Nature and Science of Sleep最新文献

{"title":"Letter to the Editor Regarding \"Development and Internal Evaluation of a Nomogram for Clinically Significant Depressive Symptoms in Obstructive Sleep Apnea-Hypopnea Syndrome\" [Letter].","authors":"Rijuan Jin","doi":"10.2147/NSS.S650563","DOIUrl":"10.2147/NSS.S650563","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"650563"},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Digital Cognitive Behavioral Therapy for Insomnia Accessible for the Deaf Community?","authors":"Veronica Van Rossen, Ishana Kapoor, Marleigh Treger, Christopher Miller, Philip Cheng","doi":"10.2147/NSS.S601462","DOIUrl":"10.2147/NSS.S601462","url":null,"abstract":"<p><p>While digital cognitive behavioral therapy for insomnia (dCBT-I) is highly effective, accessibility and adherence challenges persist, especially among vulnerable groups. To highlight unaccounted gaps in dCBT-I treatment adherence, a qualitative interview and case study were conducted to explore the experience of a deaf individual engaging in a six-week dCBT-I program. The patient showed strong adherence and improved sleep efficiency from 63% at Session 1 to 87% at Session 6, with feedback highlighting key accessibility barriers (eg, translation of audio content, inaccessible treatment recommendations) and facilitators (eg, telehealth sessions, motivational approach). This case serves as a foundation for future research and innovation, aiming to reduce treatment disparities in the digital mental health sphere.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"601462"},"PeriodicalIF":3.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Hypoxia-Induced Inflammation and the Formation of Exhaled Volatile Organic Compound Profiles in Obstructive Sleep Apnea-Hypopnea Syndrome: A Narrative Review.","authors":"Yang Wang, Lei Pan","doi":"10.2147/NSS.S637656","DOIUrl":"10.2147/NSS.S637656","url":null,"abstract":"<p><p>Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by recurrent upper airway obstruction during sleep, intermittent hypoxia (IH), and sleep fragmentation, and is associated with oxidative stress, chronic low-grade inflammation, metabolic dysregulation, and upper airway remodeling. These pathophysiological disturbances may alter the generation and release of volatile metabolites, thereby providing a rationale for investigating exhaled volatile organic compound (VOC) profiles as noninvasive indicators of OSAHS-related redox imbalance, inflammatory activity, and metabolic abnormalities. Focusing on IH-induced inflammatory responses as a central mechanistic link, this review examines the potential mechanisms through which inflammation contributes to changes in exhaled VOC profiles in OSAHS. Repeated hypoxia-reoxygenation and upper airway mechanical stress may activate inflammatory signaling pathways, including nuclear factor κB, hypoxia-inducible factor-1α, and NOD-like receptor family pyrin domain-containing 3, and may influence the generation and release of volatile metabolites such as aldehydes, alkanes, acetone, alcohols, and isoprene through amplified oxidative stress, lipid peroxidation, metabolic reprogramming, and alterations in the local airway microenvironment. Available clinical studies suggest that exhaled VOC profiles in patients with OSAHS may be associated with disease severity, nocturnal hypoxic burden, metabolic abnormalities, and treatment response. However, the specificity and reproducibility of candidate VOCs remain limited by individual metabolic profiles, exogenous exposures, and methodological heterogeneity. Future studies should integrate standardized breath sampling, high-confidence compound identification, longitudinal validation, and concurrent assessment of inflammatory, oxidative stress, and metabolic markers. Inflammation-related VOC profiling may offer mechanistic insight into the pathophysiological heterogeneity of OSAHS and support the development of noninvasive assessment tools and more personalized management strategies.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"637656"},"PeriodicalIF":3.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep-Disordered Breathing and Nocturnal Hypoxia in Cancer Patients: A Stomatological and Airway Assessment Framework.","authors":"Carlos Mas Bermejo, Carlos Mas Gómez, Luis-Alberto Bravo-González","doi":"10.2147/NSS.S629732","DOIUrl":"10.2147/NSS.S629732","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer frequently experience sleep-related symptoms and physiological disturbances that may be associated with sleep-disordered breathing (SDB) and nocturnal hypoxia. Although these conditions have attracted increasing attention in oncology, the potential contribution of craniofacial restriction and upper airway dysfunction remains insufficiently recognized in routine clinical practice.</p><p><strong>Objective: </strong>To propose a stomatological and upper airway assessment framework for the identification of anatomical factors that may contribute to sleep-disordered breathing and nocturnal hypoxia in adults with cancer.</p><p><strong>Methods: </strong>This narrative review integrates current evidence on sleep-disordered breathing, nocturnal hypoxia, craniofacial development, and upper airway dysfunction. The proposed framework was developed from recurrent clinical observations in adults with cancer together with a narrative synthesis of the available literature, with emphasis on anatomical findings identifiable during routine stomatological examination.