Sleep medicine最新文献

{"title":"Association between obstructive sleep apnea and metabolic profiles across sleep stages in pediatrics","authors":"Yiling Wan ,&nbsp;Xiaoyi Wang ,&nbsp;Xianshan Hu ,&nbsp;Xiaojun Zhan ,&nbsp;Yaru Kong ,&nbsp;Tianxu Liu ,&nbsp;Wen Hu ,&nbsp;Jun Tai","doi":"10.1016/j.sleep.2026.108763","DOIUrl":"10.1016/j.sleep.2026.108763","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between metabolic profiles and obstructive sleep apnea (OSA) during rapid eye movement (REM) and non-REM (NREM) sleep in children.</div></div><div><h3>Methods</h3><div>A total of 514 children underwent overnight polysomnography (PSG) and biochemical testing. Obstructive apnea hypopnea indices (OAHI) and oxygen desaturation indices (ODI) were recorded for total sleep time (TST), REM, and NREM. A multivariate analysis of covariance model assessed the associations of OAHI_TST, OAHI_NREM, and OAHI_REM with overall metabolic parameters, adjusting for body mass index (BMI) z-score and other covariates. Then, multivariable linear regression models were used to quantify the independent effects of sleep variables on metabolic profiles during REM and NREM sleep.</div></div><div><h3>Results</h3><div>When stratified by OAHI-defined severity of OSA, TP, TCH, TG, HDL-C, LDL-C, LDL-C/HDL-C, TyG, and ALT levels were significantly different during TST and NREM (all P &lt; 0.05). In fully adjusted multivariable linear regression models, both OAHI_TST, OAHI_NREM and OAHI_REM were independently associated with these metabolic parameters. When stratified by ODI-defined severity of OSA, HDL-C, LDL-C, LDL-C/HDL-C, and TyG levels differed significantly during NREM (all P &lt; 0.05) and were independently related to ODI_NREM. ODI_REM was independently associated with TP, TCH, TG, HDL-C, LDL-C, LDL-C/HDL-C, and TyG levels. And in fully adjusted multivariable linear regression models, associations between ODI and TG, LDL-C, and TCH were evident during REM sleep but not during NREM sleep.</div></div><div><h3>Conclusions</h3><div>In pediatric OSA, OAHI was associated with metabolic alterations throughout sleep stages. ODI showed more pronounced metabolic effects during REM sleep, where the associations of TG, LDL-C, and TCH varied across ODI severity categories.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108763"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913245","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":"Drivers of suboptimal sleep education and insomnia in children: A Cognitive and Emotional Model of Young Children's Insomnia (CEMYCI)","authors":"Florian Lecuelle ,&nbsp;Royce Anders ,&nbsp;Marie-Paule Gustin ,&nbsp;Marie-Josèphe Challamel ,&nbsp;Marc Weissbluth ,&nbsp;Patricia Franco ,&nbsp;Benjamin Putois","doi":"10.1016/j.sleep.2025.108737","DOIUrl":"10.1016/j.sleep.2025.108737","url":null,"abstract":"<div><h3>Aims</h3><div>This study involved empirical data modelling with the aim of developing a Cognitive and Emotional Model of Young Children's Insomnia (CEMYCI). This theoretical framework newly integrates influential cognitive and emotional dimensions, or drivers, and parent-child dynamics, into the classically-described behavioral framework of insomnia. It more comprehensively accounts for the mechanisms leading to or reinforcing childhood insomnia, thereby offering important clinical angles to consider for successfully managing behavioral insomnia.</div></div><div><h3>Methods</h3><div>A large array of sleep, health, cognitive, behavioral, and emotional variables were measured in children and parents, including for example nighttime parent interventions, screen exposure, and perceived guilt. 2291 mothers of children aged from 6 months to 6 years old participated in the study. Psychometrically-validated questionnaires were used for measurement. Correlation, regression, factor analyses, and structural equation modelling were performed.</div></div><div><h3>Results</h3><div>The resultant CEMYCI model successfully explained <em>R</em>^<em>2</em> = 91 % of the variance in childhood insomnia compared to <em>R</em>^<em>2</em> = 78 % from the multiple regression analysis. The CEMYCI model specifies paths between key psychological and behavioral constructs such as nighttime toddler crying, parent interpretations of crying, judgmental emotions, daytime parenting challenges, drivers of overinvolvement and maladaptive parenting interventions that exacerbate child insomnia, in-turn leading to parent distress symptoms.</div></div><div><h3>Conclusion</h3><div>This new theoretical framework highlights the importance of integrating psychoeducational strategies and cognitive restructuring into the treatment of childhood sleep disorders. By enhancing our understanding of the complex dynamics between parents and children, this model offers innovative perspectives for therapeutic interventions, aiming to reduce the impact of insomnia on children and their families.