Association between myopia and sleep duration among primary school students in minority regions of Southwest China: a school-based cross-sectional research.

OBJECTIVE: To investigate the relationship between sleep duration and myopia among primary school students in minority regions of Southwest China. METHODS: The school-based, cross-sectional study was conducted from October 2020 to January 2021. All participants underwent a comprehensive ocular examination and completed a questionnaire on demographic characteristics, ophthalmological history and major environmental factors for myopia. Spherical equivalent (SE) and ocular biometric parameters were measured after cycloplegia, with myopia being defined as SE ≤-0.5 D (Diopter). Multivariate regression models were used to examine the association of sleep duration with myopia, SE and axial length (AL). RESULTS: A total of 857 students from grades 2 to 4 were included in the analysis, of which 63.6% were myopic and 62.0% belonged to ethnic minorities. Boys had a slightly higher prevalence of myopia compared with girls (66.7% vs 60.6%, p=0.06). Myopic students had longer AL, deeper anterior chamber depth and thinner central corneal thickness compared with non-myopic students (all p<0.05). There was no significant association between sleep duration and myopia in both boys and girls (p=0.319 and 0.186, respectively). Moreover, girls with a sleep duration of 8-9 hour/day had higher SE and shorter AL compared with those with less than 8 hour/day of sleep (ß=0.41 and -0.32, respectively, all p<0.05). CONCLUSION: This cross-sectional study did not find a significant association between sleep duration and myopia. However, it suggests that 8-9 hours of sleep per day may have a protective effect on SE progression and AL elongation in girls. Future studies with objectively measured sleep duration are needed to validate the findings.

Cannabinoids for obstructive sleep apnea: A systematic review.

Cannabinoids have emerged as a potential treatment for obstructive sleep apnea (OSA). This systematic review aimed to summarize the efficacy and safety of cannabinoids to treat OSA. Databases including Ovid MEDLINE, EMBASE, Scopus, PsycINFO, and International Pharmaceutical Abstracts were searched; experimental and observational studies were eligible for inclusion. One-hundred seventy unique records were screened, and nine studies included: five full-text studies and four published abstracts. The five full-text studies were judged for quality appraisal: two studies deemed at low risk for bias, one study deemed to have some concerns for bias, and two studies deemed to have high risk for bias. Seven of nine total studies were experimental designs and evaluated dronabinol, and the other two studies were observational designs evaluating cannabis. The range of cannabinoid therapy duration spanned from 1 to 6 weeks, and the median duration was 3 weeks. Eight of nine total studies reported statistically significant, positive OSA outcomes due to cannabinoid therapy including reductions in the apnea hypopnea index and improvements in patient-reported daytime sleepiness scales. Between 70% and 80% of study participants reported neuropsychiatric and gastrointestinal adverse events attributable to cannabinoids. The American Academy of Sleep Medicine does not recommend using cannabinoids to treat OSA due to a lack of long-term safety and efficacy data. This systematic review found similar limitations, with the median cannabinoid treatment duration being only 3 weeks. Adequately powered experimental trials over longer time frames are necessary to more completely assess the long-term efficacy and safety of cannabinoids in the treatment of OSA and its effects on common comorbid conditions, such as obesity and cardiovascular disease.

Long Term Cardiovascular Outcomes Between Sleep Surgery and Continuous Positive Airway Pressure.

