Journal of Clinical Sleep Medicine最新文献

{"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":"https://doi.org/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 one technique-the implementation intention-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 (Education+II). Education+II individuals formed specific plans to go to bed earlier for the next five school nights. Participants repeated questionnaires at mid-semester (<i>M</i>=50.33 days) and next-semester (<i>M</i>=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 mid-semester 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 amongst 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>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnea, glycemic control, and cardiovascular risk in young adults with youth-onset type 2 diabetes: results from the TODAY study.","authors":"Lorraine E Levitt Katz, Laure K El Ghormli, Kristen J Nadeau, Amy Shah, Janine Higgins, Katherine Kutney, Rose Gubitosi-Klug, Brian Burke, Babak Mokhlesi","doi":"10.5664/jcsm.11784","DOIUrl":"https://doi.org/10.5664/jcsm.11784","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is a common comorbidity in type 2 diabetes and has been associated with poor glycemic control, but few data exist in youth-onset type 2 diabetes. We evaluated the prevalence of OSA and its associations with metabolic control and cardiovascular risk in young adults with pediatric type 2 diabetes.</p><p><strong>Methods: </strong>OSA presence and severity was assessed by polysomnography in 114 participants in the TODAY Study (Treatment Options for type 2 Diabetes in Adolescents and Youth) (mean: age 23.5 years, diabetes duration 10 years, BMI 35.3 kg/m²). HbA1c, β-cell function, and diabetes-related complications were collected in the TODAY cohort. Adjusted regression models evaluated relationships between OSA and outcomes.</p><p><strong>Results: </strong>The prevalence of OSA in TODAY was 38.6%. OSA was not associated with HbA1c, loss of metabolic control, or diabetes-related complications in this cohort.</p><p><strong>Conclusions: </strong>Despite nearly 10 years of poorly controlled diabetes, young adults with youth-onset type 2 diabetes had a moderate prevalence of OSA. Severity of OSA was not associated with loss of glycemic control or diabetes-related complications in the TODAY cohort. The prevalence of OSA was lower than that reported in adults with prediabetes/early type 2 diabetes.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: TODAY Study; Identifier: NCT00081328.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499051","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":"Association of primary aldosteronism with severe sleep apnea and correlation between post-treatment renin activity and amount of change in respiratory event index during sleep.","authors":"Yonekazu Kidawara, Manabu Kadoya, Masataka Igeta, Miki Kakutani-Hatayama, Akiko Morimoto, Akio Miyoshi, Akinori Kanzaki, Kosuke Konishi, Takashi Daimon, Hidenori Koyama","doi":"10.5664/jcsm.11788","DOIUrl":"https://doi.org/10.5664/jcsm.11788","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep apnea occurs more often in patients with primary aldosteronism (PA), while unsuppressed plasma renin activity (PRA) after treatment is associated with a lower risk of cardiovascular events. However, the relationship between PA and severe sleep apnea remains unclear, and it is not known whether PRA following treatment is associated with an apnea condition in affected patients.</p><p><strong>Methods: </strong>Cross-sectional relationships between PA (n=176 affected patients) and severe sleep apnea, classified by respiratory event index (REI) obtained with use of an apnomonitor, were examined, with the results compared to those of patients with essential hypertension (EH) (n=418). Additionally, the correlation between PRA at follow-up and change in REI findings obtained at baseline and follow-up examinations was analyzed in 45 patients with PA, stratified based on treatment status.</p><p><strong>Results: </strong>PA was found to be significantly associated with severe sleep apnea as compared to EH, even after adjustment for other clinical risk factors (odds ratio 2.08, 95% confidence interval 1.09-3.95, p = 0.025). Furthermore, post-treatment PRA showed a significantly negative correlation with change in REI from before to after treatment (r = -0.550, p = 0.004).</p><p><strong>Conclusions: </strong>As compared to EH patients, those with PA had a higher prevalence of severe sleep apnea. Furthermore, a significantly negative correlation of post-treatment PRA with change in REI from before to after treatment was noted.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499050","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":"Perspective: Restoring rest-the critical role of sleep in foster care well-being.","authors":"Likhita Shaik, Jill Mcleigh, Anna Wani","doi":"10.5664/jcsm.11806","DOIUrl":"https://doi.org/10.5664/jcsm.11806","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499052","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":"Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular diseases-cause mortality in older adults.","authors":"Jiao Wang, Ying Ru Li, Chao Qiang Jiang, Wei Sen Zhang, Tong Zhu, Feng Zhu, Ya Li Jin, Tai Hing Lam, Kar Keung Cheng, Lin Xu","doi":"10.5664/jcsm.11762","DOIUrl":"https://doi.org/10.5664/jcsm.11762","url":null,"abstract":"<p><strong>Study objectives: </strong>In addition to sleep duration, sleep timing is another important but severely understudied sleep characteristic that may closely associated with the cardiovascular disease (CVD) mortality. To investigate the optimal sleep timing, we assessed the associations of sleep timing with all-cause and CVD mortality in large older adults.