Sleep medicine最新文献

{"title":"Static and dynamic pupillary changes reflect autonomic effects of acute sleep deprivation in healthy adults","authors":"Dilara Ozkoyuncu Kocabas ,&nbsp;Berk Atalay ,&nbsp;Aslihan Taskiran Sag","doi":"10.1016/j.sleep.2025.106795","DOIUrl":"10.1016/j.sleep.2025.106795","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the pupillary activity and sympathetic skin responses of acute sleep-deprived participants (≤4 h) by comparing these values with non-sleep-deprived controls (&gt;7 h).</div></div><div><h3>Methods</h3><div>This study included 39 participants, comprising 23 from the sleep deprivation group and 16 from the healthy control group. Self-reported sleep duration, the Karolinska Sleepiness Scale (KSS), and the Epworth Sleepiness Scale (ESS) were used to evaluate the state of sleepiness. Static and dynamic pupillometry measurements using the Sirius topography device, the amplitude of accommodation using Tonoref III, and sympathetic skin responses quantified via EMG were examined.</div></div><div><h3>Results</h3><div>The mean scotopic and mesopic pupil diameters were higher in acute sleep-deprived participants compared to controls (6.33 ± 0.59 vs 6.05 ± 0.51, P = 0.030 for scotopic luminance; 5.28 ± 0.69 vs 5.00 ± 0.46, P = 0.047 for mesopic luminance, respectively). In dynamic pupillometry, the speed of pupil dilation in the sleep deprivation group was higher than in the control group (0.22 ± 0.03 vs 0.20 ± 0.03, P = 0.004). The photopic pupil diameter, accommodation amplitude, and sympathetic skin responses were similar between the groups (P &gt; 0.05). While sleep duration was inversely correlated with pupil diameters under all luminances, the ESS score was positively correlated with mesopic and photopic pupil diameters (P &lt; 0.05 for each).</div></div><div><h3>Conclusions</h3><div>Acute sleep deprivation alters both static and dynamic pupil responses, reflecting autonomic changes, whereas sympathetic skin responses remained unaffected. Even a single day of partial sleep deprivation is capable of impairing pupillary responses.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106795"},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046944","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":"EP300 as a potential mediator of stress-induced sleep disruption through blood-brain barrier dysfunction and neuroinflammation","authors":"Yaru Wang ,&nbsp;Xiaochen Zhang ,&nbsp;Li-Ming Jin ,&nbsp;Xiaoyun Yang ,&nbsp;Kuizhang Han ,&nbsp;Jiayi Ma ,&nbsp;Yiren Wang ,&nbsp;Yongjun Chen ,&nbsp;Lin Yao","doi":"10.1016/j.sleep.2025.106802","DOIUrl":"10.1016/j.sleep.2025.106802","url":null,"abstract":"<div><div>Sleep disorders (SDs) are complex and multigenic, and their pathogenesis remains unclear. This study sought to identify key genes influencing SDs to offer new perspectives on understanding, preventing, and treating the disorder. Differential expression and weighted gene co - expression network analyses were employed to find susceptibility modules and hub genes related to SDs. The Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analyses were used to explore the functions and mechanisms of these hub genes. Mendelian randomization was carried out to assess the causal relationship between <em>EP300</em> and SDs. We identified a total of 371 key genes associated with multiple biological processes. Five hub genes were identified, and a positive correlation between <em>EP300</em> and SD risk was confirmed. In a mouse model of chronic unpredictable stress with sleep architecture disturbance, bioinformatics findings were validated using qPCR experiments and single-cell RNA sequencing of the prefrontal cortex. We found that <em>EP300</em> expression was significantly increased in microglia of the model mice, coinciding with blood-brain barrier disruption and elevated <em>IL-1β</em> mRNA expression. This study first revealed the potential role of <em>EP300</em> in SD.