OBJECTIVES: Individuals with obstructive sleep apnea (OSA) suffer from a multitude of concurrent morbidities including cardiovascular disease (CVD). Limited data exists comparing long term cardiovascular disease (CVD) clinical outcomes for patients treated with surgical intervention versus continuous positive airway pressure (CPAP). The purpose of this study was to compare CVD outcomes at multiple time points comparing those treated with sleep surgery versus CPAP alone. METHODS: A research database was used to assess outcomes: death, myocardial infarction, atrial fibrillation, heart failure, essential hypertension, and pulmonary hypertension at 5, 8, and 20 years for patients with OSA treated with surgical interventions (upper airway stimulation [UAS], uvulopalatopharyngoplasty [UPPP], and tonsillectomy) or CPAP alone. Subjects were identified using ICD and CPT codes and analyses were conducted with and without propensity score matching for age, sex, race, BMI, myocardial infarction (MI), essential hypertension, pulmonary hypertension, atrial fibrillation, and heart failure. RESULTS: All surgical interventions demonstrated benefit over CPAP alone at most time points for most surgical interventions. At 8 years, for all sleep surgeries (UAS or UPPP or tonsillectomy) (n = 6627) versus treatment with CPAP alone (n = 6627), matched subjects demonstrated decreased risk (odds ratios) and superior survival (hazard ratios and log ranks tests) for death (OR = 0.49 [0.39, 0.62] P ≤ .0001, HR = 0.29 [0.23, 0.37], χ2 = 109.58 P ≤ .0001), myocardial infarction (OR = 0.67 [0.54, 0.84] P = .0005*, HR = 0.48 [0.38, 0.60], χ2 = 42.40 P ≤ .0001), atrial fibrillation (OR = 0.70 [0.59, 0.83] P ≤ .0001, HR = 0.54 [0.45, 0.64], χ2 = 51.53 P ≤ .0001), heart failure (OR = 0.55 [0.47, 0.64] P ≤ .0001, HR = 0.41 [0.35, 0.47], χ2 = 137.416 P ≤ .0001), essential hypertension (OR = 0.88 [0.82, 0.94] P = .0002, HR = 0.78 [0.74, 0.82], χ2 = 76.38 P ≤ .0001), and pulmonary hypertension (OR = 0.51 [0.40, 0.65] P ≤ .0001, HR = 0.38 [0.29, 0.48], χ2 = 60.67 P ≤ .0001) where P ≤ .00037 indicated statistical significance*. CONCLUSION: This investigation suggests surgical management of obstructive sleep apnea may contribute to the mitigation of long-term clinical CVD morbidity.

Association between sleep quality and uncertainty stress among healthcare professionals in hospitals in China: a nationwide cross-sectional survey.

OBJECTIVES: Sleep quality is a critical concern among healthcare professionals, yet the role of uncertainty stress has been inadequately explored. This study aims to explore the associations between sleep quality and uncertainty stress among healthcare professionals working in Chinese hospitals. DESIGN: Cross-sectional survey. SETTING: Data were collected via a cross-sectional survey administered to healthcare professionals across three Chinese provinces from 29 September 2022 to 18 January 2023. PARTICIPANTS: A total of 1902 participants contributed valid responses for analysis. PRIMARY OUTCOME MEASURE: Sleep quality. RESULTS: Out of 1902 respondents, 26.4% reported uncertainty stress and 50.5% experienced insomnia. Binary logistic regression analysis revealed that higher uncertainty stress significantly predicted poor sleep quality (OR=3.89; 95% CI 3.06, 4.95; p<0.001) while controlling for sociodemographic characteristics. Furthermore, linear regression analysis confirmed the similar relationship between uncertainty stress and sleep quality (ß=3.10; 95% CI 2.67, 3.52; p<0.001). CONCLUSIONS: The study highlights a significant association between uncertainty stress and impaired sleep quality among Chinese healthcare professionals. These findings suggest the necessity for targeted strategies to mitigate uncertainty stress, which may potentially promote better sleep and overall well-being in healthcare settings.

Chasing sleep physicians: ChatGPT-4o on the interpretation of polysomnographic results.

BACKGROUND: From a healthcare professional's perspective, the use of ChatGPT (Open AI), a large language model (LLM), offers huge potential as a practical and economic digital assistant. However, ChatGPT has not yet been evaluated for the interpretation of polysomnographic results in patients with suspected obstructive sleep apnea (OSA). AIMS/OBJECTIVES: To evaluate the agreement of polysomnographic result interpretation between ChatGPT-4o and a board-certified sleep physician and to shed light into the role of ChatGPT-4o in the field of medical decision-making in sleep medicine. MATERIAL AND METHODS: For this proof-of-concept study, 40 comprehensive patient profiles were designed, which represent a broad and typical spectrum of cases, ensuring a balanced distribution of demographics and clinical characteristics. After various prompts were tested, one prompt was used for initial diagnosis of OSA and a further for patients with positive airway pressure (PAP) therapy intolerance. Each polysomnographic result was independently evaluated by ChatGPT-4o and a board-certified sleep physician. Diagnosis and therapy suggestions were analyzed for agreement. RESULTS: ChatGPT-4o and the sleep physician showed 97% (29/30) concordance in the diagnosis of the simple cases. For the same cases the two assessment instances unveiled 100% (30/30) concordance regarding therapy suggestions. For cases with intolerance of treatment with positive airway pressure (PAP) ChatGPT-4o and the sleep physician revealed 70% (7/10) concordance in the diagnosis and 44% (22/50) concordance for therapy suggestions. CONCLUSION AND SIGNIFICANCE: Precise prompting improves the output of ChatGPT-4o and provides sleep physician-like polysomnographic result interpretation. Although ChatGPT shows some shortcomings in offering treatment advice, our results provide evidence for AI assisted automation and economization of polysomnographic interpretation by LLMs. Further research should explore data protection issues and demonstrate reproducibility with real patient data on a larger scale.