</p><p><strong>Methods: </strong>This prospective cohort study included 18,129 adults (median age=65 years) from Guangzhou Biobank Cohort Study (GBCS), recruited during 2008-2012 and followed up until July 2022. Participants' sleep timing (early, intermediate and late) were defined by the midpoint between bedtime and wake time. Four CVD susceptibility single-nucleotide polymorphism (SNPs) were used to calculate the genetic risk score.</p><p><strong>Results: </strong>During a median follow-up of 12.4 years with 213,534 person-years, 2,997 deaths occurred. Compared with the intermediate group, both early and late midpoint groups were associated with higher risk of all-cause mortality (adjusted hazard ratio (AHR)=1.18, 95% CI 1.07-1.30 and 1.13, 1.01-1.26). Restricted cubic spline curves indicate U-shaped associations of sleep midpoint, bedtime and wake time with all-cause and CVD mortality (all P for non-linearity<0.05), with the lowest risk observed at approximately 2:30 AM, 11:00 PM and 6:00 AM, respectively. The associations of early and late sleep timing with risk of all-cause mortality were more pronounced in men, older people and those with high CVD genetic risk score.</p><p><strong>Conclusions: </strong>For the first time, we identified U-shaped associations of sleep timing with all-cause and CVD mortality by identifying the specific sleep timing points associated with the lowest mortality risk, explicitly from 11:00 PM to 6:00 AM.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250620","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":"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":"https://doi.org/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 randomized 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 post-treatment (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 6FU (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 post-treatment (<i>P_adj</i> <.05) and 6FU (<i>P_adj</i><0.05). At post-treatment, the CT and CBT groups showed greater reductions in beliefs about sleep than the BT group (F_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 (F_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-I and its components each independently result in significant improvements in subjective insomnia symptoms, beliefs about sleep, worry, and fatigue in older adults.</p><p><strong>Clinical trial registration: </strong>Name: Treatments for Insomnia: Mediators, Moderators and Quality of Life; Registry: ClinicalTrials.gov; Identifier: NCT02117388.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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 one-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":"https://doi.org/10.5664/jcsm.11750","url":null,"abstract":"<p><strong>Study objectives: </strong>This study aimed to assess the effectiveness of metabolic and bariatric surgery (MBS) 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 an MBS center in a university-affiliated tertiary hospital in China. Clinical data, including body mass index (BMI), arterial blood gas (ABG) 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 1134 MBS candidates, 187 (16.5%) had comorbid OHS;151 patients with OHS met inclusion criteria and completed the 1-year follow up visit (BMI 39.1 ± 6.8 kg/m² with PaCO₂ 48.6 ± 3.0 mmHg). At 1-year follow-up, BMI decreased to 29.0 ± 6.0 kg/m² (<i>P</i><0.001) while PaCO₂ dropped to 43.8 ± 5.5 mmHg (<i>P</i><0.001). Resolution of OHS, defined as awake PaCO₂ <45mmHg with discontinuation of PAP therapy for a minimum of 6 months before obtaining the ABG at the 12-month visit, was achieved in 105 (69.5%) of the patients. Nonlinear analysis indicated that PaCO₂ did not significantly decrease until percentage total weight loss (%TWL) exceeded approximately 20%. Larger reduction in waist circumference was associated with greater reduction in PaCO₂, particularly when waist circumference reached less than 25 cm. Beyond this point, ΔPaCO₂ plateaud. In multivariate analysis, larger preoperative waist circumference (OR: 1.046, 95% CI: 1.031-1.118, <i>P</i> = 0.025) and ABG pH < 7.35 (OR: 3.921, 95% CI: 2.305-9.140, <i>P</i> < 0.001) were associated with lack of resolution of OHS, while larger %TWL after bariatric surgery (OR: 0.917, 95% CI: 0.846-0.965, <i>P</i> = 0.001) was independently associated with OHS resolution.</p><p><strong>Conclusions: </strong>MBS is an effective treatment for OHS. Achieving a sufficient %TWL is critical for the resolution of OHS.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home sleep testing in children: we probably can, but should we?","authors":"Lee J Brooks","doi":"10.5664/jcsm.11792","DOIUrl":"https://doi.org/10.5664/jcsm.11792","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235776","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":"Pharmacological management of sleep apnea and obesity, a new frontier.","authors":"Pahnwat Tonya Taweesedt, Nnamdi Orakpo, Rafael Pelayo","doi":"10.5664/jcsm.11798","DOIUrl":"https://doi.org/10.5664/jcsm.11798","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235778","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 legs move and airways close: kicking up an old controversy.","authors":"Brian B Koo","doi":"10.5664/jcsm.11794","DOIUrl":"https://doi.org/10.5664/jcsm.11794","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235779","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}