwent a complete physical examination and standard (level 1) polysomnography plus body temperature measurement with a contactless monitoring device (HoneyCube System).Results A total of 30 subjects (mean age = 46.43 ± 12.9 years; male: female = 22: 8) were finally included, and five subjects were excluded due to inadequate data in this study. The intraclass correlation coefficient values of heart rate, respiratory rate, and body temperature measured using the contactless monitoring device were 0.91 (95% confidence interval [CI]: 0.892, 0.928), 0.937 (95% CI: 0.919, 0.954), and 0.918 (95% CI: 0.895, 0.941), respectively. The mean kappa value for sleep architecture was 0.562 (95% CI: 0.529, 0.596).Conclusions The contactless monitoring device showed good (almost perfect) agreement in terms of heart rate, respiratory rate, and body temperature and moderate agreement in sleep architecture with contact measurements. These results suggest that the HoneyCube System is a good candidate device for sleep monitoring at home and in multiple accommodations.

Prevalence of sleep-disordered breathing related to malocclusion in children

Sleep-disordered breathing is characterized by airway dysfunction that can occur in any age, but most prevalent in children, caused by the occurrence of respiratory effort, snoring or even by apnea during sleep. Therefore, the aim of this study was to survey the prevalence of sleep disorders associated with malocclusion in children aged 3 to 12 years in Mineiros, State of Goiás, Brazil. Material and Methods: this is a field research with a sample of 99 children affected by some type of sleep-disordered breathing and malocclusions. Data were collected through a questionnaire about sleep-disordered breathing and a clinical record carried out through intraoral clinical examination. Results: among the 24 children with SDB, 17 had SDB and Malocclusion, which is 70.8% of the children had SDB associated with malocclusion. Of the 75 children without SDB, 11 (14.7%) had malocclusion. Conclusion: No significant differences were found between sleep-disordered breathing and sex-related malocclusions.