Journal of Clinical Sleep Medicine最新文献

{"title":"The mother and child reunion.","authors":"Lee J Brooks","doi":"10.5664/jcsm.11910","DOIUrl":"https://doi.org/10.5664/jcsm.11910","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of obstructive sleep apnea questionnaires in high-risk pregnancy.","authors":"Kristin N Sheehan, Kang Rui Xiang, Courtney L Rowland, Amit K Saha, Marissa J Millard, Laura S Dean, Samantha Shirk, Melissa Kozakiewicz, David W Carter, Adam R Schertz, Jonathan D Prest, Daniel Forest, Stephanie N Cedeno, Stephen P Peters, Edward F Haponik, Abigail L Koch, Andrew M Namen","doi":"10.5664/jcsm.11906","DOIUrl":"https://doi.org/10.5664/jcsm.11906","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is an under-recognized risk factor for pregnancy complications. Sleep questionnaires vary in ability to predict pregnant patients at risk for OSA. We aimed to assess the fidelity of the DoISnorePreg questionnaire, compare its performance with the Berlin Questionnaire, and assess the impact of the Epworth Sleepiness Scale (ESS) in high-risk obstetric patients.</p><p><strong>Methods: </strong>Patients without history of preeclampsia or gestational diabetes were recruited from a high-risk obstetric clinic, completed sleep questionnaires, and underwent home sleep apnea test at 28 weeks gestation. Patients were followed through pregnancy to assess maternal and neonatal outcomes. The predictive value of the questionnaires for OSA was assessed using C-statistics.</p><p><strong>Results: </strong>39% of participants had an apnea-hypopnea index ≥ 5, among whom, 29% had moderate or severe OSA. Patients with OSA had higher BMIs, older ages, higher sleepiness scores, more profound oxygen desaturations, longer post-partum lengths of stay, and newborns with increased NICU admissions. DoISnorePreg outperformed the Berlin Questionnaire with an area under the receiver operating curve of 0.74 versus 0.58. ESS did not enhance the performance of either questionnaire. A threshold of ≥ 4 positive responses on DoISnorePreg best predicted patients at risk for OSA with 89% sensitivity and 43% specificity (p < 0.01).</p><p><strong>Conclusions: </strong>Prevalence of OSA among high-risk obstetric patients is high. Clinical implications of oxygen desaturations, longer hospital stays, and NICU admissions highlight the need for screening. DoISnorePreg is a valid predictive tool that helps fill a gap in screening this high-risk population.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When normal isn't good enough.","authors":"Andrew R Spector","doi":"10.5664/jcsm.11912","DOIUrl":"https://doi.org/10.5664/jcsm.11912","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi setting evaluation of Watch-PAT in obstructive sleep apnea diagnosis in patients with atrial fibrillation.","authors":"Patrick L Stafford, Robert Roth, John Ferguson, Kenneth C Bilchick, Andrew E Darby, Sula Mazimba, Nishaki Mehta, Eric M Davis, Heather Bonner, Yeilim Cho, Jeongok Logan, Michelle Sobremonte-King, Younghoon Kwon","doi":"10.5664/jcsm.11898","DOIUrl":"https://doi.org/10.5664/jcsm.11898","url":null,"abstract":"<p><strong>Study objectives: </strong>Patients with atrial fibrillation (AF) have elevated risk of obstructive sleep apnea (OSA). A peripheral arterial tonometry (PAT)-based device, the Watch-PAT (WP) has been increasingly used as a home OSA test. We conducted a multi-setting evaluation of WP in OSA diagnosis by comparing results from in-lab PSG, in-lab WP, and home WP in AF patients.</p><p><strong>Methods: </strong>AF patients underwent an in-lab PSG with concurrent in-lab WP and two consecutive nights of home WP. OSA was categorized into no OSA, mild, moderate, and severe OSA by apnea hypopnea index (AHI; <5, ≥5-<15, ≥15-<29, ≥30). The primary outcome was OSA severity agreement between in-lab PSG vs. home WP. Secondary outcomes included the agreement between in-lab PSG vs. in-lab WP, as well as in-lab WP vs. home WP. Night-to-night variability of consecutive nights of home WP was also evaluated. Results were expressed by Cohen's Kappa (κ) for AHI scoring rules 1a and 1b.</p><p><strong>Results: </strong>27 patients were included for analysis. There was slight and fair agreement between in-lab PSG and home WP (κ=0.15, 0.40 for score rule 1a and 1b, respectively), substantial agreement between in-lab PSG vs. in-lab WP (κ=0.63, 0.71), moderate agreement between in-lab WP and home WP (κ=0.59, 0.59), and almost perfect agreement between first night home WP and second night home WP (κ=0.87, 0.89).