Sleep medicine最新文献

{"title":"Effect of tirzepatide treatment on patient-reported outcomes among SURMOUNT-OSA participants with obstructive sleep apnea and obesity.","authors":"Chisom Kanu, Shraddha Shinde, Sujatro Chakladar, Ellen B Dennehy, Terri E Weaver, Jiat Ling Poon, Atul Malhotra","doi":"10.1016/j.sleep.2025.106719","DOIUrl":"10.1016/j.sleep.2025.106719","url":null,"abstract":"<p><strong>Aim: </strong>In the phase 3 SURMOUNT-OSA trials, tirzepatide treatment significantly reduced the apnea-hypopnea index (AHI) among people with moderate-to-severe obstructive sleep apnea (OSA) and obesity. We evaluated effects of tirzepatide treatment on sleep disturbance, sleep-related impairment, functioning, health-related quality of life (HRQoL), and OSA symptoms in SURMOUNT-OSA participants.</p><p><strong>Methods: </strong>SURMOUNT-OSA consisted of two randomized, placebo-controlled trials of tirzepatide (10 mg or 15 mg) or placebo for 52 weeks in participants with moderate-to-severe OSA and obesity. For participants using PAP (Study 2), PAP was withdrawn prior to assessments of polysomnography and patient-reported outcome measures (PROMs). Prespecified PROM endpoints were from baseline to Week 52. Changes in sleep-related impairment, sleep disturbance, excessive daytime sleepiness, functioning, and HRQoL were assessed using analysis of covariance. Categorical shifts in OSA symptom severity were described.</p><p><strong>Results: </strong>At Week 52, compared with placebo, tirzepatide-treated participants reported significantly improved Patient-Reported Outcomes Measurement Information System (PROMIS) Short-Form Sleep-related Impairment 8a scores, PROMIS Short-Form v1.0 Sleep Disturbance 8b scores, Functional Outcomes of Sleep Questionnaire Activity-Level scores, EQ-5D-5L scores, and most domains of the Short-Form 36 Health Survey, Version 2. Tirzepatide treatment was also associated with greater improvements in Patient Global Impression of Status and Patient Global Impression of Change symptom scales compared with placebo. Additionally, Study 1 participants reported significant changes in Epworth Sleepiness Scale scores.</p><p><strong>Conclusion: </strong>Results indicate that in addition to objective outcomes of improved AHI, hypoxic burden associated with OSA, and cardiovascular risk factors, people with OSA reported benefits in symptoms, functioning, and HRQoL following tirzepatide treatment.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov number: </strong>NCT05412004.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106719"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800313","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 interplay of dyadic adjustment, sleep quality, and CPAP adherence in OSAS: A cross-sectional study on illness perceptions and depressive symptoms.","authors":"Valentina Poletti, Elvia Battaglia, Paolo Banfi, Eleonora Volpato","doi":"10.1016/j.sleep.2025.106726","DOIUrl":"10.1016/j.sleep.2025.106726","url":null,"abstract":"<p><p>Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent sleep disorder characterized by recurrent upper airway obstructions, leading to adverse health outcomes. Continuous Positive Airway Pressure (CPAP) therapy is the primary treatment, yet adherence remains suboptimal due to psychosocial a nd relational factors. Bed partners often experience sleep disturbances and can influence the patient's treatment adherence. While dyadic adjustment is known to be associated with sleep quality, its role in OSAS management remains underexplored. Illness perceptions and depressive symptoms may mediate the relationship between dyadic adjustment, sleep, and CPAP adherence. This study explored: (1) how dyadic adjustment relates to sleep quality and illness perceptions in couples coping with OSAS; (2) whether illness perceptions mediate the link between dyadic adjustment and sleep disruption; (3) whether depressive symptoms mediate the association between CPAP adherence and relationship quality; and (4) how illness perceptions and depressive symptoms interrelate in OSA management. A cross-sectional study was conducted on 123 dyads (OSAS patients and their bed partners). Participants completed validated measures assessing dyadic adjustment, illness perceptions, sleep quality, depressive symptoms, and CPAP adherence. Actor-Partner Interdependence Mediation Models (APIMeM) and mediation analyses were applied. Higher dyadic adjustment was associated with less threatening illness perceptions, which in turn predicted fewer perceived sleep disturbances in patients (p < 0.001). No significant partner effects emerged for sleep quality. Higher CPAP use was directly associated with improved dyadic adjustment, with depressive symptoms mediating this relationship (β = 0.35, p < 0.001). Illness perceptions were positively correlated with depressive symptoms in both patients and partners. Dyadic adjustment and illness perceptions shape sleep experiences, while depressive symptoms influence the CPAP adherence-relationship quality link. The interplay between cognitive and emotional factors may have clinical relevance for treatment adherence and couple adaptation. Psychosocial interventions targeting relationship dynamics and illness representations may enhance both adherence and overall well-being, fostering a more supportive treatment environment.