［Abstract］　Objective　To validate the psychometric characteristics of the Ford Insomnia Response to Stress Test—Chinese version(FIRST-C) in patients with short-term insomnia disorder(STID). Methods　One hundred and seventy-two STID patients were recruited as the STID group from the outpatient clinic of Nanfang Hospital, Southern Medical University between November 2017 and June 2019, and 150 good-sleeper controls(GSC) were selected as the GSC group. The patients were evaluated using FIRST-C, Insomnia Severity Index(ISI), Epworth Sleepiness Scale(ESS), and the Hospital Anxiety and Depression Scale(HADS). Among them, 72 STID patients underwent retesting after 3 months. Results　The total scores of FIRST-C in the STID group were significantly higher than those in the GSC group(P<0.05). Exploratory factor analysis revealed that FIRST-C exhibited a single-factor structure, explaining 51.04% of the variance, with item factor loadings ranging from 0.405 to 0.828. The FIRST-C scores in the STID group showed a moderate possitive correlation with ESS(r_s=0.498, P<0.001), a mild correlation with HADS score(r_s=0.174, P=0.024) and nonsignificant correlation with ISI score(r_s=0.001, P=0.995). The receiver operating characteristic(ROC) curve analysis revealed an optimum cut-off score of 19.5 points for FIRST-C identifying STID and GSC. Reliability analysis indicated that Cronbach′s α coefficient was 0.873 and Spearman-Brown split-half reliability was 0.864, with item and total score correlation coefficient ranging from 0.326 to 0.752. Moreover, there was statistically significant difference between the total scores of FIRST-C at the 3-month retest and those at the initial test(t=5.440, P<0.001). Conclusion　The FIRST-C demonstrates better psychometric characteristics for assessing sleep reactivity in patients with STID.]]> 2024/2/29 0:00:00 PU Yiqi, WU Aike, ZHAO Yuhan, WANG Jiajia, FANG Leqin, LUO Xue, ZHANG Bin 5true ［Abstract］　Objective　To explore the characteristics of sleep and brain function status in elderly patients with obstructive sleep apnea(OSA) complicated with cognitive disorder. Methods　A total of 102 OSA elderly patients who visited the doctors in Guangxi Center for Diagnosis and Treatment of Sleep-Related Respiratory Diseases, the People′s Hospital of Guangxi Zhuang Autonomous Region from February 2022 to October 2023 were recruited. Polysomnography monitoring parameters and brain function status data were collected, and the emotional state of the patients was assessed using Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale(SDS) and Symptom Checklist 90(SCL90), the sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI), and the cognitive impairment degree was assessed using Mini-Mental State Examination Scale(MMSE). The patients were divided into the OSA complicated with cognitive disorder group(with MMSE scores <27 points)(60 cases) and the simple OSA group(with MMSE scores ≥27 points)(42 cases) according to different MMSE scores. The indicators of polysomnography monitoring and the indicators of brain function status were compared between the two groups, and the correlation of MMSE scores with brain function status, polysomnography monitoring indicators and the other scales scores was analyzed. Results　The scores of SDS, SCL90 and PSQI in the OSA complicated with cognitive disorder group were higher than those in the simple OSA group(P<0.05). The MMSE scores(including orientation, memory, recall ability, language ability, attention and calculation ability scores) and the proportion of the patients drinking alcohol in the OSA complicated with cognitive disorder group were significantly lower than those in the simple OSA group(P<0.05). The proportion of N2 phase and sleep time in N2 phase in the OSA complicated with cognitive disorder group were higher than those in the simple OSA group. The apnea hypopnea index(AHI) in the non-rapid eye movement(NREM) phase and the AHI in the total sleep phase in the OSA complicated with cognitive disorder group were lower than those in