Sleep medicine最新文献

{"title":"Dysregulation of the orexin–leptin–ghrelin axis and its associations with chronotype and sleep disturbances in drug-naïve children with ADHD","authors":"Elif Abanoz ,&nbsp;Dilara Ulger Ozbek ,&nbsp;Ali Güven Say ,&nbsp;Ayla Uzun Cicek","doi":"10.1016/j.sleep.2025.106839","DOIUrl":"10.1016/j.sleep.2025.106839","url":null,"abstract":"<div><div>Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder defined by inattention and behavioral dysregulation. Sleep disturbances are frequently reported in ADHD and strongly associated with circadian rhythms and sleep–wake regulation. Given the pivotal involvement of orexin, leptin and ghrelin systems in the modulation of cognitive, metabolic and circadian functions, this study aimed to investigate whether serum orexin-A, orexin-B, leptin and ghrelin levels are associated with chronotype and sleep disturbances in children with ADHD. Forty-five drug-naïve ADHD patients and 45 age and sex-matched healthy controls were assessed using validated measures of chronotype and sleep habits, and serum hormone levels were analyzed via two-site sandwich ELISA. Children with ADHD exhibited substantially higher eveningness chronotype, as well as markedly elevated bedtime resistance, sleep onset delay, night wakings and daytime sleepiness (all p &lt; 0.001). Importantly, serum orexin-A (p &lt; 0.001), orexin-B (p = 0.039) and leptin (p = 0.012) levels were significantly reduced in the ADHD group, whereas serum ghrelin levels were significantly increased (p &lt; 0.001). Ghrelin levels showed strong positive associations with attention deficit scores, chronotype scores and total sleep disturbance scores (all p &lt; 0.01), whereas orexin-A/B and leptin levels were negatively correlated with these parameters (all p &lt; 0.05). Notably, children with an evening chronotype showed the highest ghrelin and lowest orexin/leptin levels. To our knowledge, these findings provide preliminary evidence of an association between disturbances in the orexin–leptin–ghrelin axis and chronotype-related circadian misalignment and sleep difficulties in childhood ADHD, suggesting that neurohormonal mechanisms may be relevant to the underlying pathophysiology.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106839"},"PeriodicalIF":3.4,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213709","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":"No nighttime I can own: The experience of insomnia expressed through poetry","authors":"Anna Joyce ,&nbsp;Sam Illingworth","doi":"10.1016/j.sleep.2025.106834","DOIUrl":"10.1016/j.sleep.2025.106834","url":null,"abstract":"<div><div>Insomnia is a chronic sleep disorder associated with difficulty sleeping and a significant deleterious impact on daytime function and quality of life. This novel study investigates the experience of insomnia, and the impact and coping strategies expressed via the creative medium of poetry.</div><div>A total of 33 poems containing the word ‘insomnia’ were selected from The Poetry Foundation and analysed using poetic content analysis; a qualitative inductive technique that involved coding meaning units to the poetry, which were then categorised and agreed between the two authors.</div><div>The final agreed categories were: Coping Strategies and Mental Engagement, which reflected a range of standard and non-standard treatments and thoughts; Physical Experiences and Reactions, such as discomfort; Socio-Emotional Dynamics and Life Impact, such as emotional impact and relationships; Environment and Temporal Factors, including the sleeping area and house, and the passage of time; and Sleep, which included dreams and nightmares, and the lack thereof.</div><div>Themes broadly represented the biopsychosocial model, which then served as a framework for interpreting the study's findings. The study provided an interesting and novel approach to investigating the creative expression of insomnia, and could be further developed by soliciting poetry from contemporary poets to provide a more immediate and diverse range of experiences.