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106802"},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046945","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 disorders in children with neurodevelopmental disorders: Comparative actigraphy and questionnaire assessment in ASD, ADHD, and controls","authors":"Sara Pinghini ,&nbsp;Lucio Giordano ,&nbsp;Francesca Banditelli ,&nbsp;Rossana Bucci ,&nbsp;Anna Eusebi ,&nbsp;Elena Filippini ,&nbsp;Michela Gritti ,&nbsp;Paola Mattei ,&nbsp;Davide Nocita ,&nbsp;Elisa Maria Fazzi ,&nbsp;Giuseppe Milito","doi":"10.1016/j.sleep.2025.106794","DOIUrl":"10.1016/j.sleep.2025.106794","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are highly prevalent in children with neurodevelopmental disorders (NDD), yet few studies have combined objective and subjective measures. The objectives of this study were to evaluate sleep patterns and sleep hygiene in children with ADHD and ASD compared age-matched typically developing children, using both parent-reported questionnaires and actigraphy, to assess the concordance between these measures, and to determine the clinical applicability of actigraphy in this population.</div></div><div><h3>Methods</h3><div>Sixty children with NDD (30 ASD, 30 ADHD) and 40 typically developing controls, matched for age, underwent seven nights of actigraphic recording. Parents completed the Sleep Disturbance Scale for Children (SDSC) and Family Inventory of Sleep Habits (FISH).</div></div><div><h3>Results</h3><div>Actigraphy was well tolerated in the NDD group (88 %), consistent with previous findings. Compared to TD controls, children with NDDs showed significantly higher SDSC scores (p &lt; 0.001) and poorer actigraphic sleep parameters, including lower sleep efficiency (82.0 % vs 87.3 %, p &lt; 0.001) and longer wake after sleep onset (78.8 vs 52.7 min, p &lt; 0.001). Concordance between actigraphy and SDSC was limited (≈53 % in NDD; 15 % in TD). No significant group differences were found in sleep hygiene, although FISH scores correlated with selected actigraphic parameters only in controls.</div></div><div><h3>Conclusions</h3><div>Sleep disturbances are highly prevalent in NDD, and actigraphy is a reliable, well-tolerated tool for clinical assessment. Given the limited agreement between actigraphy and questionnaires, multimethod approaches may be necessary. Actigraphy should be considered for integration into routine clinical practice to improve sleep evaluation in pediatric NDD populations.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106794"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020281","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":"Plasma Galectin-3 as a potential predictor of chronic insomnia and its association with NLRP3 inflammasome activation in chronic migraine: A case-control study","authors":"Wubing Zhou","doi":"10.1016/j.sleep.2025.106793","DOIUrl":"10.1016/j.sleep.2025.106793","url":null,"abstract":"<div><h3>Background</h3><div>Chronic insomnia (CI) commonly co-occurs with chronic migraine (CM), and neuroinflammation may underlie this association. Galectin-3, a pro-inflammatory mediator, has been implicated in migraine and sleep regulation, but its role in CM-related insomnia and its link to NLRP3 inflammasome activation remain unclear.</div></div><div><h3>Methods</h3><div>We conducted a case-control study of 150 CM patients, categorized by CI status using ICSD-3 criteria and Pittsburgh Sleep Quality Index (PSQI). Clinical features, psychological assessments, and plasma biomarkers (Galectin-3, NLRP3, IL-1β) were measured. Logistic regression, multiple linear regression, mediation analysis, and ROC curves evaluated associations and diagnostic performance.</div></div><div><h3>Results</h3><div>Compared with CM without insomnia (CM-nCI), CM with insomnia (CM-CI) showed higher Galectin-3 (18.69 ± 2.95 vs. 13.41 ± 2.48 ng/mL), NLRP3 (6.72 ± 1.24 vs. 4.02 ± 1.14 ng/mL), and IL-1β (5.39 ± 1.27 vs. 3.71 ± 0.87 pg/mL; all P &lt; 0.001). Galectin-3 independently predicted CI (adjusted OR = 1.393; 95 % CI: 1.153–1.681; P &lt; 0.001). Mediation analysis indicated partial mediation by NLRP3 and IL-1β (41.4 % and 36.2 %, respectively). ROC analysis demonstrated good discrimination (AUC = 0.888; cutoff = 15.85 ng/mL; sensitivity = 84.0 %; specificity = 82.0 %). Galectin-3 correlated with PSQI, anxiety, depression, migraine impact, and inflammatory markers after adjustment (all P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Elevated plasma Galectin-3 is strongly associated with CI in