Sleep-disordered breathing - clinical spectrum.

The clinical spectrum of sleep-disordered breathing comprises a range of diverse conditions including obstructive sleep apnoea, central sleep apnoea and sleep-related hypoventilation syndromes. These distinct conditions have specific diagnostic features and are managed differently from one another. Therefore, it is useful for dental practitioners to have a working knowledge of sleep-disordered breathing beyond that of uncomplicated obstructive sleep apnoea (OSA). This review paper summarizes the diagnosis and management of commonly encountered clinical sleep-disordered breathing syndromes, with a particular focus on management from a dental perspective.

The chronobiology of human heart failure: clinical implications and therapeutic opportunities.

Circadian variation in cardiovascular and metabolic dynamics arises from interactions between intrinsic rhythms and extrinsic cues. By anticipating and accommodating adaptation to awakening and activity, their synthesis maintains homeostasis and maximizes efficiency, flexibility, and resilience. The dyssynchrony of cardiovascular load and energetic capacity arising from attenuation or loss of such rhythms is strongly associated with incident heart failure (HF). Once established, molecular, neurohormonal, and metabolic rhythms are frequently misaligned with each other and with extrinsic cycles, contributing to HF progression and adverse outcomes. Realignment of biological rhythms via lifestyle interventions, chronotherapy, and time-tailored autonomic modulation represents an appealing potential strategy for improving HF-related morbidity and mortality.

[Sleep and sleep disorders in old age]. / Schlaf und Schlafstörungen im hohen Lebensalter.

The increasing interruptions of nocturnal sleep with aging must be distinguished from actual sleep disorders. Morbidity and medication have an impact on sleep. The relationship between sleep and morbidity is mutual. Disturbed sleep modifies many clinical symptoms and diseases affect sleep and the ability to sleep. Geriatric syndromes such as falls, depression and dementia are modified by sleep disorders. Geriatric syndromes can be favorably influenced by the treatment of sleep disorders. Adequate diagnostics are important prerequisites. Coincidences of different sleep disorders are frequent. The medical history of patients and a sleep diary form the basis of the diagnostics. Sleep medicine provides further technical examination procedures. Older people should be examined in a sleep laboratory if the results have consequences that are accepted by the patient. This should be clarified in advance.

The interdisciplinary field of Sleep Medicine-time for dentists to sink their teeth into it!

Sleep Medicine has evolved into a highly multidisciplinary field over the last few decades, involving respiratory physicians, neurologists, cardiologists, ENT surgeons, psychiatrists and psychologists to name a few. It is within this highly multidisciplinary context that we have seen an increasing role for dentists in the recognition, diagnosis and management of select sleep disturbances and disorders. Over the last couple of decades, this growing role for dentists has seen the informal emergence of a new interdisciplinary field of Dental Sleep Medicine-a field that bridges medicine and dentistry as it pertains to the diagnosis and management of sleep disorders. This article describes this new field in terms of its history, the evolving scope of practice for dentists, the implications for education and training, and the importance of multidisciplinary care that optimises outcomes for patients.

Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey.