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106726"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817522","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":"Self-efficacy-based web and mobile intervention to improve infant sleep: Randomized trial with Brazilian mothers.","authors":"Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa","doi":"10.1016/j.sleep.2025.106718","DOIUrl":"10.1016/j.sleep.2025.106718","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a web-based educational intervention, grounded in self-efficacy theory, on the sleep quality of infants aged 10-24 months by reducing nighttime awakenings and increasing total nighttime sleep duration.</p><p><strong>Method: </strong>A randomized controlled trial was conducted with 104 Brazilian mother-infant dyads allocated to either an intervention group (IG) or control group (CG). The IG received a structured educational intervention delivered by a sleep specialist researcher, consisting of two online sessions (50 and 30 min, respectively), combined with 30 daily motivational messages sent via WhatsApp over a 30-day period. The educational content addressed sleep hygiene, routines, sleep onset independence, and the \"camping-out\" technique, all based on the self-efficacy theoretical framework. Sleep outcomes were assessed using the Brief Infant Sleep Questionnaire (BISQ) at baseline, 15 days, and 30 days. Data were analyzed using repeated measures and a significance level of p < 0.05.</p><p><strong>Results: </strong>At baseline, infants in the IG had a mean nighttime sleep duration of 8.2 (±2.1) hours and 4.7 (±1.8) nighttime awakenings, while those in the CG had 8.6 (±1.6) hours and 4.1 (±1.1) awakenings. After 30 days, the IG showed a significant improvement, with an increase in total nighttime sleep duration to 11.2 (±0.7) hours (d = 1.96) and a reduction in nighttime awakenings to 0.5 (±0.6) (d = -3.31), compared to the CG, which remained at 8.5 (±1.3) hours and 3.7 (±1.0) awakenings. Moreover, by the end of the study, 90.9 % of infants in the IG were falling asleep independently, compared to 12 % in the CG (d = 2.63). All values are reported as mean ± standard deviation (SD).</p><p><strong>Conclusion: </strong>The web-based educational intervention, led by a sleep specialist and reinforced by mobile messaging, was effective in improving infant sleep quality. These findings support the feasibility of combining synchronous and asynchronous digital strategies to address behavioral sleep problems in early childhood, particularly in settings with limited access to in-person care.</p><p><strong>Clinical trial registration: </strong>RBR-8hvdh5r.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106718"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812412","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":"Development of the Adaptive Cognition and Behaviors about Sleep-6 (ACBS-6) for sleep-related conditions or behaviors diminishing insomnia severity.","authors":"Seockhoon Chung, Soyoung Yoo, Sooyeon Suh","doi":"10.1016/j.sleep.2025.106703","DOIUrl":"10.1016/j.sleep.2025.106703","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a scale to assess adaptive sleep-related beliefs and behaviors, measuring how well individuals accept sleep disturbances, in the Korean general population.</p><p><strong>Methods: </strong>We conducted an anonymous online survey among the Korean general population. The scale development involved the following process: 1) defining the purpose of developing the scale, 2) generating appropriate items, 3) reducing redundant items, 4) conducting psychometric tests and further reducing items, and 5) developing the final version of the scale. Furthermore, the reliability and validity of the scale were evaluated, and convergent validity was examined using the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep-6 items (DBAS-6), and Metacognition Questionnaire-Insomnia-6 items (MCQI-6).