Associations Between Complete Blood Count-Derived Inflammation Indices and Emergence Delirium in Children Undergoing Adenotonsillectomy.

Sleep has a pivotal role in physical and mental health. Sleep traits (such as sleep duration) and disorders (such as insomnia and narcolepsy) are associated with a wide spectrum of neurodegenerative diseases, psychiatric disorders, cardiovascular diseases, metabolic syndromes, as well as diseases related to the liver, lung, and kidney. For example, sleep dysregulation and short sleep duration in midlife have been linked to a higher risk of Alzheimer’s disease and other dementias. Individuals with sleep disturbance were also more likely to have mental and psychiatric disorders, such as anxiety and schizophrenia. In addition, both insufficient and excess sleep duration may cause a higher incidence of cardiovascular outcomes, including coronary heart disease, atrial fibrillation, and stroke. Sleep and circadian rhythm disorders, including obstructive sleep apnea (OSA) and circadian rhythm, have an impact on metabolic syndromes such as obesity and type 2 diabetes. Moreover, OSA leads to insulin resistance and dyslipidemia, which play an important role in the development of nonalcoholic fatty liver disease (NAFLD). Sleep complaints, including insomnia and OSA, were frequently encountered in patients with chronic kidney disease, as well as lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma. However, achieving a thorough understanding of sleep from a pan-organ perspective remains a challenge. Two methodological approaches that can be used to investigate the relationships between sleep and organ function are imaging and genetics. Magnetic resonance imaging (MRI) provides a noninvasive and comprehensive measure of organ structure and function. Many imaging traits extracted from brain, cardiac, and abdominal MRI are well-established clinical endophenotypes and have been widely used in the prediction and early detection of complex diseases. In addition, retinal optical coherence tomograph (OCT) imaging is a non-invasive approach that offers a high-resolution view of the cross-sectional structure of the retina. Using MRI and OCT data, several studies have examined the sleep-related changes in structures and functions of the brain, heart, and eye. For example, poor sleep quality is linked to reduced hippocampal volume and brain atrophy in the right superior frontal cortex, as well as decreased functional connectivity in several networks, including those in the left middle temporal and left inferior occipital regions. Cardiac MRI suggests that individuals with OSA tend to exhibit lower ventricular volumes and increased ejection fractions. Additionally, OSA is associated with thicker choroidal thickness and thinner mean (retinal nerve fiber layer (RNFL) thickness in both eyes, as observed by OCT. Three major limitations of most existing studies have been i) the limited study sample size, which was usually less than a few hundred; ii) focusing on one organ, single imaging modality (or trait), and/or one sleep trait, such as hippocampal atrophy and sleep duration; and iii) a scarcity of investigations on sleep-related changes in abdominal organs using MRI. It is known, however, that large sample sizes are needed for imaging studies to detect small effect sizes and produce reproducible findings. In addition, distinct imaging modalities and sleep traits may be relevant to different diseases and health-related characteristics. Therefore, a systematic analysis of multi-organ imaging data and multiple sleep traits would provide a more extensive map of sleep-related structural and functional variations across multiple organs. Large-scale genome-wide association studies (GWAS) have shown that sleep disorders and traits are heritable and have a polygenic genetic architecture. The sleep-associated genetic variants are enriched for genes expressed in the brain and for metabolic and psychiatric pathways. Genetic correlations between sleep traits and brain-related disorders (such as depression and schizophrenia) have been discovered, suggesting their shared neurogenetic basis. On the other hand, imaging traits are also heritable and hundreds of associated genetic loci have been identified in recent GWAS. However, few studies have ever integrated these heritable multi-organ health indexes and sleep traits to explore the genetic interactions among sleep, organ structure/function, and associated clinical endpoints.