Sleep medicine最新文献

{"title":"Solriamfetol for the treatment of excessive daytime sleepiness in participants with obstructive sleep apnea with different levels of adherence to primary OSA therapy: Subgroup analysis of a randomized clinical trial","authors":"Jiucheng Shen ,&nbsp;Kaida Guo ,&nbsp;Jing Wang ,&nbsp;Zhijun Wang ,&nbsp;Shiyuan Gao ,&nbsp;Qiaojun Wang ,&nbsp;Fei Han ,&nbsp;Weijia Zhang ,&nbsp;Xiang Li ,&nbsp;Hui Ye ,&nbsp;Rui Chen","doi":"10.1016/j.sleep.2025.106706","DOIUrl":"10.1016/j.sleep.2025.106706","url":null,"abstract":"<div><h3>Background</h3><div>Solriamfetol is a dopamine and norepinephrine reuptake inhibitor (DNRI) indicated for the treatment of excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA). The current study aims to evaluate effects of solriamfetol among participants with different adherence to primary OSA therapy using data from a randomized clinical trial conducted among Chinese participants.</div></div><div><h3>Methods</h3><div>Participants were 1:1 randomized to placebo or solriamfetol (up to 150 mg/day) for 12 weeks (stratified by adherence to primary OSA therapy). The coprimary endpoints were change from baseline in mean sleep latency of maintenance of wakefulness test (MWT) and Epworth Sleepiness Scale (ESS) at week 12 in the full analysis set. Use of primary OSA therapy and safety were also evaluated.</div></div><div><h3>Results</h3><div>At baseline, of all participants, around 50 % were adherent, 20 % were non-adherent and 30 % were not on primary OSA therapy, respectively. In all subgroups, solriamfetol treatment was associated with significant or numerical improvement in MWT sleep latency or ESS (LS mean difference vs. placebo, p &lt; 0.05 except ESS in non-adherence to primary therapy subgroup). Use of primary OSA therapy was stable throughout the 12-week study. Solriamfetol was well tolerated and the most common TEAEs included metabolism and nutrition disorders, upper respiratory tract infection, dizziness, hypertension and elevated blood creatine phosphokinase.</div></div><div><h3>Conclusion</h3><div>In the subgroup analysis of a randomized clinical trial in Chinese OSA participants with EDS, solriamfetol was effective and well tolerated regardless of adherence to primary OSA therapy. No clinically meaningful impact of solriamfetol on the use of primary OSA therapy was found.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106706"},"PeriodicalIF":3.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additive interactions of sleep disorders, insufficient sleep, and shift work on road and workplace safety incidents: A sufficient cause approach with overlap weights","authors":"Kelly Sansom ,&nbsp;Murthy N. Mittinty ,&nbsp;Claire Dunbar ,&nbsp;Andrew Vakulin ,&nbsp;Robert J.T. Adams ,&nbsp;Nigel McArdle ,&nbsp;Peter R. Eastwood ,&nbsp;Amy Reynolds","doi":"10.1016/j.sleep.2025.106699","DOIUrl":"10.1016/j.sleep.2025.106699","url":null,"abstract":"<div><h3>Background</h3><div>Behavioural and biological factors impacting healthy sleep can influence road and workplace safety. This study investigated the additive interactions of sleep-disrupting factors (sleep disorders, insufficient sleep, and shift work) on road and workplace safety in young adults (22 years) from the Raine Study.</div></div><div><h3>Methods</h3><div>Employed participants (n = 439, median age 22.0 years, IQR 21.6–22.3) were assessed for common sleep disorders (obstructive sleep apnoea, insomnia, restless legs syndrome). They provided information on shift work status, habitual sleep duration (insufficient sleep &lt;7 h), and self-reported road and work incidents. A sufficient cause approach with inverse probability of overlap weights and logistic regression was used to study additive interactions.</div></div><div><h3>Results</h3><div>Sleepiness while driving was reported by 16 % and while at work by 11 % of participants. Insufficient sleep alone increased the odds of falling asleep while driving (OR 2.29; 95 % CI 1.17, 4.32). Three sleep-disrupting factors additively increased the risk of near-miss road incidents (β, 1.40 &gt; 0). Sleep disorders with shift work was associated with the highest risk of falling asleep at work (relative excess risk due to interaction, RERI; 4.86; 95 % CI, 2.9, 6.81).</div></div><div><h3>Conclusion</h3><div>The combined burden of multiple sleep-disrupting factors including sleep disorders, insufficient sleep and shift work, is associated with an increased risk of near-miss road incidents and falling asleep at work. Given that sleepiness, both on the road and in the workplace, is common in young adults, there is a need for greater awareness and intervention to address the associated risks.