PURPOSE: Diagnosing and treating obstructive sleep apnea (OSA) requires fundamental understanding of sleep medicine, including training and clinical experience. So far, dental sleep medicine (DSM) has not yet become a mandatory part of dental education in Germany. This questionnaire-based survey for both lecturers and students aimed to evaluate DSM education among undergraduate students. METHODS: A structured questionnaire was sent to the managing directors and student councils of all 30 German university dental schools. The questionnaire contained 13 questions on teaching quantity and content, lecturers' knowledge, and future interest in DSM. For each university dental school, only one questionnaire should be completed by the student council and the managing director. A scoring system assessed lecturers' knowledge based on clinical experience and qualifications. Descriptive data and correlation coefficients were calculated (P < 0.05). RESULTS: The responses of 24 lecturers (80%) and 28 students (93.3%) could be evaluated. DSM was reported to be included in the curriculum by 14 lecturers (58.3%) and 4 students (14.3%). Mean teaching hours per semester were 1.4 ± 1.4 h (lecturers) and 0.2 ± 0.6 h (students) accordingly. Greater knowledge of lecturers in DSM was positively correlated with the inclusion of DSM in the curriculum (P = 0.022) and with the number of teaching hours per semester (P = 0.001). CONCLUSION: Postgraduate education and incorporating DSM knowledge into undergraduate education ("Teach the Teacher") seems to play a key role in fundamentally training future dentists in this field.

SoundMind Trial: a study protocol for a randomised controlled trial for online acceptance and commitment therapy and sound therapy for tinnitus.

INTRODUCTION: Tinnitus is a common ailment that affects 10%-15% of adults worldwide. Comorbidities associated with tinnitus often include hearing loss, emotional distress and sleep disorders, with insomnia being a common issue among patients with tinnitus. Audiological and psychological approaches are typically used to treat chronic subjective tinnitus, with the combination of sound therapy and cognitive-behavioural therapy-based counselling having the strongest evidence for effectiveness. Acceptance and commitment therapy (ACT) has also shown promising effects in reducing the impact of tinnitus when delivered in groups or online. However, there is a lack of evidence on the effects of combining ACT with sound therapy for patients with tinnitus-related insomnia. Therefore, this study aims to compare the efficacy of internet-delivered ACT combined with sound therapy versus sound therapy alone for tinnitus in a superiority, two-arm randomised controlled trial. METHODS AND ANALYSIS: A total of 164 patients with chronic subjective tinnitus and insomnia will be randomised to receive internet-delivered guided self-help tinnitus treatment based on ACT combined with tailored sound therapy or tailored sound therapy alone. The primary outcome is the variation in Tinnitus Handicap Inventory scores observed 2 months after randomisation between the two study groups. Secondary outcomes will include insomnia severity, sleep parameters, tinnitus loudness, tinnitus acceptance, depression and anxiety. The outcomes will be assessed at 2, 3 and 6 months post randomisation. ETHICS AND DISSEMINATION: The study is approved by the review board and ethics committee of the Eye and ENT Hospital of Fudan University (approval number: 2023066-1). The findings will be disseminated through presentations at relevant conferences and peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT05963542.

Effects of dim-evening lighting optimised for geographical orientation versus standard lighting on mental health: protocol paper for a quasiexperimental study in a psychiatric hospital.

INTRODUCTION: Research has provided novel insights into how light stimulates circadian rhythms through specialised retinal ganglion cells to the suprachiasmatic nucleus. In addition, there has been a revolution in light-emitting diode (LED) technology, leading to tunable LED light sources and lighting systems, enabling 24-hour dynamic light scenarios with bright blue-enriched short wavelength light during the day and dim evening light, stimulating the circadian system. These dynamic LED lighting systems are now being implemented at hospitals without adequate understanding of how it may affect the health and well-being of patients and staff. METHODS AND ANALYSIS: An optimised dynamic LED lighting scenario is investigated at a newly built psychiatric hospital in Copenhagen. In the 12 months baseline period, a standard lighting scenario with dynamic colour temperature and fixed light intensity is investigated. In the following 12-month intervention period, a new DEL scenario is investigated, having dynamic colour temperature as well as dynamic light intensity with a higher daytime and lower evening-time melanopic daylight equivalent illuminance. This setting is furthermore adjusted for geographical orientation to compensate for differences in sunlight access in wintertime. The study uses a quasiexperimental design comparing patients admitted in the two study periods. Prior to each of the study periods, daylight and the contribution from the LED-lighting scenarios was measured. Patient sociodemographic and mental health data will be retrieved retrospectively from electronic medical records and by questionnaires administered in the two periods, evaluating lighting, noise, sleep quality and quality of life. Primary outcome is the proportion of patients receiving pro re nata medications. Secondary outcomes are the length of stay, sleep onset latency, sleep quality and quality of life. ETHICS AND DISSEMINATION: No ethical issues are expected. The results will be disseminated through peer-reviewed international journal, lectures, posters and interviews. TRIAL REGISTRATION NUMBER: NCT05868291.

