Sleep medicine最新文献

{"title":"Respiratory polygraphy combined with pulse wave amplitude drops for the diagnosis of obstructive sleep apnea in pediatric patients","authors":"Iulia Ioan ,&nbsp;Cyril Schweitzer ,&nbsp;Yacine Touil ,&nbsp;Sofia Da Mota ,&nbsp;Laurianne Coutier ,&nbsp;Aurore Guyon ,&nbsp;Patricia Franco","doi":"10.1016/j.sleep.2025.106618","DOIUrl":"10.1016/j.sleep.2025.106618","url":null,"abstract":"<div><div>Respiratory polygraphy (RP) underestimates the obstructive apnea-hypopnea index (OAHI) compared to polysomnography (PSG) because it does not account for respiratory events associated with cortical arousals. To address this issue, RP can incorporate respiratory events associated with autonomic arousals, identified by drops in pulse wave amplitude (PWAD), obtained from the oximetry signal. This study aimed to compare the OAHI measured by RP alone, RP incorporating respiratory events associated with PWAD, and PSG.</div><div>PSG recordings from 91 children (median age [1st; 3rd quartile]: 10 [8; 14]years) were analyzed. A few weeks later, the initial analysis was deleted, and the recordings were reanalyzed as RP alone and as RP incorporating respiratory events associated with PWAD. Three PWAD thresholds were tested: drops greater than 30 % (RP-PWAD30), 40 % (RP-PWAD40), and 50 % (RP-PWAD50) from baseline.</div><div>The median [1st; 3rd quartile] OAHI measured by RP alone was 2.8 [1.7; 5.7]/h, underestimating OAHI measured by PSG (4.8 [3.0; 6.8]/h; Bland-Altman analysis: mean ± SD = −2.11 ± 2.51). In contrast, incorporating respiratory events associated with PWAD led to OAHI overestimation: 10.2 [7.0; 13.3]/h (Bland-Altman = 4.96 ± 4.18) for RP-PWAD30; 8.7 [6.0; 12.7]/h (Bland-Altman = 3.73 ± 3.76) for RP-PWAD40; 7.9 [5.1; 11.3]/h (Bland-Altman = 2.89 ± 3.69) for RP-PWAD50), in comparison to PSG.</div><div>Since cortical arousals cannot be measured during RP, incorporating respiratory events associated with PWAD can improve OAHI estimation. Among the tested thresholds, the 50 % PWAD threshold resulted in the least overestimation in comparison to PSG.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106618"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231516","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 Intersection of sleep disturbance and suicidal behavior among older Adults: A systematic review","authors":"Fahimeh Saeed ,&nbsp;Vahid Rashedi ,&nbsp;Fatemeh kashaninasab ,&nbsp;Mahboobeh Khoozan ,&nbsp;Arash Parsa Moghadam ,&nbsp;Syed Sameer Hussaini ,&nbsp;Zahra Validabady ,&nbsp;Sheikh Shoib","doi":"10.1016/j.sleep.2025.106557","DOIUrl":"10.1016/j.sleep.2025.106557","url":null,"abstract":"<div><h3>Introduction</h3><div>As the global population ages, suicide among older adults has become a critical public health concern. Older individuals often exhibit unique suicide risk factors, including chronic health conditions, social isolation, and undiagnosed psychiatric disorders. Sleep disturbances, particularly insomnia, have emerged as a potential but underexplored risk factor for suicidal behavior in this population. This systematic review aims to synthesize existing research on the relationship between sleep disturbances and suicidal behavior among older adults.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted across PubMed, Web of Science, and Scopus from their inception until June 30, 2024. Studies were included if they were comparative observational studies employing quantitative research designs, examined sleep disturbances in individuals aged 55 and older, and assessed their association with suicidal thoughts or behaviors. Studies that lacked age-stratified results or focused on populations with specific health conditions (e.g., schizophrenia, dementia) were excluded. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess study quality.</div></div><div><h3>Results</h3><div>A total of 2630 studies were identified, of which 25 met the inclusion criteria. The majority (21 out of 25) reported a significant association between sleep disturbances and suicidal behavior. Insomnia was the most commonly studied sleep disorder, with six out of eight studies confirming its independent link to suicide risk. Findings on nightmares were mixed, with some studies suggesting a moderate association and others reporting no significant effect. Short sleep duration (≤5 h) was associated with increased suicidal ideation, whereas inconsistent results were found for general sleep complaints. Variability in study methodologies, sample sizes, and measurement tools limited cross-study comparability.