Sleep最新文献

{"title":"Physiologic Mechanisms of Response to Hypoglossal Nerve Stimulation.","authors":"Linda C Magaña, Yash Dixit, Bruno Saconi, Brendan T Keenan, Everett G Seay, Alan R Schwartz, Raj C Dedhia","doi":"10.1093/sleep/zsag227","DOIUrl":"https://doi.org/10.1093/sleep/zsag227","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the relationship between physiologic mechanisms under drug-induced sleep endoscopy (DISE) and polysomnographic response to hypoglossal nerve stimulation (HGNS).</p><p><strong>Materials and methods: </strong>In an NIH-funded interventional trial, thirty subjects with HGNS devices underwent DISE with pneumotachometer, pharyngeal manometry, and positive airway pressure titration. On the previous night, subjects underwent a split-night polysomnogram (first portion without HGNS and second at a single clinically-determined voltage) in the supine position. Responder status was determined by a 50% reduction in supine apnea-hypopnea index (AHI). Groups (responders vs. nonresponders) were compared using the Wilcoxon Rank Sum Test, and Spearman's rho was used to assess correlations between physiologic mechanisms under DISE and polysomnographic response.</p><p><strong>Results: </strong>Patients (n = 30) were generally older (64.3 ± 8.9 years), female (56.7%), and overweight (BMI 28.1 ± 3.1 kg/m2) with severe OSA (supine AHI 47.7 ± 25.4 events/hour). Among 14 responders and 16 nonresponders, there was no statistical difference in baseline collapsibility (PhOP, 5.9 ± 2.4 vs 7.2 ± 3.7 cmH2O, p = 0.39) or baseline inspiratory epiglottic pressure (Pepi,-17.2 ± 9.0 vs -18.6 ± 12.8 cmH2O, p = 0.99). Improvements in collapsibility (rho = 0.70, p = 0.0001) and inspiratory epiglottic pressure (rho = -0.70, p = 0.0001) with HGNS were strongly associated with reduction in supine AHI.</p><p><strong>Conclusions: </strong>In this small interventional study, decreases in collapsibility and effort during DISE are markers of clinical response to HGNS therapy. Our novel findings demonstrate responses to acute physiologic interventions during DISE translate to natural sleep outcomes.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819481","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":"Dementia Risk in Patients with Comorbid Insomnia and Obstructive Sleep Apnea: A Propensity Score-Matched Cohort Study.","authors":"Ping-Hao Chiang, Yao Te Tsai, Yang-Chi Lin, Hsueh-Yu Li, Chieh-Hsuan Tsai, Chia-Yu Hsu","doi":"10.1093/sleep/zsag224","DOIUrl":"https://doi.org/10.1093/sleep/zsag224","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) and insomnia frequently co-occur as comorbid insomnia and sleep apnea (COMISA). While it has increasingly been recognized as a distinct clinical presentation, its cognitive consequences remain unclear. We evaluated the 5-year incident dementia risk associated with COMISA compared with OSA alone.</p><p><strong>Materials and methods: </strong>This retrospective propensity score-matched cohort study using electronic health records from the TriNetX US Collaborative Network. Adults with a first diagnosis of OSA between 2016 and 2019 were followed for up to 5 years. COMISA was defined as an insomnia diagnosis within 90 days of the OSA index date. Patients with COMISA were matched 1:1 to those with OSA alone using propensity scores. Incident all-cause dementia and major dementia subtypes were identified using ICD-10-CM codes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.</p><p><strong>Results: </strong>After matching, 51 043 patients with COMISA and 51 043 with OSA alone were analyzed. COMISA was associated with an increased risk of all-cause dementia (HR 1·34; 95% CI 1·24-1·46) over 5 year of follow-up. Consistent risk elevations were observed across major dementia subtypes, including vascular dementia (HR 1·35; 95% CI 1·13-1·60), dementia with Lewy bodies (HR 1·85; 95% CI 1·22-2·81), and Alzheimer's disease (HR 1·19; 95% CI 1·01-1·40). Risk separation became apparent within the first year and remained evident thereafter.</p><p><strong>Conclusions: </strong>Among patients with newly diagnosed OSA, comorbid insomnia was associated with a sustained increase in dementia risk. These findings support the clinical relevance of recognizing COMISA as a high-risk clinical presentation in sleep medicine practice.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819423","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":"Primary Care Providers Journey with OSA Care, Challenges and Strategies: A Qualitative Study.","authors":"Wanjae Cho, Michelle Cheng, Kenneth G Blades, Oliver David, Willis H Tsai, Marcus Povitz, Kerry A McBrien, Maoliosa Donald, Sachin R Pendharkar","doi":"10.1093/sleep/zsag233","DOIUrl":"https://doi.org/10.1093/sleep/zsag233","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is a treatable chronic condition associated with significant health and societal consequences. Primary care providers (PCPs) often manage OSA with support from sleep specialists but face challenges navigating a complex system of care. We created a Journey Map to identify factors influencing primary care OSA management and the associated PCPs' perspectives and emotions.