Nature and Science of Sleep最新文献

{"title":"Examining the Effects of Bright Light Therapy on Sleep and Resting-State Brain Activity in Parkinson's Disease: A Randomized Crossover Pilot Study.","authors":"Han-Xing Li, Ming-Hui Tang, Qin-Jie Zhou, Jin Dai, Wei-Ye Xie, Meng-Xing Tao, Chun-Feng Liu, Yun Shen","doi":"10.2147/NSS.S606007","DOIUrl":"10.2147/NSS.S606007","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances are highly prevalent in patients with Parkinson's disease (PD). Bright light therapy (BLT) seems to be a promising non-pharmacological intervention for sleep disturbance in PD. However, the neural mechanisms underlying BLT remain unclear. In this pilot study, we aimed to explore the clinical effects of BLT on sleep and to explore potential accompanying changes in brain activity and functional connectivity.</p><p><strong>Patients and methods: </strong>In this randomized, crossover, self-controlled pilot study, BLT was delivered using bright light at 10,000 lux, and dim light at 200 lux served as the control condition. Twenty-seven patients with PD were assigned to receive 30 days of BLT and 30 days of dim light therapy (DLT) in counterbalanced order, separated by a 30-day washout period. Clinical assessments of sleep, polysomnography (PSG) and resting-state functional magnetic resonance imaging (rs-fMRI) were performed at four time points: baseline, following the first intervention phase, following the washout period, and following the second intervention phase.</p><p><strong>Results: </strong>Compared with DLT, BLT was associated with a significantly greater reduction in Epworth Sleepiness Scale (ESS) scores (P=0.012) and tonic REM sleep without atonia (RWA) (P=0.002). In resting-state fMRI, no clusters showed significant alterations in fractional amplitude of low-frequency fluctuation (fALFF) or dynamic fALFF (dfALFF) after BLT compared to DLT. Functional connectivity (FC) analyses using the bilateral thalamus, bilateral calcarine cortex, and bilateral posterior cingulate cortex as seed ROIs revealed no clusters with significant between-intervention connectivity differences after multiple comparison correction.</p><p><strong>Conclusion: </strong>BLT improved excessive daytime sleepiness and reduced tonic RWA relative to control light in PD, but did not lead to detectable alterations in intrinsic activity or FC within a priori hypothesized thalamo-cortical or visual pathways. These findings warrant further validation in larger, long-term studies.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"606007"},"PeriodicalIF":3.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670308","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":"Once-Nightly Pregabalin for Co-Occurring Nightmares, Poor Sleep, and Headaches: A Case Series.","authors":"James H Bates, Sophia Brooke Rosin, Joshua A Tobin","doi":"10.2147/NSS.S600495","DOIUrl":"10.2147/NSS.S600495","url":null,"abstract":"<p><strong>Background: </strong>Nightmares, nonrestorative sleep, and headaches co-occur, are common, underdiagnosed, and contribute to substantial disability. Pregabalin modulates excitatory neurotransmission, increases slow-wave sleep, and suppresses REM sleep, suggesting a potential therapeutic role in nightmares and sleep disturbance. Pregabalin's effect on nightmares has not been systematically studied. Although sedation is a common side effect when prescribed 2-3 times daily according to the package insert, the efficacy and tolerability of once-nightly administration remain poorly characterized.</p><p><strong>Methods: </strong>Our retrospective case series included 23 outpatients seen in the neurology department of a tertiary care center from November 2022 to August 2025. They were prescribed once-nightly pregabalin for nightmares, nonrestorative sleep, and headaches. Clinical data were extracted from medical records, including nightmare frequency, fraction of 24-hour periods with restorative sleep, headache frequency, severity, and duration, and MIDAS scores. Within-subject pre-post comparisons were performed using paired t-tests or Wilcoxon signed-rank tests. All p-values were Holm-Bonferroni adjusted.