Journal of Clinical Sleep Medicine最新文献

{"title":"The Patient-reported Longitudinal Assessment Tool for OSA (PLATO): development and validation of a new clinical tool to assess response to obstructive sleep apnea treatment in adults.","authors":"Douglas Kirsch, Fariha Abbasi-Feinberg, Charles Davies, Charlene Gamaldo, Sherene Thomas, Patricia Koochaki, Christiane Otto, Kelly Lipman, Carol L Rosen","doi":"10.5664/jcsm.11790","DOIUrl":"10.5664/jcsm.11790","url":null,"abstract":"<p><strong>Study objectives: </strong>To develop and validate a publicly available, patient-reported outcome (PRO) tool specific to obstructive sleep apnea (OSA) in adults, designed for clinical use to monitor treatment response and longitudinal symptom progression.</p><p><strong>Methods: </strong>The PRO tool was developed in accordance with Food and Drug Administration guidance for PRO measures, utilizing a multiphase, mixed-methods approach. Part 1 involved concept elicitation and cognitive interviews with patients to identify key symptoms and impacts. Part 2 consisted of pilot testing the draft tool in 10 American Academy of Sleep Medicine-accredited sleep centers. Part 3 included psychometric validation using longitudinal online surveys in 560 adults with OSA and 40 controls. Analyses included exploratory factor analysis, Rasch modeling, test-retest reliability, internal consistency, construct validity, responsiveness to change, and determination of clinically important difference thresholds.</p><p><strong>Results: </strong>The final 11-item Patient-reported Longitudinal Assessment Tool for OSA has a 7-day recall period and assesses both daytime and nighttime OSA symptoms. It demonstrated strong internal consistency (α = 0.94), test-retest reliability (intraclass correlation coefficients = 0.91-0.97), and construct validity through moderate to strong correlations with established measures. The 11-item Patient-reported Longitudinal Assessment Tool for OSA scores discriminated between OSA severity and body mass index groups and were responsive to symptom improvement. The mean completion time was under 4 minutes. The tool can be used in both paper and electronic formats and has been translated into Spanish.</p><p><strong>Conclusions: </strong>The 11-item Patient-reported Longitudinal Assessment Tool for OSA is a valid, reliable, and feasible PRO instrument for assessing OSA-related symptoms in clinical practice. It enables efficient monitoring of PROs across treatment stages.</p><p><strong>Citation: </strong>Kirsch D, Abbasi-Feinberg F, Davies C, et al. The Patient-reported Longitudinal Assessment Tool for OSA (PLATO): development and validation of a new clinical tool to assess response to obstructive sleep apnea treatment in adults. <i>J Clin Sleep Med</i>. 2025;21(10):1743-1758.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1743-1758"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227450","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":"Sleep apnea, how do we help thee? Let us count the ways.","authors":"Loretta Colvin, Nancy A Collop","doi":"10.5664/jcsm.11816","DOIUrl":"10.5664/jcsm.11816","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1663-1664"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585483","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":"Polysomnographic findings of multiple system atrophy: evidence from case-control studies.","authors":"Meiou Wang, Ye Zhang, Rong Ren, Jiaxue Huang, Xujun Feng, Michael V Vitiello, Larry D Sanford, Xiangdong Tang","doi":"10.5664/jcsm.11758","DOIUrl":"10.5664/jcsm.11758","url":null,"abstract":"<p><strong>Study objectives: </strong>This study examines the polysomnographic differences between patients with multiple system atrophy and healthy controls.</p><p><strong>Methods: </strong>An electronic literature search was performed in MEDLINE, EMBASE, All EBM databases and the Web of Science database from inception to August 2024.</p><p><strong>Results: </strong>Meta-analysis found significant reductions in percent rapid eye movement sleep, sleep efficiency, and total sleep time, and increases in the apnea-hypopnea index, percent non-REM sleep stage 1, periodic limb movement index and sleep latency in patients with multiple system atrophy compared with healthy controls.</p><p><strong>Conclusions: </strong>Our meta-analysis found polysomnographic abnormalities in patients with multiple system atrophy compared with controls. Future studies should include methodological considerations (ie, rapid eye movement sleep without atonia criteria) to evaluate the contributions of potential heterogeneous factors (ie, disease duration, presence of stridor, comorbidity of rapid eye movement sleep behavior disorder) to polysomnographic changes in multiple system atrophy.</p><p><strong>Citation: </strong>Wang M, Zhang Y, Ren R, et al. Polysomnographic findings of multiple system atrophy: evidence from case-control studies. <i>J Clin Sleep Med</i>. 2025;21(10):1723-1732.