Sleep medicine最新文献

{"title":"Bridging the gap: Are OSA patients ready for Telemedicine? An Italian perspective.","authors":"Francesco Fanfulla, Caterina Pronzato, Anna Eugenia Taurino, Paola Crotti, Elena Robbi, Simona Arcovio, Pasquale Tondo","doi":"10.1016/j.sleep.2026.109328","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109328","url":null,"abstract":"<p><p>Different telemedicine approaches for managing sleep disorders have been extensively researched worldwide, yet data on patients' individual willingness to adopt these protocols remain limited. This study aims to fill this gap, focusing specifically on the Italian population. A 19-item anonymous questionnaire was administered to 255 consecutive obstructive sleep apnoea (OSA) patients. Our findings indicate a substantial willingness to use telemedicine: 56.5% were unreservedly in favour of remote follow-up and 67.4% preferred comprehensive telemonitoring to PAP-only monitoring, although only 48.6% were familiar with the term \"telemedicine\". Attitudes towards remote consultations were more nuanced: 51.8% were unreservedly in favour, but within a combined model with telemonitoring only 40.6% would also accept them, and 45.7% considered in-person consultations irreplaceable. The need for assistance increased with age and, in multinomial logistic regression, older age was the main determinant of both refusal and perceived obstacles (odds ratios per age class 2.1-2.9), whereas educational level was not significantly associated with the response pattern after adjustment. Privacy concerns were frequent: 38.0% reported doubts or concerns, including 14.9% who were unwilling to transmit their data electronically, a response that, in exploratory analyses, was more frequent among more educated patients. Most patients (90.8%) believed that telemedicine services should be provided by the Public Health Service. In conclusion, telemedicine may be well received by Italian patients with OSA as a complement to, rather than a replacement of, in-person care; its implementation should consider public funding, tailored digital support for older patients, and robust data governance and privacy safeguards.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109328"},"PeriodicalIF":4.1,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246418","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":"A systematic review of machine learning approaches for sleep posture recognition across sensing modalities (2023-2025).","authors":"Tayseer Sawaftah, Vauwez Sam El Fareez, Yavuz Türkay, Serdar Kockanat","doi":"10.1016/j.sleep.2026.109325","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109325","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep posture directly affects sleep quality, respiratory function, and musculoskeletal health. Machine learning (ML) techniques have been increasingly applied to automatic sleep posture recognition across diverse sensing modalities. However, direct comparisons across existing studies remain difficult due to widespread reliance on small, private datasets and inconsistent evaluation protocols, which limit the generalizability of reported findings. This review aims to systematically characterize recent ML-based research on sleep posture recognition, identify methodological gaps, and assess deployment readiness across sensing modalities.</p><p><strong>Methods: </strong>A systematic literature search was conducted across IEEE Xplore, Scopus, Web of Science, PubMed, and Google Scholar following PRISMA guidelines, covering studies published between January 2023 and December 2025. From an initial pool of 120 articles, 45 human-subject experimental studies met the inclusion criteria. Included studies were categorized into four sensing modalities: pressure-based, wearable sensor-based, vision- and imaging-based, and contactless radio-frequency (RF) and radar-based systems. Standardized data extraction covered dataset characteristics, preprocessing methods, learning models, sensing hardware, posture classes, and performance metrics.</p><p><strong>Results: </strong>Most studies focused on four primary posture classes - supine, prone, left lateral, and right lateral - and reported high accuracy, mostly under controlled laboratory conditions. However, subject-independent validation was not consistently applied, and few studies examined finer-grained posture taxonomies.