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. 2021 Feb 10;11(2):278. doi: 10.3390/diagnostics11020278

Table 3.

Main strengths and limitations of the studies included in the scoping review.

Reference Strengths Limitations
El-Sheik et al., 2007 [46] Homogeneous sample: healthy children (age = 8–9, similar gender proportion)
Sample size: N = 64
Sample collected at two different times (3 p.m. and 5 p.m.)
Combines objective and subjective sleep assessment methods: one-week actigraphy + School Sleep habits Survey (children) and Children’s Sleep Habits Questionnaire (CSHQ) (parents)
Only IL-6 was studied
Reinhardt et. al., 2012 [51] Homogeneous sample: healthy men
Daytime workers and overnight workers were compared.
Sample collected at two different times: wake time and midnight.
Objective and subjective methods combined: Diaries + actigraphy
Includes the study of melatonin in saliva
Small sample: N = 5
No analysis with the secondary variables assessed (depression, anxiety)
Akpinar et al., 2012 [40] Narrow age range (control: 44.7 ± 13.75; experimental: 43.79 ± 12.72)
Sample size N = 56
Healthy people and people with OSA are studied
Objective and subjective methods combined: Polysomnography and Epworth Sleepiness Scale (ESS)
Mieloperoxidase (MPO) was measured on blood and salivaIMC was measured as a secondary variable
Only MPO and PCR levels were assessed (other inflammatory markers such cytokines were not assessed).
Nizam et al., 2014 [41] Polysomnography is applied to all participants (N = 52)
Healthy people and people with OSA are studied
Several cytokines were measured: IL-6, IL-33, IL-1β, IL-21, and pentraxin-3 (PTX3)
Unbalanced sample: 32 men and 20 women
Wide age range: 21–64 years
Only one sample collected
Faraut et al., 2015 [50] Homogeneous sample: healthy men (age = 25–32)
Polysomnography
Sample collected at several time points (every two hours)
Small sample: N = 11
Only IL-6 was assessed
Pinto et al., 2016 [45] Sample collected at several times (every four hours)
Includes the study of melatonin in saliva
Heterogeneous sample: healthy people and people with chronic renal failure. Wide age range: 29–79 years (N = 39)
Only TNFα and IL-6 were assessed
Samples were collected along a period of only 24 h.
Cytokines were assessed only in blood (not in saliva)
Sleep assessed with only one questionary: Sleep Quality e Index Pittsburgh (PSQI)
Thimgam et al., 2015 [42] Objective and subjective methods combined: Polysomnography and Epworth Sleepiness Scale (ESS)
A polysomnogram was produced for all patients (N = 40)
IMC was measured as a secondary variable
Heterogeneous sample: healthy people (5 men/3 women), OSA patients (11 men/3 women), and patients with suspected OSA (6 men/12 women)
Inflammatory transcriptions were assessed, but not cytokines
Reinhardt et al., 2016 [38] Homogeneous sample: healthy men workers with day work shift.
Narrow age range (32.14 ± 7.61)
Objective and subjective methods combined: Actigraphy and diaries
Sample collected at three different times (wake, 2pm and bedtime)
Small sample: N = 21
Only IL-6 was studied
Yennurajalingam et al., 2017 [43] Sample (N = 52) collected at two different times (wake and bedtime)
IL-1β and IL-6 were assessed
Secondary variables were measured: anxiety, depression with HADS (Edmonton Symptom Assessment Scale), pain with BPI (Brief Pain Inventory) and drugs used.
Heterogeneous sample: advanced cancer patients with at least one symptom of depression, anxiety, sleep disorders, and pain.
Unbalanced sample: 32 men and 20 women
Sleep assessed with only one questionary: Pittsburgh Sleep Quality Index (PSQI)
Sample collected only once a week
Reinhardt et al. 2019 [48] Homogeneous sample: healthy men workers.
Narrow age range: day workers 32.14 ± 7.61 years old and night workers 32.59 ± 5.62 years old
Different work shifts were analyzed
Actigraphy used for 10 days (24 h/day)
Sample collected at two different times
TNFα, interleukin-1β (IL-1β), and IL-6 were studied
Melatonin levels in saliva were assessed.
Sample size: N = 38
Different number of workers in each group (day: 21; night: 17)
No secondary variable was studied
Boström et al., 2019 [44] All participants were women.
All samples collected at the same time
Secondary variables were studied: functional capacity with MIDAS (Migraine Disability Assessment), depressive symptoms with BDI (Beck Depression Inventory) and quality of life (EuroQuol EQ-5D-5L)
Heterogeneous simple (N = 24): healthy women and women with migraine
Wide age range: 34–65 years
Sleep assessed with only one questionary: Pittsburgh Sleep Quality Index (PSQI)
Samples were collected only twice along the whole research (at the beginning and at the end, after 10 weeks with nVNS).
Only IL-1β was studied
Zhang et al., 2020 [49] Homogeneous sample: nurse women that work in rotative work shifts.
Daily samples collected
Different cytokines, e.g., IL-6, IL-1β, and TNFα were
studied.
Melatonin levels in saliva were assessed. Secondary variables related to sleep were studied: insomnia, anxiety, depression (with HADS) and alert level (with PVT, psychomotor vigilance task)
Sample size: N = 32
Different sample size for the control (13) and experimental groups (19)
Sleep assessed with only subjective methods: Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI)
Samples were collected only once a week
LaVoy et al., 2020 [47] Similar gender proportion (53% women)
Narrow age range: 8–16 years
Objective and subjective methods combined: Actigraphy, sleep diaries and the School Sleep Habits Survey (SSHS)
Daily simple collection (at wake time)
All samples were analyzed twice
IL-6 and IL-1β were studied
Secondary variables were studied: the z-score of body mass index (zBMI), collection time, and season of data collection.
Heterogeneous sample: healthy people and people with at least a diagnostic of attention deficit hyperactivity disorder (n = 1), generalized anxiety disorder (n = 5), major depressive disorder (n = 2), social anxiety disorder (n = 4), specific phobia (n = 3), pervasive developmental disorder (n = 1), depressive disorder not otherwise specified (n = 1), and disruptive mood dysregulation disorder (n = 1).