Sleep Medicine Reviews最新文献

The association between gut microbiota and insomnia: A systematic review and meta-analysis 肠道微生物群与失眠之间的关系：一项系统综述和荟萃分析

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI: 10.1016/j.smrv.2026.102236

Shucheng Chen , Han Li , Meng Ning , Branda Yee Man Yu , Shirong Wu , Wai-yin Cheng , Yamin Li , Wing Fai Yeung

{"title":"The association between gut microbiota and insomnia: A systematic review and meta-analysis","authors":"Shucheng Chen , Han Li , Meng Ning , Branda Yee Man Yu , Shirong Wu , Wai-yin Cheng , Yamin Li , Wing Fai Yeung","doi":"10.1016/j.smrv.2026.102236","DOIUrl":"10.1016/j.smrv.2026.102236","url":null,"abstract":"<div><div>Emerging evidence suggests interactions between gut microbiota and sleep regulation, but specific associations with insomnia remain unclear. This systematic review evaluated alterations in gut microbiota in patients with insomnia compared with healthy controls. A systematic literature search was performed on eight databases from inception to June 2025. Case-control, cohort, and cross-sectional studies examining gut microbiota in adults with insomnia versus healthy controls were included. Fourteen studies encompassing 9036 participants (58.4 % female) were included. Alpha diversity was reduced in patients with insomnia in most of the included studies, among which observed species significantly decreased (SMD: 0.90, 95 % CI: 1.39, −0.40, k = 5). Beta diversity analysis revealed a consistently distinct microbial community structure between individuals with insomnia and healthy controls. Taxonomically, insomnia correlated with shifted Firmicutes-to-Bacteroidetes ratios. Meta-analyses revealed alterations in key genera, including significantly decreased <em>Faecalibacterium</em> and <em>Lachnospira</em>, and significantly increased <em>Blautia</em> and <em>Eubacterium hallii</em>. Changes in gut microbiota were also correlated with inflammatory markers and metabolic disturbances. In summary, gut microbiota dysbiosis was associated with insomnia and characterized by reduced microbial diversity and altered bacterial composition. These findings suggest potential applications for microbial biomarkers in insomnia diagnosis and subtyping, and the development of personalized microbiota-targeted interventions.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102236"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

OSA in the aging population: Diagnostic and therapeutic considerations 老年人群中的阻塞性睡眠呼吸暂停：诊断和治疗考虑。

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-30 DOI: 10.1016/j.smrv.2026.102247

Martino F. Pengo , Miguel Angel Martinez Garcia , Michael V. Vitiello , David Gozal

{"title":"OSA in the aging population: Diagnostic and therapeutic considerations","authors":"Martino F. Pengo , Miguel Angel Martinez Garcia , Michael V. Vitiello , David Gozal","doi":"10.1016/j.smrv.2026.102247","DOIUrl":"10.1016/j.smrv.2026.102247","url":null,"abstract":"<div><div>The extremely high prevalence of obstructive sleep apnea (OSA) in the elderly population approaches 50 % and is even higher among individuals older than 80 years, posing substantial challenges in defining an appropriate risk–benefit balance for OSA treatment in this age group. A major barrier to the formulation of coherent, evidence-based recommendations lies in the marked limitations of the available evidence, which is often derived from observational or post hoc analyses, affected by substantial heterogeneity, or based on small samples that lack adequate statistical power to detect clinically meaningful outcomes. Moreover, older adults—particularly the very old and those with multimorbidity or frailty—are systematically underrepresented in randomized controlled trials, further limiting the generalizability of existing findings. In this review, we synthesize the scarce and methodologically heterogeneous evidence on the impact of OSA in older adults, highlight conflicting results supporting either treatment or non-treatment in this population, and delineate the key unresolved clinical and research questions that must be addressed before robust consensus guidelines and informed healthcare policies can be developed.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102247"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Defining circadian health: Conceptual framework and development of a circadian health index 定义昼夜健康：昼夜健康指数的概念框架和发展。

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.smrv.2026.102244

Julien Coelho , Jean-Arthur Micoulaud-Franchi , Pierre-Alexis Geoffroy , Pierre Philip , Jacques Taillard , Patrice Bourgin