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1723-1732"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530812","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":"Pediatric sleep movements: a review of methodologies, normative data, disease associations, and research gaps.","authors":"Mimi Lu, Dominic A Fitzgerald, Mark B Norman, Colin E Sullivan, Karen A Waters","doi":"10.5664/jcsm.11748","DOIUrl":"10.5664/jcsm.11748","url":null,"abstract":"<p><p>Restless sleep is a common complaint among children, yet its quantification and clinical significance remain poorly defined. Polysomnography, the standard diagnostic tool for sleep disorders, often fails to fully explain restlessness, even when other conditions are excluded. Measuring body movement indices, proposed as an objective marker of sleep restlessness but lacking a standardized methodology, currently has limited clinical application. Recent efforts by the International Restless Legs Syndrome Study Group have led to consensus diagnostic criteria for restless sleep disorder that incorporate both self-reported and objective measures. We review various methodologies used to quantify body movements during sleep, including polysomnography with video recordings, actigraphy, and a less-invasive \"contactless\" device. Key discrepancies in measurement techniques and normative data reporting are identified. To advance the inclusion of this disorder into the clinical setting, we collated and compared studies providing normative values for sleep movements across different populations and explore their relevance to other disorders. Providing a historical perspective on how the measurements of sleep movement have evolved shows how technological advancements have influenced current approaches. In this context, the consequences of restless sleep and its potential impact on neurocognitive and behavioral outcomes are discussed. We conclude by highlighting key knowledge gaps and proposing future research directions.</p><p><strong>Citation: </strong>Lu M, Fitzgerald DA, Norman MB, Sullivan CE, Waters KA. Pediatric sleep movements: a review of methodologies, normative data, disease associations, and research gaps. <i>J Clin Sleep Med</i>. 2025;21(10):1773-1785.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1773-1785"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081674","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":"Rebreathing during CPAP therapy and its implications in obstructive sleep apnea.","authors":"William H Noah, David P White, Bernard Hete, Ludovico Messineo","doi":"10.5664/jcsm.11802","DOIUrl":"10.5664/jcsm.11802","url":null,"abstract":"<p><p>Elevated environmental carbon dioxide (CO₂) levels can have important health impacts, including increased anxiety, impaired high-level cognitive performance, reduced sleep quality, and decreased next-day alertness, especially in children. Bedrooms, where people spend a third of their lives, are often poorly ventilated, further exacerbating CO₂ exposure during sleep. These symptoms may be of particular concern for individuals with obstructive sleep apnea treated with continuous positive pressure as a result of CO₂ trapping within the mask, which is dependent on environmental levels, and circuit CO₂ rebreathing_. Additionally, lower inhaled oxygen concentrations may be encountered when exhaled gases are rebreathed from the circuit. Low expiratory positive airway pressure, high ventilation levels (eg, in large individuals or at altitude), and small exhaust valves increase rebreathing risk, which can self-propagate due to patient attempts to compensate by increasing tidal volume. Elevated environmental CO₂ may further exacerbate the clinical consequences of rebreathing, including reduced continuous positive pressure adherence. Although strategies including higher expiratory positive airway pressure or larger exhaust valves help mitigate CO₂ buildup, they can also lead to increased noise, which may potentially affect adherence. With this work, we review the available evidence on the thresholds and effects of classroom, office, bedroom, and rebreathed CO₂ levels in healthy individuals and those with obstructive sleep apnea, both adults and children. Importantly, we provide the often-overlooked link between environmental CO₂ concentrations and circuit rebreathing for patients with obstructive sleep apnea, underscoring the need to optimize current indoor ventilation standards and thresholds for mask-based CO₂ inhalation, as well as continuous positive pressure technology to maximize adherence, abate CO₂/hypoxic exposure, and improve health outcomes.</p><p><strong>Citation: </strong>Noah WH, White DP, Hete B, Messineo L. Rebreathing during CPAP therapy and its implications in obstructive sleep apnea. <i>J Clin Sleep Med</i>. 2025;21(10):1759-1771.