Nature and Science of Sleep最新文献

{"title":"Network Pharmacology-Based Elucidation of Gu's Anshen Decoction in Modulating TNF Signaling to Ameliorate Insomnia.","authors":"Sanyuan Gu, Jingyu Xu","doi":"10.2147/NSS.S582222","DOIUrl":"10.2147/NSS.S582222","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the therapeutic mechanisms of Gu's Anshen decoction (GAD) against insomnia (INS), focusing on the regulation of tumor necrosis factor (TNF)-mediated inflammatory pathways.</p><p><strong>Methods: </strong>Bioactive compounds and potential targets of GAD were identified via network pharmacology and constructed herb-compound-target interaction network. INS-related targets derived from peripheral blood mononuclear cells in the Gene Expression Omnibus (GEO) database were intersected with GAD targets to establish a protein-protein interaction (PPI) network. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to identify the key pathways. Experimental validation employed a para-chlorophenylalanine (PCPA)-induced INS rat model, integrating behavioral tests, histopathology, and inflammatory cytokine quantification.</p><p><strong>Results: </strong>Network pharmacology revealed multi-target, multi-pathway actions of GAD against INS, with the TNF signaling pathway identified as a critical axis. Animal experiments demonstrated that GAD significantly improved sleep architecture in INS rats, reduced serum and hippocampal levels of TNF-α and interleukin-1β (IL-1β), and downregulated phosphorylated NF-κB p65 (p-p65) expression, indicating suppression of TNF-driven neuroinflammation.</p><p><strong>Conclusion: </strong>GAD ameliorates INS in a rat model by inhibiting TNF-mediated inflammatory signaling, offering a potential mechanistic basis for its therapeutic use in INS management.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"582222"},"PeriodicalIF":3.4,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150608","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 Social Jetlag and Gut Microbiome Profiles in Adolescents.","authors":"Qinghai Gong, Keqin Ding, Wangwei Lou, Jinwen Wang, Guolin Bian","doi":"10.2147/NSS.S603131","DOIUrl":"10.2147/NSS.S603131","url":null,"abstract":"<p><strong>Background: </strong>The microbiota-gut-brain axis plays a vital role in health, with growing evidence linking SJL to the gut microbiome. In this study, the relationship between self-reported SJL and gut microbiome composition is evaluated in an adolescent population.</p><p><strong>Methods: </strong>A total of 120 healthy adolescents (69 females, 51 males; mean age 12.69±0.65 years) were included. We investigated the associations of self-reported SJL with gut microbial α-diversity, the Firmicutes/Bacteroidetes (F/B) ratio, specific bacterial taxa, and functional gene diversity.</p><p><strong>Results: </strong>Participants had an average SJL of 0.87±0.73 h, with 25.0% experiencing SJL ≥2 h/d. Although continuous SJL was negatively correlated with α-diversity at the family level (Shannon and Simpson indices, all <i>P</i><0.05), no significant differences were found between the SJL <2 and ≥2 h/d groups. Several taxa across multiple taxonomic levels (e.g. Bacteroidia and Bacteroidales) were associated with SJL (<i>P</i><0.05). Differential abundance was observed for multiple families and genera between these two SJL groups. After FDR correction (<i>q</i>≤0.05), only the glutamate dehydrogenase gene gdh_K00262 was significantly enriched in the high SJL group (<i>q</i>=0.05).</p><p><strong>Conclusion: </strong>SJL is associated with shifts in functionally relevant gut taxa, rather than a global ecological restructuring, in adolescents. Future work is needed to decipher the mechanisms of this microbiome-SJL interaction and its health significance.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"603131"},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144021","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":"Patient-Reported Outcomes for LEMborexant Treatment in Chinese Patients with Insomnia (PROEM): A Multicenter, Prospective, Real-World Observational Study.","authors":"Shuqiong Zheng, Xueli Li, Weiying Jian, Yamei Tang, Yongqiang Lin, Fujun Jia, Bin Zhang","doi":"10.2147/NSS.S596731","DOIUrl":"10.2147/NSS.S596731","url":null,"abstract":"<p><strong>Purpose: </strong>Studies of Lemborexant (LEM) treatment for patients with insomnia in China in real-world setting have been limited. This study assessed efficacy and safety of LEM in treating Chinese patients with insomnia.