Sleep最新文献

{"title":"Polysomnographic endotypes of successful multilevel upper airway surgery for obstructive sleep apnea.","authors":"Xiaoting Wang, Jingyu Zhang, Jianyin Zou, Tianjiao Zhou, Enhui Zhou, Li Shen, Siyu Yang, Weijun Huang, Huaming Zhu, Jian Guan, Hongliang Yi, Shankai Yin","doi":"10.1093/sleep/zsaf012","DOIUrl":"10.1093/sleep/zsaf012","url":null,"abstract":"<p><strong>Study objectives: </strong>Multilevel upper airway surgery is effective for some patients with obstructive sleep apnea (OSA), but predicting the response to surgery remains a challenge. The underlying endotypes of OSA include upper airway collapsibility, muscle compensation, loop gain, and the arousal threshold. This study aimed to explore the effect of surgery on polysomnography (PSG)-derived OSA endotypes and establish a surgical response prediction model.</p><p><strong>Methods: </strong>Our study included 54 Chinese patients with OSA who underwent multilevel upper airway surgery. Participants underwent PSG before and after surgery with a median follow-up time of 6.5 months. Using AHIBaseline/AHIpost-surgery ≥ 2 and AHIpost-surgery < 10 events/h as criteria, participants were classified as surgery responders and non-responders. The surgical success rate was 26%. These endotypic traits were derived from a standard PSG data by validated methods.</p><p><strong>Results: </strong>The surgery altered both anatomical and non-anatomical endotypic traits, including increased Vpassive (baseline vs post-surgery: 51.5 [18.7-84.2] vs 86.8 [67.4-93.7] %Veupnea, p < .001), decreased loop gain (baseline vs post-surgery: 0.7 [0.7-0.8] vs 0.6 [0.5-0.6]; p < .001), and a higher arousal threshold (baseline vs post-surgery: 202.9 [183.7-222.0] vs 160.7 [143.9-177.4] %Veupnea; p < .001). However, it did not significantly affect muscle compensation. Fully adjusted logistic regression analyses indicated that a favorable response to surgery was independently associated with a lower LG (OR [CI 95%], 0.1 [0.0-0.5], p = .032). In patients with improved muscle compensation or a more collapsible airway (lower Vpassive), a lower loop gain was more strongly indicative of success. However, when muscle compensation was lower or collapsibility was less severe (higher Vpassive), a lower loop gain was less predictive of success.</p><p><strong>Conclusions: </strong>This study demonstrated that multilevel upper airway surgery altered both anatomical and non-anatomical endotypes in Chinese patients with OSA. An endotype based regression model may meaningfully predict surgical success.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations of catch-up sleep for cardiometabolic health: is it time for personalized recommendations?","authors":"Kristen L Knutson, Brooke Aggarwal, Julio Fernandez-Mendoza","doi":"10.1093/sleep/zsaf033","DOIUrl":"10.1093/sleep/zsaf033","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374809","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":"Chronic obstructive pulmonary disease exacerbations, obstructive sleep apnea and CPAP treatment. A prospective study.","authors":"Grace Oscullo, Amina Bekki, Thais Beaperthuy, Jose Daniel Gómez-Olivas, Marina Anglés, Sergio Mompeán, Rosalía Martínez, Miguel Angel Martinez-Garcia","doi":"10.1093/sleep/zsaf037","DOIUrl":"10.1093/sleep/zsaf037","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-omics study of the association between insomnia with objective short sleep duration phenotype and high blood pressure.","authors":"Yanyuan Dai, Alexandros N Vgontzas, Le Chen, Dandan Zheng, Baixin Chen, Jun Wu, Ruifan Shao, Yun Li","doi":"10.1093/sleep/zsaf030","DOIUrl":"10.1093/sleep/zsaf030","url":null,"abstract":"<p><strong>Study objectives: </strong>Insomnia with objective short sleep duration is associated with increased hypertension risk. We aimed to explore the mechanism underlying the association between objective short sleep duration and hypertension in patients with chronic insomnia disorder (CID) by multi-omics.