{"title":"Comorbid Insomnia and Sleep Apnea Mechanistic Convergence, Phenotypic Heterogeneity, and Clinical Implications.","authors":"Syed Nahidi, Senyo Agidi, Ali A El-Solh","doi":"10.1007/s40675-026-00384-w","DOIUrl":"10.1007/s40675-026-00384-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Comorbid insomnia and obstructive sleep apnea (COMISA) is increasingly viewed as more than two coexisting sleep disorders. This review asks whether COMISA reflects a distinct phenotype driven by mechanistic convergence, how heterogeneous it is across patients, and what that means for diagnosis and treatment.</p><p><strong>Recent findings: </strong>Recent studies show COMISA is common, linked to greater sleep fragmentation, and higher cardiometabolic and psychiatric burden than either disorder alone. Mechanistic work supports bidirectional interaction between ventilatory instability and chronic hyperarousal, with autonomic and EEG findings suggesting persistent sympathetic activation and cortical hyperactivation. Treatment studies indicate that PAP and CBT-I each help, but single-modality treatment often leaves residual symptoms; combined, phenotype-informed care appears more effective.</p><p><strong>Summary: </strong>The evidence supports COMISA as a clinically important, heterogeneous convergence phenotype rather than a simple comorbidity. Future research should prioritize longitudinal outcomes, biomarker-based phenotyping, and endotype-stratified trials. This shift could move COMISA care toward more precise, mechanism-guided management.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen P Becker, Alison E Pritchard, Jessica R Lunsford-Avery
{"title":"Behavioral Sleep Treatment in ADHD Across Child and Adolescent Development: Recent Findings, Integration with Existing Interventions, and Emerging Directions.","authors":"Stephen P Becker, Alison E Pritchard, Jessica R Lunsford-Avery","doi":"10.1007/s40675-026-00387-7","DOIUrl":"10.1007/s40675-026-00387-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sleep disturbances are highly prevalent among youth with attention-deficit/hyperactivity disorder (ADHD) and contribute to emotional, cognitive, and functional impairments. Although historically under-addressed in ADHD treatment, there is increasing recognition of sleep as a critical intervention target. This paper synthesizes recent advances in behavioral sleep interventions for youth with ADHD, emphasizing developmental considerations spanning early childhood, middle childhood, and adolescence.</p><p><strong>Recent findings: </strong>Across developmental periods, growing evidence supports the feasibility and effectiveness of behavioral sleep interventions, particularly for improving parent- and self-reported sleep outcomes. We also examine the limited literature on integrating sleep-focused strategies into established evidence-based behavioral treatments for ADHD, highlighting opportunities and challenges for embedding sleep within existing care models.</p><p><strong>Summary: </strong>We identify key emerging directions, including the need for developmentally-tailored and mechanistically-informed interventions, increased focus on circadian and sleep regularity processes, and scalable delivery approaches leveraging digital and integrated care settings. Advancing this work holds promise for improving both nighttime sleep and daytime functioning for youth with ADHD and their families.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 ","pages":"34"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophia Oliver, Kelly Dombek, Anne E Milner, Allison G Harvey
{"title":"Innovative Approaches to Advancing Equitable Access to Insomnia Interventions.","authors":"Sophia Oliver, Kelly Dombek, Anne E Milner, Allison G Harvey","doi":"10.1007/s40675-026-00385-9","DOIUrl":"10.1007/s40675-026-00385-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Insomnia disorder is a prevalent and impairing sleep-wake disorder characterized by persistent difficulty initiating or maintaining sleep, accompanied by daytime impairment. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment and has a strong evidence base. Building on this foundation, recent work has increasingly focused on translating these advances into accessible and scalable interventions. This review (1) highlights key challenges in the delivery of insomnia interventions that constrain equitable access and (2) examines emerging approaches that may address these gaps.</p><p><strong>Recent findings: </strong>Recent research has identified four primary challenges limiting equitable access to insomnia interventions: high comorbidity with mental health and other sleep and circadian disorders, limited testing and adaptation outside of academic settings, a shortage of trained providers, and structural barriers related to funding and reimbursement. In response, growing evidence supports transdiagnostic treatment approaches, implementation strategies for real-world settings, delivery by non-specialist providers, brief and single-session interventions, and digital and stepped care models as promising pathways to improve access and scalability.</p><p><strong>Summary: </strong>Our review underscores the importance of moving beyond testing efficacy to address the practical and structural barriers that limit access to evidence-based insomnia interventions. Advancing research that prioritizes real-world application remains essential for narrowing the longstanding gap between evidence and practice and to improve equitable access to effective insomnia interventions.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"36"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aswathy B Suseela Devi, Katherine Lyman, Colleen A McClung
