Sleep medicine最新文献

{"title":"Genetic predisposition for morningness-eveningness and economic disadvantage: Evidence from Finland over 25 years","authors":"Aaro Hazak ,&nbsp;Katri Kantojärvi ,&nbsp;Johanna Liuhanen ,&nbsp;Sonja Sulkava ,&nbsp;Tuija Jääskeläinen ,&nbsp;Veikko Salomaa ,&nbsp;Seppo Koskinen ,&nbsp;Markus Perola ,&nbsp;Tiina Paunio","doi":"10.1016/j.sleep.2025.106811","DOIUrl":"10.1016/j.sleep.2025.106811","url":null,"abstract":"<div><h3>Objectives</h3><div>Individual chronotype may shape economic outcomes through alignment or misalignment with work and societal schedules. Genome-wide association studies suggest that morningness–eveningness has a partially genetic basis. This study examines how genetic predisposition to chronotype relates to economic disadvantage, using polygenic indices for morningness–eveningness both as predictors and as instruments for phenotypic chronotype.</div></div><div><h3>Methods</h3><div>Employing various regression and extended regression models, we studied data from 20,121 working-aged adults representative of Finnish regions, combining genetic, registry, and survey data from 1992 to 2017.</div></div><div><h3>Results</h3><div>Genetic markers for morningness were monotonically negatively associated with educational attainment (p = 0.002)—a key determinant of economic success—particularly in males. Conversely, the same genetic markers were also monotonically negatively associated with the likelihood of belonging to the lowest income quintile in males (p = 0.012), suggesting differential valuation of chronotype traits in education versus the labour market. This pattern emerged in post-2000. Furthermore, among males with higher education, genetic predisposition to eveningness was linked to a higher likelihood of falling into the lowest income quintile (p &lt; 0.001), indicating reduced economic returns to their education. No significant associations between chronotype-related genetic markers and income were observed in females across education levels.</div></div><div><h3>Conclusions</h3><div>This study reveals emerging, gender-specific inequalities in how genetically influenced chronotype traits relate to economic outcomes. Genetic predisposition to eveningness favoured education but hindered income—especially in highly educated males—via phenotypic chronotype pathways. Though modest, these effects highlight the need for workplace inclusion through recognition of chronotype diversity, public sleep health initiatives, and flexible work structures.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106811"},"PeriodicalIF":3.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092412","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":"Temporal distribution of electromyographic activity and behaviors in REM sleep in patients with isolated REM sleep behavior disorder","authors":"Nathalie Mariño ,&nbsp;Mónica Serradell ,&nbsp;Gerard Mayà ,&nbsp;Angelica Montini ,&nbsp;Nuria Matos ,&nbsp;Claustre Pont-Sunyer ,&nbsp;Karol Uscamaita ,&nbsp;Paula Marrero-González ,&nbsp;Oriol de Fabregues ,&nbsp;Mariateresa Buongiorno ,&nbsp;Desiree Muriana ,&nbsp;Carles Gaig ,&nbsp;Alex Iranzo","doi":"10.1016/j.sleep.2025.106805","DOIUrl":"10.1016/j.sleep.2025.106805","url":null,"abstract":"<div><h3>Background</h3><div>REM sleep behavior disorder (RBD) is characterized by excessive electromyographic (EMG) activity and abnormal behaviors in REM sleep. We aimed to examine the temporal distribution of EMG activity and behaviors in REM sleep in isolated RBD (IRBD) to better understand its nocturnal REM sleep circadian dynamics.</div></div><div><h3>Methods</h3><div>We examined the EMG activity in the mentalis and flexor digitorum superficialis muscles plus the clinical manifestations occurring in the first (from 11.00 p.m. to 3.00 a.m.) and last (from 3.01 a.m. to 7.00 a.m.) REM sleep episodes in the video-polysomnogram (V-PSG) of consecutive IRBD patients and controls without RBD.</div></div><div><h3>Results</h3><div>We assessed the V-PSG of 45 IRBD patients and 39 matched controls. The last REM sleep episode showed higher EMG activity than the first in both patients (p = 0.010) and controls (p = 0.024). In patients, movements and vocalizations were more frequent and severe in the last REM sleep episode than in the first, but differences were not significant. In controls, the last REM sleep episode showed more simple minor movements (p = 0.026) of mild severity (p = 0.032) than the first. In both first and last REM sleep episodes, patients showed higher EMG activity (≥0.001) and more behaviors (≥0.001) than controls. REM sleep percentage, REM sleep duration, REM sleep latency and number of REM sleep episodes were similar between patients and controls.