Sleep medicine最新文献

{"title":"The inter-night variability of REM sleep without atonia in adult patients with central disorders of hypersomnolence","authors":"Francesco Biscarini ,&nbsp;Francesca Buracchi Torresi ,&nbsp;Stefano Vandi ,&nbsp;Valentina Baldini ,&nbsp;Francesco Colaci ,&nbsp;Elena Antelmi ,&nbsp;Luca Morandi ,&nbsp;Emanuel Mignot ,&nbsp;Raffaele Ferri ,&nbsp;Giuseppe Plazzi ,&nbsp;Fabio Pizza","doi":"10.1016/j.sleep.2025.106687","DOIUrl":"10.1016/j.sleep.2025.106687","url":null,"abstract":"<div><h3>Study objectives</h3><div>Rapid eye movement (REM) sleep without atonia (RWA), the neurophysiological hallmark of REM sleep behavior disorder, is a typical feature of nocturnal sleep in patients with narcolepsy type 1 (NT1). Its reproducibility across different nocturnal polysomnographies (PSG) has never been investigated in patients with CDH. We assessed the inter-night variability of RWA.</div></div><div><h3>Methods</h3><div>Two-hundred-fifty adults (45 % males) hospitalized for suspected CDH, including 92 NT1, 29 narcolepsy type 2 (NT2), 36 idiopathic hypersomnia (IH), and 93 subjective hypersomnolence (sHS), undergoing two consecutive night-PSGs, multiple sleep latency test (MSLT) and cerebrospinal fluid hypocretin-1 (CSF-HCRT1) measurement, were recruited. The inter-night variability of REM atonia index (RAI) was assessed with Wilkoxon's test, McNemar's test, Bland-Altman plots, and Cohen's kappa.</div></div><div><h3>Results</h3><div>Compared with the other groups, NT1 patients presented lower RAI both as absolute values and frequency in the pathological range (RAI≤0.8). RAI slightly decreased from night1 to night2 only in NT1 (difference = 0.03, 95 %CI = 0.01–0.05), whereas it did not vary in other groups. In NT1, the frequency of pathological RAI≤0.8 was not different across the nights and showed good agreement (32.5 %vs.42.5 %; p = 0.09, kappa = 0.7). In NT1, after adjustment, RAI≤0.8 was independently associated with older age, lower MSLT sleep latency, more MSLT-sleep onset REM periods, higher wake after sleep onset, non-REM stage-1, and less non-REM stage-3.</div></div><div><h3>Conclusions</h3><div>In CDHs, RWA has low inter-night variability, which makes it a valuable marker in clinical practice and research activity. In adult NT1, RWA is associated with older age and with features suggestive of a poorer sleep quality and higher daytime sleep propensity.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106687"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678865","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":"Cognitive-friendly sleep patterns in older Adults:A cross-regional HCAP study","authors":"Jianhong Liao ,&nbsp;Yunhan Shi ,&nbsp;Yanru Li ,&nbsp;Demin Han","doi":"10.1016/j.sleep.2025.106684","DOIUrl":"10.1016/j.sleep.2025.106684","url":null,"abstract":"<div><h3>Background</h3><div>Sleep patterns, including daytime napping and nighttime sleep duration, have complex relationships with cognitive health, yet the nonlinear associations across diverse populations remain underexplored.</div></div><div><h3>Methods</h3><div>Utilizing harmonized cognitive assessment protocol from the China Health and Retirement Longitudinal Study (CHARLS-HCAP) and the Survey of Health, Ageing, and Retirement in Europe(SHARE-HCAP). Cognitive function was assessed based on Minimum Mental State Examination (MMSE), Brief Community Screening Instrument-Dementia (BCSID,10/66). Cognitive domains included orientation, memory, visuospatial, executive, and language function, measured via several protocols such as Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Trail Making Test A/B (TMT-A/B), number series and Symbol Digit Modalities Test (SDMT). Restricted cubic spline (RCS) models and multivariate regression were applied to assess the threshold effect.</div></div><div><h3>Results</h3><div>In CHARLS, 4307 subjects were included and 2685 in SHARE. Chinese older adults napping rate is 66 % versus 31.51 % in Europe. In CHARLS, napping exhibited an inverted U-shaped relationship with cognitive function, with optimal nap duration at 42–50 min and sleep duration of 5.8–7 h. Although exhibiting similar inverted U-shaped trends, SHARE demonstrated distinct sleep pattern effects on cognition, particularly nap duration (35–40 min for naps; 6–6.7 h for sleep). Cross-regional studies reveal cognitively friendly sleep pattern, with Chinese older adults napping for 35–60 min and sleeping for 5–7 h, and European napping for 5–75 min, sleeping for 4–8 h.</div></div><div><h3>Conclusions</h3><div>Both napping and sleep duration exhibit nonlinear, domain-specific relationships with cognitive performance. Public health guidelines should emphasize association between sleep patterns and cognitive performance in older adults, with attention to the impact of lifestyle habits.