CM and shows good predictive value. Its relationship with NLRP3 and IL-1β suggests a shared neuroinflammatory pathway, highlighting Galectin-3 as a potential biomarker for risk stratification and targeted management of CM patients with insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106793"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989525","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":"Translation and linguistic validation study of Munich Parasomnia Screening tool for Turkish","authors":"İlknur Güçlü Altun ,&nbsp;Kadriye Agan","doi":"10.1016/j.sleep.2025.106762","DOIUrl":"10.1016/j.sleep.2025.106762","url":null,"abstract":"<div><h3>Background</h3><div>Parasomnias are prevalent sleep disorders that frequently go unrecognized and can have a substantial impact on an individual's sleep quality and daily functioning. The objective of this study was to translate and culturally adapt the Munich Parasomnia Screening (MUPS) scale into Turkish and to evaluate the psychometric properties of the MUPS-TR.</div></div><div><h3>Methods</h3><div>The present study was conducted with a sample of 311 adult Turkish-speaking individuals. The MUPS scale was adapted into Turkish using the forward-backward translation method, and content validity was ensured with expert opinions. The final text was obtained subsequent to the pilot test. A test-retest analysis was conducted with 40 bilingual participants, and internal consistency was assessed using Cronbach's α coefficient. Additionally, time-dependent consistency was assessed using Spearman's correlation. The frequency of symptoms was also analyzed. Prior to their involvement in the study, written informed consent was obtained from all participants.</div></div><div><h3>Results</h3><div>The internal consistency coefficient for the total scale was calculated as Cronbach's α = 0.87. The test-retest correlations ranged from Spearman's r = 0.76 to 0.88. Cross-language item correlations in bilingual participants ranged from 0.79 to 0.88. The most prevalent symptoms were identified as hypnic twitching (85 %), nightmares (46.3 %), and rhythmic leg movements (60.2 %).</div></div><div><h3>Conclusions</h3><div>The MUPS-TR instrument is a valid and reliable tool for rapid screening of parasomnia symptoms in Turkish-speaking adults. Its efficacy in clinical practice is particularly pronounced, especially in the domains of initial assessment and referral processes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106762"},"PeriodicalIF":3.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989428","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":"Maternal sleep trajectories from preconception to postpartum in a population-based cohort: The Generation R next study","authors":"Fangxiang Mao ,&nbsp;Hanan El Marroun ,&nbsp;Desana Kocevska ,&nbsp;Annemarie I. Luik","doi":"10.1016/j.sleep.2025.106791","DOIUrl":"10.1016/j.sleep.2025.106791","url":null,"abstract":"<div><h3>Objectives</h3><div>Sleep is known to change around pregnancy. Yet current studies often do not take into account the multidimensionality of sleep and its changes from preconception to postpartum. Therefore, this study aims to explore maternal multivariate sleep trajectory from preconception to 6 months postpartum and related determinants.</div></div><div><h3>Methods</h3><div>We included 556 women of the Generation R <em>Next</em> Study with sleep measurements between preconception and postpartum at ≥2 time points, and 850 women with sleep measurements at ≥2 time points from pregnancy onwards. Sleep duration, sleep midpoint, sleep latency, sleep quality, and general sleep disturbance were assessed at preconception (or inclusion), first trimester, third trimester, and 6 months postpartum with the Munich Chronotype Questionnaire and General Sleep Disturbance Scale. We used multivariate and univariate latent class models to identify multidimensional and unidimensional sleep trajectories. Associations of sociodemographic, lifestyle and psychopathological factors with sleep trajectories were assessed with multinomial regressions.