</p><p><strong>Patients and methods: </strong>In this 12-week, multicenter, prospective, observational study, 205 adult patients diagnosed with insomnia with an Insomnia Severity Index (ISI) score of ≥10 were enrolled and treated with LEM in China. The primary endpoint was remission rate (the proportion of patients with an ISI<8) after 4 weeks of LEM treatment. Treatment-emergent adverse events (TEAEs) were recorded.</p><p><strong>Results: </strong>The full analysis set included 200 patients with a mean baseline ISI of 17.44±4.45. Remission rate and responder (≥6-point reduction in ISI) rate after 4 weeks of LEM treatment was 30.5% (61/200) and 55.0% (110/200), respectively. ISI scores decreased significantly from baseline after 1 weeks of treatment and kept decreasing. LEM treatment also improved symptoms of depression and anxiety. Compared with patients with mild insomnia, patients with severe baseline insomnia were less likely to be insomnia remitters and more likely to be LEM responders and to have greater ISI decrease after 4 weeks of treatment. Additionally, patients who switched to LEM from other hypnotics were less likely to be LEM responders than patient receiving initial LEM monotherapy. 21.0% (43/205) of the patients reported at least one mild or moderate TEAE, and none reported serious TEAEs. Ten (4.9%) patients withdrew from the study due to TEAEs. The most common TEAEs were somnolence, dizziness and nightmare.</p><p><strong>Conclusion: </strong>Lemborexant was effective and safe in treating Chinese adult patients with insomnia.</p><p><strong>Clinicaltrialsgov registration number: </strong>NCT06225947 (Date of registration: January 17, 2024).</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"596731"},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144093","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: \"Association of Prognostic Nutritional Index with Mortality in High-Risk OSA Individuals and with Disease Severity in Clinical OSA Patients\" [Letter].","authors":"Keyuan Fang, Xiaoxiao Ding","doi":"10.2147/NSS.S621279","DOIUrl":"10.2147/NSS.S621279","url":null,"abstract":"","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"621279"},"PeriodicalIF":3.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144080","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 Level of Smartphone Addiction and Its Relationship to High Blood Pressure Among Middle-Aged and Elderly People in Rural Areas of China.","authors":"Liandi Cheng, Yunhao Zheng, Xiaoguang Chen, Jiazhi Wu, Yixuan Pan, Xin Xiong, Zheng Ye","doi":"10.2147/NSS.S560764","DOIUrl":"10.2147/NSS.S560764","url":null,"abstract":"<p><strong>Objective: </strong>There is a lack of research on the association between smartphone addiction and hypertension (HTN) in middle-aged and elderly populations, and their associations with employment status and sleep quality are still unclear.</p><p><strong>Methods: </strong>This study was conducted in 85 villages in southeastern China. A total of 975 middle-aged and elderly participants (mean age: 60.70 years; 483 males and 492 females) were included. Demographic data were collected. Smartphone addiction was assessed using the Smartphone Addiction Scale-Short Version (SAS-SV), and sleep quality was measured using the Brief version of the Pittsburgh Sleep Quality Index (B-PSQI). Multiple regression and moderated mediation analyses were used to explore the potential moderating role of employment status (employed vs. unemployed/retired) and the mediating role of sleep quality in the association between smartphone addiction and HTN.</p><p><strong>Results: </strong>A total of 415 (42.56%) individuals were suffering from HTN. Smartphone addiction was significantly and positively associated with sleep quality (<i>p</i> < 0.001). And sleep quality was also significantly positively associated with HTN (<i>p</i> < 0.05). Distinct patterns were observed across employment status groups, with a significant association between smartphone addiction and HTN in unemployed/retired participants (1.511, 95% CI: 1.140-2.002, <i>p</i> = 0.004), whereas this association was mediated by sleep quality among employed participants. The direct association was 0.940 (95% CI: 0.787-1.122) and the indirect association was 1.034 (95% CI: 1.002-1.071).</p><p><strong>Conclusion: </strong>Smartphone addiction is associated with HTN among middle-aged and elderly individuals in rural China. Among unemployed or retired individuals, smartphone addiction may be directly associated with HTN, whereas among employed individuals, this association may be mediated by sleep quality. Reducing excessive smartphone use in rural middle-aged and elderly residents and improving sleep quality (especially in employed individuals) may help mitigate HTN risk. Future studies are warranted to explore underlying mechanisms using longitudinal designs.