Nature and Science of Sleep最新文献

{"title":"Vagus Nerve Stimulation for Sleep Disorders: Emerging Evidence and Future Directions.","authors":"Xinyi Wang, Qingqing Sun, Yanan Zhang, Yaru Wang, Lijia Cai, Zan Wang","doi":"10.2147/NSS.S630809","DOIUrl":"10.2147/NSS.S630809","url":null,"abstract":"<p><p>Sleep disorders are increasingly prevalent clinical conditions that significantly impair physical and mental health. Given the observed limitations of pharmacological therapies, there has been increasing research interest in effective non-pharmacological interventions. Vagus nerve stimulation (VNS), including invasive VNS and non-invasive methods such as transcutaneous auricular VNS (taVNS), has emerged as a promising neuromodulatory strategy. This review summarizes current evidence on VNS for insomnia, central hypersomnia, restless legs syndrome, and sleep-related breathing disorders, highlighting both clinical findings and proposed mechanisms. Relevant literature was identified through searches of PubMed and Web of Science up to May 2026 using terms related to VNS (eg, \"vagus nerve stimulation\" and \"taVNS\") and sleep disorders (eg, \"insomnia\", \"narcolepsy\", \"hypersomnia\", and \"sleep-related breathing/movement disorders\"). The proposed mechanisms include multilevel regulation of sleep-wake neural pathways; immunomodulation via anti-inflammatory pathways; inhibition of cortical spreading depression; and enhancement of neuroplasticity, cerebral blood flow, and blood-brain barrier integrity. Finally, we discuss key challenges regarding inter-individual variability and stimulation parameter optimization, as well as outline future directions centered on precision neuromodulation. These include the development of intelligent closed‑loop stimulation systems (ie, devices that automatically adjust stimulation parameters based on real time physiological feedback) and the testing of state dependent neuromodulation hypotheses. Taken together, this review not only summarizes current evidence but also proposes a theoretical framework and translational perspective to inform future research and clinical applications.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"630809"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897703","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":"Rapid Eye Movement Sleep-Related Indicators with Promising Performance in Diagnosing Narcolepsy.","authors":"Min Wu, Xinyan Zhang, Jiafeng Ren, Xiao Li, Shirley Xin Li, Junying Zhou","doi":"10.2147/NSS.S614945","DOIUrl":"10.2147/NSS.S614945","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The dysregulation of rapid eye movement (REM) sleep is an intrinsic nature of narcolepsy. This study aimed to evaluate the performances of REM sleep-related clinical features and the parallel objective indicators for distinguishing narcolepsy type 1 (NT1) and, more specifically, narcolepsy type 2 (NT2) from patients with hypersomnias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Drug-free patients with excessive daytime sleepiness (EDS) were consecutively recruited between January 2020 and March 2023. All the patients were categorized into three groups, including NT1, NT2, and EDS controls. The REM sleep-related clinical features and REM sleep parameters were compared across these three groups. Receiver operating characteristic (ROC) analyses were applied to quantify the diagnostic performances of REM sleep-related indicators in differentiating NT1 and NT2 from patients with hypersomnias, with bootstrap resampling to stabilize cut-offs and related metrics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 206 patients were enrolled in this study (NT1 = 87, NT2 = 27, EDS controls = 92). In the multiple sleep latency test (MSLT), a daytime REM sleep duration of ≥ 11.91 (7.90-18.75) minutes for NT1 (AUC: 0.943 [0.908-0.974], sensitivity: 0.87 [0.76-0.95], specificity: 0.93 [0.84-1.00]) and ≥ 8.41 (3.00-12.50) minutes for NT2 (AUC: 0.922 [0.852-0.973], sensitivity: 0.90 [0.77-1.00], specificity: 0.88 [0.73-0.96]) yielded optimal differentiation from other hypersomnias. Stratified subgroup ROC analyses focusing on NT1 vs IH (AUC: 0.948 [0.897-0.986], cut-off: 12.67 [0.50-18.50] min, sensitivity: 0.85 [0.72-0.99], specificity: 0.97 [0.80-1.00]) and NT2 vs IH (AUC: 0.918 [0.819-0.986], cut-off: 