Miguel Meira e Cruz

Centro Cardiovascular da Universidade de Lisboa, School of Medicine · Sleep Unit

Objective: To evaluate a ring wearable’s accuracy in the measurement of SpO2 compared to a simultaneous SaO2 obtained SaO2 from arterial blood gases because oximeters may underestimate oxyhemoglobin saturation in darkly pigmented individuals resulting in occult hypoxemia. Subjects: 24 subjects (8 Black, 16 Non-Black) participated in the validatio...

Sleep related sexualized behaviors occur in the parasomnia known as sexsomnia, recognized as a variant of confusional arousals in the ICSD-3. These instinctive behaviors of a sexual nature emerge from deep NREM sleep and patients often present with distinguishing features within this sleep disorder category. There are often adverse psychosocial con...

Introduction As a major cause of disability among older people, Temporomandibular Joint Osteoarthritis (OA) remain a critical issue for both geriatric medicine and public health. While etiologic foundations of this condition are still unclear, it is well known that 24h-driven biological (circadian) rhythms are basic physiological requirements for t...

Introduction The potential impact of skin pigmentation on the accuracy of oximetric assessment has long been known to be a clinically relevant matter. During the COVID pandemic it became apparent that oximeters may underestimate oxyhemoglobin saturation in darkly pigmented individuals. Validation data for SaO2 is not generally available for the man...

Introduction Sleep difficulties are commonly referred by health care workers that can affect quality of life and productivity, both in patients and healthy individuals. This study firstly aimed to evaluate sleep quality in distinct groups of health care workers as well as the impact of shift work and health related habits on the sleep of such profe...

Introduction With this pilot study, authors aimed to find how OSA and insomnias (sleep onset and maintenance insomnia) interact. Methods Data from PSG-level 1 consecutive Obstructive Sleep Apnea (OSA) patients were retrospectively collected. Insomnia and OSA severity were assessed. Arousals (A), arousal index (AI), wakefulness after sleep onset (W...

This book explores the different ways sleep medicine is practiced in the world by presenting information from multiple countries from all continents. The editors, all sleep medicine experts, dive into both clinical practice, and research keeping an eye on healthcare needs and disparities, before proposing solutions. The contributions also take into...

Obstructive Sleep Apnea (OSA) corresponds to episodes of complete or partial upper airway obstruction during sleep. The gold standard for diagnosing OSA is polysomnography; however, metabolomics is an innovative and highly sensitive method that seeks to identify and quantify small molecules in biological systems. Identify the metabolites most frequ...

Objective: To compare polysomnographic parameters with others from the literature in order to provide more accurate information about Rapid Maxillary Expansion (RME) for treating Obstructive Sleep Apnea (OSA) in children, through raising the question: Is RME a good option for treating OSA in children? Prevention of mouth breathing during children'...

For the practicing clinician sleep problems are a common parental complaint, occurring in up to 25 per cent of children over the course from infancy, childhood, and adolescence. Presentations of significance pointing toward obstructive sleep apnea can include learning and behavioral problems, cardiovascular complications, and impaired growth (inclu...

Insomnia and sleep‐disordered breathing (SDB) are prevalent sleep disorders. These disorders can therefore be concurrently present – comorbid insomnia and sleep apnea (COMISA). The prevalence of COMISA in the paediatric age range is unclear. As such, phenotypic constructs should help better define this comorbid condition if it exists in children an...

Introduction: A circadian bruxism profile has been suggested to characterize sleep/awake RMMA fluctuations. It is, however, unclear whether a true circadian regulation independent of sleep-wake states may contribute to such fluctuations and therefore, if circadian regulatory factors could explain commonly observed phenotypical differences between b...

Background: Temporomandibular disorders (TMD) is a collective term that refers to complaints of temporomandibular joint (TMJ) pain, fatigue and/or pain of the craniocervical muscles, limitation of movement of the mandible, and TMJ noises. Sleep bruxism (SB) is a disorder involving rhythmic (phasic) or non-rhythmic (tonic) masticatory muscle activit...

Purpose Sleep is a crucial component of life, characterized by global behavioral and neurochemical inhibition of brain activity. The gold-standard measurement of sleep is polysomnography (PSG). It assesses several organic functions during sleep, embracing brain activity, eyes movements, muscular pattern, and heart rhythm. Despite motor function bei...

Background: Sleep patterns vary depending on variables such as gender and age, but adequate and sufficient sleep is fundamental for well-being, health and survival regardless of these factors. The elderly experience changes in their sleep patterns, such as a decrease in total sleep time and an increase in the duration of more superficial sleep, con...

The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background t...

Objectives Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OAm) is being recommended treatment for patients who ref...

Introduction: Co-morbid insomnia and sleep apnea (COMISA) is a prevalent disorder, which results in additive impairments to patients' sleep, cardiometabolic comorbidities and death .Although Insomnia and SDB as isolated conditions have been focus of different clinical studies, there are no reports focusing on their interactive role as in comorbid i...

