Sleep Health最新文献

{"title":"Long-term trajectories of insomnia and their lifestyle and health correlates.","authors":"Jie Guo, Linda L Magnusson Hanson, Torbjörn Åkerstedt, Anna Karin Hedström","doi":"10.1016/j.sleh.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.08.002","url":null,"abstract":"<p><strong>Objectives: </strong>Insomnia is highly prevalent in the general population. We aimed to identify long-term insomnia trajectories, examine baseline predictors of trajectory membership, and assess how lifestyle factors and health outcomes evolve across these trajectories.</p><p><strong>Methods: </strong>Data were obtained from the Swedish Longitudinal Occupational Survey of Health, including 15,807 participants with repeated sleep assessments collected biennially between 2010 and 2018. Latent class trajectory modeling identified 4 distinct insomnia trajectories. Multinomial logistic regression examined baseline predictors of trajectory membership, and repeated-measures regression models assessed longitudinal associations with lifestyle factors and somatic and psychiatric morbidity.</p><p><strong>Results: </strong>Four trajectories were identified as follows: low and stable, increasing, decreasing, and persistently high insomnia probability. Compared with the low and stable trajectory, all higher-risk trajectory groups at baseline consisted of a higher proportion with female sex, younger age, lower physical activity, higher body mass index, and a higher prevalence of sleep apnea and neurological and psychiatric disorders. During follow-up, body mass index increased more steeply for those in the increasing and persistently high trajectories, whereas physical activity increased in the decreasing trajectory. Individuals with persistently high insomnia trajectory also showed a more rapid increase in psychiatric disorders and sleep duration compared to those who remained free of disease.</p><p><strong>Conclusions: </strong>Higher-risk insomnia trajectories are associated with adverse lifestyle profiles and increasing morbidity over time, whereas decreasing insomnia probability is accompanied by increasing physical activity. These findings highlight the dynamic and heterogeneous nature of insomnia and the relevance of lifestyle factors and evolving morbidity in long-term insomnia patterns.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867338","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":"Association of sleep duration, lifestyle habits, and motor vehicle accident mortality-A prospective cohort study.","authors":"Chun-Wei Wu, Cheng-Wei Chan, Min-Kuang Tsai, Thu Win Kyaw, Chi-Pang Wen","doi":"10.1016/j.sleh.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.06.006","url":null,"abstract":"<p><strong>Objectives: </strong>While insufficient sleep is known to contribute to motor vehicle accident (MVA) mortality, limited research has focused on the impact of self-reported sleep duration and quality. This study aims to investigate the relationship between sleep duration, sleep quality, and MVA mortality.</p><p><strong>Methods: </strong>In a cohort of 482,507 participants aged 20 years or older, medical screenings were conducted from 1996 to 2017. Sleep characteristics, including self-reported duration, quality, and sleeping pill use, were assessed via self-reported questionnaires. MVA mortality was identified using International Classification of Diseases-9 and ICD-10 codes. Cox proportional hazards models were applied to calculate hazard ratios (HRs) for MVA mortality.</p><p><strong>Results: </strong>There were 37,541 deaths, including 791 due to accidents. Approximately 70% of participants reported sleeping 6-8 hours per night, while 20.2% reported 4-6 hours, 1.2% less than 4 hours, and 8.7% more than 8 hours. After adjusting for covariates, participants with a shorter sleep duration (4-6 hours) had a 30% increased risk of MVA mortality compared with those with 6-8 hours (HR: 1.30; 95% CI: 1.09-1.55). Those with sleep durations exceeding 8 hours had a similar 31% increase in risk (HR: 1.31; 95% CI: 1.05-1.64). This risk was further elevated among smokers, frequent alcohol drinkers, and sleeping pill users.</p><p><strong>Conclusions: </strong>Both self-reported shorter sleep durations (less than 6 hours) and longer sleep durations (more than 8 hours) are associated with elevated MVA mortality risk, forming a U-shaped relationship. This risk is amplified among smokers, frequent alcohol consumers, and sleeping pill users.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867277","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":"Does the age interaction reflect underweight-or a changing insomnia phenotype?","authors":"Fei Yang, Haoyang Hu","doi":"10.1016/j.sleh.