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108737"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889899","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 of estimated cardiorespiratory fitness with circadian syndrome: A cross-national analysis of two large aging cohorts","authors":"Mingjie Liu ,&nbsp;Chendong Wang ,&nbsp;Bohan Xiang ,&nbsp;Rundong Liu ,&nbsp;Yingjia Hu ,&nbsp;Haili Ma","doi":"10.1016/j.sleep.2025.108736","DOIUrl":"10.1016/j.sleep.2025.108736","url":null,"abstract":"<div><h3>Background</h3><div>Promoting healthy aging requires identifying modifiable factors that can preserve physiological regulation. Cardiorespiratory fitness (CRF), a key pillar of healthspan, and Circadian Syndrome (CircS), an emerging marker of systemic dysregulation, are both strongly linked to health outcomes, yet their direct relationship is unknown. This study aimed to investigate the cross-sectional and longitudinal associations between estimated CRF (eCRF) and CircS in two large, distinct aging populations.</div></div><div><h3>Methods</h3><div>This population-based study utilized data from the China Health and Retirement Longitudinal Study (CHARLS; n = 3116) and the English Longitudinal Study of Ageing (ELSA; n = 7039). Associations were evaluated using logistic regression for prevalent CircS and Cox proportional hazards models for incident CircS. Covariate selection for these models was guided by a Directed Acyclic Graph (DAG). Restricted cubic splines were used to model non-linear associations, and stratified analyses were conducted to identify potential effect modifiers.</div></div><div><h3>Results</h3><div>A total of 10,155 participants were included. Cross-sectionally, higher eCRF was robustly associated with lower odds of prevalent CircS in both CHARLS (OR for high vs. low: 0.12, 95 %CI 0.10–0.15) and ELSA (OR: 0.16, 95 %CI 0.14–0.18), with a linear dose-response in CHARLS but a non-linear one in ELSA. Longitudinally, higher baseline eCRF was associated with a lower risk of incident CircS in both the CHARLS (HR: 0.38, 95 %CI 0.25–0.56) and the ELSA cohorts (HR: 0.45, 95 %CI 0.36–0.56). The association in ELSA was significantly modified by sex (P-interaction&lt;0.001), being stronger in females; this interaction was observed in both cross-sectional and longitudinal analyses.</div></div><div><h3>Conclusion</h3><div>Higher eCRF is associated with both a lower prevalence and reduced long-term incidence of CircS in both Chinese and English older adults. However, the characteristics of this association, including dose-response patterns and modification by sex, appear to be population-dependent.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108736"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820753","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":"Remote assessments of sleep and cognition in cognitively normal older adults at risk for Alzheimer disease","authors":"Hannah M. Wilks ,&nbsp;Matthew S. Welhaf ,&nbsp;Andrew J. Aschenbrenner ,&nbsp;Brian D. Carpenter ,&nbsp;Brian A. Gordon ,&nbsp;Suzanne E. Schindler ,&nbsp;Brendan P. Lucey ,&nbsp;John C. Morris ,&nbsp;Jason Hassenstab","doi":"10.1016/j.sleep.2025.108734","DOIUrl":"10.1016/j.sleep.2025.108734","url":null,"abstract":"<div><h3>Study objectives</h3><div>Sleep is a marker of brain function that could potentially identify patients for early intervention by detecting cognitive change during the early asymptomatic stages of Alzheimer disease (AD). We examined the relationship between sleep and cognition in cognitively unimpaired older adults and evaluated whether the relationship was altered by AD risk factors.</div></div><div><h3>Methods</h3><div>Cognitively unimpaired older adults (N = 319, age 54–97 years) were administered a sleep diary (1x/day) and brief cognitive assessments (4x/day) for seven consecutive days via a smartphone application. We evaluated if a previous night's sleep predicts next-day cognition and if sleep averaged over a week predicts cognitive performance averaged over a week. Additional analyses included the effects of carrying an apolipoprotein <em>(APOE)</em> ε4 allele and cerebrospinal fluid biomarkers of AD pathology.</div></div><div><h3>Results</h3><div>At the between-person level, no associations were observed between sleep and cognition. Within-person analyses revealed that deviations (both higher and lower scores) from an individual's usual sleep pattern were associated poorer next day cognitive performance. Carriage of the <em>APOE</em> ε4 allele and AD biomarkers did not interact with sleep-cognition relationships.