Sleep medicine最新文献

{"title":"Response to “Letter to the editor regarding ‘Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea’ by Kushida et al.”","authors":"Clete A. Kushida , Gary K. Zammit , Jocelyn Y. Cheng , Dinesh Kumar , Margaret Moline","doi":"10.1016/j.sleep.2025.02.014","DOIUrl":"10.1016/j.sleep.2025.02.014","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Page 195"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430337","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":"Aperiodic and periodic components of resting-state EEG in primary insomnia","authors":"Duo Bai ,&nbsp;Yatong Guo ,&nbsp;Simon Jülich ,&nbsp;Xu Lei","doi":"10.1016/j.sleep.2025.02.007","DOIUrl":"10.1016/j.sleep.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is one of the most prevalent health concerns within the general population, with a multitude of existing electroencephalographic (EEG) spectral studies supporting heightened levels of high-frequency EEG activity as an index of cortical arousal. Nevertheless, traditional spectral analysis has been limited by its inability to distinguish between aperiodic and periodic elements. In contrast, a novel method, Spectral Parameterization (SpecParam), can separate these components and reveal the neural mechanisms of cortical arousal.</div></div><div><h3>Methods</h3><div>The aperiodic and periodic activities of 42 insomnia disorder (ID) patients and 45 age- and sex-matched healthy controls (HC) were evaluated during eyes-closed resting state. The associations between behavioral scales and aperiodic/periodic parameters were further examined to elucidate the underlying psychophysiological significance.</div></div><div><h3>Results</h3><div>We found that the aperiodic exponent was diminished in the ID group compared to the HC group. Additionally, the ID group exhibited an elevated central frequency and a more constrained bandwidth for periodic activity within the alpha band. Within-group correlation analyses revealed that a reduced exponent was associated with worse sleep quality and more frequent failures in inhibitory control within the ID group.</div></div><div><h3>Conclusions</h3><div>A smaller exponent within the ID group may reflect impaired inhibitory neuronal activity, potentially leading to cortical hyperarousal. The association of a smaller exponent with deteriorated sleep quality and impaired inhibitory control supports this hypothesis. Furthermore, the increased center frequency of the alpha band across extensive brain regions, along with a narrower alpha bandwidth in the left frontal and right parieto-occipital regions, may represent abnormal manifestations associated with excessive arousal. In summary, these results support the role of aperiodic activity as an index of impaired excitation/inhibition balance in neural activity within in ID group.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 45-54"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444857","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":"Quality of life and its associates in narcolepsy 1 and 2 types and idiopathic hypersomnia","authors":"K. Galušková ,&nbsp;S. Nevšímalová ,&nbsp;I. Příhodová ,&nbsp;S. Dostálová ,&nbsp;A. Mazouchová ,&nbsp;K. Šonka","doi":"10.1016/j.sleep.2025.02.019","DOIUrl":"10.1016/j.sleep.2025.02.019","url":null,"abstract":"<div><h3>Objective and background</h3><div>Health-related quality of life (HRQoL) is reduced in narcolepsy type 1 (NT1), but proper information on HRQoL in narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) is lacking. This study examines HRQoL of NT1, NT2, IH, and healthy controls (HC) and assesses the HRQoL associates in these diseases.</div></div><div><h3>Patients and methods</h3><div>117 adults (64 NT1, 22 NT2, 31 IH; 61.5 % women; 38.3 ± 12.0 years; 71.8 % treated) and 41 HC (53.7 % women; 35.9 ± 9.6 years) completed questionnaires assessing sleepiness, fatigue, symptoms severity, sleep inertia, depressive and anxiety symptoms, HRQoL, and underwent a semi-structured interview. Data were analyzed using the Mann-Whitney and Kruskal-Wallis tests, Spearman's correlation coefficient, and regression analysis.</div></div><div><h3>Results</h3><div>HRQoL of NT1, NT2, and IH, separately, was poorer compared to HC (p &lt; 0.001). According to the 36-Item Short Form Health Survey, the mental HRQoL was more impaired in NT2 and IH than NT1 (p &lt; 0.05) in association with more pronounced depressive symptoms (p &lt; 0.01; p &lt; 0.05, respectively) and sleep inertia (p &lt; 0.01; p &lt; 0.01, respectively). Psychiatric disorders were more prevalent in NT2 and IH versus NT1 (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>HRQoL is reduced in NT1, NT2, and IH, with this reduction being more pronounced in NT2 and IH. Poor mental HRQoL of NT2 and IH was associated both with the severity of depressive symptoms and more intense sleep inertia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 31-39"},"PeriodicalIF":3.