{"title":"Defining circadian health: Conceptual framework and development of a circadian health index","authors":"Julien Coelho , Jean-Arthur Micoulaud-Franchi , Pierre-Alexis Geoffroy , Pierre Philip , Jacques Taillard , Patrice Bourgin","doi":"10.1016/j.smrv.2026.102244","DOIUrl":"10.1016/j.smrv.2026.102244","url":null,"abstract":"<div><div>Circadian rhythms are key determinants of physical and mental health at the nexus of physiology and behavior. Classically, endogenous circadian rhythms are characterized according to three principal dimensions: circadian phase, amplitude and stability. From a behavioral perspective, the timing and regularity of nychthemeral behaviors represent two additional dimensions, and we propose as a sixth dimension the sleep complaints arising from a circadian disruption due to a mismatch between circadian physiology and nycthemeral behaviors. This article reviews each of these dimensions and examines their interactions, along with their effects on sleep and health. On this basis, we propose an integrated definition of circadian health. We then review both, objective (melatonin, temperature, actimetry) and subjective (sleep diaries, self-report questionnaires) tools for assessing each of the circadian health dimensions. Finally, we propose a novel tool aimed at assessing those circadian health dimensions as well as the computation of a composite index to quantify circadian health, along with a graphical representation to visualize it. While further validation is still needed, this proposal will help clinicians and researchers better decipher circadian rhythms and their impact on mental and physical health and may offer new opportunities for public health promotion in both general and clinical populations.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102244"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision sleep medicine for the aging population: Moving from device-centered to person-centered care 针对老龄化人口的精准睡眠医学：从以设备为中心转向以人为中心的护理。

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-02-18 DOI: 10.1016/j.smrv.2026.102261

Ronaldo Piovezan MD, PhD

引用次数: 0

Understanding delayed sleep-wake phase disorder (DSWPD): Mechanisms, comorbidities, and evolving approaches to diagnosis and treatment 了解延迟睡眠-觉醒阶段障碍（DSWPD）：机制、合并症和不断发展的诊断和治疗方法

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-30 DOI: 10.1016/j.smrv.2026.102240

Gorica Micic , Amy C. Reynolds , Andrew J.K. Phillips , Phyllis Zee , Cele Richardson , Helen J. Burgess , Leon Lack , Peter Catcheside , Cathy A. Goldstein , Hannah Scott , Sean Cain , Robert Adams , Nicole Lovato

{"title":"Understanding delayed sleep-wake phase disorder (DSWPD): Mechanisms, comorbidities, and evolving approaches to diagnosis and treatment","authors":"Gorica Micic , Amy C. Reynolds , Andrew J.K. Phillips , Phyllis Zee , Cele Richardson , Helen J. Burgess , Leon Lack , Peter Catcheside , Cathy A. Goldstein , Hannah Scott , Sean Cain , Robert Adams , Nicole Lovato","doi":"10.1016/j.smrv.2026.102240","DOIUrl":"10.1016/j.smrv.2026.102240","url":null,"abstract":"<div><h3>Background</h3><div>Delayed Sleep-Wake Phase Disorder (DSWPD) is a circadian rhythm disorder marked by a consistent and distressing delay in sleep timing relative to societal norms. While traditionally viewed as a circadian phase disorder, growing evidence shows psychological, behavioural, and physical health factors interact with circadian biology to influence onset, maintenance, and outcomes.</div></div><div><h3>Purpose</h3><div>of review: This review synthesises recent literature on DSWPD's multifactorial nature, focusing on aetiology, nosology, comorbidities, and treatment. It highlights emerging evidence supporting a multidimensional diagnostic approach and personalised, multimodal management.</div></div><div><h3>Recent findings</h3><div>Some individuals with DSWPD exhibit a significantly delayed circadian phase, while others show normal circadian timing but persistently delayed sleep behaviour. A spectrum approach or subtyping into circadian and behavioural variants has been proposed. Comorbidities with psychiatric conditions including depression, anxiety, ADHD and autism are common and may affect treatment response. Chronobiotic treatments remain core, but cognitive-behavioural and psychotherapeutic interventions are increasingly essential, especially in non-circadian or comorbid cases. Advances in wearable technology and circadian modelling offer promising tools for diagnosis, monitoring, intervention.</div></div><div><h3>Summary</h3><div>DSWPD is heterogeneous and requires an integrative, individualised approach considering circadian biology, behaviour and psychiatric comorbidities. A multidimensional diagnostic and treatment model could improve outcomes and functioning.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102240"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigating the association between post-traumatic stress disorder and REM sleep behavior disorder: a systematic review 调查创伤后应激障碍和快速眼动睡眠行为障碍之间的关系：一个系统的回顾