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106684"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704250","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 “Factors associated with diagnostic delay in narcolepsy: Real-world data from a Korean multicenter study” [Sleep Med 133 (2025) 106646]","authors":"Yu Jin Jung ,&nbsp;Ki-Hwan Ji ,&nbsp;Daeyoung Kim ,&nbsp;Kyung Min Kim ,&nbsp;Yun Ho Choi ,&nbsp;Jae Wook Cho ,&nbsp;Hyeyun Kim ,&nbsp;Wonwoo Lee ,&nbsp;Jun-Sang Sunwoo ,&nbsp;Dae Lim Koo ,&nbsp;Hee-Jin Im ,&nbsp;Kwang Ik Yang","doi":"10.1016/j.sleep.2025.106656","DOIUrl":"10.1016/j.sleep.2025.106656","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106656"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653679","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":"Predictors of poor sleep quality in multiple sclerosis: The independent role of anxiety and restless legs syndrome","authors":"Ceren Alis,&nbsp;Nuray Kose,&nbsp;Sibel Sen Kilic,&nbsp;Gencer Genc,&nbsp;Serpil Bulut","doi":"10.1016/j.sleep.2025.106691","DOIUrl":"10.1016/j.sleep.2025.106691","url":null,"abstract":"<div><h3>Study objectives</h3><div>Sleep disturbances are common in multiple sclerosis (MS) and significantly affect patients’ quality of life. However, the specific predictors of poor sleep quality in MS remain underexplored. This study aimed to determine the prevalence of poor sleep quality and to identify clinical and psychological factors independently associated with poor sleep in patients with MS.</div></div><div><h3>Methods</h3><div>This cross-sectional observational study included 103 consecutively enrolled MS patients during a one-month recruitment period. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), with scores &gt;5 indicating poor sleep. Other measures included the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scales. Participants were grouped as good or poor sleepers, and predictors of poor sleep were determined using multivariate logistic regression.</div></div><div><h3>Results</h3><div>Poor sleep quality was identified in 53.4 % of patients. Poor sleepers had significantly higher ISI, ESS, FSS, PHQ-9, GAD-7, and S-LANSS scores and reported lower EQ-5D-3L-based quality of life (all p &lt; 0.01). Multivariate analysis revealed that anxiety symptoms and the presence of restless legs syndrome (RLS) were the only independent predictors of poor sleep quality. Depression, fatigue, disability, and neuropathic pain were not independent predictors after adjustment.</div></div><div><h3>Conclusions</h3><div>Poor sleep is prevalent in MS and independently associated with anxiety symptoms and RLS. These findings highlight the need for targeted screening and treatment of these comorbidities to improve sleep and overall quality of life in this population.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106691"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665854","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":"Sympathetic arousals during sleep - observations in a cohort of healthy subjects","authors":"Sofie Britzius,&nbsp;Kruthika Thangavelu,&nbsp;Wieland Behr,&nbsp;C. Emika Birk,&nbsp;Boris A. Stuck,&nbsp;Richard Birk","doi":"10.1016/j.sleep.2025.106689","DOIUrl":"10.1016/j.sleep.2025.106689","url":null,"abstract":"<div><h3>Study objectives</h3><div>In peripheral arterial tonometry (PAT) based sleep assessment sympathetic activations can be calculated in addition to respiratory events. However, they do not necessarily represent a respiratory or other pathologic events. The primary aim of this study is to investigate these events in a sleep healthy population and to identify the physiological variation of these events and possible influencing factors.</div></div><div><h3>Methods</h3><div>70 healthy subjects were evaluated. A variety of indices of sympathetic arousal were calculated over a period of six nights using PAT as a diagnostic modality. The present study centered on the pRDI, the PAT activation index (PAI), and various sub-calculations of the PAI, which detects events that follow a specific pattern in the case of increased sympathetic activity. The cohort was divided into two age groups. A mixed model linear regression and a repeated-measures analysis of variance (ANOVA) were implemented to assess the intra- and interindividual variability as well as as the influence of gender, age, day of testing and selected life style parameters.