Journal of Clinical Sleep Medicine最新文献

{"title":"Sleep loss as a cardiometabolic risk factor: a narrative review of clinical and public health implications.","authors":"Firas K Ghanem, Hrayr Attarian, Zeina Al-Khalil, Colette S Kabrita","doi":"10.1007/s44470-026-00144-1","DOIUrl":"10.1007/s44470-026-00144-1","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize current evidence on how sleep deprivation, impaired sleep architecture, and circadian misalignment affect cardiovascular and metabolic regulation across autonomic, hormonal, inflammatory, and behavioral pathways, and to highlight remaining research gaps in cardiometabolic sleep medicine.</p><p><strong>Methods: </strong>A structured literature search was conducted using PubMed, Scopus, and Google Scholar to identify peer‑reviewed primary and review articles published within the past decade, using chronobiological and cardiometabolic search terms. Reference lists of retrieved articles were screened to identify additional relevant studies.</p><p><strong>Results: </strong>Experimental and epidemiologic data consistently link short or disturbed sleep with increased incidence of hypertension, coronary artery disease, stroke, obesity, type 2 diabetes, and metabolic syndrome. Sleep loss activates the sympathetic nervous system and elevates cortisol, while suppressing growth hormone, thereby promoting vasoconstriction, endothelial dysfunction, and cardiac remodeling. Parallel disruption of leptin, ghrelin, and endocannabinoid signaling increases hunger, caloric intake, and preference for energy‑dense foods, driving weight gain, visceral adiposity, and insulin resistance. Circadian misalignment from shift work and social jet lag further amplifies inflammatory signaling and metabolic risk across the lifespan. Limited interventional data suggest that sleep extension can improve appetite regulation, blood pressure, and some glycemic indices, but mechanistic and long‑term outcomes remain underexplored.</p><p><strong>Conclusion: </strong>Sleep deprivation and circadian disruption mediate cardiometabolic disease through converging neuroendocrine, autonomic, inflammatory, and behavioral pathways. Future research should employ longitudinal designs and integrated multi- \"omics\" approaches combined with sleep phenotyping to clarify causal mechanisms and identify novel biomarkers and therapeutic targets in clinical sleep medicine.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671136","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 and obesity-known interactions and open questions.","authors":"Christopher N Schmickl, Rahul Gomez, Bernie Y Sunwoo, Omar Mesarwi, Avnee J Kumar, Atul Malhotra","doi":"10.1007/s44470-026-00130-7","DOIUrl":"10.1007/s44470-026-00130-7","url":null,"abstract":"<p><p>Sleep and obesity are tightly interconnected, with bidirectional relationships that influence cardiometabolic health and the development and progression of sleep disorders. In this review, we synthesize current evidence linking insufficient sleep, insomnia, obstructive sleep apnea (OSA), and other sleep disorders with obesity, with a focus on pathophysiology, clinical implications, and emerging therapeutic strategies. Insufficient sleep is consistently associated with weight gain through hormonal, behavioral, and metabolic mechanisms, whereas the relationship between insomnia and obesity appears weaker and more heterogeneous. Obesity is a major driver of OSA via effects on upper airway anatomy, respiratory mechanics, and ventilatory control, though reciprocal effects of OSA on weight remain less clear. Recent advances in obesity pharmacotherapy, particularly incretin-based therapies such as dual GIP/GLP-1 receptor agonists, will likely reshape treatment paradigms. Clinical trial data demonstrate meaningful improvements in both weight and OSA severity, highlighting the potential for integrated management of comorbid obesity and OSA (COBOSA); however, traditional therapies-including continuous positive airway pressure (CPAP), exercise, and lifestyle modification-remain foundational components of care. We also review obesity hypoventilation syndrome and other sleep disorders associated with obesity, emphasizing shared and distinct mechanisms. Despite substantial progress, key knowledge gaps remain regarding optimal treatment integration, heterogeneity of treatment response, and long-term outcomes. Overall, effective management of obesity is increasingly central to sleep medicine, underscoring the need for multidisciplinary, patient-centered approaches and further research. Likewise, promoting adequate sleep should be considered an important component of weight management and overall health.