Review and perspective on sleep-disordered breathing research and translation to clinics

Korkalainen, Henri; Kainulainen, Samu; Islind, Anna Sigridur; Óskarsdóttir, María; Strassberger, Christian; Nikkonen, Sami; Töyräs, Juha; Kulkas, Antti; Grote, Ludger; Hedner, Jan; Sund, Reijo; Hrubos-Strom, Harald; Saavedra, Jose M.; Ólafsdóttir, Kristín Anna; Ágústsson, Jón S.; Terrill, Philip I.; McNicholas, Walter T.; Arnardóttir, Erna Sif; Leppänen, Timo

doi:10.1016/j.smrv.2023.101874

Cited by 5 publications

(1 citation statement)

References 144 publications

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“…This scenario underscores the critical need for alternative treatment modalities. The integration of machine learning, advanced diagnostic technologies, and novel therapeutic strategies heralds a move toward more personalized care and improved outcomes for patients (Korkalainen et al, 2024). This Research Topic delves into the forefront of innovation in the diagnosis and management of SDB, highlighting a shift toward diagnostic tools and treatment methods that promise greater accuracy, efficiency, and patient-centric care.…”

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confidence: 99%

Editorial: Novel technologies in the diagnosis and management of sleep-disordered breathing

Korkalainen,

Zou

2024

Front. Sleep

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confidence: 99%

Editorial: Novel technologies in the diagnosis and management of sleep-disordered breathing

Korkalainen,

Zou

2024

Front. Sleep

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Phenotyping sleep disturbances in ADHD and identifying harmonised outcome measures

Ipsiroglu,

Klösch,

Stein

et al. 2024

Somnologie

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Attention deficit hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder. Currently, the diagnosis and treatment of ADHD in children and adolescents is primarily centred on daytime functioning and the associated impairment of academic performance, although disrupted and restless sleep have been frequently reported in individuals with ADHD. Further, it has been recognised that sleep disorders not only intensify existing ADHD symptoms but in some cases can also mimic ADHD symptoms in the paediatric population with primary sleep disorders. Under the title ‘The blind spot: sleep as a child’s right issue?’, professionals from diverse disciplines, including medicine and social sciences as well as individuals with an interest in ADHD and sleep medicine, including laypeople, have initiated a unifying discourse. The objective of this discourse is to improve our understanding of the diagnosis and treatment of ADHD and disruptive behaviours and to develop personalised and precision medicine. Research has shown that the existing, primarily descriptive and categorical diagnostic systems do not capture the heterogeneous nature of youth with attentional and behavioural difficulties and the phenotypic expressions thereof, including nighttime behaviours and sleep. New strategies for clinical phenotyping and the exploration of patient-reported behaviours are necessary to expand our understanding and develop personalised treatment approaches. In this position paper, we outline gaps in the clinical care of ADHD and related sleep disturbances, review strategies for closing these gaps to meet the needs of individuals with ADHD, and suggest a roadmap for escaping the one-size-fits-all approach that has characterised ADHD treatment algorithms to date.

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Control of breathing by orexinergic signaling in the nucleus tractus solitarii

Wang,

Deng,

Zhao

et al. 2024

Sci Rep

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Orexin signaling plays a facilitatory role in respiration. Abnormalities in orexin levels correlate with disordered breathing patterns and impaired central respiratory chemoreception. Nucleus tractus solitarii (NTS) neurons expressing the transcription factor Phox2b contribute to the chemoreceptive regulation of respiration. However, the extent to which orexinergic signaling modulates respiratory activity in these Phox2b-expressing NTS neurons remains unclear. In the present study, the injection of orexin A into the NTS significantly increased the firing rate of the phrenic nerve. Further analysis using fluorescence in situ hybridization and immunohistochemistry revealed that orexin 1 receptors (OX1Rs) were primarily located in the ventrolateral subdivision of the NTS and expressed in 25% of Phox2b-expressing neurons. Additionally, electrophysiological recordings showed that exposure to orexin A increased the spontaneous firing rate of Phox2b-expressing neurons. Immunostaining experiments with cFos revealed that the OX1R-residing Phox2b-expressing neurons were activated by an 8% CO2 stimulus. Crucially, OX1R knockdown in these NTS neurons notably blunted the ventilatory response to 8% CO2, alongside an increase in sigh-related apneas. In conclusion, orexinergic signaling in the NTS facilitates breathing through the activation of OX1Rs, which induces the depolarization of Phox2b-expressing neurons. OX1Rs are essential for the involvement of Phox2b-expressing NTS neurons in the hypercapnic ventilatory response.

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Review and perspective on sleep-disordered breathing research and translation to clinics

Cited by 5 publications

References 144 publications

Editorial: Novel technologies in the diagnosis and management of sleep-disordered breathing

Editorial: Novel technologies in the diagnosis and management of sleep-disordered breathing

Phenotyping sleep disturbances in ADHD and identifying harmonised outcome measures

Control of breathing by orexinergic signaling in the nucleus tractus solitarii

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