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"560764"},"PeriodicalIF":3.4,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138610","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":"Health Sciences Students' Knowledge and Attitudes Toward Snoring: A Cross-Sectional Study in Jeddah, Saudi Arabia.","authors":"Shahd Ali Alshamrani, Sara Abdullah Alrogaib, Rema Mohammed Alharthi, Norah Abdullah Alharthi, Muhammad Anwar Khan, Raju Suresh Kumar","doi":"10.2147/NSS.S575295","DOIUrl":"10.2147/NSS.S575295","url":null,"abstract":"<p><strong>Objective: </strong>Snoring is a sound produced by the vibrations of upper airway soft tissues due to partial airway obstruction during sleep. It is often linked to sleep-disordered breathing and may suggest underlying conditions such as obstructive sleep apnea. As future healthcare professionals, health sciences students should possess adequate knowledge and appropriate attitudes regarding snoring and its clinical implications. This study aimed to assess health sciences students' knowledge and attitudes toward snoring.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among 760 health sciences students from three universities in Jeddah, Saudi Arabia. Participants were recruited using quota sampling and completed a validated, self-administered questionnaire assessing demographic characteristics, knowledge, and attitudes regarding snoring. Data were analyzed using descriptive statistics and inferential tests. Independent <i>t</i>-tests and one-way ANOVA were used to compare mean scores between groups, with statistical significance set at p < 0.05. Likert-scale responses were coded from 1 to 5, and mean scores were calculated. Given the large sample size, Likert responses were treated as approximately continuous variables and analyzed using parametric tests.</p><p><strong>Results: </strong>Most participants reported that snoring disrupts sleep (75.5%) and is more common among males (73.3%). Female students demonstrated significantly greater agreement that snoring can worsen nasal symptoms (<i>p</i> = 0.005). Differences in knowledge and attitudes were observed across academic disciplines, with students from the anesthesia technology program demonstrating a stronger understanding of several snoring-related concepts.Across all disciplines, most participants disagreed with the statement that continuous positive airway pressure (CPAP) increases snoring (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Health sciences students demonstrated varying levels of knowledge and attitudes toward snoring, with notable differences by gender and academic discipline. These findings highlighted the importance of incorporating targeted educational strategies within health sciences curricula to enhance awareness and support early recognition of snoring-related health conditions.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"575295"},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148033030","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":"Restoring Physiological Normoxia as an Adjuvant Strategy to Improve Cancer Treatment Outcomes.","authors":"Carlos Mas Bermejo, Carlos Mas Gómez, Ma-Agustina Sevilla-García, Carlos O'Connor-Reina, Susana Falardo Ramos, José Luis Alonso-Romero, Luis-Alberto Bravo-González","doi":"10.2147/NSS.S593331","DOIUrl":"10.2147/NSS.S593331","url":null,"abstract":"<p><p>Hypoxia is a central driver of cancer progression, immune evasion, and resistance to anticancer therapies. While hypoxia has traditionally been considered an intrinsic feature of the tumor microenvironment, growing evidence indicates that chronic intermittent hypoxia-particularly that occurring during sleep-represents a systemic and potentially modifiable contributor to hypoxia-driven oncogenic signaling. Sleep-disordered breathing is the most prevalent cause of nocturnal intermittent hypoxia and induces oxidative stress, inflammation, metabolic reprogramming, and immune dysregulation through mechanisms that overlap with those observed in hypoxic tumors.This narrative review synthesizes current experimental, translational, and clinical evidence supporting the concept that restoration of physiological normoxia, especially during sleep, may attenuate hypoxia-mediated cancer biology and improve responsiveness to standard anticancer therapies. We