{"title":"The Role of Chronopsychiatry in Precision Medicine: Circadian Dysregulation as Diagnostic Marker and Therapeutic Target.","authors":"Aswathy B Suseela Devi, Katherine Lyman, Colleen A McClung","doi":"10.1007/s40675-026-00357-z","DOIUrl":"10.1007/s40675-026-00357-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronopsychiatry refers to a research and clinical approach which studies psychiatric illness through the lens of circadian rhythms and aims to reset the body's biological clock to counteract circadian rhythm abnormalities in psychiatric disorders. This review highlights the use of circadian biomarkers collected from wearable devices and other methods to help the development of personalized treatment plans based on patients' individual circadian functioning. Circadian biomarkers, such as activity, heart rate, skin temperature, and light exposure recorded over 24 h, has shown promise in diagnosing and assessing the severity of various neuropsychiatric disorders.</p><p><strong>Recent findings: </strong>Wearable devices capable of recording multiple circadian parameters have greatly aided data collection, and when integrated into treatment, have shown promise for revolutionizing circadian medicine. Therapies that entrain or shift the circadian system can help stabilize sleep-wake rhythms or better align rhythms with the environment.</p><p><strong>Summary: </strong>These approaches support the emerging field of precision psychiatry, moving beyond a one-size-fits-all approach and addressing the heterogeneity and complexity of psychiatric disorders.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"1"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer N Felder, Bernadette McClelland, Candance Sorensen, Meghan Brown, Richelle Mah
{"title":"Behavioral Sleep Therapies During the Perinatal Period: A Scoping Review.","authors":"Jennifer N Felder, Bernadette McClelland, Candance Sorensen, Meghan Brown, Richelle Mah","doi":"10.1007/s40675-026-00359-x","DOIUrl":"10.1007/s40675-026-00359-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Perinatal insomnia is common and consequential. This review presents findings from randomized controlled trials of behavioral sleep therapies in perinatal samples published since 2020.</p><p><strong>Recent findings: </strong>Eleven studies were included; seven investigated cognitive behavioral therapy for insomnia (CBT-I) and four investigated mindfulness-based interventions (MBI). CBT-I is effective for improving perinatal sleep. Benefits attenuate in the early postpartum period, and re-emerge around six months postpartum. Impact on mental health outcomes is mixed, possibly due to variations in comparator groups and assessment timepoints. Two of the MBI trials were adequately powered to investigate effects on insomnia severity, and suggest that MBIs may be effective for reducing insomnia during pregnancy.</p><p><strong>Summary: </strong>Future work should evaluate the effectiveness of behavioral sleep therapies in real world settings, examine benefits beyond six months postpartum, evaluate impacts on offspring, conduct rigorous research to better quantify mental health benefits, and elucidate for whom MBI is indicated vs. CBT-I.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"5"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexis J Dickerson, Jelaina R Shipman-Lacewell, Marcus O Reed, Dayna A Johnson
{"title":"Interventions to Address Sleep Disparities in the United States: A Narrative Review.","authors":"Alexis J Dickerson, Jelaina R Shipman-Lacewell, Marcus O Reed, Dayna A Johnson","doi":"10.1007/s40675-026-00369-9","DOIUrl":"https://doi.org/10.1007/s40675-026-00369-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this narrative review is to synthesize existing literature on interventions that address sleep disparities across the lifespan. These populations include racial and ethnic minoritized populations, individuals with disabilities, sexual and gender minoritized communities, socioeconomically disadvantaged individuals, and those living in both rural and urban environments.</p><p><strong>Recent findings: </strong>We identified 16 studies focused on interventions targeting sleep disparities among racial and ethnic minoritized, socioeconomically disadvantaged, rural, and urban populations. Key intervention strategies included culturally, racially, linguistically, and individually tailored messaging; remote and community-based delivery to increase access; and stress management techniques.</p><p><strong>Summary: </strong>Despite evidence of sleep disparities, there is a lack of research focused on interventions targeting these disparities, especially among individuals with disabilities and sexual and gender minoritized communities. This narrative review highlights the need for culturally relevant, accessible, and scalable solutions across all populations who experience sleep disparities.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rupsha Singh, Symielle A Gaston, Harold G Koenig, Chandra L Jackson
{"title":"Religion and Spirituality as Social Determinants of Sleep Health Across the Globe: A Narrative Review.","authors":"Rupsha Singh, Symielle A Gaston, Harold G Koenig, Chandra L Jackson","doi":"10.1007/s40675-026-00374-y","DOIUrl":"10.1007/s40675-026-00374-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize existing evidence of associations between religion and spirituality in relation to multiple dimensions of sleep health, illuminate strengths and limitations of the existing literature, and outline gaps that inform opportunities for future research.</p><p><strong>Recent findings: </strong>Positive dimensions of religion and spirituality, such as spiritual well-being, supportive coping, and community integration, were generally associated with better sleep outcomes across global populations. Adverse experiences, including doubt, conflict, and spiritual struggle, were often associated with poorer sleep. Among the 59 included studies, most were cross-sectional and relied on self-reported measures, used inconsistent conceptualizations of religion and spirituality, did not sufficiently assess potentially adverse religious or spiritual experiences, and were limited to certain geographic regions of the world (e.g., North America and Southwest Asia).