Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA). In OSA, the upper airway muscle tone reduces excessively during sleep, allowing structures supported by these muscles to collapse into and block airflow partially or fully. CPAP treatment involves blowing slightly pressurized air through a mask, which fits over the nose and/or mouth, to push against airway structures so they do not collapse into the airway during sleep. Unfortunately, many patients are not compliant with CPAP treatment because of discomfort from the pressure or mask and adverse effects (e.g., aerophagia [air in the stomach]).
When athletes obtain optimal sleep, their mood, fatigue, mental and physical performance, recovery, and cognition improve while their risk of injury decreases. However, incorporating sleep as part of an athlete’s training regimen is often overlooked. Additionally, obtaining sufficient sleep can be difficult as athletes travel to tournaments — especially if it involves traveling across time zones. The change in time disrupts an athlete’s circadian rhythm, which can contribute to sleepiness and fatigue, and negatively impact an athlete’s performance. A recent study by the American Academy of Sleep Medicine (AASM) demonstrated that baseball players’ performance decreased as the season progressed due to frequent travel (i.e., disruptions in the sleep-wake schedule). Improving sleep could potentially improve performance and prevent injury in athletes, and in recent years, scientists have used partial body and whole-body cooling as a way to do this. Some results have been promising.
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The use of wearable sleep technology (i.e., devices worn on the body to measure aspects of sleep such as sleep/wake cycles) is increasing among consumers. Benefits of wearable sleep technology are that it collects information about a person's sleep in their natural environment and can record information over an extended period of time, compared to having a polysomnographic study in which the “first night effect” and having incomplete data in a sleep diary can negatively impact results. However, little guidance exists regarding how to use these devices effectively in clinical and nonclinical settings (e.g., sleep research, consumer market). In addition, scientists have concerns regarding the devices’ validity, accuracy and reliability in measuring various sleep parameters (e.g., sleep stages, sleep/wake cycles).
Aging and neurodegenerative conditions such as Alzheimer’s disease are associated with changes in slow-wave sleep (SWS), slow oscillations (SOs) and spindles, and changes in these sleep features have been associated with impaired memory and cognition. Some recent research indicates that administering noninvasive brain stimulation using transcranial magnetic stimulation and transcranial ultrasound stimulation can enhance SWS, SOs and spindles. These techniques can also improve certain aspects of memory in older adults and in adults with mild cognitive impairment.
On Dec. 31, 2019, the Municipal Health Commission of Wuhan, China, reported a cluster of cases of severe pneumonia of unknown etiology. On Jan. 12, China publicly shared the genetic sequence of the virus that caused the novel pneumonia. On Feb. 11, 2020, the World Health Organization announced the official name for the disease: coronavirus disease 2019, commonly shortened to COVID-19. Shortly thereafter, the International Committee on Taxonomy of Viruses officially named the virus causing COVID-19 as severe acute respiratory syndrome coronavirus (abbreviated SARS-CoV-2).
In 1934, French researcher Henri Roger coined the term parasomnie (in English, parasomnia; from the Greek para meaning “alongside” and Latin somnum meaning “sleep”) for phenomena that occur in the transition from sleep to wake or vice versa. A parasomnia can occur during the transition between nonrapid eye movement (NREM) sleep and wake (i.e., NREM parasomnias such as sleepwalking, sleep terrors, confusional arousal, sleep-related eating disorder) or during the transition between rapid eye movement (REM) sleep and wake (i.e., REM parasomnias such as REM sleep behavior disorder [RBD], recurrent isolated sleep paralysis, nightmare disorder). A parasomnia has the following features: recurrent episodes of incomplete awakening from sleep, an inappropriate or lack of response to intervention or redirection during an episode, limited or no cognition of dream imagery and partial or complete amnesia for the event. In addition, the nocturnal disturbance is not explained by another sleep, psychiatric or medical disorder or medication/substance use. Some people experience REM parasomnias and NREM parasomnias, a condition called parasomnia overlap disorder (POD). A person with POD has a disorder of arousal (e.g., sleepwalking confusional arousal, sleep terror) and rapid eye movement sleep behavior disorder (RBD; which involves vivid, often unpleasant dreams; vocalization during sleep and sudden, often violent, arm and leg movements during REM sleep [i.e., dream-enacting behavior]).
Obstructive sleep apnea (OSA) is the intermittent obstruction of the upper airway during sleep. OSA can result from a nasal obstruction, oropharyngeal obstruction, hypopharyngeal obstruction or obstruction in a combination of these areas. The most common treatment for OSA is continuous positive airway pressure (CPAP) in which lightly pressurized air is blown into the airway by way of a mask that covers the nose or nose and mouth. The force of the air pressure pushes against upper airway tissues to maintain an open airway.
Scientists have noted that children with narcolepsy-cataplexy have an increased prevalence of overweight/obesity.1-3 More recent studies have linked narcolepsy-cataplexy with precocious puberty, and have indicated that the earlier the onset of narcolepsy-cataplexy in a child, the greater the risk of precocious puberty.3 Weight loss can occur after treating narcolepsy-cataplexy in children, but the extent that treating narcolepsy-cataplexy can reverse precocious puberty has not been examined in depth.4 Exactly how narcolepsy and precocious puberty are related is unclear but research studies have produced some interesting findings.
The advent of actigraphy in the 1990s made it possible to indirectly record a person’s sleep-wake cycles based on the person’s activity level, with increased activity indicating wakefulness and decreased activity indicating sleep.1,2 In actigraphy, a device — an actigraph — which is typically worn on the wrist, continually records movement data over a prolonged time — one week or more.3
An overlooked symptom in people with obstructive sleep apnea (OSA) is olfactory dysfunction (i.e., impairment in the sense of smell) such as an inability to detect or distinguish between odors. A finding that the sense of smell improves soon after a person with OSA begins continuous positive airway pressure (CPAP) treatment corroborates a possible link between olfactory dysfunction and OSA.1,2