Sleep medicine最新文献

{"title":"Sleep disturbances in children and adolescents with epilepsy: Clinical, polysomnographic and management aspects","authors":"Camila dos Santos El Halal ,&nbsp;Magda Lahorgue Nunes","doi":"10.1016/j.sleep.2026.108794","DOIUrl":"10.1016/j.sleep.2026.108794","url":null,"abstract":"<div><h3>Background</h3><div>Sleep and epilepsy interact through bidirectional neurobiological mechanisms. In children, sleep disturbances are highly prevalent and may exacerbate seizures while adversely affecting cognition, behaviour, and quality of life.</div></div><div><h3>Objective</h3><div>To synthesise current evidence on sleep disturbances in paediatric epilepsy by integrating subjective reports and objective sleep measures across epilepsy severity, syndromes, and common neurodevelopmental comorbidities, and to discuss implications for clinical management.</div></div><div><h3>Methods</h3><div>Narrative review of studies assessing sleep in children and adolescents with epilepsy using validated questionnaires and objective tools, including polysomnography/video-EEG–polysomnography, actigraphy, and cyclic alternating pattern analysis. Evidence was summarised according to epilepsy severity, epilepsy syndrome, comorbid ADHD/ASD, caregiver outcomes, and management strategies.</div></div><div><h3>Results</h3><div>Questionnaire-based studies consistently report high rates of sleep problems and associations with behavioural difficulties and poorer cognitive performance. Objective evidence, including meta-analytic data, demonstrates reduced total sleep time, decreased sleep efficiency, increased sleep fragmentation, and altered sleep-stage distribution compared with healthy controls. Drug-resistant epilepsy shows a severity gradient characterised by marked macrostructural disruption (reduced N3 and REM sleep, increased wake after sleep onset) and microstructural NREM instability, particularly in children with cognitive impairment. Reported sleep alterations appear syndrome-specific and influenced by seizure burden, nocturnal epileptiform activity, and treatment-related factors. Sleep disruption is also prominent in epilepsy with neurodevelopmental comorbidities and is closely associated with caregiver sleep disturbance and mental health burden.</div></div><div><h3>Conclusions</h3><div>Sleep impairment in childhood epilepsy is common, clinically meaningful, and potentially modifiable. Systematic screening with validated tools and targeted objective assessment may support interventions that improve sleep quality, seizure-related outcomes, daytime functioning, and family well-being.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108794"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between high loop gain sleep apnea detected by respiratory self-similarity and left ventricular remodeling","authors":"Wentao Wu ,&nbsp;Shanlin Zhong ,&nbsp;Eline Oppersma ,&nbsp;Wolfgang Ganglberger ,&nbsp;Fengming Luo ,&nbsp;Yuenan Ni ,&nbsp;Robert Joseph Thomas","doi":"10.1016/j.sleep.2026.108796","DOIUrl":"10.1016/j.sleep.2026.108796","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated if high loop gain (HLG), a specific sleep apnea endotype characterized by unstable respiratory control, is independently associated with adverse cardiac remodeling.</div></div><div><h3>Methods</h3><div>Using the Multi-Ethnic Study of Atherosclerosis (MESA) data, a HLG surrogate was quantified using a polysomnographic algorithm measuring respiratory self-similarity (Central Respiratory Event Index [CREI] and respiratory Self-Similarity [SS%]). Cardiac structure was assessed via MRI. Multivariable linear regression analyzed probable HLG associations with the left ventricular mass-to-volume ratio (LVMVR). Propensity score matching compared SS and CREI between participants with and without reduced left ventricular ejection fraction (LVEF).