</p><p><strong>Conclusion: </strong>Recurring limitations, including private datasets and insufficient cross-subject validation, highlight the need for open benchmark datasets, standardized evaluation protocols, and deployment-oriented assessment to advance reliable and generalizable sleep posture recognition systems.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109325"},"PeriodicalIF":4.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224911","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":"Three-month follow-up after discontinuation of steam-assisted respiratory muscle training in mild-to-moderate obstructive sleep apnea: an exploratory polysomnographic study.","authors":"Usame Al-Rammahi, Tero Soukka, Jarmo Malinen, Risto-Pekka Happonen, Anssi Sovijärvi, Ulla Anttalainen","doi":"10.1016/j.sleep.2026.109326","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109326","url":null,"abstract":"<p><strong>Purpose: </strong>To explore polysomnographic findings three months after discontinuation of steam-assisted respiratory muscle training (RMT) in mild-to-moderate obstructive sleep apnea.</p><p><strong>Methods: </strong>This exploratory secondary follow-up included 33 of 48 intervention entrants who completed polysomnography at baseline, after 12 weeks of training, and three months after cessation. The primary analysis used repeated-measures ANOVA (RM-ANOVA). Distributional diagnostics and exact Friedman sensitivity analyses were conducted for eight sleep-stage and periodic limb movement outcomes.</p><p><strong>Results: </strong>Conventional respiratory-event indices showed no overall time effect (all p ≥ 0.3). Flow limitation differed across visits (p = 0.02), without an immediate post-intervention reduction. The RM-ANOVA identified visit differences in REM latency (169.9 ± 74.9 min at baseline, 138.8 ± 66.4 min post-intervention, and 134.0 ± 66.5 min at follow-up; p = 0.003), N1 proportion (6.6 ± 4.0%, 10.8 ± 5.9%, and 11.2 ± 6.1%, respectively; p = 0.002), and PLMS-related arousal index (1.3 ± 2.1/h, 0.6 ± 1.1/h, and 0.7 ± 1.4/h, respectively; p = 0.01) and count (9.3 ± 15.2, 4.3 ± 7.9, and 5.2 ± 10.0, respectively; p = 0.02). Exact Friedman analyses yielded visit differences for N1 (p = 0.002) and the PLMS-related arousal index and count (p = 0.01 and 0.02), but not REM latency (p = 0.1).</p><p><strong>Conclusion: </strong>This exploratory follow-up identified differences in N1 proportion and PLMS-related arousal measures across visits, supported by sensitivity analyses, while no overall visit differences were detected in conventional respiratory-event indices. REM latency differed significantly across visits in RM-ANOVA, but not in the sensitivity analysis. These observations warrant further investigation in controlled studies; the single-arm design and absence of an adaptation night prevent attribution to steam-assisted RMT or confirmation of lasting clinical benefit.</p><p><strong>Clinicaltrials: </strong>GOV: NCT05320952.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109326"},"PeriodicalIF":4.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224938","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":"The development and validation of the pre-sleep excitement-inducing activities scale.","authors":"Haitham Jahrami, Waqar Husain, Khaled Trabelsi, Achraf Ammar, Seithikurippu R Pandi-Perumal, Mai Helmy, Zahra Saif, Ahmed S BaHammam, Markus Jansson-Fröjmark, Amir H Pakpour, Michael V Vitiello","doi":"10.1016/j.sleep.2026.109311","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109311","url":null,"abstract":"<p><strong>Background: </strong>Existing pre-sleep arousal measures emphasize distress-based symptoms, leaving positively valenced sources of activation, such as excitement-inducing evening activities, largely unassessed and a potential unmeasured contributor to sleep-onset difficulty. We developed and evaluated the Pre-Sleep Excitement-Inducing Activities Scale (PSEIA) to address this gap.</p><p><strong>Methods: </strong>A 34-item pool underwent expert review and cognitive debriefing. Exploratory factor analysis (EFA) was conducted in Phase 1 (n = 150). In an independent Phase 2 sample (n = 301), confirmatory factor analysis (CFA) tested correlated three-factor, higher-order, and bifactor models. Internal consistency, two-week test-retest reliability (n = 150), and associations with the Pre-Sleep Arousal Scale (PSAS) were evaluated.