Journal of Clinical Sleep Medicine最新文献

{"title":"Clinical significance of sleepiness: an American Academy of Sleep Medicine position statement.","authors":"Thomas M Heffron, Indira Gurubhagavatula, Lynn Marie Trotti, Fariha Abbasi-Feinberg, Alexandre Rocha Abreu, Anuja Bandyopadhyay, Vishesh K Kapur, David Kuhlmann, Jennifer L Martin, Eric J Olson, Susheel P Patil, Anita V Shelgikar, Emerson M Wickwire, James A Rowley","doi":"10.5664/jcsm.11658","DOIUrl":"10.5664/jcsm.11658","url":null,"abstract":"<p><p>Alertness is a necessity for well-being and performance, and sleepiness is associated with cognitive and functional impairments that can have a negative impact on performance, health, mood, safety, and quality of life. In severe cases, sleepiness can lead to debilitation, injury, or death. Sleepiness is a marker of insufficient sleep and is the major patient-reported symptom associated with disorders of sleep and wakefulness such as narcolepsy and obstructive sleep apnea. Excessive sleepiness-the inability to stay awake and alert during the major waking episodes of the day-is reported by one third of US adults. It is the position of the American Academy of Sleep Medicine that sleepiness is a critical patient-reported outcome that is associated with increased risk for adverse health effects and diminished quality of life. The evaluation and management of sleepiness is essential for patient safety and patient-centered care. The health care system must support the evaluation and management of sleepiness so that patients can experience restorative sleep and daytime alertness. More research and innovation are needed to improve the treatment of sleep-wake disorders, including studies in diverse populations that support the development of tailored therapies for daytime sleepiness.</p><p><strong>Citation: </strong>Heffron TM, Gurubhagavatula I, Trotti LM, et al. Clinical significance of sleepiness: an American Academy of Sleep Medicine position statement. <i>J Clin Sleep Med.</i> 2025;21(6):1103-1107.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1103-1107"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617744","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":"Nasal biomarker inflammatory profile in response to intranasal corticosteroids in pediatric obstructive sleep apnea syndrome.","authors":"Ambika G Chidambaram, Christopher M Cielo, Inna Chervoneva, Jonathan M Spergel, Ignacio E Tapia","doi":"10.5664/jcsm.11604","DOIUrl":"10.5664/jcsm.11604","url":null,"abstract":"<p><strong>Study objectives: </strong>Nasopharyngeal inflammation contributes to pediatric obstructive sleep apnea syndrome (OSAS). Intranasal corticosteroids (INCS) are used to treat pediatric OSAS; a randomized controlled trial showed an improvement in OSAS symptoms but without polysomnography or neurobehavioral outcome differences. There is a lack of data demonstrating an objective decrease in the nasal inflammatory biomarker profile associated with INCS. Hence, we evaluated the association of nasal inflammatory biomarker profile and response to INCS.</p><p><strong>Methods: </strong>Secondary analysis of a randomized controlled trial of INCS vs placebo in pediatric OSAS (n = 134). The difference in intranasal biomarkers (interleukin (IL)-4, IL-13, tumor necrosis factor-alpha) between the groups after 3 and 12 months was evaluated. The association of the nasal inflammatory biomarker profile and response to INCS was assessed. Multiple regression analysis was performed to identify clinical predictors of response to INCS.</p><p><strong>Results: </strong>There were no statistically significant differences in the nasal IL-4, IL-13, and tumor necrosis factor-alpha levels between INCS and placebo groups after 3 and 12 months of treatment. Within the INCS group, there was no statistically significant change in the nasal IL-4, IL-13, and tumor necrosis factor-alpha levels after 3 months of therapy based on responder status. However, among those who received INCS, obesity and a higher obstructive apnea-hypopnea index at baseline were clinical predictors of greater obstructive apnea-hypopnea index after 3 months (<i>P</i> = .038 and .002, respectively).