Sleep medicine最新文献

{"title":"Validation of transcutaneous CO2 measurement in awake children undergoing sleep studies","authors":"Alessia Mariani ,&nbsp;Juliette Dardenne ,&nbsp;Maxime Beydon ,&nbsp;Jessica Taytard ,&nbsp;Nicole Beydon","doi":"10.1016/j.sleep.2026.108816","DOIUrl":"10.1016/j.sleep.2026.108816","url":null,"abstract":"<div><div>Despite the reliance on transcutaneous CO₂ measurement (PtcCO₂) for continuous alveolar ventilation monitoring in pediatric sleep studies, the agreement between PtcCO₂ and arterial CO₂ pressure in hemodynamically stable children has not been assessed. To address this gap, we conducted a retrospective study to compare PtcCO₂ and arterialized capillary CO₂ pressure (PcapCO₂) values obtained upon awakening and to identify factors influencing any differences.</div><div>We retrospectively analysed 335 pediatric records where each patient underwent both earlobe arterialized capillary blood gas measurement and PtcCO₂ recording (Sentec ResMed or Radiometer TCM4) prior to sleep on the day of polysomnography while breathing room air. Statistical analysis included Bland-Altman analysis, student's t-test, chi-square test, and univariate and multivariate regression models to determine predictors of the PtcCO₂ - PcapCO₂ difference (ΔCO₂).</div><div>The median age of the participants was 12.2 years (IQR 8.8–15.3), with 60 % being male. Paired measurements showed a strong positive correlation (<em>r</em> = 0.703; <em>p</em> &lt; 0.0001) between PtcCO₂ and PcapCO₂. Bland-Altman analysis indicated a ΔCO₂ mean bias of −0.59 mmHg, with limits of agreement from −5.56 to +4.38 mmHg. No significant differences in ΔCO₂ were found across devices (<em>p</em> = 0.41). In the multivariate regression analysis, mean pH emerged as the sole independent predictor of ΔCO₂, with each 0.01-unit pH increase associated with an approximately 0.31 mmHg larger ΔCO₂ (<em>β</em> = 0.31; <em>95 % CI</em> = 0.18, 0.43).</div><div>These findings suggest that PtcCO₂ measurements provide a reliable estimation of PcapCO₂ in this population, although temporary differences may arise due to hyperventilation during blood sampling.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"140 ","pages":"Article 108816"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120087","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":"Attentional function and nocturnal electroencephalography theta/beta ratio in children with rapid-eye movement sleep-related obstructive sleep apnea","authors":"Yunxiao Wu ,&nbsp;Dandi Ma ,&nbsp;Yao Song ,&nbsp;Xiaolin Ning ,&nbsp;Zhifei Xu","doi":"10.1016/j.sleep.2025.108723","DOIUrl":"10.1016/j.sleep.2025.108723","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate daytime attentional function in children with rapid eye movement (REM) sleep-related obstructive sleep apnea (OSA; REM-OSA) and its relationship with sleep electroencephalography theta/beta ratio (TBR).</div></div><div><h3>Methods</h3><div>One-hundred-and-three children (aged 6–11 years) with snoring/mouth breathing were recruited from Beijing Children's Hospital. Participants completed the Attentional Networks Test for Interactions and Vigilance - executive and arousal components (ANTI-Vea) and underwent polysomnography. Groups were classified according to the obstructive apnea/hypopnea index (OAHI): 20 non-OSA, 53 non-REM-OSA, and 30 REM-OSA. The TBR of the frontal, central, and occipital regions was analyzed.</div></div><div><h3>Results</h3><div>Children with REM-OSA exhibited higher reaction time variability for executive vigilance and more errors during invalid condition ANTI-Vea trials than the non-REM-OSA group. The REM-OSA group exhibited higher TBRs in the frontal and central regions during all sleep stages than the non-OSA and non-REM-OSA groups and a higher TBR in the frontal and central region during REM sleep than the non-OSA group. Occipital TBR did not differ among the three groups. Reaction time variability for executive vigilance correlated positively with OAHI during REM sleep (OAHI_REM). TBR in the frontal and central regions during all sleep stages and TBR in the frontal region during REM sleep correlated positively with the number of errors during invalid condition ANTI-Vea trials.