Sleep最新文献

{"title":"Objective, but not subjective, daytime sleepiness predicts mortality in obstructive sleep apnea.","authors":"Yanyuan Dai, Alexandros N Vgontzas, Baixin Chen, Le Chen, Jun Wu, Dandan Zheng, Yun Li","doi":"10.1093/sleep/zsaf138","DOIUrl":"10.1093/sleep/zsaf138","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) with objective but not subjective excessive daytime sleepiness (EDS) has been reported to be associated with cardiovascular comorbidity. We aimed to investigate the association between OSA with objective or subjective EDS and mortality in a general population sample.</p><p><strong>Methods: </strong>In this retrospective cohort study, we included 244 subjects with OSA and 553 subjects without OSA with a median follow-up duration of 8 years. Objective EDS was defined based on a mean latency value of the multiple sleep latency test (MSL) ≤ 8 min. Subjective EDS was defined based on the total score of the Epworth Sleepiness Scale > 10.</p><p><strong>Results: </strong>After adjusting for potential confounders, OSA with objective EDS was associated with an approximately 2.5-fold higher risk of all-cause mortality (hazard ratio [HR] = 2.451, 95% confidence interval [95% CI] = 1.319 to 4.556) and 3.9-fold higher risk of CVD mortality (HR = 3.876, 95% CI = 1.293 to 11.622) compared to subjects without OSA or objective EDS. Furthermore, subjects with OSA, objective EDS, and CVD at baseline had about a 2.9-fold higher risk of all-cause mortality (HR = 2.872, 95% CI = 1.186 to 6.953) compared to subjects without OSA, objective EDS, or CVD at baseline. In contrast, OSA with subjective EDS was not associated with increased hazard of all cause or CVD mortality.</p><p><strong>Conclusions: </strong>Objective EDS appears to be an important marker of the biological severity of OSA. Future studies to validate the findings in diverse populations and interventional studies are needed.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133113","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 self-initiated breaks during drowsy driving.","authors":"John Gaspar, Brian Tefft, Cher Carney, William J Horrey","doi":"10.1093/sleep/zsaf150","DOIUrl":"10.1093/sleep/zsaf150","url":null,"abstract":"<p><p>Data suggest that drowsiness contributes to a large number of motor vehicle crashes, injuries, and deaths each year. Research suggests that taking breaks, examined via forced breaks at set points during simulator or test track driving, can at least momentarily decrease drowsiness and improve subsequent driving performance. In the real world, however, breaks must be initiated by drivers, who also have control over factors such as the break duration and activities engaged during the break. This study examined the impact of self-initiated breaks on driving performance and drowsiness over the course of long overnight drives. Ninety drivers completed a 150-mile highway drive in a driving simulator after a day of partial sleep restriction. They had the opportunity to take breaks at rest areas and could engage in different activities during breaks. An incentive method was used to mimic the motivational conditions of drowsy driving. Driving performance, as measured by lane departure frequency, improved immediately following breaks. Post-break performance began to decline shortly after the break and within 40 minutes performance returned to pre-break levels. Breaks with caffeine were particularly effective in delaying the decline in driving performance. These results indicate that self-initiated breaks, particularly those that involve caffeine consumption, can at least momentarily offset some of the performance impacts of drowsiness. However, breaks may not increase driver alertness and the benefits of breaks are fleeting for most drivers. The findings suggest that breaks may help drowsy drivers, but that they do not completely alleviate the effects of drowsiness.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226782","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":"Fitbit-measured sleep duration in young adolescents is associated with functional connectivity in attentional, executive control, memory, and sensory networks.","authors":"Ozerk Turan, Jonathan Garner, Amal Isaiah, Maylin Palatino, Thomas Ernst, Ze Wang, Linda Chang","doi":"10.1093/sleep/zsaf088","DOIUrl":"10.1093/sleep/zsaf088","url":null,"abstract":"<p><strong>Study objectives: </strong>Adolescents often do not sleep as much as recommended by most national guidelines, which may impact their brain development. The current study aims to evaluate the relationship between objective assessment of sleep duration measured with actigraphy and brain network connectivity on functional magnetic resonance imaging (fMRI).