Sleep medicine最新文献

{"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}

{"title":"Child sleep: A cross-sectional survey assessing parent perspectives and support needs","authors":"Mirjana Subotic-Kerry,&nbsp;Brittany Corkish,&nbsp;Kate Maston,&nbsp;Sophie H. Li ,&nbsp;Aliza Werner-Seidler","doi":"10.1016/j.sleep.2025.108742","DOIUrl":"10.1016/j.sleep.2025.108742","url":null,"abstract":"<div><h3>Aim</h3><div>This study examined parents' perspectives about sleep challenges in their child aged 10–12 years and their preferences for information, tools, and resources to support healthy sleep.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was completed by 250 Australian parents/guardians, who reported on the sleep challenges experienced by their own children aged 10–12 years, between May and June 2023. The survey assessed child sleep difficulties, perceived barriers to sleep, the impact of sleep challenges, and parental support needs. Quantitative data were analysed using descriptive statistics, and free-text responses were thematically analysed using an inductive, reflexive approach.</div></div><div><h3>Results</h3><div>Nearly half of parents (47.6 %) reported that their child often had trouble falling asleep, or regularly worried at bedtime (44.8 %). Two in five (40.8 %) reported their child slept fewer than 9 h per night, below national guidelines. The most common barriers to sleep were worry and rumination (62.8 %), difficulty initiating or maintaining sleep (50.4 %), and screen use (37.2 %). Parents described impacts on children's mood, concentration, school engagement, and family functioning. While most parents were motivated to improve their child's sleep, they identified gaps in their knowledge and access to resources. Key areas of need included sleep hygiene education, guidance on managing anxiety, rumination, and screen use, strategies for establishing routines, and developmentally tailored resources.</div></div><div><h3>Conclusions</h3><div>Parents reported that sleep problems were common among their 10–12-year-old children and were often underpinned by worry and rumination. Findings from this study highlighted the need for credible, accessible, and age-appropriate resources tailored to child and family contexts, together with the need for co-designed, family-centred resources to promote healthy sleep in childhood.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108742"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906852","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":"Facial recognition in late-life insomnia: Preserved positivity bias and associations with negative emotions","authors":"Zilu Zhang ,&nbsp;Stephanie Wong ,&nbsp;Tim Windsor ,&nbsp;Xu Lei","doi":"10.1016/j.sleep.2025.108731","DOIUrl":"10.1016/j.sleep.2025.108731","url":null,"abstract":"<div><h3>Background</h3><div>Facial emotion recognition (FER) is essential for social functioning. Although aging is typically associated with reduced FER performance, recognition of positive emotions (e.g., happiness) often remains intact—an effect attributed to an age-related positivity bias. However, insomnia, which is highly prevalent in older adults, may disrupt emotional processing and compromise this typically well-preserved component of FER. Yet, few studies have examined the relationship between insomnia and FER specifically in late life.</div></div><div><h3>Methods</h3><div>Fifty-four older adults with insomnia and fifty healthy controls completed a facial emotion recognition task involving happy, sad, fear, and neutral expressions. Groups were matched for age, and gender and education were statistically controlled as covariates in all analyses. Accuracy and response time were analyzed using linear mixed-effects models. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and correlations between PSQI and FER performance were examined within each group.</div></div><div><h3>Results</h3><div>No significant group differences were observed in overall FER accuracy. However, emotion-specific patterns emerged: happy expressions were recognized more accurately and rapidly across both groups relative to negative emotions (sadness, fear), consistent with the positivity bias. In addition, exploratory analyses revealed different sleep–emotion patterns across groups: in the control group, a non-significant trend suggested that poorer sleep quality may relate to lower accuracy for happy expressions, whereas in the insomnia group poorer sleep quality was significantly associated with faster and more accurate recognition of negative emotions.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that the positivity bias in facial emotion recognition remains behaviorally evident in late life but is not fully robust and appears vulnerable to variation in sleep quality. Within-group exploratory analyses further indicated a preliminary association between poorer sleep quality and potential shift in emotional responsiveness to negative emotional cues in older adult with insomnia, without producing a global deficit in recognition accuracy. These patterns highlight the importance of considering sleep quality and emotion-specific profiles, when evaluating emotional functioning in older adults.