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Contribution of sleep disturbances to cognitive changes in vascular cognitive impairment 睡眠障碍对血管性认知障碍患者认知变化的影响。
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-26 DOI: 10.1016/j.sleep.2025.106832
Jiaqi Luo , Fei Li , Pengjun Zhao , Jianwen Xu , Huijing Hu
{"title":"Contribution of sleep disturbances to cognitive changes in vascular cognitive impairment","authors":"Jiaqi Luo ,&nbsp;Fei Li ,&nbsp;Pengjun Zhao ,&nbsp;Jianwen Xu ,&nbsp;Huijing Hu","doi":"10.1016/j.sleep.2025.106832","DOIUrl":"10.1016/j.sleep.2025.106832","url":null,"abstract":"<div><h3>Background and purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 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}
引用次数: 0
Actigraphy and diary-assessed sleep in first-trimester pregnant women: A Bland-Altman analysis 活动记录仪和日记评估妊娠早期妇女的睡眠:一项Bland-Altman分析。
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-26 DOI: 10.1016/j.sleep.2025.106831
Shao-Yu Tsai , Pei-Lin Lee , Christopher Gordon , Shu-Yu Kuo , Chien-Nan Lee
{"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}
引用次数: 0
Identifying multimodal digital features of insomnia using an app in Hong Kong: An ecological momentary assessment study 在香港使用应用程序识别失眠的多模态数字特征:一项生态瞬时评估研究
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-24 DOI: 10.1016/j.sleep.2025.106825
Calvin Lam , Jie Chen , Kit Ying Chan , Joey W.Y. Chan , Ngan Yin Chan , Shirley Xin Li , Bei Huang , Yun Kwok Wing , Tim M.H. Li
{"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}
引用次数: 0
Actigraphy-based measures of sleep quality and duration are associated with maternal glycemia in mid-pregnancy 基于活动记录仪的睡眠质量和持续时间测量与孕妇妊娠中期的血糖有关
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106827
Robyn Larsen , Ashleigh Homer , Martha Lappas , Gabrielle Pell , Georgia I. Panagiotopoulos , Paddy C. Dempsey , Neville Owen , David W. Dunstan
{"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<sup>−1</sup>, <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<sup>−1</sup>, <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}
引用次数: 0
Suggested immobilization test in RLS clinical trials: A systematic review and methodological appraisal 建议固定试验在RLS临床试验:系统回顾和方法学评价。
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106828
Sasikanth Gorantla , Vamsi Krishna Gorijala , Lynn Marie Trotti
{"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}
引用次数: 0
Evaluating reduced cognitive flexibility as a link between Insomnia and future depression: A systematic review 评估认知灵活性降低与失眠和未来抑郁之间的联系:一项系统综述
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106824
Christopher A. Crawford, Kyle S. Minor, Melissa A. Cyders, Jesse C. Stewart
{"title":"Evaluating reduced cognitive flexibility as a link between Insomnia and future depression: A systematic review","authors":"Christopher A. Crawford,&nbsp;Kyle S. Minor,&nbsp;Melissa A. Cyders,&nbsp;Jesse C. Stewart","doi":"10.1016/j.sleep.2025.106824","DOIUrl":"10.1016/j.sleep.2025.106824","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is a causal risk factor for depression, but the underlying mechanisms are unclear. Reduced cognitive flexibility, a component of executive function, is linked to both insomnia and depression and may mediate their relationship. This systematic review evaluated this potential mediation model by examining studies reporting associations among insomnia, cognitive flexibility, and depression.</div></div><div><h3>Methods</h3><div>A comprehensive search identified 35 studies reporting associations between insomnia and cognitive flexibility (<em>a</em> path) and 11 studies examining cognitive flexibility as a predictor of future depression (<em>b</em> path). No studies formally tested cognitive flexibility as a mediator of the insomnia-depression relationship (<em>ab</em> path). Studies were assessed for quality and capacity for directional and causal inference. Findings were synthesized to evaluate the mediation model.</div></div><div><h3>Results</h3><div>For the <em>a</em> path, 35 studies reported 117 eligible associations. Longitudinal studies consistently reported null associations between insomnia and cognitive flexibility. Cross-sectional findings were also predominantly null. Significant associations generally did not withstand covariate adjustment or were observed only in older participants or those taking benzodiazepines. For the <em>b</em> path, 11 prospective cohort studies reported 37 eligible associations. Most associations were null, but significant associations emerged in participants without baseline depression, suggesting cognitive flexibility may relate more to depression risk than prognosis.</div></div><div><h3>Conclusions</h3><div>Current evidence does not support reduced cognitive flexibility as a mediator in the insomnia-depression pathway. Subjective cognitive concerns may offer a more promising explanatory mechanism. Future research should integrate objective and subjective cognitive assessments, test formal mediation models, and evaluate alternative pathways.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106824"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158420","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}
