Nature and Science of Sleep最新文献

{"title":"Knowledge, Attitudes, and Self‑Reported Practices Regarding Sleep‑Focused Delirium Prevention Among ICU Professionals: A Multicenter Survey in Jiangxi, China.","authors":"Xueting Yao, Zonglin Rao, Taobin Liu, Yi Gao","doi":"10.2147/NSS.S616912","DOIUrl":"10.2147/NSS.S616912","url":null,"abstract":"<p><strong>Objective: </strong>To apply a knowledge, attitude, and practice (KAP) framework to assess ICU healthcare professionals' knowledge, attitudes, and self-reported practices regarding sleep management as one component of delirium prevention and care in the ICU.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted from December 2025 to January 2026 in seven hospitals in Jiangxi Province, China, with ICU healthcare professionals. A self-designed questionnaire on sleep and delirium, developed through literature review, expert review, and pilot testing, was used to collect demographic data and assess KAP.</p><p><strong>Results: </strong>The analysis included 509 questionnaires. The mean scores were 14.07±2.27 for knowledge (82.8% of the maximum score), 63.38±6.26 for attitude (90.5%), and 49.52±8.59 for self-reported practice (82.5%). Knowledge gaps were identified: only 44.8% of participants correctly recognized that delirium is not a chronic mental disorder; uncertainty persisted on several sleep-related items; and 53.6% reported no prior delirium-related training. Knowledge showed a modest positive association with attitude (β=0.099, 95% CI 0.014-0.185; P=0.023), but knowledge was not associated with self-reported practice (P=0.824 and P=0.260), while attitude was associated with self-reported practice (β=0.528, 95% CI 0.465-0.591; P<0.001); those results must be considered cautiously because of model saturation.</p><p><strong>Conclusion: </strong>In this regional, multicenter sample, ICU healthcare professionals reported positive attitudes and relatively high self-reported practice in sleep management for delirium, but important conceptual knowledge gaps and limited training persisted. The findings suggest caution in interpreting high self-reported practice as equivalent to high-fidelity clinical implementation and support the need for targeted education and future studies using more objective measures of practice.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"616912"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813530","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":"Age-Associated Development of Sleep Disturbances in <i>db/db</i> Diabetic Mice.","authors":"Ke-Xin Wang, Huai Huang, Wei Xu, Kai-Lin Zhang, Zhi-Li Huang, Shan-Qun Li, Lu Wang","doi":"10.2147/NSS.S607937","DOIUrl":"10.2147/NSS.S607937","url":null,"abstract":"<p><strong>Purpose: </strong>Disturbed sleep quantity and quality are associated with diabetes and have been recognized as significant risk factors for its development. However, it remains unclear whether sleep disturbances arise during the progression of diabetes and what underlying neurobiological mechanisms may be involved. We aimed to characterize the dynamic development of sleep-wake phenotype in diabetic <i>db/db</i> mice and to investigate the associated neural mechanisms.</p><p><strong>Methods: </strong>Polysomnographic recordings were conducted to characterize age-dependent changes in sleep-wake characteristics in diabetic <i>db/db</i> mice aged 2 to 6 months. Transcriptomic analyses of brain tissues were performed to investigate the underlying neural mechanisms associated with sleep alterations.</p><p><strong>Results: </strong>Although hyperglycemia was present in <i>db/db</i> mice at 2 months of age, significant fragmentation of non-rapid eye movement (NREM) sleep began at 3 months of age. The total amount of NREM sleep remained unchanged during light phase but was disrupted by an increased frequency of microarousal episodes lasting ≤ 8 s. The darkness-induced wakefulness response progressively declined from 3 months of age and was markedly attenuated by 6 months. Transcriptomic analyses revealed pronounced dysregulation of genes associated with sleep-wake regulation in subcortical regions at 3 months of age.</p><p><strong>Conclusion: </strong>These results indicate that diabetes contributes to fragmented sleep and impaired diurnal rhythmicity by influencing sleep-wake regulatory systems in subcortical brain regions.