</div></div><div><h3>Conclusions</h3><div>When compared to the first REM sleep episode, the last REM sleep episode shows higher EMG activity and more frequent behaviors in both patients and controls, which are greater in patients than in controls. IRBD represents a pathological overrepresentation of the temporal physiological distribution of EMG activity and behaviors in REM sleep across the night.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106805"},"PeriodicalIF":3.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109172","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":"Corrigendum to “Glymphatic pathway dysfunction in severe obstructive sleep apnea: A meta-analysis” [Sleep Medicine 131 (2025) 106528]","authors":"Sadegh Ghaderi ,&nbsp;Sana Mohammadi ,&nbsp;Farzad Fatehi","doi":"10.1016/j.sleep.2025.106810","DOIUrl":"10.1016/j.sleep.2025.106810","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106810"},"PeriodicalIF":3.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087368","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":"Good sleep, good tolerance: Sleep disturbance predicts adolescent intolerance of uncertainty through self-control","authors":"Haoxian Ye ,&nbsp;Yike Huang ,&nbsp;Fang Fan","doi":"10.1016/j.sleep.2025.106813","DOIUrl":"10.1016/j.sleep.2025.106813","url":null,"abstract":"<div><h3>Background</h3><div>Intolerance of uncertainty (IU) has recently been identified as a transdiagnostic vulnerability for various forms of psychopathology in adolescents. However, little research has explored the factors contributing to IU, limiting the development of effective early intervention and prevention strategies. This study investigated whether sleep disturbance predicts IU and examined the mediating role of self-control in this relationship.</div></div><div><h3>Methods</h3><div>A total of 910 adolescents (Mean age = 14.63 years, SD = 1.41, range = 12–18; 60.7 % girls) completed a two-wave survey assessing sleep disturbance, self-control, and IU. Cross-sectional and longitudinal mediation analyses were conducted to test the predictive role of sleep disturbance on IU and the indirect effect through self-control.</div></div><div><h3>Results</h3><div>Sleep disturbance significantly predicted IU concurrently and prospectively, with self-control mediating these relationships. In the cross-sectional mediation model, self-control accounts for 35.9 % of the association between sleep disturbance and IU (indirect effect = 0.104, SE = 0.017, 95 % CI [0.072, 0.138]). In the longitudinal mediation models, baseline self-control mediated 27.8 % of the association between sleep disturbance and later IU (indirect effect = 0.050, SE = 0.013, 95 % CI [0.025, 0.077]); Meanwhile, later self-control also mediated 41.5 % of the association between baseline sleep disturbance and later IU (indirect effect = 0.054, SE = 0.013, 95 % CI [0.030, 0.081]).</div></div><div><h3>Conclusions</h3><div>These findings preliminarily suggested sleep disturbance as a risk factor for adolescent IU and identified self-control as a key underlying mechanism. Interventions aimed at improving sleep hygiene and enhancing self-control may help reduce IU and support mental health during adolescence.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106813"},"PeriodicalIF":3.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109171","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":"Obstructive sleep apnea detection and prevalence in men and women using a continuous large U.S. sample by home under-mattress devices","authors":"Jatuporn Wanchaitanawong ,&nbsp;Andrew Cotton-Clay ,&nbsp;Susan Baron ,&nbsp;Laura Fava ,&nbsp;Venkat Easwar ,&nbsp;Arthur Kinsolving ,&nbsp;Jennifer Zitser ,&nbsp;Yue Leng ,&nbsp;Philippe Kahn ,&nbsp;Clete Kushida","doi":"10.1016/j.sleep.2025.106808","DOIUrl":"10.1016/j.sleep.2025.106808","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) often goes undiagnosed, hindering timely intervention. This condition is associated with adverse cardiovascular and metabolic outcomes.</div></div><div><h3>Objectives</h3><div>To investigate the prevalence of OSA in a large real-world U.S. sample, as well as night-to-night variability in OSA detection using home under-mattress sleep monitoring devices.