Introduction: Mathematical models have been long used to identify and stratify risk for obstructive sleep apnea (OSA) . Clete Kushida developed a predictive morphometric model (MMK) with potential advantages for the accuracy and speed of diagnosis. However their actual predictive value is still uncertain. Objective: To assess whether the Kushida mo...

Objective: To review, critically analyze and synthesize knowledge from the international literature regarding the association between allergic rhinitis (AR) and sleep disorders, the impact of AR treatment on children’s sleep and lay the foundation for future research on this topic. Source of data: A literature search using PubMed database including...

Introduction: Insomnia is a common sleep disorder in elderly. Although the HIV-positive population have a similar life expectancy when compared to the general population, some factors may interact with immunity conditions and therefore contribute to a worse prognosis. Objective: This is a review of literature that aims to identify prevalence of ins...

Objective The aim was to verify if Manual Lymphatic Drainage (MLD) and Muscular Energy Techniques (MET) helps on pain control and amplitude of mouth opening, in patients submitted to bilateral third molars surgeries. Methods 30 consecutive patients, aged between 18 and 45 years, 53.7% males, were randomized in two groups: Physical therapy Group (P...

Normal sleep is critical for well-being. Significant physiological and psychological distress is evoked by sleep disorders. Sleep disturbances, in particular insomnia, co-exist frequently with pain in the orofacial region (OF) but the relation between OF pain (OFP), insomnia and psychosocial factors has not yet been evaluated and therefore was the...

Introduction: Sleep-related breathing disorders (SRBD)is the most common group of sleep disorders and a major public health concern. Obstructive sleep apnea (OSA) is the most prevalent, ranging from 9% to 38% in the general population. OSA is associated with several physiological changes, including intermittent hypoxia, sympathetic activation, slee...

Introduction: Sleep disturbances and chronic pain are highly prevalent conditions compromising health and well-being. Among the many and complex functions of sleep, it ameliorates pain which in turn favors sleep. Interactions between inadequate or insufficient sleep on pain modulatory pathways frequently result in adverse clinical outcomes affectin...

Introduction: Insomnia and obstructive sleep apnea (OSA) are the most common sleep disorders among the different age groups, and therefore can co-occur. When co-morbid insomnia and OSA co-exist (COMISA), they may interact and mutually potentiate some of the downstream morbidities associated with either one of these sleep disorders. Indeed, the risk...

Introduction: Rhythmic movement disorder (RMD) consists of repetitive stereotypic movements, such as head banging or body rocking, recurring every second or so and lasting from a few minutes to hours, usually prior to sleep onset. It is likely to start in infancy and have a developmental course with spontaneous resolution in early childhood. It is...

Introduction: Insomnia, the most common sleep disorder, is highly prevalent and causes clinically significant functional distress or impairment, both at physical and psychological levels. Orofacial pain (OFP) includes the pain arising from the regions above the neck, in front of the ears and below the orbitomeatal line, the oral cavity itself and i...

Introduction: Insomnia and obstructive sleep apnea (OSA) are the most common sleep disorders among the different age groups, and therefore can co-occur. When co-morbid insomnia and OSA co-exist (COMISA), they may interact and mutually potentiate some of the downstream morbidities associated with either one of these sleep disorders. Indeed, the risk...

Biological rhythms and sleep as their main representative are relevant biofunctional factors to the neuro-cognitive and behavioral development with particular interest in pediatric domain. Some aspects associated to central nervous system and higher function homeostasis, like social-afective equilibrium, critical judgement and memories consolidatio...

A Medicina Oral no Sono É controversa a divisão segmentar de disciplinas focadas no doente humano, um doente que, por si só, não se divide senão de forma artificial e não pode, por isso, ser contemplado ou tratado por partes. A medicina oral, sobretudo no seu espectro odontológico tem sido exemplo de quão necessário é o conhecimento integral do do...

Aim: The aim of this study will be to perform respiratory physiotherapy on patients with sleep bruxism and associated respiratory events (apnea and hypopnea). Methodology: The study will be a randomized, controlled, double-blind, clinical trial with a sample of individuals with sleep bruxism and associated respiratory events. Respiratory (inspirato...

Introduction: Studies have shown that narcolepsy patients may present with low serum acylcarnitine levels, demonstrating a dysfunctional beta fatty acid oxidation pathway in these patients. Objective: Evaluate the therapeutic efficacy of L-carnitine as a treatment for narcolepsy patients. Methods: This study runned in form of systematic review. The...

Pain is a multidimensional experience comprising sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions. Clinical and research findings have demonstrated a complex interplay between social burdens, individual coping strategies, mood states, psychological disorders, sleep disturbances, masticatory muscle tone, and orofac...

Obstructive sleep apnea (OSA) is the most prevalent sleep-disordered breathing in the adult population and if untreated remains a significant cause of morbidity and mortality. Continuous positive airway pressure (CPAP) therapy is still the gold standard treatment for OSA, but patient acceptance and adherence are often poor due to a multitude of fac...