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"607937"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813532","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 Instability and Severe Obstructive Sleep Apnea are Associated with Carotid Atherosclerotic Burden but Not Plaque Vulnerability in Acute Ischemic Stroke.","authors":"Chengxin Ku, Jing Yang, Ziyi Yao, Yuqing Yuan, Xianhui Zhong, Tiantian Yin, Yuxin Liu, Xinyao Xu, Yongmin Ding, Fen Wang, Kuisi Yan, Jianglong Tu, Liang Xie","doi":"10.2147/NSS.S623090","DOIUrl":"10.2147/NSS.S623090","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disorders, including sleep instability and obstructive sleep apnea-hypopnea syndrome (OSAHS), are closely associated with cardiovascular and cerebrovascular disease. Prior studies have primarily focused on OSAHS, characterized by respiratory events, with limited attention to non-respiratory sleep disturbances. In patients with acute ischemic stroke (AIS), the relationship between sleep instability and carotid atherosclerotic burden, as well as plaque vulnerability, remains unclear.</p><p><strong>Patients and methods: </strong>In this cross-sectional study, 1003 hospitalized patients with AIS were enrolled. All participants underwent portable sleep monitoring (PSM) within 72 hours of admission. Sleep instability derived from cardiopulmonary coupling (CPC) analysis was categorized into low- and high-sleep instability groups according to the median value, while OSAHS severity was classified based on the apnea-hypopnea index (AHI). Carotid ultrasonography was performed to measure common carotid intima-media thickness (CIMT) and to assess the presence of carotid plaques and ultrasound-defined vulnerable plaque features. Multivariable linear and logistic regression analyses were used to examine the associations of sleep instability and OSAHS severity with carotid atherosclerotic phenotypes.</p><p><strong>Results: </strong>In multivariable regression models, CPC-derived sleep instability was associated with increased CIMT (β = 0.042 mm, 95% CI: 0.021-0.062, <i>P</i> < 0.001) and was associated with an increased prevalence of carotid plaque (adjusted OR = 2.68, 95% CI: 1.76-4.08). The severity of OSAHS showed a graded association with CIMT, while only severe OSAHS was significantly associated with carotid plaque (adjusted OR = 2.11, 95% CI: 1.15-3.87), and mild-to-moderate OSAHS showed no significant association across models. Neither CPC-derived sleep instability nor OSAHS severity was significantly associated with vulnerable plaque features. Compared with mild-to-moderate OSAHS, CPC-derived sleep instability showed a stronger and more consistent association with carotid atherosclerotic burden, suggesting that it may provide vascular risk information beyond traditional AHI-based stratification.</p><p><strong>Conclusion: </strong>In AIS patients, CPC-derived sleep instability and severe OSAHS each showed associations with carotid atherosclerotic burden in separate adjusted models, whereas no significant association was observed with plaque vulnerability. Although both CPC-derived sleep instability and AHI reflect underlying physiological oscillations related to periodic respiratory activity during sleep, CPC-derived sleep instability additionally captures non-respiratory sleep instability and autonomic dysregulation, thereby providing a complementary perspective for the assessment of sleep-related vascular risk.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"623090"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819013","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":"Medication Treatment Modulates Sleep Architecture and Cognitive-Related Cortical Hemodynamics in Narcolepsy Type 1.","authors":"Mao Zhuofeng, Kong Xinyu, Zhang Haodong, Qu Zhenzhen, Jia Lijing, Xiao Fulong, Wang Weiping","doi":"10.2147/NSS.S612135","DOIUrl":"10.2147/NSS.S612135","url":null,"abstract":"<p><strong>Objective: </strong>This exploratory pilot study aimed to evaluate the associations between combination medication treatment and changes in sleep architecture and cognitive task-related cortical hemodynamics in narcolepsy type 1 (NT1).</p><p><strong>Methods: </strong>A total of 16 drug-naive NT1 patients were enrolled. All participants underwent polysomnography (PSG), multiple sleep latency test (MSLT), and fNIRS monitoring during Verbal Fluency Test (VFT) and Go/NoGo task before and after pharmacological intervention. Paired nonparametric tests were used to compare differences in PSG, MSLT, and fNIRS parameters before and after treatment. Least absolute shrinkage and selection operator (LASSO) regression and stepwise regression were applied to screen predictors of sleep latency.