Sleep medicine最新文献

{"title":"Insomnia and emotional dysfunction: Altered brain network connectivity across sleep and wakefulness states","authors":"Siyu Li ,&nbsp;Zhuo Wang ,&nbsp;Yun Li ,&nbsp;Xue Luo ,&nbsp;Taotao Ru ,&nbsp;Qingwei Chen ,&nbsp;Guofu Zhou","doi":"10.1016/j.sleep.2025.106582","DOIUrl":"10.1016/j.sleep.2025.106582","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between insomnia-induced sleep disturbance and emotional dysfunction and whether the brain network functional connectivity patterns during either wakefulness or sleep states functioned as a mediator in this relationship.</div></div><div><h3>Methods</h3><div>Twenty participants with non-clinical insomnia disorder (ID) and 20 normal controls (NC) were recruited and underwent resting-state Electroencephalography (EEG) recordings during wakefulness and sleep stages. Functional connectivity was analyzed using coherence (COH) across multiple frequency bands. The relationships between COH metrics and self-reported emotional measures and the potential mediation effects were investigated.</div></div><div><h3>Results</h3><div>The ID group revealed sleep stage-specific alterations in brain network functional connectivity, with enhanced alpha connectivity being observed in non-rapid eye movement (NREM) sleep and increased delta connectivity in both phasic and tonic rapid eye movement (REM) sleep stages. Increased alpha band connectivity in anterior-posterior networks during wakefulness was associated with emotional regulation difficulties and depressive symptoms. Mediation analyses showed that alpha and delta band connectivity between frontal-occipital regions mediated the relationship between insomnia and emotional dysregulation.</div></div><div><h3>Conclusions</h3><div>These findings reveal the pattern of functional connectivity is differently changed in insomnia disorder across wakefulness and sleep states, and such connectivities play a mediation rolein relationship between chronic sleep disruption and emotional regulation in insomnia disorder. These findings provide a novel insight into the neurophysiological mechanisms linking sleep disruption to emotional dysfunction and suggest these aberrant functional connectivity patterns as potential neurophysiological targets for insomnia intervention.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106582"},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170783","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":"Resting-state brain change on treatment improvement in insomnia disorder: A coordinate-based meta-analysis","authors":"Zhangwei Lv ,&nbsp;Yuhan Fan ,&nbsp;Haobo Zhang ,&nbsp;Shiyan Yang ,&nbsp;Linman Weng ,&nbsp;Xu Lei","doi":"10.1016/j.sleep.2025.106601","DOIUrl":"10.1016/j.sleep.2025.106601","url":null,"abstract":"<div><div>Many people suffer from insomnia worldwide, but we know little about the neuroimaging mechanisms of treatment improvement of insomnia disorder. This study aimed to investigate resting-state brain changes on treatment improvement in insomnia disorder. We searched Pubmed, web of science, and PsycINFO databases and finalized 14 studies, which reported changes in brain activity or functional connectivity in insomnia patients after treatment. Using activation likelihood estimation found that insomnia patients showed significant convergence in the superior frontal gyrus (SFG) after effective intervention. Behavioural decoding using the BrainMap database revealed that the SFG plays an important role in inhibition behavior, working memory (WM), reward emotion, and thermoregulation. Meta-analytic connectivity modelling analysis found that the SFG is shown to connect to several core nodes of the default mode network, including the middle frontal gyrus, precuneus, and cingulate gyrus. In conclusion, this study reveals the important role of SFG in the treatment of insomnia and provides a stable intervention target region for clinical intervention in insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106601"},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242880","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":"Beyond infantile colic: tracking motor skills, sensory processing, and sleep at the cusp of toddlerhood","authors":"Rabia Zorlular ,&nbsp;Halil Degirmencioglu ,&nbsp;Ali Zorlular","doi":"10.1016/j.sleep.2025.106598","DOIUrl":"10.1016/j.sleep.2025.106598","url":null,"abstract":"<div><div>This study aimed to evaluate the motor development, sensory processing skills, and sleep characteristics of