</p><p><strong>Results: </strong>Although parallel analysis suggested four factors, a more interpretable three-factor solution retained 18 items: Cognitive Stimulation, Informational Stimulation, and Recreational Stimulation. The correlated three-factor model showed CFI = .99, TLI = .99, RMSEA = .08, and SRMR = .06. The higher-order model had identical global fit; the bifactor model showed CFI = .99, TLI = .99, RMSEA = .07, and SRMR = .05. Total-score reliability was high (α = .92; ω = .95; ωH = .74), as was test-retest reliability (ICC = .93). The PSEIA correlated moderately with PSAS total score (r = .51, p < .001). The two shorter factors showed substantial overlap, and the three-item factor had marginal alpha (.69).</p><p><strong>Conclusion: </strong>The PSEIA provides an initial measure of activity-linked pre-sleep activation. Its reliable total score is supported by shared variance across factors, but subscale distinctiveness and clinical utility require further validation.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109311"},"PeriodicalIF":4.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228704","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 underestimation and subjective sleep appraisal: Limited value of routine polysomnographic and electroencephalographic features.","authors":"Chunyan Long, Junyi Chen, Xiaolan Xu, Dandan Mao, Tao Zhang, Lisha Zhong, Ling Li, Chunrong Liang","doi":"10.1016/j.sleep.2026.109321","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109321","url":null,"abstract":"<p><strong>Objectives: </strong>Whether routine polysomnographic (PSG) and electroencephalographic (EEG) features distinguish patients who underestimate sleep remains unclear. We examined associations of clinical, subjective, PSG, and EEG features with sleep underestimation and tested whether EEG features added discrimination beyond a parsimonious three-predictor baseline model.</p><p><strong>Methods: </strong>We analysed 225 adults undergoing clinically indicated in-laboratory PSG in this single-centre retrospective cross-sectional study. The misperception index ([objective - subjective total sleep time]/objective total sleep time) was dichotomised at the cohort median (0.148) and analysed continuously. Group differences across 717 variables underwent Benjamini-Hochberg false discovery rate (FDR) correction. Out-of-fold (OOF) discrimination was compared between a three-predictor baseline model (sleep quality, Epworth Sleepiness Scale score, and age) and an EEG-enhanced model; continuous-index analyses were exploratory.</p><p><strong>Results: </strong>Fifty-six participants (24.9%) overestimated sleep. Objective total sleep time did not differ between groups, whereas self-rated sleep quality did (q = 0.002). None of 600 EEG features survived FDR correction (smallest q = 0.064). At the median threshold, OOF areas under the receiver operating characteristic curve (AUCs) were 0.6786 (baseline) and 0.6564 (EEG-enhanced; ΔAUC = -0.0221; paired DeLong P = 0.4483). Across 50 repeated partitions, median ΔAUC was -0.0261 for EEG features and +0.0096 for four macrostructural PSG variables. Obstructive sleep apnoea prevalence did not differ significantly between groups.</p><p><strong>Conclusions: </strong>Self-rated sleep quality was more consistently associated with sleep underestimation than routine PSG and EEG features. EEG features did not demonstrate incremental OOF discrimination beyond the baseline model. Subjective sleep appraisal should be assessed alongside PSG; underlying mechanisms require prospective investigation.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109321"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220627","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 duration and risk of microvascular complications in type 2 diabetes: A prospective cohort study.","authors":"Yanning Zhou, Jialin Li, Yonghai Wu, Lin Qiu, Xiaoting Chen, Mingyue Wang, Li Li, Youxin Wang, Miao Xu","doi":"10.1016/j.sleep.2026.109317","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109317","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal evidence on sleep duration's effects on type 2 diabetes mellitus (T2DM) microvascular outcomes, particularly in Asian populations, remains limited. This study investigated the prospective association between sleep duration and microvascular complication incidence in T2DM patients.</p><p><strong>Methods: </strong>This prospective cohort included 1236 T2DM adults, free of microvascular complications at baseline from National Metabolic Management Centre Ningbo Branch (2018-2023). Self-reported sleep duration was categorized into 5 groups (<7, 7-8, 8-9, 9-10, or ≥10h). Incident diabetic kidney disease (DKD), retinopathy (DR), and peripheral neuropathy (DPN) were ascertained. Cox regression and restricted cubic spline analyses estimated hazard ratio (HRs) and dose-response relationships.