Paradoxical intention as a treatment for insomnia disorder: study protocol for a mixed-methods pilot trial.

INTRODUCTION: Paradoxical intention (PI) is an insomnia treatment developed in the 1970s, which instructs patients to gently attempt to remain awake while in bed at night with the lights off. Previous research indicates PI's potential in improving insomnia, although no study has been conducted in the last few decades during which the insomnia diagnostic criteria have changed. Additionally, there are knowledge gaps regarding outcomes related to wake after sleep onset, the treatment mechanisms as well as the acceptability and feasibility of the treatment. This study therefore aims to address these gaps by assessing the potential mechanisms, preliminary efficacy, and patient experience and acceptability of PI. METHODS AND ANALYSIS: We aim to include 40 adult participants with insomnia, aged 18 and above, from the Swedish general population. In this uncontrolled pilot study using a mixed-methods approach, both qualitative and quantitative data will be collected. The trial will be conducted on a self-help online platform, accessible from participants' homes, with weekly phone call support by therapists. Process and outcome measures will be assessed weekly across a 4-week intervention period and at a 3-month follow-up. A subset of participants will be asked to participate in qualitative semistructured interviews regarding the treatment. ETHICS AND DISSEMINATION: Ethical approval for this project has been granted by the Swedish Ethical Review Authority (Dnr: 2023-06594-01). All participants will sign informed consent forms on a web service application prior to enrolment. From this mixed-methods study, we anticipate insights into the preliminary efficacy and mechanisms of paradoxical intention for treating insomnia, enriched by patient experience data. Results will be disseminated through peer-reviewed publications. The findings will inform adaptations to the treatment protocol and serve as groundwork for a possible larger scale randomised controlled trial. TRIAL REGISTRATION NUMBER: NCT06259682.

Disappearance and dissemination of sleep symptoms: the importance of sleep medicine expertise for psychiatry. A comment on Forbes et al.

Commentary of 'Elemental psychopathology: distilling constituent symptoms and patterns of repetition in the diagnostic criteria of the DSM-5' Vincent P. Martin 1, Régis Lopez 2,3, Jean-Arthur Micoulaud-Franchi 4,5, Christophe Gauld 4,6,.

A cross-sectional study of the association between physical activity and depressive symptoms among adolescents in southwest China stratified by parental absence: the mediating role of insomnia and the moderating role of resilience.

OBJECTIVES: This study explored the mechanisms by which physical activity was associated with depressive symptoms in multi-ethnic (Han, Yi and Tibetan) adolescents in southwest China. The mediating role of insomnia in the association of physical activity with depressive symptoms, the moderating role of resilience in this mediation model and the moderating role of parental absence in the moderated mediation model were also examined. DESIGN: A cross-sectional survey. SETTING: In southwest China (Sichuan Province and Tibet Autonomous Region). PARTICIPANTS: 3195 adolescents from a school-based survey conducted between April and October 2020. METHODS: There were 3143 valid samples in this study (47.2% males with mean age=12.88±1.68 years). Structural equation models were developed to estimate the direct and mediating effect, and the moderating effect. Multigroup comparison was performed to examine the differences and similarities of the moderated mediation model across three parental absence subgroups: (1) both parents present, (2) one parent absent and (3) both parents absent. RESULTS: As hypothesised, physical activity was significantly and positively associated with the reduction of depressive symptoms in adolescents. Insomnia partially mediated the effect of physical activity on depressive symptoms. In addition, resilience moderated the direct and indirect effects of physical activity (through insomnia) on depressive symptoms. Finally, the multigroup comparison indicated the moderating effect of parental absence on the moderated mediation model. CONCLUSIONS: Physical activity was associated with alleviating insomnia symptoms among adolescents, thus correlating with the improvement of their depressive symptoms. Resilience was associated with enhancing the beneficial effects of physical activity, further improving depressive symptoms among adolescents, especially those with both absent parents. It is evident that physical activity interventions should be further incorporated into public health programmes to foster the physical and mental health of left-behind adolescents in southwest China.