toddlers with a history of infantile colic and compare them to their typically developing peers. A total of 46 toddlers were included in the study: 24 toddlers with a history of infantile colic and 22 typically developing peers (control group), aged between 10 and 15 months. Sensory processing skills, motor development, and sleep characteristics were evaluated using the Test of Sensory Functions in Infants, the Peabody Developmental Motor Scales–2, and the Brief Infant Sleep Questionnaire, respectively. Significant differences in favor of the control group were observed in reactivity to tactile deep pressure (p = 0.026), adaptive motor function (p = 0.003), visual-tactile integration (p = 0.012), and total scores (p &lt; 0.001) assessed by the TSFI, as well as in the control group scored higher in gross motor (p &lt; 0.001), fine motor (p = 0.025), and total motor scores (p &lt; 0.001) measured by the PDMS-2. Upon examining the sleep characteristics of the groups, nighttime sleep duration (p = 0.039) and total sleep duration (p = 0.009) were significantly longer in the control group. The colic group exhibited a significantly higher frequency of nocturnal awakenings (p = 0.004) and greater nocturnal wakefulness (p = 0.006). Toddlers with a history of infantile colic experience greater difficulties in sleep patterns, sensory processing, and motor development compared to their peers. Early evaluation and targeted intervention programs are crucial for addressing these potential developmental delays.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106598"},"PeriodicalIF":3.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124968","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":"Same scale, different names? An assessment of the psychometric properties of three established scales that measure cognitive processes in insomnia, and the introduction of the sleep worry 7 questionnaire","authors":"Sebastian Isaksson ,&nbsp;Vera Henriksson ,&nbsp;Osame Salim ,&nbsp;Charlotte Bäccman ,&nbsp;Annika Norell","doi":"10.1016/j.sleep.2025.106595","DOIUrl":"10.1016/j.sleep.2025.106595","url":null,"abstract":"<div><h3>Background</h3><div>Previous reports have highlighted the abundance of cognitive constructs in insomnia research as a growing issue. Several questionnaires that measure sleep-related cognitions have been developed and there are indications of conceptual overlap between different cognitive constructs and the questions used to operationalize them.</div></div><div><h3>Objectives</h3><div>This study examines the convergent validity of three established questionnaires measuring cognitive processes in insomnia: the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-10), and the Pre-Sleep Arousal Scale (PSAS-C). Another objective was to explore how a briefer scale can be structured as well as to investigate this scale's ability to predict incident and persistent insomnia compared to the established scales.</div></div><div><h3>Methods</h3><div>2333 participants from the general population completed surveys on insomnia symptoms and cognitive processes at baseline and 18 months later. Confirmatory factor analysis was used to investigate the scales' conceptual overlap as well as distinctive factors. An exploratory factor analysis was conducted to investigate the underlying factor structure of the items from the APSQ, the DBAS-10 and the PSAS-C. This analysis formed the basis of the creation of a new short scale: Sleep Worry 7. Binary logistic regressions were used to assess all scales’ abilities to predict incident and persistent insomnia.</div></div><div><h3>Results and conclusions</h3><div>The overlap between the three scales was neither large enough to conclude that they are measuring the same construct, nor could it be confirmed that they measure three distinct questionnaire-specific cognitive processes within insomnia. The brief scale created within this study was able to predict persistent insomnia at similar levels to the three established scales combined, indicating that it captures important cognitions involved in the maintenance of insomnia. Measuring sleep-related cognitions with fewer items might be beneficial in both clinical contexts and research.