引用次数: 0
Patients’ experiences of group-delivered sleep restriction therapy in primary care: a qualitative study undertaken alongside a randomized controlled trial 初级保健患者群体睡眠限制疗法的经验:一项与随机对照试验同时进行的定性研究
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106822
Christina Bini , Josefin Bäckström , Kristofer Årestedt , Markus Jansson-Fröjmark , Christina Sandlund
{"title":"Patients’ experiences of group-delivered sleep restriction therapy in primary care: a qualitative study undertaken alongside a randomized controlled trial","authors":"Christina Bini ,&nbsp;Josefin Bäckström ,&nbsp;Kristofer Årestedt ,&nbsp;Markus Jansson-Fröjmark ,&nbsp;Christina Sandlund","doi":"10.1016/j.sleep.2025.106822","DOIUrl":"10.1016/j.sleep.2025.106822","url":null,"abstract":"<div><h3>Background</h3><div>Sleep restriction therapy (SRT) is an effective and brief behavioral treatment for insomnia and could serve as a valuable complement to insomnia care. This study explores patients’ experiences of being offered and attending group-SRT at their primary care centers, including experiences of feasibility and mechanisms of impact.</div></div><div><h3>Methods</h3><div>This qualitative study was undertaken alongside a randomized controlled trial on nurse-led group-SRT in Swedish primary care, involving adults with insomnia disorder. Semi-structured interviews were conducted within three months post-intervention with fourteen patients. Verbatim transcripts were analyzed using qualitative content analysis before trial results were examined. The study was guided by the Medical Research Council framework for process evaluation of complex interventions.</div></div><div><h3>Results</h3><div>The result is presented in two themes: <em>Increased knowledge, motivation, and flexibility in enhancing adherence to group-SRT</em> and <em>Struggles, solutions, and group dynamics: A path to empowerment</em>. Patients found that understanding sleep reinforced their commitment to group-SRT by providing a rationale for participation. Adherence was influenced by treatment flexibility, personal motivation, and group dynamics. Patients experienced that while group-SRT was challenging, it also offered solutions for better sleep. However, life circumstances and depressive symptoms hindered compliance.</div></div><div><h3>Conclusions</h3><div>Patients' experience of group-SRT were influenced by the patient-provider relationship, motivation, and comorbid depression, all which impacted engagement. This study provides valuable insights into how patients perceive group-SRT, contributing to the refinement of future insomnia treatments. Further research should explore healthcare providers’ perspectives on both the challenges and opportunities for implementing group-SRT in primary care.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106822"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158422","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}
引用次数: 0
Excessive daytime sleepiness and sex-related differences in the clinical presentation of obstructive sleep apnea in Italian patients 意大利患者阻塞性睡眠呼吸暂停临床表现的日间过度嗜睡和性别相关差异
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106819
Giuseppe Insalaco , Alberto Braghiroli , Francesca Buzzi , Simone Cappellano , Alessandro Castelli , Alessandra Castelnuovo , Francesco Fanfulla , Luigi Ferini Strambi , Anna Lo Bue , Sara Marelli , Fabio Pizza , Fabio Placidi , Giuseppe Plazzi , Caterina Pronzato , Andrea Romigi , Tommaso Sacco , Adriana Salvaggio , Maria Rosaria Bonsignore
{"title":"Excessive daytime sleepiness and sex-related differences in the clinical presentation of obstructive sleep apnea in Italian patients","authors":"Giuseppe Insalaco ,&nbsp;Alberto Braghiroli ,&nbsp;Francesca Buzzi ,&nbsp;Simone Cappellano ,&nbsp;Alessandro Castelli ,&nbsp;Alessandra Castelnuovo ,&nbsp;Francesco Fanfulla ,&nbsp;Luigi Ferini Strambi ,&nbsp;Anna Lo Bue ,&nbsp;Sara Marelli ,&nbsp;Fabio Pizza ,&nbsp;Fabio Placidi ,&nbsp;Giuseppe Plazzi ,&nbsp;Caterina Pronzato ,&nbsp;Andrea Romigi ,&nbsp;Tommaso Sacco ,&nbsp;Adriana Salvaggio ,&nbsp;Maria Rosaria Bonsignore","doi":"10.1016/j.sleep.2025.106819","DOIUrl":"10.1016/j.sleep.2025.106819","url":null,"abstract":"<div><h3>Background</h3><div>Excessive Daytime Sleepiness (EDS) is a key symptom of Obstructive Sleep Apnea (OSA). The clinical presentation of OSA differs between sexes. EDS and sex-related clinical differences were studied in Italian OSA patients.</div></div><div><h3>Objectives</h3><div>This multicenter study in Italian OSA patients at diagnosis assessed: 1) the EDS prevalence and its association with OSA severity, comorbidities, and other symptoms; 2) sex-related differences in clinical features of OSA.