</p><p><strong>Results: </strong>REM latency and mean sleep latency from MSLT were significantly prolonged, and REM sleep proportion was significantly reduced after medication treatment. During VFT, significant changes in oxyhemoglobin (HbO₂) concentration were observed in 5 channels: increased HbO₂ levels in frontopolar area, middle temporal gyrus, and subcentral area, and decreased HbO₂ levels in retrosplenial cortex (BA 29/30) and dorsolateral prefrontal cortex. No significant HbO₂ changes were found during Go/NoGo task. Regression analysis identified that pre-treatment HbO₂ change of subcentral area and post-treatment HbO₂ change of middle temporal gyrus predicted post-treatment mean sleep latency from MSLT.</p><p><strong>Conclusion: </strong>In this pilot cohort, combination medication therapy was associated with prolongation of sleep latency and task-specific alterations in cortical hemodynamics in NT1 patients. fNIRS-derived parameters show preliminary potential as non-invasive biomarkers for predicting post-treatment sleep latency, which requires validation in larger independent cohorts.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"612135"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830613","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":"Letter to Effectiveness and Safety of Electroacupuncture in Patients with Treatment-Resistant Insomnia: A Randomized, Assessor-Blinded, Waitlist-Controlled Pilot Trial [Letter].","authors":"Xiaotian Wang, Bihong Ye","doi":"10.2147/NSS.S630654","DOIUrl":"10.2147/NSS.S630654","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"630654"},"PeriodicalIF":3.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808737","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":"Deciphering the Biological Basis of Inflammatory Markers Associated with Trouble Sleeping [Letter].","authors":"Yuhang Dong","doi":"10.2147/NSS.S639702","DOIUrl":"10.2147/NSS.S639702","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"639702"},"PeriodicalIF":3.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795790","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":"Letter to the Editor Regarding: \"Analysis of the Correlation Between Tongue Fat and Retroglossal Obstruction in Patients with Obstructive Sleep Apnea\" [Letter].","authors":"Bin Chen, Mingyu Yao","doi":"10.2147/NSS.S641860","DOIUrl":"10.2147/NSS.S641860","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"641860"},"PeriodicalIF":3.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795806","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":"Melatonin and Cortisol Concentration Before and After CPAP Treatment of Obstructive Sleep Apnea [Retraction].","authors":"","doi":"10.2147/NSS.S646824","DOIUrl":"https://doi.org/10.2147/NSS.S646824","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.2147/NSS.S553499.].</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"646824"},"PeriodicalIF":3.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808748","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":"From Brain Networks to Sleep Perception: EEG-Derived Global Efficiency is Associated with Subjective Sleep Quality in University Students.","authors":"Ankita Garg, Arun Sasidharan, Varun Dutt, Laxmidhar Behera","doi":"10.2147/NSS.S601619","DOIUrl":"10.2147/NSS.S601619","url":null,"abstract":"<p><strong>Objective: </strong>The correspondence between objective sleep physiology and subjective sleep experience remains poorly understood. Conventional polysomnography (PSG) primarily captures sleep macrostructure and may fail to reflect large-scale neural integration processes underlying perceived sleep quality. This study examined whether sleep-stage-specific brain network integration, quantified via EEG-derived global efficiency (GE), is associated with daytime sleepiness and insomnia severity in healthy university students.</p><p><strong>Methods: </strong>In this cross-sectional observational study, overnight full-night PSG was recorded in 52 healthy male university students. The debiased weighted Phase Lag Index was used to measure functional connectivity to minimize volume conduction effects. GE was computed across five canonical frequency bands during N3 and REM sleep. Subjective sleep outcomes were assessed using the Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Associations between GE, subjective sleep measures, and conventional PSG parameters were evaluated using linear and multiple regression analyses.