</p><p><strong>Conclusions: </strong>INCS did not affect the nasal inflammatory biomarker profile in children with OSAS, including the responders. In addition, INCS is not recommended as a treatment option in children with obesity or high obstructive apnea-hypopnea index at baseline.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Steroids for Pediatric Apnea Research in Kids (SPARK); URL: https://clinicaltrials.gov/study/NCT02180672; Identifier: NCT02180672.</p><p><strong>Citation: </strong>Chidambaram AG, Cielo CM, Chervoneva I, Spergel JM, Tapia IE. Nasal biomarker inflammatory profile in response to intranasal corticosteroids in pediatric obstructive sleep apnea syndrome. <i>J Clin Sleep Med</i>. 2025;21(6):1033-1040.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1033-1040"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574520","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":"Measuring hypoglossal nerve stimulator outcomes.","authors":"Eric J Kezirian","doi":"10.5664/jcsm.11608","DOIUrl":"10.5664/jcsm.11608","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1143"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411383","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 effectiveness of high-flow nasal cannula therapy in comparison with continuous positive airway pressure therapy in patients with obstructive sleep apnea: an open-label randomized crossover trial.","authors":"Siraj Wali, Ghadah Batawi, Ghufran Bin Afeef, Ahmad A Bamagoos, Arwa Jamal, Omar Kanbr, Ranya Alshumrani, Faris Alhejaili, M Safwan Badr","doi":"10.5664/jcsm.11640","DOIUrl":"10.5664/jcsm.11640","url":null,"abstract":"<p><strong>Study objectives: </strong>Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea (OSA). However, its effectiveness is limited by poor long-term adherence. A few recent studies have investigated the effectiveness of high-flow nasal cannula (HFNC) in treating OSA; however, its role remains uncertain. This study aimed to determine the effectiveness of HFNC, compared with CPAP, in the treatment of patients with OSA.</p><p><strong>Methods: </strong>This prospective, open-label, randomized crossover trial was conducted on treatment-naïve, newly diagnosed patients with OSA. Participants underwent CPAP and HFNC titration studies in 1 of 2 crossover sequences. The American Academy of Sleep Medicine guidelines for CPAP titration were followed for titration of both CPAP and HFNC. The initial flow rate of HFNC was set at 10 L/min, and the flow rate was increased by 10 L/min, up to a maximum of 60 L/min, to eliminate all respiratory events.</p><p><strong>Results: </strong>Sixty-eight participants completed the study. Compared with the diagnostic polysomnography, the apnea-hypopnea index decreased by a median of 52% with HFNC therapy (18-77%, <i>P</i> value < .001). Clinically acceptable titration was observed in 48% of patients receiving HFNC therapy, whereas 53% experienced a ≥ 50% reduction in the apnea-hypopnea index. The efficacy of HFNC decreased as OSA severity increased. However, CPAP therapy provided superior control of OSA, with a lower apnea-hypopnea index (5.8 vs 16.6 events/h, <i>P</i> values < .001). Sleep architecture significantly improved with CPAP but declined with HFNC.</p><p><strong>Conclusions: </strong>HFNC serves as a viable option for patients intolerant to CPAP, although careful patient selection is essential.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Effect of High Flow Nasal Cannula Versus Continues Positive Airway Pressure in Adults With Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/study/NCT05475119; Identifier: NCT05475119.</p><p><strong>Citation: </strong>Wali S, Batawi G, Bin Afeef G, et al. The effectiveness of high-flow nasal cannula therapy in comparison with continuous positive airway pressure therapy in patients with obstructive sleep apnea: an open-label randomized crossover trial. <i>J Clin Sleep Med.</i> 2025;21(6):1023-1031.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1023-1031"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574522","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 behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea.","authors":"Elliot J Brooker, Shane A Landry, Pedro R Genta, Gabriel T Abdelmessih, Bradley A Edwards, Sean P A Drummond","doi":"10.5664/jcsm.11636","DOIUrl":"10.5664/jcsm.11636","url":null,"abstract":"<p><strong>Study objectives: </strong>Cognitive behavioral therapy for insomnia (CBT-I) improves obstructive sleep apnea (OSA) severity in comorbid insomnia and sleep apnea, though the mechanisms underlying this change are unstudied. CBT-I, which promotes sleep continuity and reduces hyperarousal, may improve OSA by raising the respiratory arousal threshold. We aimed to investigate the effect of CBT-I on OSA severity and its impact on the arousal threshold and other endotype traits.