</div></div><div><h3>Conclusions</h3><div>Remote, multi-day assessments of cognition and sleep revealed subtle non-linear associations between nightly sleep and next-day cognition in cognitively unimpaired older adults. Furthermore, the individualized nature of sleep-cognition relationships underscores the importance of maintaining consistent person-centered sleep health metrics to support cognitive function. Capturing latent AD-related changes in sleep and cognition among asymptomatic older adults may require repeated assessments across extended timeframes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108734"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841759","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":"Co-classification network analysis reveals nodal dysfunction and dimension-specific alterations in obstructive sleep apnea-hypopnea syndrome","authors":"Zhiyuan Yang ,&nbsp;Maoyuan Jiang ,&nbsp;Jialiu Jiang ,&nbsp;Ruozhu Xiong ,&nbsp;Chenglu Mao ,&nbsp;Shuang Fang ,&nbsp;Lili Huang ,&nbsp;Zhihong Ke ,&nbsp;Zheqi Hu ,&nbsp;Yuting Mo ,&nbsp;Yun Xu","doi":"10.1016/j.sleep.2026.108764","DOIUrl":"10.1016/j.sleep.2026.108764","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a prevalent sleep disorder linked to brain alterations, but its brain network patterns and convenient screening methods remain unclear. This study aimed to characterize OSAHS functional brain networks via co-classification network analysis and assess their diagnostic utility.</div></div><div><h3>Methods</h3><div>174 participants were stratified by the apnea-hypopnea index (AHI) into none or mild (nm-OSAHS) and moderate or severe (ms-OSAHS) groups, and by the lowest oxygen saturation (SpO₂ nadir) into none or mild (nm-hypoxemia) and moderate or severe (ms-hypoxemia) groups. (Registered number: MR-32-25-040098). They underwent out-of-center sleep testing, neuropsychological tests, and MRI. Co-classification networks (via consensus modularity analysis) and traditional functional networks (via graph theory) were analyzed, with random forest model for diagnostic accuracy.</div></div><div><h3>Results</h3><div>Ms-OSAHS and ms-hypoxemia groups showed worse sleep respiratory parameters. Co-classification network analysis revealed significant alterations in intra-module z score, participation coefficient (PC), and diversity coefficient (SD) in the visual, dorsal attention, salience/ventral attention, and executive control networks in ms-OSAHS patients. PC in the left temporo-occipital junction and right parietal operculum was positively correlated with AHI, while PC in limbic regions was negatively correlated with lowest SpO₂. The random forest model using co-classification metrics demonstrates good diagnostic performance for OSAHS, with dorsal attention, control, and salience networks mostly contributing to classification.</div></div><div><h3>Conclusions</h3><div>OSAHS induced widespread nodal dysfunction in brain networks, with distinct changes driven by hypoxemia and apnea frequency. Co-classification network analysis outperforms traditional methods in detecting network abnormalities, and machine learning models based on nodal parameters show high diagnostic accuracy, suggesting potential for OSAHS screening.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108764"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967029","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":"Sex-specific changes and age-specific trends in sleep quality and sleep apnea: Analysis of one-million nights of sleep","authors":"Hugi Hilmisson ,&nbsp;Solveig Magnusdottir ,&nbsp;Robert J. Thomas","doi":"10.1016/j.sleep.2025.108728","DOIUrl":"10.1016/j.sleep.2025.108728","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleep quality and breathing changes with aging. Women report worse subjective sleep-quality while having better objective polysomnographic (PSG) sleep quality, than men. Electroencephalogram (EEG) slow-wave sleep shows marked reductions with age, but non-EEG based sleep quality is relatively well preserved.</div></div><div><h3>Methods</h3><div>The CPC-based SleepImage® System was used to estimate a sleep quality index (SQI), sleep fragmentation and sleep apnea. Included in the analysis are 1 million nights of clinical home recordings including ≥6-h of duration and ≥4-h of estimated total-sleep time, with good signal quality (≥80%) from individuals ≥18-years (45.5%-women, average 2-nights).</div></div><div><h3>Results</h3><div>Age groups in years (n = 1 million, 45.4 % women) were defined as 18-30-years (n = 97,192, 46.0%-women), 31-40-years (n = 170,879, 41.6%-women), 41-50-years (n = 211,795, 42.7%-women), 51-60-years (n = 224,795, 46.8%-women), 61-70-years (188,798, 48.8%-women) and ≥71-years (107,065, 47.1%-women). Paralleling known N3 patterns, women have significantly higher SQI in all age-groups. However, sleep efficiency is significantly lower in women in all age-groups and starts to decline in both sexes ≥71-years of age. The SQI gradually declines in both sexes until ≥61-years and then stabilizes, unlike the EEG based N3. AHI₃_% is significantly lower in women in all age-groups. AHI₃_% gradually increases with age, most prominently in men from 31 to 51 years and women after 51 years AHI₃_% has stronger negative correlation with SQI in men, then declines ≥61 years.