</div></div><div><h3>Conclusions</h3><div>Children with REM-OSA exhibited impaired attentional function, characterized by increased reaction time variability for executive vigilance and poorer performance in the invalid condition attention task trials. The OAHI_REM and TBR reflect distinct dimensions of attentional impairment in pediatric OSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108723"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of digital cognitive behavioral therapy for insomnia in hypnotic reduction among patients with insomnia: A randomized controlled trial","authors":"Min Liu ,&nbsp;Ruhan Yi ,&nbsp;Ziliang Han ,&nbsp;Ruiqi Wang ,&nbsp;Min Chen ,&nbsp;Ping Yao ,&nbsp;Bin Zhang ,&nbsp;Wuhong Lin ,&nbsp;Dongsheng Lv","doi":"10.1016/j.sleep.2025.108727","DOIUrl":"10.1016/j.sleep.2025.108727","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the efficacy and adherence of digital cognitive behavioral therapy for insomnia (dCBT-I) for hypnotic medication reduction in patients with insomnia disorder comorbid with anxiety and depressive symptoms who require long-term pharmacotherapy.</div></div><div><h3>Methods</h3><div>A single-center, randomized, double-blind, parallel-group trial was conducted at the Brain Hospital of Inner Mongolia Autonomous Region. A total of 112 adult outpatients who met the DSM-5 criteria for insomnia comorbid with anxiety and depressive symptoms were enrolled. Participants were randomly assigned (1:1) to receive either 4 weeks of dCBT-I (n = 56) or digital sleep hygiene education (dSHE; n = 56) as an active control. For participants who showed sleep improvement, a gradual tapering protocol was implemented for hypnotic medications at a rate of 25 % reduction from the initial dose per week. Dosages of antidepressants and hypnotics were converted to fluoxetine equivalents and alprazolam equivalents, respectively. The medication reduction rate (derived from the alprazolam equivalents dosage) and ISI scores were the primary outcomes, assessed at weeks 4, 8, and 12.</div></div><div><h3>Results</h3><div>A total of 76 participants (42 in the dCBT-I group and 34 in the dSHE group) completed the 4-week intervention, yielding an overall adherence rate of 74. 5 %. Significant between-group differences favoring dCBT-I over dSHE in hypnotic medication reduction were observed at week 4 (β = −0.17, t = −2.17, P &lt; 0.05), week 8 (β = −0.21, t = −2.70, P &lt; 0.01), and week 12 (β = −0.18, t = −2.41, P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>dCBT-I represents an effective and adherence-friendly treatment model for reducing hypnotic medication use in patients with insomnia comorbid with anxiety and depressive symptoms.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108727"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792169","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":"REM – predominant obstructive sleep apnea in adults with a history of COVID-19 infection: A case-control study","authors":"Ipek Calik ,&nbsp;Yüksel Peker","doi":"10.1016/j.sleep.2025.108729","DOIUrl":"10.1016/j.sleep.2025.108729","url":null,"abstract":"<div><h3>Study objectives</h3><div>An association between COVID-19 and obstructive sleep apnea (OSA) has been reported in literature. We aimed to address the occurrence and phenotypes of OSA in adults with a history of COVID-19 infection and its possible association with long-COVID.</div></div><div><h3>Methods</h3><div>In this matched case-control study, 152 individuals with a history of COVID-19 and 152 without were evaluated in a sleep laboratory. Groups were matched for age, sex, and body mass index. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. Rapid Eye Movement (REM)-predominant OSA was defined as AHI ≥15/h and REM-AHI/non-REM-AHI ≥2. Fatigue, reported as “frequent/very frequent,” was used as a surrogate marker of long-COVID.