Sleep medicine最新文献

{"title":"Resolution of central sleep apnea following upper airway surgery: A case report","authors":"Nathan G. Rasmussen ,&nbsp;Kari A. Martin ,&nbsp;Ryan A. Dunn ,&nbsp;Ashley L. Garrett ,&nbsp;Stephen F. Bansberg ,&nbsp;Chad M. Ruoff","doi":"10.1016/j.sleep.2026.108776","DOIUrl":"10.1016/j.sleep.2026.108776","url":null,"abstract":"<div><h3>Introduction</h3><div>Central sleep apnea (CSA) and obstructive sleep apnea (OSA) are characterized by recurrent pauses in breathing secondary to decreased central respiratory drive and upper airway obstruction, respectively. Oropharyngeal surgery is not a treatment option for CSA but may be considered in select patients with OSA.</div></div><div><h3>Case presentation</h3><div>A 37-year-old female presented with an Apnea Hypopnea Index (AHI) of 122/hour that included a Central Apnea Index (CAI) of 74/hour, and chronic tonsillitis with tonsillar hypertrophy and a baseline BMI of 36 kg/m². Complete resolution of CSA and marked improvement in sleep were noted following tonsillectomy combined with expansion pharyngoplasty.</div></div><div><h3>Conclusions</h3><div>Although there can be significant overlap between OSA and CSA, resolution of CSA following soft tissue oropharyngeal surgery in an adult has not been previously reported. For this patient an unusual underlying pathophysiology, possibly post-arousal in nature, may explain the unanticipated outcome.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108776"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980742","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 modified Baveno classification for obstructive sleep apnoea: design of a pan-European prospective study","authors":"Sandhya Matthes ,&nbsp;Marcel Treml ,&nbsp;Sofia E. Schiza ,&nbsp;Izolde Bouloukaki ,&nbsp;Georgia Trakada ,&nbsp;Athanasia Pataka ,&nbsp;Paschalis Steiropoulos ,&nbsp;Dries Testelmans ,&nbsp;Johann Verbraecken ,&nbsp;Francesco Fanfulla ,&nbsp;Carolina Lombardi ,&nbsp;Elisa Perger ,&nbsp;Gianfranco Parati ,&nbsp;Holger Hein ,&nbsp;Stefan Mihaicuta ,&nbsp;Özen K. Basoglu ,&nbsp;Esther Schwarz ,&nbsp;Renaud Tamisier ,&nbsp;Sébastien Baillieul ,&nbsp;Sébastien Bailly ,&nbsp;G. Roisman","doi":"10.1016/j.sleep.2026.108774","DOIUrl":"10.1016/j.sleep.2026.108774","url":null,"abstract":"<div><h3>Background</h3><div>Using the apnoea-hypopnoea index (AHI) as the sole determinant for treating obstructive sleep apnoea (OSA) is being critically discussed. The modified Baveno classification is a multicomponent grading tool combining respiratory disturbance, symptoms and cardiovascular disease (CVD) risk assessment to guide treatment of OSA. Retrospective analyses of an existing database showed that treatment according to this classification resulted in significantly improved symptoms and cardiovascular parameters. We report the design of the first prospective study to evaluate the modified Baveno classification.</div></div><div><h3>Methods</h3><div>Patients with OSA (≥40 years) recruited in this multicentre, prospective, observational long-term follow-up study will be treated with OSA-specific therapy according to the modified Baveno classification. Patients with AHI≥30/h or with established CVD, severe renal disease, diabetes with end-organ damage, difficult-to-treat hypertension or chronic/recurrent atrial fibrillation are associated with strong treatment indication. For the remaining patients, SCORE2/SCORE2-OP/SCORE2-diabetes risk assessment of CVD together with symptom scores, determines the strength of treatment indication. The first hierarchical primary outcome is change in office systolic blood pressure (SBP), followed by Epworth Sleepiness Scale. Follow-up will occur at 6-,12-, 24- and 36-months from baseline. Retrospective data analysis revealed a mean change in SBP of −5±14 mmHg in 393/1081 patients. A power of 99.9 % with a two-sided alpha of 0.001 results in a sample size of 894. The target sample size is 1800 patients, assuming a drop-out rate of 50 % at 3 years.</div></div><div><h3>Discussion</h3><div>This study investigates the clinical relevance of the modified Baveno classification for OSA severity assessment and treatment decision making in clinical practice.