</p><p><strong>Conclusions: </strong>We demonstrate overall slight to fair agreement between home WP vs. in-lab PSG, suggesting inadequate performance against the standard reference test. This should be considered when interpreting the results of home WP. Other evaluations demonstrated moderate agreement for in-lab WP and home WP in the classification of OSA severity, substantial agreement between in-lab PSG and in-lab WP, and almost perfect agreement in the comparison both home WP.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A double-blind, randomized, placebo-controlled trial of doxazosin for posttraumatic distressing dreams and sleep disturbance in men and women with posttraumatic stress.","authors":"Anne Richards, Anthony Santistevan, Leslie Yack, Anna C West, Emily Berg, Shane Pracar, Steven Batki, Karen H Seal, Thomas C Neylan","doi":"10.5664/jcsm.11908","DOIUrl":"https://doi.org/10.5664/jcsm.11908","url":null,"abstract":"<p><strong>Study objectives: </strong>Distressing dreams and sleep disturbance more broadly are core features of posttraumatic stress disorder. Effective treatments remain elusive. Doxazosin is an alpha-1 adrenergic blocker with demonstrated promise for PTSD, but there is a dearth of evidence from randomized controlled trials. The current randomized, double-blind, placebo-controlled trial evaluated the effectiveness of doxazosin for distressing dreams and sleep disturbances in adult men and women with trauma history and prominent distressing dreams.</p><p><strong>Methods: </strong>N = 65 trauma-exposed adults (60 veterans, 21 female) with full or subclinical PTSD and prominent nightmares were randomized to either placebo (N=32) or doxazosin (N = 33) titrated to a maximum dose of 10 mg daily. Prespecified primary outcomes were distressing dream frequency and intensity (CAPS-IV), and sleep quality (PSQI). Prespecified secondary outcomes were distressing dream frequency, worst distressing dream severity, and properties of sleep (sleep latency, wake after sleep onset, sleep maintenance, and total sleep time) measured daily using a sleep diary mobile application.</p><p><strong>Results: </strong>Compared to placebo, CAPS-IV nightmare and PSQI sleep quality outcomes did not differ significantly over the course of the trial between treatment groups (adjusted p's > 0.05), in part due to robust placebo effects in these measures. In contrast, participants randomized to doxazosin showed a greater increase in sleep maintenance (adjusted p = 0.047) and greater reduction in worst distressing dream severity (adjusted p < 0.001) over the course of the trial as measured by a daily sleep diary. These effects predominated in males and were moderated by baseline standing orthostatic systolic blood pressure.</p><p><strong>Conclusions: </strong>Doxazosin demonstrated statistically significant, clinically modest effects on prespecified sleep diary measures of distressing dream and sleep outcomes relative to placebo, but no effects based on clinical interview and survey measures. Ongoing research is therefore critical to improve treatment options for both males and females, for whom treatment benefits may differ, and to improve measurement in distressing dreams research so as to further develop targeted and effective treatment solutions.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: A Randomized Controlled Trial of Doxazosin for Nightmares, Sleep Disturbance, and Non-Nightmare Clinical Symptoms in PTSD; Identifier: NCT03339258; URL: https://clinicaltrials.gov/study/NCT03339258.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep research, quality and implementation priorities in the Veterans Health Administration: a white paper.","authors":"Q Afifa Shamim-Uzzaman, Michelle R Zeidler, Eilis A Boudreau, Susmita Chowdhuri, Lucas M Donovan, Ali El-Solh, Amado X Freire, Daniel J Gottlieb, Ripu D Jindal, Sean Hesselbacher, Brian Koo, Samuel Kuna, Miranda M Lim, Sherwin Mina, Carl Stepnowsky, Sadeka Tamanna, Lauren Tobias, Christi Ulmer, Klar Yaggi, Salim Surani, Charles Atwood, Kathleen Sarmiento, Octavian C Ioachimescu","doi":"10.5664/jcsm.11734","DOIUrl":"10.5664/jcsm.11734","url":null,"abstract":"<p><p>The Veterans Affairs (VA) seeks to improve the quality of life and long-term health outcomes for veterans facing unique sleep challenges related to their military service. The prevalence and burden of sleep disorders among military service members and veterans are alarmingly high, often worsened by inadequate sleep environments, insufficient sleep, shift work, and exposure to