</div></div><div><h3>Results</h3><div>Severe expressed HLG was defined as the top 2.5 % of CREI values, a criterion that categorized 35 of the 1440 participants, and showed higher LVMVR (1.23 ± 0.31 vs 1.03 ± 0.22, p &lt; 0.001). After central sleep apnea (CSA) adjustment, severe expressed HLG remained an independent predictor for LVMVR (β = 0.110 ± 0.068, p = 0.002) with a significant sex interaction (p for interaction = 0.041), observed in males (β = 0.15 ± 0.09, p &lt; 0.001) but not females. Reduced LVEF participants exhibited elevated SS% (11.41 ± 8.07 vs 8.13 ± 6.26, p = 0.037) and CREI (29.25 ± 19.50 vs 21.49 ± 19.86, p = 0.032). Post-PSM, differences persisted (SS%: 11.53 ± 8.26 vs 7.26 ± 7.07, p = 0 0.032; CREI: 28.96 ± 19.60 vs 18.15 ± 18.46, p = 0.041).</div></div><div><h3>Conclusion</h3><div>Expressed HLG may be an important biomarker for left ventricular modeling/HF progression and allow risk stratification for targeted management.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108796"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047257","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":"Rising U.S. mortality associated with coexisting obstructive sleep apnea and obesity, 1999–2019","authors":"Areej Javeid ,&nbsp;Dinesh Kumar ,&nbsp;Javeria Nawaz ,&nbsp;Diya Rathi ,&nbsp;Wajeeh Hassan ,&nbsp;Saad Ahmed Waqas ,&nbsp;Bareera Wajahat","doi":"10.1016/j.sleep.2026.108783","DOIUrl":"10.1016/j.sleep.2026.108783","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive Sleep Apnea (OSA) and obesity are common health conditions in sleep medicine and nutrition sciences, respectively. The two conditions frequently co-exist and are likely to influence each other. While obesity is one among many factors that predispose individuals to OSA, OSA may also worsen metabolic health and contribute to weight gain. Their coexistence, therefore, may compound mortality risk. However, national mortality patterns among individuals with concomitantly occurring OSA and obesity remain underexplored.</div></div><div><h3>Objective</h3><div>To evaluate regional and demographic disparities in mortality among adults with coexisting OSA and obesity in the United States (U.S.) from 1999 to 2019.</div></div><div><h3>Methods</h3><div>This retrospective analysis used death certificate data from the US CDC WONDER database of adults ≥25 years with concomitantly occurring OSA and obesity. Age-adjusted mortality rates (AAMRs) per 100,000 population, annual percent change (APC), and average annual percent change (AAPC) were calculated through Joinpoint regression. We used ICD-10 codes for OSA (G47.3) and obesity (E66).</div></div><div><h3>Results</h3><div>Between 1999 and 2019, a total of 60,898 deaths were attributed to coexisting OSA and obesity, with an overall AAMR of 1.35. Notably, the AAMR increased from 1999 to 2005 (APC = 14.55; 95 % CI: 12.51 to 16.63), followed by a further increase from 2005 to 2013 (APC = 6.36; 95 % CI: 5.49 to 7.25), and finally increased until 2019 (APC: 3.43; 95 % CI: 2.5 to 4.36). Men had higher AAMRs than women (1.67 vs 1.05, respectively). Non-Hispanic (NH) African Americans had the highest AAMRs (1.99), followed by NH Whites (1.37) and Hispanics (0.84). Among different age groups, individuals aged 65+ had the highest AAMR (2.75). Geographically, the Midwest had the highest AAMR (1.56), followed by the West (1.55), South (1.29), and Northeast (0.99). Rural areas AAMRs (1.62) dominated the urban areas AAMRs (1.29).</div></div><div><h3>Conclusions</h3><div>An overall increasing trend in mortality was seen in adults with coexisting OSA and obesity in the US from 1999 to 2019, although these results may be affected by under-reporting of OSA on death certificates. Notable disparities in mortality were observed among NH African Americans, males over 65 years, and residents of rural and Midwestern regions. These rising mortality trends underscore the importance of timely recognition and clinical evaluation of individuals with co-occurring OSA and obesity. These findings further highlight the need for integrated obesity and sleep-health surveillance programs at the macro level. At the meso level, preventive screening measures for high-risk populations should be implemented. Early detection, lifestyle interventions, and adherence to the treatment should be prioritised at the micro level.