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106834"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213765","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":"Application of down-phase targeted auditory stimulation during sleep in a home setting: A feasibility study across seven consecutive nights","authors":"Corinne Eicher ,&nbsp;Cristina Gallego Vázquez ,&nbsp;Cinzia Schmid ,&nbsp;Golo Kronenberg ,&nbsp;Hans-Peter Landolt ,&nbsp;Erich Seifritz ,&nbsp;Giulia Da Poian ,&nbsp;Reto Huber","doi":"10.1016/j.sleep.2025.106830","DOIUrl":"10.1016/j.sleep.2025.106830","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleep deprivation, also known as “wake therapy”, has long been recognized as a powerful antidepressant. Phase-targeted auditory stimulation (PTAS) has been suggested as an auspicious non-invasive nocturnal substitute for sleep deprivation. Down-PTAS with stimuli presentation during the down-phase of slow waves, in particular, may have therapeutic potential to improve mood by selectively reducing slow-wave activity (SWA). With down-PTAS being more nuanced than sleep deprivation, its effects presumably develop over multiple nights, thus necessitating transfer from sleep laboratory to home settings. Therefore, in this study, we investigated the technical feasibility, tolerability, and potential risks associated with a wearable device employed for down-PTAS in an unsupervised home setting.</div></div><div><h3>Methods</h3><div>We recorded frontal EEG using the MHSL Sleepband Version 3 (MHSL-SB) in five healthy participants (23.8 ± 0.8 years, three women) over seven consecutive nights with (STIM) and without (SHAM) tone application at their homes. Tones were delivered shortly before the negative peak of slow waves during N2/N3 sleep, using alternating 10-s ON-OFF windows. Sleep staging followed American Academy of Sleep Medicine (AASM) guidelines. Of the 67 available sleep recordings, we excluded three due to parameter adjustments and another six for technical issues, leaving 58 sleep recordings (29 SHAM, 29 STIM) for further analyses. Low SWA (0.5–2 Hz, lSWA) was computed across the entire night, ON-OFF windows, and sleep cycles. Time-frequency analyses were performed time-locked to stimulus onset. We computed linear mixed effect models with condition (STIM vs. SHAM) as a fixed effect and random participant intercepts.</div></div><div><h3>Results</h3><div>Data quality was sufficient for analyses in 87 % of the available sleep recordings, with an average of over 1500 correctly delivered stimuli per recording. Down-PTAS did not affect sleep architecture, but it reduced lSWA primarily during the first sleep cycle when sleep pressure and lSWA were highest, and particularly in OFF windows. Additionally, stimulation elicited a K-complex-like auditory evoked response, aligning with previous laboratory findings.</div></div><div><h3>Conclusion</h3><div>Our results demonstrate the successful implementation of down-PTAS in a home setting, confirming its feasibility for long-term, unsupervised use. The K-complex-like auditory evoked response may mask potential reductions in lSWA during ON windows, posing a scientific analytical challenge. Taken together, future clinical research should now assess the effects of down-PTAS in depressed patients, in whom reducing lSWA may partly mimic sleep deprivation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106830"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207726","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":"Pre-stroke subjective sleep quality predicts 1-year clinical outcomes in patients with ischemic stroke or transient ischemic attack: A national cohort study","authors":"Jianyu Dong ,&nbsp;Shuo Wang ,&nbsp;Yang Yang ,&nbsp;Anxin Wang ,&nbsp;Yijun Zhang ,&nbsp;Ning Zhang ,&nbsp;Chunxue Wang ,&nbsp;Yongjun Wang","doi":"10.1016/j.sleep.2025.106829","DOIUrl":"10.1016/j.sleep.2025.106829","url":null,"abstract":"<div><h3>Background</h3><div>Sleep quality may be a predictor of outcomes following ischemic stroke. This study aims to investigate the impact of pre-stroke subjective sleep quality on clinical outcomes in stroke patients.</div></div><div><h3>Methods</h3><div>Patients diagnosed with acute ischemic stroke (AIS) or transient ischemic attack (TIA) were recruited from China National Stroke Registry-III. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate pre-stroke subjective sleep quality. Cox regression was to explore the relationship between PSQI and recurrent stroke, mortality, and composite vascular events; logistic regression was used for poor functional outcome.</div></div><div><h3>Results</h3><div>A total of 2,266 patients were enrolled. After 1 year of follow-up, 44 (1.9 %) individuals died, 180 (7.9 %) individuals experienced stroke recurrence, 195 (8.6 %) individuals experienced composite vascular events, and 172 (7.6 %) individuals had poor functional outcome. Patients in the highest quartile of PSQI score (score range: 10–20) exhibited a significantly increased risk of mortality (HR = 3.73, 95 % CI = 1.24–11.22) and poor functional outcome (OR = 2.15 95 % CI = 1.27–3.63) when compared with patients in the lowest quartile (score range: 3–5).