</p><p><strong>Results: </strong>Nightmare frequency decreased 81% (17.5 to 3.3/month, p_adj=0.006). Nightmares decreased numerically more for those who transitioned from gabapentin to pregabalin (91%) than for those not initially taking gabapentin (73%). Restorative sleep frequency increased 127% (1.8 to 4.0/week, p_adj=0.006). Headache frequency decreased 50% (17.0 to 8.5/month, p_adj=0.040). Migraine Disability Assessment Questionnaire scores decreased numerically by 34% (38.0 to 24.0) but did not reach statistical significance after correction (p_adj=0.084). Six patients reported side effects, and 19 continued pregabalin at three months.</p><p><strong>Conclusion: </strong>Once-nightly pregabalin was associated with robust reductions in nightmare frequency, nonrestorative sleep, and headache frequency. The improvement in nightmares validates two prior case reports through systematic cohort evaluation. Nightmares improved even among patients transitioning from gabapentin to pregabalin, suggesting that pregabalin may be superior to gabapentin. No prior studies have addressed these three co-occurring problems simultaneously. Larger controlled studies are needed to test the hypothesis that once-nightly pregabalin may be useful for this patient population.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"600495"},"PeriodicalIF":3.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549596","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":"Analysis of the Correlation Between Tongue Fat and Retroglossal Obstruction in Patients with Obstructive Sleep Apnea.","authors":"Yibo Hao, Jie Qin, Zhe Wang, Yanru Duan, Xiangrong Cao, Zhiming Zhang, Dahai Wu","doi":"10.2147/NSS.S596746","DOIUrl":"10.2147/NSS.S596746","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of tongue fat on glossoptosis and lingual hypertrophy and the relationship between tongue fat and retroglossal obstruction in patients with obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This study enrolled 97 patients with moderate-to-severe OSA. All patients underwent standard diagnostic polysomnography (PSG) and a second PSG with a nasopharyngeal tube inserted (NPT-PSG). The NPT stents open the nasal, nasopharyngeal, and retropalatal airways, so the residual apnea-hypopnea index (NPT-AHI) specifically quantifies retroglossal obstruction. Patients were classified based on NPT-PSG and upper airway CT into three groups: non-retroglossal obstruction (non-RGO), glossoptosis (GLO), and lingual hypertrophy (LH). Three-dimensional CT reconstructions were used to assess tongue anatomy, including volume, fat volume, and fat percentage. Group differences in baseline traits and tongue measurements were analyzed. We further examined the relationship between tongue fat and RGO, and identified factors influencing RGO in OSA.</p><p><strong>Results: </strong>After adjusting for gender, age, and BMI, the LH group had larger tongue volume compared to the other two groups, whereas the GLO group had more tongue fat and a higher tongue fat percentage compared to the non-RGO group. Apnea-hypopnea index (AHI) for NPT-PSG (NPT-AHI) was positively correlated with tongue volume (r=0.349, P<0.001), tongue fat volume (r=0.368, P<0.001), and tongue fat percentage (r=0.281, P=0.006), and negatively correlated with LSaO₂ (r=-0.312, P<0.001). Multiple regression indicated tongue volume (β=0.264, P=0.005), tongue fat volume (β=0.271, P=0.002), and LSaO₂ (β=-0.285, P=0.006) were independent influencing factors of NPT-AHI.</p><p><strong>Conclusion: </strong>Tongue fat volume is more strongly associated with glossoptosis, whereas overall tongue volume is more closely associated with lingual hypertrophy. Increased tongue volume, higher tongue fat content, and decreased LSaO₂ are associated with more severe retroglossal obstruction. Precise therapies targeting tongue fat may benefit OSA patients with RGO.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"596746"},"PeriodicalIF":3.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448192","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 and Substance Use Among Firefighters: Associations with Alcohol, Caffeine, and Nicotine Use.","authors":"David A Reichenberger, Lauren J Lee, Joey Hebl, Aanuoluwakiitan O Ayeni, LaTroy D Robinson Ii, Shelby L Watkins, Ayeisha H Haswarey, David A Hurtado, Andrew W McHill, Todd Bodner, Steven A Shea, Nicole P Bowles","doi":"10.2147/NSS.S605149","DOIUrl":"10.2147/NSS.S605149","url":null,"abstract":"<p><strong>Purpose: </strong>Firefighters are at high risk for sleep disruption due to shift work. Use of alcohol, caffeine, and nicotine can also affect sleep. Thus, we evaluated daily, bidirectional associations between substance use and actigraphy-assessed sleep among firefighters.