</div></div><div><h3>Conclusion</h3><div>This review underscores sleep disturbances, particularly insomnia, as a modifiable risk factor for suicidal behavior in older adults. Given the lack of stigma surrounding sleep problems, targeted interventions to improve sleep quality could serve as an effective strategy for suicide prevention. Future research should focus on longitudinal studies to clarify causal pathways and explore the impact of sleep interventions on reducing suicide risk.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106557"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231515","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":"Weight changes during treatment with low-sodium oxybate in two phase 3 clinical studies in participants with narcolepsy or idiopathic hypersomnia","authors":"Nancy Foldvary-Schaefer ,&nbsp;Roman Skowronski ,&nbsp;Patricia Chandler ,&nbsp;Douglas S. Fuller ,&nbsp;Teresa L. Steininger ,&nbsp;Thomas J. Measey ,&nbsp;Shawn Candler ,&nbsp;Marisa Whalen ,&nbsp;Yves Dauvilliers","doi":"10.1016/j.sleep.2025.106602","DOIUrl":"10.1016/j.sleep.2025.106602","url":null,"abstract":"<div><h3>Objective</h3><div>Low-sodium oxybate (LXB) is approved in the United States for treating cataplexy or excessive daytime sleepiness in patients aged ≥7 years with narcolepsy and idiopathic hypersomnia in adults. This post hoc analysis evaluated LXB effects on weight in patients with narcolepsy or idiopathic hypersomnia from two phase 3 studies.</div></div><div><h3>Methods</h3><div>Adults with narcolepsy with cataplexy or idiopathic hypersomnia began LXB treatment during open-label titration (10–14 weeks), followed by 2-week stable-dose periods (SDP).</div></div><div><h3>Results</h3><div>Safety populations comprised 201 participants with narcolepsy (75 previously taking sodium oxybate) and 148 with idiopathic hypersomnia (oxybate-naive at study entry); most were overweight or obese at baseline (narcolepsy, 67 %; idiopathic hypersomnia, 60 %). Least-squares (LS) mean (95 % CI) weight changes at end of SDP were −1.0 (−2.2, 0.1), −3.5 (−4.7, −2.3), and −2.3 (−3.4, −1.1) kg in oxybate-naive participants with narcolepsy and normal weight, overweight, and obese, respectively, and 0.0 (−1.6, 1.6), −0.7 (−2.2, 0.8), and 0.3 (−1.1, 1.7) kg in participants with narcolepsy previously taking oxybate and normal weight, overweight, and obese, respectively. In oxybate-naive participants with idiopathic hypersomnia, LS mean (95 % CI) changes at end of SDP were −2.2 (−3.5, −0.8), −2.6 (−4.1, −1.2), and −3.4 (−4.9, −1.8) kg in normal weight, overweight, and obese participants, respectively. Weight loss ≥5 % at end of SDP occurred in 26 % of oxybate-naive participants with narcolepsy, 5 % of those with narcolepsy previously taking oxybate, and 30 % with idiopathic hypersomnia.</div></div><div><h3>Conclusion</h3><div>Open-label LXB was associated with modest weight loss in participants with narcolepsy with cataplexy or idiopathic hypersomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106602"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471831","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 the association between sleep disturbances and repetitive behaviors in autistic children and adolescents: a systematic review","authors":"Sara Passarini ,&nbsp;Martina Parisi ,&nbsp;Silvia Guerrera ,&nbsp;Giulia Lazzaro ,&nbsp;Floriana Costanzo ,&nbsp;Deny Menghini ,&nbsp;Stefano Vicari ,&nbsp;Elisa Fucà","doi":"10.1016/j.sleep.2025.106609","DOIUrl":"10.1016/j.sleep.2025.106609","url":null,"abstract":"<div><h3>Introduction</h3><div>Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction and the presence of restricted and repetitive behaviors (RBs), which can be distinguished into lower and higher-level RBs. Autistic individuals frequently experience sleep disturbances that may be related to the autistic core features, particularly RBs. However, the current literature on this topic is fragmented. This systematic review aims to examine the relationship between RBs and sleep difficulties in autistic children and adolescents, also exploring whether this relationship varies between lower versus higher-level RBs.</div></div><div><h3>Method</h3><div>This systematic review followed PRISMA guidelines and it is registered in PROSPERO (ID CRD420250644207). The search in the PubMed, Psycinfo, PsycArticles, and Scopus databases yielded 379 unique English-language records. According to inclusion/exclusion criteria, 21 records were considered eligible.</div></div><div><h3>Results</h3><div>Eleven studies explored the relationship between RBs and sleep disturbances, without distinguishing between lower and higher-level RBs. The remaining records examined the relationship between RBs and sleep disturbances considering the two different levels of RBs. All studies found a clear relationship between RBs and sleep difficulties, although mixed evidence emerged regarding lower-level RBs (i.e., self-injurious behaviors). Various hypotheses were proposed regarding the associative links between RBs and sleep disturbances. Further, some studies underscored that the relationship between RBs and sleep could be modulating by emotional symptoms, such as anxiety.