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108783"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980743","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":"Beyond the X's and Z's: Sleep disorders in Klinefelter syndrome from case report to cohort and literature review","authors":"Nayla Ahmed ,&nbsp;Julie M. Baughn ,&nbsp;Christine A. Matarese ,&nbsp;Timothy I. Morgenthaler","doi":"10.1016/j.sleep.2026.108782","DOIUrl":"10.1016/j.sleep.2026.108782","url":null,"abstract":"<div><h3>Study objectives</h3><div>Klinefelter syndrome (KS) is a genetic disorder characterized by hypogonadism and hormone imbalances. The coexistence of sleep disorders in the setting of Klinefelter syndrome is relatively unexplored in literature, highlighting the need for better understanding.</div></div><div><h3>Methods</h3><div>We reviewed the case of a 29-year-old male with Klinefelter syndrome, sleep disruption, and an abnormal overnight oximetry. This case prompted a retrospective chart review of patients with KS seen at our institution since 2000, as well as a review of the literature of sleep disorders in Klinefelter syndrome.</div></div><div><h3>Results</h3><div>We identified that nearly one-third of confirmed patients with KS had either confirmed or suspected Obstructive Sleep Apnea (OSA), a markedly higher prevalence than reported in the general population. Additionally, although the prevalence of Central Sleep Apnea (CSA) in KS in our series was similar to that of the general population, its occurrence in the absence of typical risk factors suggests a predisposition to idiopathic CSA. Although circadian rhythm disorders have been described in individual reports, our review did not identify many cases, implying that these disorders may be underrecognized or less commonly documented in routine care.</div></div><div><h3>Conclusions</h3><div>The prevalence of presumed idiopathic CSA in confirmed patients with KS raises the possibility of KS-specific mechanisms of ventilatory control instability. Importantly, three-quarters of patients with KS with documented sleep complaints had no formal sleep medicine evaluation, underscoring a gap in structured assessment. This may be secondary to constraints surrounding access or referral bias, and bears further evaluation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108782"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980744","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 health in the family Context: Predictors and qualitative exploration of parentally perceived early childhood insomnia","authors":"Hatice Ezgi Baris ,&nbsp;Mahmut Caner Us ,&nbsp;Hulya Barlak ,&nbsp;Perran Boran","doi":"10.1016/j.sleep.2026.108817","DOIUrl":"10.1016/j.sleep.2026.108817","url":null,"abstract":"<div><h3>Background</h3><div>Early childhood sleep problems are associated with adverse parental outcomes. Limited research has examined parentally perceived early childhood insomnia (ECI) using a family sleep health framework. This mixed-method study investigated the predictors of parent-reported ECI, fusing a family sleep health framework.</div></div><div><h3>Methods</h3><div>Infants aged 6–36 months with and without sleep problems and their parents were included based on a convenience sample. Infant sleep was evaluated by Brief Infant Sleep Questionnaire (BISQ) and actigraphy. Parents were assessed for mental health symptoms, sleep characteristics and in-depth interviews were conducted to explore parental perception of infant sleep. Logistic regression was used to identify predictors of parentally perceived ECI, and thematic analysis was applied to qualitative data.</div></div><div><h3>Results</h3><div>41 families with ECI and 45 without ECI were included. According to the BISQ, infants with ECI had longer sleep onset time and wakefulness after sleep onset, more frequent night awakenings and shorter total sleep duration (p &lt; 0.01). Actigraphy data revealed no significant differences except for later bedtimes and wake times in the control group. Mothers in the ECI group had higher depression and anxiety scores (p &lt; 0.01), and fathers had higher anxiety scores (p = 0.048). After controlling for parental mental health, higher number of infant night awakenings, maternal daytime dysfunction and paternal subjective sleep quality were predicting parentally perceived ECI. Qualitative data revealed that parental emotional adaptation and expectations shaped the perception of sleep problems.