</div></div><div><h3>Methods</h3><div>We analyzed de-identified sleep and respiratory data from over 47 million nights recorded by the Sleeptracker-AI Monitor in 151,013 individual-years between September 1, 2021, and August 31, 2023. Individuals with at least 300 recorded nights in one of two one-year study periods (September to August) were included on the first year they met this criterion. Each one-year study period for each individual was analyzed, with mean AHI for the one-year period used to determine OSA categories.</div></div><div><h3>Results</h3><div>A total of 12,400,521 recorded nights from 38,084 participants across the two one-year cohorts (17,516 men, 15,360 women, and 5208 undisclosed gender) were analyzed. OSA (AHI ≥5) prevalence [95 % CI] among individuals with normal BMIs (&lt;25kg/m2) increased with age: women &lt;50 years, 2.8 % [2.2 %, 3.5 %]; women ≥50 years, 16.1 % [14.6 %, 17.8 %] (OR: 6.8 [5.2, 8.7]); men &lt;50 years, 11.2 % [9.7 %, 12.7 %]; and men ≥50 years, 37.5 % [34.8 %, 40.2 %] (OR: 4.8 [4.0, 5.7]). Moderate-to-severe and severe OSA subjects showed a ≥2-category severity reduction (moderate to normal or severe to mild/normal) on 5.1 ± 7.6 % and 5.3 ± 6.9 % of nights (mean ± SD), respectively. Maximum AHI values from 3 randomly selected nights demonstrated sensitivities/specificities [95 % CIs] of 95.2 % [94.2, 96.1]/94.4 % [94.2, 94.7] (moderate-to-severe OSA), and 95.6 % [93.7, 97.2]/98.0 % [97.9, 98.1] (severe OSA), categorized by mean AHI over 1 year.</div></div><div><h3>Conclusion</h3><div>OSA prevalence increased with age in both genders, with higher rates in men and women≥ 50 years. Meanwhile, 5.1 % and 5.3 % of nights in moderate-to-severe and severe OSA cases had a 2-category lower OSA classification than their mean AHI category for that year.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106808"},"PeriodicalIF":3.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106607","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":"DUSP21 expression is associated with obstructive sleep apnea in pediatric patients with obesity","authors":"Fabio Affaticati ,&nbsp;Eline Vermeiren ,&nbsp;Pieter Meysman ,&nbsp;Esther Bartholomeus ,&nbsp;Kim Van Hoorenbeeck ,&nbsp;Benson Ogunjimi ,&nbsp;Stijn Verhulst ,&nbsp;Annelies Van Eyck","doi":"10.1016/j.sleep.2025.106809","DOIUrl":"10.1016/j.sleep.2025.106809","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a well-known risk factor for developing obstructive sleep apnea (OSA) in children. Both OSA and obesity are independently associated with cardiovascular and metabolic comorbidities. These comorbidities are driven by shared pathophysiological pathways, making it difficult to distinguish the individual contributions of obesity and OSA. This study aimed to investigate the molecular mechanisms of OSA in children with obesity through whole blood mRNA sequencing.</div></div><div><h3>Methodology</h3><div>Children with obesity, aged 8–18 years, were enrolled at the start of a multidisciplinary weight loss treatment in a tertiary hospital. Polysomnography was used to diagnose OSA (oAHI ≥2), and whole blood samples were collected for mRNA sequencing.</div></div><div><h3>Results</h3><div>A total of 40 children (mean age 12.4 ± 2.3 years, 57.5 % female) were included, of which 10 patients were diagnosed with OSA. Differential expression analysis identified 11 differentially expressed genes (DEGs) between patients with and without OSA. Seven genes were upregulated (<em>SLC43A3, KLRC3, DAAM2, USP9Y, KDM5D, TTTY15, DBCORP1</em>), while 4 genes were downregulated (<em>DUSP21, XIST, MAP, POLR3D</em>). <em>DUSP21</em> showed the most significant change, with a Log2FoldChange of −7.88 (p = 0.0002).</div></div><div><h3>Conclusion</h3><div>Children with both obesity and OSA exhibit distinct gene expression profiles compared to children with obesity alone. Notably, DUSP21 may play a significant role in the pathophysiological mechanisms of OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106809"},"PeriodicalIF":3.4,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087361","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":"Probable trauma-associated sleep disorder among Ukrainian combatants with stress-related mental disorders","authors":"Dmytro I. Boiko ,&nbsp;Anastasiia Shkodina ,&nbsp;Md Ekhtiar Uddin ,&nbsp;Md Habibur Rahman ,&nbsp;Mohammed Abdul Kader","doi":"10.1016/j.sleep.2025.106803","DOIUrl":"10.1016/j.sleep.2025.106803","url":null,"abstract":"<div><div>The Russian-Ukrainian war has created a mental health crisis among combatants, with sleep disorders representing a critical aspect of combat-related conditions. The objective