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106595"},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177758","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":"Cardiovascular burden of individuals diagnosed with idiopathic hypersomnia: Real-World Idiopathic Hypersomnia Total Health Model (CV-RHYTHM)","authors":"Ragy Saad ,&nbsp;Prasheel Lillaney ,&nbsp;Deb A. Profant ,&nbsp;Douglas S. Fuller ,&nbsp;Elizabeth M. Poole ,&nbsp;Trevor Alvord ,&nbsp;Patricia Prince ,&nbsp;Shaina Desai ,&nbsp;Marisa Whalen ,&nbsp;Weiyi Ni ,&nbsp;Jed Black","doi":"10.1016/j.sleep.2025.106587","DOIUrl":"10.1016/j.sleep.2025.106587","url":null,"abstract":"<div><h3>Objective/background</h3><div>Limited research assesses cardiovascular risk in people with idiopathic hypersomnia. This study compared cardiovascular conditions or events among individuals with idiopathic hypersomnia with those among matched non–idiopathic hypersomnia controls.</div></div><div><h3>Patients/methods</h3><div>Claims from Merative™ MarketScan® Research Databases (12/2013–2/2020) were analyzed. Eligible individuals with idiopathic hypersomnia were ≥18 years of age upon cohort entry, continuously enrolled for 365 days before and after cohort entry (gaps ≤30 days allowed), and without cataplexy. Individuals with idiopathic hypersomnia entered the cohort upon their earliest medical claim with an idiopathic hypersomnia diagnosis code. Controls were matched 5:1, without replacement, to individuals with idiopathic hypersomnia using demographic characteristics. Odds of prevalent cardiovascular conditions or events during the 2-year assessment period (365 days before and after cohort entry date) were compared using unconditional logistic regression. Results were reported as odds ratios (ORs) with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Final cohorts included 11,412 individuals with idiopathic hypersomnia and 57,058 matched controls. Odds (OR, 95 % CI) of cardiovascular disease (2.26, 2.14–2.38), major adverse cardiovascular event (2.08, 1.89–2.30), stroke (2.07, 1.87–2.29), hypertension diagnosis or antihypertensive use (2.02, 1.93–2.12), heart failure (1.97, 1.76–2.20), atrial fibrillation (1.91, 1.66–2.20), myocardial infarction (1.74, 1.42–2.12), and coronary revascularization (1.58, 1.12–2.17) were higher in individuals with idiopathic hypersomnia than matched controls.</div></div><div><h3>Conclusions</h3><div>Individuals with idiopathic hypersomnia had higher odds of prevalent cardiovascular conditions or events than matched controls. These results reinforce that clinicians should be aware of patients’ cardiovascular risk profiles when selecting idiopathic hypersomnia treatments.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106587"},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242869","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":"Patient-reported outcome measure for central disorders of hypersomnolence (PROM-CDH): development and validation","authors":"Bijlenga Denise ,&nbsp;De Boer Josephine ,&nbsp;Fronczek Rolf ,&nbsp;Tiemensma Jitske ,&nbsp;Lammers Gert Jan","doi":"10.1016/j.sleep.2025.106589","DOIUrl":"10.1016/j.sleep.2025.106589","url":null,"abstract":"<div><h3>Study objectives</h3><div>Central disorders of hypersomnolence (CDH) have a major impact on patients' quality of life (QoL). We developed and validated a disease-specific patient-reported outcome measure (PROM) to measure QoL in CDH: the PROM-CDH, for adults with narcolepsy types 1 and 2 (NT1 and NT2), and idiopathic hypersomnia (IH).</div></div><div><h3>Methods</h3><div>The developmental process involved focus groups and interviews with adults with CDH (n = 27), family members (n = 8) and sleep medicine specialists (n = 5). In the quantitative evaluation, the draft version of the PROM-CDH, together with the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), ADHD rating scale (ADHD-RS) and the 36-item Short Form (SF-36) were filled out online by N = 369 patients with (suspected) CDH.</div></div><div><h3>Results</h3><div>Internal consistency was good for the total group and within diagnostic groups (all Cronbach's α &gt; .8). Age was positively (β = .11; p = .003), and female gender (β = −3.67; p = .002), comorbid sleep apnea (β = −4.77; p = .005), and depression (β = −12.71; p &lt; .001) were negatively associated with the PROM-CDH score. Exploratory and confirmatory factor analyses resulted in five subscales. Convergent validity showed highest correlation between the PROM-CDH total score and HADS Depression (r = −.71; p &lt; .01); and the SF-36 subscales Emotional wellbeing (r = .65; p &lt; .01) and Energy/fatigue (r = .71; p &lt; .01). Additional adjustments including content validity in consensus rounds resulted in the final PROM-CDH (version 1, 2023).