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106699"},"PeriodicalIF":3.4,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disordered breathing symptoms in children: a prospective evaluation 5 years after maxillary expansion","authors":"Nathalie Nietvelt ,&nbsp;Guy Willems ,&nbsp;Bertien Buyse ,&nbsp;Valentine Detailleur ,&nbsp;Maria Cadenas de Llano-Pérula","doi":"10.1016/j.sleep.2025.106700","DOIUrl":"10.1016/j.sleep.2025.106700","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of maxillary expansion and of different types of subsequent comprehensive orthodontic treatment on sleep disordered breathing (SDB) symptoms in children five years after maxillary expansion.</div></div><div><h3>Methods</h3><div>Children needing early maxillary expansion were asked to fill the Pediatric Sleep Questionnaire (PSQ) at three time points: before the start of maxillary expansion (T0; N = 404), after active expansion (T1; N = 309) and after the completion of comprehensive orthodontic treatment (T2; N = 113). Maxillary expansion was achieved using a removable expansion plate (80,49 %), a hyrax (18,03 %) or a quadhelix (1,48 %). When indicated, comprehensive orthodontic treatment either consisted of fixed appliances alone or was combined with a class II functional appliance, a headgear or a hyrax. Linear mixed models corrected for age were used to compare the PSQ results per time point.</div></div><div><h3>Results</h3><div>Significant reductions in the total PSQ scores (p &lt; 0.0001), breathing (p &lt; 0.0001), behavior (p = 0.0026) and loudness of snoring (p = 0.0107) were observed between T0 and T1, which maintained between T0 and T2 (p = 0.0275; p = 0.0281; p = 0.0243). Between T1 and T2 and T0 and T2, sleepiness significantly increased (p &lt; 0.0001; p = 0.0004).</div><div>No significant interaction was found between the four different types of comprehensive orthodontic treatment and the PSQ scores.</div></div><div><h3>Conclusion</h3><div>Early maxillary expansion with removable plates has general a positive effect on PSQ scores. These improvements exhibit a stability for at least five years, regardless of the type of subsequent comprehensive orthodontic treatment. Therefore, the orthodontist plays an important role in the early detection and multidisciplinary treatment of pediatric obstructive sleep apnea syndrome.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106700"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and validation of the adolescent sleep hygiene scale for Spanish-speaking populations","authors":"A. Muñoz-Alonso ,&nbsp;M. Romero-Saldaña ,&nbsp;F.J. Rodríguez-Cortés ,&nbsp;C. Rodríguez-Garriguet ,&nbsp;M. Carretero-Serrrano ,&nbsp;C. Rivas-Cruces ,&nbsp;M.I. Tovar-Gálvez ,&nbsp;P.J. López-Soto","doi":"10.1016/j.sleep.2025.106685","DOIUrl":"10.1016/j.sleep.2025.106685","url":null,"abstract":"<div><div>The school environment is essential for forming healthy habits, and having validated scales measuring sleep and wakefulness behaviours is critical for addressing adolescent sleep hygiene. Validation of such tools enables us to accurately assess sleep habits and design and implement more effective interventions that enhance young people's well-being and academic performance. This study aimed to adapt and culturally validate the Adolescent Sleep Hygiene Scale (ASHS) for Spanish-speaking adolescents, ensuring that the included items adequately reflected this population's cultural practices and sleep habits. Content validation was performed by a group of 45 expert judges, ensuring that the items were relevant and appropriate from a professional perspective. Subsequently, a pilot study was conducted with a sample of 255 adolescents, which allowed us to validate the scale construct robustly. The results of this study confirm that the ASHS is a valid and reliable tool that accurately reflects the sleep habits of Spanish adolescents. The translation and cultural validation of the ASHS represent a significant advance in promoting sleep hygiene among this vulnerable population, facilitating the identification of sleep-related problems and thereby contributing to improved health and academic performance among young people.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106685"},"PeriodicalIF":3.