</div></div><div><h3>Results</h3><div>All indexes of sympathetic activations were found to undergo relevant intraindividual variations in a multi-night-testing. In some subjects the indexes reached values above 100 events/h. Female study participants had a 2.5-fold lower pRDI and also the age of the participants influenced the sympathetic parameters. Day, previous illness, alcohol consumption, or daytime sleep had no effect on the frequency of sympathetic activations.</div></div><div><h3>Conclusion</h3><div>This study was the first to describe the distribution of sympathetic activations in peripheral arterial tone in a sleep-healthy population. The measures of sympathetic activations were largely stable between individuals. However, there were relevant intraindividual fluctuations in the multi-night measurement. A statistically significant influence of gender and age was found. The presented data could be a possibility to better understand and further investigate sympathetic activations during sleep.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106689"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702472","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":"Cognitive complaints in obstructive sleep Apnea: The overlooked role of coping styles","authors":"Tim J.A. Vaessen ,&nbsp;Ruth E. Mark ,&nbsp;Sebastiaan Overeem ,&nbsp;Margriet M. Sitskoorn","doi":"10.1016/j.sleep.2025.106695","DOIUrl":"10.1016/j.sleep.2025.106695","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive complaints are common in obstructive sleep apnea (OSA) but do not correlate with objective cognitive impairments, leaving their underlying cause unclear. The present study aims to (1) compare coping styles between OSA patients and healthy controls, and (2) investigate the relationship between cognitive complaints and various coping styles in OSA patients.</div></div><div><h3>Methods</h3><div>In a cross-sectional design, cognitive complaints and coping styles were compared between OSA patients (n = 24) and healthy controls (n = 15). Validated questionnaires were used to assess cognitive complaints (Cognitive Failure Questionnaire, CFQ; Behavior Rating Inventory of Executive Function for adults, BRIEF-A) and coping styles (Utrecht Coping List, UCL). Additional variables included demographics, indicators of OSA severity, sleep quality, subjective sleepiness, anxiety, depression, and cognitive impairments. Pearson correlations were used to identify variables associated with cognitive complaints. These variables were then included as controls in hierarchical regression analyses to determine the unique contribution of coping styles to explaining cognitive complaints.</div></div><div><h3>Results</h3><div>Compared to healthy controls, OSA patients reported more cognitive complaints on the CFQ and reported a more passive coping style. In OSA patients, reduced active problem-solving on the UCL was independently associated with higher CFQ scores (β = −.43), regardless of AHI, anxiety or depression symptoms. Avoidant (β = .49) coping styles were independently linked to higher BRIEF-A scores. Coping styles accounted for 51 %–59 % of the variance in cognitive complaints among OSA patients.</div></div><div><h3>Conclusions</h3><div>Psychological mechanisms, specifically avoidant and less pro-active coping styles, significantly contribute to cognitive complaints in OSA, independent of OSA severity and symptoms of anxiety and depression. Psychological interventions improving coping skills may benefit OSA patients experiencing cognitive complaints.</div></div><div><h3>Registration of clinical trials</h3><div>clinicaltrials.gov, NCT02769663.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106695"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686153","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 serum GFAP, BDNF and NfL levels and clinical symptoms in restless legs syndrome: a case-control study","authors":"Fang Yan,&nbsp;Yanwei Cheng,&nbsp;Shuman Feng","doi":"10.1016/j.sleep.2025.106694","DOIUrl":"10.1016/j.sleep.2025.106694","url":null,"abstract":"<div><h3>Background</h3><div>Restless legs syndrome (RLS) is a prevalent neurological condition marked by an uncontrollable urge to move the legs, which often disrupts sleep and impairs quality of life. Although neuroinflammatory and neurodegenerative processes have been implicated, the roles of serum glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), and neurofilament light chain (NfL) in treatment-naïve RLS remain unclear.