</div></div><div><h3>Conclusions</h3><div>The PROM-CDH has high potential in clinical practice for patients with CDH, to support clinical care, as an important outcome in clinical trials, and as a sleep care quality indicator. Further international validation is ongoing, and it is freely available in multiple languages.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106589"},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116836","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 effect of sleep quality on glucose variability among adolescents with type 1 diabetes in China: A multi-central temporal longitudinal association analysis","authors":"Qingting Li ,&nbsp;Wencong Lv ,&nbsp;Weichao Yuwen ,&nbsp;Zhumin Jia ,&nbsp;Xia Li ,&nbsp;Jia Guo","doi":"10.1016/j.sleep.2025.106597","DOIUrl":"10.1016/j.sleep.2025.106597","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Study objectives&lt;/h3&gt;&lt;div&gt;High glucose variability is common among adolescents with type 1 diabetes mellitus (T1DM). On person level, poor sleep quality has been reported to be an important factor associated with high glucose variability among adolescents with T1DM. However, on day level, the effect of sleep quality on glucose variability remains unclear, limiting temporal adjustment of treatment regimens. This study aimed to concurrently explore associations between sleep quality and glucose variability at both day and person levels among Chinese adolescents with T1DM based on the 24-h Recursive Cycle model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A multi-center, seven-day, temporal longitudinal study was conducted among Chinese adolescents with T1DM. Glucose variability measures were calculated by fingertip blood glucose level at least seven times a day. Subjective sleep quality was measured by total sleep time, wake after sleep onset, number of awakenings, a score of sleep quality, sleep time, and wake time using a sleep diary. Objective sleep quality was assessed by Fitbit Inspire HR and included total sleep time, wake after sleep onset, and number of awakenings, rapid eye movement, light sleep time, deep sleep time, sleep time, wake time, sleep midpoint, and sleep efficiency. A multilevel linear regression model was performed to examine the associations between objective and subjective sleep quality and glucose variability at day and person levels. Gender, age, diabetes duration, complications documented within the preceding 6 months, HbA1c, and insulin pump therapy were controlled at person-level model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 51 adolescents with T1DM participated in this study, which included 357 records of data. Only 21.57 % (N = 12) of adolescents met the recommended sleep time of 480 min per night measured by Fitbit. About a quarter (N = 11) of adolescents had a coefficient of variation of blood glucose &gt;36 %. At person level, there was no significant association between sleep quality and glucose variability (&lt;em&gt;p &gt;&lt;/em&gt; 0.05). Multilevel models found significant associations between sleep quality and glucose variability at day level. Lower score of subjective sleep quality was significantly associated with higher standard deviation of blood glucose (&lt;em&gt;p &lt;&lt;/em&gt; 0.05) in the next day. Less Fitbit-measured light sleep time was significantly associated with higher standard deviation of blood glucose, and postprandial of glycemic excursions in the next day (&lt;em&gt;p &lt;&lt;/em&gt; 0.05). More Fitbit-measured awakenings and less rapid eye movement were associated with higher postprandial glycemic excursions in the next day (&lt;em&gt;p &lt;&lt;/em&gt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Nearly 80 % of Chinese adolescents with T1DM did not meet the recommended amount of sleep for their age group. They experienced more wakes after sleep onset at night and poorer sleep quality than their subjective experience. A","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106597"},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134134","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 informed choice model of care: Offering caregivers choices for infant behavioural sleep intervention","authors":"Sarah Blunden ,&nbsp;Sarah Honaker ,&nbsp;Jacy Hyland ,&nbsp;Perran Boran ,&nbsp;Alex Metse","doi":"10.1016/j.sleep.2025.106596","DOIUrl":"10.1016/j.sleep.2025.106596","url":null,"abstract":"<div><div>Sleep in infants aged 6–18 months can be disrupted and may cause impairment in some families. Caregivers often seek assistance to improve