</p><p><strong>Results: </strong>The final six items extracted through exploratory factor analysis were clustered into two factors: adaptive sleep-related cognitions and behaviors. Model fit indices (comparative fit index = 0.96, Tucker-Lewis index = 0.93, root mean square error of approximation = 0.06, and standardized root mean square residual = 0.04) supported the two-factor structure of the scale in confirmatory factor analysis. The Adaptive Cognition and Behaviors about Sleep-6 (ACBS-6) demonstrated good internal consistency reliability (McDonald's omega = 0.734). Linear regression analysis revealed that the DBAS-6 (β = 0.50, p < 0.001) and MCQI-6 (β = 0.22, p < 0.001) positively contributed to the ISI score, whereas ACBS-6 (β = -0.07, p = 0.041) inversely contributed to the ISI score.</p><p><strong>Conclusions: </strong>The ACBS-6 exhibits acceptable reliability and strong structural validity, supporting its two-factor model of adaptive sleep-related cognitions and behaviors.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106703"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812411","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":"100 ms matter: Impact of back-up Ti on triggered breaths in pediatric NIV.","authors":"Sonia Khirani, Lucie Griffon, Marine Dosso, Sarath Capriles, Meryl Vedrenne-Cloquet, Clément Poirault, Brigitte Fauroux","doi":"10.1016/j.sleep.2025.106727","DOIUrl":"10.1016/j.sleep.2025.106727","url":null,"abstract":"<p><p>Noninvasive ventilation (NIV) is widely used in children, including children with neuromuscular disorders (NMD). Pressure support (PSV) mode is the most used mode for home NIV, and combines controlled, assisted, and spontaneous breaths. The patient can trigger a breath based on the inspiratory trigger (TgI) sensitivity and cycle the breath based on the expiratory trigger (TgE) sensitivity. Some ventilators proposed to cycle the controlled breaths based on a back-up inspiratory time (Ti). There are no guidelines to adjust TgI parameter according to the age and/or disease of the patient. In patients with NMD, TgI may be set at a low sensitivity to impede the patient to trigger the breaths and force the respiratory muscles to rest, as done by some centers. It is not our practice, as we believe that a low TgI sensitivity will generate further respiratory efforts for the patients, particularly during some sleep periods or nighttime wakefulness. According to our experience, even with a high TgI sensitivity, our patients with NMD do not trigger the ventilator for almost the entire nighttime if they are efficiently ventilated. We report the cases of 4 children, including two children with NMD or suspicion of NMD, for whom an adaptation of the back-up Ti had a direct impact on the triggered/controlled breath ratio.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106727"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817521","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-related disruptions potentially synergistically exacerbate attentional impairments in temporal lobe epilepsy, especially the alerting network.","authors":"Yiting Ding, Weiting Tang, Zengzhen Yin, Zhongling Wu, Haojun Yang","doi":"10.1016/j.sleep.2025.106731","DOIUrl":"10.1016/j.sleep.2025.106731","url":null,"abstract":"<p><strong>Aim: </strong>To explore the potential synergistic effect of sleep-related disruptions (SRD) on attention dysfunction in temporal lobe epilepsy (TLE), focusing on how SRD impacts specific attention networks, including alertness, orientation, and executive control.</p><p><strong>Methods: </strong>Ninety-three patients with TLE and matched healthy controls participated. Attention was assessed using the Attention Network Test (ANT) and eye-tracking data, while SRD severity was determined via the Pittsburgh Sleep Quality Index. Participants were categorized based on SRD severity, and attention performance across the three networks was evaluated.</p><p><strong>Results: </strong>Patients with TLE demonstrated significant attention impairments, predominantly affecting the alertness and executive control networks. SRD aggravated these deficits, particularly in the alertness network, with more severe SRD correlating with greater dysfunction. Moderate to severe SRD led to significant declines in alertness, while minimal SRD showed no substantial impact on attention performance.</p><p><strong>Conclusion: </strong>SRD exacerbates attention dysfunction in patients with TLE, particularly within the alertness network. These findings highlight the critical role of sleep quality in managing cognitive function in TLE and suggest early intervention for patients with significant SRD to improve outcomes.