</div></div><div><h3>Results</h3><div>The prevalence of OSA was significantly lower in the case group (50.0 %) compared to the control group (77.6 %) (p &lt; 0.001). However, 36 cases (47.4 %) exhibited REM-predominant OSA while 21 controls (17.8 %) demonstrated this phenotype (p &lt; 0.001). In a multiple logistic regression analysis, there was a significant correlation between prior COVID-19 infection and the occurrence of REM-predominant OSA (Odds ratio [OR] 3.14; 95 % confidence interval [CI] 1.89–5.25; p &lt; 0.001). Fatigue was observed in 52.8 % of patients with REM-predominant OSA and 35.7 % of patients without REM-predominant OSA (p = 0.033). In the entire cohort, the factors determining the fatigue were female sex (OR 2.02; 95 % CI 1.12–3.64, p = 0.019) and REM-predominant OSA (OR 2.18; 95 % CI 1.29–3.69; p = 0.004).</div></div><div><h3>Conclusions</h3><div>REM-predominant OSA is highly prevalent among individuals with prior COVID-19 infection and is significantly associated with fatigue, underscoring the need to recognize this phenotype in the evaluation and management of Long-COVID.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108729"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766057","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":"Validation of the Korean version of the Time Monitoring Behavior-10 (TMB-10) and its relationship with sleep effort and adaptive sleep-related cognition","authors":"Seockhoon Chung ,&nbsp;Barry Krakow","doi":"10.1016/j.sleep.2025.108741","DOIUrl":"10.1016/j.sleep.2025.108741","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to validate the Korean version of the Time Monitoring Behavior-10 (TMB-10) among individuals who complain of insomnia. In addition, we examined the relationship among sleep-related cognition, time-monitoring behavior, and insomnia severity.</div></div><div><h3>Methods</h3><div>We conducted an online survey among members of the general population who complain of insomnia. Data from 548 participants were analyzed. Participants’ sleep-wake patterns and psychological status were assessed using rating scales, including the TMB-10, Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), Glasgow Sleep Effort Scale (GSES), and Adaptive Cognition and Behaviors about Sleep-6 (ACBS-6).</div></div><div><h3>Results</h3><div>Exploratory factor analysis using Sample I (N = 271) determined a two-factor model for the TMB-10. Confirmatory factor analysis for the two-factor model revealed a good fit, as indicated by a comparative fit index of 0.996, Tucker–Lewis index of 0.995, root-mean-square error of approximation of 0.123, and standardized root-mean-square residual of 0.001. The internal consistency reliability of the Korean version of the TMB-10 was high (McDonald's omega = 0.940). The TMB-10 significantly correlated with sleep onset time (r = 0.26), sleep onset latency (r = 0.23), wake-up time (r = 0.11), desired time in bed (r = 0.12), ISI (r = 0.59), PHQ-9 (r = 0.45), GSES (r = 0.60), and ACBS-6 (r = −0.13; all p &lt; 0.01). Linear regression analysis revealed that age (<em>β</em> = −0.09), ISI (<em>β</em> = 0.32), ACBS-6 (<em>β</em> = −0.08), and GSES (<em>β</em> = 0.39) were associated with the TMB-10. Adaptive sleep-related cognition was associated with improved, and sleep effort was associated with worsened insomnia severity, and time-monitoring behavior mediated the influence of adaptive sleep-related cognition and sleep effort on insomnia severity.</div></div><div><h3>Conclusion</h3><div>The Korean TMB-10 is a reliable and valid tool for assessing time-monitoring behavior. Time monitoring was correlated with greater insomnia severity, higher sleep effort, and less adaptive sleep-related cognition.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108741"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 3, multicenter, double-blind, randomized, placebo-controlled clinical trial of lemborexant in adults with insomnia disorder","authors":"Wei-Feng Mi ,&nbsp;Dan Wen ,&nbsp;Lijun Xu ,&nbsp;Jiyang Pan ,&nbsp;Ping Gu ,&nbsp;Changhong Wang ,&nbsp;Jiyou Tang ,&nbsp;Li Zhang ,&nbsp;Chun-feng Liu ,&nbsp;Chengmei Yuan ,&nbsp;Hanqiao Wang ,&nbsp;Naoto Yamakawa ,&nbsp;Takao Takase ,&nbsp;Margaret Moline ,&nbsp;Lin Lu","doi":"10.1016/j.sleep.2025.108722","DOIUrl":"10.1016/j.sleep.2025.108722","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated the efficacy and safety of lemborexant (LEM), a dual orexin-receptor antagonist, in participants with insomnia disorder in China.