</p><p><strong>Summary: </strong>Positive dimensions of religion and spirituality (e.g., meaning, coping) were generally associated with better sleep, while struggles and doubt were associated with poorer sleep. Future research that employs longitudinal and experimental designs, validated multidimensional measures, objective sleep assessments, and diverse populations is needed to clarify mechanisms and inform culturally responsive approaches to promoting sleep health.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40675-026-00374-y.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"26"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Better Sleep to Improved Mood: A Review of the Biopsychosocial Pathways for Cognitive Behavioral Therapy for Insomnia's Antidepressant Effects.","authors":"Ivan Vargas, Harrison Dickens, Arash Assar","doi":"10.1007/s40675-026-00376-w","DOIUrl":"10.1007/s40675-026-00376-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent research supports that Cognitive Behavioral Therapy for Insomnia (CBT-I) improves both insomnia and depression symptoms. The primary purpose of the current review was to summarize potential mechanistic pathways linking insomnia and depression while evaluating how improvements in sleep via CBT-I may lead to reduced depressive symptoms.</p><p><strong>Recent findings: </strong>The current literature supports that there are several potential biological, behavioral, and cognitive-affective mechanisms, including improved hypothalamic-pituitary-adrenal (HPA) axis and inflammatory functioning, behavioral activation, and emotion regulation, that may explain the antidepressant effects of CBT-I.</p><p><strong>Summary: </strong>Critically evaluating the potential mechanisms by which CBT-I improves depression (e.g., HPA-axis, inflammatory, behavioral, and emotional processes) will inform future efforts to enhance the overall effectiveness of CBT-I in patients with comorbid depression. Specifically, it will identify specific mechanisms that can be the focus of more targeted interventions or strategies to streamline CBT-I in patients with depression.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"21"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current Evidence for Sleep States in <i>Drosophila</i>: Findings and Implications.","authors":"Maria E Colt, Susan T Harbison","doi":"10.1007/s40675-025-00352-w","DOIUrl":"10.1007/s40675-025-00352-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sleep is an essential biological behavior, with its absence leading to severe consequences, including death. In mammals, sleep consists of distinct states-such as REM and non-REM-that are often thought to serve different physiological functions. Traditionally, <i>Drosophila melanogaster</i> were believed to experience sleep as a single, unitary state. However, recent research suggests that sleep in flies is more complex than previously understood and can be divided into distinct states. This raises the possibility that the fly model can be used to investigate the functional role(s) of each sleep state.</p><p><strong>Recent findings: </strong>In this review, we explore the behavioral, neurophysiological, metabolic, and transcriptional evidence supporting the existence of these sleep states in <i>Drosophila</i>. We assess whether consistent criteria can be established for these sleep states and propose a new direction for sleep research by identifying genetic correlates associated with these states.</p><p><strong>Summary: </strong>This approach has the potential to deepen our understanding of sleep architecture and its genetic underpinnings, offering insights that may extend beyond the <i>Drosophila</i> model to other species, including humans.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"14"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Community-engaged and Implementation Science-informed Pediatric Sleep Intervention Research.","authors":"Ariel A Williamson, Jessica C Levenson","doi":"10.1007/s40675-026-00389-5","DOIUrl":"10.1007/s40675-026-00389-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Community-engaged research (CEnR) and implementation science can address gaps in translating evidence-based interventions to real-world practice by considering the needs of patients/families, clinicians, and contexts. This review summarizes recent pediatric sleep intervention research that incorporates CEnR and/or implementation science principles. We also identify key areas for future research.</p><p><strong>Recent findings: </strong>Most reviewed studies incorporated CEnR methods during intervention development, adaptation, and/or pilot testing. Studies with community members collaborating in named research team roles were rare. Although some studies evaluated intervention acceptability, feasibility, and fidelity, very few used established implementation science theories, models, or frameworks, and even fewer focused on developing and testing implementation strategies.</p><p><strong>Summary: </strong>It is critical to establish sleep researcher-community partnerships that promote community empowerment and capacity-building, and to conduct implementation strategy research. We encourage researchers to further integrate CEnR and implementation science to advance pediatric sleep health and address the many gaps in care.</p>","PeriodicalId":37449,"journal":{"name":"Current Sleep Medicine Reports","volume":"12 1","pages":"38"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}