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal study of the bi-directional relations between parental bedtime and nighttime involvement and infant sleep","authors":"Ofek Matzliach,&nbsp;Avel Horwitz,&nbsp;Dar Ran-Peled,&nbsp;Liat Tikotzky","doi":"10.1016/j.sleep.2025.02.017","DOIUrl":"10.1016/j.sleep.2025.02.017","url":null,"abstract":"<div><h3>Objective</h3><div>This longitudinal study assessed the prospective bidirectional links between parental involvement during bedtime and nighttime and infants' sleep during the first year of life.</div></div><div><h3>Methods</h3><div>The sample included 207 families at 4 months, 177 at 8 months, and 154 at 12 months. Infant sleep was assessed at home for seven nights using actigraphy, sleep diaries, and the Brief Infant Sleep Questionnaire (BISQ). Parental bedtime and nighttime involvement were reported daily by parents through sleep diaries at all time points.</div></div><div><h3>Results</h3><div>Concomitant associations (controlling for sleeping arrangements) were found between parental bedtime and nighttime involvement and between infant objective and reported sleep quality measures (i.e., number of night-wakings, wake after sleep onset [WASO], and subjective infant sleep problems). Structural Equation Modeling analyses demonstrated significant prospective associations: Higher parental bedtime involvement at 4 months predicted an increase in infant number of night-wakings from 4 to 8 months. Moreover, higher levels of parental bedtime and nighttime involvement at 8 months predicted an increase in infant WASO from 8 to 12 months. Only one SEM model demonstrated a significant cross-lagged link from infant sleep quality to parental involvement: More perceived infant sleep problems at 4 months predicted a decrease in parental bedtime involvement from 4 to 8 months.</div></div><div><h3>Conclusions</h3><div>The findings suggest that higher levels of parental involvement in soothing the infant to sleep at bedtime and nighttime predict poorer infant sleep quality. Only limited evidence was found for infant-driven links.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 55-66"},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454648","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":"Correlation between changes of sleep quality and brain functional connectivity patterns in COVID-19 patients: A three-month longitudinal cohort study","authors":"Bei Peng ,&nbsp;Ying Liu ,&nbsp;Yuxin Chen ,&nbsp;Xiaoyan Zhou ,&nbsp;Yan Zhang ,&nbsp;Jinli Huang ,&nbsp;Jiazhu Huang ,&nbsp;Ruijing Sun ,&nbsp;Shihuan Lin ,&nbsp;Lixia Qin ,&nbsp;Yian Lu ,&nbsp;Mingming Zhao ,&nbsp;Demao Deng","doi":"10.1016/j.sleep.2025.02.016","DOIUrl":"10.1016/j.sleep.2025.02.016","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore variations of brain functional connectivity patterns among post-COVID-19 patients with different outcomes of sleep quality.</div></div><div><h3>Methods</h3><div>Post-COVID-19 patients were prospectively enrolled and categorized into improvement or deterioration groups based on changes in sleep quality after a three-month follow-up. Functional MRI and blood samples were collected, while a battery of assessments was administered to evaluate sleep quality, mental status, and cognition. Baseline and follow-up data were compared to identify post-infection alterations. Brain functional networks and graph theory analysis were employed to derive network properties, with subsequent investigation into the correlation between these properties, sleep and psychological assessment scores, and blood test outcomes.</div></div><div><h3>Results</h3><div>The graph theory analysis revealed a significantly increase in global efficiency (Eglob) and local efficiency (Eloc), and a decrease in λ, in the improvement group. A notable enhancement of frontoparietal network (FPN) were observed. The deterioration group exhibited a significant increase in Eloc and λ, along with a decrease in Eglob. Furthermore, the deterioration group demonstrated a lower level of Eglob at follow-up. With respect to network strength, all networks except FPN showed significantly higher values in the improvement group. Pittsburgh Sleep Quality Index and Self-Rating Anxiety Scale scores differed between two groups.