The Impact of Living in a Low Food Access/Low Income Area on Obstructive Sleep Apnea.

OBJECTIVE: To assess differences in obstructive sleep apnea (OSA)-related health parameters between residents of low income/low access (LILA) census tracts-food deserts-and non-LILA residents STUDY DESIGN: Retrospective review. SETTING: Single institution serving a large region in Southern California from 2017 to 2023. METHODS: Census tracts are defined as LILA if a significant proportion of residents live below the poverty threshold and far from healthy food vendors. Adults newly diagnosed with OSA on polysomnography were included. Food access status was determined by searching patient addresses in the US Department of Agriculture Food Access Research Atlas. Baseline and 1-year follow-up body mass index (BMI) and vitals were collected and compared based on food access and other demographic variables. RESULTS: A total of 379 patients in the LILA+ group and 2281 patients in the LILA- group met inclusion criteria. BMI was higher in the LILA group (36.6 ± 9.4 vs 35.2 ± 8.9; P = .006). The effect of food access was most significant in certain demographic groups: patients aged < 65, males, Asian/Pacific Islanders, Hispanics, and patients with Medicaid coverage all had a higher BMI when in the LILA+ group compared to the LILA- group. When considering insurance, LILA+ patients with Medicaid coverage had a significantly higher BMI than LILA- patients with non-Medicaid coverage (40.4 ± 10.3 vs 34.2 ± 8.4, P < .001. Blood pressure, heart rate, and apnea-hypopnea index were also significantly higher in LILA+/Medicaid group. BMI change across all demographic groups was minimal at 1-year follow-up. CONCLUSION: Living in a LILA census tract may result in worse OSA-related health parameters. When accounting for insurance status, the effects are even more profound. Intensive counseling on the importance of weight management should begin at the diagnosis of OSA.

Current situation and relationship between occupational stress, burn-out and sleep quality among ambulance drivers: a cross-sectional study.

OBJECTIVE: To understand the current status of occupational stress, occupational burn-out and sleep quality among ambulance drivers in Hengyang, China and to analyse the relationship between occupational stress, occupational burn-out and sleep quality of ambulance drivers. DESIGN: A cross-sectional study. SETTING: Prehospital emergency centre of third-class hospital in Hengyang, China. PARTICIPANTS: From October 2023 to December 2023, a cross-sectional survey was conducted, with 213 ambulance drivers from Hengyang, China, selected as participants. METHODS: General demographic questionnaires, the Chinese Occupational Stress Inventory, the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index were used for data collection and analysis. RESULTS: Occupational stress among ambulance drivers was positively correlated with occupational burn-out and sleep quality (r=0.528, 0.447, both p<0.01) while occupational burn-out was positively correlated with sleep quality (r=0.394, p<0.01). Occupational burn-out partially mediated the relationship between occupational stress and sleep quality among ambulance drivers, with a mediation effect value of 0.168, accounting for 26.09% of the total effect. CONCLUSION: The sleep quality of ambulance drivers in Hengyang, China is suboptimal, with occupational stress directly predicting sleep quality. Occupational burn-out plays a partial positive mediating role between occupational stress and sleep quality among ambulance drivers. Reducing occupational stress and burn-out is beneficial for improving the sleep quality of ambulance drivers.

Analysis of Recent Sleep Surgery Fellowship Training.

OBJECTIVE: Since 2011, otolaryngologists aiming to become certified in sleep medicine have had to complete an ACGME accredited sleep medicine fellowship. In addition to standard sleep medicine and sleep surgery fellowships, several institutions have developed hybrid ACGME sleep medicine programs that incorporate sleep surgery training. Our primary aims were to understand the balance between sleep medicine and surgical training requirements and the surgical volume of recent graduates across the three pathways. Our secondary aim was to assess their employment post-graduation. An improved understanding of the current state of sleep surgeon training could better inform both applicants and programs and be used to guide fellowship curriculum development. METHODS: Between 2017 and 2023, we identified 26 surgeons who completed a sleep focused fellowship. An anonymous survey was developed and emailed to them. The survey assessed clinic and operating balance, procedures completed during fellowship, and comfort with these procedures as attendings. Finally, the survey assessed the job prospects of graduates. Data were analyzed with Prism 10. RESULTS: There were 19 respondents with 52.6% completing a hybrid fellowship, 21.3% completing a sleep medicine fellowship, and 31.6% completing a sleep surgery fellowship. Approximately 84.8% completed ACGME accredited otolaryngology training prior to fellowship. The three most common surgeries were hypoglossal nerve stimulators, pharyngoplasty, and nasal surgeries. Respondents on average received 2.4 job offers, 55% returned to their residency institution, and 89.5% were in academics. CONCLUSION: Our survey demonstrates a wide variability in sleep-focused fellowships for surgeons, but the employment market for these trainees is robust. LEVEL OF EVIDENCE: N/A Laryngoscope, 2024.