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106731"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812413","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":"Exploring the relationship between work performance and nonrestorative sleep among daytime workers with and without insomnia symptoms.","authors":"Yuta Takano, Rui Ibata, Naho Machida, Mizuki Bando, Isa Okajima","doi":"10.1016/j.sleep.2025.106702","DOIUrl":"10.1016/j.sleep.2025.106702","url":null,"abstract":"<p><strong>Objective: </strong>Insomnia and nonrestorative sleep are associated with presenteeism, which is an indicator of work performance and a predictor of absenteeism. However, the mechanisms by which insomnia symptoms and nonrestorative sleep are associated with presenteeism remain unclear.</p><p><strong>Methods: </strong>This study included 1093 daytime workers categorized into four groups: the combination group, defined as having both insomnia symptoms and nonrestorative sleep; the nonrestorative sleep group, defined as having only nonrestorative sleep; the insomnia group, defined as having only insomnia symptoms; and the healthy group, defined as having no sleep complaints. They completed self-report questionnaires on insomnia symptoms, nonrestorative sleep, and presenteeism.</p><p><strong>Results: </strong>The marginal effects of logistic regression analysis estimated that the probability of presenteeism in the combination group was higher by 42, 29, and 28 % compared with the healthy, insomnia, and nonrestorative sleep groups, respectively. The probability of presenteeism was 15 % higher in the nonrestorative sleep group and 13 % higher in the insomnia group than in the healthy group. Network analysis determined that a bad mood upon waking-up, lack of readiness to start the day upon waking-up, low mental alertness upon waking-up, daytime dysfunction, low well-being, and poor sleep quality were associated with presenteeism in the combination group. A feeling of tiredness upon waking-up was associated with presenteeism in the nonrestorative sleep group. Grouchiness upon waking-up was associated with presenteeism in the insomnia group.</p><p><strong>Conclusion: </strong>When addressing presenteeism, the feeling of restfulness upon waking-up and during daytime activities should be considered, rather than just nocturnal sleep.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106702"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804807","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":"Associations between clinical or polysomnographic features and the risk of continuous positive airway pressure therapy termination in patients with obstructive sleep apnea: a 5-year cohort study.","authors":"Perrine Petit, Sébastien Baillieul, Marie Destors, Maëlle Guellerin, Rita Clin, Sébastien Bailly, Thi Hong Van Ngo, Jean-Louis Pépin, Renaud Tamisier","doi":"10.1016/j.sleep.2025.106720","DOIUrl":"10.1016/j.sleep.2025.106720","url":null,"abstract":"<p><strong>Background: </strong>Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA). Despite CPAP recognized benefits, the 3-year CPAP termination rate in France is 47.7 %, with sex, age, and comorbidities identified as significant predictors of therapy termination. The contribution of symptoms, OSA severity and objective sleep parameters to CPAP termination remains to be investigated.</p><p><strong>Methods: </strong>This single-center study used real-life data from a tertiary university for patients diagnosed with OSA and started on CPAP. Data were prospectively collected and linked to CPAP telemonitoring data from a single healthcare provider. CPAP termination was defined as the date when the device was returned to the healthcare provider by the patient.</p><p><strong>Results: </strong>A total of 637 patients were included. Overall CPAP termination rates at 1, 3 and 5 years were 17.1 %, 26.8 % and 28.9 % respectively. On multivariable analysis CPAP continuation was significantly associated with male sex (hazard ratio [95 % confidence interval] 0.71 [0.52-0.97]; p = 0.03), OSA severity (severe vs. mild: 0.46 [0.25-0.86]; p < 0.001; severe vs. moderate: 0.57 [0.42-0.77]; p < 0.001) and longer total sleep time at diagnosis (0.99 [0.96-1.0]; p = 0.049). CPAP termination was significantly associated with a higher mean oxygen saturation (1.20 [1.10-1.31]; p < 0.001).</p><p><strong>Conclusions: </strong>Clinical and polysomnographic phenotyping is useful in risk stratification for prediction of CPAP termination. Sleep quality metrics at diagnosis are among the key predictors of CPAP termination and should inform the personalization of follow-up management pathways.