Sleep medicine最新文献

{"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 , 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":"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":"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":"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":"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":"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}

{"title":"A case report of dyadic CBT-I treatment for post-stroke insomnia with severe impairment","authors":"Kelly Glazer Baron","doi":"10.1016/j.sleep.2026.108765","DOIUrl":"10.1016/j.sleep.2026.108765","url":null,"abstract":"<div><div>Sleep disorders, including insomnia and sleep apnea, are highly prevalent among stroke survivors and impact quality of life and mortality risk. Moreover, patient sleep disruptions contribute to poor sleep and burnout among caregivers. Although CBT-I is the first-line recommended treatment for chronic insomnia disorder, mobility and cognitive impairments increase barriers for stroke survivors to engage in CBT-I. This case report demonstrates a dyadic perspective on insomnia treatment in a patient who experienced a both stroke and cancer treatment. The description discusses the facilitating factors and barriers from his spouse/caregiver who experiences challenges to treatment related to the patient illness and caregiver sleep disruption/burden. The case demonstrates how the therapist and couple worked collaboratively using a dyadic perspective to problem solve barriers to CBT-I and demonstrates effects of sleep improvement on the patient and caregiver.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108765"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980745","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":"Endogenous circadian rhythm sleep disorders through the lens of nonparametric variables of actigraphy: an exploratory study in myotonic dystrophy type 1","authors":"Luc Laberge ,&nbsp;Olivier Turcotte ,&nbsp;Nathalie Angeard ,&nbsp;Alexandre Maltais ,&nbsp;Jeanne-Sophie Martin ,&nbsp;Cynthia Gagnon","doi":"10.1016/j.sleep.2026.108781","DOIUrl":"10.1016/j.sleep.2026.108781","url":null,"abstract":"<div><h3>Background</h3><div>A recent case study reported a non-24 h sleep-wake disorder in a patient with myotonic dystrophy type 1 (DM1). Research on intrinsic circadian rhythm sleep-wake disorders (CRSWDs) in DM1 patients is though lacking. This study utilized actigraphy to ascertain the presence of CRSWDs in DM1 patients and establish a comparison with healthy control subjects.</div></div><div><h3>Methods</h3><div>Thirty-three patients with genetic diagnosis of DM1 and 33 age- and sex-matched healthy control subjects wore an actigraph and filled out a sleep diary for two consecutive weeks. Sleep, light exposure, and nonparametric measures were computed from actigraphic data.</div></div><div><h3>Results</h3><div>DM1 patients exhibit poorer sleep quality and delayed sleep-wake episodes as well as reduced daylight exposure compared to healthy control subjects. Importantly, 3 DM1 patients (9.1 %) had a delayed sleep phase disorder and 3 DM1 patients had an irregular sleep-wake rhythm disorder (ISWRD) (9.1 %) whereas no control subject exhibited a CRSWD. DM1 patients with an ISWRD presented lower inter-daily stability (IS) (0.16 vs. 0.44, p &lt; 0.05) and relative amplitude (RA) (0.36 vs. 0.79, p &lt; 0.01) as well as higher intra-daily variability (IV) (1.22 vs. 0.79, p &lt; 0.05) than DM1 patients with a normal sleep phenotype. DM1 patients with CRSWDs were more likely to exhibit excessive daytime sleepiness (EDS) than those with a normal sleep phenotype (83.3 % vs. 37.0 %, p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Core clinical implications are the need to systematically screen DM1 patients for CRSWDs and apply a multimodal chronotherapy (sleep hygiene, timed light, and melatonin). Recognizing and treating CRSWDs can help address significant sleep disturbances, like EDS.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108781"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980806","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":"Regional, cultural, and socioeconomic differences in sleep health: enhancing local representation to increase global relevance","authors":"Stijn A.A. Massar ,&nbsp;Rachel N.Y. Chan","doi":"10.1016/j.sleep.2026.108770","DOIUrl":"10.1016/j.sleep.2026.108770","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108770"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967091","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}