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108774"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004155","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":"Disentangling trait and developmental chronotype across the lifespan: An augmented regression-based approach to norms for morningness–eveningness scales","authors":"Imke Buekenhout ,&nbsp;Ana Allen Gomes ,&nbsp;José Leitão","doi":"10.1016/j.sleep.2026.108768","DOIUrl":"10.1016/j.sleep.2026.108768","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Chronotype manifests trait-like dispositions and age-related developmental shifts; yet the psychometrics of existing morningness–eveningness (ME) scales do not reflect the distinctness of these influences. Three issues contribute to this construct–measurement mismatch: assumed age-invariance of reliability and validity, uniform cutoffs across age/sex, and unwarranted conflation of trait and developmental ME. We aimed to exemplify solutions for these issues and deliver age-stratified psychometrics and augmented regression-based norms (RBN) that disentangle trait and developmental ME for the European Portuguese CSM.</div></div><div><h3>Methods</h3><div>Multi-cohort data from Portuguese residents/native speakers were pooled. Reliability (<em>N</em> = 2890; 12–94 years) and validity (<em>n</em> = 1880; 12–75 years) were examined overall and across five age groups. Hierarchical step-down regression selected predictors for the augmented RBN. Predictive performance was compared with conventional whole-sample norming on sleep timing and mental-health outcomes.</div></div><div><h3>Results</h3><div>Age-stratified analyses showed adolescents and older adults diverged from overall reliability and validity patterns; nevertheless, indices were adequate. RBN included linear and quadratic age in adolescence and, in adulthood, an additional Age × Sex interaction. Augmented scores’ disentangled trait and developmental components better predicted validity indicators and mental-health outcomes than conventionally normed scores. A public calculator returns ME <em>z</em>-scores, percentiles, and a 9-category chronotype classification for trait, developmental, and combined chronotype.</div></div><div><h3>Conclusions</h3><div>Augmented RBN for the CSM deliver trait, developmental, and combined ME scores and classifications that improve prediction and offer clinical utility for exploring vulnerabilities to psychological distress, sleep problems, and cognitive complaints. The approach may generalize to other ME scales.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108768"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep duration, body composition and mortality: a prospective study of 156,565 Mexican adults","authors":"Weder Alves da Silva ,&nbsp;Marina Silveira ,&nbsp;Carlos Cristi-Montero ,&nbsp;Cezimar Correia Borges ,&nbsp;Alberto S. Sá Filho ,&nbsp;Leandro F.M. Rezende ,&nbsp;Gerson Ferrari","doi":"10.1016/j.sleep.2026.108775","DOIUrl":"10.1016/j.sleep.2026.108775","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the joint association of sleep duration and body composition, assessed by body mass index (BMI) and waist circumference (WC), with all-cause, cardiovascular disease (CVD), and respiratory mortality among Mexican adults.</div></div><div><h3>Methods</h3><div>This prospective cohort included 156,565 participants (median follow-up: 15.5 years), excluding those with pre-existing conditions and early deaths. Cox proportional hazards models estimated hazard ratios (HRs) for combinations of sleep duration (reference: 7–9 h/day for adults &lt;65 years; 7–8 h/day for those ≥65 years; short sleep: &lt;7 h/day; long sleep: &gt;9 h/day for adults &lt;65 years; &gt;8 h/day for those ≥65 years) and body composition categories (normal weight, overweight, obesity; normal or high WC).</div></div><div><h3>Results</h3><div>After full-adjustment, excess adiposity, particularly WC, emerged as the primary determinant of mortality risk, largely independent of sleep duration. CVD mortality risk was highest among individuals with high WC, particularly those with short sleep (HR: 7.28; 95 %CI: 2.22–23.79), with similarly elevated risks observed for high WC combined with reference or long sleep. Obesity was also independently associated with increased CVD mortality among individuals reporting reference sleep duration (HR: 3.11; 95 %CI: 1.28–7.55). For all-cause mortality, obesity increased risk across all sleep duration categories, while high WC was associated with elevated mortality regardless of sleep duration. No significant associations were observed for respiratory mortality after full adjustment.</div></div><div><h3>Conclusions</h3><div>Sleep duration and body composition jointly influence mortality risk. Obesity and high WC substantially worsen these risks, underscoring the need for integrated strategies targeting both sleep and metabolic health.