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671141","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":"Psychometric evaluation of the Pittsburgh Sleep Quality Index among South African women participating in the Bukhali trial: Healthy Life Trajectories Initiative.","authors":"Stephanie Alcock, Johanna Beukes, Claire Hart, Karine Scheuermaier, Stephen J Lye, Shane A Norris","doi":"10.1007/s44470-026-00146-z","DOIUrl":"10.1007/s44470-026-00146-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;We examined the psychometric properties of the Pittsburgh Sleep Quality Index (PSQI) in a large sample of young women in Soweto, South Africa, to assess its reliability and structural validity in this context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected from 7182 women enrolled in the Bukhali randomized controlled trial, part of the Healthy Life Trajectories Initiative (HeLTI). Sociodemographic information and PSQI data were collected through interviewer-administered surveys. Internal consistency was assessed using Cronbach's alpha, McDonald's omega and item-level correlations. Confirmatory factor analysis (CFA) evaluated the original one-factor and established two- and three-factor multidimensional models. Model fit was examined using Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Most women (57.4%) reported good sleep quality (PSQI ≤ 5). Poor sleep quality was associated with higher household socioeconomic status (assets score), higher education, and single relationship status. Average sleep was 7.8 hours, characterized by prolonged onset latency and high fragmentation, suggesting that continuity disruptions rather than opportunity shortage drove poor sleep. The PSQI had modest internal consistency (α = .57; ω = .57; item-total r = .33 - .65). The one-factor model demonstrated poor fit (χ&lt;sup&gt;2&lt;/sup&gt;(14) = 1677.70; CFI = .65; TLI = .48; RMSEA = .13) whereas fit was good for the two-factor (χ&lt;sup&gt;2&lt;/sup&gt;(13) = 291.46; CFI = .94; TLI = .91; RMSEA = .05) and three-factor models (χ&lt;sup&gt;2&lt;/sup&gt;(11) = 285.21; CFI = .94; TLI = .89; RMSEA = .06).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The PSQI showed a multidimensional structure in this population. While both multidimensional models performed well, the two-factor model showed slightly better fit and is recommended for use in this population. Interpreting PSQI components rather than the global score offers more meaningful insight into sleep quality and highlights the need for context-specific psychometric validation in diverse settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Current knowledge/study rationale: &lt;/strong&gt;The Pittsburgh Sleep Quality Index is widely used, but prior evidence shows its reliability and factor structure vary across populations, settings, and sex. Young women in under-resourced urban South African settings may experience sleep disruption shaped by psychosocial stress, safety concerns, caregiving demands, and environmental factors, yet the PSQI had not been evaluated in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study impact: &lt;/strong&gt;In this large Soweto cohort, sleep problems appeared driven more by fragmented sleep and continuity disruptions than by insufficient sleep opportunity. The PSQI performed better as a multidimensional measure, particularly a parsimonious two-factor structure, than as a single global score. The findings support using component- or factor-informed PSQI interpretati","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671195","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 \"Usage is not efficacy in transvenous phrenic nerve stimulation for central sleep apnea\".","authors":"Rami N Khayat, Meena Khan, Timothy I Morgenthaler, Scott McKane, Robin Germany, Maria Rosa Costanzo","doi":"10.1007/s44470-026-00099-3","DOIUrl":"10.1007/s44470-026-00099-3","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609709","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":"Beyond coexistence: attempting to unlock the diabetes-COMISA Link.","authors":"Abdulghani Sankari","doi":"10.1007/s44470-026-00135-2","DOIUrl":"10.1007/s44470-026-00135-2","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609611","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 \"Unexpectedly higher mortality in non‑type 1 narcolepsy: diagnostic heterogeneity or unmeasured confounders?