Climate change and sleep: A systematic review of the literature and conceptual framework.

From disaster related stress causing insomnia, to poor air quality causing sleep related breathing problems, climate change poses a potentially serious threat to human sleep. We conducted a systematic review evaluating the relationship between climate change and human sleep in the PubMed, Scopus, and Cochrane databases from 1980 through 2017 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria included epidemiologic studies published in English that reported observational population data on human sleep and its relationship to climate change, temperature, extreme weather events and climate related disasters (e.g. hurricanes, floods, and wildfires). We excluded non-human studies, laboratory or experimental physiology studies, commentaries or letters, review articles, and articles on wind turbines. Using a systematic search strategy, 16 studies met the inclusion criteria. Six studies related to the effects of rising temperature, seven studies related to extreme weather events, and three studies related to floods or wildfires. Diminished total sleep times and sleep disruption were most commonly reported, especially among the most vulnerable populations including the elderly and low-income; however, the body of evidence was limited and further well-designed human studies are clearly needed. We present a conceptual framework for identifying the emerging threats of climate change and understanding their respective effects on human sleep.

Quality measures for the care of patients with narcolepsy.

ABSTRACT: The American Academy of Sleep Medicine (AASM) commissioned a Workgroup to develop quality measures for the care of patients with narcolepsy. Following a comprehensive literature search, 306 publications were found addressing quality care or measures. Strength of association was graded between proposed process measures and desired outcomes. Following the AASM process for quality measure development, we identified three outcomes (including one outcome measure) and seven process measures. The first desired outcome was to reduce excessive daytime sleepiness by employing two process measures: quantifying sleepiness and initiating treatment. The second outcome was to improve the accuracy of diagnosis by employing the two process measures: completing both a comprehensive sleep history and an objective sleep assessment. The third outcome was to reduce adverse events through three steps: ensuring treatment follow-up, documenting medical comorbidities, and documenting safety measures counseling. All narcolepsy measures described in this report were developed by the Narcolepsy Quality Measures Work-group and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with narcolepsy.