Journal of Clinical Sleep Medicine最新文献

{"title":"The role of the transdiagnostic sleep and circadian intervention in adolescent bedtime and sleep quality: a pilot study.","authors":"Kara M Duraccio, Afton B Craig, Sarah L H Kamhout, Isabella D Wright, Jamon Jex, Brandon Pattillo, Reagan Geary, Gracie Crandall, Maryn Ringger, Sarah Brewer, Meredith Woolley","doi":"10.1007/s44470-026-00180-x","DOIUrl":"10.1007/s44470-026-00180-x","url":null,"abstract":"<p><strong>Purpose: </strong>Circadian misalignment is prevalent among adolescents and contributes to sleep deficiency and mental health struggles. There is a need for interventions targeting sleep and circadian difficulties in adolescents. This pilot study examined the effectiveness of a Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in a community-based adolescent sample with circadian misalignment. We hypothesized that TSC would improve sleep timing and duration, lessen circadian misalignment, improve subjective sleep quality, shorten sleep onset latency, and improve mental health outcomes.</p><p><strong>Methods: </strong>Thirty-one adolescents (M age = 15.9 years (SD = 1.3); 45.2% female; 67.7% White) with self-reported circadian misalignment completed the six-week TSC intervention. Using a within-subject design, outcomes were assessed via actigraphy, dim-light melatonin onset (DLMO), Morningness-Evening Questionnaire, Pittsburgh Sleep Quality Index, and Depression Anxiety and Stress Scale-21 Item before and after the intervention. Repeated-measure Generalized Linear Models were conducted to examine differences across outcomes from pre- to post-intervention.</p><p><strong>Results: </strong>TSC was associated with a significant earlier shift in sleep midpoint (~ 30 min; p = .023, g = .591) and weekend sleep onset (p = .003, g = .856), alongside improved subjective sleep quality (p = .021, g = .452). No significant changes were observed in DLMO, circadian misalignment index, total sleep duration, sleep onset latency, chronotype, or any mental health outcomes.</p><p><strong>Conclusion: </strong>TSC demonstrated improvements in behavioral sleep timing and perceived sleep quality in a community-based adolescent sample, even without detectable biological circadian phase shifts. These findings extend prior efficacy research into real-world clinical contexts. Future studies should incorporate control groups, longer follow-up periods, and more diverse samples to clarify TSC's mechanisms and broader effectiveness.</p><p><strong>Current knowledge/study rationale: </strong>Circadian misalignment is prevalent among adolescents and contributes to sleep deficiency and mental health struggles, highlighting a need for effective interventions targeting sleep and circadian difficulties in adolescents. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) is a promising intervention, but more research is needed to fully understand its effectiveness across multiple contexts.</p><p><strong>Study impact: </strong>This pilot study investigated the effectiveness of TSC on the sleep, circadian functioning, and mental health of adolescents with circadian misalignment. Our results increase our understanding of the strengths and limitations of TSC, which informs future research and clinical practice.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002835","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":"Methodological caveats in interpreting slow-wave slope as a marker of synaptic homeostasis in OSA.","authors":"Bin Huang, Yuqian Shen","doi":"10.1007/s44470-026-00189-2","DOIUrl":"10.1007/s44470-026-00189-2","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972113","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":"Clinical and subthreshold insomnia in U.S. veterans: increasing prevalence and mental health burden.","authors":"Robert H Pietrzak, Ian C Fischer, Elissa McCarthy, Jason C DeViva, Peter J Na","doi":"10.1007/s44470-026-00143-2","DOIUrl":"10.1007/s44470-026-00143-2","url":null,"abstract":"<p><p>This study examined the prevalence, correlates, and mental health burden of insomnia in a contemporary, nationally representative sample of 2,632 U.S. military veterans. Using established cutoffs on the Insomnia Severity Index (clinical insomnia, ≥ 15; subthreshold insomnia, 8-14), 13.6% of veterans met criteria for clinical insomnia and 29.7% for subthreshold insomnia, representing significant increases from the 11.4% and 26.0% observed in a nationally representative veteran sample surveyed in 2019-2020. Veterans with clinical and subthreshold insomnia were younger, more likely to belong to racial and ethnic minority groups, and reported greater trauma exposure, military sexual trauma, homelessness, and medical conditions. After adjustment for sociodemographic, trauma, and other health characteristics, subthreshold insomnia was associated with 2- to 6-fold greater odds of depression, anxiety, posttraumatic stress disorder, and suicidal ideation, whereas clinical insomnia was associated with 2- to 12-fold greater odds of these outcomes, including nearly 4-fold greater odds of future suicidal intent. These findings suggest that the burden of insomnia among U.S veterans has increased since the pre-pandemic period and underscore the importance of early identification and evidence-based treatment of insomnia to reduce psychiatric morbidity and suicide risk in this population.