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dreem headband performance in Insomnia Disorder: An in-lab comparison to polysomnography","authors":"Qiutian A.L. Beau ,&nbsp;Johanna M. Boardman ,&nbsp;Alix Mellor ,&nbsp;Rowan P. Ogeil ,&nbsp;Sean P.A. Drummond","doi":"10.1016/j.sleep.2025.106698","DOIUrl":"10.1016/j.sleep.2025.106698","url":null,"abstract":"<div><h3>Background</h3><div>Capturing sleep data historically required complex, expensive, and labour-intensive equipment, with the gold standard being overnight polysomnography (PSG). Newer portable devices, such as the Dreem 3 headband, provide a novel opportunity to collect field-based data and have demonstrated accuracy in healthy sleepers compared to PSG. However, this device's performance has not been assessed in Insomnia Disorder, despite sleep-tracking technologies traditionally performing poorly in disordered sleepers. This study aimed to evaluate the performance of Dreem 3 against PSG on key sleep outcomes.</div></div><div><h3>Methods</h3><div>Thirty-one adults (<em>M</em>_<em>age</em> = 45.9 years, 16 males) with Insomnia Disorder participated in an overnight sleep study wearing Dreem 3 and PSG simultaneously. Sensitivity and specificity were calculated using an epoch-by-epoch analysis. Bland-Altman plots further assessed performance related to sleep stages and continuity variables: total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake after sleep onset (WASO).</div></div><div><h3>Results</h3><div>Dreem 3 showed the highest sensitivity for REM sleep (89.88 %) and the lowest sensitivity for N1 (29.79 %). N3 sensitivity was also notably low (65.65 %). Specificity was &gt;90 % for all stages, except N2 (83.39 %). Dreem accurately summarised SL and WASO but significantly overestimated TST and SE.</div></div><div><h3>Conclusion</h3><div>The Dreem 3 headband can accurately evaluate and report most sleep staging and continuity variables in individuals with Insomnia Disorder. Users should be mindful of the strengths and limitations of the device when deciding whether the Dreem 3 is suitable for their needs. If applied and interpreted correctly, this device could facilitate large-scale, longitudinal sleep studies and assessment of sleep in Insomnia Disorder.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106698"},"PeriodicalIF":3.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized sleep-aiding music intervention for insomnia: A closed-loop neurofeedback approach","authors":"Jin Li ,&nbsp;Meiling Zhou ,&nbsp;Jiabo Zhang ,&nbsp;Jiashuo Zhang ,&nbsp;Lei Zhang ,&nbsp;Xianxiang Zeng ,&nbsp;Hanling Zhang","doi":"10.1016/j.sleep.2025.106693","DOIUrl":"10.1016/j.sleep.2025.106693","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is a common sleep disorder that severely impacts health and quality of life. Although music therapy is a widely used non-pharmacological treatment for sleep improvement, its lack of personalization limits its effectiveness.</div></div><div><h3>Methods</h3><div>We proposed a novel EEG neurofeedback intervention for sleep-aiding music therapy. A sleep-aiding style transfer model was developed to convert traditional five-element music into a sleep-aiding style. Subsequently, we established a neurofeedback framework linking an EEG parameter, the sleep state, and musical features. Leveraging the EEG alpha/theta power ratio, our system dynamically adjusted the tempo and volume of sleep-aiding five-element music in real time.</div></div><div><h3>Results</h3><div>EEG neurofeedback intervention significantly improved ISI, PSQI, and sleep latency compared with the non-neurofeedback intervention. Notably, potential biomarkers were identified: reduced prefrontal-parietal functional connectivity in the alpha band during wakefulness (W) and increased functional connectivity from the central region to the central, occipital, and temporal regions in the theta band during light sleep (N1).</div></div><div><h3>Conclusion</h3><div>These findings highlight the potential of personalized, closed-loop neurofeedback music as an effective non-pharmacological intervention for insomnia. By dynamically adapting music parameters based on real-time EEG, this approach offers a novel method for optimizing sleep regulation and improving treatment outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106693"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between arousal index during REM sleep and the incidence of atrial fibrillation in patients with obstructive sleep apnea","authors":"Li-Da Chen ,&nbsp;Bin-Hua Yang ,&nbsp;Yan-Qin Zhang ,&nbsp;Shen-Liang Wu ,&nbsp;Chun-Hua Li ,&nbsp;Liang-Ji Zhang ,&nbsp;Li Lin ,&nbsp;Ning-Fang Lian ,&nbsp;Hui-Xue Zeng","doi":"10.1016/j.sleep.2025.106697","DOIUrl":"10.1016/j.sleep.2025.106697","url":null,"abstract":"<div><h3>Background</h3><div>Accumulating studies have linked obstructive sleep apnea (OSA) to the occurrence of atrial fibrillation (AF). However, data on the relationship between sleep architecture parameters in OSA patients and the occurrence of AF are limited.