</div></div><div><h3>Conclusion</h3><div>Changes in sleep quality following COVID-19 infection are associated with brain functional connectivity patterns. Decreased Eglob is related to worsened sleep quality. The normalized strength of FPN serves as a key indicator for improved sleep quality, while other networks also play roles in regulating sleep quality.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 187-194"},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420443","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 diagnostic and therapeutic value of time in bed extension in Insufficient Sleep Syndrome","authors":"Marco De Pieri ,&nbsp;Anna Castelnovo ,&nbsp;Silvia Miano ,&nbsp;Mauro Manconi","doi":"10.1016/j.sleep.2025.02.013","DOIUrl":"10.1016/j.sleep.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>Insufficient sleep syndrome (ISS) represents an emerging health concern but remains poorly defined as a diagnostic entity, though included in the international classification of sleep disorders. In the present study, we aimed to clarify the longitudinal course of ISS and to identify prognostic factors by comparing remitting and non-remitting patients.</div></div><div><h3>Methods</h3><div>A chart-review was realized, retrieving fifty-five patients with ISS (aged 39.8 ± 16.6 years, with 44.6 % of women) who underwent a comprehensive clinical evaluation at baseline and during a follow-up visit after 3–6 months. This evaluation included sleep symptoms, sleep logs, medications, and comorbidities. Additionally, actigraphy, video-polysomnography, and a multiple sleep latency test were conducted at baseline, and at the same moment standard psychoeducation on sleep was provided.</div></div><div><h3>Results</h3><div>During the follow-up visit, 69 % of patients still met the criteria for a clinical diagnosis of ISS, experiencing symptoms such as daytime sleepiness, disrupted nighttime sleep, unrefreshing sleep, and sleep attacks. Comparing sleep patterns of remitters and non-remitters based on sleep diaries, we observed that remission is associated with not only an increase in total sleep time but also a more regular sleep schedule. This regularity includes a reduction in napping and a lesser difference in sleep timings between weekdays and weekends. However, comparing baseline clinical and instrumental data between remitters and non-remitters revealed no significant differences, hindering the use of these features as prognostic factors.</div></div><div><h3>Conclusions</h3><div>Given the low remission rate with standard treatment (i.e. psychoeducation on sleep), we propose the following: (1) Criterion E (extension of total sleep time results in resolution of the symptoms of sleepiness) should be considered as a therapeutic advice, and supportive rather than necessary for the diagnosis; (2) specific cognitive-behavioral therapy protocols targeting the cognitive factors underlying sleep-depriving behaviors are required, as single routine behavioral interventions are insufficient.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 219-228"},"PeriodicalIF":3.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary coupling estimated sleep quality and memory in children with obstructive sleep-disordered breathing","authors":"Zhang Yuanjie ,&nbsp;Wu Yunxiao ,&nbsp;Robert Joseph Thomas ,&nbsp;Tang Yufen ,&nbsp;Zhengli ,&nbsp;Xu Zhifei","doi":"10.1016/j.sleep.2025.01.024","DOIUrl":"10.1016/j.sleep.2025.01.024","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between sleep quality/stability and memory in children with sleep-disordered breathing.</div></div><div><h3>Methods</h3><div>Children aged 5–12 years with suspected sleep-disordered breathing who visited the Sleep Center of Beijing Children's Hospital, from June 2022 to March 2023 were enrolled. All patients underwent polysomnography (PSG) and cardiopulmonary coupling monitoring (CPC) analysis based on the photoplethysmogram, and memory tests (immediate and delayed recognition and recall) before sleep and after sleep, respectively. In the CPC analysis, high frequency coupling (HFC) as percentage of total sleep time is stable sleep. A sleep quality index (SQI) integrates HFC, sleep duration and sleep fragmentation. The correlation between memory function and sleep quality/stability was analyzed. Cyclic variation in heart rate was quantified as a sleep apnea indicator (SAI).