</p><p><strong>Methods: </strong>In this single-arm trial, 25 patients with comorbid insomnia and sleep apnea (13 females and 12 males, mean age [standard deviation] = 53.7 [8.7] years) completed a 7-week individual CBT-I program. Patients met diagnostic criteria for insomnia and demonstrated an apnea-hypopnea index (AHI) ≥ 10 events/h (mean AHI [standard deviation] <i>=</i> 35.2 [16.4] events/h). Overnight polysomnography before and after CBT-I measured OSA severity, sleep architecture, and the 4 OSA endotypes (ie, collapsibility, muscle compensation, loop gain, and arousal threshold).</p><p><strong>Results: </strong>There was a 7.7 ± 10.2 events/h reduction in the AHI from baseline to posttreatment (<i>P</i> = .001) but no change in any of the OSA endotype traits studied (all <i>P</i> > .05). Secondary analyses showed a relationship whereby increases in stage N3 sleep were associated with decreases in AHI (<i>r</i>² = .19, <i>P</i> = .03). Significant improvements were also found in insomnia severity and sleep diary-based sleep efficiency, sleep onset latency, and wake after sleep onset at posttreatment (all <i>P</i> < .001).</p><p><strong>Conclusions: </strong>CBT-I is beneficial in improving insomnia symptoms and we provide further support CBT-I improves OSA severity. Despite no change in the OSA endotype traits, the improvement in the AHI may be associated with increased amounts of stage N3 sleep. These results underscore the importance of managing insomnia in comorbid insomnia and sleep apnea.</p><p><strong>Clinical trial registration: </strong>Registry: Australian New Zealand Clinical Trial Registry; Name: Project COMISA (Comorbid Insomnia and obstructive Sleep Apnea): A study investigating the effect of cognitive behavioral therapy for insomnia (CBT-I) on obstructive sleep apnea severity and cognitive functioning in patients experiencing COMISA; URL: http://www.anzctr.org.au/; Identifier: ACTRN12622000226707.</p><p><strong>Citation: </strong>Brooker EJ, Landry SA, Genta PR, Abdelmessih GT, Edwards BA, Drummond SPA. Cognitive behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea. <i>J Clin Sleep Med.</i> 2025;21(6):1041-1051.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1041-1051"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617746","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":"Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy.","authors":"İbrahim Arslan, Mesut Güneş, Ömer Tarık Selçuk, Hülya Eyigör","doi":"10.5664/jcsm.11772","DOIUrl":"https://doi.org/10.5664/jcsm.11772","url":null,"abstract":"<p><strong>Study objectives: </strong>To investigate the diagnostic role of vestibular evoked myogenic potential (VEMP) in detecting potential damage to the otolithic organs and brainstem in patients with obstructive sleep apnea syndrome (OSAS) and evaluate the effect of continuous positive airway pressure (CPAP) therapy on the vestibular system through VEMP measurements.</p><p><strong>Methods: </strong>This single-center, prospective study included 51 patients with severe OSAS (102 ears) and 20 controls without OSAS (40 ears). Cervical and ocular VEMP tests were administered to both groups. For patients with OSAS, VEMP tests were repeated after three-month CPAP therapy. Pre- and post-treatment VEMP data were compared between the groups.</p><p><strong>Results: </strong>Patients with OSAS had significantly lower response rates of both ocular and cervical VEMP compared to controls (p=0.003 and p=0.027, respectively). In ocular VEMP, prolonged p1 and n1 latencies, shortened p1-n1 interpeak latencies, and decreased amplitudes were observed (p<0.0001 for all). In cervical VEMP, prolonged n1 and p1-n1 interpeak latencies and reduced amplitudes were noted (p<0.0001 for all), while no significant changes were observed in p1 latency. Significant post-treatment improvements were detected in ocular VEMP parameters, including n1 latency, p1-n1 latency, and amplitudes (p<0.0001, p=0.001, and p=0.001, respectively). Similarly, significant post-treatment improvements were observed in cervical VEMP parameters, namely n1 latency, p1-n1 latency, and amplitudes (p<0.0001, p<0.0001, and p=0.003, respectively). There was no significant change in p1 latency.