</div></div><div><h3>Conclusion</h3><div>Parentally perceived ECI has impacts on the whole family sleep health, associated prominently with reduced infant nocturnal sleep continuity, increased maternal daytime dysfunction and poorer paternal sleep quality.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108817"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114131","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 apnoea and its consequences: from animal models to precision medicine","authors":"Raphael Heinzer ,&nbsp;Jean-Louis Pepin ,&nbsp;Silke Ryan ,&nbsp;Claire Arnaud ,&nbsp;Margaux Blanchard ,&nbsp;Rene Cortese ,&nbsp;Carolina Lombardi ,&nbsp;Oren Cohen ,&nbsp;Adrien Waeber ,&nbsp;Martino Pengo ,&nbsp;Yuksel Peker ,&nbsp;Jordi de Batlle ,&nbsp;Walter T. McNicholas ,&nbsp;Winfried Randerath ,&nbsp;Frederic Gagnadoux ,&nbsp;Ali Azarbarzin ,&nbsp;Manuel Sanchez-de-la-Torre","doi":"10.1016/j.sleep.2026.108777","DOIUrl":"10.1016/j.sleep.2026.108777","url":null,"abstract":"<div><div>A European Respiratory Society research seminar entitled \"Sleep Apnoea and Its Consequences: From Animal Models to Precision Medicine\" was held in January 2024 in Lisbon, Portugal. It provided an in-depth analysis of the current landscape and future directions in OSA research, integrating recent findings from metabolomics, animal models, clinical predictors of cardiometabolic consequences of OSA, artificial intelligence (AI), and advances in diagnostic algorithms. This article presents a narrative review of the seminar's key discussions and conclusions.</div><div>The limitations of current randomized controlled trials (RCTs) in assessing OSA treatment, such as low adherence and patient selection bias (e.g., absence of sleepiness or severe hypoxemia), were critically discussed. The expert panel recommended the use of real-world data, including patients commonly seen in clinical practice, and the use of digital tools for real-time monitoring of adherence and side effects. The concept of platform \"disease-focused\" trials was discussed as a more efficient and adaptable research design that could allow clinical trials to be more representative of the general OSA population and to compare CPAP with emerging treatments such as new drugs, devices and lifestyle interventions to gain a broader understanding of effective management strategies.</div><div>The seminar concluded that a multifaceted approach to OSA research that leverages the strengths of animal models, advanced AI, metabolomics, and improved diagnostic algorithms is needed to gain deeper insights into the mechanisms of OSA and its treatment response. This new approach, coupled with new \"platform\" clinical trial designs, could contribute to improved outcomes in patients with OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108777"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980848","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 effect of Dual Orexin Receptor Antagonists on sleep: a systematic review and pairwise meta-analysis","authors":"Anastasios Stefanou ,&nbsp;Paraskevi Lampropoulou ,&nbsp;Paraskevi Papageorgiou ,&nbsp;Ioanna Boskou ,&nbsp;Andreas S. Lappas ,&nbsp;Nikolaos Christodoulou ,&nbsp;Vasilios Panteleimon Bozikas ,&nbsp;Myrto T. Samara","doi":"10.1016/j.sleep.2026.108792","DOIUrl":"10.1016/j.sleep.2026.108792","url":null,"abstract":"<div><div>Evidence supporting pharmacological treatment of insomnia remains limited. Dual orexin receptor antagonists (DORAs), a novel drug class, show therapeutic promise. This systematic review and meta-analysis evaluates DORAs’ efficacy, safety, and tolerability across all eligible populations, regardless of diagnosis.</div><div>We systematically searched MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, WHO ICTRP, ClinicalTrials.gov through January 2026 for randomised controlled trials comparing DORAs with placebo. We included studies across all patient populations. Analyses employed random-effects models, calculating risk ratios (RR) for dichotomous outcomes, weighted mean differences (MD) for continuous outcomes, and standardised mean differences (SMD) when scales varied. Primary outcomes included subjective total sleep time, sleep quality, treatment-emergent somnolence and insomnia. Subgroup and sensitivity analyses explored heterogeneity and result robustness.