</p><p><strong>Methods: </strong>CID was defined according to International Classification of Sleep Disorders-3, and objective short sleep duration was based on the median value of total sleep time of the overall subjects during an overnight polysomnography. We used the mean values of measured nighttime and morning systolic (SBP) and diastolic blood pressure (DBP) for analysis. Serum metabolomics and fecal 16S rDNA amplicon sequencing were used to explore characteristic metabolites and analyze gut microbiota distribution, respectively.</p><p><strong>Results: </strong>One hundred and three patients with CID and 70 normal sleepers were included. We found 52 objective short sleep duration insomnia phenotype (ISSD)-related serum metabolites. Among the 52 ISSD-related serum metabolites, indoxyl sulfate was positively correlated with BP after adjusting for confounding factors (SBP: β = 0.250, p = .028; DBP: β = 0.256, p = .030) in ISSD. In addition, the level of serum indoxyl sulfate was significantly correlated with the genera Prevotella 9 (r = .378, p = .027), CAG-56 (r = -.359, p = .037), Ruminiclostridium 9 (r = -.340, p = .049), and Ruminococcus 2 (r = -.356, p = .039) in ISSD.</p><p><strong>Conclusions: </strong>Our study suggests that the ISSD phenotype is associated with significant changes in serum metabolic profile, including high levels of indoxyl sulfate. The latter molecule correlates both with BP and gut microbiota in patients with the ISSD phenotype, suggesting that indoxyl sulfate may be the molecular path resulting in increased hypertension risk in this phenotype.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067995","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":"Short-term γ-aminobutyric acid antagonist treatment improves long-term sleep quality, memory, and decision-making in a Down syndrome mouse model.","authors":"Elsa C Pittaras, Jonathan M Artal, Grace Ajibola, Giancarlo Allocca, Mia Bennett, Alexandra Camargo, Angelica Carpio, Nicholas Gessner, Myles Hinton, Rebecca Pizzitola, Natalie Tan, Evelyn Zhang, Alan Zhong, Horace C Heller","doi":"10.1093/sleep/zsae300","DOIUrl":"10.1093/sleep/zsae300","url":null,"abstract":"<p><p>Down syndrome (DS) is a common genetic condition affecting people worldwide. It involves cognitive disabilities for which there are no drug therapies. The Ts65Dn mouse model of DS shows cognitive impairment due to a reduction in neuron number and connectivity as well as excessive neuronal activity, as γ-aminobutyric acid (GABA) antagonist treatment restores memory in these mice. Our study showed the effects of GABA antagonist treatment on sleep and decision-making in Ts65Dn mice. We administered a daily, low oral dose of pentylenetetrazol (PTZ) in milk to Ts65Dn mice for 17 days. Decision-making was tested with and without PTZ treatment. Short and long-term memories were tested before, immediately after, and 1 month following PTZ treatment. Electro-encephalography was also recorded at these three time points to study the effect of the treatment on sleep. We showed that PTZ treatment improved long-term recognition, but not short term memory and led to more Ts65Dn mice showing safer decision-making behavior. PTZ treatment showed a moderate and only global beneficial effect on sleep by decreasing the global amount of wake and increasing non-rapid eye movement sleep in the Ts65Dn mice, which may explain the observed cognitive improvements. These results bring new knowledge on the role of GABA in sleep, memory consolidation, and decision-making abilities in DS.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886019","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 promotion in the hospitalized elderly.","authors":"Sairam Parthasarathy, Monisha Das Ireland, Joyce Lee-Iannotti","doi":"10.1093/sleep/zsaf043","DOIUrl":"10.1093/sleep/zsaf043","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a fingertip home sleep apnea testing system using deep learning AI and a temporal event localization analysis.","authors":"Ke-Wei Chen, Chun-Hsien Tseng, Hsin-Chien Lee, Wen-Te Liu, Kun-Ta Chou, Hau-Tieng Wu","doi":"10.1093/sleep/zsae317","DOIUrl":"10.1093/sleep/zsae317","url":null,"abstract":"<p><strong>Study objectives: </strong>This paper validates TipTraQ, a compact home sleep apnea testing (HSAT) system. TipTraQ comprises a fingertip-worn device, a mobile application, and a cloud-based deep learning artificial intelligence (AI) system. The device utilizes photoplethysmography (red, infrared, and green channels) and accelerometer sensors to assess sleep apnea by the AI system.