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108775"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929262","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 a probability model for high-resolution drowsiness detection using electroencephalogram","authors":"Ahnaf Rashik Hassan ,&nbsp;Muammar Kabir ,&nbsp;Shumit Saha ,&nbsp;Behrang Keshavarz ,&nbsp;Azadeh Yadollahi","doi":"10.1016/j.sleep.2025.108733","DOIUrl":"10.1016/j.sleep.2025.108733","url":null,"abstract":"<div><h3>Purpose</h3><div>Capturing the dynamics of sleep onset process is fundamental to sleep medicine and circadian neurobiology. Even though wakefulness/sleep transition is a gradual and continuous process, it has been considered instantaneous and scored subjectively at low resolution. Therefore, a model to capture the dynamics of wakefulness to sleep transition is needed. The purpose of this study is to develop an efficient, high-resolution, and reliable model to quantitatively capture the dynamics of wakefulness/sleep transition using electroencephalogram (EEG).</div></div><div><h3>Methods</h3><div>We collected EEG signals from 53 subjects during an overnight sleep study. We extracted relative power features from EEG to develop a new model that yields the likelihood of wakefulness for each of the 3-s EEG segments. Furthermore, using the model, we identified three clusters, namely wakefulness, drowsiness and sleep, and employed statistical analyses, cluster quality evaluation, and graphical analysis for validation.</div></div><div><h3>Results</h3><div>The proposed method successfully separated three distinct cases of alertness. The mean silhouette value on the test data was 0.74 and the mean Davies-Bouldin index value was 0.43, which indicated that the three discovered clusters were compact. Based on the silhouette values, the detection accuracy was 93.21 %. One-way repeated measures analysis of variance results suggested that the feature values were significantly different (p &lt; .0001) among the three detected clusters.</div></div><div><h3>Conclusion</h3><div>The proposed method was able to detect short episodes of wakefulness, drowsiness, and sleep with high accuracy in overnight polysomnography data. This proof-of-concept study suggests potential future applications in drowsiness detection, pending validation in relevant contexts such as driving simulators and workplace environments.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108733"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024524","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":"Re ‘efficacy and safety of insomnia pharmacotherapies: Convergent evidence from Bayesian network meta-regression and FAERS-based disproportionality analysis’ – by Liu et al.","authors":"William V. McCall ,&nbsp;Antonio Olivieri","doi":"10.1016/j.sleep.2026.108779","DOIUrl":"10.1016/j.sleep.2026.108779","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108779"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980849","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":"Erratum to “Exploring relationships between sleep quality and clinical depression in the Canadian Longitudinal Study on Aging” [Sleep Med. 138 (2026) 108692]","authors":"Samia Salame ,&nbsp;Therese Chan ,&nbsp;Tetyana Kendzerska ,&nbsp;Stacey Fisher ,&nbsp;Douglas Manuel ,&nbsp;Amy T. Hsu","doi":"10.1016/j.sleep.2026.108808","DOIUrl":"10.1016/j.sleep.2026.108808","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108808"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Response to: “Letter to the Editor regarding 'A preliminary analysis of large muscle group movements in adults with attention deficit hyperactivity disorder'”","authors":"Gulcin Benbir Senel ,&nbsp;Lourdes M. DelRosso","doi":"10.1016/j.sleep.2026.108812","DOIUrl":"10.1016/j.sleep.2026.108812","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108812"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114058","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":"Restless legs syndrome and sleep quality in patients with multiple sclerosis: A moderated mediation model of anxiety, fatigue, and disease duration","authors":"Eshrak Salama Hashem ,&nbsp;Narges Mohammed Mohammed Syam ,&nbsp;Wafaa Hassan Ali Awad ,&nbsp;Nadia Hassan Ali Awad ,&nbsp;Nabila Salem Mohammed ,&nbsp;Daniel Joseph E. Berdida ,&nbsp;Naglaa Fathalla Elsayed","doi":"10.1016/j.sleep.2026.108790","DOIUrl":"10.1016/j.sleep.2026.108790","url":null,"abstract":"<div><h3>Aims</h3><div>Restless Legs Syndrome (RLS) is common among individuals with Multiple Sclerosis (MS) and frequently co-occurs with poor sleep quality, fatigue, and psychological distress. Understanding how these symptoms are interrelated may inform nursing assessment and symptom management. This study examined the association between RLS severity and sleep quality in individuals with MS and explored a theory-driven moderated mediation model in which anxiety and fatigue were examined as indirect correlates, and disease duration as a moderating factor.