trauma. VA's National Sleep Medicine Program Office has outlined key priorities for enhancing sleep medicine research and quality improvement. These recommendations reflect the consensus within the Sleep Research and Quality Improvement Subcommittee of the Field Advisory Board for the Sleep Medicine Program Office. These priorities include advancing sleep science at basic, clinical, and population levels; promoting sleep health through personalized treatment strategies tailored to veterans; increasing funding for sleep research; establishing a network of VA sleep research centers to conduct high-quality, multicenter, collaborative studies; developing a veteran-specific portfolio of sleep research and innovations; and optimizing the dissemination of diagnostic tools and therapies through quality improvement initiatives. VA aims to achieve these goals through a series of strategic objectives and milestones that consider importance, timeline, effort, and cost. Specific topics of interest are highlighted and investigators are encouraged to address knowledge gaps in these areas. This white paper seeks to strengthen sleep research within VA by developing a comprehensive pipeline of researchers and systematically evaluating strategies to improve sleep health care for veterans. The ultimate goal is to generate actionable insights that could potentially influence broader sleep-related clinical guidelines and policies within and beyond the VA health care system.</p><p><strong>Citation: </strong>Shamim-Uzzaman QA, Zeidler MR, Boudreau EA, et al. Sleep research, quality and implementation priorities in the Veterans Health Administration: a white paper. <i>J Clin Sleep Med</i>. 2025;21(10):1787-1797.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1787-1797"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinforcing sleep education with behavioral change strategies: intervention effects on sleep timing, sleep duration, and academic performance.","authors":"Blake K Barley, Michael K Scullin","doi":"10.5664/jcsm.11780","DOIUrl":"10.5664/jcsm.11780","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep education programs are emerging in university settings, but educating students about sleep health does not always change nighttime behaviors. A potential solution for bridging this knowledge-behavior gap is to incorporate behavioral change techniques into sleep education programs. This study's objective was to test the implementation intention technique in students completing an academically-demanding gateway course for medical career paths.</p><p><strong>Methods: </strong>Participants were undergraduate students enrolled in organic chemistry courses (n = 101, 64.4% females, 51.5% nonwhite). After completing baseline questionnaires and actigraphy monitoring, participants took the Sleep 101 educational program. They were randomly assigned to an Education-Only condition or to also form an implementation intention (combining sleep education with an implementation intention strategy [Education+II]). Education+II individuals formed specific plans to go to bed earlier for the next 5 school nights. Participants repeated questionnaires at midsemester (mean = 50.33 days) and next-semester (mean = 248.51 days) follow-ups. Academic performance records were extracted prior to the study, during the study semester, and during the following semester.</p><p><strong>Results: </strong>Following the educational program, both groups reported improvements in sleep quality, but only Education+II participants showed actigraphy-measured improvements in bedtimes and sleep duration. Some effects in the Education+II condition persisted at midsemester and next-semester follow-ups. Adjusting for prior academic performance, the Education+II condition showed worse academic outcomes initially (but not long term) than the Education-Only condition, particularly among students with evening circadian preferences.</p><p><strong>Conclusions: </strong>Incorporating behavioral change strategies into sleep education programs can improve sleep outcomes. The relationship between sleep and academic performance is complex in demanding academic programs.</p><p><strong>Citation: </strong>Barley BK, Scullin MK. Reinforcing sleep education with behavioral change strategies: intervention effects on sleep timing, sleep duration, and academic performance. <i>J Clin Sleep Med</i>. 2025;21(10):1697-1707.