</p><p><strong>Methods: </strong>Twenty-one Calgary-based PCPs were interviewed. We used conventional content analysis, utilizing inductive coding to define journey phases and deductive coding via the Theoretical Domains Framework (TDF) to identify barriers and enablers. These were then mapped onto journey phases for OSA management to create a Journey Map.</p><p><strong>Results: </strong>The Journey Map included five phases of OSA care. PCPs described feeling neutral during the Learning phase and expressed neutral to positive emotions during the Patient Encounter and Diagnosing OSA phases. In contrast, the Initial Treatment and Ongoing Management phases were associated with neutral to negative emotional experiences. Barriers included limited OSA-related training and education, unclear roles among provider groups, and low patient engagement. Enablers included accessible knowledge resources, a shared key role in OSA screening, and availability of sleep testing. Opportunities to enhance primary care OSA management were identified at each step.</p><p><strong>Conclusions: </strong>This study identified several behavioural factors influencing PCP decision-making across the OSA care continuum. The Journey Map illustrates how high diagnostic confidence of PCPs shifts to escalating challenges and negative sentiment during treatment and long-term management of OSA.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797435","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":"Are different consumer sleep technologies measuring the same essential aspects of sleep?","authors":"Kiran K G Ravindran, Ciro Della Monica, Giuseppe Atzori, Marta M Pineda, Ramin Nilforooshan, Hana Hassanin, Victoria Revell, Derk-Jan Dijk","doi":"10.1093/sleep/zsag231","DOIUrl":"https://doi.org/10.1093/sleep/zsag231","url":null,"abstract":"<p><strong>Study objectives: </strong>Consumer sleep technologies (CSTs) enable low-burden longitudinal sleep monitoring, and their measures are often interpreted as equivalent to polysomnography (PSG) measures. We applied measurement reliability-aware approaches to determine whether CST-derived 'sleep' measures (1) are interchangeable or device-specific, (2) can reliably assess participant-level sleep characteristics and (3) converge onto interpretable principal components representing essential aspects of sleep.</p><p><strong>Methods: </strong>Data from 74 older adults (20 people living with dementia) were collected at-home (total=752 paired nights) using four modalities simultaneously: research-grade actigraphy (Axivity), a wearable (Withings Watch), a nearable (Withings Sleep Analyser) and Sleep Diary, followed by one in-lab PSG assessment. We applied Bland-Altman analyses, repeated-measures correlation analyses, intraclass correlation coefficients (ICC) and principal component analysis (PCA).</p><p><strong>Results: </strong>Single-night between-device correlations and correlations with PSG were weak (r<0.3) for most measures but moderate (0.3≤r<0.7) for duration- and timing measures. Bland-Altman analyses revealed systematic disagreement with PSG, with total sleep time and sleep efficiency overestimated, wake after sleep onset underestimated, and poor agreement for sleep-stage durations. The number of nights required to obtain acceptable reliability (ICC≥0.7) varied across measures, modalities and participant groups, with 71% of measures reaching an ICC ≥0.7 within seven nights. Reliability-filtered PCA yielded interpretable principal components, with Duration being the only sleep aspect showing consistent moderate between-device associations.</p><p><strong>Conclusions: </strong>Correlation of most sleep measures across assessment modalities is poor, suggesting that the consumer sleep technologies tested in our study may not measure the same essential aspects of sleep. Duration was the only sleep aspect transferable between these devices.