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.08.003","url":null,"abstract":"","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867294","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 sleep, cognitive function, and work performance among rotating shift and night-shift healthcare workers: A systematic review.","authors":"Isaac Nuako, Emmanuel Frimpong, Thien Thanh Dang-Vu","doi":"10.1016/j.sleh.2026.07.013","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.07.013","url":null,"abstract":"<p><p>Rotating shift work, including night shifts, disrupts circadian rhythms and the sleep-wake cycle, contributing to sleep disturbances, cognitive impairment, and increased medical errors among healthcare workers. We evaluated associations between sleep quality and quantity, rotating shift work characteristics, cognitive function, and work performance among healthcare workers, and to identify moderating factors influencing these relationships in a systematic review. Six databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, and PsycINFO) and Google Scholar were searched from inception to April 30, 2026. Eligible experimental or observational studies were published in English and assessed sleep, cognitive functions, or work performance in rotating shift healthcare workers. Risk of bias was assessed using the Newcastle-Ottawa Scale, RoB 2, and ROBINS-I V2 tools. Findings were synthesized narratively. We included 59 studies involving 17,660 participants. Poor sleep quality affected 52% to 90% of rotating night shift healthcare workers and was associated with impaired attention (50% higher at night vs. day), memory (OR = 1.86), medical errors (OR = 1.78-2.1), and slowed reaction time after 6 to 7 consecutive nights (comparable to BAC 0.05%). Counterclockwise and rapidly rotating schedules were associated with 1.3-hour less sleep, 44% greater attentional problems, and 36% to 50% greater work-life interference than clockwise rotation. Limiting shifts to ≤16 hours reduced attentional failures by 50%, while scheduled 30-minute naps reduced sleepiness (d = 0.43) and improved cognition (d = 0.23-0.33). Overall, rotating shift and night work substantially impair sleep, cognition, and occupational functioning among healthcare workers. Clockwise rotation, slower rotation, scheduled naps, and limiting extended shifts may mitigate these impairments. PROSPERO REGISTRATION: CRD420251128550.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867349","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":"Differential impact of school start times: Exploring heterogeneous treatment effects of delaying school start times on sleep and BMI in the START study.","authors":"Emma Billmyer, Ashley Petersen, Darin J Erickson, Kyla Wahlstrom, Melissa N Laska, Rachel Widome","doi":"10.1016/j.sleh.2026.07.016","DOIUrl":"10.1016/j.sleh.2026.07.016","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to demonstrate a method for identifying subgroups that may have experienced heterogeneous effects of a delayed high school start time policy. This approach could suggest how the implementation of a policy might be prioritized.</p><p><strong>Methods: </strong>In the START study, students (n = 2230) from 5 schools in the Twin Cities, Minnesota metropolitan area were followed over 3 waves of annual data collection. All schools started early (7:30 or 7:45 am) at baseline. Two \"policy change schools\" had set start times later by roughly 1 hour by follow-up 1; 3 \"comparison schools\" maintained their early start time throughout the study. We employed generalized linear mixed model trees, a data-driven method that detects potential treatment-subgroup interactions while accounting for the clustered nature of the data. The stability of variable selection was assessed using a subsampling approach.</p><p><strong>Results: </strong>Among Asian and Black students whose parents did not complete college (a subgroup identified by the generalized linear mixed model trees), those who attended policy change schools gained over 1 hour and 15 minutes of sleep per night, relative to comparison school students. The other subgroups had lesser treatment effects. With body mass index, minimal differences were observed between subgroups identified by generalized linear mixed model trees.</p><p><strong>Conclusion: </strong>We showed how the generalized linear mixed model trees method can enable identification of groups that may experience differing impacts from a population-based policy. However, this analysis was meant primarily as a demonstration and the results should be seen as preliminary and hypothesis generating, due to the small number of participants in some subgroups.