</div></div><div><h3>Methods</h3><div>E2006-J086-311 (Study 311; NCT04549168), a 1-month, multicenter, randomized, double-blind, placebo (PBO)-controlled, parallel-group study, enrolled adults (≥18 years) with insomnia disorder in China. Pairs of polysomnograms were conducted during a 7-day PBO run-in period (baseline), after the first 2 doses of LEM 10 mg (LEM10) or PBO, and after the last 2 doses at the end of 1 month of treatment. Objective sleep parameter assessments included latency to persistent sleep (LPS; primary endpoint) and secondary endpoints of sleep efficiency, wake after sleep onset (WASO), and total sleep time (TST; exploratory endpoint). Safety data were collected.</div></div><div><h3>Results</h3><div>Among 194 participants randomized (PBO, n = 100; LEM10, n = 94), the median age was approximately 42 years; most participants were female (PBO: 74.0 %; LEM10: 61.3 %). Following 1 month of treatment, mean (standard deviation [SD]) decreases from baseline in LPS were larger (improved) for the LEM10 treatment group (−39.47 min [46.147 min]) versus PBO (−21.71 min [42.809 min]; post hoc Box-Cox transformation, <em>p</em> = 0.0096). LEM10 demonstrated larger and statistically significant increases from baseline (improvements) in sleep efficiency (<em>p</em> &lt; 0.0001) and TST (<em>p</em> &lt; 0.0001) and significant decreases from baseline (improvement) in WASO (<em>p</em> = 0.0002) versus PBO and was well-tolerated. No new safety signals with LEM were observed in the current study compared with the known safety profile.</div></div><div><h3>Conclusions</h3><div>LEM may be an important potential treatment option for patients with insomnia in China.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier (first submitted on 09-09-2020): NCT04549168; Study protocol and statistical analysis plan may be accessed at: <span><span>https://clinicaltrials.gov/study/NCT04549168</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108722"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828457","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":"Circadian rest-activity rhythm in patients with narcolepsy following modafinil treatment: Outcomes and predictive markers","authors":"Wei-Chih Chin ,&nbsp;Si-Yu Chu ,&nbsp;Tsun-Yi Roan ,&nbsp;Pin-Yi Lee ,&nbsp;I. Tang ,&nbsp;Chen Lin ,&nbsp;Yu-Shu Huang","doi":"10.1016/j.sleep.2025.108756","DOIUrl":"10.1016/j.sleep.2025.108756","url":null,"abstract":"<div><h3>Objectives</h3><div>Hypersomnolence of narcolepsy is commonly treated with modafinil, but its impacts on circadian rhythm remain unclear. Compared with standard parametric analyses, the non-parametric analysis of actigraphy offers more details to observe sleep-wake patterns. This study monitored narcolepsy patients' rest-activity patterns before and after modafinil treatment by actigraphy. Data were analyzed with non-parametric methods to evaluate outcomes and investigate the potential predictive markers for treatment response.</div></div><div><h3>Methods</h3><div>We prospectively recruited participants with type 1 and 2 narcolepsy. Participants received 200–400 mg of modafinil daily for six months and actigraphy was worn for 7–14 days before and after treatment. We used paired sample t-tests for pre- and post-treatment comparisons and independent sample t-tests and chi-square tests to assess group differences. Correlation analyses were conducted using Pearson's correlation test.</div></div><div><h3>Results</h3><div>A total of 103 participants (mean age: 23.95 ± 10.14 years; 53.4 % male) were recruited, including 64 with NT1 and 39 with NT2. After modafinil treatment, significant increases in daytime activity were observed, along with an earlier shift in the midpoint time of daytime activity. Patients with NT1 showed more improvements than those with NT2. Correlation analysis showed that subjective sleepiness and quality of life were associated with circadian parameters, and patients with a higher REM percentage and those with nocturnal sleep onset REM period demonstrated greater improvements in circadian parameters.