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108731"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820765","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":"Positive airway pressure therapy and cardiovascular events in obstructive sleep apnoea: an observational clinical cohort study","authors":"Diego R. Mazzotti ,&nbsp;Aiyu Chen ,&nbsp;Jaejin An ,&nbsp;Joanie Chung ,&nbsp;Jessica Arguelles ,&nbsp;Brendan T. Keenan ,&nbsp;Greg Maislin ,&nbsp;Bruno Saconi ,&nbsp;Alexa J. Watach ,&nbsp;Henry Glick ,&nbsp;Samuel T. Kuna ,&nbsp;Allan I. Pack ,&nbsp;Amy M. Sawyer ,&nbsp;Dennis Hwang ,&nbsp;Jiaxiao Shi","doi":"10.1016/j.sleep.2025.108732","DOIUrl":"10.1016/j.sleep.2025.108732","url":null,"abstract":"<div><h3>Aims</h3><div>Studies support the short-term benefit of continuous positive airway pressure (CPAP) therapy on cardiometabolic risk in adults with obstructive sleep apnoea (OSA). Evidence is limited on the benefits of CPAP for preventing acute major adverse cardiovascular events (MACE). This study aimed to assess the association between CPAP use and incidence of MACE in a longitudinal clinical cohort of adults with OSA at a large U.S. healthcare system.</div></div><div><h3>Methods</h3><div>Adults with OSA (apnoea-hypopnoea index [AHI]≥5) were identified from Kaiser Permanente Southern California between 2018 and 2020 (N = 34,782). MACE was defined as first occurrence of myocardial infarction, stroke, unstable angina, heart failure or cardiovascular death, using validated electronic health record algorithms. CPAP use (h/night) was based on daily telemonitoring data. Inverse probability of treatment weighted Cox proportional hazards models stratified by OSA severity (mild [5≤AHI&lt;15]), moderate-severe [AHI ≥15]), were used to assess associations between CPAP use and MACE.</div></div><div><h3>Results</h3><div>Among individuals with moderate-severe OSA, those using CPAP &lt;4 h/night (HR [95 % CI] = 0.53 [0.35–0.82]; p = 0.004) or ≥4 h/night (HR [95 % CI] = 0.46 [0.27–0.77]; p = 0.004) had lower MACE incidence compared to those not using CPAP. Increased CPAP use (in hours) was associated with lower MACE incidence in moderate-severe OSA (HR [95 % CI] = 0.90 [0.82–0.98]; p = 0.021). In individuals with mild OSA, CPAP use was not associated with lower MACE incidence.</div></div><div><h3>Conclusion</h3><div>CPAP use was associated with lower MACE incidence in adults with moderate-severe OSA. Treatment of moderate-severe OSA may have a positive impact on prevention of MACE.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108732"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879134","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":"Clock gene influences on sleep quality and HPA axis in major depressive disorder","authors":"Alex Ferrer ,&nbsp;Ariadna Pelegrí ,&nbsp;Javier Labad ,&nbsp;Teresa Sagués ,&nbsp;Neus Salvat-Pujol ,&nbsp;Aida de Arriba-Arnau ,&nbsp;José M. Menchón ,&nbsp;Diego Palao ,&nbsp;Javier Costas ,&nbsp;Angel Carracedo ,&nbsp;Virginia Soria","doi":"10.1016/j.sleep.2025.108730","DOIUrl":"10.1016/j.sleep.2025.108730","url":null,"abstract":"<div><h3>Background</h3><div>Major Depressive Disorder (MDD) has been associated with disruptions in circadian rhythms and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Circadian rhythms are regulated by “clock” genes, including <em>BMAL1</em>, which are also implicated in HPA axis function. This study aimed to examine the association between <em>BMAL1</em> polymorphisms and sleep quality, their interactions with sex and MDD diagnosis, and their potential influence on HPA axis activity in MDD.</div></div><div><h3>Methods</h3><div>The sample included 84 patients with MDD and 120 healthy controls (HCs). Clinical and sociodemographic variables were assessed. HPA axis activity was measured using the cortisol awakening response (CAR) and diurnal cortisol slope. Six single nucleotide polymorphisms (SNPs) in the <em>BMAL1</em> gene were analyzed. Multiple regression models were used, adjusting for relevant covariates.</div></div><div><h3>Results</h3><div>The <em>BMAL1</em> SNP rs11022778 was significantly associated with sleep quality in the total sample. Interaction analyses revealed that this association was specific to individuals with MDD. Additionally, rs11022778 was significantly associated with both CAR and slope measures among MDD patients.</div></div><div><h3>Conclusions</h3><div>These findings highlight the potential role of <em>BMAL1</em> gene variants in modulating biological and clinical phenotypes related to circadian and stress regulation. The rs11022778 variant may contribute to altered sleep quality and HPA axis activity in MDD. Future research should consider such genetic markers to inform more personalized approaches to MDD treatment.