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798052","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":"Future goals after clear illustrations of morbidity and mortality associated with wearable-measured short sleep duration.","authors":"Stephen F Smagula","doi":"10.1093/sleep/zsag232","DOIUrl":"https://doi.org/10.1093/sleep/zsag232","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797202","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 Wellness Education: A Museum-University joint forces project.","authors":"Rafael Santana-Miranda, Marcia Olga Larios-Morales, Paulina Rojas-Sánchez, Aura Abigail Bueno-Jímenez, Gabriela Millán-Rosas, María José Rodríguez-Sosa, Gabriela Hurtado-Alvarado","doi":"10.1093/sleep/zsag234","DOIUrl":"https://doi.org/10.1093/sleep/zsag234","url":null,"abstract":"<p><p>Most educational interventions available primarily target parents and caregivers. Early childhood represents a crucial period of rapid cognitive development, during which play activities enhance brain structure and function, thereby promoting executive functions. Through a collaborative effort among museum staff, sleep researchers, and medical professionals specializing in neurodevelopment, we aimed to design educational experiences that detail the process of creating a role-playing game and to evaluate whether visitors could assimilate the intended messages without formal intervention. In a retrospective study, surveys with open-ended questions (400 visitors, of whom 60% were children) were evaluated, and timed, tracked behavioral observations were conducted for 50 visitors. The results indicated that visitors successfully received and articulated the messages we aimed to convey. The most frequently mentioned answers emphasized that good sleep is essential (22%) and beneficial for health (21%). Furthermore, our exhibition engaged 97% of visitors with sustained attention, suggesting that the experience design effectively captured their interest. This study underscores the significance of sleep education through play and demonstrates that intentionally designed, evidence-based spaces can effectively reach a broad audience, fostering a clear understanding of the importance of sleep in overall health.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797478","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":"Characterizing Nonlinear Heterogeneous Sleep Trajectories across the Menstrual Cycle in a Transdiagnostic Psychiatric Population.","authors":"Anisha Nagpal, Anna Patterson, Ashley Ross, Loran Knol, Sajal Shukla, Adam Bryant Miller, Fiona Baker, Katja M Schmalenberger, Tory A Eisenlohr-Moul","doi":"10.1093/sleep/zsag220","DOIUrl":"https://doi.org/10.1093/sleep/zsag220","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep disturbance is closely linked to affective symptoms and suicidal ideation (SI). These symptoms fluctuate across the menstrual cycle; however, menstrual cycle-related sleep variability remains poorly characterized in psychiatric populations. This study examined how subjective and objective sleep fluctuate across the menstrual cycle in a psychiatric sample, considering individual differences and associations with negative affective and SI symptom trajectories.</p><p><strong>Materials and methods: </strong>A transdiagnostic psychiatric sample recruited for recent suicidality provided intensive daily subjective sleep and symptom ratings (N = 142,M = 26.59,years SD = 5.34) alongside wearable-derived (Oura) objective sleep measures (N = 39) across 1-3 menstrual cycles. Cycle timing was aligned to ovulation and menses using Phase-Aligned Cycle Time Scaling. Generalized additive mixed models quantified average cyclical effects and interindividual heterogeneity. Exploratory smooth mixture modeling (SMM) identified latent subgroups with shared temporal sleep trajectories which were compared to trait-level demographic and clinical characteristics as well as affective, SI, and pain cyclical symptom trajectory subgroups.</p><p><strong>Results: </strong>Most sleep outcomes showed substantial within-person cyclical variability. SMM identified distinct subgroups for Oura-derived sleep efficiency, and for subjective ratings of fatigue, insomnia, sleep quality, and hypersomnia, with patterns including perimenstrual or luteal worsening, as well as no cycle-related variability. Sleep subgroups, especially for subjective ratings, frequently significantly aligned with parallel affective, pain, and SI trajectories, suggesting temporally-coupled vulnerability.</p><p><strong>Conclusions: </strong>Sleep trajectories across the menstrual cycle are heterogeneous and meaningfully coupled with psychiatric symptom patterns. These findings support cycle-aware sleep monitoring and suggest that cyclical sleep disruption may help identify windows of heightened psychiatric risk, motivating replication and personalized intervention approaches.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797190","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":"Machine learning prediction of the change in sleepiness following continuous positive airway pressure in obstructive sleep apnea: a multi-cohort analysis.","authors":"Eric Staykov, Juha Töyräs, Dwayne L Mann, Timo Leppänen, Samu Kainulainen, Ali Azarbarzin, Scott A Sands, Philip I Terrill","doi":"10.1093/sleep/zsag222","DOIUrl":"10.1093/sleep/zsag222","url":null,"abstract":"<p><strong>Study objectives: </strong>To predict the improvement in sleepiness following continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) using baseline characteristics.