Sleep-disordered breathing (SDB) and insomnia have long been recognized as important sleep disrupters often associated with increased morbidity and mortality. Although they are often seen as divergent conditions, mainly because their cardinal symptoms (excessive daytime sleepiness, and sleep loss) differ, these two sleep disorders present with many...

Introduction Insomnia is a common sleep disorder in elderly. Although the HIV-positive population have a similar life expectancy when compared to the general population, some factors may interact with immunity conditions and therefore contribute to a worse prognosis. Little is known however, about the frequency of insomnia in older HIV-positive pat...

Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at r...

Introduction Although bruxism, either during awake and during sleep is still a controversial topic in contemporary Medicine, its prevalence and its putative relationship with several conditions interfering with health and wellbeing make it relevant as a target to be studied in distinct scientific domains. Histological and morphological on the crani...

Objectives: COVID-19 pandemic imposed a relevant number of stressful factors potentially impacting either daytime function or sleep quality. This study aimed to assess the sleep quality and anxiety among the general population living in Egypt. Material and methods: A cross-sectional survey was conducted among 1,000 individuals who have been recr...

BACKGROUND AND OBJECTIVES: Literature has shown that behavioral and educational modalities are effective options in the treatment of chronic pain, including temporomandibular disorder, and techniques such as biofeedback have been used for single therapy or in combination for effective pain control in these individuals. Furthermore, the severity of...

Study objectives: The stress imposed by the COVID-19 pandemic and ensuing social isolation could adversely affect sleep. As sleep problems may persist and hurt health, it is important to identify which populations have experienced changes in sleeping patterns during the pandemic and their extent. Methods: In Study 1, 3,062 responders from 49 count...

COVID-19 is the offcial name for the disease caused by SARS-CoV-2, which has become a pandemic, infecting more than 5 million people worldwide. Transmission occurs by inhaling droplets generated when an infected person coughs, sneezes or exhales, or by touching contaminated surfaces and then rubbing their hands over their eyes, nose or mouth. Some...

Exacerbation of nighttime sleep-related oromotor activity is often recognized as a relevant clinical entity commonly known as sleep bruxism (SB). Many pragmatic issues about SB diagnosis and management remain controversial. Therefore, within a critical review of the literature, this article proposes an operational clinical approach for SB diagnosis...

Insomnia remains the most prevalent sleep disorder worldwide, and its pathophysiology suggests an interface with circadian rhythm sleep-wake disorders (CRSWDs). Some epidemiological studies have linked insomnia and circadian misalignment with adverse cardiometabolic outcomes, but the mechanisms underlying this relationship are still unclear. The au...

The inaugural case of SARS-CoV-2 infection in China in the end of 2019 and the worldwide spread of COVID-19 outbreak leaded to dramatic changes in most of the population dynamics with direct and indirect impact on physical and mental health. Some indicators of psychosocial stress, which exacerbated during social isolation such as anxiety, depressio...

Introduction To our knowledge, no studies have accessed theawake bruxism (AB) and stage by stage sleep bruxism (SB) in adults with Down syndrome. Recent works have shown that portable PSG systems are accurate for SB assessment even in the absence of audio-video recording. We aimed to evaluate the prevalence of awake bruxism, stage-by-stage sleep br...

Introduction Obstructive sleep apnea (OSA) may trigger systemic changes linked to important cardiometabolic risk factors such as hypertension, stroke and diabetes II. As a life-threatening, multifactorial disorder, OSA demands a multiprofessional approach. The most common worldwide treatments are Continuous Positive Airway Pressure (CPAP) and Mandi...

Introduction Normal respiratory function is crucial for adequate sleep. Sleep Related Breathing Disorders, namely Obstructive Sleep Apnea (OSA) are frequent conditions among a large spectrum of obstructive events in the upper airway which are often linked to significant sleep related oxyhemoglobin dessaturation levels compared to those observed in...

Abstract: Obstructive Sleep Apnea (OSA) is one of the most common sleep disorders, and invokes numerous negative health related outcomes and physiopathological processes. Understanding the mechanisms by which OSA potentiates cardiometabolic risk of patients remains a current challenge. Sleep disruption is highly prevalent among shift workers and sh...

Impact of intermittent fasting (IF) on health, aging and disease was recently revisited by de Cabo et al, focusing on the evidence from preclinical and clinical trials showing a broad-spectrum benefit on several health domains. Although a highly relevant and interesting critical discussion was conducted, sleep, as a major factor interfering on seve...

BACKGROUND AND OBJECTIVES: Burning mouth syndrome is a dysfunctional state affecting physical, mental and social welfare, often contributing to chronic stress conditions. Despite the lack of objective data, patients experience pain-related discomfort with impact in their daily life. The objective of this study was to assess the impact of burning mo...

The literature has shown that behavioral and educational modalities are effective options in the treatment of chronic pain, including Temporomandibular Disorder (TMD) and techniques such as biofeedback have been used for single therapy or in combination for effective pain control in these individuals. Furthermore, the severity of symptoms is relate...