Knowledge of Narcolepsy Among Physicians in Makkah Region, Saudi Arabia: A Cross-Sectional Study.

Background Narcolepsy is a chronic sleep disorder that is characterized by excessive daytime sleepiness and cataplexy. It has been increasingly diagnosed over the years, impacting productivity and employment rates. Awareness of healthcare providers is crucial for the early identification and management of this condition. Objectives This study assessed physicians' knowledge of narcolepsy in the Makkah region of Saudi Arabia. Method This cross-sectional study was conducted from February to November 2023. An online self-administered questionnaire has been used to target physicians working in the Makkah region of Saudi Arabia. The utilized questionnaire assessed demographic and professional data as well as the participants' knowledge of narcolepsy. Statistical analysis was performed using RStudio (R version 4.3.1.). Statistical differences in knowledge were assessed using Pearson's chi-squared and Fisher's exact tests. Factors associated with knowledge of narcolepsy were investigated through univariable and multivariable regression analyses expressed using beta coefficients and 95% confidence intervals (95% CIs). Statistical significance was considered at p < 0.05. Results A total of 226 physicians participated in this study. Male physicians (54.4%, n = 123), practicing in governmental hospitals (77.9%, n = 176) and residing in Makkah City (43.4%, n = 98) were predominant. Non-surgical specialties represented 73.5% (n = 166) of the sample. Around 81% (n = 184) of the participants were aware of narcolepsy, with a significant difference according to professional status (p = 0.045). The majority of physicians have correctly identified narcolepsy as a sleep disorder (78.3%, n = 177), but only 32.3% (n = 73) have identified its typical onset age group and recognized that there are two types of narcolepsy. Almost half of the respondents indicated a lack of knowledge about the diagnostic criteria for narcolepsy in the DSM-5 (52.2%, n = 118). Only 27.4% (n = 62) recognized the correct diagnostic criteria. Half of the sample (51.3%, n = 116) recognized the use of multiple sleep latency tests for the diagnosis. For factors associated with higher participants' knowledge, non-surgical specialties showed significantly higher knowledge scores compared to surgical specialties (beta = 0.91, 95% CI, 0.13 to 1.7, p = 0.024). Conclusion This study has revealed a significant lack of knowledge about narcolepsy among physicians in Makkah region. This raises concerns about the timely identification, proper understanding, and accurate diagnosis of patients with narcolepsy. Adequate understanding of narcolepsy is crucial to avoid its misdiagnosis or delays in receiving appropriate treatment and support, ultimately impacting their quality of life.

Predictability of sleep in insomnia: sleep patterns of patients from a sleep psychology clinic.

The present study aims at identifying sleep patterns in insomnia in a clinical sample using three strategies to define poor nights. Sleep diaries and self-reported questionnaires were collected from 77 clinical patients with insomnia. The conditional probabilities of observing a poor night after 1, 2, or 3 consecutive poor nights were computed according to three strategies with same criteria for sleep onset latency, wake after sleep onset, and sleep efficiency, but varying criterion for total sleep time. Latent profile analyses were conducted to derive sleep patterns. Uni- and multivariate analyses were conducted to characterise the sleep patterns identified. A total of 1586 nights were analysed. The strategy used significantly influenced the average percentage of reported poor nights. Two to three sleep patterns were derived per strategy. Within each strategy, sleep patterns differed from each other on sleep variables and night-to-night variability. Results suggest the existence of sleep patterns in insomnia among individuals consulting in psychological clinics. Adding a total sleep time of 6-h cut-off as a criterion to define poor nights increases the accuracy of the strategy to define poor night and allows to identify sleep patterns of poor nights in insomnia.