</p><p><strong>Patients and methods: </strong>Micro-longitudinal data were drawn from 120 firefighters participating in the Shiftwork in Firefighters (SWIFT) Study. Participants completed surveys on daily alcohol and caffeine use, current and lifetime tobacco use, and wore actigraphy devices to assess sleep timing, duration, and quality (2,617 observations). Multilevel models were used to examine both between- and within-person associations between substance use and subsequent sleep, and between sleep and next-day substance use. Models were adjusted for covariates (shift schedule, on-shift status, nighttime call volume, and naps).</p><p><strong>Results: </strong>Alcohol use demonstrated strong bidirectional associations with sleep. Greater within-person alcohol consumption predicted shorter sleep and earlier waketimes, while later sleep timing and shorter sleep predicted greater next-day alcohol use. Unexpectedly, greater caffeine consumption was associated with higher sleep efficiency and fewer nighttime awakenings at the between-person level and longer total sleep time at the within-person level. Current between-person use of smokeless tobacco was associated with approximately 30 minutes shorter total sleep time, whereas lifetime cigarette use showed no association with sleep outcomes.</p><p><strong>Conclusion: </strong>Substance use among firefighters exhibited substance-specific and temporally dynamic relationships with sleep. Nicotine and caffeine effects were largely person-dependent, whereas daily alcohol showed consistent bidirectional effects on sleep. These findings highlight potential intervention targets aimed at improving sleep and reducing alcohol-related risk among firefighters.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"605149"},"PeriodicalIF":3.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448060","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 Rhythmicity as a Core Domain of Multidimensional Sleep Health Associated with Cognitive Impairment in Older Men.","authors":"Chunlin Chen, Miaoyu Zhang, Zhilin Wang, Shanshan Qu, Xinying Liu, Chi Zhang, Jiahui Deng, Yanping Bao, Jie Shi, Wenqiang Li, Lin Lu, Le Shi","doi":"10.2147/NSS.S598846","DOIUrl":"10.2147/NSS.S598846","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep encompasses multiple dimensions, each potentially involving distinct parameters that collectively capture the complex features of sleep health. However, limited studies focused on the construction of objective sleep multidimensions and its associations with cognitive impairment.</p><p><strong>Patients and methods: </strong>The study included 2670 community-dwelling older men from the Osteoporotic Fractures in Men study. Wrist actigraphy was used to collect sleep data. Latent sleep dimensions were identified from objectively measured sleep parameters using exploratory factor analysis without prespecified structures. Longitudinal associations between sleep domains and cognitive impairment were evaluated using Cox proportional hazards models over a mean follow-up of 7.4 years. XGBoost with SHapley Additive exPlanations (SHAP) was used to rank the predictive importance of each domain.</p><p><strong>Results: </strong>Five dimensions of sleep health framework were identified: rhythmicity, quality, duration, regularity, and timing. Disrupted rhythmicity was significantly associated with an increased risk of cognitive impairment (HR = 1.21, 95% CI: 1.07-1.37, p = 0.002). Longer duration (HR = 1.13, 95% CI: 1.00-1.28, p = 0.043), poorer regularity (HR = 1.13, 95% CI: 1.00-1.27, p = 0.046) and lower quality (HR = 1.13, 95% CI: 1.01-1.27, p = 0.040) were also linked to elevated risk in fully adjusted model. No significant association was observed between timing and cognitive impairment. SHAP analysis indicated that rhythmicity ranked high in predictive importance compared with traditional risk factors and was the most influential domain among the sleep dimensions. After stratification, disrupted rhythmicity remained significantly associated with cognitive impairment in most demographic and lifestyle subgroups.</p><p><strong>Conclusion: </strong>Our integrative modelling approach provides novel insights into the complex relationships between distinct sleep domains and cognitive impairment, highlighting rhythmicity as a key factor for preserving cognitive health in aging men. These findings suggest that sleep-related interventions, especially for management of rhythmicity, may be a promising approach for the prevention of cognitive impairment.