</p><p><strong>Methods: </strong>We prospectively enrolled 240 participants suspected of obstructive sleep apnea (OSA) at a tertiary medical center for internal validation and 112 participants independently at another center for external validation. All participants underwent simultaneous polysomnography and TipTraQ HSAT. We compared TipTraQ-derived total sleep time (TQ-TST) and TipTraQ-derived Respiratory Events Index (TQ-REI) with expert-determined TST and apnea-hypopnea index (AHI), based on AASM standards with the 1B hypopnea rule. Temporal event localization analysis for respiratory event prediction was conducted at both event and hourly levels.</p><p><strong>Results: </strong>In the external validation, the Spearman correlation coefficients for TQ-TST vs. TST and TQ-REI vs. AHI were 0.81 and 0.95, respectively. The root mean square error were 0.53 hours for TQ-TST vs. TST and 7.53 events/h for TQ-REI vs. AHI. For apnea/hypopnea prediction with a 10-second grace period, the true positive, false positive, and false negative rates in temporal event localization analysis were 0.76, 0.24, and 0.23, respectively. The four-way OSA severity classification achieved a Cohen's kappa of 0.7.</p><p><strong>Conclusions: </strong>TQ-TST and TQ-REI predict TST and AHI with comparable performance to existing devices of the same type, and respiratory event prediction is validated through temporal event localization analysis.</p><p><strong>Clinical trials: </strong>Development of TipTraQ Home Sleep Test, https://clinicaltrials.gov/study/NCT06474351?term=NCT06474351&rank=1, NCT06474351TipTraQ Home Sleep Test Study, SHH, https://clinicaltrials.gov/study/NCT06633887?term=NCT06633887&rank=1, NCT06633887.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011884","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":"Transcriptional regulation of daily sleep amount by TCF4-HDAC4-CREB complex in mice.","authors":"Rui Zhou, Chaodong Zhang, Rui Gan, Xin Yin, Meng Wang, Bihan Shi, Lin Chen, Chongyang Wu, Qi Li, Qinghua Liu","doi":"10.1093/sleep/zsae313","DOIUrl":"10.1093/sleep/zsae313","url":null,"abstract":"<p><p>Histone deacetylase HDAC4/5 cooperates with cAMP response element-binding protein (CREB) in the transcriptional regulation of daily sleep amount downstream of LKB1-SIK3 kinase cascade in mice. Here, we report a significant enrichment of the E-box motifs for the basic loop-helix-loop (bHLH) proteins near the CREB- and HDAC4-binding sites in the mouse genome. Adeno-associated virus-mediated expression of class I bHLH transcription factors, such as TCF4, TCF3, or TCF12, across the mouse brain neurons reduces the duration of rapid eye movement sleep (REMS) and non-REMS (NREMS). TCF4 requires its bHLH domain to regulate REMS or NREMS amount, of which the latter is mostly independent of the E-box-binding activity. Consistent with that TCF4 interacts with CREB and HDAC4 via the bHLH domain, TCF4 relies on CREB and partly on HDAC4 to regulate NREMS/REMS amount. Conversely, the ability of CREB to regulate sleep duration also requires its binding to TCF4 and HDAC4. Together, these results indicate that TCF4, HDAC4, and CREB could function cooperatively in the transcriptional regulation of daily sleep amount in mice.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923231","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 trajectory of hospitalized medically ill older adults: do sleep medications make a difference?","authors":"Juliana Smichenko, Tamar Shochat, Anna Zisberg","doi":"10.1093/sleep/zsaf013","DOIUrl":"10.1093/sleep/zsaf013","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep disturbances are prevalent during acute hospitalization in medically ill older patients, with undesirable outcomes. Sleep medication use is common, but its effectiveness is questionable. This study explored the trajectory of sleep parameters from home to hospital and assessed the impact of sleep medication use, considering covariates such as physical symptom burden.