</div></div><div><h3>Conclusion</h3><div>Modafinil improves circadian rest-activity rhythms in narcolepsy patients, especially those with NT1. The role of REM percentage and nocturnal SOREMP as predictive markers for treatment outcomes warrant further investigation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108756"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913194","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, biomarker profiles, and clinical progression in Parkinson's disease: Longitudinal effects of CPAP therapy","authors":"Shasha Zhu ,&nbsp;Di An ,&nbsp;Xiaoxi Liu","doi":"10.1016/j.sleep.2026.108766","DOIUrl":"10.1016/j.sleep.2026.108766","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is common in Parkinson's disease (PD) and may exacerbate neurodegeneration via inflammatory and glial mechanisms, yet longitudinal biomarker data are scarce. We aimed to compare inflammatory, glial, and neurodegenerative biomarkers in PD patients with and without OSA, assess associations between OSA severity and biomarker levels, evaluate biomarker–symptom relationships, and determine the longitudinal effects of continuous positive airway pressure (CPAP) therapy on clinical and biomarker outcomes.</div></div><div><h3>Methods</h3><div>In this 12-month prospective cohort study, 140 PD patients (PD + OSA n = 72; PD−OSA n = 68) underwent polysomnography, clinical evaluations, and blood/CSF sampling. Biomarkers included IL-1β, IL-18, IL-6, TNF-α, CRP, CHI3L1, S100B, GFAP, and NfL. Cross-sectional and longitudinal associations were analyzed using multivariable regression and linear mixed-effects models. CPAP-treated participants were stratified by adherence. Mediation analyses (5000 bootstraps) assessed pathways linking biomarker changes to clinical improvement.</div></div><div><h3>Results</h3><div>Among 140 patients with Parkinson's disease (PD), 72 (51.4 %) had obstructive sleep apnea (OSA). PD + OSA showed higher BMI (27.41 vs 25.92 kg/m²; P = 0.018), worse ESS (10.91 vs 8.42; P &lt; 0.001), and lower MoCA (24.41 vs 25.82; P = 0.009). Sleep studies confirmed markedly elevated AHI (24.82 vs 4.82/h; P &lt; 0.001) and deeper desaturation. PD + OSA displayed higher inflammatory (IL-1β, IL-6, TNF-α), glial (CHI3L1, GFAP, S100B), and neurodegeneration markers (NfL; 1584 vs 1291 pg/mL; P = 0.001). OSA severity correlated strongly with biomarker levels, especially ODI (e.g., IL-6 β = 0.40; P &lt; 0.001; NfL β = 0.34; P = 0.001). Biomarkers predicted symptoms: IL-6 with UPDRS III, CHI3L1 with ESS, and NfL with MoCA decline. Longitudinally, PD + OSA worsened faster in motor (UPDRS III +2.34 vs + 1.12/year; P &lt; 0.001), non-motor, and cognitive outcomes (MoCA −1.01 vs −0.42/year; P = 0.003). Among 58 PD + OSA initiating CPAP, 29 were adherent. Adherence reduced AHI (−12.60; P &lt; 0.001), slowed motor decline (UPDRS III −0.62 vs + 2.41/year; P &lt; 0.001), preserved cognition, and lowered IL-6, TNF-α, CRP, CHI3L1, and S100B. Reductions in IL-6 and NfL mediated ∼40 % of CPAP's motor benefits, and CHI3L1 mediated improvements in daytime sleepiness.</div></div><div><h3>Conclusions</h3><div>OSA substantially enhances inflammatory, glial, and neuroaxonal injury pathways in PD and contributes to worse motor, non-motor, and cognitive outcomes. CPAP therapy attenuates these pathological processes and improves clinical symptoms, suggesting a mechanistic basis for incorporating OSA screening and treatment into comprehensive PD management.