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"598846"},"PeriodicalIF":3.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437362","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":"Loop Gain in Obstructive Sleep Apnea: From Physiological Endotype to Clinical Translation.","authors":"Chaofan Li, Chaohua Wang, Ying Zhang, Juan Ye, Bin Guo, Min Wu, Chun Zhang, Shaokun Huang, Guanghao Yue","doi":"10.2147/NSS.S616733","DOIUrl":"10.2147/NSS.S616733","url":null,"abstract":"<p><strong>Objective: </strong>To define how loop gain can move from a physiological endotype to a clinically actionable metric in obstructive sleep apnea.</p><p><strong>Methods: </strong>This clinical translational narrative review identified relevant literature from PubMed, Web of Science, Embase, and reference/citation searching, focusing on adult obstructive sleep apnea studies related to loop gain physiology, assessment methods, treatment stratification, and clinical implementation.</p><p><strong>Results: </strong>Loop gain helps explain why patients with similar apnea-hypopnea index values may show different disease expression and treatment responses. Research-grade perturbation methods remain the physiological reference standard, whereas raw-polysomnography (PSG) modeling currently represents the most practical route for clinical deployment. Simplified screening tools and emerging automated approaches based on polygraphy, photoplethysmography, or respiratory inductance plethysmography may expand access, provided their outputs are interpreted within method-specific contexts. Clinically, elevated loop gain may inform pre-treatment restratification before surgery or oral appliance therapy, selection of oxygen or ventilatory-control-targeted pharmacotherapy, and interpretation of residual instability during continuous positive airway pressure.</p><p><strong>Conclusion: </strong>Loop gain is most useful as a selective decision-support metric rather than as an isolated physiological number. Staged implementation, method-specific reporting, and outcome-oriented studies are needed to determine when LG-guided stratification improves clinical decisions in obstructive sleep apnea.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"616733"},"PeriodicalIF":3.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437305","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":"Research on Large Endothelial Cell-Derived Extracellular Vesicles in Pediatric Obstructive Sleep Apnea Syndrome.","authors":"Weinan Lin, Hezi Zhang, Lichao Cao, Sihan Wang, Yunfei Cui, Ting Huang, Tao Wu, Xiao Huang, Qinghua Lu, Qin Yang","doi":"10.2147/NSS.S593831","DOIUrl":"10.2147/NSS.S593831","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the association between clinical indicators of obstructive sleep apnea (OSA) and large endothelial cell-derived extracellular vesicles (large endothelial EVs) in children, and to explore their potential association with disease severity.</p><p><strong>Patients and methods: </strong>A total of 81 children with OSA were enrolled, including 29 cases of mild OSA and 52 cases of moderate-to-severe OSA. Receiver operating characteristic (ROC) curves evaluated the discriminatory ability of these EVs for severity groups. The correlation between large endothelial EVs and OSA clinical results, including sleep architecture and sleep-disordered breathing events, was evaluated using Spearman correlation analysis and multiple regression analysis.</p><p><strong>Results: </strong>Levels of CD31+CD41- large endothelial EVs were significantly elevated in children with moderate-to-severe OSA compared to the mild OSA group (<i>p</i>< 0.05). While CD62E levels were nominally elevated in moderate-to-severe OSA (p<0.05), this association did not persist following false discovery rate correction, and the marker showed limited predictive utility in the validation cohort (AUC = 0.538). The ROC curve results indicated that the sensitivity and specificity of CD31+CD41- in distinguishing mild OSA from moderate-to-severe OSA were 82.8% and 75%, respectively, with an area under the curve of 0.848. CD31+CD41- large endothelial EVs in children with OSA showed significant positive correlations with the Obstructive Apnea-Hypopnea Index (OAHI), hypopnea index, and oxygen desaturation index (<i>p</i><0.05). Multiple regression analysis revealed a logarithmic positive correlation between OAHI and CD31+CD41- large endothelial EVs (<i>p</i><0.01). Sleep efficiency was negatively correlated with CD31+CD41- large endothelial EVs (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>CD31+CD41- large endothelial EVs were closely associated with OAHI and sleep efficiency. These exploratory findings suggest their potential as a biomarker of OSA severity, but prospective validation is required before clinical application.