</p><p><strong>Results: </strong>In 2459 person-years, 237 participants developed microvascular complications. A U-shaped association emerged between sleep duration and composite microvascular complications (P < 0.001) and DPN (P = 0.039), with lowest risk at 7-8h. Compared to 7-8h, shorter (<7h) and longer (≥10h) durations significantly increased composite microvascular complication risks (HR = 1.71, P = 0.018; HR = 1.87, P = 0.005). No statistically significant interactions were observed between sleep duration and age, BMI, sedentary time, or sleep quality (all P for interaction >0.05).</p><p><strong>Conclusion: </strong>Both insufficient and excessive sleep increase T2DM microvascular complication risks. Maintaining 7-8 h of sleep daily may be a vital behavioral target in comprehensive T2DM management, potentially reducing microvascular complication burden.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"149 ","pages":"109317"},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224853","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":"Corrigendum to \"Sleep problems in preschool mediate the association between chronotype and socioemotional problems at school-age\" [Sleep Med 124 (2024) 174 - 186].","authors":"Derric Z H Eng, Elaine K H Tham, Nur K Jafar, Jael S Y Tan, Daniel Y T Goh, Yung Seng Lee, Lynette P Shek, Oon-Hoe Teoh, Fabian Yap, Kok Hian Tan, Johan G Eriksson, Yap Seng Chong, Michael J Meaney, Shirong Cai, Birit F P Broekman","doi":"10.1016/j.sleep.2026.109228","DOIUrl":"https://doi.org/10.1016/j.sleep.2026.109228","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":" ","pages":"109228"},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114986","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 left ventricular end-diastolic volume and cardiovascular disease in systemic hypertensive patients with obstructive sleep apnea","authors":"Sharezhati Yishajiang ,&nbsp;Qing Zhu ,&nbsp;Delian Zhang ,&nbsp;Shasha Liu ,&nbsp;Mengru Wang ,&nbsp;Ting Wu ,&nbsp;Jing Hong ,&nbsp;Nanfang Li","doi":"10.1016/j.sleep.2026.108832","DOIUrl":"10.1016/j.sleep.2026.108832","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Systemic hypertension and obstructive sleep apnea (OSA) are closely linked conditions that substantially increase the risk of cardiovascular disease (CVD). Left ventricular end-diastolic volume (LVEDV) is a crucial echocardiographic marker of cardiac remodeling; however, its prognostic value in patients with concomitant systemic hypertension and OSA remains poorly defined. This study aimed to examine the association between LVEDV and the incidence of CVD in this high-risk population.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with confirmed systemic hypertension and OSA, who were stratified into tertiles based on baseline LVEDV. Multivariable Cox proportional hazards models, adjusted for demographic factors, comorbid conditions, and OSA severity, were used to evaluate CVD risk. Sensitivity and stratified analyses were conducted to assess the robustness of the findings.</div></div><div><h3>Results</h3><div>A total of 1914 patients (mean age 48.7 ± 10.2 years) were followed for a median of 83 months, during which 186 incident CVD events were documented. The incidence of CVD increased progressively across LVEDV tertiles. In fully adjusted analyses, patients in the highest tertile (T3: &gt;81 mL) showed a significantly higher risk of CVD compared with those in the lowest tertile (T1: &lt;70 mL) (hazard ratio [HR] = 1.86; 95% confidence interval [CI]: 1.30–2.67; <em>P</em> = 0.001). Although a higher risk was observed for the intermediate tertile (T2: 70–81 mL), this association did not reach statistical significance (HR = 1.29; 95% CI: 0.88–1.88; <em>P</em> = 0.19). These associations remained stable across sensitivity and stratified analyses.</div></div><div><h3>Conclusion</h3><div>Elevated LVEDV is independently associated with an increased risk of CVD in patients with coexisting systemic hypertension and OSA. These findings support LVEDV as a novel and readily obtainable echocardiographic biomarker for cardiovascular risk stratification in this population. Routine assessment of LVEDV may enable earlier identification of individuals at heightened risk and inform timely preventive strategies in patients with OSA-related systemic hypertension.