</div></div><div><h3>Methods</h3><div>A cross-sectional correlational study was conducted with 110 individuals diagnosed with MS, recruited from a governmental hospital outpatient clinic in Egypt. Data were collected using validated self-report measures of RLS severity, sleep quality, anxiety, fatigue, and disease duration. Structural equation modeling was used to examine direct and indirect associations among variables, following the STROBE checklist.</div></div><div><h3>Results</h3><div>Greater RLS severity was significantly associated with poorer sleep quality (<em>β</em> = 0.31, <em>p</em> &lt; 0.001), higher anxiety (<em>β</em> = 0.42, <em>p</em> &lt; 0.001), and greater fatigue (<em>β</em> = 0.28, <em>p</em> = 0.001). Anxiety and fatigue statistically accounted for a significant portion of the association between RLS severity and sleep quality. Conditional indirect associations indicated that these relationships were stronger among individuals with longer MS duration (&gt;5 years).</div></div><div><h3>Conclusion</h3><div>RLS severity is associated with poorer sleep quality in individuals with MS, both directly and indirectly through anxiety and fatigue, with these indirect associations varying as a function of disease duration. Although exploratory and cross-sectional, these findings highlight the importance of comprehensive nursing assessment and integrated symptom management approaches addressing RLS, anxiety, and fatigue to support sleep quality and overall well-being in MS care.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108790"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019612","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":"Efficacy and safety of tonic motor activation (TOMAC) for restless legs syndrome as adjunctive and monotherapy: An individual participant data systematic review and meta-analysis","authors":"Elias G. Karroum ,&nbsp;Cornelius G. Bachmann ,&nbsp;Amy Bronstone ,&nbsp;Leavitt Morrison","doi":"10.1016/j.sleep.2026.108810","DOIUrl":"10.1016/j.sleep.2026.108810","url":null,"abstract":"<div><h3>Introduction</h3><div>Tonic motor activation (TOMAC) is a non-pharmacological treatment for moderate-to-severe medication-refractory Restless Legs Syndrome (RLS). This bilateral wearable device applies high-frequency electrical stimulation to the peroneal nerve, engaging the therapeutic mechanism while minimizing sleep discomfort. A recent meta-analysis evaluated TOMAC in RLS using aggregate data, which precluded subgroup analyses. The aim of our systematic review and meta-analysis was to extract individual participant data to enable the evaluation of TOMAC as adjunctive treatment and monotherapy in RLS.</div></div><div><h3>Methods</h3><div>This study was registered on PROSPERO (CRD420251005571). Web of Science, Scopus, and PubMed were searched, from inception to March 31, 2025, to identify studies evaluating TOMAC for RLS. Risk of bias (Cochrane Risk of Bias Tool and Downs and Black checklist) and quality of evidence (Oxford Centre for Evidence-Based Medicine 2011 guidelines) of eligible studies were assessed. Primary outcomes were changes in International RLS Study Group Rating Scale (IRLS) score for efficacy and in Medical Outcomes Study Sleep Problem Index II (MOS-II) score for sleep improvement. Main safety outcome was the incidence of device-related adverse events. Subgroup analyses evaluated TOMAC as adjunctive therapy and as monotherapy, as well as by age, RLS age-of-onset, sex, RLS severity, and stimulation amplitude.</div></div><div><h3>Results</h3><div>Five studies from the United States were extracted including three randomized-controlled-trials with 252 participants for analyses (69 monotherapy/183 adjunctive TOMAC therapy). Relative to sham, TOMAC significantly reduced IRLS score both as adjunctive therapy (MD: 3.39, p = 0.0001) and monotherapy (mean difference [MD]: 3.80, p = 0.0047), and significantly reduced MOS-II score both as adjunctive therapy (MD: 8.23, p = 0.0006) and monotherapy (MD: 9.65, p = 0.0236). There were no significant differences in IRLS MD based on age, age of RLS onset, sex, RLS severity, and stimulation amplitude. Mild discomfort was the only adverse event with higher prevalence for TOMAC than sham.</div></div><div><h3>Conclusion</h3><div>These results suggest that TOMAC is a tolerable non-pharmacological treatment that reduces RLS symptoms and improves sleep, both as adjunctive therapy and as monotherapy.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108810"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024091","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}