</div></div><div><h3>Objective</h3><div>This exploratory study examined the association between 14 objectively collected sleep architecture parameters and the incidence of AF in OSA patients.</div></div><div><h3>Methods</h3><div>This study is a population-based prospective cohort study that included 1810 participants from the Sleep Heart Health Study (SHHS) who underwent in-home polysomnography monitoring at baseline. Logistic regression analysis was used to investigate the relationship between sleep architecture parameters in OSA patients and the occurrence of AF.</div></div><div><h3>Results</h3><div>A significant inverse association was observed between arousal index during REM sleep (ArI-REM) and the occurrence of AF after full adjustment (OR = 0.982, 95 % CI = 0.966–0.998, p = 0.027). Individuals in the highest quartile of ArI-REM had a significantly lower risk of new-onset AF compared to the lowest quartile (adjusted OR = 0.623, 95 % CI = 0.410–0.929, p = 0.023). The relationship between ArI-REM and the occurrence of AF was linear (p for trend = 0.030). Stratified analyses demonstrated a significant interaction with OSA severity (p_interaction = 0.004), with the most notable association observed in the severe OSA subgroup (adjusted OR = 0.96; 95 % CI = 0.94–0.99; p = 0.008).</div></div><div><h3>Conclusion</h3><div>There was a significant linear inverse relationship between an increase in ArI-REM and the risk of incident AF. The association was most notable in those severe OSA subgroups. Future research should explore whether continuous positive airway pressure can lower AF risk in severe OSA patients with a low ArI-REM.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106697"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of Large Language Models (LLMs) compared with physicians in sleep medicine","authors":"Anshum Patel ,&nbsp;Chad Ruoff ,&nbsp;Scott A. Helgeson ,&nbsp;Diego Z. Carvalho ,&nbsp;Pablo R. Castillo ,&nbsp;Joseph Cheung","doi":"10.1016/j.sleep.2025.106677","DOIUrl":"10.1016/j.sleep.2025.106677","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI), particularly large language models (LLMs) are increasingly being explored for diagnostic capabilities in medicine. Leveraging LLMs within clinical systems may augment clinicians’ diagnostic reasoning. The diagnostic effectiveness of LLMs in sleep medicine remains unevaluated against expert performance in clinical case scenarios.</div></div><div><h3>Objective</h3><div>To compare the diagnostic accuracy of three widely used LLMs and experienced sleep physicians on real-world clinical vignettes.</div></div><div><h3>Methods</h3><div>Using sixteen diverse sleep disorder vignettes from the AASM Case Book (2019), each was independently presented to three LLMs (ChatGPT-4, Gemini 2.0, DeepSeek) and three board-certified sleep physicians. Differential diagnoses were compared to AASM reference lists (mean % matches), and final diagnoses were scored against the AASM final diagnosis (3-point Likert: 0 = No match, 1 = Partial match, 2 = Full match).</div></div><div><h3>Results</h3><div>Analysis of differential diagnoses showed similar mean agreement percentages for ChatGPT-4 (76.7 %), Gemini 2.0 (77.7 %), DeepSeek (70.7 %), and physicians’ average (72.9 %). Repeated measures ANOVA indicated no statistically significant difference in differential diagnostic accuracy between LLMs and physicians (p = 0.839). For final diagnoses, all three LLMs achieved an identical average concordance score (87.5 %), falling within the performance range of experienced physicians (81.3 %–96.9 %), indicating LLM diagnostic proficiency was comparable to experts on these case vignettes. Non-parametric Friedman testing showed no statistically significant difference among the individual entities (p = 0.602). Paired t-tests comparing average final diagnosis scores also showed no significant differences (p = 0.606).</div></div><div><h3>Conclusions</h3><div>LLMs showed diagnostic performance comparable to experienced sleep clinicians, suggesting their potential as supplementary tools. Future research should explore broader applications and integration.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106677"},"PeriodicalIF":3.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astrocyte activation: A key mediator underlying chronic intermittent hypoxia-induced cognitive dysfunction","authors":"Huiling Chu ,&nbsp;Wanjin Jiang ,&nbsp;Na Zuo ,&nbsp;Fuqin Sun ,&nbsp;Cheng Wu ,&nbsp;Shaofeng Liu","doi":"10.1016/j.sleep.2025.106692","DOIUrl":"10.1016/j.sleep.2025.106692","url":null,"abstract":"<div><h3>Objective/background</h3><div>This study aimed to investigate the role of astrocyte activation in cognitive dysfunction induced by chronic intermittent hypoxia (CIH) in juvenile rats, along with the underlying mechanisms and related molecular targets.