7.18 [1.75-17.50] min, sensitivity: 0.89 [0.60-1.00], specificity: 0.86 [0.67-1.00]) further support the promising discriminatory potential of this marker. Additionally, ROC analyses showed high AUC values for any REM sleep without atonia (RSWA) index during MSLT in discriminating NT1 (AUC: 0.882 [0.826-0.930], cut-off value: 36.61% [3.71-71.81%], sensitivity: 0.91 [0.81-0.98], specificity: 0.80 [0.69-0.89]) and NT2 (AUC: 0.865 [0.796-0.924], cut-off value: 18.83% [7.41-43.85%], sensitivity: 0.99 [0.90-1.00], specificity: 0.75 [0.65-0.85]) from other hypersomnias. Comparable separation performance was also seen in separate NT1 vs IH (AUC: 0.885 [0.772-0.968], cut-off: 42.81% [3.71-82.58%], sensitivity: 0.86 [0.67-0.99], specificity: 0.86 [0.65-1.00]) and NT2 vs IH (AUC: 0.863 [0.701-0.974], cut-off: 20.09% [7.41-82.29%], sensitivity: 0.97 [0.71-1.00], specificity: 0.77 [0.54-1.00]) subgroup analyses. The co-occurrence of REM sleep-related symptoms of sleep paralysis, hypnagogic hallucinations, and REM sleep behavior disorder exhibited a high specificity in diagnosing patients with NT1 (AUC: 0.711 [0.647-0.773], specificity: 0.87 [0.80-0.94]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The daytime REM sleep duration, any RSWA in MSLT, and REM sleep-r","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"614945"},"PeriodicalIF":3.4,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888080","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 Duration and Quality, Sleep Disorders and Their Association with Adiposity Markers in Adults from the Middle East: A Systematic Review.","authors":"Hadi Ismail, Olivia Halabicky, Mallika Ajmani, Hazar Kassem, Nouran Hammad, Safa Sankari, Aya Eve Ghutmi, Bilal Irfan, Hrayr P Attarian, Abdulghani Sankari, Galit Levi Dunietz","doi":"10.2147/NSS.S612732","DOIUrl":"10.2147/NSS.S612732","url":null,"abstract":"<p><strong>Introduction: </strong>Middle Eastern and North African (MENA) populations face a high burden of metabolic syndrome; however, the potential associations between poor sleep and adiposity remain unexplored in these groups. To address this gap, the present systematic review evaluated the correlations between sleep duration, sleep quality, sleep disorders (specifically, obstructive sleep apnea [OSA] and insomnia) and markers of adiposity. Unlike Western cohorts, MENA populations may exhibit distinct circadian-dietary phenotypes shaped by nighttime social engagement and religiously driven sleep fragmentation.</p><p><strong>Methods: </strong>We conducted a systematic search of the literature on April 2, 2025, across four databases: PubMed, Scopus, Web of Science, and Embase. Data were synthesized narratively because of heterogeneity in study designs and outcome measures.</p><p><strong>Results: </strong>Our screening identified 517 studies, of which 10 (primarily cross-sectional) met the inclusion criteria. Poor sleep quality was disproportionately prevalent in women (up to 77% vs 49% in men). Subjective sleep duration (<6-7 hours) was associated with higher odds of excessive weight (OR=1.55-1.60), whereas actigraphy-verified sleep metrics were inversely correlated with BMI. Insomnia symptoms or disorders were observed in up to 50% of women and 35% of men, although no significant associations were found between insomnia and adiposity measures. OSA prevalence ranged from 6.1% in general population samples to 71% in clinical cohorts. Severe OSA was driven by increased neck circumference (OR=1.26, 95% CI: 1.09, 1.45) and waist circumference (OR=1.06, 95% CI: 1.02, 1.10). Sex-specific associations remain uncertain, as only a few of the included studies conducted stratified analyses.</p><p><strong>Conclusion: </strong>Cross-sectional associations between poor sleep and markers of adiposity have been observed, although the sparse literature and lack of longitudinal, objective data preclude any causal inferences. Whether MENA women are more vulnerable than men to poor sleep and subsequent adiposity remains unknown, but this is plausible considering their disproportionate obesity rates. The synthesis of current evidence exposes literature gaps that necessitate longitudinal research to clarify the magnitude and directionality of these metabolic risks.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"612732"},"PeriodicalIF":3.