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841671","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":"School-based sleep education in kindergarten: Integrating classroom and policy perspectives.","authors":"Martha Sheridan, Sarah Mulligan, Julie Bruch, Amber Neff","doi":"10.1016/j.sleh.2026.07.015","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.07.015","url":null,"abstract":"","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841746","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":"Socioeconomic impact of central disorders of hypersomnolence: A national register-based case-control study.","authors":"Niels Christian Haubjerg Østerby, Poul Jørgen Jennum","doi":"10.1016/j.sleh.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.08.001","url":null,"abstract":"<p><strong>Objectives: </strong>Several studies have examined the disease burden of narcolepsy type 1 (NT1). However, comprehensive comparisons of disease impact across NT1, narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) are lacking.</p><p><strong>Methods: </strong>In this single-center retrospective matched case-control study, 433 patients with a central disorder of hypersomnolence (CDH; including NT1, NT2, and IH) were collected from local storage between 2004 and 2022 then matched to population controls from national Danish registry in a ratio 1:4 and compared on comorbidity and socioeconomic, and health outcomes 2 years before and after diagnosis.</p><p><strong>Results: </strong>Costs were greatest in NT2 (€9.846 vs €1.568; P < .001) and IH (€8.713 vs €2.357; P < .001) compared to NT1 (€6.011 vs €2.143; P < .001). Before CDH diagnosis, NT2 patients had higher psychiatric care costs than controls (€1.224 vs €61; P < .001). Unemployment increased over time in all groups: NT1 9.5%-12.4%, IH 9.6%-25.5%, and NT2 16.9%-28.6%. Unemployment increased in NT1 (OR 2.8, 95% CI 1.2-6.5), NT2 (OR 4.6, 95% CI 2.1-10.1), and IH (OR 2.2, 95% CI 1.2-3.9).</p><p><strong>Conclusions: </strong>The disease burden of NT2 was more severe than that of other CDH. These findings support subtype-specific clinical attention and multidisciplinary management.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841688","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":"Metabolic signatures of sleep health and stroke risk: A prospective cohort study with mediation analysis.","authors":"Zhe Xu, Jinxia Zhang, Zhixing Fan, Haifang Zhou, Lei Zhang, Linlin Hu, Xiuhong Zhang","doi":"10.1016/j.sleh.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.08.008","url":null,"abstract":"<p><strong>Objectives: </strong>Healthy sleep is associated with lower stroke risk, but the underlying metabolic mechanisms remain poorly understood. We investigated whether a nuclear magnetic resonance-derived metabolic signature mediates this association.</p><p><strong>Methods: </strong>This prospective cohort study included 200,729 UK Biobank participants (mean age 56.48±8.10 years, 53.80% female) free of stroke at baseline. A healthy sleep score (0-6) was derived from 6 behaviors as follows: chronotype, sleep duration, insomnia, snoring, daytime dozing, and ease of getting up. Sleep-related metabolites among 249 plasma nuclear magnetic resonance biomarkers were selected using elastic net regression and combined into a metabolic signature score. Associations with incident stroke were estimated using Cox models, and mediation was assessed using counterfactual analyses over a median 12.6 -year follow-up.</p><p><strong>Results: </strong>During 2,530,392 person-years, 5140 incident strokes occurred. Elastic net identified 35 sleep-related metabolites, mainly reflecting lower glycoprotein acetyls and VLDL particles and higher polyunsaturated fatty acids, including DHA and linoleic acid. Each 1-point higher healthy sleep score was associated with lower risk of stroke (HR 0.97; 95% CI, 0.95-0.99). Each 1-SD higher metabolic signature score was associated with a reduced risk of stroke (HR 0.93; 95% CI, 0.90-0.96), and the highest versus lowest tertile had lower risk (HR 0.86; 95% CI, 0.79-0.93). The signature mediated 8.63% (95% CI, 3.65%-18.25%) of the sleep-stroke association, with omega-3 fatty acids, HDL subfractions, amino acids, and GlycA as major contributors.</p><p><strong>Conclusions: </strong>A nuclear magnetic resonance-derived metabolic signature partially mediates the protective effect of healthy sleep on stroke risk through lipid metabolism, amino acid homeostasis, and systemic inflammation pathways, highlighting potential metabolic targets for stroke prevention in individuals with sleep disturbances.