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106720"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812410","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":"Altered functional brain networks in isolated REM sleep behavior disorder during phasic REM sleep.","authors":"Kang-Min Choi, Tae-Gon Noh, Jun-Sang Sunwoo, Jung-Ick Byun, Ki-Young Jung","doi":"10.1016/j.sleep.2025.106724","DOIUrl":"10.1016/j.sleep.2025.106724","url":null,"abstract":"<p><strong>Study objectives: </strong>Isolated REM sleep behavior disorder (iRBD) is characterized by vivid, emotionally charged, and often aggressive dreams, yet the underlying neural correlates remain poorly understood. This study aimed to investigate alterations in functional brain networks during REM sleep in iRBD patients using electroencephalogram (EEG), which is potentially associated with their dream characteristics.</p><p><strong>Methods: </strong>We analyzed EEG data from 13 drug-naïve iRBD patients and 10 healthy controls (HCs) during phasic and tonic REM sleep. Source-level functional connectivity was computed across 14 cortical regions associated with dream generation, and network topology was evaluated using graph theory metrics.</p><p><strong>Results: </strong>iRBD patients showed significantly increased gamma-band functional connectivity during phasic REM sleep (p = 0.003, network-based statistic). This hyperconnectivity correlated with reduced REM atonia (RAI; R = -0.725, p = 0.007) and trended with increased dream-related symptom severity. Key network hubs included the posterior cingulate cortex (PCC) and right inferior parietal lobule (rIPL)-core nodes of the default mode network-implicated in self-referential and spatial processing. Additionally, increased connectivity between rIPL and salience-motor circuits (anterior cingulate cortex, insula, and M1) may underlie emotional overactivation and aggressive dream content.</p><p><strong>Conclusion: </strong>Our findings suggest that gamma-band hyperconnectivity during phasic REM sleep reflects altered 'dream-related network' dynamics in iRBD, potentially contributing to the intensity and emotional valence of dream experiences. This study provides preliminary evidence that functional network alterations during REM sleep may shape dream characteristics in iRBD, offering new perspectives on its neurophysiological basis.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106724"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812409","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":"Respiratory event-related pulse transit time drop rate predicts left ventricular impairment in obstructive sleep apnea.","authors":"Ning Ding, Biao Xue, Guihong Wei, Neda Esmaeili, Mei Su, Qiyun Ma, Jiani Shen, Wei Chen, Ali Azarbarzin, Jing Xu","doi":"10.1016/j.sleep.2025.106725","DOIUrl":"10.1016/j.sleep.2025.106725","url":null,"abstract":"<p><strong>Objectives: </strong>Pulse transit time (PTT) is used to assess vascular elasticity. We aim to investigate whether respiratory event-related PTT metrics can predict left ventricular (LV) impairment in obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This retrospective study included OSA patients without pre-existing LV impairment who underwent polysomnography from January 2014 to May 2017 at Affiliated Huai'an No.1 People's Hospital and The First Affiliated Hospital of Nanjing Medical University. LV impairment was assessed via echocardiography and blood tests from December 2023 to May 2024. Respiratory event-related PTT metrics (drop rate, magnitude, index, nadir, area) were measured using SOMNOscreen + polysomnographic system. Cox models estimated hazard ratios for LV impairment, and receiver operating characteristic (ROC) curves assessed the predictive value.</p><p><strong>Results: </strong>The sample included 517 individuals (82.8 % male) with a median age of 53.0 years (IQR: 43.0-63.0). Over a median follow-up of 8.3 years, 112 patients (21.7 %) were diagnosed with LV hypertrophy (LVH) and 249 (48.2 %) with LV diastolic dysfunction (LVDD), none had systolic dysfunction. Patients in the fourth quartile of the PTT drop rate had adjusted hazard ratios of 2.49 [95 % CI, 1.38-4.49] for LVH and 3.84 [95 % CI, 2.49-5.92] for LVDD, and 0.53 ng/ml [95 % CI, 0.33-0.73] higher cardiac troponin T than those in the first quartile. No consistent associations were found with other PTT metrics. In ROC analysis, the PTT drop rate showed greater accuracy than traditional metrics in predicting LVDD.</p><p><strong>Conclusions: </strong>A high respiratory event-related PTT drop rate, reflecting vascular hyperactivity, may help stratify LV impairment risk in OSA.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"106725"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804808","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}