</div></div><div><h3>Results</h3><div>Patients were divided into three groups based on HFC: low (&lt;60), moderate (60–80) and high (&gt;80). A total of 152 children were included in the study, 100 males and 52 females, with an average age of 8.2 ± 1.7 years.HFC% was negatively correlated with AHI and OAHI (r: −0.32,p: &lt;0.01; r: −0.31, p: &lt;0.01), while LFC% was positively correlated with AHI and OAHI (r: 0.29, p: &lt;0.01; r: 0.28, p: &lt;0.01). The SQI and HFC was positively correlated with the delayed recall test score(r: 0.19, p: &lt;0.05), and with the recognition consolidation rate (r: 0.23, p: &lt;0.05). In contrast, LFC was negatively correlated with delayed recall test score (r:0.19, p: &lt;0.05), delayed recognition score (r:0.15,p &lt; 0.05), and recognition consolidation rate (r:0.21, p: &lt;0.01). SAI was negatively correlated with Recognition consolidation rate score (r: −0.17, p: &lt;0.05).</div></div><div><h3>Conclusions</h3><div>Sleep stability assessed via CPC may reflect a risk biomarker for memory function in children with OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 8-13"},"PeriodicalIF":3.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427711","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":"Interim analysis of a post-authorization safety study of pitolisant in treating narcolepsy: A real-world European study","authors":"Giuseppe Plazzi ,&nbsp;Geert Mayer ,&nbsp;Ralf Bodenschatz ,&nbsp;Enrica Bonanni ,&nbsp;Alessandro Cicolin ,&nbsp;Giacomo Della Marca ,&nbsp;Pierluigi Dolso ,&nbsp;Luigi Ferini Strambi ,&nbsp;Raffaele Ferri ,&nbsp;Peter Geisler ,&nbsp;Svenja Happe ,&nbsp;Anna Heidbreder ,&nbsp;Jürgen Herold ,&nbsp;Ulf Kallweit ,&nbsp;Laurène Leclair-Visonneau ,&nbsp;Katharina Lederer ,&nbsp;Claudio Liguori ,&nbsp;Johan Meurling ,&nbsp;Liborio Parrino ,&nbsp;Paola Proserpio ,&nbsp;Yves Dauvilliers","doi":"10.1016/j.sleep.2025.02.012","DOIUrl":"10.1016/j.sleep.2025.02.012","url":null,"abstract":"<div><h3>Background</h3><div>Narcolepsy is a chronic sleep disorder characterized mainly by excessive daytime sleepiness (EDS) and cataplexy in the case of narcolepsy type 1 (NT1). Pitolisant is a histamine 3 receptor antagonist/inverse agonist that reduces EDS and cataplexy in patients with narcolepsy.</div></div><div><h3>Methods</h3><div>We performed a prospective 5‐year follow‐up, non‐interventional study of adults with NT1 and NT2 receiving pitolisant. The primary objectives were to collect information on the long-term safety of pitolisant and analyze the utilization patterns of pitolisant. The secondary objectives were to assess clinical benefit, adherence, impact on patients’ quality of life, disease burden, and patient satisfaction. We reported the results of an interim analysis after 42.6 months.</div></div><div><h3>Results</h3><div>The population comprised 370 patients (mean age, 40 ± 15 years; 51.4 % women; NT1, 71.4 %; NT2, 28.6 %); 364 received ≥1 dose of pitolisant. Data were available for 356 patients (97.8 %).</div><div>Most patients (68.4 %) had ≥1 comorbidity (obesity [BMI≥30], 31.9 %; neuropsychiatric, 31 %; and cardiovascular, 22.8 %). Forty-eight patients (13.2 %) had received no prior narcoleptic treatment, while 98 (31 %) were taking a previous therapy, which was switched to pitolisant. Treatment was combined with pitolisant in 218 (69 %) patients. Pitolisant was discontinued by 131 patients (35.4 %), mainly for safety reasons (14.3 %), lack of response (8.7 %), and patient decision (7.6 %). Overall, 355 treatment-emergent adverse events (3 serious) were reported by 156 patients (42.9 % of safety population), with 218 possibly treatment-related (61.4 %) in 109 patients (29.9 %). Improvements were observed in EDS, cataplexy, and quality of life.</div></div><div><h3>Conclusions</h3><div>Pitolisant was generally safe and well tolerated in patients with NT1 and NT2 and can be used in both types. Improvements were found in EDS, cataplexy, and quality of life, with good adherence and satisfaction.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 20-30"},"PeriodicalIF":3.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437161","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":"An inter-rater variability study between human and automatic scorers in 5-s mini-epochs of sleep","authors":"Louise Frøstrup Follin ,&nbsp;Alexander Neergaard Zahid ,&nbsp;Rannveig Viste ,&nbsp;Janita Vevelstad ,&nbsp;Tobias Kaufmann ,&nbsp;Anette Ramm-Pettersen ,&nbsp;Hilde T. Juvodden ,&nbsp;Berit Hjelde Hansen ,&nbsp;Julie Anja Engelhard Christensen ,&nbsp;Stine Knudsen-Heier","doi":"10.1016/j.sleep.2025.02.005","DOIUrl":"10.1016/j.sleep.2025.02.005","url":null,"abstract":"<div><h3>Study objective</h3><div>Sleep is traditionally scored using 30-s epochs of polysomnographies. As sleep is physiologically dynamic and 30-s epochs may conceal important characteristics, we aim to challenge this standard by scoring sleep in 5-s mini-epochs and analyzing inter-rater variability between human and automatic scorers.