the simple OSA group, and the differences were significant(P<0.05). The results of Spearman correlation analysis showed that MMSE score was negatively correlated with PLM index of the NREM phase(r_s=-0.243, P=0.014), PLM index of the sleep phase(r_s=-0.237, P=0.016), sleep time of the N2 phase(r_s=-0.243, P=0.014), SDS score(r_s=-0.244, P=0.014) and SAS score(r_s=-0.218, P=0.028). The results of multivariate linear regression analysis showed that the sleep time of the N2 phase was related to decline in cognitive function in the OSA patients(β=-0.019, P=0.017). Conclusion　The anxiety and depression of OSA patients with cognitive disorder are more obvious, and the more severe the anxiety and depression symptoms, the worse the cognitive function of the OSA patients. Depression, anxiety and other emotional problems may accelerate the cognitive decline of the OSA patients, mainly affecting the orientation, language ability, attention and calculation ability of the patients. Sleep fragmentation, chronic sleep deprivation, changes in sleep structure and poor subjective sleep quality may be the main factors leading to cognitive decline in the OSA patients.]]> 2024/2/29 11:51:54 QIN Lixia, ZHONG Qingqing, LU Yian, TANG Binjun, SHI Lingli, PAN Fengjin, LIANG Bifang, CHEN Roujun, ZHAO Mingming 4true ［Abstract］　Objective　To evaluate the application value of smartphone software Sleepok based on snoring analysis technology in adult obstructive sleep apnea(OSA), and to compare its predictive value with the commonly used OSA screening scales for OSA. Methods　One hundred and seventy-three adult subjects who came to the clinic in the Department of Respiratory and Sleep Medicine of Peking University People′s Hospital from July 2022 to April 2023 due to snoring and underwent polysomnography(PSG) were enrolled. Sleepok was used to monitor snoring during PSG monitoring. On the night of monitoring, the subjects completed a paper questionnaire(including basic information and commonly used OSA screening scales) under the guidance of the researchers. Results　There was not significant difference between apnea hypopnea index(AHI) obtained by Sleepok and that obtained by PSG(P>0.05). The results of Pearson regression analysis showed that Sleepok_AHI had a good correlation with PSG_AHI(r=0.80, P<0.001). Bland-Altman consistency test results showed that Sleepok_AHI and PSG_AHI had higher consistency(P=0.118), and their average difference was only -1.82 events/hour. The results of receiver operating characteristic(ROC) curve analysis showed that Sleepok_AHI had better diagnostic value in OSA, moderate to severe OSA and severe OSA, and their cut-off values were 16.6 events/hour, 18.9 events/hour and 28.0 events/hour, respectively. There were significant differences in the scoring values of 6 scales(No-Apnea, GOAL, NoSAS, STOP, STOP-Bang, CNCQ-OSA) and Sleepok_AHI level between the simple snoring group and the OSA group(P<0.05). The results of ROC curve analysis showed that all the 6 scales had application value in diagnosing OSA(P<0.05). Conclusion　The smartphone software Sleepok based on snoring analysis technology can effectively identify respiratory events during sleep, and has better sensitivity and specificity for the patients at high risk of OSA, and can be used for OSA screening.]]> 2024/2/29 11:51:54 1,2, PENG Maohuan², DONG Xiaosong^1,2, ZHAO Rui², SUN Mingze², GU Jiahui², ZHANG Xueli², ZHAO Long², ZHOU Bing², WU Lanbo², WANG Weihan², HAN Fang²]]> CHEN Yuanyuan^1,2, PENG Maohuan², DONG Xiaosong^1,2, ZHAO Rui², SUN Mingze², GU Jiahui², ZHANG Xueli², ZHAO Long², ZHOU Bing², WU Lanbo², WANG Weihan², HAN Fang² 3true ［Abstract］　Objective　To explore the incidence of increased hemoglobin(Hb) in elderly women with obstructive sleep apnea(OSA) and its influencing factors. Methods　The medical record data of 363 elderly female patients diagnosed with OSA in six tertiary hospitals from January 2015 to October 2017 were selected. The patients were divided into simple OSA group(329 cases) and OSA complicated with