</div></div><div><h3>Conclusion</h3><div>The reviewed studies support the connection between sleep disturbances and RBs in autistic children and adolescents. This relationship appears to vary based on the levels of RBs and the presence of co-occurring symptoms.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106609"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242881","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":"Predictors and moderators of cognitive therapy and behavior therapy for insomnia disorder","authors":"Rikard Sunnhed ,&nbsp;Hugo Hesser ,&nbsp;Per Carlbring ,&nbsp;Allison G. Harvey ,&nbsp;Markus Jansson-Fröjmark","doi":"10.1016/j.sleep.2025.106611","DOIUrl":"10.1016/j.sleep.2025.106611","url":null,"abstract":"<div><h3>Introduction</h3><div>Little is known about what pretreatment patient characteristics the outcome of Cognitive Therapy (CT) and Behavioral Therapy (BT) for insomnia disorder depends on. Identifying for whom treatment is most useful is essential for treatment optimization and personalized care. Therefore, this investigation aimed to examine both theory-driven constructs and insomnia-associated clinical variables as potential predictors and moderators of outcomes in CT and BT.</div></div><div><h3>Materials and methods</h3><div>One hundred forty-five participants diagnosed with insomnia disorder were randomly assigned to 10 weekly internet-delivered modules of CT or BT, along with 15 min of weekly telephone support. General clinical predictors and theory-driven moderators (cognitive and behavioral processes) assessed in a previous randomized controlled trial were analyzed using multiple linear regression, with insomnia severity as the outcome.</div></div><div><h3>Results</h3><div>Bedtime variability and early morning awakening interacted with treatment and indicated that lower bedtime variability and early morning awakening were associated with a higher effect for CT, whereas the opposite was true for BT. Wake time after sleep onset, insomnia severity index, and sleep efficiency emerged as predictors, indicating prognostic value for treatment outcome.</div></div><div><h3>Conclusions</h3><div>In addition to identifying three insomnia-associated variables as predictors of outcome across both treatments, this trial showed that CT and BT could be differentially effective based on patient insomnia heterogeneity at baseline. The differential moderator findings are in line with the theoretical models of CT and BT and might clinically implicate the ability to match therapy to patient features to optimize outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106611"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231517","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":"Folate and vitamin B-12 status and sleep duration in middle childhood","authors":"Mia Q. Zhu ,&nbsp;Mercedes Mora-Plazas ,&nbsp;Eduardo Villamor","doi":"10.1016/j.sleep.2025.106610","DOIUrl":"10.1016/j.sleep.2025.106610","url":null,"abstract":"<div><div>Insufficient sleep duration is prevalent in middle childhood and is associated with substantial health risks. Few investigations have addressed the role of folate and vitamin B-12 on sleep duration, and no studies have evaluated their potential interaction on sleep. We assessed associations of erythrocyte folate and plasma vitamin B-12 on sleep duration in middle childhood longitudinally, among 1642 participants in the Bogotá School Children Cohort. Nighttime sleep duration was assessed through parental report after a median 2 years of follow-up. We estimated adjusted mean differences in sleep hours with 95 % confidence intervals (CI) by micronutrient concentrations using linear regression with restricted cubic splines. Erythrocyte folate concentration was positively associated with nighttime sleep duration in a non-linear manner. Compared with the median (827 nmol/L), children at the 95th percentile of the distribution (1274 nmol/L) had an adjusted 0.26 (95 % CI: 0.07, 0.44) hours longer sleep duration. There was a significant interaction between folate and vitamin B-12; the association between folate and sleep duration was only apparent in children with low vitamin B-12 status (&lt;221 pmol/L). In this group, the adjusted mean difference (95 % CI) in sleep duration between the 95th and the 50th percentiles of folate was 0.61 (0.17, 1.04) hours, whereas in children with vitamin B-12 ≥ 221 pmol/L the difference was 0.11 (−0.10, 0.32) (<em>P</em>, interaction = 0.01). Vitamin B-12 was not associated with sleep duration. Erythrocyte folate is positively associated with nighttime sleep duration in children with low vitamin B-12 serostatus.