</div></div><div><h3>Conclusions</h3><div>Pre-stroke poor subjective sleep quality independently predicts 1-year mortality and poor functional outcome in patients with AIS or TIA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106829"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207797","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":"RimeSleepNet: A hybrid deep learning network for s-EEG sleep stage classification","authors":"Xiaolin Wang ,&nbsp;Xiaowei Li ,&nbsp;Jing Li ,&nbsp;Yunfa Fu ,&nbsp;Dan Zhang ,&nbsp;Yan Peng","doi":"10.1016/j.sleep.2025.106835","DOIUrl":"10.1016/j.sleep.2025.106835","url":null,"abstract":"<div><div>Sleep stage classification is essential for sleep research and clinical diagnostics. However, frequency aliasing in sleep electroencephalogram (s-EEG) signals remains a significant challenge, existing methods have yet to effectively address this issue. This study proposes a hybrid deep-learning model, RimeSleepNet, comprising four key components. First, the rime optimization algorithm adaptively tunes variational mode decomposition (VMD) to reduce frequency aliasing by generating intrinsic mode functions (IMFs). Second, a convolutional neural network (CNN) automatically extracts stage-specific features from IMFs. A multi-head self-attention (MHSA) mechanism then dynamically weights these features to prioritize stage-specific patterns, followed by long short-term memory (LSTM) networks that model temporal dynamics for robust classification of NREM, REM, and WAKE stages. Evaluated on the Chengdu People's Hospital and Sleep-EDF datasets, RimeSleepNet achieves the highest F1 scores of 0.94, 0.89, and 0.92 for NREM, REM, and WAKE stages, respectively, with an AUC of 0.92, outperforming baseline models like CNN and LSTM. Cross-dataset validation confirms its robust generalization (Cohen's κ = 0.90), and it reduces validation loss by 53 % compared to LSTM, providing an advanced tool for automated sleep stage analysis in sleep disorder diagnosis and personalized monitoring.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106835"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213728","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":"Contribution of sleep disturbances to cognitive changes in vascular cognitive impairment.","authors":"Jiaqi Luo, Fei Li, Pengjun Zhao, Jianwen Xu, Huijing Hu","doi":"10.1016/j.sleep.2025.106832","DOIUrl":"https://doi.org/10.1016/j.sleep.2025.106832","url":null,"abstract":"<p><strong>Background and purpose: </strong>Vascular cognitive impairment (VCI) is highly prevalent and is associated with increased disability, mortality, as well as social and economic burden, highlighting the necessities of early monitoring and management. Previous studies suggested that early intervention on modifiable risk factors reduced its prevalence and therefore, it is crucial to identify these factors for efficient management and reduction of these outcomes. Sleep disturbances have been previously linked to onset and progression of stroke, as well as cognitive impairment. However, its contribution to changes in cognition and specific cognitive domains in individuals with cerebrovascular conditions remain unclear. This study aims to determine correlations between sleep disturbances and cognitive impairment in patients with cerebrovascular conditions and identify vulnerable cognitive domains for monitoring and intervention of the disease.</p><p><strong>Methods: </strong>A systematic review was performed on human studies investigating associations between sleep disturbances and cognitive impairment in individuals with cerebrovascular conditions by searching PubMed, Embase, Web of science (WOS), Scopus and Cochrane central databases. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).</p><p><strong>Results: </strong>Twelve studies including a total of 5525 samples were included. Breathing-related sleep disorders (BSD), insomnia, excessive daytime sleepiness (EDS) and period limb movement disorders (PLMD) were frequently present following stroke. Sleep disorders such as obstructive sleep apnea (OSA), sleep fragmentation, and changes in sleep quality as well as total sleep time (TST) were associated with general cognition or cognitive domains (such as visuospatial ability, delayed recall, working memory, executive function, attention and verbal fluency) in various types of cerebrovascular conditions (such as cerebral small vessel disease (CSVD), stroke and minor ischemic stroke).