is to assess the prevalence of insomnia, nightmares, and their association with clinically probable Trauma-Associated Sleep Disorder (TASD) among Ukrainian combatants with stress-related mental disorders. This cross-sectional study included 99 male combatants (aged 18–59) undergoing inpatient treatment for stress-associated disorders (adjustment disorder, n = 36; PTSD, n = 63). Assessments included psychiatric interviews using ICD-10 criteria, the Insomnia Severity Index, Hamburg Nightmare Questionnaire, and TASD symptom assessment. Clinically significant insomnia was observed in 77.8 % of individuals with adjustment disorder and 82.5 % with PTSD (p = 0.562). Nightmares were reported by 86.1 % and 90.5 %, respectively (p = 0.533). Probable TASD criteria were met by 80.6 % of those with adjustment disorder and 84.1 % with PTSD (p = 0.650). Combatants with clinically significant insomnia had a 2.5 times higher risk of developing TASD compared to those without insomnia (RR = 2.55, 95 % CI 1.41–4.60, p &lt; 0.001), with this relationship persisting after adjusting for confounding factors. This study demonstrates a high prevalence of probable TASD among Ukrainian combatants with both PTSD and adjustment disorders. The strong association between insomnia and TASD underscores the importance of insomnia as a clinical marker for TASD screening in combatants with stress-associated disorders.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106803"},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081625","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":"Independent association between hourly apnea-hypopnea duration and prevalence of diabetes in male adults","authors":"Yuhan Wang ,&nbsp;Beini Zhou ,&nbsp;Wuriliga Yue ,&nbsp;Jingyi Zhang,&nbsp;Yang He,&nbsp;Mengcan Wang,&nbsp;Ke Hu","doi":"10.1016/j.sleep.2025.106807","DOIUrl":"10.1016/j.sleep.2025.106807","url":null,"abstract":"<div><h3>Objective</h3><div>Although the apnea-hypopnea index (AHI) is currently used as a diagnostic indicator to assess the severity of obstructive sleep apnea (OSA), the AHI alone cannot adequately identify the risk of diabetes mellitus. On the other hand, the hourly apnea-hypopnea duration (HAD) has been shown to be a better predictor of nocturnal hypoxemia in patients with OSA. This study aimed to evaluate whether HAD is associated with the prevalence of diabetes.</div></div><div><h3>Methods</h3><div>The study sample was 590 male participants with suspected OSA who completed a home sleep apnea test. The main outcome of the study was the prevalence of diabetes, and a multivariable logistic regression model was constructed to estimate the odds ratio (ORs) of HAD to the prevalence of diabetes. The main model was adjusted for AHI, age, body mass index, tobacco smoking, alcohol, insomnia, Epworth Sleepiness Scale score, sleep efficiency, hypertension, and cardiovascular disease.</div></div><div><h3>Results</h3><div>The prevalence of diabetes was 13.90 % in the selected population (quartile age 48.00–68.00 years). The proportion of diabetes was higher in the second and third tertile groups of HAD, with adjusted ORs of 2.48 (95 % CI 1.14, 5.39) and 4.37 (95 % CI 1.22, 15.70), respectively. In the sensitivity analysis, when the oxygen desaturation index (ODI) and lowest oxygen saturation by pulse oximetry were included simultaneously in the same statistical model, the results remained statistically significant. In the multivariable regression analysis, neither AHI nor ODI showed a significant association with the prevalence of diabetes (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>After adjusting for multiple potential confounders, higher HAD tertiles were associated with a higher prevalence of diabetes. In the clinical assessment of OSA-related adverse health outcomes, the HAD deserves more consideration.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106807"},"PeriodicalIF":3.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102973","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":"Cognitive factors increase the risk of shift work disorder through insomnia symptoms","authors":"Rachael Harris,&nbsp;Sean P.A. Drummond,&nbsp;Tracey L. Sletten,&nbsp;Alexander P. Wolkow","doi":"10.1016/j.sleep.2025.106806","DOIUrl":"10.1016/j.sleep.2025.106806","url":null,"abstract":"<div><h3>Objectives</h3><div>The primary aims of the current study were to 1) investigate whether cognitive factors are associated with an increased risk of shift work disorder (SWD), and 2) whether symptoms of insomnia and/or excessive sleepiness mediate this association. Additionally, a third exploratory aim of the study was to examine whether these mediators of insomnia and excessive sleepiness vary in the relationship between cognitive factors and two phenotypes of SWD (i.e., SWD with high insomnia and low excessive sleepiness (SWD-I), and SWD with high excessive sleepiness with or without high insomnia (SWD-E)).