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106610"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205774","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":"Development of an individualized and functional CPAP ventilation mask using a fully digital workflow by facial scanning and additive manufacturing for a child with craniofacial anomalies","authors":"Marit Bockstedte ,&nbsp;Mirja Quante ,&nbsp;Christian F. Poets ,&nbsp;Maite Aretxabaleta","doi":"10.1016/j.sleep.2025.106608","DOIUrl":"10.1016/j.sleep.2025.106608","url":null,"abstract":"<div><h3>Aims</h3><div>Non-Invasive Ventilation (NIV) effectiveness relies on proper mask fit, which is often difficult to achieve in patients with craniofacial anomalies. Advances in Computer-Aided Design and Manufacturing (CAD/CAM) enable rapid in-house production of customized NIV masks. Despite its potential, these remain limited by manufacturing constraints. This pilot study aimed to develop a workflow for in-house production of personalized masks and evaluate its effectiveness in an exemplary patient.</div></div><div><h3>Methods</h3><div>A 4.5-year-old girl with achondroplasia was referred because of a poor fit of commercially available NIV masks. A facial scan allowed the design of a personalized nasal mask using Fusion 360 software in a semi-automated workflow. The customized interface was fabricated using additive manufacturing with medically-approved soft material. Sleep studies assessed the effectiveness of commercial versus customized masks.</div></div><div><h3>Results</h3><div>Compared to the conventional mask, the Obstructive Apnoea-Hypopnea Index (OAHI) was reduced from 22.1/h to 0.1/h. Caregiver reported a reduction in pressure marks and fewer night-time alarms. The initial version of the personalized mask caused minor forehead pressure marks, which were effectively addressed in the second iteration. Initial setup costs were &lt;$5400 (€6500), with material costs per mask of &lt;$15 (€16).</div></div><div><h3>Conclusion</h3><div>This study demonstrates a fully digital CAD/CAM workflow for the in-house production of customized NIV masks. The approach offers a feasible solution for patients with craniofacial anomalies, enhancing NIV efficacy, comfort, and accessibility to personalized respiratory interfaces.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106608"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196040","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":"Theta-tACS modulates brain-heart interplay to enhance sleep in insomnia disorder","authors":"Ziqiang Shao ,&nbsp;Zhen Wang ,&nbsp;Qihan Li ,&nbsp;Zhe Du ,&nbsp;Jiayi Liu ,&nbsp;Yan Li ,&nbsp;Xumeng Zhao ,&nbsp;Dahua Yu ,&nbsp;Xiaona Sheng ,&nbsp;Yifei Zhu ,&nbsp;Kai Yuan","doi":"10.1016/j.sleep.2025.106606","DOIUrl":"10.1016/j.sleep.2025.106606","url":null,"abstract":"<div><div>Insomnia disorder (ID) is not merely a psychiatric condition but is also closely related to cardiovascular health. However, the role of brain-heart interplay (BHI) in the pathophysiology of ID, as well as the impact of transcranial current stimulation (tACS) on BHI, remains poorly understood. This study aimed to examine BHI alterations in ID and to investigate whether tACS can modulate these changes. Forty-four individuals with ID and 32 healthy controls (HCs) were enrolled. Patients with ID received theta-frequency tACS targeting the F3 electrode for 10 consecutive days. Synchronous electroencephalogram (EEG) and electrocardiogram (ECG) recordings were collected for the IDs before and after treatment. Bidirectional BHI metrics, derived from a synthetic data generation (SDG) model, as well as EEG power and heart rate variability (HRV), were compared between IDs and HCs at baseline, and pre-vs. post-tACS in IDs. Correlation and mediation analyses were conducted between BHI and behavioral outcomes. Our results revealed significantly increased BHI in both directions in IDs compared to HCs. Top-down BHI was associated with sleep quality (Pittsburgh Sleep Quality Index), while bottom-up BHI correlated with anxiety severity (Hamilton Anxiety Rating Scale). Notably, θ-tACS modulated the aberrant BHI in IDs. Furthermore, baseline top-down BHI at Fz predicted improvements in sleep quality and depressive symptoms, and mediated their recovery. These findings extend the hyperarousal theory of ID by highlighting the role of BHI, and suggest that BHI may serve as a promising predictor of clinical outcomes following θ-tACS intervention.