</p><p><strong>Conclusions: </strong>The present systematic review revealed high prevalence of sleep disturbances such as BSD, insomnia, EDS, and PLMD, and associations between OSA, sleep fragmentation, changes in sleep quality as well as TST and impairment in general cognition or cognitive domains such as memory and verbal fluency. These findings provide useful information on exploration of early detection, monitoring and management of this modifiable condition for VCI.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"106832"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245241","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":"Actigraphy and diary-assessed sleep in first-trimester pregnant women: A Bland-Altman analysis","authors":"Shao-Yu Tsai ,&nbsp;Pei-Lin Lee ,&nbsp;Christopher Gordon ,&nbsp;Shu-Yu Kuo ,&nbsp;Chien-Nan Lee","doi":"10.1016/j.sleep.2025.106831","DOIUrl":"10.1016/j.sleep.2025.106831","url":null,"abstract":"<div><h3>Study objectives</h3><div>To evaluate the agreement between actigraphy and sleep diaries in pregnant women and to examine the impact of sleep-related symptoms on this agreement.</div></div><div><h3>Methods</h3><div>A total of 251 first-trimester pregnant women were recruited from prenatal clinics at a university-affiliated hospital in Taipei, Taiwan. Participants completed standardized symptom questionnaires and wore an actigraph for 7 days while maintaining a concurrent sleep diary. The Bland-Altman method was applied to assess the agreement between actigraphy and diary-derived sleep measures. Unpaired t-tests were performed to analyze associations between sleep-related symptoms and discrepancies in sleep measures between the two methods.</div></div><div><h3>Results</h3><div>Mean differences for sleep onset, offset, sleep onset latency, and daytime sleep duration, along with their 95 % limits of agreement, were within ±30 min. Total sleep time and wake after sleep onset had wider 95 % limits of agreement, ranging from ±68 to ±88 min and ±58 to ±74 min, respectively. Women with elevated symptoms of depression or insomnia showed greater discrepancies in sleep onset latency than those without such symptoms (both p = .01).</div></div><div><h3>Conclusions</h3><div>Actigraphy and sleep diaries show an acceptable level of agreement for tracking sleep onset time, offset time, sleep onset latency, and daytime sleep duration in first-trimester pregnant women, but insufficient agreement for total sleep time and wake after sleep onset, with women experiencing depressive or insomnia symptoms more likely to misperceive their sleep. Healthcare professionals should consider integrating actigraphy into clinical and research settings to enhance early identification and management of sleep disturbances in pregnant women.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106831"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207753","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":"Identifying multimodal digital features of insomnia using an app in Hong Kong: An ecological momentary assessment study","authors":"Calvin Lam ,&nbsp;Jie Chen ,&nbsp;Kit Ying Chan ,&nbsp;Joey W.Y. Chan ,&nbsp;Ngan Yin Chan ,&nbsp;Shirley Xin Li ,&nbsp;Bei Huang ,&nbsp;Yun Kwok Wing ,&nbsp;Tim M.H. Li","doi":"10.1016/j.sleep.2025.106825","DOIUrl":"10.1016/j.sleep.2025.106825","url":null,"abstract":"<div><h3>Background</h3><div>Digital phenotyping of insomnia remains underexplored, particularly in the context of depression, despite the high comorbidity between these two conditions. This study aims to investigate the associations between insomnia and multimodal features using active data collection during awake states, including facial expressions, acoustic characteristics, and language use.</div></div><div><h3>Methods</h3><div>A sample of 92 participants was recruited, 39 % of them presented with clinical insomnia as measured by Insomnia Severity Index. Multimodal features were extracted from video-taped mood diaries recorded for one week. We analyzed the associations between multimodal features and insomnia using generalized logistic regression models, while controlling for demographic data, psychiatric diagnosis, scores of depression and anxiety.</div></div><div><h3>Results</h3><div>Insomnia was associated with facial, acoustic, and linguistic features, included less lip corner pulling, more upper lip raising and lip corner depressing, slower articulation rate, increased non-fluencies and the use of fillers, fewer family- and health-related words.</div></div><div><h3>Conclusions</h3><div>The current findings enhance our understanding of the multimodal digital phenotypic characteristics of insomnia, facilitating a more objective assessment in future research.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106825"},"PeriodicalIF":3.