Julien Coelho, Florian Pécune, Alex Chanteclair, Christophe Gauld, Etienne de Sevin, Emmanuel d'Incau, Patricia Sagaspe, Tafsir Ka, Hervé Alia, Charles M Morin, Jean-Arthur Micoulaud-Franchi, Pierre Philip
{"title":"Excessive Daytime Sleepiness Should Be Systematically Assessed in Individuals With Insomnia: A Population-Based Study Employing a Virtual Agent-Based Digital Tool.","authors":"Julien Coelho, Florian Pécune, Alex Chanteclair, Christophe Gauld, Etienne de Sevin, Emmanuel d'Incau, Patricia Sagaspe, Tafsir Ka, Hervé Alia, Charles M Morin, Jean-Arthur Micoulaud-Franchi, Pierre Philip","doi":"10.1111/jsr.70178","DOIUrl":"https://doi.org/10.1111/jsr.70178","url":null,"abstract":"<p><p>Insomnia and excessive daytime sleepiness (EDS) often co-occur, despite involving distinct physiological mechanisms. The KANOPÉE application, a fully autonomous virtual agent that collects sleep-related data and delivers personalised behavioural recommendations over a 17-day period, offers a unique opportunity to better understand this unexpected phenotype. Our primary aim was to characterise these 'sleepy insomniacs', and our secondary aim was to evaluate their response to this digital sleep intervention. Among 21,590 participants, individuals with an Epworth Sleepiness Scale score ≥ 11 and an Insomnia Severity Index score ≥ 15 were classified as 'sleepy insomniacs'. Comorbidities (i.e., obstructive sleep apnea syndrome, restless legs syndrome, depression, and sleep medication use) were first described and then excluded for further analyses. At baseline, 4843 (47.9%) of the 10,114 participants with insomnia also reported EDS and were categorised as 'sleepy insomniacs'. Half of this subgroup reported at least one comorbidity, with depression being the most common. After excluding participants with comorbidities, 3239 individuals (44.3%) remained in the 'sleepy insomniacs' category. These individuals were more likely to experience middle or late insomnia symptoms compared to those with insomnia without EDS but responded similarly to the digital sleep intervention. In conclusion, EDS is highly prevalent among individuals with insomnia symptoms. While comorbidities, particularly depression, explained the co-occurrence in approximately half of the sample, a substantial proportion of participants without comorbidities also exhibited this unexpected phenotype. The association with specific insomnia subtypes highlights the need for further investigation. Notably, a 17-day digital sleep intervention proved effective in treating 'sleepy insomniacs'.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70178"},"PeriodicalIF":3.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monique E H Valk-Geuke, Gert J Geurtsen, Rob M A de Bie, Rick Schuurman, Martijn Beudel, Esmée Verwijk
{"title":"The Effect of Deep Brain Stimulation on Sleep and Cognition in Patients With Parkinson's Disease.","authors":"Monique E H Valk-Geuke, Gert J Geurtsen, Rob M A de Bie, Rick Schuurman, Martijn Beudel, Esmée Verwijk","doi":"10.1111/jsr.70193","DOIUrl":"https://doi.org/10.1111/jsr.70193","url":null,"abstract":"<p><p>Sleep-wake disturbances and cognitive decline are among the most common nonmotor symptoms of Parkinson's disease (PD). Deep brain stimulation (DBS) can successfully alleviate motor symptoms. However, the impact on sleep-wake disturbances and cognitive decline, and their interaction, is yet unclear. We aim to investigate changes in and interaction between subjective sleep and cognition following DBS. We performed a study on data from the Amsterdam-PD-DBS database with assessments at baseline and at 6 months post-operative. Subjective sleep was assessed with the sleep and sleepiness items of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale. Cognition was assessed with neuropsychological tests for the domains of language, processing speed, executive functioning, and memory. Three hundred and sixty-five PD patients were included. Subjective sleep and sleepiness significantly improved after DBS. The proportion of patients with clinically relevant sleep disturbances dropped significantly from 76.4% to 50.1% (p < 0.001). Significant declines were observed in verbal fluency (p < 0.001, p = 0.005), processing speed (p < 0.001), and executive function (p < 0.001, p = 0.013), while delayed memory showed a significant improvement (p = 0.025). Significant associations were found for reduction in sleepiness and less decline in category fluency (p = 0.014) while no significant relationship between changes in sleep and changes in cognitive outcomes was present. This study provides strong evidence for the beneficial effects of DBS on sleep and sleepiness. No evidence was found for an association between reduction in subjective sleep disturbances following DBS and change in cognition.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70193"},"PeriodicalIF":3.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Veneruso, Paola Del Sette, Ramona Cordani, Antonella Barbieri, Lorenzo Chiarella, Serena Lecce, Cristina Venturino, Salvatore Lo Cascio, Francesco Biscarini, Fabio Pizza, Lino Nobili, Giuseppe Plazzi