</p><p><strong>Results: </strong>Distinct stage-dependent differences in network topology were observed, with lower alpha-band GE during REM sleep and lower delta-band GE during N3 sleep. Higher daytime sleepiness (ESS) was associated with increased GE during REM sleep in the delta, beta, and gamma bands, whereas higher theta-band GE during N3 sleep was associated with lower insomnia severity (ISI). GE-based models accounted for a modest proportion of variance in subjective outcomes (ISI: <i>R²</i> =0.082; ESS: <i>R²</i> =0.190). Conventional PSG macrostructural indices were not significantly associated with subjective sleep measures.</p><p><strong>Conclusion: </strong>EEG-derived GE showed stage- and frequency-specific associations with subjective sleep outcomes, with limited additional contribution beyond conventional macrostructural PSG measures. These findings provide preliminary evidence that sleep network topology may partially capture aspects of subjective sleep experience not fully reflected by standard sleep architecture indices. EEG-based GE may serve as a potential network-level correlate of subjective sleep experience, suggesting a possible network-level link between sleep physiology and perceived sleep quality in non-clinical populations.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"601619"},"PeriodicalIF":3.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819084","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":"Development and Internal Evaluation of a Nomogram for Clinically Significant Depressive Symptoms in Obstructive Sleep Apnea-Hypopnea Syndrome.","authors":"Fan Yi, Jie Zhang, Qing Feng, Xiaopei Wang, Rongrong Zhang, Jinqiao Zhang, Lingyu Song, Jihua Zhang","doi":"10.2147/NSS.S614574","DOIUrl":"10.2147/NSS.S614574","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and internally evaluate a nomogram for identifying clinically significant depressive symptoms in hospitalized patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).</p><p><strong>Methods: </strong>A single-center retrospective study included adults hospitalized at the First Hospital of Hebei Medical University between January and December 2025. OSAHS was confirmed by overnight polysomnography (PSG) and defined as an apnea-hypopnea index (AHI) ≥5 events/h. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS), with a standardized score ≥53 defining clinically significant depressive symptoms. Thirty-six candidate predictors were extracted from electronic medical records and laboratory information systems. The cohort was randomly divided into a training cohort (n=574) and an internal validation cohort (n=246). Least absolute shrinkage and selection operator (LASSO) logistic regression with 10-fold cross-validation, followed by post-LASSO multivariable logistic regression, was used to select predictors and construct the nomogram. Discrimination, calibration, and clinical utility were assessed using the area under the curve (AUC), calibration analyses, and decision curve analysis.</p><p><strong>Results: </strong>Among 820 patients, 88 (10.7%) had clinically significant depressive symptoms, including 62 events in the training cohort and 26 in the internal validation cohort. LASSO initially retained seven candidate predictors. Five predictors remained statistically significant after post-LASSO multivariable logistic regression and were included in the final nomogram: oxygen desaturation index (ODI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), thyroid-stimulating hormone (TSH), and free triiodothyronine (FT3). The model showed favorable discrimination in the training cohort (AUC=0.910, 95% confidence interval [CI] 0.869-0.950) and internal validation cohort (AUC=0.915, 95% CI 0.853-0.977). Calibration was acceptable, with calibration intercepts of approximately 0.000 and -0.438 and calibration slopes of 1.000 and 0.814, respectively.</p><p><strong>Conclusion: </strong>This internally evaluated nomogram integrating ODI, PSQI, ESS, TSH, and FT3 showed favorable performance for identifying SDS-defined clinically significant depressive symptoms in hospitalized patients with OSAHS. Prospective multicenter and temporal external validation is required to assess its generalizability and clinical applicability.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"614574"},"PeriodicalIF":3.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795749","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}