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1697-1707"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness and predictors of cognitive behavioral therapy for insomnia and its components in older adults: main outcomes of a randomized dismantling trial.","authors":"Kathleen P O'Hora, Allison B Morehouse, Leah Freidman, Donn Posner, Maryam Ahmadi, Beatriz Hernandez, Kristen Faye Burda, Clete Kushida, Jamie M Zeitzer, Laura C Lazzeroni, Rachel Manber, Jerome Yesavage, Andrea N Goldstein-Piekarski","doi":"10.5664/jcsm.11756","DOIUrl":"10.5664/jcsm.11756","url":null,"abstract":"<p><strong>Study objectives: </strong>To determine the relative effectiveness and predictors of cognitive therapy (CT), behavioral therapy (BT), and cognitive behavioral therapy (CBT) for insomnia in older adults.</p><p><strong>Methods: </strong>In a registered clinical trial (NCT02117388), 128 older adults with insomnia disorder were randomly assigned to receive CBT, BT, or CT. Insomnia Severity Index (ISI) score was the primary outcome. Sleep diaries, fatigue, beliefs about sleep, cognitive arousal, and stress were secondary outcomes. Split-plot linear mixed models assessed within- and between-subject changes in outcomes among the treatments. As a secondary analysis, we used linear regression to test predictors of insomnia symptoms improvement, including sleep diary measures, cognitive arousal, stress, beliefs about sleep, baseline ISI score, and age. Benjamini-Hochberg correction was applied.</p><p><strong>Results: </strong>All groups exhibited insomnia symptom reduction at posttreatment (CT: <i>d =</i> -2.53, <i>P</i> < .001; BT: <i>d =</i> -2.39, <i>P</i> < .001; CBT: <i>d</i> = -2.90, <i>P</i> < .001) and at the 6-month follow-up (CT: <i>d =</i> -2.68, <i>P</i> < .001; BT: <i>d =</i> -2.85, <i>P</i> < .001; CBT: <i>d</i> = -3.14, <i>P</i> < .001). There were no group differences in the magnitude of ISI improvement (<i>P_adj</i> = .63), response (<i>P_adj</i> > .63), or remission (ISI < 8; <i>P_adj</i> > .27). All groups exhibited significant improvements in secondary outcomes at posttreatment (<i>P_adj</i> < .05) and at the 6-month follow-up (<i>P_adj</i> < .05). At posttreatment, the CT and CBT groups showed greater reductions in beliefs about sleep than the BT group (<i>F</i>_Interaction(2,185) = 5.99, <i>P_adj</i> = .03), and the CBT group showed a greater time in bed reduction than the CT group (<i>F</i>_Interaction(2,185) = 7.05, <i>P_adj</i> = .01). Baseline ISI was the only treatment predictor (<i>b =</i> 1.95, <i>P_adj</i> < .001).</p><p><strong>Conclusions: </strong>CBT for insomnia and its components each independently result in significant improvements in self-reported insomnia symptoms, beliefs about sleep, worry, and fatigue in older adults.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Treatments for Insomnia: Mediators, Moderators and Quality of Life; URL: https://clinicaltrials.gov/study/NCT02117388; Identifier: NCT02117388.</p><p><strong>Citation: </strong>O'Hora KP, Morehouse AB, Freidman L, et al. Comparative effectiveness and predictors of cognitive behavioral therapy for insomnia and its components in older adults: main outcomes of a randomized dismantling trial. <i>J Clin Sleep Med</i>. 2025;21(10):1679-1695.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1679-1695"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bariatric surgery on the resolution of obesity hypoventilation syndrome at 1-year follow-up: a retrospective study.","authors":"Shuai Ma, Wenwen Yu, Chengcan Yang, Yining He, Dongzi Zhu, Fen Gu, Bei Xu, Xiaozhen Xu, Kan Yao, Xiurong Tao, Min Zhu, Bing Wang","doi":"10.5664/jcsm.11750","DOIUrl":"10.5664/jcsm.11750","url":null,"abstract":"<p><strong>Study objectives: </strong>This study aimed to assess the effectiveness of metabolic and bariatric surgery in patients with obesity comorbid with obesity hypoventilation syndrome (OHS) at 1-year follow-up.</p><p><strong>Methods: </strong>This retrospective study was conducted between January 2020 and June 2023 at a metabolic and bariatric surgery center in a university-affiliated tertiary hospital in China. Clinical data, including body mass index, arterial blood gas values, portable sleep study results, and anthropometric parameters, were recorded pre- and postoperatively. Correlations between variables and risk factors for OHS resolution were analyzed.