Migration Characteristics and Mechanism of Active Components From Jieyu Anshen Granule in Different Insomnia Mouse Models
Yan S, Lu M, Sun P, Wan R, Ge Y, Yan J, Zhang Y, Sun M, Xu X, Wu Y and Zhang C
Migration Characteristics and Mechanism of Active Components From Jieyu Anshen Granule in Different Insomnia Mouse Models
Yan S, Lu M, Sun P, Wan R, Ge Y, Yan J, Zhang Y, Sun M, Xu X, Wu Y and Zhang C
Insomnia is a highly prevalent disorder with substantial health and socioeconomic impacts, for which traditional Chinese medicine is an important treatment option. Jieyu Anshen Granule (JYAS-G) shows excellent clinical efficacy in insomnia treatment, but its active components, in vivo migration characteristics and underlying mechanisms remain unclear.
Improvement in peripheral airway function after a 12-week exercise intervention in COPD
Cederberg A, Öhrneman H, Elowsson L, Tufvesson E, Larsson C, Falcones B, Karlsson L, Akbarshahi H, Ankerst J, Bjermer L, Palm A, Löndahl J, Malinovschi A, Janson C, Emtner M and Westergren-Thorsson G
Improvement in peripheral airway function after a 12-week exercise intervention in COPD
Cederberg A, Öhrneman H, Elowsson L, Tufvesson E, Larsson C, Falcones B, Karlsson L, Akbarshahi H, Ankerst J, Bjermer L, Palm A, Löndahl J, Malinovschi A, Janson C, Emtner M and Westergren-Thorsson G
Exercise is a cornerstone of chronic obstructive pulmonary disease (COPD) management and improves quality of life, exercise capacity, exacerbation frequency and survival. However, the physiological mechanisms underlying these effects remain unclear. Small airway dysfunction and airway remodeling may not be adequately captured by spirometry, whereas impulse oscillometry (IOS) may be more sensitive to changes in respiratory mechanics. We hypothesized that an exercise intervention designed to engage the peripheral lung may promote adaptive, and potentially, reparative processes in COPD. The aim of the study was to evaluate changes in lung function after a 12-week exercise intervention, focusing on small airway-related measures assessed by IOS. Secondary aims were to assess changes in exercise capacity and patient-reported outcomes.
Surgical management of periorbital non-traumatic subcutaneous emphysema during continuous positive airway pressure
Ramanathan D, Kapoor K and Malhotra R
Surgical management of periorbital non-traumatic subcutaneous emphysema during continuous positive airway pressure
Ramanathan D, Kapoor K and Malhotra R
A 47-year-old male requested treatment for recurrent, rapid left upper eyelid swelling due to subcutaneous emphysema (SE) with use of continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnoea. There was no previous history of facial trauma or surgery. Computerised tomography revealed pneumatisation of the lacrimal sac fossa and nasolacrimal duct with a prominent agger nasi air cell medial to the lacrimal sac extending down the nasolacrimal duct. He underwent endoscopic surgery to reduce the pneumatisation superomedial to the lacrimal sac. The subcutaneous emphysema significantly improved, only now occurring with very high CPAP pressure. Periorbital and orbital emphysema are typically secondary to trauma or iatrogenic causes. To the best of our knowledge, only one case of periorbital, non-traumatic emphysema secondary to CPAP has been reported. This is the first case to describe surgical reduction of a pneumatised lacrimal sac fossa to successfully treat CPAP-related non-traumatic subcutaneous emphysema.
Long-term outcomes of daridorexant in those with comorbid insomnia
Saladi S, Jouda H, Yong T and Anderson KN
Long-term outcomes of daridorexant in those with comorbid insomnia
Saladi S, Jouda H, Yong T and Anderson KN
Daridorexant is a dual orexin receptor antagonist recently licensed for chronic insomnia disorder. Guidelines recommend it as a second-line treatment for insomnia, after cognitive-behavioural therapy. Initial trials excluded common comorbidities despite comorbid insomnia being the norm, not the exception. The long-term benefit from daridorexant remains unclear, with few long-term trials. We aimed to assess long-term outcomes in those with comorbid insomnia.This was a retrospective analysis of 38 patients with insomnia who commenced daridorexant. Mental health disorders were common in those referred. Adverse events and a range of insomnia outcomes were assessed.
Acute Onset Orolingual Choreoathetosis and Auditory Hallucinations in a Healthy Young Adult Following High Melatonin Dose
Bain HL, Yanez AM and Bartlett SI
Acute Onset Orolingual Choreoathetosis and Auditory Hallucinations in a Healthy Young Adult Following High Melatonin Dose
Bain HL, Yanez AM and Bartlett SI
Melatonin is considered a safe OTC sleep aid with rarely reported adverse effects despite limited data. We present a case of acute orolingual choreoathetosis and auditory hallucinations following 132 mg ingestion of melatonin in an otherwise healthy, 22-year-old active-duty male in IBOLC training. The patient developed abrupt, predominantly orolingual choreoathetosis and mild auditory hallucinations, 1 hour after waking. Three days earlier, he began taking 24 mg of melatonin nightly for insomnia and ingested 132 mg the night before presentation. He denied alcohol, illicit drug, or other medication use. On ED arrival, he was hemodynamically stable with continuous orolingual choreoathetosis. Initial labs demonstrated mild acute kidney injury and transaminitis. Head CT was unremarkable. MRI head showed a nonspecific left frontal white matter hyperintensity. Lumbar puncture revealed normal protein and WBC, negative culture, and negative oligoclonal bands, though CSF processing difficulties prevented autoimmune panel completion. Neurologic symptoms resolved by the next morning without recurrence, and a subsequent EEG was unremarkable. This case documents a temporal association between high-dose melatonin exposure and acute neurologic symptoms but does not establish melatonin as the cause. The clinical presentation also occurred in the setting of substantial confounders, including sleep deprivation and heat exposure. This observation supports further investigation of uncommon neurologic presentations occurring after high-dose melatonin intake.