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865914","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":"Beyond Sleep Perception: Does the Largest WASO Bias Reflect Impaired Memory Rather Than Blunted Perception? [Letter].","authors":"Wenfang Zhang, Xuanqi Guo","doi":"10.2147/NSS.S637818","DOIUrl":"10.2147/NSS.S637818","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"637818"},"PeriodicalIF":3.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865769","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":"Associations Between Obstructive Sleep Apnea, Macro-Scale Glymphatic Coupling, and Episodic Memory Impairment in Middle-Aged and Older Adults.","authors":"Qianqian Gao, Boyu Zhang, Haixia Mao, Jiaming Huang, Yachen Shi, Xiaochuan Cui, He Wang, Yunyun Zhang, Xiangming Fang","doi":"10.2147/NSS.S618511","DOIUrl":"10.2147/NSS.S618511","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sleep disorders are highly prevalent among middle-aged and older adults and represent a crucial modifiable risk factor for cognitive decline. Impaired brain waste clearance is hypothesized to underlie this association, but clinical evidence remains limited. We utilized global blood-oxygen-level-dependent and cerebrospinal fluid (gBOLD-CSF) coupling as a non-invasive macro-scale surrogate of fluid clearance dynamics to investigate its associations across distinct clinical phenotypes, including obstructive sleep apnea (OSA), insomnia, and comorbid insomnia and sleep apnea (COMISsA) and to delineate how objective respiratory metrics and subjective insomnia severity differentially relate to domain-specific cognitive impairment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 143 adults were enrolled and categosrized into four groups: healthy controls (HCs, n = 30), obstructive sleep apnea (OSA, n = 46), insomnia (n = 32), and comorbid insomnia and sleep apnea (COMISA, n = 35). Participants underwent home sleep apnea testing, comprehensive neuropsychological assessments, and 3.0 T magnetic resonance imaging. gBOLD-CSF coupling strength was quantified by computing the peak negative cross-correlation between the global cortical BOLD signal and the signal extracted from the CSF regions at the bottom slice of the fMRI acquisition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with HCs, individuals with sleep disorders exhibited significantly reduced gBOLD-CSF coupling strength (all Bonferroni-corrected &lt;i&gt;p&lt;/i&gt; &lt; 0.05). This attenuation correlated with advancing age (&lt;i&gt;r&lt;/i&gt; = 0.185, &lt;i&gt;p&lt;/i&gt; = 0.027) and greater global sleep disturbances (as indexed by higher PSQI total scores, &lt;i&gt;r&lt;/i&gt; = 0.261, FDR-corrected &lt;i&gt;p&lt;/i&gt; = 0.012). Using the entropy balancing (EBAL) weighted dataset, structural equation modeling revealed that in participants with sleep apnea (OSA and COMISA), reduced gBOLD-CSF coupling strength statistically mediated the relationship between nocturnal hypoxia and episodic memory deficits. Specifically, elevated apnea-hypopnea index (AHI), oxygen desaturation index (ODI) and the percentage of total sleep time with oxygen saturation below 90% (T90) were associated with a positive shift in coupling values toward zero (&lt;i&gt;all a coefficients &gt; 0, p&lt;/i&gt; &lt; 0.05), representing weakened glymphatic coupling strength. This diminished coupling, in turn, predicted poorer delayed episodic memory (AVLT-20 min delayed recall; indirect effects: AHI, -0.029; ODI, -0.079; T90, -0.111). Notably, the direct effects of these hypoxic parameters on memory consolidation were non-significant. In contrast, no significant glymphatic mediation pathways were identified for the insomnia-executive function model, even after adjusting for depressive burden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In summary, gBOLD-CSF coupling characteristically tracks distinct sleep disorder subtypes, showing significant reductions in middle-aged and older adults with OSA","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"618511"},"PeriodicalIF":3.