</div></div><div><h3>Methods</h3><div>Patient-reported data on symptoms and comorbidities were retrospectively collected from eCRF in 2663 patients (age, mean ± SD 55.7 ± 9.4 years, M 77.4 %, BMI 31.2 ± 4.6 kg/m<sup>2</sup>). EDS was defined as an Epworth Sleepiness Score &gt;10.</div></div><div><h3>Results</h3><div>Overall, 39.5 % of patients reported EDS at diagnosis, especially younger and obese patients.</div><div>Referral patterns and symptoms driving OSA evaluation were affected by both occurrences of EDS and sex. OSA was more severe in patients with than without EDS. At multivariate analysis, predictors of EDS were: fatigue, subjectively impaired cognitive function, and % time spent at oxygen saturation&lt;90 %, while being on a hypocaloric diet was protective. Women showed milder OSA severity but similar prevalence of EDS, and a different clinical phenotype and comorbidities, i.e., higher rates of fatigue, anxiety, depression, arterial hypertension, cognitive dysfunction, type 2 diabetes, gastroesophageal reflux, and asthma.</div></div><div><h3>Conclusion</h3><div>EDS occurred in &lt;50 % of Italian untreated OSA patients and appeared modulated by several symptoms and hypoxemia. Compared to men, women showed similar EDS and a different pattern of symptoms/comorbidities. These findings provide insights for tailoring clinical management strategies in the Italian population.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106819"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158424","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}
引用次数: 0
Efficacy and safety of lemborexant in patients with insomnia: a systematic review and meta-analysis lemborexant对失眠症患者的疗效和安全性:一项系统综述和荟萃分析
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106823
Allahdad Khan , Shree Rath , Hamza Khan , Umama Alam , Hammad Javaid , Zaryab Bacha , Asad Ali Ahmed Cheema , Umair Hayat , Muhammad Abdullah Ali , Abdul Qadeer , Charles Dominic Ward , Raheel Ahmed
{"title":"Efficacy and safety of lemborexant in patients with insomnia: a systematic review and meta-analysis","authors":"Allahdad Khan ,&nbsp;Shree Rath ,&nbsp;Hamza Khan ,&nbsp;Umama Alam ,&nbsp;Hammad Javaid ,&nbsp;Zaryab Bacha ,&nbsp;Asad Ali Ahmed Cheema ,&nbsp;Umair Hayat ,&nbsp;Muhammad Abdullah Ali ,&nbsp;Abdul Qadeer ,&nbsp;Charles Dominic Ward ,&nbsp;Raheel Ahmed","doi":"10.1016/j.sleep.2025.106823","DOIUrl":"10.1016/j.sleep.2025.106823","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is a prevalent sleep disorder that significantly impacts quality of life and overall health. Lemborexant, a dual orexin receptor antagonist, has emerged as a promising treatment. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Lemborexant in adults with insomnia.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, Cochrane, and clinicaltrials.gov through March 5, 2025, for randomized controlled trials (RCTs) comparing lemborexant with placebo. Primary outcomes included changes in wake after sleep onset (WASO), sleep efficiency, and sleep onset latency. Safety outcomes included treatment-emergent adverse events (TEAEs), treatment-related TEAEs, and headache. Data were synthesized using a random-effects model and assessed for heterogeneity. Meta-analyses used a random-effects model and heterogeneity was assessed using the I<sup>2</sup> statistic.</div></div><div><h3>Results</h3><div>Six RCTs involving 2257 patients were included. Lemborexant significantly reduced WASO (MD: 20.73 min; 95 % CI: 28.58 to −12.88), improved sleep efficiency (MD: 4.84 %; 95 % CI: 2.69 to 7.00), and reduced sleep onset latency (MD: 10.85 min; 95 % CI: 18.47 to −3.23). Lemborexant was associated with a higher risk of treatment-related TEAEs (RR: 1.82; 95 % CI: 1.41 to 2.34) but showed no significant difference in overall TEAEs or headache compared to placebo.</div></div><div><h3>Conclusion</h3><div>Lemborexant demonstrates significant efficacy in improving sleep parameters in patients with insomnia and has a generally favorable safety profile. These findings support its role as an effective pharmacological option. Further high-quality studies are needed to confirm its efficacy and safety.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106823"},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158421","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}
引用次数: 0
Procedural learning worsens with OSA severity in older adults and is insensitive to short exposure supplemental oxygen therapy 在老年人中,程序性学习随着OSA的严重程度而恶化,并且对短时间暴露的补充氧治疗不敏感
IF 3.4 2区 医学
Sleep medicine Pub Date : 2025-09-23 DOI: 10.1016/j.sleep.2025.106821
Christian D. Harding , Breanna M. Holloway , Pamela N. DeYoung , Crystal Kwan , Ina Djonlagic , Sonia Ancoli-Israel , Xiaoying Sun , Sonia Jain , Sarah J. Banks , Atul Malhotra
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