</div></div><div><h3>Methods</h3><div>In 40 polysomnography recordings, 120 mini-epochs per polysomnography were scored manually by three human experts (expert1_5s, expert2_5s and expert3_5s) and automatically by a validated sleep classifier (USleep_5s). Additionally, 5-s mini-epochs (clinical_5s) extracted from conventional human-scored 30-s epochs were considered. We assessed inter-rater variability and stage shifting in epochs and mini-epochs and further in narcolepsy type 1 (NT1) patients and siblings.</div></div><div><h3>Results</h3><div>Agreement for mini-epochs was κ = 0.50 ± 0.11 (expert1_5s vs clinical_5s) and κ = 0.51 ± 0.12, (expert1_5s vs USleep_5s). Between human experts, agreement was κ = 0.51 ± 0.16 (expert1_5s vs expert2_5s), and κ = 0.57 ± 0.11 (expert1_5s vs expert3_5s). Stage shift percentages were significantly higher in mini-epochs scored by expert1_5s (27.75 %) and USleep_5s (22.88 %) than corresponding conventional epochs (5.12 %), with no significant difference between NT1 patients and siblings.</div></div><div><h3>Conclusion</h3><div>While mini-epoch scoring agreement was generally high, it was still lower than within epochs, likely due to a lack of standard mini-epoch scoring procedure and the automatic classifier being trained on epochs. However, stage discrepancies between epochs and mini-epochs and increased stage shifting in mini-epochs support that epochs can contain several stages, and that mini-epochs could supplement more detailed sleep characterization potentially enabling more precise diagnosis and finding new polysomnographic biomarkers. Future studies should include larger datasets to refine mini-epoch scoring rules and exploit automatic classifiers e.g. via transfer learning.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 139-150"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered brain dynamic functional connectivity in patients with obstructive sleep apnea and its association with cognitive performance","authors":"Jing Wang ,&nbsp;Zhijun Wang ,&nbsp;Xin Wang ,&nbsp;Lirong Ji ,&nbsp;Yezhou Li ,&nbsp;Chaohong Cheng ,&nbsp;Tong Su ,&nbsp;Erlei Wang ,&nbsp;Fei Han ,&nbsp;Rui Chen","doi":"10.1016/j.sleep.2025.02.009","DOIUrl":"10.1016/j.sleep.2025.02.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Obstructive sleep apnea (OSA) is associated with potential disruptions in brain function and structure. The aim was to investigate alterations in dynamic functional connectivity (dFC) in OSA patients utilizing resting-state functional magnetic resonance imaging (rs-fMRI) and multiplication of temporal derivatives (MTD) to better understand the neurological implications of OSA.</div></div><div><h3>Methods</h3><div>This cross-sectional study eventually recruited 111 patients, aged 25–65 years. We categorized participants based on the apnea-hypopnea index (AHI) assessed via polysomnography (PSG), 43 patients were groupAHI &lt;15 and 68 patients were group AHI ≥15. Rs-fMRI and neuropsychological assessments were conducted to assess the brain function and visual-spatial memory, respectively. We evaluated the intergroup differences in dFC as well as its correlation with clinical parameters.</div></div><div><h3>Results</h3><div>The dFC analysis identified five distinct connectivity states, comprising four hyperconnected states (State 1, 2, 3, and 5) and one hypoconnected state (State 4). Group AHI≥ 15 showed altered fraction time (FT) and mean dwell time (MDT) in States 1, 3, and 4. The partial correlation showed that the FT/MDT of State 1 negatively correlated with hypoxia parameters, while the FT/MDT of State 3 positively correlated with total sleep time in Group AHI≥ 15. Group AHI≥ 15 exhibited a negative association between FT of state 3 and Visuospatial/Executive score in MoCA (r = −0.297, p = 0.033).</div></div><div><h3>Conclusions</h3><div>Untreated male moderate to severe OSA patients exhibited altered in dFC, which significantly correlated with hypoxia parameters and cognitive performance, high lighting that dFC changes may be an indicator of the neurological consequence of OSA, especially moderate to severe OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 174-182"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402618","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}