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865759","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":"Quality and Reliability of Social Media Videos on Weight-Loss Interventions for Obstructive Sleep Apnea: A Multi-Platform Cross-Sectional Study.","authors":"Rexidanmu Hudabai, Jiaomin Jian, Peng Yang, Yan Yi, Yingxiang Xu, Aiqing Peng, Jingyu Yao, Xianzhen Chen","doi":"10.2147/NSS.S599776","DOIUrl":"10.2147/NSS.S599776","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the quality and reliability of social media videos addressing weight loss for OSA across three major platforms (YouTube, TikTok, Bilibili) and to identify key determinants of trustworthy content.</p><p><strong>Methods: </strong>We conducted a cross-platform content analysis of publicly available videos on weight loss for OSA from YouTube, TikTok, and Bilibili, representing major video-sharing platforms with different regional audiences and content formats. The top 100 default search results from each platform were screened using predefined criteria, yielding 235 eligible videos. Video and uploader characteristics, engagement metrics, and quality scores were extracted. Videos were assessed using PEMAT, VIQI, GQS, mDISCERN, and JAMA benchmarks. The primary outcome was overall video quality assessed by the Global Quality Score (GQS), while other assessment tools were considered secondary outcomes. For TikTok, we used English-language search terms (\"obstructive sleep apnea and weight loss\" and \"OSA and weight loss\") to capture content comparable with YouTube. The Chinese-language TikTok counterpart (Douyin) was not included because it operates under a distinct platform ecosystem with different content algorithms, regional audience, and moderation policies.</p><p><strong>Results: </strong>YouTube videos scored significantly higher in understandability, actionability, and overall quality compared with TikTok and Bilibili. Content from verified institutions and healthcare professionals consistently received higher ratings across all tools. Engagement metrics (likes, shares, comments) showed weak correlations with information quality. In regression models, production quality (VIQI) and source transparency (JAMA benchmarks) emerged as the strongest predictors of content reliability, while video duration had minimal effect.</p><p><strong>Conclusion: </strong>Within digital health environments, popular engagement does not equate to informational quality for OSA-related weight-loss content. Platform- and uploader-level characteristics-particularly verification status and production standards-are key markers of reliability. These findings underscore the need for platform-level governance that prioritizes verified health sources, algorithmic transparency, and integrated digital health literacy efforts to safeguard patients navigating lifestyle advice for OSA online.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"599776"},"PeriodicalIF":3.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865829","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":"Comparative Treatment Strategies for Obstructive Sleep Apnea and Their Relationships with Aberrant Driving Behaviors: Taxi Drivers in Taipei Metropolitan Area.","authors":"Zhihe Chen, Wen-Te Liu, Arnab Majumdar, Wen-Hua Hsu, Yi-Chun Kuan, Jiunn-Horng Kang, Yen-Ling Chen, Rachel Chien, Peizheng Wang, Kang-Yun Lee, Po-Hao Feng, Kuan-Yuan Chen, Hsin-Chien Lee, Yi-Chih Lin, Wun-Hao Cheng, Cheng-Yu Tsai","doi":"10.2147/NSS.S596899","DOIUrl":"10.2147/NSS.S596899","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is prevalent among professional drivers and is associated with an increased risk of aberrant driving behaviors (ADBs). This study evaluated and compared the effectiveness of continuous positive airway pressure (CPAP) and conservative treatments in mitigating ADBs and improving sleep health among urban taxi drivers.</p><p><strong>Methods: </strong>In this prospective non-randomized comparative study, taxi drivers diagnosed with OSA through polysomnography were assigned to either the CPAP group or the conservative treatment group. Home-based sleep parameters (oxygen desaturation index [ODI], cyclic variation of the heart rate index [CVHRI], and chest effort index [CEI]) were measured using wearable devices. Driving data were recorded with a validated navigation application. Subjective measures such as Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the 27-item Driving Behavior Questionnaire (DBQ) were also collected. Pre- and post treatment outcomes were compared within and between groups using non-parametric statistical tests following the 3-month treatment.