\"","authors":"Amir Sharafkhaneh, Yves Dauvilliers, Ahmed S BaHammam, Mehnaz Azarian, Michael Thorpy, Fang Han, Gulcin Benbir Senel, Murat Aksu, Javad Razjouyan","doi":"10.1007/s44470-026-00120-9","DOIUrl":"10.1007/s44470-026-00120-9","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563464","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":"Increasing reports and shifting categorical trends in adverse events for oral appliances.","authors":"Aaron Glick, Sue Ellen Richardson","doi":"10.1007/s44470-026-00139-y","DOIUrl":"10.1007/s44470-026-00139-y","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551204","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":"The effect of short-term descent to low altitude in healthy residents at moderate altitude - a randomized crossover trial.","authors":"Nadja Deflorin, Michael Furian, Jan Vontobel, David Niederseer, Tsogyal Daniela Latshang","doi":"10.1007/s44470-026-00128-1","DOIUrl":"10.1007/s44470-026-00128-1","url":null,"abstract":"<p><strong>Study objectives: </strong>We examined the effect of a short-term descent to low altitude on sleep-disordered breathing (SDB) in healthy moderate altitude residents.</p><p><strong>Methods: </strong>Forty-four healthy participants (50% females), median age 47 years, living > 1000 m (median (IQR) altitude of 1230 m (1130; 1560)), were included. Polysomnographies were carried out for two consecutive nights at the participants' home elevations and for two nights at the sleep laboratory in Chur (590 m), Switzerland, after a 2-week washout period, in accordance with a randomized crossover design. The primary outcome was time spent under 90% oxygen saturation (T90). Important secondary outcomes were nocturnal oxygen saturation (SpO₂), apnea-hypopnea index (AHI), and oxygen desaturation index (ODI). Additional outcomes were sleep stage-related parameters. The trial has been registered at clinicaltrials.gov (NCT05826808).</p><p><strong>Results: </strong>Mean ± SE T90 was 1 ± 2 min at 590 m and 5 ± 2 min at > 1000 m (mean difference of 4 min, 95% CI of 1 to 7, p = 0.005). At 590 m, the total AHI was 9.2 ± 1.6/h (2.3% with AHI > 30/h), ODI 6.0 ± 1.4/h, and SpO₂ 95.2 ± 0.2%. At > 1000 m, the total AHI was 14.2 ± 1.6/h (13.6% with AHI > 30/h, p = 0.025 vs. 590 m), ODI 10.0 ± 1.4/h, and SpO₂ 93.8 ± 0.2% (p < 0.001 all comparisons versus 590 m). Mean slow wave sleep on the second night at 590 m was 10.0 ± 1% and 8.0 ± 1% at > 1000 m (p = 0.001). In males, descent to low altitude showed a more significant effect on T90 (mean difference of 7 min, 95% CI of 1 to 12, p = 0.024) and REM sleep stage (mean difference of 4%TST, 95% CI of 1 to 7, p = 0.011) compared to females.</p><p><strong>Conclusion: </strong>A short-term, low-altitude stay of healthy moderate altitude residents leads to a reduction in nocturnal hypoxemia and SDB, especially in males. These findings suggest that sleep-disordered breathing assessments at lower-than-living altitude might underestimate the severity of SDB in patients permanently living at moderate altitudes.</p><p><strong>Study rationale: </strong>Several million people worldwide permanently live at moderate altitude. Due to the vast variety in heights worldwide, the altitude of the closest sleep laboratory might vary and be at a lower altitude, which may lead to underestimated results. Study impact: To our knowledge, the current study is the first to investigate the effect of a short-term descent to low altitude on sleep-disordered breathing (SDB) in healthy moderate altitude residents. In this paper, we show that a short-term, low-altitude stay leads to a reduction in nocturnal hypoxemia and less sleep-associated breathing disorders, especially in males. Moreover, the proportion of severe SDB is underestimated at lower-than-living sleep laboratory assessments.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551201","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":"Evaluating sleep duration, psychological burden, and cognition in cadets: methodological and interpretive considerations.","authors":"Mohamad Saripudin","doi":"10.1007/s44470-026-00140-5","DOIUrl":"10.1007/s44470-026-00140-5","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551218","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":"Correction: Emerging evidence reinforces and expands the case for later school start times.","authors":"Muhammad A Rishi, Ayan De, Jocelyn Cheng, Andrew Namen, Stanley Thomas","doi":"10.1007/s44470-026-00147-y","DOIUrl":"10.1007/s44470-026-00147-y","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537640","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}