their infant's sleep through behavioural sleep interventions (BSI). BSI approaches can vary considerably ranging from leaving a child to cry alone to reactive co-sleeping. The majority of available literature on BSI focusses on less responsive approaches (such as controlled crying or cry-it-out) and so understandably these are the most commonly recommended and prescribed by health professionals. However, these may not be the preferred option for some caregivers. Many factors influence caregiver choice of a preferred intervention for their infant, including their beliefs about controlled crying, caregiver cry-tolerance, infant age and temperament, and cultural norms. Yet many caregivers seeking help from healthcare providers for infant sleep report being presented with only one or two BSI options, denying them the opportunity to make an informed decision about a preferred choice.</div><div>We propose here the notion of an Informed Choice Model of Care (ICMoC) in which those caregivers who are seeking help for perceived sleep problems in their infants, are informed about a broad range of BSIs and select an approach that best fits their needs and preferences in collaboration with their child's healthcare provider. We suggest that the use of the ICMoC may increase caregiver agency and empowerment, facilitate successful completion of BSI protocols, and thus reduce the negative impacts of poor sleep for infants and their families.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106596"},"PeriodicalIF":3.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134049","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":"Letter to the editor: “Towards a consistent assessment of sex hormones and thermic curve in reproduction life related Kleine-Levin syndrome patients and controls”","authors":"Michel Billiard ,&nbsp;Isabelle Jaussent","doi":"10.1016/j.sleep.2025.106592","DOIUrl":"10.1016/j.sleep.2025.106592","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106592"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146769","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":"Adverse effect of beta-blockers in non-ST elevation acute coronary syndrome patients with obstructive sleep apnea","authors":"Zekun Zhang ,&nbsp;Siyi Li ,&nbsp;Ge Wang ,&nbsp;Yun Zhou ,&nbsp;Yan Yan ,&nbsp;Jingyao Fan ,&nbsp;Hui Ai ,&nbsp;Wei Gong ,&nbsp;Shaoping Nie","doi":"10.1016/j.sleep.2025.106593","DOIUrl":"10.1016/j.sleep.2025.106593","url":null,"abstract":"<div><h3>Background</h3><div>Currently, beta-blockers are recommended for non-ST elevation acute coronary syndrome (NSTE-ACS). However, there is still a lack of studies evaluating the use of beta-blockers in patients with NSTE-ACS complicated by obstructive sleep apnea (OSA).</div></div><div><h3>Methods</h3><div>This is the sub-analysis of OSA-ACS project (NCT03362385), a prospective, observational study recruited ACS patients undergoing portable sleep monitoring between June 2015 and January 2020. Patients with NSTE-ACS were selected in this analysis. The primary endpoint was major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction or ischemia-driven revascularization.</div></div><div><h3>Results</h3><div>After exclusion, 1452 NSTE-ACS patients were enrolled, and 75.3 % of patients received beta-blockers at discharge. The proportion of beta-blockers users in the OSA group was 77.4 % and 73.2 % in the non-OSA group, with no significant difference (P = 0.068). In OSA group, beta-blocker users had higher rate of MACE (18.2 % versus 9.0 %, adjusted hazard ratio [HR] 1.90, 95 % confidence interval [CI] 1.04–3.45, p = 0.037) but not in non-OSA group (14.1 % versus 9.9 %, adjusted HR 1.45, 95 % CI 0.80–2.62, p = 0.219). After propensity score matching, beta-blocker users were still at higher risk of MACE (19.3 % versus 9.3 %, adjusted HR 2.18, 95 % CI 1.09–4.35, p = 0.028) in OSA group, in contrast the risk was comparable in non-OSA group (13.2 % versus 9.9 %, adjusted HR 1.27, 95 % CI 0.63–2.57, p = 0.501). Sensitivity analysis was consistent with the main results. Subgroup analysis showed no significant interactions (P &gt; 0.10, for all comparisons).</div></div><div><h3>Conclusion</h3><div>The administration of beta-blockers is associated with higher risk of adverse cardiovascular outcomes in NSTE-ACS patients with concomitant OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"132 ","pages":"Article 106593"},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099753","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}