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972095","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":"Changes in sleep characteristics in Parkinson's disease: a prospective 5-year follow-up study.","authors":"Eemil Partinen, Ari Ylikoski, Christer Hublin, Markku Partinen","doi":"10.1007/s44470-026-00169-6","DOIUrl":"10.1007/s44470-026-00169-6","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances are common and disabling symptoms in Parkinson's disease (PD). Evolution of sleep disturbances in PD remains incompletely characterized. We aimed to describe changes in sleep parameters and sleep disorders over 5 years in a prospective PD cohort.</p><p><strong>Methods: </strong>A structured sleep questionnaire was administered to members of the Finnish Parkinson's Association at baseline and at 5-year follow-up. Longitudinal changes were analyzed in 183 participants with complete data at both time.</p><p><strong>Results: </strong>Daytime sleepiness increased significantly, with the proportion of participants with Epworth Sleepiness Scale (ESS) > 10 rising from 30.6% to 38.8% (P = 0.026) and daily napping from 21.4% to 31.7% (P = 0.004). Sleep talking (≥ 1/week) increased from 17.4% to 30.4% (P < 0.001), nightmares from 14.8% to 24.6% (P = 0.003), and mean, REM Sleep Behavior Disorder Screening Questionnaire score (RBDSQ) from 4.4 to 5.3 points (P < 0.001). Restless legs syndrome (RLS) prevalence increased from 21.0% to 31.2% (P = 0.038). In contrast, insomnia symptoms, circadian timing and total sleep time remained stable. In multivariate logistic regression, excessive daytime sleepiness was independently associated with depressive symptoms, use of dopamine agonists, and risk of sleep apnea.</p><p><strong>Conclusion: </strong>Sleep disturbances in PD show a selective pattern of progression over 5 years. Daytime sleepiness, napping, RLS symptoms, sleep talking, nightmares and RBDSQ score increase while insomnia symptoms remain stable. These findings highlight the need for longitudinal, multi-domain sleep assessment in PD clinical care. The longitudinal increase in RBD-related symptoms and sleep talking strengthens their utility as markers of disease progression and clinical prognostic relevance.</p><p><strong>Current knowledge/study rationale: </strong>Sleep disturbances are among the most frequent and disabling non-motor symptoms of Parkinson's disease. These include insomnia, excessive daytime sleepiness, REM sleep behavior disorder, and restless legs syndrome. Long-term prospective data on how multiple sleep disorders and sleep characteristics evolve over time in PD is lacking.</p><p><strong>Study impact: </strong>In this 5-year prospective cohort study sleep disturbances in PD progress selectively. Daytime sleepiness, napping, restless legs syndrome, sleep talking, nightmares and RBD-related features worsen significantly while insomnia symptoms remain stable. This provides evidence that sleep characteristics and disorders evolve in time. Sleep disturbances in PD should be assessed routinely in clinical practice.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946120","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":"Association between sleep paralysis and anxiety: a systematic review and meta-analysis.","authors":"Gustavo Garrido, Kenzo Donato, João Victor Gonzalez, Gabriela Nunes E Brito, Bianca Romeo, Vanessa Machado, Letícia Guimarães Lopes, Cristina Salles","doi":"10.1007/s44470-026-00190-9","DOIUrl":"10.1007/s44470-026-00190-9","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep paralysis is a REM-sleep parasomnia which manifests as a temporary inability to perform voluntary muscle movements during the sleep-wake transition. Anxiety disorders are characterized by excessive fear, anxiety, and related behavioral disturbances. Notably, lifetime prevalence of sleep paralysis is elevated among psychiatric populations. The purpose of this review and meta-analysis was to evaluate the association between sleep paralysis and anxiety, encompassing both anxiety symptoms and formally diagnosed anxiety disorders.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA and Cochrane guidelines and was registered in PROSPERO (CRD42024579831). PubMed, Embase, and Cochrane Library were searched. Risk ratios (RR) and standardized mean differences (SMD) were pooled using random-effects models estimated with restricted maximum likelihood (REML). Heterogeneity was quantified using I². Subgroup and leave-one-out sensitivity analyses were performed. Publication bias was evaluated using funnel plots and Egger's test. Statistical analysis was conducted using R (version 4.4.1) with the metafor package.</p><p><strong>Results: </strong>Eleven eligible studies involving 5568 participants were included. Sleep paralysis was associated with significantly higher anxiety scores compared to controls (SMD 0.35; 95% CI 0.27-0.44; p < 0.01) with zero heterogeneity (I² = 0.0%). Publication bias was low. In a different analysis, meta-analysis showed no significant difference in anxiety prevalence (RR 1.28; 95% CI 0.59-2.77; p = 0.53); sensitivity analysis excluding one outlier demonstrated a significant risk (RR 1.80; 95% CI 1.08-2.99).</p><p><strong>Conclusion: </strong>Sleep paralysis appears to be associated with elevated anxiety levels and may occur more frequently among individuals with anxiety-related conditions.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931732","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":"Reply to \"Occupational sleep restriction: a missing piece in residual EDS of PAP-adherent OSA?