</p><p><strong>Methods: </strong>We used data from the 2-year follow-up of the Adolescent Brain Cognitive Development (ABCD) study comprising 3799 adolescents, ages 10-13 years old, to assess the relationship between sleep duration, measured by 2 weeks of Fitbit-derived actigraphy, and brain network connectivity derived from resting-state fMRI, using linear regression models. Linear regression analysis was also used to investigate the interaction between participant sex and sleep duration on brain network connectivity.</p><p><strong>Results: </strong>We identified both positive and negative correlations between mean sleep duration and 6 within-brain network and 30 between-network pairs. These included networks involved in attention (dorsal and ventral attention networks), executive control (cingulo-opercular and default mode networks), memory (retrosplenial temporal network), and sensory function (auditory and sensorimotor networks). We also identified sex-specific effects in three network pairs (auditory-retrosplenial temporal, retrosplenial temporal-sensorimotor, and visual-visual) and sex differences in functional connectivity across 23 distinct within- and between-network connections.</p><p><strong>Conclusions: </strong>Sleep duration is associated with the functional network connectivity in attentional, executive control, memory, and sensory networks during early adolescence. The identification of sex-specific effects in select network pairs underscores the importance of sex as a biological variable in studies of adolescent sleep and brain development.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743887","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":"Incorporating respiratory signals for machine learning-based multimodal sleep stage classification: a large-scale benchmark study with actigraphy and heart rate variability.","authors":"Daniel Krauss, Robert Richer, Arne Küderle, Jelena Jukic, Alexander German, Heike Leutheuser, Martin Regensburger, Jürgen Winkler, Bjoern M Eskofier","doi":"10.1093/sleep/zsaf091","DOIUrl":"10.1093/sleep/zsaf091","url":null,"abstract":"<p><p>Insufficient sleep quality is directly linked to various diseases, making reliable sleep monitoring crucial for prevention, diagnosis, and treatment. As sleep laboratories are cost- and resource-prohibitive, wearable sensors offer a promising alternative for long-term unobtrusive sleep monitoring at home. Current unobtrusive sleep detection systems are mostly based on actigraphy (ACT) that tend to overestimate sleep due to a lack of movement in short periods of wakefulness. Previous research established sleep stage classification by combining ACT with cardiac information but has not investigated the incorporation of respiration in large-scale studies. For that reason, this work aims to systematically compare ACT-based sleep-stage classification with multimodal approaches combining ACT, heart rate variability (HRV) as well as respiration rate variability (RRV) using state-of-the-art machine- and deep learning algorithms. The evaluation is performed on a publicly available sleep dataset including more than 1000 recordings. Respiratory information is introduced through ECG-derived respiration features, which are evaluated against traditional respiration belt data. Results show that including RRV features improves the Matthews Correlation Coefficient (MCC), with long short-term memory (LSTM) algorithms performing best. For sleep staging based on AASM standards, the LSTM achieved a median MCC of 0.51 (0.16 IQR). Respiratory information enhanced classification performance, particularly in detecting wake and rapid eye movement (REM) sleep epochs. Our findings underscore the potential of including respiratory information in sleep analysis to improve sleep detection algorithms and, thus, help to transfer sleep laboratories into a home monitoring environment. The code used in this work can be found online at https://github.com/mad-lab-fau/sleep_analysis.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998410","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":"Association between positive airway pressure therapy and healthcare costs among older adults with comorbid obstructive sleep apnea and common chronic conditions: an actuarial analysis.","authors":"Emerson M Wickwire, Chris R Fernandez, Nhan Huynh, Nathaniel F Watson, Ian Duncan","doi":"10.1093/sleep/zsaf009","DOIUrl":"10.1093/sleep/zsaf009","url":null,"abstract":"<p><strong>Study objectives: </strong>To determine the association between adherence to positive airway pressure and healthcare costs among a national sample of older adults with comorbid obstructive sleep apnea (OSA) and common chronic conditions.