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"593831"},"PeriodicalIF":3.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422788","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 Clinical, Humanistic, and Economic Burden of Idiopathic Hypersomnia in the United States: Analysis of the National Health and Wellness Survey.","authors":"Caroleen Drachenberg, M Janelle Cambron-Mellott, Lin Yang, Bridget L Balkaran, Marisa Whalen, David T Plante","doi":"10.2147/NSS.S568980","DOIUrl":"10.2147/NSS.S568980","url":null,"abstract":"<p><strong>Purpose: </strong>Limited self-reported data on the real-world burden of idiopathic hypersomnia exist from a representative sample of the US general adult population. This study described the clinical, humanistic, and economic burden of adults with idiopathic hypersomnia compared to matched adults without idiopathic hypersomnia.</p><p><strong>Patients and methods: </strong>This cross-sectional study used 2021 and 2023 US National Health and Wellness Survey data. Propensity score matching (1:2) was performed for adults (≥18 years) who self-reported a physician diagnosis of idiopathic hypersomnia and adults without idiopathic hypersomnia (non-idiopathic hypersomnia cohort). Post matching, outcomes were compared between cohorts using cluster-robust regression models; <i>P</i> values for primary outcomes were not adjusted for multiplicity.</p><p><strong>Results: </strong>Included were 163 adults with idiopathic hypersomnia (64.4% female, mean age 38.45 years) and 326 matched adults without idiopathic hypersomnia (66.0% female, mean age 39.60 years). The idiopathic hypersomnia cohort had higher prevalence of comorbidities (eg cardiovascular, cardiometabolic, sleep, psychiatric), higher mean Charlson comorbidity index scores (1.43 vs 0.34), and reported worse depression (PHQ-9) and anxiety (GAD-7) and poorer mental health, physical function (SF-36v2, RAND-36), and HRQoL (EQ-5D-5L, SF-6D, EQ-VAS) compared to the matched non-idiopathic hypersomnia cohort (<i>P</i> < 0.01). The idiopathic hypersomnia cohort reported more mean healthcare provider visits (13.34 vs 3.14), emergency department visits (0.88 vs 0.45), and hospitalizations (0.95 vs 0.35) in the past 6 months and higher annualized direct medical costs ($46,424.39 vs $14,700.21) than the matched non-idiopathic hypersomnia cohort (<i>P</i> < 0.05). The idiopathic hypersomnia cohort reported greater mean work productivity loss (49.07 vs 32.28) and activity impairment (48.22 vs 30.77), and annualized indirect costs ($15,269.22 vs $10,576.96) than the matched non-idiopathic hypersomnia cohort (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the substantial real-world burden, including comorbidity, HRQoL, and economic, of idiopathic hypersomnia compared to the matched non-idiopathic hypersomnia cohort.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"568980"},"PeriodicalIF":3.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369273","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 Prognostic Value of Early Treatment Factors for Cognitive Behavioral Therapy for Insomnia (CBT-I) Outcomes.","authors":"Yanyu Hu, Zhiyong Ni, Shiyu Wang, Shuchuan Zheng, Nana Weng, Peng Lai, Shujuan Huang, Xuan Wei","doi":"10.2147/NSS.S599377","DOIUrl":"10.2147/NSS.S599377","url":null,"abstract":"<p><strong>Background: </strong>Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia, yet a significant proportion of patients fail to achieve favorable outcomes. Baseline-only prognostic models show limited predictive performance, and the added value of early treatment variables remains unclear. This retrospective study aimed to investigate this issue.