</p><p><strong>Methods: </strong>A prospective multicenter study was conducted in four Israeli hospitals. Cognitively intact older patients (n = 683), with an admission interview and at least one follow-up, were recruited. Total sleep time (TST), sleep efficiency (SE), sleep quality (SQ), number of awakenings (NOAs), sleep medication use, sleep medication burden (quantity and dosage), and physical symptom burden were recorded daily. Personal and illness-related covariates were included in a repeated measures mixed models design.</p><p><strong>Results: </strong>Participants (male: 54%, aged 77.31 ± 6.60) showed shorter TST (329.73 ± 111.94 vs. 377.03 ± 101.06 min), lower SE (71.49 ± 19.28% vs. 76.14 ± 15.53%), and higher probability for lower SQ, in the hospital compared to home. Sleep medication use was not correlated with any sleep parameters; sleep medication burden was associated with NOA. Physical symptom burden showed significant main effects on SE, SQ, and NOA, and a significant interaction was found with time points on TST, such that higher burden was more strongly associated with shorter TST at first in-hospital follow-up than at admission, with no differences between all subsequent in-hospital time points.</p><p><strong>Conclusions: </strong>Sleep declined during acute hospitalization compared to the home, with sleep medications showing minimal effect. Managing symptom burden should be prioritized when addressing sleep disturbances in older patients during hospitalization.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011880","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 timing, sleep timing regularity, and cognitive performance in women entering late adulthood: the Study of Women's Health Across the Nation (SWAN).","authors":"Leslie M Swanson, Michelle M Hood, Rebecca C Thurston, Meryl A Butters, Christopher E Kline, Howard M Kravitz, Nancy E Avis, Genevieve Neal-Perry, Hadine Joffe, Siobán D Harlow, Carol A Derby","doi":"10.1093/sleep/zsaf041","DOIUrl":"10.1093/sleep/zsaf041","url":null,"abstract":"<p><strong>Study objectives: </strong>This study examined whether sleep timing and its regularity are associated with cognitive performance in older women and whether associations vary based on cardiometabolic risk factors.</p><p><strong>Methods: </strong>The cross-sectional analysis included 1177 community-dwelling females (mean age 65 years) from the observational Study of Women's Health Across the Nation (SWAN) annual visit 15. Sleep timing (mean midpoint from sleep onset to wake-up) and its regularity (standard deviation of midpoint) were assessed using actigraphy. Cognitive measures included immediate and delayed verbal memory, working memory, and processing speed. Cardiometabolic risk measures included central obesity, hypertension, diabetes, and the Atherosclerotic Cardiovascular Disease (ASCVD) risk score. Linear regression models, adjusted for covariates, tested associations between sleep and cognitive measures.</p><p><strong>Results: </strong>After covariate adjustment, early sleep timing was associated with worse delayed verbal memory (β = -0.37; p = .047) and late sleep timing was associated with worse processing speed (β = -1.80; p = .008). Irregular sleep timing was associated with worse immediate (β = -0.29; p = .020) and delayed verbal memory (β = -0.36; p = .006), and better working memory (β = 0.50; p = .004). Associations between early sleep timing and delayed verbal memory strengthened as ASCVD risk increased (interaction β = -8.83, p = .026), and sleep timing irregularity's effect on working memory was stronger among women with hypertension (interaction β = -3.35, p = .039).</p><p><strong>Conclusions: </strong>Sleep timing and its regularity are concurrently associated with cognitive performance in older women. Cardiovascular disease risk may modify some of these associations. Future longitudinal studies are needed to clarify these relationships.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}