</p><p><strong>Main findings: </strong>Current evidence indicates that anatomical features such as maxillary constriction, nasal airway narrowing, altered craniofacial development, and ankyloglossia may contribute to upper airway dysfunction and nocturnal hypoxia. Despite increasing recognition of the systemic consequences of nocturnal hypoxia, these upstream anatomical factors are rarely incorporated into routine oncological assessment. Based on the available evidence, a practical clinical framework is proposed to facilitate early identification of patients who may benefit from further respiratory evaluation.</p><p><strong>Conclusion: </strong>Integrating stomatological and upper airway assessment into the multidisciplinary evaluation of adults with cancer may improve recognition of previously unrecognized sleep-disordered breathing and nocturnal hypoxia. This framework provides a clinically applicable approach for identifying potentially modifiable anatomical contributors to respiratory dysfunction and may support future research evaluating their relevance in supportive cancer care.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"629732"},"PeriodicalIF":3.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dynamic Model of Microsleep and Vigilance Tradeoffs in Nesting Chinstrap Penguins.","authors":"Kerk L Phillips, Mark H Showalter, Eric R Eide, James H Cardon","doi":"10.2147/NSS.S612907","DOIUrl":"10.2147/NSS.S612907","url":null,"abstract":"<p><strong>Background: </strong>Sleep in wild animals reflects both physiological regulation and ecological demands. Nesting chinstrap penguins exhibit extreme sleep fragmentation, obtaining substantial sleep through thousands of brief microsleep episodes while maintaining vigilance.</p><p><strong>Objective: </strong>To examine whether a dynamic model integrating sleep regulation with ecological trade-offs can account for the fragmented sleep patterns observed in nesting chinstrap penguins.</p><p><strong>Methods: </strong>We adapted a dynamic model of sleep choice in which an animal switches between sleep and wakefulness on the basis of homeostatic sleep pressure, circadian alignment, switching costs, and stochastic waking opportunities. The model was calibrated to published sleep data from 14 nesting chinstrap penguins using five simulated moments: average hours of sleep per day, the standard deviation of hours of sleep per day, the number of sleep events, the maximum sleep duration, and the percentage of sleep durations less than 10 seconds.</p><p><strong>Results: </strong>The model reproduced several key qualitative features of penguin sleep. Simulated sleep episodes were very short, with an average duration of 2.774 seconds compared with 3.91 seconds in the observed data. The model also generated frequent transitions between sleep and wake, closely matching the observed number of daily sleep events and reproducing the maximum observed sleep duration. However, it underestimated total sleep time and produced a larger share of very short episodes than observed in the data. Estimated parameters implied minimal switching costs, rapid homeostatic adjustment over seconds-long bouts, and a strong relative weight on sleep utility within the fitted model.</p><p><strong>Conclusion: </strong>A dynamic optimization framework can capture important qualitative features of fragmented sleep in nesting chinstrap penguins. The findings suggest that microsleeps may reflect adaptive trade-offs between restorative sleep and wakeful activity under ecological constraint. Because the model treats sleep as a binary behavioral state, it does not distinguish unihemispheric from bihemispheric slow-wave sleep. We therefore interpret the model primarily as a model of microsleep timing and fragmentation rather than as a complete model of penguin sleep architecture or fragmented sleep across wild animals.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"612907"},"PeriodicalIF":3.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Depressive Symptoms and Toddler Sleep: Moderating Effects of Sleep Parenting Practices.","authors":"Hsiao-Yen Wu, Pey-Ling Shieh, Yen-Chun Liu","doi":"10.2147/NSS.S615753","DOIUrl":"10.2147/NSS.S615753","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Toddler sleep is more consolidated than infant sleep and may better reflect long-term sleep regulation. Despite growing interest in maternal mental health, evidence linking maternal depression to toddler sleep remains limited. Moreover, sleep parenting practices may shape this relationship. This study aimed to examine the status of maternal depression, toddler sleep, and sleep parenting practices, as well as the moderating role of these practices in the association between maternal depression and toddler sleep.