</p><p><strong>Results: </strong>Twenty-four taxi drivers were enrolled, with 13 in the CPAP group and 11 in the conservative treatment group. CPAP treatment significantly improved objective and subjective measures of sleep health and driving performance, evidenced by decreases in PSQI (p=0.04), ESS (p=0.01), and DBQ errors (p<0.01) and lapses (p=0.03). Additionally, the occurrence of ADBs per 20 km decreased (p<0.01), and sleep disorder indices improved (ODI, p<0.01; CEI, p=0.03).</p><p><strong>Conclusion: </strong>The conservative treatment group showed no significant changes in these measures. CPAP demonstrated its potential as a primary intervention for occupational drivers with severe OSA. Conservative treatment showed limited effectiveness and could serve as a supplementary approach.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"596899"},"PeriodicalIF":3.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865774","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":"Effect of Hypertension on Left Ventricular Diastolic Dysfunction Associated with Obstructive Sleep Apnea.","authors":"Jia-Le Chen, Shu-Han Chen, Wei-Ze Lin, Ruo-Ying Chen, Wan-Qi Li, Ping-Yu Cai, Hui-Li Lin","doi":"10.2147/NSS.S586614","DOIUrl":"10.2147/NSS.S586614","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) and hypertension are known cardiovascular risk factors, but the effect of hypertension on OSA-related left ventricular diastolic dysfunction remains unclear.</p><p><strong>Patients and methods: </strong>This cross-sectional study enrolled 289 patients from the Second Affiliated Hospital of Fujian Medical University (January 2013-January 2023). Participants were classified as healthy controls (HC), OSA-only (OSA), hypertension only (HTN), and OSA with hypertension (OSA-HTN). Furthermore, based on the AHI (Apnea-Hypopnea Index) values, the OSA group and the OSA-HTN group were further divided into three subgroups: mild (5≤AHI<15 events/hour), moderate (15≤AHI<30 events/hour), and (AHI≥30 events/hour). Participants underwent biochemical testing, echocardiography, and polysomnography. Echocardiographic parameters of diastolic function-interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPW), left atrial volume index (LAVI), E/A ratio, and E/e' ratio-were compared among the groups. One-way analysis of variance and statistical interaction analysis evaluated the independent and interactive effects of hypertension and OSA severity on E/e'.</p><p><strong>Results: </strong>Compared with the HC group, the HTN, OSA, and OSA-HTN groups showed significantly higher IVST, LVPW, LAVI, and E/e' ratio (p<0.05), with the OSA-HTN group exhibiting the greatest impairment. The E/e' ratio increased with OSA severity and correlated positively with systolic blood pressure and diastolic blood pressure, most strongly in the OSA-HTN group. Hypertension (mean difference=-1.784, 95% CI: -2.868 to -0.701, p=0.001) and OSA severity independently affected E/e' with a significant multiplicative interaction (p<0.05).</p><p><strong>Conclusion: </strong>Both hypertension and severe obstructive sleep apnea are independently associated with impaired left ventricular diastolic function, and their coexistence may have a potential synergistic effect.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"586614"},"PeriodicalIF":3.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850995","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 Weekly Sleep Timing: Endogenous Origins of Social Jetlag.","authors":"James H Cardon, Eric R Eide, Mark H Showalter","doi":"10.2147/NSS.S610753","DOIUrl":"10.2147/NSS.S610753","url":null,"abstract":"<p><strong>Background: </strong>Social jetlag is commonly attributed to externally imposed schedules that conflict with biological sleep timing. However, individuals also make daily decisions about how to allocate time between sleep and waking activities, suggesting that behavioral tradeoffs may contribute to within-week variation in sleep patterns.</p><p><strong>Objective: </strong>To examine whether weekly patterns in sleep timing and duration, including social jetlag, can emerge endogenously from the interaction of biological sleep regulation and time allocation decisions.