</div></div><div><h3>Methods</h3><div>In this case-control study, 108 treatment-naïve RLS patients and 90 age- and sex-matched healthy controls were enrolled. Serum levels of GFAP, BDNF, and NfL were quantified using enzyme-linked immunosorbent assays (ELISA). Symptom severity and quality of life were assessed using the International Restless Legs Syndrome Study Group Rating Scale (IRLS) and the RLS Quality of Life Questionnaire (QoL-RLS), respectively. Multivariate logistic regression was conducted to evaluate biomarker associations with disease risk. In addition, receiver operating characteristic (ROC) curve analyses were conducted to assess the discriminative ability of serum GFAP, BDNF, and NfL levels in differentiating RLS patients from controls. The area under the curve (AUC), sensitivity, and specificity were calculated to evaluate diagnostic performance.</div></div><div><h3>Results</h3><div>Compared to controls, RLS patients had significantly higher serum levels of GFAP (148.27 ± 32.53 vs. 96.44 ± 27.81 pg/mL, p &lt; 0.001) and NfL (15.35 ± 4.82 vs. 9.78 ± 3.59 pg/mL, p &lt; 0.001), and lower levels of BDNF (18.71 ± 5.69 vs. 23.95 ± 6.12 pg/mL, p = 0.002). Multivariate analyses confirmed these markers as independent predictors of RLS (GFAP: OR = 1.592, BDNF: OR = 0.372, NfL: OR = 1.953, all p &lt; 0.01). NfL was positively correlated with both IRLS (β = 0.531, p = 0.012) and QoL-RLS scores (β = 0.356, p = 0.007), while GFAP was associated with QoL impairment (β = 0.724, p &lt; 0.001), and BDNF showed a negative association with symptom severity (β = −0.287, p = 0.003). ROC analyses showed strong discriminative power for GFAP (AUC = 0.919), NfL (AUC = 0.856), and BDNF (AUC = 0.797).</div></div><div><h3>Conclusion</h3><div>Serum GFAP, BDNF, and NfL are independently associated with RLS presence and severity, highlighting their potential as peripheral biomarkers of neuroglial and axonal dysfunction. These findings provide mechanistic insight and support their utility in the diagnosis and monitoring of <span>RLS</span> and may serve as peripheral indicators of neurobiological involvement and could have potential utility in future research related to disease monitoring or treatment response.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106694"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687588","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":"JWA mediates oxidative stress to promote vascular endothelial repair in obstructive sleep apnea-hypopnea syndrome","authors":"Yaru Yan ,&nbsp;Jun Lan ,&nbsp;Hongmei Zhang,&nbsp;Yi Ren,&nbsp;Xiu Cheng,&nbsp;Yanyan Li,&nbsp;Meng Wu,&nbsp;Junyu Lu","doi":"10.1016/j.sleep.2025.106686","DOIUrl":"10.1016/j.sleep.2025.106686","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea-hypopnea syndrome (OSA) can induce various cardiovascular diseases, posing a heavy burden on individuals, families, and society. Current treatments for OSA lack effective drugs, and patient compliance with other invasive treatments is poor. Therefore, this study aimed to explore effective OSA relief medications and delve into their molecular mechanisms.</div></div><div><h3>Methods</h3><div>Established rat models of intermittent hypoxia and pulmonary artery endothelial cells (PAECs) models of intermittent hypoxia. Hematoxylin and eosin staining was used to observe pulmonary artery hypertension in rats. Enzyme-linked immunosorbent assay was employed to detect levels of SOD, MDA, IL-6, and TNF-α in rat peripheral blood and PAECs. Western blotting was used to detect changes in Ras homolog gene family member A/Rho-associated coiled-coil forming protein kinase (RhoA/ROCK) signaling and endothelin 1 (ET-1) expression. Reverse transcription quantitative polymerase chain reaction was performed to measure ARF Like GTPase 6 Interacting Protein 5 (ARL6IP5, namely JWA) expression. Transwell assays evaluated migration ability, while cell counting kit-8 assessed proliferation capacity.</div></div><div><h3>Results</h3><div>In rat models of intermittent hypoxia and PAECs models of intermittent hypoxia, treatment with all-trans retinoic acid (atRA) upregulated JWA expression in a dose-dependent manner. atRA treatment alleviated pulmonary artery wall thickening, oxidative stress, and inflammatory responses induced by intermittent hypoxia in the rat model, promoting endothelial repair. JWA overexpression inhibited the migration and proliferation of PAECs while suppressing oxidative stress responses. Rescue experiments using antioxidant treatment reversed endothelial dysfunction caused by JWA knockdown.</div></div><div><h3>Conclusion</h3><div>atRA upregulates JWA expression, promoting vascular endothelial repair in OSA by inhibiting oxidative stress responses. This suggests the potential of atRA in treating OSA and controlling its progression to pulmonary artery hypertension.