</p><p><strong>Methods: </strong>Data from five polysomnography cohorts (HomePAP, BestAIR, ABC, STAGES, and MESA; total n=2332) were analyzed. Associations between polysomnographic metrics and Epworth Sleepiness Scale (ESS) were assessed using multivariable linear regression. Cross-validated LASSO regression was used to select predictor variables. Prediction of ESS improvement was evaluated in CPAP-treated participants (n=213) using linear regression models trained on 139 participants and tested in a holdout group (n=74).</p><p><strong>Results: </strong>Cross-sectional analysis revealed significant associations between baseline ESS and ventilatory burden (0.56 points/SD; 95% CI 0.34-0.78), hypoxic burden (0.51; 0.28-0.74), the apnea-hypopnea index (AHI, 0.45; 0.23-0.68), time below 90% oxygen saturation (0.36; 0.15-0.57), and flow limitation severity (0.31; 0.10-0.53). Baseline ESS and baseline ventilatory burden were the most frequently selected predictors of ESS improvement. Using these two variables in a regression model, predicted and actual ESS improvement were correlated in the holdout group (adjusted R2=0.313). The model classified CPAP responders (≥2 points ESS improvement) more accurately than current clinical guidelines (78.1% [3.5% SD] versus 68.4% [3.7%]). Substituting the AHI for ventilatory burden slightly reduced accuracy (77.3% [3.4%]). Charts were developed to assist in predicting ESS improvement from baseline metrics.</p><p><strong>Conclusions: </strong>Models incorporating baseline ESS and either ventilatory burden or AHI predict ESS improvement and may help identify patients with OSA likely to benefit from CPAP. The ventilatory burden model demonstrated modestly better performance, while the AHI-based model offers greater clinical applicability.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797156","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 Foundation Models: Present Performance, Future Potential.","authors":"Diego R Mazzotti, Grace M Travers, Benjamin Fox, Ankit Parekh","doi":"10.1093/sleep/zsag228","DOIUrl":"https://doi.org/10.1093/sleep/zsag228","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797484","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":"Associations Between Daily Neighborhood Crime and Physical Disorder Exposure and Sleep Patterns in Adolescents.","authors":"Stephanie L Mayne, Gabrielle DiFiore, Alexander G Fiks, Hannah Martin, Vicky Tam, Jonathan A Mitchell, Ian Barnett, Douglas J Wiebe, Mathias Basner, Karen Glanz","doi":"10.1093/sleep/zsag226","DOIUrl":"https://doi.org/10.1093/sleep/zsag226","url":null,"abstract":"<p><strong>Study objectives: </strong>While growing evidence suggests neighborhood safety and physical disorder may impact adolescent sleep, prior research has not accounted for mobility outside the home neighborhood. This study examined associations of crime and physical disorder surrounding adolescents' homes, schools, and in their daily activity spaces with sleep patterns.</p><p><strong>Methods: </strong>Adolescents aged 15-18 years (n=142) were followed for 14 days using smartphone GPS tracking and actigraphy. GPS locations recorded during adolescents' waking hours were spatially linked to local data on crime and vacant lots to derive exposures surrounding adolescents' homes, schools, and daily activity spaces. Mixed-effects linear and modified Poisson models estimated associations of crime and vacant lots with sleep duration, timing, efficiency, insufficient (<8 hours) and very short sleep (<6 hours). Fixed-effects models estimated associations of within-person differences in activity-space crime and vacant lot exposures with sleep patterns.</p><p><strong>Results: </strong>Higher crime exposure surrounding adolescents' homes and schools was associated with shorter sleep duration, higher risk of insufficient and very short sleep, earlier offset timing (home only) and later onset timing (school only). Higher activity-space exposure to vacant lots was associated with shorter sleep duration, later onset, and higher risk of insufficient sleep. On days when adolescents' exposure to vacant lots was higher relative to their own average, they had shorter sleep duration, earlier offset timing, and higher risk of insufficient and very short sleep, while such associations were not seen for neighborhood crime.</p><p><strong>Conclusions: </strong>Associations of crime and vacant lot exposures with actigraphy-assessed adolescent sleep patterns varied by setting.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797188","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}