</p><p><strong>Methods: </strong>We develop a dynamic model of sleep timing that integrates the two-process model of sleep regulation with decision-making over time use. Individuals choose sleep onset and offset each day while a stock of sleep evolves over time, determining sleep pressure. The model is calibrated to a steady-state schedule and simulated under alternative workweek structures, with and without preferences for leisure and direct, external constraints on the choice variables, such as fixed wake times and delayed sleep onset.</p><p><strong>Results: </strong>The model produces a stable weekly pattern in which individuals sleep less during the workweek and sleep longer on free days. Weekend sleep is also later, generating a workday-free-day shift in midsleep similar to the pattern commonly described as social jetlag. These patterns can arise even without imposing fixed wake times or required bedtimes, suggesting that the scarcity of discretionary time on workdays may contribute to delayed sleep and weekend recovery sleep. Adding realistic constraints, such as early weekday wake times and later weekend bedtimes, increases the size of the midsleep shift and brings the simulated pattern closer to empirical estimates of social jetlag.</p><p><strong>Conclusion: </strong>The model suggests that behavioral tradeoffs over scarce workday leisure can account for part of the weekday-free-day variation in sleep timing and duration, producing shorter workday sleep, weekend recovery sleep, and later free-day midsleep. Social jetlag may therefore reflect both externally imposed schedules and endogenous responses to the changing value of waking time across the week.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"610753"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897730","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":"Prevalence and Determinants of Bed-Sharing Among Infants and Toddlers in Jeddah, Saudi Arabia: A Cross-Sectional Study.","authors":"Ahlam Mazi, Kholoud A Hothan, Ebtehal Ahmed Qulisy, Azizah Hendi Aljohany, Maryam Saud Aljaid, Esraa M Bukhari, Nouf Mohammed ALNosani, Muslim Mohammed AlSaadi","doi":"10.2147/NSS.S619514","DOIUrl":"10.2147/NSS.S619514","url":null,"abstract":"<p><strong>Background: </strong>Bed-sharing is a prevalent but contested sleep practice with important child safety implications. Population-specific data from Saudi Arabia remain limited among children aged up to four years.</p><p><strong>Objective: </strong>To determine the prevalence of bed-sharing among infants and toddlers in Jeddah, identify associated factors, and examine its relationship with sleep outcome.</p><p><strong>Methods: </strong>This cross-sectional study used consecutive sampling to enrol 437 children aged one month to four years at primary healthcare centres and paediatric clinics affiliated with King Abdulaziz University Hospital, Jeddah, between September 2025 and January 2026. Sleep data, collected using the Brief Infant Sleep Questionnaire-Revised Short Form (BISQ-R-SF), were analysed using the Mann-Whitney <i>U</i>-test, chi-square test, and logistic regression.</p><p><strong>Results: </strong>Bed-sharing prevalence was 87.2%. Exclusive breastfeeding was independently associated with lower bed-sharing odds ratios (multivariate OR: 0.44; 95% CI: 0.25-0.80; p = 0.007). The receipt of safe sleep counselling was paradoxically associated with higher odds of bed-sharing (OR: 1.89; 95% CI: 1.03-3.47; p = 0.042). Most sleep parameters were similar between groups; however, the sleep problem score was higher among non-bed-sharing children [median 3 (IQR 2) vs 2 (IQR 2); p = 0.039]. Sleep consolidation improved progressively with age.</p><p><strong>Conclusion: </strong>Bed-sharing was highly prevalent among young Saudi children but was not associated with worse sleep outcomes in this cohort; sleep consolidation instead improved with age in both bed-sharing and non-bed-sharing children. Because the cross-sectional design precludes causal inference, counselling should be culturally sensitive, behaviorally grounded, and focused on modifiable risk practices rather than bed-sharing status alone.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"619514"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813523","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}