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.smrv.2026.102245

Valentina Baldini , Martina Gnazzo , Giorgia Varallo , Diana De Ronchi , Fabio Pizza , Giuseppe Plazzi , Elena Antelmi

{"title":"Investigating the association between post-traumatic stress disorder and REM sleep behavior disorder: a systematic review","authors":"Valentina Baldini , Martina Gnazzo , Giorgia Varallo , Diana De Ronchi , Fabio Pizza , Giuseppe Plazzi , Elena Antelmi","doi":"10.1016/j.smrv.2026.102245","DOIUrl":"10.1016/j.smrv.2026.102245","url":null,"abstract":"<div><div>Post-traumatic stress disorder (PTSD) is frequently accompanied by additional sleep disturbances, such as nightmares and insomnia. Recent findings suggest a potential association between PTSD and REM sleep behavior disorder (RBD). This systematic review evaluates the current evidence on the PTSD–RBD relationship, with attention to prevalence, diagnostic approaches, shared pathophysiological mechanisms, and clinical implications.</div><div>A comprehensive search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted up to July 2025. Eligible studies included observational, cohort, and experimental designs assessing RBD in individuals with PTSD. Methodological quality was appraised using the Newcastle–Ottawa Scale.</div><div>Seven studies, encompassing 4152 participants, met the inclusion criteria. Overall, PTSD was linked to a higher prevalence of probable or confirmed RBD, particularly among veterans. Adding to this, patients with isolated RBD appeared more likely to report comorbid PTSD than those diagnosed with other parasomnias. Evidence also indicated that PTSD-related RBD may be associated with more severe psychopathology, including heightened depressive symptoms, recurrent nightmares, and emotional dysregulation.</div><div>From a clinical standpoint, it is advisable to evaluate PTSD patients presenting with parasomnia symptoms for possible RBD, and to investigate PTSD history in those exhibiting dream enactment behaviors.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102245"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic accuracy of the neck circumference, obesity, snoring, age, and sex score in screening obstructive sleep apnea: A systematic review and meta-analysis 颈围、肥胖、打鼾、年龄和性别评分在筛查阻塞性睡眠呼吸暂停中的诊断准确性：一项系统回顾和荟萃分析

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1016/j.smrv.2026.102254

Muhammad Amirul Mukminin , Li-Pang Chuang , Pin-Yuan Chen , Huan-Xi Huang , Iftitakhur Rohmah , Hsiao-Yean Chiu

{"title":"Diagnostic accuracy of the neck circumference, obesity, snoring, age, and sex score in screening obstructive sleep apnea: A systematic review and meta-analysis","authors":"Muhammad Amirul Mukminin , Li-Pang Chuang , Pin-Yuan Chen , Huan-Xi Huang , Iftitakhur Rohmah , Hsiao-Yean Chiu","doi":"10.1016/j.smrv.2026.102254","DOIUrl":"10.1016/j.smrv.2026.102254","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed condition. Although the Neck Circumference, Obesity, Snoring, Age, and Sex (NoSAS) score is commonly used in clinical practice. This study aimed to evaluate the performance of the NoSAS score in detecting mild, moderate, and severe OSA, based on the apnea–hypopnea index (AHI) or respiratory event index (REI). PubMed, Embase, ProQuest Dissertations and Theses A&I, Ovid Medline, CINAHL Plus, and Web of Science were searched for relevant articles published before August 29, 2025. We included studies evaluating the sensitivity and specificity of the NoSAS score compared with polysomnography or other validated references. A bivariate random-effects model was used for data analysis. Our meta-analysis included 31 studies, 25 on mild or AHI/REI ≥5 events/h, 31 on moderate or AHI/REI ≥15 events/h, and 24 on severe or AHI/REI ≥30 events/h. The pooled sensitivity and specificity were 71% and 66% for mild OSA, 73% and 62% for moderate OSA, and 82% and 50% for severe OSA, respectively. Moderator analysis revealed an association between BMI and higher sensitivity for mild and severe OSA. Larger sample sizes were associated with higher specificity for mild OSA. Advanced age was associated with pooled specificity in severe OSA. Caucasian countries increased sensitivity in all OSA severity and increased specificity in severe OSA compared to Asian countries. Sleep-related clinic has higher specificity in both of moderate and severe OSA and increased sensitivity in moderate OSA (all p < 0.05) compared to community-based settings. We suggest that the NoSAS score performed consistently across OSA severities, making it useful in resource-limited settings. Nevertheless, our findings should be interpreted with caution due to the high degree of heterogeneity.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102254"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Toward precision medicine in delayed sleep-wake phase disorder: Definitions, dimensions, and the path to personalised care 延迟睡眠-觉醒阶段障碍的精准医疗：定义、维度和个性化护理之路。