</p><p><strong>Methods: </strong>Our data source was a random sample of Medicare administrative claims for years 2016-2019. Inclusion criteria included age ≥65 years and new diagnosis of OSA. Exclusion criteria included evidence of prior OSA treatment during the 12 months prior to the index date, active cancer, or end-stage renal disease. OSA was defined using physician-assigned diagnostic codes. Common chronic conditions included chronic obstructive pulmonary disease, congestive heart failure, depression, hypertension, type 2 diabetes mellitus, obesity, and stroke. Based on Medicare policy, individuals were classified as adherers, nonadherers, or noninitiators. Risk adjustment was based on the Centers for Medicare and Medicaid Hierarchical Condition Categories approach developed by the Centers for Medicaid and Medicare Service specifically to estimate anticipated costs. To examine the impact of PAP adherence on costs, we employed a weighted DID regression framework to account for baseline variations in health status and other confounding factors.</p><p><strong>Results: </strong>Participants included 28 220 Medicare beneficiaries with comorbid OSA. Of these, 45% were adherent to PAP, 10% were nonadherent, and 44% did not initiate PAP. Relative to noninitiators, beneficiaries who initiated PAP displayed $195 reduced per-member per-month costs over 24 months. This finding remained consistent across all seven medical and psychiatric subgroups, as well as among individuals with multimorbidity.</p><p><strong>Conclusions: </strong>In this national analysis of Medicare beneficiaries with common chronic conditions, PAP adherence was associated with reduced costs over 24 months.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972214","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 architecture and dementia risk in adults: an analysis of 5 cohorts from the Sleep and Dementia Consortium.","authors":"Stephanie Yiallourou, Andree-Ann Baril, Crystal Wiedner, Jeffrey R Misialek, Christopher E Kline, Stephanie Harrison, Ethan Cannon, Qiong Yang, Rebecca Bernal, Alycia Bisson, Dibya Himali, Marina Cavuoto, Antoine Weihs, Alexa Beiser, Rebecca F Gottesman, Yue Leng, Oscar Lopez, Pamela L Lutsey, Shaun M Purcell, Susan Redline, Sudha Seshadri, Katie L Stone, Kristine Yaffe, Sonia Ancoli-Israel, Qian Xiao, Eleni Okeanis Vaou, Jayandra J Himali, Matthew P Pase","doi":"10.1093/sleep/zsaf129","DOIUrl":"10.1093/sleep/zsaf129","url":null,"abstract":"<p><strong>Study objectives: </strong>Poor sleep may play a role in the risk of dementia. However, few studies have investigated the association between polysomnography (PSG)-derived sleep architecture and dementia incidence. We examined the relationship between sleep architecture and dementia incidence across five US-based cohort studies from the Sleep and Dementia Consortium.</p><p><strong>Methods: </strong>Percent of time spent in stages of sleep (N1, N2, N3, rapid eye movement sleep), wake after sleep onset, sleep maintenance efficiency, apnea-hypopnea index, and relative delta power were derived from a single night home-based PSG. Dementia was ascertained in each cohort using its cohort-specific criteria. Each cohort performed Cox proportional hazard regressions for each sleep exposure and incident dementia, adjusting for age, sex, body mass index, antidepressant use, sedative use, and APOE e4 status. Results were then pooled in a random effects model.</p><p><strong>Results: </strong>The pooled sample comprised 4657 participants (30% women) aged ≥ 60 years (mean age was 74 years at sleep assessment). There were 998 (21.4%) dementia cases (median follow-up time of 5 to 19 years). Pooled effects of the five cohorts showed no association between sleep architecture and incident dementia. When pooled analysis was restricted to the three cohorts which had dementia case ascertainment based on DSM-IV/V criteria (n = 2374), higher N3% was marginally associated with an increased risk of dementia (hazard ratio (HR): 1.06; 95%CI: 1.00-1.12, per percent increase N3, p = .050).</p><p><strong>Conclusions: </strong>There were no consistent associations between sleep architecture measured and the risk of incident dementia. Implementing more nuanced sleep metrics and examination of associations with dementia subtypes remains an important next step for uncovering more about sleep-dementia associations.