</div><div>77 trials (16,416 participants) were included. DORAs improved subjective total sleep time (MD = 18.91 min , 95 % CI: 15.87 to 21.95). Sleep quality was not improved (SMD = 0.19, 95 % CI: 0.02 to 0.39). DORAs increased the risk of somnolence (RR = 2.91, 95 % CI: 2.31 to 3.67), while no difference was found for insomnia (RR = 0.97, 95 % CI: 0.60 to 1.57). Effects were consistent across treatment durations.</div><div>DORAs appear largely efficacious, safe and tolerable. Clinical interpretation should be done with caution, in conditions other than insomnia, as data for these diagnoses were scarce.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108792"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079422","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":"Modulation of spinal and cortical neuronal excitability by transcutaneous spinal direct current stimulation in restless legs syndrome","authors":"Li Wang ,&nbsp;Wensi Hao ,&nbsp;Dequan Wang ,&nbsp;Siran Li ,&nbsp;Xin Su ,&nbsp;Chunyan Liu ,&nbsp;Yuping Wang","doi":"10.1016/j.sleep.2026.108789","DOIUrl":"10.1016/j.sleep.2026.108789","url":null,"abstract":"<div><h3>Study objectives</h3><div>This study explored the changes in cortical and spinal excitability in patients with restless legs syndrome (RLS) induced by transcutaneous spinal cord direct current stimulation (tsDCS), thereby revealing the neural electrophysiological mechanism underlying tsDCS-mediated improvements in RLS symptoms.</div></div><div><h3>Methods</h3><div>Thirty patients with RLS were randomly assigned to active RLS-tsDCS group or sham stimulation group for 2 consecutive weeks. Symptom severity and sleep quality were assessed using the International Restless Legs Syndrome Rating Scale (IRLS-RS) and the Pittsburgh Sleep Quality Index (PSQI). Electrophysiological parameters, including the H-reflex from the gastrocnemius muscle and transcranial magnetic stimulation-induced motor evoked potentials (TMS-MEP), were performed to assess changes in cortical and spinal excitability before and after treatment.</div></div><div><h3>Results</h3><div>The main analysis showed that the improvement in IRLS-RS score in the RLS-tsDCS group (Δ = 12.20 ± 5.68) was significantly greater than that in the sham stimulation group (Δ = 1.20 ± 3.59, t = 6.337, p = 0.000). PSQI score improvement was greater in the RLS-tsDCS group (Δ = 4.60 ± 2.72) compared to the sham stimulation group (Δ = 0.40 ± 2.26; t = 4.598, p &lt; 0.001). After 14 days tsDCS treatments, the RLS-tsDCS group exhibited a significantly prolonged cortical silent period, a significant increase in MEP amplitude after 15min rest during movement tasks, and a significant reduction in the paired H-reflex ratio (H2/H1) in the lower limbs compared to baseline. No significant changes were observed in any neurophysiological parameters in the sham stimulation group.</div></div><div><h3>Conclusion</h3><div>Our research results indicated that anodal tsDCS can significantly improve the clinical symptoms of RLS patients and reduce the IRLS-RS and PSQI scores. This may be achieved through tsDCS enhancing the cortical inhibitory function and thereby reducing spinal neuronal excitability.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108789"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079423","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":"Relationship between hypoxic burden and cardiovascular effects in OSA – a post hoc analysis of an RCT","authors":"Matteo Bradicich ,&nbsp;Lara Benning ,&nbsp;Zoe Bousraou ,&nbsp;John R. Stradling ,&nbsp;Malcolm Kohler ,&nbsp;Esther Irene Schwarz","doi":"10.1016/j.sleep.2026.108799","DOIUrl":"10.1016/j.sleep.2026.108799","url":null,"abstract":"<div><h3>Objectives</h3><div>Hypoxic burden (HB) quantifies obstructive sleep apnoea (OSA)-associated nocturnal intermittent hypoxemia as the area under the peripheral desaturation curve near an apnoeic or hypopnoeic event. We assessed whether HB is a better marker of the cardiovascular effects of OSA than usual OSA severity markers.