</div></div><div><h3>Conclusion</h3><div>The sleep quality decline with age in a non-PSG EEG based assessment is less evident than the reported steep decline in N3 sleep. The CPC-SQI is higher in women in all age-groups, but sleep efficiency is lower, which may help explain lower subjective sleep quality in women.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108728"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820781","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 problems in relation to emotion dysregulation in children with ADHD","authors":"Lin Sørensen ,&nbsp;Camille Hjo ,&nbsp;Stephen P. Becker","doi":"10.1016/j.sleep.2025.108738","DOIUrl":"10.1016/j.sleep.2025.108738","url":null,"abstract":"<div><div>Sleep disturbances are highly prevalent in children with attention-deficit/hyperactivity disorder (ADHD). Although situation-inappropriate emotion regulation is a well-established characteristic of ADHD, and sleep problems have been linked to such emotion dysregulation (EDR) in children more broadly, the nature of this relationship in ADHD remains insufficiently understood. EDR in ADHD is typically characterized by emotion lability, most prominently through heightened negative emotions. However, increasing evidence suggests that children with ADHD also struggle with lability in regulating positive affect. In this study, we applied a four-factor model of EDR—negative emotion lability, positive emotion lability, socially inappropriate affect, and socially incongruent affect—to examine associations between sleep disturbances and EDR in a sample of children with ADHD. Caregivers of 139 children aged 8–12 years completed the Children's Sleep Habits Questionnaire and the Emotion Regulation Checklist. Based on prior evidence, we hypothesized that sleep disturbances would be more strongly related to emotion lability than to socially inappropriate or socially incongruent affect. Multiple linear regression analyses supported this hypothesis: sleep disturbances were primarily associated with emotion lability, particularly fluctuations in positive affect. These findings provide clinically relevant insights into the interplay between sleep and EDR in ADHD and extend the focus beyond the traditional emphasis on negative emotion lability.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108738"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820757","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":"Pharmacological management of insomnia with a focus on GABAA receptor positive allosteric modulators and orexin receptor antagonists","authors":"Chelsea Unger,&nbsp;Kristi A. Kohlmeier","doi":"10.1016/j.sleep.2025.108743","DOIUrl":"10.1016/j.sleep.2025.108743","url":null,"abstract":"<div><div>The scientific literature regarding the effectiveness of two insomnia treatments: GABA_A receptor positive allosteric modulators, and orexin receptor antagonists is reviewed. In this review, we define insomnia, present epidemiological statistics on insomnia, and provide a rationale for use of medications targeting GABA_A and orexin receptors for management of insomnia. Following this, we present results of a PRISM guideline-based literature search spanning multiple databases, including PubMed, Google Scholar, ScienceDirect as well as curated searches through Baker Library at Harvard Business School covering publications evaluating insomnia therapies based on targeting GABA_A and orexin receptors available as of March 2025. We conclude that orexin receptor antagonists, notably lemborexant, were found to be more effective, safer, and improve quality of life greater when compared to GABA_A receptor positive allosteric modulators for short and long-term treatment of insomnia. While GABA_A receptor positive allosteric modulators are effective for short-term use, which typically spans two to four weeks, they present a greater number of contraindications than orexin receptor antagonists, and orexin receptor antagonists are superior at preserving the natural sleep architecture. Adverse events are particularly exacerbated when GABA_A receptor positive allosteric modulators are used for longer treatment durations spanning months, whereas orexin receptor antagonists tend to show a more favorable profile over similar long-term use. Nevertheless, there is an observed dose-response relationship with orexin receptor antagonists that may increase the risk of abuse at higher dosages. Approval for use of orexin receptor antagonists for management of insomnia is more restrictive in European countries than that seen in other regions around the globe. Taken together, the findings advocate for increased accessibility of orexin receptor antagonists in Europe for management of primary insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108743"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926935","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":"Clinical and socioeconomic burden among people with narcolepsy or idiopathic hypersomnia: A retrospective cohort analysis of the Danish National Patient Registry","authors":"Poul Jørgen Jennum ,&nbsp;Michael Ibsen ,&nbsp;Sam Mettam ,&nbsp;Sarah C. Markt ,&nbsp;Douglas S. Fuller ,&nbsp;Jessica K. Alexander ,&nbsp;Rikke Ibsen ,&nbsp;Jakob Kjellberg ,&nbsp;Caroleen Drachenberg","doi":"10.1016/j.sleep.2025.108690","DOIUrl":"10.1016/j.sleep.2025.108690","url":null,"abstract":"<div><h3>Objective/background</h3><div>To assess the clinical and socioeconomic burden of narcolepsy and idiopathic hypersomnia (IH) in Denmark.