{"title":"Facial Emotion Recognition in Children With Narcolepsy Type 1.","authors":"Marco Veneruso, Paola Del Sette, Ramona Cordani, Antonella Barbieri, Lorenzo Chiarella, Serena Lecce, Cristina Venturino, Salvatore Lo Cascio, Francesco Biscarini, Fabio Pizza, Lino Nobili, Giuseppe Plazzi","doi":"10.1111/jsr.70191","DOIUrl":"https://doi.org/10.1111/jsr.70191","url":null,"abstract":"<p><p>Narcolepsy type 1 is a neurological disorder typically emerging in childhood or adolescence, characterised by excessive daytime sleepiness, cataplexy and rapid eye movement sleep-related symptoms. Beyond its core features, increasing evidence suggests an impact on socio-cognitive development, including difficulties in understanding others' mental states. In this study, we aimed to clarify whether such impairments extend to more basic emotional processes. We expanded previous work on Theory of Mind by including an analysis of facial emotion recognition and comparing children with narcolepsy type 1 to a newly recruited group of typically developing peers. Twenty-two children with narcolepsy type 1 and twenty-two age- and sex-matched controls completed standardised tasks assessing Theory of Mind and facial emotion recognition. Results confirmed a significant impairment in Theory of Mind among children with narcolepsy compared to controls. In contrast, no differences emerged in facial emotion recognition, suggesting a selective disruption in higher-order socio-cognitive processes. Additionally, greater daytime sleepiness was associated with poorer Theory of Mind performance, but not with emotion recognition accuracy. These results indicate a specific vulnerability in social understanding during the development of type 1 narcolepsy, probably aggravated by narcoleptic symptoms. However, facial emotion recognition is not affected in these patients, suggesting the involvement of different networks. Early identification of these difficulties and targeted interventions may be crucial to support peer relationships and long-term psychosocial outcomes in affected children.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70191"},"PeriodicalIF":3.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luis E Ortiz, Anne Marie Morse, Michael J Thorpy, Clete A Kushida, John Harsh, Thomas Roth, Jennifer Gudeman, Yves Dauvilliers
{"title":"Once-Nightly Sodium Oxybate Meets American Academy of Sleep Medicine Criteria for Treatment of Narcolepsy.","authors":"Luis E Ortiz, Anne Marie Morse, Michael J Thorpy, Clete A Kushida, John Harsh, Thomas Roth, Jennifer Gudeman, Yves Dauvilliers","doi":"10.1111/jsr.70189","DOIUrl":"https://doi.org/10.1111/jsr.70189","url":null,"abstract":"<p><p>Data from the REST-ON trial were not available before the 2021 American Academy of Sleep Medicine (AASM) clinical practice guideline update, which included a literature review through August 2020. This post hoc analysis from REST-ON assessed participants who achieved clinically significant improvements on individual AASM clinical significance thresholds (CSTs). Composites of the coprimary endpoints and a secondary endpoint were also analysed. Participants with narcolepsy aged ≥ 16 years were randomised 1:1 to once-nightly sodium oxybate (ON-SXB) or placebo for 13 weeks. Coprimary endpoints were mean sleep latency on the Maintenance of Wakefulness Test (MWT), Clinical Global Impression of Improvement (CGI-I) rating, and number of cataplexy episodes; secondary endpoints included the Epworth Sleepiness Scale (ESS) score. Outcomes with ON-SXB treatment compared with baseline were assessed according to the CSTs, and for those who met CSTs, the proportions of participants who experienced clinically significant improvements on a composite of ≥ 2, ≥ 3, or 4 endpoints were calculated. For improvements from baseline with ON-SXB at Week 13 (9-g dose), mean sleep latency on the MWT increased 10.8 min (CST, ≥ 2-min increase), 92.8% rated improvement on the CGI-I (CST, ≥ 33% of participants reporting improvement), reduction in number of cataplexy episodes was 60.8% reduction (CST, ≥ 25% reduction), and reduction in ESS score was -6.5 (CST, ≥ 2-point decrease). At Weeks 3, 8 and 13, significantly more participants treated with ON-SXB versus placebo experienced clinical improvements on ≥ 2, ≥ 3, or 4 endpoints (p ≤ 0.05). These data demonstrate the robust efficacy of ON-SXB across multiple clinically important narcolepsy symptoms per established CSTs, further supporting the use of ON-SXB in clinical practice. Trial Registration: This manuscript presents the results of a post hoc analysis from the REST-ON clinical trial (NCT02720744).</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70189"},"PeriodicalIF":3.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dana M Dijkgraaf, Pantea Kiani, Maureen N Zijlstra, Pauline A Hendriksen, Johan Garssen, Joris C Verster