</p><p><strong>Conclusions: </strong>Subclinical abnormalities in otolithic organs and the brainstem in severe OSAS could be detected early using non-invasive VEMP testing. VEMP tests also revealed that a three-month CPAP therapy ameliorated these vestibular system abnormalities.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144266","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":"Respiratory center function in patients under adaptive servoventilation: etiology and outcome.","authors":"Isabel Martinez-Gonzalez Posada, Ramon Fernandez Alvarez, Andres Ortiz Reyes, Marina Acebo Castro, Ines Ruiz Alvarez, Pablo Lozano Cuesta, Claudia Madrid Carvajal, Maria Vazquez López, Marta Garcia Clemente, Gemma Rubinos Cuadrado","doi":"10.5664/jcsm.11764","DOIUrl":"https://doi.org/10.5664/jcsm.11764","url":null,"abstract":"<p><strong>Study objectives: </strong>Central sleep apnea (CSA) is a sleep disorder characterized by instability in the respiratory center's (RC) function, leading to an excessive ventilatory response. The most effective treatment for these patients is adaptive servo-ventilation (ASV). We hypothesize that individuals with CSA may exhibit hyperresponsiveness of the RC, and ASV treatment could normalize its function. We aimed to measure the ventilatory response to hypercapnia (VRH) and its relationship with the outcomes following ASV treatment.</p><p><strong>Methods: </strong>A prospective study with repeated measurements was conducted on subjects with CSA treated with ASV. A VHR test was performed using p0.1/pEtCO₂ determinations: a first determination at the time of inclusion and a second one after at least six months of ASV treatment. We used the Pearson correlation test and the comparison of means (t-test) for independent and paired variables for statistical analysis. A p0.1/pEtCO₂ value of 0.43 cmH₂O/mmHg was considered a reference value.</p><p><strong>Results: </strong>We analyzed 46 subjects, 82% male. AHI 47/h (23), central AHI 27/h (12). The initial p0.1/pEtCO₂ was 0.48 (0.24) cmH₂O/mmHg, significantly higher than the reference value (p=0.02). After ASV treatment, 63% of subjects normalized p0.1/pEtCO₂ and decreased to 0.37 (0.23) cmH₂O/mmHg, which was significantly lower than the initial value (p=0.015) and comparable to the reference value (p=0.26). CSA secondary to opioid use has a substantially lower p0.1/pEtCO₂: 0.27 cmH₂O/mmHg SD 0.11 (p=0,021).</p><p><strong>Conclusions: </strong>VRH in patients with CSA and ASV treatment, could differentiate phenotypes and impact on therapeutic decisions.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144269","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":"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":"https://doi.org/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 Substance Act (CSA), Drug Enforcement Agency (DEA), 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 CSA, DEA, 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 DEA 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 non-opioids. The evolving role of telemedicine and e-prescriptions requires ongoing evaluation and adaptation of practices to ensure patient safety and regulatory compliance.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms associated with obstructive sleep apnea in achondroplasia.","authors":"G Dave Singh","doi":"10.5664/jcsm.11778","DOIUrl":"https://doi.org/10.5664/jcsm.11778","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121218","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":"https://doi.org/10.5664/jcsm.11734","url":null,"abstract":"<p><p>The Veterans Administration (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 (SMPO) 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 SMPO. 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, multi-center, 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 healthcare system.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}