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080607","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":"Individual differences in medial temporal lobe functional network architecture predict the capacity for sleep-related consolidation of emotional memories in older adults.","authors":"Miranda G Chappel-Farley, Jenna N Adams, Richard F Betzel, Negin S Sattari, Destiny E Berisha, Novelle J Meza, John T Janecek, Hamid Niknazar, Soyun Kim, Abhishek Dave, Ivy Y Chen, Kitty K Lui, Ariel B Neikrug, Ruth M Benca, Michael A Yassa, Bryce A Mander","doi":"10.1093/sleep/zsaf117","DOIUrl":"10.1093/sleep/zsaf117","url":null,"abstract":"<p><strong>Study objectives: </strong>Memory consolidation during non-rapid eye movement slow wave sleep (NREM SWS) involves reactivation of a hippocampal index which integrates distributed cortical representations of an experience. This study examined whether individual differences in brain network properties that align with this theoretical organization were associated with interindividual variability in memory consolidation during sleep.</p><p><strong>Methods: </strong>Thirty-six older adults (μage = 72.9 ± 5.6) completed overnight polysomnography with pre- and post-sleep emotional memory testing. Slow oscillation (SO) power and SO-sleep spindle (SO-SP) coupling were computed. Participants also completed 3T structural and resting-state functional magnetic resonance imaging (rsfMRI). Resting-state fMRI network modularity (Q), hippocampal and amygdala eigenvector centrality (EC), and betweenness centrality (BC) were calculated.</p><p><strong>Results: </strong>Greater Q was associated with reduced emotional memory retention and greater SWS. Hippocampal and amygdala EC were associated with better emotional memory retention. Hippocampal BC was associated with immediate test performance, whereas amygdala BC was associated with delayed test and memory retention. Hippocampal centrality measures were associated with SO power and SO-SP coupling. Random forest classification revealed distinct network measure combinations predict different stages of memory processing.</p><p><strong>Conclusions: </strong>Network integration supports overnight emotional memory retention. Individuals with more influential medial temporal lobe nodes exhibited better memory consolidation, suggesting functional network architecture contributes to memory processing. These measures were associated with sleep oscillations implicated in consolidation. Individual differences in functional network organization may predict the capacity of older adults to consolidate memories.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180122","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":"Positive airway pressure therapy lowers healthcare costs in older adults, but initiation remains a challenge.","authors":"Faith S Luyster, Patrick J Strollo","doi":"10.1093/sleep/zsaf036","DOIUrl":"10.1093/sleep/zsaf036","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374894","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":"Seasonal and daily variation in indoor light and temperature are associated with sleep disturbance in dementia.","authors":"Anne C Skeldon, Thalia Rodriguez, Eyal Soreq, Chloe Walsh, Derk-Jan Dijk","doi":"10.1093/sleep/zsaf125","DOIUrl":"10.1093/sleep/zsaf125","url":null,"abstract":"<p><p>Mechanisms regulating human sleep and physiology have evolved in response to rhythmic variation in environmental variables driven by the Earth's rotation around its axis and the Sun. To what extent these mechanisms are operable in vulnerable people who are primarily exposed to the indoor environment remains unknown. We analyzed 26 523 days of data from outdoor and indoor environmental sensors and a contactless behavior-and-physiology sensor tracking bed occupancy, heart, and breathing rate in 70 people living with dementia. Indoor light and temperature, sleep timing, duration, and fragmentation, as well as the timing of the heart rate minimum, all varied across seasons. Beyond the effects of season, higher bedroom temperature and less bright indoor daytime light are associated with more disrupted sleep and higher respiratory rate. This sensitivity of sleep and physiology to ecologically relevant variations in indoor environmental variables implies that implementing approaches to control indoor light and temperature can improve sleep.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044670","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":"Letter to the Editor: Melatonin as an adjuvant treatment for atopic dermatitis.","authors":"Ana Luíza P Godoy, Ellen M S Xerfan, Sergio Tufik, Monica L Andersen","doi":"10.1093/sleep/zsaf271","DOIUrl":"https://doi.org/10.1093/sleep/zsaf271","url":null,"abstract":"","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016199","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}