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108730"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811198","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":"Exploring sleep outcomes in youth across settings: Are there differences based on rurality or medically underserved status in the ECHO cohort?","authors":"Brittany D. Lancaster ,&nbsp;Anna Wallisch ,&nbsp;Emily A. Knapp ,&nbsp;Xuan Li ,&nbsp;Lacey A. McCormack ,&nbsp;Kelly A. Hirko ,&nbsp;Traci A. Bekelman ,&nbsp;Christine W. Hockett ,&nbsp;for the ECHO Cohort Consortium","doi":"10.1016/j.sleep.2025.108754","DOIUrl":"10.1016/j.sleep.2025.108754","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate associations between rurality and medically underserved status with sleep outcomes (e.g., duration, bed and wake times, latency) among youth in the United States.</div></div><div><h3>Methods</h3><div>The study sample included 22,234 youth (aged 1–17 years) from the Environmental influences on Child Health Outcomes (ECHO) Program. Sleep was measured by parent-report questionnaire for children ages 7 and under and child-report for older children. Residential addresses and Federal Information Processing Standards codes were utilized to classify participants into two binary exposure variables: rural vs. nonrural and medically underserved vs. not medically underserved. Differences between groups for each developmental period were compared using t-tests and chi-squared tests.</div></div><div><h3>Results</h3><div>Across children ages 1–12, rural youth went to bed significantly earlier (mean differences [MD] range from 18 to 52 min) and woke earlier (MD range 15–52 min) compared to non-rural youth. Children aged 1–12 living in medically underserved areas were significantly less likely to meet sleep recommendations (MD range 3.2 %–6.6 % less), and youth of all ages tended to have later bedtimes (MD range 7–30 min) compared to youth not living in medically underserved areas.</div></div><div><h3>Discussion</h3><div>This study is novel because it evaluates differences in youth sleep health based on rurality and medically underserved status in the United States. Multiple variations in children's sleep health were identified based on living in medically underserved areas while minimal differences were noted based on rurality. Future research should focus on the development or dissemination of effective programs into pre-established resources (e.g., daycares, community centers) for youth in medically underserved areas.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108754"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879129","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 duration and efficiency from 6 to 18 years of age in a birth cohort","authors":"Iná S. Santos ,&nbsp;Priscila Echevarria ,&nbsp;Isabel Oliveira Bierhals ,&nbsp;Luciana Tovo-Rodrigues ,&nbsp;Inácio Crochemore-Silva ,&nbsp;Alicia Matijasevich","doi":"10.1016/j.sleep.2025.108739","DOIUrl":"10.1016/j.sleep.2025.108739","url":null,"abstract":"<div><h3>Background</h3><div>Healthy sleep comprises a multidimensional sleep-wake pattern, adapted to individual, social and environmental demands, which promotes physical and mental well-being.</div></div><div><h3>Objective</h3><div>To describe sleep multitrajectories from 6 to 18 years of age.</div></div><div><h3>Methods</h3><div>Population-based birth cohort using information from 4231 participants assessed at birth and at 6, 11, 15, and 18 years of age. Bedtime, wake-up time, sleep duration, and sleep efficiency were measured through actigraphy. Group-based multitrajectory models (GBMTM) were applied to jointly explore the longitudinal changes in bedtime, wake-up time, sleep duration, and sleep efficiency over time. Maternal and child characteristics at birth were used to describe prevalence (with 95 % confidence interval) of sleep multitrajectories.</div></div><div><h3>Results</h3><div>3595, 3547, 1940, and 3447, respectively, at ages 6, 11, 15, and 18 years had information on sleep parameters, and 2412 were included in the multitrajectory analysis. In the entire cohort, sleep duration decreased from 7.54 h at 6 years to 6.84, 6.14, and 6.42 h, respectively, at 11, 15, and 18 years, and sleep efficiency improved with age from 81.0 % at 6 years to 85.0 % at 18. Three multitrajectory groups containning the simultaneous analysis on the four sleep parameters were defined: G1, G2 and G3, comprising, respectively, 28.8 %, 33.8 %, and 37.4 % of the sample. At 18 years, only adolescents from G3 achieved sleep duration and efficiency within the recommended range for age (respectively, 7.60 h/day and 86.0 %). Female adolescents and those with low birth weight had a greater likelihood of belonging to G3.</div></div><div><h3>Conclusions</h3><div>Although adolescents from the three groups presented an acceptable sleep duration at 6 years, by the end of adolescence only 37.4 % of them achieved the recommended sleep duration and efficiency needed for a good health and well-being, as defined by the United States National Sleep Foundation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108739"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841758","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}