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108766"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918522","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":"Is a full psychotherapy program necessary to reduce benzodiazepine dependence for insomnia? A Randomized Controlled Trial Comparing Drug Tapering with Single-Session CBT vs. Full Acceptance and Commitment Therapy","authors":"Mélinée Chapoutot ,&nbsp;Marie-Paule Gustin ,&nbsp;Royce Anders ,&nbsp;Laure Peter-Derex ,&nbsp;Hélène Bastuji ,&nbsp;Yasser Khazaal ,&nbsp;Benjamin Putois","doi":"10.1016/j.sleep.2025.108744","DOIUrl":"10.1016/j.sleep.2025.108744","url":null,"abstract":"<div><h3>Objective</h3><div>Benzodiazepines and Z-drugs (BZs) are known to present a high-risk for chronic dependence when patients do not adhere to duration of use guidelines. Cognitive Behavioral Therapy for Insomnia (CBT-I) has shown effectiveness to reduce dependence, but is not frequently sought by consumers due to being costly and time intensive. A single session of CBT-I may show promise as a compromise. The efficacy of these two approaches is herein compared in the context of a drug tapering program.</div></div><div><h3>Method</h3><div>In this randomized controlled trial, the latest generation of CBT-I, Acceptance and Commitment Therapy for Insomnia (ACT-I), was compared to a single session of CBT-I in the context of a tapering program assessing two tapering speeds (rapid-6 weeks vs. long-18 weeks), and short vs. long BZs drug half-lives. The taper program consisted of 10-min phone guided sessions with a psychologist. Participants were evaluated pre-treatment, and at 1, 3, and 12 months post-treatment.</div></div><div><h3>Results</h3><div>Across all experimental groups, by 12 months, 58.6 % of the 87 participants achieved successful abstinence, and 29.9 % reduced their daily dosage by more than 50 %. No significant difference was observed between ACT-I and the single session of CBT-I. The rapid taper condition led to cumulative withdrawal symptoms in long BZ half-life consumers.</div></div><div><h3>Conclusion</h3><div>Both ACT-I and the single session of CBT-I are associated with similar success rates when combined with a drug tapering program consisting of periodic telephone consultations. Clinical practice may be reevaluated to propose slow tapering for long BZ half-lives. The data show this program to be effective to a broad population.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108744"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927333","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 sleep disturbances and circulating inflammatory markers in depressive and bipolar disorders: a systematic review and meta-analysis","authors":"Valeria Fiori,&nbsp;Caterina Lombardo,&nbsp;Andrea Ballesio","doi":"10.1016/j.sleep.2025.108735","DOIUrl":"10.1016/j.sleep.2025.108735","url":null,"abstract":"<div><div>Evidence of a connection between sleep disturbances (i.e., difficulties in sleep onset or sleep maintenance) and inflammation in major depression (MDD) and bipolar (BD) disorders is still under debate. Here, we report a systematic review and meta-analysis on the correlation between sleep disturbances and peripheral proinflammatory markers in adult individuals with MDD or BD. The review followed the PRISMA guidelines and was registered in PROSPERO (CRD42025638037). Pubmed, Scopus, PsycInfo, Web of Science, MEDLINE, and CINAHL were searched up to January 2025. Of the 5694 articles retrieved, 21 studies met the inclusion criteria and were considered for the systematic review; 13 reported data for meta-analysis. DerSimonian and Laird random effect models showed that subjective sleep disturbances were significantly associated with pooled inflammatory markers (k = 13, n = 5261, r = .12, 95 % CI = .056 to .175, p &lt; .001) and specifically C-reactive protein (CRP) levels (k = 8, n = 4949, r = .08, 95 % CI = .018 to .147, p = .012) in MDD patients. Meta-regressions revealed no evidence of moderation by BMI and sex. Analysis on interleukins (IL-6, IL-1β, IL-8), and tumour necrosis factor-α (TNF-α), did not reach statistical significance. The number of studies in BD patients did not suffice meta-analysis. While results may suggest a sleep-immune cross-talk in the pathophysiology of MDD, findings should be interpreted in light of the substantial meta-analytic heterogeneity.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108735"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879020","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}