</div></div><div><h3>Results</h3><div>We identified three multivariate sleep trajectories, labelled as ‘good’, ‘average’ and ‘poor’ sleep health. All trajectories were relatively stable over time and with similar sleep duration, but with a different midpoint (03:00, 03:20, 03:40), latency (7.5, 16, 37.5 min), and quality (good, moderate, poor) respectively. Women born outside the Netherlands, with lower socioeconomic status, smoking, using illicit substances, or with depression/anxious symptoms had more poor sleep trajectories.</div></div><div><h3>Conclusion</h3><div>Maternal sleep trajectories varied in individuals from preconception to postpartum. Comprehensively considering multiple sleep components, rather than a single sleep component, could provide more insights for prevention of poor maternal sleep.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106791"},"PeriodicalIF":3.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005010","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 apnea in interstitial lung disease: A systematic review and meta-analysis of prevalence, severity, and risk factors","authors":"Jia-Wei Sun ,&nbsp;Hsiang-Chih Hsu ,&nbsp;Jie-Syuan Wu ,&nbsp;Tsai-Wei Huang ,&nbsp;Yuan-Si Tsai ,&nbsp;Wun-Hao Cheng ,&nbsp;Lee-Yuan Lin","doi":"10.1016/j.sleep.2025.106768","DOIUrl":"10.1016/j.sleep.2025.106768","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is common in interstitial lung disease (ILD) patients and affects disease progression and outcomes. This meta-analysis aims to estimate OSA prevalence in ILD and examine associations with lung function parameters and risk factors.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane Library were searched for studies assessing OSA prevalence or apnea-hypopnea index (AHI) in ILD, published before February 2025. Primary outcomes were OSA prevalence and severity (assessed by AHI). Secondary outcomes assessed the influence of forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide (DL_CO), 6-min walk distance (6MWD), BMI, smoking rate, and male percentage. The study protocol was registered in PROSPERO (CRD420250650698).</div></div><div><h3>Results</h3><div>17 studies comprising 1092 participants were included. Meta-analysis revealed an OSA prevalence of 68 % (95 % CI: 59–75 %), with higher rates in IPF (71 %, 95 % CI: 61–80 %) than non-IPF ILD. The pooled mean AHI was 13.36 (95 % CI: 10.87–16.41); moderate-to-severe OSA prevalence was 36 %. In multivariate analysis, OSA prevalence was associated with lower FVC (<em>P</em> = 0.086), male sex (<em>P</em> &lt; 0.05), and BMI (<em>P</em> = 0.065–0.081). AHI was mildly associated with 6MWD (<em>P</em> = 0.086) and BMI (<em>P</em> = 0.065–0.084). Subgroup analyses identified that ILD patients with FVC &lt; 80 % (<em>P</em> = 0.065), 6MWD &lt; 372 m (<em>P</em> = 0.036), and BMI &gt; 31 kg/m² (<em>P</em> = 0.21) were at increased risk for OSA.</div></div><div><h3>Conclusion</h3><div>Given the high OSA prevalence in ILD patients, routine screening—particularly in males with FVC &lt; 80 % predicted, BMI &gt; 31 kg/m², or 6MWD &lt; 372 m—is recommended. Early detection may enable timely intervention and improve outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106768"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106606","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":"Nocturnal hypoxemia in infants with or without upper airway obstruction and its association with nocturnal pulse rate","authors":"Maria Eleni Liagkaki ,&nbsp;Anastasios-Panagiotis Chantzaras ,&nbsp;Angeliki Moudaki,&nbsp;Christina Kanaka-Gantenbein,&nbsp;Athanasios G. Kaditis","doi":"10.1016/j.sleep.2025.106765","DOIUrl":"10.1016/j.sleep.2025.106765","url":null,"abstract":"<div><h3>Objective</h3><div>Nocturnal intermittent hypoxemia may enhance sympathetic nervous system activity. We aimed to assess the potential relationship of age-adjusted nocturnal pulse rate (% distance from 95th percentile for age-pulse rate index) with nocturnal oximetry parameters and their interaction with upper airway obstruction (UAO) presence.</div></div><div><h3>Methods</h3><div>Nocturnal oximetry data of 1-12-month-old infants without UAO/lung disease who were hospitalized for common pediatric problems (e.g. urinary tract infection) and of infants with clinically apparent UAO were analyzed. General linear models were applied to evaluate associations of nocturnal pulse rate index with group (infants with vs. without UAO) or nocturnal hypoxemia severity (oxygen desaturation [≥3 %] index for events lasting ≥2s, ≥5s, ≥10s or ≥20s (ODI3-2s, ODI3-5s, ODI3-10s or ODI3-20s, respectively).