increased Hb group(34 cases) according to the occurrence of increased Hb. The baseline data, polysomnography monitoring data and history of relevant comorbidities were compared between the two groups. Multivariate linear regression analysis was used to analyze the influencing factors of Hb level in the elderly OSA women. Results　A total of 363 elderly female OSA patients were enrolled, and 34 cases(9.37%) of the elderly female OSA patients had increased Hb. According to the oxygen desaturation index(ODI), there were 9 cases(5.96%) of mild OSA patients, 7 cases(7.07%) of moderate OSA patients, and 18 cases(15.93%) of severe OSA patients had increased Hb. The ODI, time with blood oxygen saturation less than 90%, diastolic blood pressure, red blood cell, white blood cell and eosinophil levels of the OSA complicated with increased Hb group were significantly higher than those in the simple OSA group, and the lowest oxygen saturation(LSpO_r) and the mean oxygen saturation(MSpO_r) in the OSA group were significantly lower than those in the simple OSA group, and the differences were significant(P<0.05). The results of multivariate linear regression analysis showed that age, white blood cell, time with blood oxygen saturation less than 90% and diastolic blood pressure were the influencing factors of Hb level(P<0.05). Conclusion　The incidence rate of increased Hb in the elderly female patients with OSA is elevated, and the incidence rate of increased Hb is significantly high in the severity OSA patients. Higher levels of white blood cell, diastolic blood pressure, time with blood oxygen saturation less than 90% and younger age are the risk factors for increased Hb in this population.]]> 2024/2/29 0:00:00 1,2, ZHAO Libo^1,3, RUI Dong^1,2, LI Kailiang⁴, GAO Yinghui⁵, CHEN Kaibing⁶, GAO Yan⁷, LIN Junling⁸, DING Qidi⁹, LIU Lin²]]> CAI Weimeng^1,2, ZHAO Libo^1,3, RUI Dong^1,2, LI Kailiang⁴, GAO Yinghui⁵, CHEN Kaibing⁶, GAO Yan⁷, LIN Junling⁸, DING Qidi⁹, LIU Lin² 2true ［Abstract］　Objective　To compare the differences in the effects of telehealth cognitive behavioral therapy for insomnia(CBT-I) and face-to-face CBT-I on sleep in insomnia patients, and to study the effectiveness of telehealth CBT-I. Methods　A total of 108-patients with chronic insomnia disorder who were treated in the Outpatient Service of Sleep Medicine of Chongqing Traditional Chinese Medicine Hospital were recruited, and after excluding some patients, 74 cases were ultimately included and analyzed, including 38 patients in the telehealth group and 36 patients in the face-to-face group. The insomnia symptoms and sleep quality were assessed using Insomnia Severity Index(ISI) and Pittsburgh Sleep Quality Index(PSQI). The patients′ anxiety and depression were assessed using Generalized Anxiety Disorder-7(GAD-7) and Patient Health Questionnaire-9(PHQ-9). The patients′ irrational perceptions of sleep were assessed using Dysfunctional Beliefs and Attitudes about Sleep Scale-16(DBAS-16). Glasgow Sleep Effort Scale(GSES) was used to quantify the patients′ sleep effort. The therapeutic effects were compared between the two groups. Results　There were no significant differences in ISI, PSQI, GAD-7, PHQ-9, DBAS-16 and GSES scores between the two groups before and after the intervention(P>0.05). After the intervention, the scores of each questionnaire in the face-to-face group were significantly lower than those before the intervention(P<0.05). Except for those of GAD-7, the scores of each questionnaire in the telehealth group after the intervention were also significantly lower than those befor the intervention(P<0.05). Conclusion　Telehealth CBT-I can effectively improve the nocturnal and daytime symptoms, poor sleep beliefs and behaviors of Chinese insomnia patients, and it is a method to expand the accessibility of CBT-I.]]> 2024/2/29 11:51:54 1, LI Fan^2,3 ZHAO Wenrui¹, GAO Jie¹, JIANG Chunfeng¹, ZHAO Yuhua¹, HU Chen¹, LI Chenyu¹]]> CHEN Junjun¹, LI Fan^2,3 ZHAO Wenrui¹, GAO Jie¹, JIANG Chunfeng¹, ZHAO Yuhua¹, HU Chen¹, LI Chenyu¹ 1true