</div></div><div><h3>Methods</h3><div>Shift workers (n = 126), predominantly working a schedule involving night shifts, completed a survey comprising measures of SWD risk, insomnia, excessive sleepiness, and cognitive factors, including pre-sleep cognitive and somatic arousal, dysfunctional beliefs about sleep, and sleep reactivity.</div></div><div><h3>Results</h3><div>Logistic regressions found cognitive factors were not associated with SWD risk. Mediation analysis showed insomnia symptoms mediated the impact of pre-sleep somatic arousal, dysfunctional beliefs about sleep, and sleep reactivity on high SWD risk. Of those at high risk of SWD (37 %), 43 % and 34 % had the SWD-I and SWD-E phenotype, respectively. Insomnia symptoms mediated the relationship between all cognitive factors and SWD-I, but not SWD-E.</div></div><div><h3>Conclusions</h3><div>Although cognitive factors were not directly associated with SWD risk, insomnia severity, but not excessive sleepiness, was a significant cross-sectional mediator in the relationship between cognitive factors and risk of SWD. When exploring SWD phenotypes, cognitive factors were associated with a risk of having SWD when participants did not have excessive sleepiness (i.e., SWD-I). To expand on our findings, future research should investigate insomnia's role as a mediator in individuals diagnosed with SWD and to investigate the SWD phenotypes with larger samples.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106806"},"PeriodicalIF":3.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213741","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":"Ischemia-modified albumin and cardiovascular risk in obstructive sleep apnea and acute coronary syndrome. Long term follow-up after treatment from the ISAACC study","authors":"Pilar Resano-Barrio ,&nbsp;Esther Gracia-Lavedan ,&nbsp;Esther Solano-Pérez ,&nbsp;Belén García-Mediano ,&nbsp;Carolina Cubillos-Zapata ,&nbsp;Elena Díaz-García ,&nbsp;Sofía Romero-Peralta ,&nbsp;María Castillo-García ,&nbsp;Ferran Barbé ,&nbsp;Francisco García-Rio ,&nbsp;Manuel Sánchez-de-la-Torre ,&nbsp;Olga Mediano","doi":"10.1016/j.sleep.2025.106804","DOIUrl":"10.1016/j.sleep.2025.106804","url":null,"abstract":"<div><h3>Introduction</h3><div>In the context of the prevailing interest in biomarkers that can assess cardiovascular (CV) risk in obstructive sleep apnea (OSA), ischemia-modified albumin (IMA) is proposed as a potential risk predictor.</div></div><div><h3>Objectives</h3><div>To evaluate whether IMA levels predict recurrent CV events in patients with acute coronary syndrome (ACS) and OSA, and whether continuous positive airway pressure (CPAP) treatment modifies this risk.</div></div><div><h3>Methods</h3><div>This <em>post hoc</em> analysis is based on data from the ISAACC study, including 1.011 non-sleepy patients with an ACS. During hospitalization for ACS, a sleep study was conducted and blood samples for IMA determination were obtained. Patients were categorized by their apnea–hypopnea index (AHI) in non-OSA (AHI &lt;15 events/h) or OSA group (AHI ≥15 events/h). “Low” or “high” IMA levels were established based on the median value (⩽ 34.1 U/L or &gt; 34.1 U/L, respectively). The OSA group was randomized to either CPAP or usual care. The recurrence of CV events was evaluated over a 36-months follow-up.</div></div><div><h3>Results</h3><div>Adjusted cox regression models showed that the OSA group with high IMA level had a significantly reduced risk for CV event recurrence compared with the non-OSA group (HR [95 % CI] 0.59 [0.38–0.93], p = 0.024). In the OSA group with high IMA level, CPAP treatment did not significantly reduce CV recurrence.</div></div><div><h3>Conclusions</h3><div>OSA was associated with higher IMA levels in patients with ACS. Interestingly, patients with both OSA and high IMA experienced fewer CVEs during follow-up. CPAP treatment demonstrated a non-significant risk reduction in patients with low IMA, whereas no effect was noted in those with high IMA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106804"},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046946","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}