</p><p><strong>Methods: </strong>We retrospectively included 1059 patients who completed face-to-face group CBT-I. Post-treatment outcomes were assessed using the Insomnia Severity Index (ISI), and 12-month follow-up outcomes were evaluated using the Pittsburgh Sleep Quality Index (PSQI). The dataset was randomly split into training (70%) and test (30%) sets. Candidate predictors were selected using Least Absolute Shrinkage and Selection Operator, Random Forest, and eXtreme Gradient Boosting. Variables consistently identified across all three algorithms were entered into multivariable logistic regression models. Predictive performance of baseline-only and combined models (baseline plus early treatment variables) was evaluated using the area under the receiver operating characteristic curve (AUC) and Brier Score, with bootstrap resampling used for model comparison.</p><p><strong>Results: </strong>Unfavorable outcomes were observed in 32.4% of patients at post-treatment (neither ISI < 8 nor a reduction > 7) and in 44.5% at the 12-month follow-up (PSQI > 5). The combined model significantly outperformed the baseline-only model in predicting post-treatment outcomes in the test set (AUC: 0.741 vs 0.630, p < 0.001), with week  2 ISI change identified as the strongest predictor. For the 12-month follow-up, the combined model demonstrated a non-significantly higher AUC compared with the baseline-only model (0.742 vs 0.735, p > 0.05), with age emerging as the strongest predictor.</p><p><strong>Conclusion: </strong>Incorporating early treatment variables, particularly Week 2 ISI score reduction, may provide incremental value in predicting short-term CBT-I outcomes. However, the added value of early treatment variables for long-term outcomes appeared limited.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"599377"},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361661","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":"Content Validity and Psychometric Evaluation of the Idiopathic Hypersomnia Severity Scale (IHSS) in Adults with Idiopathic Hypersomnia.","authors":"Junji Lin, Caitlyn Lowe, Benjamin Banderas, Patricia Chandler, Ethan Arenson, Alan L Shields, Susan Morris, Bhavini Srivastava, Yves Dauvilliers","doi":"10.2147/NSS.S571289","DOIUrl":"10.2147/NSS.S571289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate content validity, psychometric properties, and score interpretability of the Idiopathic Hypersomnia Severity Scale (IHSS).</p><p><strong>Patients and methods: </strong>Adults with idiopathic hypersomnia recruited from US patient organizations participated in qualitative interviews; transcripts were coded and qualitatively analyzed. Using data from a phase 3 trial of low-sodium oxybate in adults with idiopathic hypersomnia (NCT03533114), IHSS scores were psychometrically evaluated at Baseline, Weeks 1 and 8, end of titration, end of Stable Dose Period, and end of Double-Blind Randomized Withdrawal Period. Reliability, validity, and meaningful within-patient change (MWPC) were assessed.</p><p><strong>Results: </strong>In qualitative interviews, 20 participants (mean [SD] age, 35.0 [10.2] years; 70.0% female; 90.0% White) reported 18 idiopathic hypersomnia-related symptoms. Most frequently reported symptom/impact domains were excessive daytime sleepiness (100.0%) and emotional impact (100.0%). All participants understood and interpreted IHSS instructions, items, and response options as intended. Using the psychometric sample (N=115 participants; mean [SD] age, 40.9 [13.9] years; 71.3% female; 80.9% White), IHSS scores were found to be sufficiently reliable with respect to internal consistency (α≥0.80, average inter-item correlations 0.15-0.50) and reproducibility (intraclass correlation coefficient range, 0.73-0.98). Moderate to strong (0.30 < |<i>r</i>| ≤ 0.90) correlations were found between IHSS and other assessments (eg, Epworth Sleepiness Scale, Clinical and Patient Global Impression of Change). A large effect size (Cohen's |<i>d</i>|=0.89) was found in change scores. Interpretation analyses demonstrated a 3-point minimum increase for detecting MWPC for IHSS total score.</p><p><strong>Conclusion: </strong>The IHSS is a content-valid patient-reported outcome questionnaire that may produce valid, reliable, interpretable scores.</p><p><strong>Clinical trial registration: </strong>NCT03533114.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"571289"},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361620","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}