examine the biological effects of normoxia restoration on hypoxia-inducible signaling, redox homeostasis, tumor metabolism, and antitumor immunity, highlighting its potential role as a host-directed, adjuvant strategy rather than a direct tumor-targeting intervention.We further review sleep and airway-centered therapeutic approaches capable of reducing nocturnal hypoxic burden, including continuous positive airway pressure, mandibular advancement devices, upper airway surgery, myofunctional therapy, and respiratory physiotherapy. Although these interventions are not cancer-specific, their ability to stabilize nocturnal oxygenation positions them as clinically relevant tools within a multidisciplinary framework aimed at hypoxia normalization.Collectively, the evidence suggests that nocturnal normoxia is a biologically meaningful and clinically actionable target. Integrating sleep and airway interventions into cancer care pathways may represent a novel avenue to mitigate hypoxia-driven treatment resistance and enhance therapeutic outcomes. Prospective clinical studies incorporating objective measures of hypoxic burden are warranted to validate this integrative approach.Restoration of physiological normoxia is therefore proposed as a host-directed, adjuvant strategy aimed at mitigating hypoxia-driven oncogenic pathways and improving responsiveness to standard anticancer therapies.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"593331"},"PeriodicalIF":3.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032986","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":"Chloral Hydrate in the Treatment of Severe Insomnia When Other Treatments Have Failed: Results From a Real-World Evidence Study (RESTORE).","authors":"John A Groeger, John Luke Twelves, Jan Multmeier, Hannah Swayze, Mushtaque Mastim Snr, Adrian Williams, Stephen Deacon","doi":"10.2147/NSS.S587588","DOIUrl":"10.2147/NSS.S587588","url":null,"abstract":"<p><strong>Study objectives: </strong>The efficacy and safety of chloral hydrate, used as approved for severe insomnia in the UK, were assessed in a single-arm, open-label, real-world, decentralized clinical trial using contemporary self-reported outcome measures.</p><p><strong>Methods: </strong>Participants (18-75 years) had clinically significant impairment by severe insomnia (Insomnia Severity Index (ISI) score of 20-28), and history of behavioral and pharmacological sleep therapy failure. Specialists confirmed the clinical diagnosis and prescribed chloral hydrate (500 mg/5 mL oral solution, 430 or 860 mg daily) for 2 weeks followed by a 4-week follow-up period. Endpoints included change in ISI score from confirmatory diagnosis to treatment end (primary); and sleep measures, health-related quality of life (HRQoL), anxiety, depression, and adverse events (AEs; secondaries).</p><p><strong>Results: </strong>Of the 96 participants (mean baseline ISI, 24.03 [SD, 2.06]), 85 completed the study. Improvements were observed with ISI at treatment end (week 2 mean change was -10.79 [95% confidence interval, -12.12, -9.47]; n=93; week 6 mean change was -8.04 (95% confidence interval, -9.13, -6.95; p < 0.0001; n=85), exceeding the 6-point change considered a minimal clinically important difference. Self-reported sleep measures including Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, HRQoL, and anxiety shows significant improvements during treatment with some outcomes indicating continued benefit up to 4 weeks post-treatment. Most treatment-related AEs were mild in nature (83.9%, 256/305 events) including wind (73.9%), headache (58.7%), and stomach pain (31.5%). While no events met criteria for serious or severe intensity, seven participants (7.6%) withdrew owing to AEs.</p><p><strong>Conclusion: </strong>Short-term UK-approved chloral hydrate may provide a potential option for severe adult insomnia only when prior treatments have failed.</p><p><strong>Trial registration: </strong>NCT06053840 (https://clinicaltrials.gov); ISRCTN10433315 (https://www.isrctn.com/).</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"587588"},"PeriodicalIF":3.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032998","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":"Polysomnographic Characteristics and Sleep Disorders in Pediatric Moyamoya Arteriopathy.","authors":"Kantisa Sirianansopa, Reshma Amin, Jackie Chiang","doi":"10.2147/NSS.S596046","DOIUrl":"10.2147/NSS.S596046","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe the polysomnographic characteristics and sleep-related symptoms in pediatric patients with Moyamoya arteriopathy (MMA) referred for sleep evaluation.