</div></div><div><h3>Patients/methods</h3><div>This retrospective cohort study using Danish National Patient Registry data included individuals diagnosed with narcolepsy or IH (1/1/2005–12/31/2017). Individuals with narcolepsy were matched 1:4 with controls without narcolepsy; matching was repeated for individuals with IH. Comorbidities, employment, income, and healthcare costs were assessed in the 3 years before and after diagnosis using logistic regression and generalized linear models.</div></div><div><h3>Results</h3><div>1183 individuals with narcolepsy (4728 controls) and 1801 individuals with IH (7204 controls) were assessed. Before diagnosis, individuals with narcolepsy had higher odds (odds ratio [OR]; 95 % confidence interval [CI]) of having nervous system (7.92 [6.46, 9.71]) or circulatory system diseases (2.45 [1.95, 3.07]) than controls, in addition to higher unemployment (2.30 [1.79, 2.96]). Individuals with narcolepsy had lower mean income before (€22,076 vs €26,538) and after (€21,786 vs €27,090) diagnosis and higher mean healthcare costs before (€4547 vs €1909) and after (€7411 vs €2178) diagnosis. Before diagnosis, individuals with IH had higher odds (OR [95 % CI]) of having nervous system (9.37 [7.93, 11.08]) or circulatory system diseases (1.80 [1.49, 2.16]) than controls, in addition to higher unemployment (1.73 [1.42, 2.10]). Individuals with IH had lower mean income before (€31,947 vs €34,503) and after (€30,262 vs €35,139) diagnosis and higher mean healthcare costs before (€4050 vs €1840) and after (€5124 vs €2106) diagnosis.</div></div><div><h3>Conclusions</h3><div>Danish individuals with narcolepsy or IH had a greater clinical and socioeconomic burden than controls.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108690"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953077","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 impact of exercise training on the obstructive sleep apnea endotypes","authors":"Caroline J. Beatty ,&nbsp;Shane A. Landry ,&nbsp;Dwayne L. Mann ,&nbsp;Simon A. Joosten ,&nbsp;Jinny Collet ,&nbsp;Rosyvaldo Ferreira-Silva ,&nbsp;Linda M. Ueno-Pardi ,&nbsp;Pedro R. Genta ,&nbsp;Garun S. Hamilton ,&nbsp;Bradley A. Edwards","doi":"10.1016/j.sleep.2025.108740","DOIUrl":"10.1016/j.sleep.2025.108740","url":null,"abstract":"<div><h3>Rationale</h3><div>Weight-loss interventions such as exercise are often recommended to manage obstructive sleep apnea (OSA). Interestingly, exercise can modestly improve OSA severity even without significant changes in body weight. However, the mechanisms underlying the improvements in OSA severity, separate from those observed with weight loss, are currently unknown. We aimed to assess how exercise affects the OSA endotypes (upper-airway collapsibility, loop gain, arousal threshold and upper-airway muscle compensation) and identify individuals most likely to benefit.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from participants with OSA (mean age = 52.8 ± 7.0 years) who underwent a 6-month exercise intervention (n = 22). OSA endotypes were calculated from routine polysomnographic recordings before and following the intervention. Paired t-tests were used to compare the OSA endotypes before and after the exercise intervention. Regression analysis was used to assess whether the baseline OSA endotype(s) predict change in OSA severity.</div></div><div><h3>Results</h3><div>Following exercise training, there was an improvement in the apnea-hypopnea index (AHI; 37.2[17.1, 57.4] to 27.9[15.9, 48.8] events/hr, p = 0.046) but no significant change in body weight. Overall, there was no change in OSA endotypes; however, improvements in AHI were associated with improvements in muscle compensation (r² = 0.332, p = 0.006) and reductions in the arousal threshold (r² = 0.256, p = 0.023). Furthermore, poor muscle compensation (r² = 0.462, p = 0.001) and a high arousal threshold (r² = 0.397, p = 0.004) at baseline predicted greater reductions in OSA severity.</div></div><div><h3>Conclusion</h3><div>Exercise may improve OSA by strengthening the upper airway muscles. As such, regular exercise may be helpful to improve OSA in those with poor upper airway muscle function (and a high arousal threshold).</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108740"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834829","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}