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-02-19 DOI: 10.1016/j.smrv.2026.102260

Cátia Reis , Ana Rita Peralta , Charles A. Czeisler , Shantha M.W. Rajaratnam

引用次数: 0

Circulating markers of biological aging associated with obstructive sleep apnea or insomnia in adults: A systematic review and meta-analysis 与成人阻塞性睡眠呼吸暂停或失眠相关的生物衰老循环标志物：一项系统综述和荟萃分析

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.smrv.2026.102255

Tak Hou Calvin Chang , Joshua B. Hicks , Zahra Izadi , Arshdeep Marwaha , AJ Hirsch Allen , Mohammadreza Hajipour , Annalijn I. Conklin , Najib T. Ayas

{"title":"Circulating markers of biological aging associated with obstructive sleep apnea or insomnia in adults: A systematic review and meta-analysis","authors":"Tak Hou Calvin Chang , Joshua B. Hicks , Zahra Izadi , Arshdeep Marwaha , AJ Hirsch Allen , Mohammadreza Hajipour , Annalijn I. Conklin , Najib T. Ayas","doi":"10.1016/j.smrv.2026.102255","DOIUrl":"10.1016/j.smrv.2026.102255","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) and insomnia could accelerate biological aging through pathways including oxidative stress and systemic inflammation. This systematic review aimed to determine the association of sleep disorders with circulating markers of biological aging. We searched MEDLINE, Embase, CINAHL, Cochrane, PsycINFO from inception to October 2024. Eligibility criteria included full manuscript English studies on adult humans examining OSA or insomnia and circulating markers of aging. Of the 1839 deduplicated records screened, 49 full-text studies were eligible for inclusion. Included studies ranged from poor to good quality and assessed telomere length (TL), DNA methylation clocks (epigenetics), mitochondrial alterations, sirtuin levels and activity, autophagy protein levels, and <em>klotho</em> gene expression. Telomeres were the most extensively studied marker, with our findings showing a significant association between TL and OSA, based on both unadjusted and adjusted values (SMD = −0.451, 95% CI: 0.688 to −0.215, p = 0.0026 and SMD = −3.01, 95% CI: 4.98 to −1.04, p = 0.033, respectively). Most studies linked insomnia and poor sleep quality to shorter TL. Although evidence for other aging biomarkers was more limited, the published literature supports the role of OSA and insomnia in accelerating biological aging, especially for telomere length.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102255"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nurturing care for early childhood sleep interventions with tailored care: the NEST Approach 通过量身定制的护理培养幼儿睡眠干预：NEST方法。

IF 9.7 1区医学

Sleep Medicine Reviews Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.smrv.2026.102241

Perran Boran , Lourdes M. DelRosso

{"title":"Nurturing care for early childhood sleep interventions with tailored care: the NEST Approach","authors":"Perran Boran , Lourdes M. DelRosso","doi":"10.1016/j.smrv.2026.102241","DOIUrl":"10.1016/j.smrv.2026.102241","url":null,"abstract":"<div><div>Early childhood insomnia (ECI) affects 20–30 % of children aged 6–36 months, making it the most common sleep disturbance in this age group. Current interventions often focus on independent sleep through extinction-based behavioral methods, with less emphasis on broader socioecological influences such as caregiving quality and feeding practices. This paper introduces a conceptual model to reframe ECI interventions using the World Health Organization endorsed Nurturing care framework (NCF), which includes five components: good health, adequate nutrition, safety and security, responsive caregiving and opportunities for learning. Sleep is essential for health, and early childhood represent a critical window for shaping lifelong sleep patterns. Breastfeeding helps integration of all five components while responsive caregiving, supports the other four components. Sensory-motor nourishment fosters a sense of safety and early learning opportunities promote self-regulation. The model outlines actionable strategies under each NCF components, offering guidance for researchers and supporting adaptation across diverse settings, viewing sleep health as part of a broader caregiver ecosystem rather than isolated behavioral problem.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"86 ","pages":"Article 102241"},"PeriodicalIF":9.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0