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"141 ","pages":"Article 108832"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146171925","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":"Multi-level surgery for obstructive sleep apnoea in syndromic and non-syndromic paediatric patients – A systematic review and meta-analysis","authors":"Ryan Seng Hong Wong ,&nbsp;Tanya Xin Yu Tan ,&nbsp;Omkar Mahadevan ,&nbsp;Brian Sheng Yep Yeo ,&nbsp;Celeste Ann Chua ,&nbsp;Lynn Huiting Koh ,&nbsp;Henry Kun Kiaang Tan ,&nbsp;Chu Qin Phua","doi":"10.1016/j.sleep.2026.108826","DOIUrl":"10.1016/j.sleep.2026.108826","url":null,"abstract":"<div><h3>Study objectives</h3><div>Multilevel surgery for obstructive sleep apnoea treatment is a well-accepted option for adult patients. However, in paediatric populations, it is less established. This study evaluates the efficacy of multi-level airway surgery in treating both non-syndromic and syndromic paediatric obstructive sleep apnoea.</div></div><div><h3>Methods</h3><div>PubMed, Embase and The Cochrane Library databases were searched from inception to November 30, 2025. Two independent authors performed screening and extraction of studies according to PRISMA guidelines. Observational and randomised studies pertaining to sleep outcomes of various multi-level sleep surgeries in syndromic and non-syndromic children were selected. Pooled analyses were performed for post-operative improvements in Apnoea-Hypopnea Index (AHI) and SpO₂ Sleep Nadir. Quality of evidence assessment was assessed with respective risk of bias appraisal tools.</div></div><div><h3>Results</h3><div>From 2925 initial non-duplicate studies, 17 studies were included for analysis, comprising 338 children (228 non-syndromic children, 80 children with Down Syndrome and 30 children with other syndromes). In non-syndromic children, AHI improved by −10.13 (95%CI -13.30 to −6.97; I² = 71.7%) and SpO₂ sleep nadir by 4.39 (95%CI 1.68–7.11; I² = 79.5%), with AHI normalisation rate at 66.4%. In children with Down syndrome, AHI improved by −14.58 (95%CI [-16.23, −12.93], I² = 0%) and SpO₂ nadir by +3.75 (95%CI [1.72, 5.78], I² = 0%).</div></div><div><h3>Conclusion</h3><div>Multi-level airway surgery presents a valuable adjunct to adenotonsillectomy in addressing paediatric OSA, particularly for selected syndromic and refractory cases. Future research should identify specific syndromic subgroups that would benefit most from multi-level surgery, to better inform individualised treatment strategies.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"141 ","pages":"Article 108826"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146171924","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":"Circadian rhythms in ischemic stroke: From pathogenesis to chronotherapy","authors":"Hongli Fan ,&nbsp;Zhuorao Wu ,&nbsp;Jianqiao Zhao ,&nbsp;Jingjing Kou ,&nbsp;Qiang Xu","doi":"10.1016/j.sleep.2026.108825","DOIUrl":"10.1016/j.sleep.2026.108825","url":null,"abstract":"<div><div>Circadian rhythms significantly influence the onset, development, and outcome of ischemic stroke, with the biological clock likely playing a key role in its pathophysiology. In this review, we provide a systematic summary of the influence of circadian rhythms on stroke risk factors, including blood pressure, glucose metabolism, lipid homeostasis, and atrial fibrillation, and further explore their impact across different stages of recovery post-stroke. These encompass metabolic alterations in the ischemic penumbra during the hyperacute phase, excitotoxicity, oxidative stress, and neuroinflammation in the acute phase, as well as glial scar formation and neural remodeling during the subacute and chronic recovery phases. Building on this mechanistic foundation, we assess the role of chronobiology in stroke interventions, including thrombolysis, thrombectomy, neuroprotective strategies, and rehabilitation training. We also discuss key challenges in the field, such as barriers to translating preclinical findings to clinical applications, limitations in circadian rhythm assessment, and practical challenges in implementing circadian-based interventions. Ultimately, this review aims to evaluate the potential of chronotherapy in ischemic stroke and to advance the development of personalized, precision medicine approaches.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"141 ","pages":"Article 108825"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133143","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}