</div></div><div><h3>Methods</h3><div>In a continuous positive airway pressure (CPAP) withdrawal study in OSA patients (apnoea-hypopnoea-index (AHI) &gt; 10/h), randomized in a 1:1 ratio to two weeks of CPAP continuation or sham CPAP, the relationship between the treatment effect on HB (ΔHB) and the treatment effect on office morning blood pressure, heart rate (HR), endothelial function (flow-mediated dilatation, FMD), and urinary catecholamines was assessed using linear regression and multivariate fractional polynomial regression. The capacity of ΔHB in predicting CPAP response of these cardiovascular outcomes was compared with other OSA severity markers.</div></div><div><h3>Results</h3><div>In 40 patients with OSA (age 63.1 ± 5.8y, AHI at diagnosis 37 (26–55)/h), AHI and HB significantly increased after CPAP withdrawal compared to the control group with 28 (19–62)/h and 37.8 (18.8–112.6) %min/h. Controlling for baseline values and confounders, ΔHB was associated with change in urinary catecholamines and morning HR, but not in FMD, morning blood pressure and nocturnal HR. Using a multivariate fractional polynomial regression model, ΔHB predicted the CPAP effect on catecholamines and morning HR better than AHI, oxygen desaturation index (ODI), time&lt;90 % SpO₂, and arousal index.</div></div><div><h3>Conclusions</h3><div>HB in untreated OSA was associated with an increase in urinary catecholamines and morning HR and predicted their CPAP response better than other OSA severity markers.</div></div><div><h3>Trial registration</h3><div><span><span>Controlled-Trials.com</span><svg><path></path></svg></span>, registration number ISRCTN 93153804.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108799"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079424","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":"Intelligence quotient in adults with idiopathic hypersomnia and narcolepsy type 1","authors":"Elisee Zhuang ,&nbsp;Pauline Dodet ,&nbsp;Smaranda Leu-Semenescu ,&nbsp;Charlotte Chaumereuil ,&nbsp;Ginevra Uguccioni ,&nbsp;Jean-Baptiste Maranci ,&nbsp;Ana-Zenovia Gales ,&nbsp;Benjamin Dudoignon ,&nbsp;Isabelle Arnulf","doi":"10.1016/j.sleep.2026.108778","DOIUrl":"10.1016/j.sleep.2026.108778","url":null,"abstract":"<div><h3>Study objectives</h3><div>Given that intelligence quotient (IQ) has not previously been assessed in idiopathic hypersomnia (IH) and only rarely in adults with narcolepsy type 1 (NT1), this study examined IQ in adults with IH and NT1.</div></div><div><h3>Methods</h3><div>The Wechsler Adult Intelligence Scale–Fourth Edition (WAIS-IV), comprising the Full Scale IQ, four indices and 10 subtests, was administered to 29 participants with IH (22 women; age: 34.1 ± 11.3 y [mean ± SD]; Epworth Sleepiness Scale [ESS] score: 12.4 ± 4.7), 30 with NT1 (19 women; age: 30.1 ± 10.6 y; ESS: 15.5 ± 5), and 30 healthy controls (21 women, age: 30.7 ± 8.7 y; ESS: 5.0 ± 3.6).</div></div><div><h3>Results</h3><div>Full-Scale IQ scores differed across groups (IH: 114.6 ± 13.4; NT1: 104.1 ± 14.3; and controls: 108.4 ± 17.0; <em>p</em> = 0.03, medium effect size). Both IH and NT1 groups showed IQ comparable to controls, although IH participants tended to outperform those with NT1. Group differences emerged in the perceptual reasoning and working memory domains, although none of pairwise comparisons reached significance. The only cognitive area showing group differences was visuospatial reasoning. Global cognitive abilities, including Full-scale IQ, General Ability Index, Verbal Comprehension Index and Working Memory Index showed moderate correlation with years of education, though not with disease duration, daytime sleepiness or treatment status. Pre-test fatigue, though not daytime sleepiness, was associated with poorer working memory performances.</div></div><div><h3>Conclusions</h3><div>Adults with IH and NT1 exhibit normal-range IQs despite chronic hypersomnolence and cognitive complaints. Emphasizing preserved intellectual functioning may contribute to enhanced self-esteem and support professional development in these populations.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108778"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967024","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}