\"","authors":"Barbara Junco, Alberto R Ramos, Roger McIntosh","doi":"10.1007/s44470-026-00173-w","DOIUrl":"10.1007/s44470-026-00173-w","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931748","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":"Dual orexin receptor antagonist-assisted dose reduction of benzodiazepines and benzodiazepine receptor agonists: a mirror-image analysis of insurance claims data.","authors":"Kentaro Matsui, Ko Sugiura, Akiyoshi Shimura, Shunsuke Takagi, Kazuhiro Kurihara, Yoshikazu Takaesu, Yuichi Inoue","doi":"10.1007/s44470-026-00164-x","DOIUrl":"10.1007/s44470-026-00164-x","url":null,"abstract":"<p><strong>Purpose: </strong>Discontinuing benzodiazepines and benzodiazepine receptor agonists (BZ/BZRAs) remains challenging for patients with chronic insomnia despite safety concerns. This study evaluated whether continuous treatment with dual orexin receptor antagonists (DORAs) facilitates a reduction in BZ/BZRA doses among long-term users.</p><p><strong>Methods: </strong>This self-controlled (mirror-image) study, in which each patient served as their own control, used Japanese health insurance claims data (Dokenpo database, 2019-2024). Eligible patients had continuous BZ/BZRA use for ≥ 6 months and initiated suvorexant or lemborexant for ≥ 6 months. Changes in bedtime BZ/BZRA dose (diazepam equivalents) were compared between pre- and post-DORA periods. Logistic regression analyses identified factors associated with ≥ 50% dose reduction and BZ/BZRA discontinuation.</p><p><strong>Results: </strong>Prior to DORA initiation, 605 patients were taking a mean of 1.9 ± 1.0 types of BZ/BZRAs at a pretreatment total daily dose of 8.2 ± 7.4 mg diazepam equivalent. Of these, 42.1% achieved ≥ 50% bedtime BZ/BZRA dose reduction and 21.3% achieved discontinuation. Mean bedtime doses decreased in both the suvorexant group (7.2 to 5.2 mg) and the lemborexant group (8.3 to 5.2 mg). In adjusted analyses, age ≥ 65 years was independently associated with both ≥ 50% reduction (odds ratio [OR] 2.485; 95% confidence interval [CI] 1.190-5.192; p = 0.015) and discontinuation (OR 2.636; 95% CI 1.158-6.000; p = 0.021). Lower pretreatment BZ/BZRA dose and lemborexant use were also associated with dose reduction and discontinuation.</p><p><strong>Conclusion: </strong>DORA treatment for at least six months may support BZ/BZRA dose reduction among long-term users, particularly in older patients.</p><p><strong>Current knowledge/study rationale: </strong>Discontinuing benzodiazepine and benzodiazepine receptor agonists (BZ/BZRAs) in patients with long-term use remains clinically challenging despite well-documented safety concerns. Whether sustained treatment with dual orexin receptor antagonists (DORAs) facilitates BZ/BZRA dose reduction in real-world practice has not been adequately examined in patients already exposed for six months or longer.</p><p><strong>Study impact: </strong>Sustained DORA treatment for at least six months was associated with substantial bedtime BZ/BZRA dose reduction and discontinuation among long-term users, with older adults (aged 65 years or older) showing the highest odds of success. These findings support DORA co-administration as a practical pharmacological switching strategy to enable safer insomnia management, particularly in populations vulnerable to BZ/BZRA-related adverse events.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921616","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":"Optimizing the role of acceptance and commitment therapy for insomnia: methodological challenges, stepped-care integration, and acceptability metrics.","authors":"Mohamad Saripudin, Hany Saputri","doi":"10.1007/s44470-026-00184-7","DOIUrl":"10.1007/s44470-026-00184-7","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921571","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":"Timing of GLP-1RA exposure in real-world cardiovascular risk analyses.","authors":"Güney Sarıoğlu","doi":"10.1007/s44470-026-00188-3","DOIUrl":"10.1007/s44470-026-00188-3","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921558","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":"When sleep advice goes viral: medical reliability of insomnia content on TikTok.","authors":"Styliani Papadopoulou, Aliki Karkala, Ellen Engelshove, Dries Testelmans, Paschalis Steiropoulos, Alexandros Kalkanis","doi":"10.1007/s44470-026-00163-y","DOIUrl":"10.1007/s44470-026-00163-y","url":null,"abstract":"<p><p>The reliability and educational quality of TikTok videos addressing insomnia management remain uncertain. A total of 127 TikTok videos were assessed with Global Quality Score (GQS) for educational value and with Viewing and Engagement Index for popularity. Among these, 66 videos by general users, 20 by physicians, 32 by other healthcare professionals, and 9 by brand-affiliated accounts showed overall poor quality: only 20 videos (15.7%) had high educational value, while another 11 (8.7%) had moderate educational value; only 5 videos received the highest score for consistency with guidelines, only 5 videos recommended consulting a physician, and only 2 included scientific references. Approximately 55% of physicians' videos had GQS ≥ 3, compared with 25%, 18%, and 0% of other healthcare professionals, general users, and brand accounts respectively. GQS was not correlated with engagement metrics. Sponsored videos were associated with lower-quality content. In conclusion, TikTok videos related to insomnia management generally do not provide reliable, guidelines-based information, raising concerns regarding the use of TikTok as a source of insomnia management information.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921561","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}