</p><p><strong>Results: </strong>Among 1,134 candidates for metabolic and bariatric surgery, 187 (16.5%) had comorbid OHS; 151 patients with OHS met inclusion criteria and completed the 1-year follow-up visit (body mass index 39.1 ± 6.8 kg/m² with partial pressure of carbon dioxide in arterial blood [PaCO₂] 48.6 ± 3.0 mmHg). At 1-year follow-up, body mass index decreased to 29.0 ± 6.0 kg/m² (<i>P</i> < .001) and PaCO₂ dropped to 43.8 ± 5.5 mmHg (<i>P</i> < .001). Resolution of OHS, defined as awake PaCO₂ < 45 mmHg with discontinuation of positive airway pressure therapy for a minimum of 6 months before obtaining the arterial blood gas at the 12-month visit, was achieved in 105 (69.5%) of the patients. Nonlinear analysis indicated that PaCO₂ did not significantly decrease until the percentage of total weight loss exceeded approximately 20%. A larger reduction in waist circumference was associated with a greater reduction in PaCO₂, particularly when waist circumference reached less than 25 cm. Beyond this point, ΔPaCO₂ reached a plateau. In multivariate analysis, a larger preoperative waist circumference (odds ratio: 1.046, 95% confidence interval: 1.031-1.118, <i>P =</i> .025) and arterial blood gas pH < 7.35 (odds ratio: 3.921, 95% confidence interval: 2.305-9.140, <i>P</i> < .001) were associated with lack of resolution of OHS, and a larger percentage of total weight loss after bariatric surgery (odds ratio: 0.917, 95% confidence interval: 0.846-0.965, <i>P =</i> .001) was independently associated with OHS resolution.</p><p><strong>Conclusions: </strong>Metabolic and bariatric surgery is an effective treatment for OHS. Achieving a sufficient percentage of total weight loss is critical for the resolution of OHS.</p><p><strong>Citation: </strong>Ma S, Yu W, Yang C, et al. Impact of bariatric surgery on the resolution of obesity hypoventilation syndrome at 1-year follow-up: a retrospective study. <i>J Clin Sleep Med.</i> 2025;21(10):1665-1678.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1665-1678"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing controlled substances in sleep medicine clinics: an overview of legal issues and best safety practices.","authors":"Bhanu Prakash Kolla, Michael H Silber, David R Rushlow, Kannan Ramar, Meghna P Mansukhani","doi":"10.5664/jcsm.11770","DOIUrl":"10.5664/jcsm.11770","url":null,"abstract":"<p><strong>Study objectives: </strong>This review describes the legal and regulatory landscape surrounding controlled substance prescribing in sleep medicine, focusing on the Controlled Substances Act, Drug Enforcement Agency, and best practices. It explores abuse and dependence risks associated with these medications and addresses telemedicine and e-prescribing considerations.</p><p><strong>Methods: </strong>We synthesized information from the Controlled Substances Act, Drug Enforcement Agency, Centers for Disease Control and Prevention, Federation of State Medical Boards, peer-reviewed medical literature, and professional organizational position statements regarding controlled substances in sleep medicine.</p><p><strong>Results: </strong>Managing controlled substances in sleep medicine necessitates careful consideration of Drug Enforcement Agency scheduling, regulatory requirements, and potential risks. Opioids pose a risk of dependence or abuse, but the lower doses used in sleep medicine may mitigate this risk. There is less evidence available regarding the abuse potential of stimulants. Hypnotics and benzodiazepines require cautious prescribing due to the potential for long-term use by patients and possibility of dose escalation. Oxybates are subject to strict risk evaluation and mitigation strategy programs. Best practices include comprehensive patient evaluations, thorough risk assessments, prescription drug monitoring program checks, and transparent patient communication. Telemedicine prescribing is governed by strict regulatory statutes, with temporary exceptions currently in place.</p><p><strong>Conclusions: </strong>Controlled substances are vital for managing various sleep disorders. Balancing patient access to effective medications while minimizing abuse and diversion is crucial. Further research is needed to refine risk assessment tools and develop standardized protocols, particularly for nonopioids. The evolving role of telemedicine and e-prescriptions requires ongoing evaluation and adaptation of practices to ensure patient safety and regulatory adherence.</p><p><strong>Citation: </strong>Kolla BP, Silber MH, Rushlow DR, Ramar K, Mansukhani MP. Prescribing controlled substances in sleep medicine clinics: an overview of legal issues and best safety practices. <i>J Clin Sleep Med</i>. 2025;21(10):1799-1807.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1799-1807"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}