</p><p><strong>Patients and methods: </strong>We conducted a retrospective case series of pediatric patients with MMA who were referred to the sleep clinic at The Hospital for Sick Children, Toronto, Canada, and underwent level 1 polysomnography (PSG) between 2014 and 2024. Clinical, demographic, genetic, and sleep-related data, including PSG and multiple sleep latency test (MSLT) findings were reviewed.</p><p><strong>Results: </strong>Eleven pediatric patients were included, with a median (IQR) age of 15 (13, 17) years. Sleep fragmentation was commonly observed on PSG (n=10, 90.9%), while no patients demonstrated clinically significant sleep-disordered breathing. A trend toward shorter REM latency was noted compared with age-matched normative values. Daytime fatigue was the most frequently reported symptom (n=6, 54.5%). Two patients underwent MSLT due to persistent hypersomnolence; one met diagnostic criteria for narcolepsy.</p><p><strong>Conclusion: </strong>In this retrospective case series, sleep fragmentation and a trend toward shorter REM latency were commonly observed in pediatric patients with MMA. However, given the small sample size and absence of pre-revascularization baseline data, these findings should be interpreted with caution. These results are descriptive and hypothesis-generating, and further prospective studies are needed to better understand sleep disturbances in this population.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"596046"},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982468","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":"Association Between Work Stress and Sleep Disorders in Law Enforcement: A Systematic Review and Meta-Analysis.","authors":"Huaihan Yang, Shuchen Tang","doi":"10.2147/NSS.S601666","DOIUrl":"10.2147/NSS.S601666","url":null,"abstract":"<p><strong>Background: </strong>Law enforcement personnel face diverse occupational stressors, including shift work, organizational pressure, operational demands, and traumatic incidents. Previous systematic reviews have primarily focused on prevalence estimates of sleep disturbances, whereas the strength of the association with occupational stress and the relative contribution of distinct stressor domains remain to be systematically quantified.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD420261284369). Four databases (PubMed, Cochrane Library, Web of Science, and SpringerLink) were searched from inception to January 2026. Observational studies using validated instruments to assess occupational stress and sleep outcomes were included. A random-effects model was used to pool odds ratios (ORs). Subgroup analyses distinguished three stressor domains: shift work, work and organizational stress, and dual stress exposure.</p><p><strong>Results: </strong>Seventeen studies were included in the qualitative synthesis, of which ten (N = 5124) provided data for meta-analysis. Occupational stress was significantly associated with sleep disorders (pooled OR = 3.51, 95% CI: 2.54-4.84), with moderate to substantial heterogeneity (I² = 69%). Subgroup analyses showed that shift work (OR = 3.02), work and organizational stress (OR = 5.94), and dual stress exposure (OR = 3.66) were each associated with elevated sleep risk, with no significant subgroup difference (P = 0.19). The dual stress exposure subgroup exhibited high heterogeneity (I² = 87%), possibly attributable to differences in measurement tools, study populations, and confounder adjustment.</p><p><strong>Conclusion: </strong>This study provides a quantitative estimate of the association between occupational stress and sleep disorders in law enforcement personnel. Differentiating occupational stress into distinct stressor domains may help clarify its relationship with sleep, with different stressors potentially operating through distinct pathways (eg, circadian disruption, cognitive rumination, hyperarousal). Methodologically, the study highlights issues in measurement standardization and confounder adjustment. From an intervention perspective, organizational-level strategies-such as enhancing decision-making autonomy and supportive leadership-may warrant further exploration alongside individual-level approaches. Safeguarding sleep health in this population is important for both individual well-being and public safety.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"601666"},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982537","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}