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106686"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703201","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 regularity is associated with cognitive function and shows an inverted U-shaped relationship with serum brain-derived neurotrophic factor","authors":"Yue Cao ,&nbsp;Jaehee Lee ,&nbsp;Jaehoon Seol ,&nbsp;Kyohei Shibuya ,&nbsp;Jieun Yoon ,&nbsp;Tetsuaki Arai ,&nbsp;Masashi Yanagisawa ,&nbsp;Tomohiro Okura","doi":"10.1016/j.sleep.2025.106688","DOIUrl":"10.1016/j.sleep.2025.106688","url":null,"abstract":"<div><h3>Objectives</h3><div>Day-to-day sleep patterns have been hypothesized to influence cognitive health and Alzheimer's disease. However, it remains unclear whether sleep irregularity is associated with cognitive function and its key marker, brain-derived neurotrophic factor (BDNF), especially in individuals with subjective concerns about cognition and sleep but who are otherwise relatively healthy.</div></div><div><h3>Methods</h3><div>A total of 458 participants (aged 65.0 ± 11.1 years, 51.1 % female) participated in the Tsukuba Happiness Life Study between 2023 and 2024 in Japan. Day-to-day sleep patterns were measured using the Sleep Regularity Index (SRI) via 24/7 actigraphy. Cognitive function was evaluated using a comprehensive assessment battery. Serum BDNF was measured in a subgroup of 232 participants. Multivariate regression analysis was used for the main analysis.</div></div><div><h3>Results</h3><div>Overall, the SRI ranged from 10.86 to 85.59; after adjusting for demographic factors and total sleep time, participants with higher SRI (range, 65.35–85.59) exhibited higher global cognitive function (B = 0.13, 95 % CI = 0.02, 0.24) than the lower SRI group (range, 10.86–54.08). Notably, a nonlinear relationship (inverted U-shaped) was observed between SRI and serum BDNF levels, whereas balanced SRI (around 60) and the middle SRI group exhibited significantly higher serum BDNF levels (B = 0.17, 95 % CI = 0.04, 0.30) than the lower SRI group.</div></div><div><h3>Conclusions</h3><div>Higher SRI serves as an important factor for cognitive function. Maintaining a balanced SRI, which is neither too rigid nor highly irregular, might benefit Alzheimer's disease progression.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106688"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703200","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":"Health, social, and economic consequences of idiopathic REM Sleep Behavior Disorder: a controlled national study evaluating societal effects","authors":"Huda El-Asadi ,&nbsp;Rune Frandsen ,&nbsp;Sine Arvedsen ,&nbsp;Michael Ibsen ,&nbsp;Poul Jørgen Jennum","doi":"10.1016/j.sleep.2025.106682","DOIUrl":"10.1016/j.sleep.2025.106682","url":null,"abstract":"<div><h3>Objective</h3><div>Idiopathic REM Sleep Behavior Disorder (iRBD) is one of the strongest known risk markers for alpha-synuclein disorder development including Parkinson Disease (prodromal PD). We aimed to determine the socioeconomic and overall health burden for patients with iRBD, and ultimately for society.</div></div><div><h3>Methods</h3><div>A nationwide retrospective cohort study, based on anonymized patient data from the Danish National Patient Registry (DNPR) and other Danish registers. Patients hospital-diagnosed (ICD-10) with iRBD without Parkinson Disease (PD) between 1 January 2006 and 31 December 2018 were included. 392 cases were compared with 1568 controls matched by age, sex, marital status, and geographic location (municipality). All patients were eligible for 2 years follow-up after their index date.</div></div><div><h3>Results</h3><div>The direct total health costs of iRBD patients, from 4 years before until 1 year after the index date, were higher than those of controls in each year. This was also reflected in the results of a comorbidity analysis, in which patients had significantly higher rates of diseases within a wide variety of the ICD-10 classification groups compared with controls. Up until index year +1, there was no difference in income from employment. Cases received higher levels of public transfers from index year −2 to up to year +1.</div></div><div><h3>Conclusion</h3><div>Patients diagnosed with iRBD showed more frequent contact with the healthcare system in the 4 years up to the diagnosis, than their matched controls, indicating that disease onset has occurred years before iRBD diagnosis. However, this was not reflected in patients’ levels of educational attainment and employability before the diagnosis, which shows that iRBD is independent of social factors.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106682"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678864","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}