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841744","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 inequities at the intersections of racialized, gender, and sexual identity in the U.S.: An intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA).","authors":"Dougie Zubizarreta, Ariel L Beccia, Jarvis T Chen, Brent A Coull, S Bryn Austin","doi":"10.1016/j.sleh.2026.07.014","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.07.014","url":null,"abstract":"<p><strong>Objectives: </strong>Sleep inequities are marked and persistent in the U.S., yet there remains limited research examining the patterning of adverse sleep outcomes across intersecting dimensions of social identity. This study's objective was to estimate the prevalence of short and long sleep duration across population subgroups jointly defined by racialized identity, sex, and sexual identity, and quantify inequities.</p><p><strong>Methods: </strong>Data came from the 2022 Behavioral Risk Factor Surveillance System (N = 235,326). We implemented Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) by grouping participants into 20 intersectional social strata and fitting Bayesian multilevel logistic models to obtain intersectional social stratum-specific prevalence estimates for each outcome. Intersectional social strata were jointly defined by racialized identity (Black, Latine, White, multiracial/other) and sex/sexual identity (heterosexual-cisgender males, heterosexual-cisgender females, LGBQ-cisgender males, LGBQ-cisgender females, trans and gender nonconforming people).</p><p><strong>Results: </strong>Multiply marginalized groups (e.g., people of color who are also LGBQ+) had the highest prevalence of both short and long sleep duration.</p><p><strong>Conclusions: </strong>Equity-focused policies and interventions targeting sleep health should center the needs and priorities of multiply marginalized groups who are at particularly elevated risk of both short and long sleep duration.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841669","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 of sleep duration and quality with cardiometabolic risk factors in US adults: Evidence from the 2022 National Health Interview Survey.","authors":"Kushagra Vashist, Laura Ward, Amit Shah, Viola Vaccarino, Dayna A Johnson","doi":"10.1016/j.sleh.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.sleh.2026.07.005","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the association between sleep duration and quality with cardiometabolic risk factors, assessed whether these associations varied by socioeconomic status, and identified prevalent risk factor combinations in those with poor sleep health.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 25,433 adults using the 2022 National Health Interview Survey data. Sleep health exposures included self-reported sleep duration (<7, 7-9, >9 h), sleep quality measures (frequency of feeling well rested, difficulty falling asleep, difficulty staying asleep), and a composite sleep health indicator. Cardiometabolic risk factors included overweight/obesity, diabetes, hypertension, and hyperlipidemia. We examined the mean count of cardiometabolic risk factors (individual range: 0-4) and patterns of cardiometabolic risk factor combinations across sleep measures using Poisson regression with marginal standardization for covariates, accounting for the complex survey design.</p><p><strong>Results: </strong>Population-average cardiometabolic risk factor count was 9% higher among short sleepers, 15% to 20% higher across poor sleep quality measures, and 18% higher among those without healthy composite sleep compared with healthy reference groups. Associations between difficulty staying asleep and mean cardiometabolic risk factor count were stronger among those with lower SES (p-interaction ≤0.001) on the ratio scale. Poor sleep quality was associated with more severe CMRF combinations and patterns, while sleep duration showed heterogeneous associations across cardiometabolic outcomes.</p><p><strong>Conclusion: </strong>Poor sleep quality and short sleep duration were associated with higher population-level cardiometabolic risk factor burden. Associations for difficulty staying asleep were stronger among individuals with lower socioeconomic status. Poor sleep quality was also associated with more severe cardiometabolic risk factor combinations, suggesting sleep quality may be a potential target for multimorbidity prevention.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833286","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}