{"title":"The Number of Newly Dispensed Hypnotic Drugs During the First COVID-19 Lockdown Period in The Netherlands.","authors":"Dana M Dijkgraaf, Pantea Kiani, Maureen N Zijlstra, Pauline A Hendriksen, Johan Garssen, Joris C Verster","doi":"10.1111/jsr.70190","DOIUrl":"https://doi.org/10.1111/jsr.70190","url":null,"abstract":"<p><p>The 2019 coronavirus (COVID-19) pandemic and associated lockdowns significantly disrupted healthcare systems, including access to pharmacological treatments such as sleep medication. This study investigated the number of first-time dispensed hypnotic drugs during the first COVID-19 lockdown in the Netherlands, using data from the Dutch Foundation for Pharmaceutical Statistics (SFK), which covers approximately 96% of all pharmacy dispensations (5.46 million patients). First-time dispensing was defined as no use of hypnotics in the previous year and included benzodiazepines, benzodiazepine-related drugs, and melatonin receptor agonists. Data from 2020 were analysed across three periods: pre-lockdown (Weeks 1-11), lockdown (Weeks 12-19) and post-lockdown (Weeks 20-26), and were compared to the same periods in 2019. Analyses were stratified by age group (children: 0-9, adolescents: 10-19, adults: 20-64, elderly: 65+) and sex. The data revealed a significant reduction in first-time hypnotic dispensations in 2020 (155,961) compared to 2019 (168,814, p < 0.001), with declines across all three time periods (p < 0.001). During the lockdown, significant reductions were found among children, adolescents, and adults (p < 0.001), but not among the elderly. Female adults and the elderly received significantly more hypnotics than their male counterparts (p < 0.001), consistent with higher reported rates of sleep disturbances. In conclusion, the overall number of first-time dispensed hypnotics was significantly lower during the first COVID-19 lockdown in the Netherlands, except among the elderly. It remains unclear to what extent individuals self-medicated with over-the-counter sleep medication, or experienced untreated sleep complaints during the first lockdown in the Netherlands.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70190"},"PeriodicalIF":3.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of the Agreement Between Research-Grade Actigraphy Sleep, Consumer-Grade Smartwatches and Self-Reported Sleep Diaries in Masters Endurance Athletes.","authors":"Asli Devrim-Lanpir, Simon Devenney, Brendan Egan","doi":"10.1111/jsr.70177","DOIUrl":"https://doi.org/10.1111/jsr.70177","url":null,"abstract":"<p><p>Sleep monitoring is a tool widely used to support recovery and performance in endurance athletes. This study aimed to assess agreement between research-grade actigraphy (ActiGraph GT9X), consumer-grade smartwatches (Garmin), and self-reported sleep diaries in masters endurance athletes. Seventy athletes (43 males, 46.3 ± 7.3 years; 27 females, 49.3 ± 8.3 years) wore ActiGraph and smartwatch devices on their non-dominant wrist while maintaining a self-reported sleep diary for seven consecutive nights. ActiGraph recorded the shortest total sleep time (332 ± 87 min), whereas the diary and smartwatch recorded longer sleep durations by 109 and 126 min, respectively (p < 0.001). Sleep efficiency (%) was also higher in the sleep diary and smartwatch compared to ActiGraph, with mean biases of -5.9% and -4.1%, respectively. Sleep diary values closely agreed with smartwatch values (ICC = 0.880, 95% CI: 0.624 to 0.946), while poor agreement was found between ActiGraph and the sleep diary (ICC = 0.190, 95% CI: -0.149 to 0.459). Proportional bias was evident in both the sleep diary and smartwatch, with greater differences in total sleep time and efficiency observed in athletes with shorter durations and lower sleep efficiency, respectively. Sex differences emerged, with stronger agreement between smartwatch and ActiGraph in sleep efficiency in females (ICC = 0.690, 95% CI: 0.336 to 0.857) than males (ICC = 0.481, 95% CI: -0.020 to 0.723). Findings suggest that both consumer-grade devices and self-reported sleep diaries report longer sleep durations and higher sleep efficiency relative to actigraphy. Sleep metrics from these methods should be interpreted with caution, particularly in athletes with shorter or more fragmented sleep.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70177"},"PeriodicalIF":3.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xuan Cai, Xue Wu, Hao Chen, Xinmin Lu, Cheng Zhang, Yupu Liu, Xueyan Zhang, Da Long