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This research employed a cross-sectional design conducted between November 2022 and March 2023 among mothers of toddlers in Taiwan. A total of 126 mothers of toddlers aged 1 to 3 years completed an online survey. The mean age of mothers was 33.01 years (SD = 4.33), and the mean age of toddlers was 1.79 years (SD = 0.58). Maternal depression was assessed using the Beck Depression Inventory-II (BDI-II, Beck, 1996). Toddler sleep was measured using the Brief Infant Sleep Questionnaire-Reviesd (Mindell et al, 2019), including four indicators: maternal perceived sleep problem, sleep latency, number of nocturnal awakenings, and nighttime sleep duration. Two sleep parenting practices were assessed: co-sleeping (co-sleep vs not co-sleep) and consistency of sleep routines. Data were analyzed using descriptive statistics, group comparisons, correlation analyses, and multiple regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Approximately 33.3% of mothers exhibited depressive tendencies (BDI-II &gt; 13). Most toddlers had nighttime sleep duration shorter than 12 hours (91.3%). Around half of the toddlers had sleep latency longer than 45 minutes (50.8%), 34.9% experienced at least two nocturnal awakenings, and 11.9% were reported to have sleep problem. Co-sleep was reported by 51.6% of mothers, and 45.2% had low consistency in their sleep routines (≤5 nights/week). After controlling for child health status, maternal income, and education level, higher maternal depressive symptoms were associated with greater toddler sleep problem severity and longer sleep latency (Bs = 0.02 and 0.87, ps &lt; 0.05 and 0.01, respectively). Co-sleep moderated the association between maternal depression and toddler sleep problem (B = -0.05, p &lt; 0.05). Simple slope analyses indicated that higher maternal depression was associated with more severe toddler sleep problem in the co-sleep group (B = 0.05, p &lt; 0.01), but not in the not co-sleep group (B = 0.00, p &gt; 0.05). No moderating effect was found for sleep routine consistency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Maternal depression is associated with more severe sleep problem and longer sleep latency in toddlers. Co-sleep may amplify the spillover associations of maternal depression on toddler sleep. For mothers with elevated depressive symptoms, encouraging separate sleeping arrangements may help buffer the association between maternal depression and mat","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"615753"},"PeriodicalIF":3.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Different Sleep Positions on the Severity of Obstructive Sleep Apnea: A Retrospective Study.","authors":"Rahaf A Jereisat, Hala Qaryouti, Hakam Alsawalha, Alfred Maksoud, Yazan Abdeen","doi":"10.2147/NSS.S627693","DOIUrl":"10.2147/NSS.S627693","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea is a risk factor for cardiovascular diseases. Positional sleep apnea is a subtype of obstructive sleep apnea where severity is influenced by the patient's sleeping position. Previous studies have compared supine to non-supine positions; the effect of right lateral versus left lateral position remains in question. Our objective is to study and compare the severity of obstructive sleep apnea across different sleeping positions.</p><p><strong>Methods: </strong>We conducted a retrospective, single-centered study on 338 adult patients (age ≥18 years) diagnosed with Obstructive Sleep Apnea on home sleep study test in the time period between January 2023 and January 2025 in an outpatient community clinic. Linear mixed-effects models were used for statistical analyses.</p><p><strong>Results: </strong>The mean age of the participants was 55.29 years, with an average AHI of 29.54. Supine position was associated with a higher AHI than prone position (Adjusted model SE= 1.06, p=0.001). However, there were no significant differences between left and right positions across different patients (p =0.327) nor within the same patient (SE 1.31, P 0.65). Comparing sleep positions that were observed more than 20% of the time showed that supine positioning was associated with a significantly higher AHI than right-lateral positioning (CI 15.08-20.61; P<0.001) and left-lateral positioning (95% CI 14.49-20.23; P<0.001). No significant difference was identified between left- and right-lateral positioning (95% CI -2.64 to 3.61; P=0.762).</p><p><strong>Conclusion: </strong>There was no statistically significant difference between right lateral and left lateral positions on sleep apnea severity, whereas supine position had the highest AHI in comparison to all sleeping positions. Positional therapy remains a valid option for patients with supine‑predominant OSA. Further large scale studies are recommended to compare the true nature and severity of sleep apnea of each sleeping position.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"627693"},"PeriodicalIF":3.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Cephalometry and Acoustic Pharyngometry for the Assessment of Moderate to Severe Obstructive Sleep Apnea Before Treatment in Childhood.","authors":"Plamen Bokov, Benjamin Dudoignon, Amina Baydoun, Jacques Dahan, Philippe Amat, Fayrouz Sghaier, Imene Boujemla, Anne-Laure Bonnet, Christophe Delclaux","doi":"10.2147/NSS.S628495","DOIUrl":"10.2147/NSS.S628495","url":null,"abstract":"<p><strong>Purpose: </strong>The ERS Statement dealing with childhood obstructive sleep apnea (OSA) declared that cephalometry and acoustic pharyngometry may be useful exams for the management of OSA. The objective of our cross-sectional study was to evaluate the correlations between the severity of OSA, namely obstructive apnea-hypopnea index (OAHI), and indices obtained from both acoustic pharyngometry and cephalometry in children referred for OSA treatment.