</div></div><div><h3>Results</h3><div>Oximetry data of 158 infants without UAO (age 1–12.7 months) and 23 with UAO (age 1–11.1 months) were analyzed. There were no significant associations of pulse rate index with group or ODI3 (<em>P &gt; .05)</em>. However, significant interactions were identified between ODI3-10s or ODI3-20s and group: in infants with UAO, pulse rate increased with raising ODI3-10s or ODI3-20s compared to participants without UAO (beta .612 [95 %CI .083–1.140; <em>P = .023</em> and 1.140 [.145–2.134]; <em>P = .025</em>, respectively). For every 10 episodes/h increase in ODI3-20s among infants with UAO, average pulse rate approached or exceeded the 95th percentile for age by 11.4 % compared to infants without UAO.</div></div><div><h3>Conclusions</h3><div>Despite overlap of desaturation indices values in infants without UAO and those with UAO, only in the latter, frequency of intermittent hypoxemia predicts an enhanced heart rate response.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"135 ","pages":"Article 106765"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925916","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":"Reconsidering the role of ArI-REM in AF risk among OSA patients","authors":"Jie Huang ,&nbsp;Yarong Ding ,&nbsp;Jingcan Qin","doi":"10.1016/j.sleep.2025.106792","DOIUrl":"10.1016/j.sleep.2025.106792","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"135 ","pages":"Article 106792"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922396","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 prevalence of vagus nerve stimulator-induced sleep disordered breathing in children with refractory Epilepsy: A retrospective cohort study","authors":"Rahul Verma ,&nbsp;Haley Fishman ,&nbsp;Puneet Jain ,&nbsp;Lyndsey McRae ,&nbsp;Kaitlin Flynn ,&nbsp;Ivanna Yau ,&nbsp;Cristina Go ,&nbsp;Indra Narang ,&nbsp;Jackie Chiang ,&nbsp;Sundeep Bola ,&nbsp;James Rutka ,&nbsp;George Ibrahim ,&nbsp;Reshma Amin","doi":"10.1016/j.sleep.2025.106790","DOIUrl":"10.1016/j.sleep.2025.106790","url":null,"abstract":"<div><h3>Rationale</h3><div>Vagus nerve stimulators (VNS) can reduce seizure burden in children but may result in sleep-disordered breathing (SDB). Our objectives were to assess the prevalence of SDB in children with epilepsy using polysomnography (PSG) before and after VNS implantation as well to explore management strategies for VNS-induced SDB.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted (May 2019 to September 2024) of children aged 0–18 years old with refractory epilepsy and VNS insertion at The Hospital for Sick Children, Toronto, Canada. All included children underwent level 1 baseline PSG evaluation within 1 year prior to VNS insertion. Once VNS was inserted, a repeat PSG was conducted within 18 months. Paired t-tests and Wilcoxon-matched-pair tests compared respiratory variables from PSGs before and after VNS insertion.</div></div><div><h3>Results</h3><div>Twenty-seven children with a mean (SD) age of 8.8 (4.2) years were included. Prior to VNS insertion, 5 (19 %) children had mild obstructive sleep apnea (OSA), 1 (4 %) child had moderate OSA, no child had severe OSA, 2 (7 %) children had central sleep apnea (CSA), and 1 (4 %) child had nocturnal hypoventilation. After VNS insertion, 9 (33 %) children experienced worsened SDB, with most progressing from having no OSA to developing mild OSA. Management strategies for VNS-induced SDB included conservative management, alteration of VNS settings, adenotonsillectomy, and continuous positive airway pressure therapy.</div></div><div><h3>Conclusions</h3><div>The severity of OSA may increase in children with epilepsy treated with VNS. All children being considered for VNS should be routinely screened for symptoms of SDB. Various management strategies can be used for VNS-induced SDB are available.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"135 ","pages":"Article 106790"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916778","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}