Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Duchenne muscular dystrophy (DMD) is a neuromuscular disorder that leads to chronic respiratory insufficiency and failure. Use of home noninvasive ventilation (NIV) has been linked to improved outcomes including reduced mortality. Despite the importance of NIV, factors promoting optimal NIV usage and determinants of nonadherence have not been rigorously examined. Moreover, given that respiratory issues in DMD span between childhood and adulthood, examination across a broad age group is needed. The objectives of this study were to (1) evaluate NIV usage across a broad spectrum of patients with DMD, including both children and adults, and (2) identify biological and socioeconomic determinants of NIV usage and NIV nonadherence. ⋯ Hurvitz MS, Bhattacharjee R, Lesser DJ, Skalsky AJ, Orr JE. Determinants of usage and nonadherence to noninvasive ventilation in children and adults with Duchenne muscular dystrophy. J Clin Sleep Med. 2021;17(10):1973-1980.
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Insomnia is a diagnosis with broad health and economic implications that has been increasingly recognized in military service members. This trend was concurrent with an increase in traumatic wartime injuries. Accordingly, we sought to determine longitudinal predictors of persistent insomnia in combat veterans who sustained traumatic injuries. ⋯ Haynes ZA, Collen JF, Poltavskiy EA, et al. Risk factors of persistent insomnia among survivors of traumatic injury: a retrospective cohort study. J Clin Sleep Med. 2021;17(9):1831-1840.
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Association of obstructive sleep apnea severity with the composition of the upper airway microbiome.
Although the airway mucosal system plays a pivotal role in the pathogenesis of obstructive sleep apnea (OSA), the underlying disease mechanism remains unclear. The microbiome greatly impacts human health and disease, particularly in the mucosa, where it can have direct interactions. In this study, we aimed to analyze the microbiome composition in the upper airway mucosa of individuals with and without OSA to identify potential disease severity-related microbial signatures. ⋯ The upper airway microbiome of older patients with mild-moderate OSA exhibited minor differences in composition compared with that of individuals without OSA, possibly owing to environmental changes in the upper airway mucosa resulting from recurrent airway obstruction and intermittent hypoxia in patients with OSA.
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To investigate gender distribution of US sleep professionals who received major recognition awards over a 40-year period from the 2 national sleep societies: the American Academy of Sleep Medicine and the Sleep Research Society. ⋯ Naime S, Karroum EG. Women are underrepresented in major US sleep societies recognition awards. J Clin Sleep Med. 2021;17(8):1665-1673.
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To examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization (HCU) among a nationally representative and multimorbid sample of older adults with pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea (OSA) in the US. ⋯ In this nationally representative sample of older multimorbid Medicare beneficiaries and relative to low adherers, high adherers demonstrated reduced inpatient utilization.