</p><p><strong>Methods: </strong>Children referred for treatment of their moderate to severe OSA (AHI ≥ 5/hour) underwent acoustic pharyngometry in sitting and supine positions (measurement of pharyngeal volume and calculation of estimated pharyngeal compliance) and cephalometry (measurement of Frankfort Mandibular plane Angle: FMA and Frankfort Mandibular Incisal Angle: FMIA, hyoid bone distance to mandibular plane).</p><p><strong>Results: </strong>Two hundred and five consecutive children were enrolled (mean age ± SD: 11.2 ± 3.7 years, 73 females, type 1 OSA \"enlarged tonsils\": 55 children, type 2 \"obese\": 80, type 3 \"syndromes\": 70). In a multiple regression analysis, only FMA and hyoid bone distance remained independently linked to OAHI (adjusted r² of the model: 0.12, p< 0.001, weak explanatory power). The FMA angle allowed differentiating normodivergence (21°< FMA < 29°: 41% of the children), hyperdivergence (FMA ≥ 29°: 32%), and hypodivergence (≤ 21: 27%). The participants with hyperdivergence were younger, less obese, and had a longer lower face (adenoid facies). In a multiple regression analysis, only height and FMIA remained independently linked to pharyngeal volume (adjusted r² of the model: 0.32, p<0.001, moderate explanatory power).</p><p><strong>Conclusion: </strong>Childhood OSA can be associated with hypodivergence. Its severity is linked to craniofacial morphology, and cephalometry provides additional endotypic information in selected children.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"628495"},"PeriodicalIF":3.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journey Mapping the Unmet Needs in Pediatric Adenoid Hypertrophy: A Caregiver's Perspective.","authors":"Shidi Xu, Xiaoyan Feng, Minjuan Yu, Tianhong Xu, Zhenzhen Pan, Ling Li","doi":"10.2147/NSS.S583647","DOIUrl":"10.2147/NSS.S583647","url":null,"abstract":"<p><strong>Objective: </strong>To systematically map the patient journey and identify unmet needs in children with adenoid hypertrophy and their caregivers.</p><p><strong>Methods: </strong>A qualitative study using in-depth interviews with 25 caregivers of children aged 3-9 years was conducted. Adenoid hypertrophy was confirmed by nasoendoscopy (≥70% obstruction) and/or polysomnography (OAHI >1 event/hour). Data were analyzed through reflexive thematic analysis to construct a comprehensive journey map. The emotional curve was derived qualitatively from caregiver narratives as a heuristic visualization of emotional trajectories across care stages, not as a quantitative measure.</p><p><strong>Results: </strong>Analysis revealed two distinct emotional trajectories: surgical path caregivers experienced a post-discharge crisis due to support vacuum, while conservative path caregivers endured persistent anxiety from efficacy uncertainty. We identified both pathway-specific needs (post-discharge support, efficacy feedback) and cross-cutting needs (proactive information, holistic habit guidance).</p><p><strong>Conclusion: </strong>This journey mapping provides an evidence-based framework for developing targeted interventions to inform caregiver education, discharge planning, follow-up strategies, and multidisciplinary care pathways, addressing critical system failures and enhancing patient-centered care in pediatric adenoid hypertrophy.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"583647"},"PeriodicalIF":3.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-State Functional Connectivity Alterations in Insomnia Disorder: A Systematic Review of Studies Published from 2020 to July 2025.","authors":"Yani Zhang, Yiwen Zhang, Caili Shi, Tian Wang, Rong Xian, Dongdong Wu, Shuochen Fan, Haijing Liu","doi":"10.2147/NSS.S628716","DOIUrl":"10.2147/NSS.S628716","url":null,"abstract":"<p><p>Insomnia disorder is increasingly linked to abnormalities in resting-state functional connectivity (rsFC). We systematically synthesized rs-fMRI studies published from January 2020 to July 2025 to characterize disorder-related connectivity patterns and methodological limitations. Twenty-four study reports met the eligibility criteria; reported sample sizes summed to 1,229 participants with insomnia disorder and 1,077 healthy controls, although some cohorts may overlap across publications. Alterations involved the default mode, salience, executive-control, emotion, and sensorimotor systems and sleep-wake regulatory hubs, including the thalamus and hypothalamus. The overall pattern is compatible with hyperarousal, but both increased and decreased connectivity were reported; diagnostic definitions, sex, symptom severity and duration, medication exposure, acquisition conditions, and seed-based versus data-driven analyses may moderate direction and magnitude. A formal study-level appraisal with the JBI analytical cross-sectional checklist identified predominantly low risk or some concerns, most often related to confounding control. Because all included comparisons were cross-sectional, rsFC alterations cannot be interpreted as causes rather than consequences or correlates of insomnia. Methodological heterogeneity precluded quantitative pooling. Standardized phenotyping, medication control, acquisition and preprocessing, preregistered longitudinal studies, and external validation are required before connectivity markers can be used clinically.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"628716"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}