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158473","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":"Actigraphy-based measures of sleep quality and duration are associated with maternal glycemia in mid-pregnancy","authors":"Robyn Larsen ,&nbsp;Ashleigh Homer ,&nbsp;Martha Lappas ,&nbsp;Gabrielle Pell ,&nbsp;Georgia I. Panagiotopoulos ,&nbsp;Paddy C. Dempsey ,&nbsp;Neville Owen ,&nbsp;David W. Dunstan","doi":"10.1016/j.sleep.2025.106827","DOIUrl":"10.1016/j.sleep.2025.106827","url":null,"abstract":"<div><h3>Background</h3><div>Studies in nonpregnant populations have linked insufficient and poor-quality sleep with hyperglycemia. However, this association is not well characterized in pregnancy, mainly due to challenges with self-reported measures of sleep. In this exploratory analysis, we examined associations of actigraphy-measured sleep duration and sleep efficiency with post-challenge glucose levels in mid-pregnancy.</div></div><div><h3>Methods</h3><div>Pregnant women (n = 67) recruited via convenience sampling from an outpatient clinic wore an Actigraph GTX3+ sleep monitor for 7-days prior to their 75g oral glucose tolerance test. Hourly glucose concentrations were used to calculate the incremental area-under-the-curve (iAUC) for glucose. Multivariate linear regression analyses examined associations of sleep and glucose outcomes after adjustment for potential confounders (age, pre-pregnancy BMI and ethnicity).</div></div><div><h3>Results</h3><div>Actigraphy-measured shorter sleep was associated with a higher post-challenge glucose response (iAUC; β = −0.78 [95 % CI: −1.38, −0.12] mmol.L⁻¹, <em>P</em> = 0.018), and lower sleep efficiency with higher 2-h glucose (β = −0.074 [95 % CI: −0.121, −0.027] mmol.L⁻¹, <em>P</em> = 0.003). These relationships persisted after adjustment for potential confounders.</div></div><div><h3>Conclusion</h3><div>We found that shorter sleep duration and lower sleep efficiency were associated with maternal hyperglycemia during mid-gestation. These findings highlight the potential importance of considering sleep quality and duration for managing glycemic risk in routine antenatal care.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106827"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158476","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":"Suggested immobilization test in RLS clinical trials: A systematic review and methodological appraisal","authors":"Sasikanth Gorantla ,&nbsp;Vamsi Krishna Gorijala ,&nbsp;Lynn Marie Trotti","doi":"10.1016/j.sleep.2025.106828","DOIUrl":"10.1016/j.sleep.2025.106828","url":null,"abstract":"<div><h3>Background</h3><div>The suggested immobilization test investigates restless legs syndrome symptoms in a controlled environment. Given the procedure's unique features and strengths, we traced its methodological evolution, investigated its utilization in RLS efficacy trials, and compared SIT metrics with conventional outcome measures.</div></div><div><h3>Methods</h3><div>We registered the study in PROSPERO (CRD42024542580). A systematic review was performed using four databases (PubMed, Embase, Web of Science, and Cochrane databases) from inception to January 2024. RLS placebo-controlled randomized controlled trials that used SIT were included in the final review. Cohen's d effect size was calculated for the outcome measures to standardize and compare IRLS and PSG PLMI with discomfort score and PLMI on SIT. A narrative review of SIT was also performed to analyze the methodological evolution.</div></div><div><h3>Results</h3><div>Eight hundred eighty-two studies were screened, and nine RCTs were included in this systematic review. Since its inception in 1988, the methodology has evolved over the years, including multiple SITs to capture circadian fluctuations and a refined discomfort scale. The majority of RCTs were performed in Europe, and only one RCT with SIT was conducted in the USA. Cohen's effect size analysis suggested the superior performance of the SIT PLM index over PLMSI on PSG, while IRLS captured a larger effect size compared to SIT DS.</div></div><div><h3>Conclusion</h3><div>Despite robust assessment of current RLS symptoms by SIT/mSIT, they remain underutilized in RLS efficacy trials. mSIT captures all RLS features in a controlled environment, and it adds depth, precision and critical complementary data to conventional RLS outcome measures in RLS treatment evaluations.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106828"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213678","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}