Composite sleep score and risk of psychiatric disorders via proteomic features in preclinical obesity: a prospective cohort study from the UK Biobank
Xu M, Cao W, Sun H, Lu S, Shen Y and Hu G
Composite sleep score and risk of psychiatric disorders via proteomic features in preclinical obesity: a prospective cohort study from the UK Biobank
Xu M, Cao W, Sun H, Lu S, Shen Y and Hu G
Sleep disturbances are linked to psychiatric disorders, and obesity is associated with a higher risk of several psychiatric disorders. However, evidence is lacking on how a composite sleep score relates to psychiatric disorder risk in preclinical obesity and on the proteomic pathways that mediate this relationship. Our study aimed to investigate the association of composite sleep score and the risk of multiple specific psychiatric disorders in participants with preclinical obesity.
Sleep Is Integral to School Health and Adolescent Wellbeing: An Evidence-Based Call to Action
Saletin JM, Ziporyn TD, Wolfson AR and Crowley SJ
Sleep Is Integral to School Health and Adolescent Wellbeing: An Evidence-Based Call to Action
Saletin JM, Ziporyn TD, Wolfson AR and Crowley SJ
Sleep is essential for healthy growth and function. Sleepiness is common in middle and high school classrooms; many adolescents struggle to receive sufficient, well-timed sleep.
Non-linear Age-related Patterns of Sleep Architecture in First-episode Schizophrenia: A Restricted Cubic Spline Analysis
Xiu M, Yao J, Guan X and Lang X
Non-linear Age-related Patterns of Sleep Architecture in First-episode Schizophrenia: A Restricted Cubic Spline Analysis
Xiu M, Yao J, Guan X and Lang X
The dynamic relationship between age and sleep architecture in the early stages of schizophrenia remains poorly characterized. Traditional linear models may fail to capture the complex patterns of sleep stages across different age groups. This study aimed to examine the non-linear associations between age and sleep parameters in First-Episode Schizophrenia (FES) patients.
Effects of General Anaesthesia on the Sleep Structure of Patients With Prolonged Disorders of Consciousness
Jian M, Chen Y, Wang X, Liang Y, Yang W, Ma J, Wang C, He J and Han R
Effects of General Anaesthesia on the Sleep Structure of Patients With Prolonged Disorders of Consciousness
Jian M, Chen Y, Wang X, Liang Y, Yang W, Ma J, Wang C, He J and Han R
Sleep disturbances are common in patients with prolonged disorders of consciousness (pDoC) and are closely correlated with clinical outcomes. With an increasing number of pDoC patients undergoing surgery under general anaesthesia (GA), this study characterized sleep patterns in pDoC patients and evaluated the effects of GA on consciousness and nocturnal sleep. We prospectively enrolled 30 pDoC patients (14 in vegetative state [VS] and 16 in minimally conscious state [MCS]) undergoing spinal cord stimulation and 12 healthy controls. Among pDoC patients, 19 (10 VS, 9 MCS) with complete pre- and postoperative PSG data were analysed for GA effects. Controls underwent one overnight polysomnography (PSG); pDoC patients underwent pre- and postoperative PSG. Consciousness was assessed with Coma Recovery Scale-Revised (CRS-R) before and after surgery. Compared with controls, pDoC patients presented significantly impaired sleep structure, including reduced total sleep time (TST), decreased NREM Stage 2 sleep, diminished slow-wave sleep (SWS), reduced rapid eye movement (REM) sleep duration and percentage relative to TST (all p < 0.05). No significant short-term changes in CRS-R scores were observed following GA. Although GA significantly prolonged TST (p = 0.039), with numerical increases in absolute NREM and SWS durations, no statistically significant changes were observed in sleep stage percentages relative to TST (all p > 0.05). Subgroup analysis showed no significant within-group changes in sleep stage percentages in either the VS or MCS group. These findings suggest that GA increases TST without statistically significant changes in sleep structure in pDoC patients.
Exploring the feasibility, safety and preliminary clinical effects of amygdala-targeted temporal interference stimulation for major depressive disorder: a pilot study
Zeng Z, Zhou S, Shi D, Long M, Zhang S, Wu F, Zhang Q, Zhang L, Gong H and Huang J
Exploring the feasibility, safety and preliminary clinical effects of amygdala-targeted temporal interference stimulation for major depressive disorder: a pilot study
Zeng Z, Zhou S, Shi D, Long M, Zhang S, Wu F, Zhang Q, Zhang L, Gong H and Huang J
Temporal interference stimulation (TIS) is a novel noninvasive neuromodulation technique. However, whether it can be applied in patients with major depressive disorder (MDD) remains unclear. This pilot study investigated the feasibility, safety, and preliminary clinical effects of amygdala-targeted TIS in patients with MDD.