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106606"},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146767","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":"Trajectory of sleep patterns across adolescence in autistic and neurotypical youth","authors":"Beth A. Malow ,&nbsp;Rachael A. Muscatello ,&nbsp;Trey McGonigle ,&nbsp;Simon Vandekar ,&nbsp;Blythe A. Corbett","doi":"10.1016/j.sleep.2025.106604","DOIUrl":"10.1016/j.sleep.2025.106604","url":null,"abstract":"<div><h3>Study objectives</h3><div>Changes in sleep-wake patterns are synonymous with the developmental transition to adolescence. To examine the trajectory of sleep-wake patterns in adolescents with autism spectrum disorder (ASD) compared to typically developing (TD) adolescents.</div></div><div><h3>Methods</h3><div>The total sample consisted of 244 participants, 140 with ASD and 104 who were TD. Sleep data were collected annually in a 4-year longitudinal study on pubertal development, at four time points (10–13 years, 11–14 years, 12–15 years, and 13–16 years). Changes in self-reported weekday and weekend bedtime and waketime across pubertal status were compared between TD and ASD participants, using mixed effects models adjusted for sex, reported night wakings, melatonin use and a diagnosis by puberty interaction. A repeated measures adjusted proportional odds model was used to model reported daytime sleepiness using the same independent variables.</div></div><div><h3>Results</h3><div>The ASD and TD groups differed in the change in bedtime across pubertal stages (diagnosis by puberty interaction, X² = 24.27, df = 3, p &lt; 0.001). At time 1 (ages 10–13 years), bedtime was comparable in the autism and TD groups for both weekdays and weekends. As Tanner stage progressed, the TD group had later bedtimes compared to those with ASD. Moreover, there was a significant diagnosis by puberty interaction in daytime sleepiness (X² = 20.71, df = 3, p = 0.001) characterized by TD youth endorsing greater daytime sleepiness at later pubertal stages than ASD youth.</div></div><div><h3>Conclusions</h3><div>Autistic and TD adolescents exhibit differences in bedtime and daytime sleepiness with pubertal development. These differences may be related to hormonal differences or behavioral factors in these populations and warrant further study.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106604"},"PeriodicalIF":3.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138323","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 spindle density and sleep depth as predictors of cardiovascular outcomes: A prospective EEG study","authors":"Alen Juginović ,&nbsp;Ivan Aranza ,&nbsp;Valentina Biloš","doi":"10.1016/j.sleep.2025.106599","DOIUrl":"10.1016/j.sleep.2025.106599","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to investigate the relationship between sleep EEG features and cardiovascular outcomes in a large prospective cohort. We aimed to identify key EEG markers that could serve as indicators of cardiovascular risk.</div></div><div><h3>Methods</h3><div>This study utilized baseline polysomnography (PSG) data from Sleep Heart Health Study Visit 1 (SHHS1), including 5782 participants aged 40 and older. PSG recorded EEG features including sleep spindle density, power, and the odds ratio product (ORP), a measure of sleep depth. Cardiovascular outcomes, including CHD and CVD incidence and mortality, were assessed during the follow-up visit (SHHS2). Statistical analysis included logistic regression and receiver operating characteristic (ROC) curves to examine associations between EEG features and CHD/CVD risk.</div></div><div><h3>Results</h3><div>Among 5782 participants (median age: 63 years; 47.6 % male), 15.7 % had CHD, and 23.7 % had CVD. CHD- and CVD-related deaths occurred in 4.6 % and 7.1 % of participants, respectively. Higher ORP, indicating shallower sleep, was associated with a 78.2 % increased risk of CHD and a 63.8 % increased risk of CVD. Short REM latency was also linked to increased cardiovascular risk. In contrast, higher sleep spindle density and frequency and greater REM sleep proportion were protective, reducing odds of CHD, CVD, and mortality. Elevated ORP in non-REM sleep was associated with a 133.8 % increase in CHD mortality and 63.7 % increase in CVD mortality.</div></div><div><h3>Conclusions</h3><div>Sleep spindle density and sleep depth are key EEG features associated with cardiovascular outcomes. EEG patterns from routine sleep studies may offer valuable biomarkers for identifying individuals at elevated cardiovascular risk, enabling earlier preventive interventions.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"133 ","pages":"Article 106599"},"PeriodicalIF":3.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177762","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}