</div></div><div><h3>Methods</h3><div>A total of 40 postnatal day 18 Sprague-Dawley rats were randomized into four groups (n = 10/group): control, CIH, vehicle, and CIH + iβARK group. The CIH model was established by exposing rats to intermittent hypoxia for 8 h daily (7 %–21 %) for 4 weeks. Four days before hypoxia exposure, AAV5-GfaABC1D-iβARK-p2A-mCherry (viral titer:2.60E+12) was stereotactically injected into the bilateral lateral ventricles (2 μl per ventricle) (coordinates: AP -0.8 mm, ML ±1.5 mm, DV -3.6 mm relative to bregma). After hypoxia ends, rat learning and memory were assessed using the water maze (n = 6/group), the activity of astrocytes was detected by immunofluorescence, morphological changes in hippocampal and dendritic spines were examined using HE staining and Golgi staining (n = 3/group), and the expressions of SYP, PSD - 95, Hevin, TSP - 1 and PI3K - AKT - mTOR were detected by western blotting and Q-PCR (n = 3/group).</div></div><div><h3>Results</h3><div>Compared with the Control group (14.83 ± 1.17 s), rats in the CIH group spent more time locating the escape platform (19.67 ± 3.33 s, p &lt; 0.05), with a decrease in the number of platform explorations and crossings (5.00 ± 0.89 vs 2.33 ± 0.82, p &lt; 0.001). In the CA1 region of the hippocampus, neuronal degeneration and a reduction in dendritic spine density (6.65 ± 1.03 vs 4.08 ± 1.02, p &lt; 0.05) were noted. The expression levels of SYP(1.00 ± 0.05 vs 0.44 ± 0.05,p &lt; 0.001), PSD - 95 (1.00 ± 0.08 vs 0.46 ± 0.06,p &lt; 0.001), Hevin (1.00 ± 0.11 vs 0.44 ± 0.12,p &lt; 0.01), and TSP - 1 (1.00 ± 0.02 vs 0.49 ± 0.02,p &lt; 0.0001), as well as the ratios of p - PI3K/PI3K(1.00 ± 0.10 vs 0.09 ± 0.15, p &lt; 0.001), p - AKT/AKT (1.00 ± 0.02 vs 0.44 ± 0.06, p &lt; 0.01), and p - mTOR/mTOR (1.00 ± 0.05 vs 0.58 ± 0.08, p &lt; 0.001), decreased. Nevertheless, in the CIH + iβARK group with inhibited astrocyte activity, all these changes were reversed, and the differences were statistically significant.</div></div><div><h3>Conclusions</h3><div>Astrocyte activation was closely associated with CIH - induced cognitive dysfunction in juvenile rats. The underlying mechanism may be linked to decreased expression of synapse-related proteins and reduced dendritic spine density. Inhibiting astrocyte activation could alleviate synaptic dysfunction and cognitive decline in juvenile rats. This finding may provide a direction for exploring new treatment strategies for cognitive impairments related to obstructive sleep apnea in children.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106692"},"PeriodicalIF":3.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sleep and awake bruxism with sleep quality and duration in children and adolescents: A systematic review and meta-analysis","authors":"Guilherme Azario de Holanda,&nbsp;Thiago Azario de Holanda,&nbsp;Maísa Casarin","doi":"10.1016/j.sleep.2025.106681","DOIUrl":"10.1016/j.sleep.2025.106681","url":null,"abstract":"<div><div>Sleep is essential for health, potentially influencing awake and sleep bruxism, which may lead to outcomes that can persist from childhood through adult life. The objective of this systematic review was to investigate the association between sleep quality and awake or sleep bruxism in children and adolescents. PubMed, Embase, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were searched until June 2025 to assess the association between bruxism and sleep quality or duration. Only observational studies were analyzed. Biases were assessed by the JBI Critical Appraisal Checklist and the Newcastle-Ottawa scale for cross-sectional and case-control studies, respectively. Fourteen studies were included. Meta-analyses showed no differences between sleep bruxism and control individuals regarding polysomnography parameters and subjective sleep duration. Individuals with caregivers’ reports of poor sleep quality showed a higher odds ratio (OR) for presenting sleep bruxism (OR = 1.92; 95 % confidence interval [CI] = 1.48–2.48; I² = 32 %). The single study on awake bruxism showed an association with self-reported poor sleep quality in adolescents. The certainty of evidence was rated as low for objective parameters and very low for subjective parameters<strong>.</strong> Objective sleep quality was not associated with sleep bruxism, while poor sleep quality reported by caregivers was. The perception of sleep quality in children and adolescents stood out as a relevant factor for assessing bruxism. Further evidence is needed for awake bruxism.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106681"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}