{"title":"Assessment of Retinal Perfusion and Vascular Density in Obstructive Sleep Apnea Syndrome With Swept-Source Optical Coherence Tomography Angiography.","authors":"Xuan Cai, Xue Wu, Hao Chen, Xinmin Lu, Cheng Zhang, Yupu Liu, Xueyan Zhang, Da Long","doi":"10.1111/jsr.70182","DOIUrl":"https://doi.org/10.1111/jsr.70182","url":null,"abstract":"<p><p>Numerous ocular conditions, including non-arteritic anterior ischemic optic neuropathy, glaucoma, retinal venous occlusion, and diabetic retinopathy, are associated with obstructive sleep apnea syndrome (OSAS). This study aimed to assess changes in the vascular density and perfusion area across various retinal layers in patients diagnosed with OSAS using swept-source optical coherence tomography angiography (OCTA) with a 12 × 12 mm scan mode. A total of 80 participants with OSAS underwent overnight polysomnography to assess the severity of sleep apnea, followed by OCTA measurements to collect data on vascular density and perfusion area across each retinal layer and segmentation. Participants were divided into three groups: 28 in Group 1 (no OSAS/mild OSAS), 22 in Group 2 (moderate OSAS), and 30 in Group 3 (severe OSAS). Perfusion areas differed significantly among the three groups in the retina, inner retina, choroid, nerve fibres, superficial vascular plexus (SVP), and intermediate capillary plexus (ICP) layers. In addition, vascular densities also showed significant differences in the inner retina, nerve fibres, and ICP layers. Notably, apnea-hypopnoea index scores correlated significantly with perfusion areas in the retina, SVP, and ICP, as well as with vascular densities in the nerve fibre layer, SVP, and ICP. Significant changes in vascular density and perfusion area were observed in patients with moderate to severe OSAS, suggesting that OCTA may be a valuable non-invasive method to assess changes in blood flow that are associated with sleep apnea.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70182"},"PeriodicalIF":3.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Chorvoz, C Rabec, M Labruyère, H Devilliers, P Sabot, A Berrier, D Schenesse, P Mouillot, P Bonniaud, M Georges
{"title":"Continuous Positive Airway Pressure Improves Marital Relationship and Sexual Satisfaction in Obstructive Sleep Apnea Patients and Partners.","authors":"J Chorvoz, C Rabec, M Labruyère, H Devilliers, P Sabot, A Berrier, D Schenesse, P Mouillot, P Bonniaud, M Georges","doi":"10.1111/jsr.70167","DOIUrl":"https://doi.org/10.1111/jsr.70167","url":null,"abstract":"<p><p>Symptoms of obstructive sleep apnea and hypopnea can interfere with sleep and quality of life for the patient's partner and affect marital relationships. Our primary objective was to assess how continuous positive airway pressure (CPAP) treatment affects couples using the Dyadic Adjustment Questionnaire (DAS-16). Secondary objectives focused on the effects on the dyad's quality of life and sleep, depending on the technical characteristics of the device. Prospective monocentric study including consecutive couples in which one of the partners began treatment by CPAP between July 2022 and February 2024 at Dijon University Hospital. After inclusion, dyads were evaluated 2 and 6 months after treatment initiation. Fifty-four couples were analysed. After 2 months under CPAP, the dyadic adjustment score (DAS-16) significantly improved in partners (ΔDAS-16 = +1 [-1; 3], p = 0.025) and in patients (ΔDAS-16 = +2 [-1; 5], p = 0.002). DAS-16 improvement was stable after 6 months. Sexual satisfaction followed the same trend. Sleep quality assessed by the Pittsburgh Sleep Quality Index (patients) and the Athens Insomnia Scale (partners) improved significantly, as did daytime sleepiness. A significant reduction in anxiety and depression scores, as well as an improvement in several domains of the SF-36 questionnaire, were also demonstrated in both groups. Our study shows that the use of CPAP improves the quality of marital relationships, as perceived by both partners. These findings could provide clinicians with additional tools to enhance patient adherence and compliance with therapy.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70167"},"PeriodicalIF":3.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}