This study aimed to verify the effect of eight weeks of resistance training (RT) on subjective sleep quality, daytime sleepiness, and quality of life in adults with OSA. In this randomized controlled clinical trial, 25 adults with moderate to severe OSA (age: 54.6 ± 7.2 years; BMI: 36.1 ± 7.9 kg/m²; apnea-hypopnea index: 52.2 ± 27.4 events/hour) were included. Participants were randomized into an RT group (three sessions per week) or a control group [CG (two sessions per week)]. Sleep quality, excessive daytime sleepiness, and quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), SF-36, respectively. Generalized estimated equations verified differences between groups over time. Differences were observed in domains sleep latency (RT: Δ -1.0 ± 0.3 vs. CG: 0.2 ± 0.2; p = 0.018), sleep duration (RT: Δ -0.6 ± 0.3 vs. CG: -0.2 ± 0.2; p = 0.012), sleeping medication (RT: Δ -0.2 ± 0.1 vs. CG: 0.8 ± 0.3; p = 0.007), and overall PSQI score (RT: Δ -3.2 ± 0.6 vs. CG: 0.2 ± 0.8; p = 0.004). Regarding SF-36, differences were found in emotional aspects (RT: Δ 29.6 ± 14.8 vs. CG: -17.9 ± 10.0; p = 0.008) and global score (RT: Δ 10.8 ± 3.3 vs. CG: -3.4 ± 3.1; p = 0.002) were observed. No difference was observed in ESS. An eight-week RT program improves subjective sleep quality and quality of life in adults with moderate to severe OSA. Clinical trial registration (Brazilian Clinical Trials Registry [ReBec]): # RBR-2rg97kz. Date of registration: 01/17/2025.
It is unclear whether haematological inflammatory indices or CT-derived cardiac parameters add discriminative information beyond standard clinical variables in obstructive sleep apnoea syndrome (OSAS). We compared both modalities, alone and combined, against age, sex and body mass index (BMI) for identifying severe OSAS and associated cardiovascular comorbidity. This was a retrospective cross-sectional study of 401 participants (240 OSAS, 161 controls). Four nested logistic regression models were fitted in the OSAS cohort: M0 (age, sex, BMI); M1 (M0 plus biochemical indices CAR, NLR, PLR, SII); M2 (M0 plus CT-derived cardiac parameters: pulmonary artery [PA] diameter, PA/aorta ratio, RV/LV ratio, ventricular wall thicknesses); and M3 (M0 plus CT plus biochemical). We compared discrimination (AUC, DeLong), reclassification (continuous NRI, IDI) and model fit (likelihood ratio tests), with internal validation by 500-iteration bootstrap optimism correction and repeated tenfold cross-validation. Missing predictor data were handled by multiple imputation (MICE, m = 20) as the primary approach. Cardiovascular outcomes were defined from echocardiography to avoid predictor–outcome overlap. For severe OSAS, M2 improved on M0 (AUC 0.755 vs 0.716; LR p = 0.005; NRI + 0.60 [95
Socioeconomic status has been associated with sleep disturbance; however, the link between annual household income and insomnia symptoms, considering the additive association with work–life balance, has yet to be examined. Therefore, we investigated this association among Japanese female care workers. Between 2015 and 2016, 451 women aged 18–60 years who worked in older adult care services were enrolled in this cross-sectional study. Insomnia symptoms were measured using the Athens Insomnia Scale. Categorized annual household income was divided into two categories (high/middle vs. low) based on the median annual household income from the national survey. Work–life balance was assessed by examining work-to-family and family-to-work conflicts. Exposure was defined as a combined category of income and work–life balance. Data were collected via self-administered questionnaires. Prevalence ratios (PRs) of insomnia symptoms were estimated using modified Poisson regression. The multivariable-adjusted PR (95
The indications for pediatric long-term non-invasive ventilation (LT-NIV) have expanded. However, a standardized definition of pediatric adherence is lacking. To propose a novel physiological definition of adherence to pediatric LT-NIV and compare it with the two commonly used adult-derived definitions. Retrospective cross-sectional study including all eligible children aged 0.15-18 years enrolled in the LT-NIV follow-up program at Hospital Garrahan, Argentina. Clinical data were obtained from medical records and adherence from device memory downloads. The proposed definition classified patients as “adherent” when LT-NIV use reached ≥ 70
Sleep bruxism (SB) is masticatory muscle activity during sleep, most often studied through its polysomnographic marker, rhythmic masticatory muscle activity (RMMA). Cannabinoids have attracted interest for their analgesic, anxiolytic and sleep-modulating properties, but whether they influence SB, and whether such modulation would benefit patients, remains unclear. This review examines cannabidiol (CBD), tetrahydrocannabinol (THC) and cannabinol (CBN) in relation to sleep, arousal and masticatory muscle activity, and separates what has been demonstrated from what is inferred. We searched PubMed/MEDLINE, Embase and Web of Science for records published between 1 January 2004 and 14 June 2026, with searches last run on 14 June 2026. Cannabinoid terms were crossed with sleep terms and with bruxism terms, and searched independently for mechanistic literature. Seminal earlier work was retrieved by hand-searching reference lists. Each source was classified by level and directness of evidence. Meta-analytic evidence indicates that cannabis administration at therapeutic doses does not consistently alter total sleep time, sleep onset latency, sleep efficiency or sleep staging. A randomised polysomnographic trial of CBN missed its primary endpoint (wake after sleep onset); in uncorrected secondary and tertiary analyses, 300 mg reduced the electroencephalographic arousal index and sleep onset latency and increased N2 sleep. Preclinical polysomnography supports a hypnotic action of CBN and of its brain-penetrant metabolite, with partial tolerance within two weeks. One randomised trial reported that topical CBD reduced a portable device bruxism index and masseter activity in patients with SB and painful temporomandibular disorders, through a proposed local mechanism involving myorelaxation and analgesia. The entire direct clinical evidence base comes from a single research group, and no study has measured RMMA by polysomnography under any cannabinoid. Two distinct pathways could link cannabinoids to SB, one peripheral and one central, and neither has been demonstrated in patients with SB. The clinically relevant question is not whether a cannabinoid lowers a motor activity index, but whether it improves outcomes that matter in patients whose SB carries consequences. Trials combining polysomnography, masseter electromyography and patient-centred outcomes are required before any clinical recommendation. Not applicable (narrative review).