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1759-1771"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555581","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":"Now is the time to prioritize sleep timing for cardiovascular health.","authors":"Nathan C Nowalk, Brendan T Keenan, Richard J Schwab","doi":"10.5664/jcsm.11854","DOIUrl":"10.5664/jcsm.11854","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1659-1661"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849544","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":"Cognitive and behavioral therapies for insomnia: must they always be in bed together?","authors":"Michael A Grandner, Alessio A Gugliotta, Bhanu Prakash Kolla, Suzanne B Gorovoy, Jason G Ellis, Celyne H Bastien, Rina S Fox","doi":"10.5664/jcsm.11862","DOIUrl":"10.5664/jcsm.11862","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1655-1657"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876558","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":"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":"10.5664/jcsm.11806","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1809-1811"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493072/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disturbance and maladaptive sleep-related cognitions in borderline personality disorder in the longitudinal McLean Study of Adult Development.","authors":"David T Plante, Isabel V Glass, Mary C Zanarini","doi":"10.5664/jcsm.11786","DOIUrl":"10.5664/jcsm.11786","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep and mental illnesses, particularly mood disorders, share complex bidirectional relationships. Emerging evidence suggests sleep may also play an important role in the course of borderline personality disorder (BPD). This study was designed to examine associations between sleep disturbance and maladaptive sleep-related cognitions with recovery from BPD in a longitudinal sample.</p><p><strong>Methods: </strong>The Pittsburgh Sleep Quality Index and brief Dysfunctional Beliefs and Attitudes about Sleep-16 scales were completed by 223 participants in the McLean Study of Adult Development at the 16-year follow-up wave and over 4 additional consecutive biannual follow-up waves. Generalized estimating equations were used to assess relationships between sleep-related outcomes and recovery vs nonrecovery among participants with BPD over time.</p><p><strong>Results: </strong>After controlling for clinical and demographic covariates, nonrecovered BPD participants had poorer sleep quality as assessed by the Pittsburgh Sleep Quality Index, lower self-reported sleep quality, greater sleep disturbance, higher use of sleep medication, and greater daytime dysfunction compared to recovered BPD (all <i>P</i> < .002). Additionally, in adjusted analyses, nonrecovered BPD participants had greater maladaptive sleep-related cognitions measured by the overall Dysfunctional Beliefs and Attitudes about Sleep-16 and its related subscales (all <i>P</i> < .006).</p><p><strong>Conclusions: </strong>These findings demonstrate relationships between sleep disturbance and maladaptive sleep-related cognitions with recovery from BPD over a decade of longitudinal evaluation. Further research to determine whether interventions that target sleep improve core symptoms, functional impairment, and recovery in BPD is indicated.</p><p><strong>Citation: </strong>Plante DT, Glass IV, Zanarini MC. Sleep disturbance and maladaptive sleep-related cognitions in borderline personality disorder in the longitudinal McLean Study of Adult Development. <i>J Clin Sleep Med</i>. 2025;21(10):1733-1741.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1733-1741"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530814","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":"Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular disease-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":"10.5664/jcsm.11762","url":null,"abstract":"<p><strong>Study objectives: </strong>In addition to sleep duration, sleep timing is another important but significantly understudied sleep characteristic that may be closely associated with cardiovascular disease (CVD) mortality. To investigate optimal sleep timing, we assessed the associations of sleep timing with all-cause and CVD mortality in a large sample of older adults.</p><p><strong>Methods: </strong>This prospective cohort study included 18,129 adults (median age = 65 years) from Guangzhou Biobank Cohort Study, recruited during 2008-2012 and followed up until July 2022. Participants' sleep timing (early, intermediate, and late) was defined by the midpoint between bedtime and wake time. Four CVD susceptibility single-nucleotide polymorphisms 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 a higher risk of all-cause mortality (adjusted hazard ratio = 1.18, 95% confidence interval = 1.07-1.30; and adjusted hazard ratio = 1.13, confidence interval = 1.01-1.26, respectively). Restricted cubic spline curves indicated U-shaped associations of sleep at midpoint, bedtime, and wake time with all-cause and CVD mortality (all <i>P</i> for nonlinearity < .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 males, older people, and those with a 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><p><strong>Citation: </strong>Wang J, Li YR, Jiang CQ, et al. Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular disease-cause mortality in older adults. <i>J Clin Sleep Med</i>. 2025;21(10):1709-1722.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1709-1722"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493074/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}