Sleep & breathing = Schlaf & Atmung最新文献

{"title":"Pre-stroke sleep symptoms and neurological outcomes after stroke: an exploratory secondary analysis of two prospective cohorts.","authors":"Bilal Benomar, Sofie Amalie Simonsen, Helle Klingenberg Iversen, Poul Jørgen Jennum, Anders Sode West","doi":"10.1007/s11325-026-03817-6","DOIUrl":"10.1007/s11325-026-03817-6","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances before stroke have been associated with stroke risk and severity, but the relationships between habitual pre-stroke sleep symptoms and subsequent neurological and functional outcomes remain unclear. We examined associations between self-reported pre-stroke sleep symptoms and stroke outcomes at admission and follow-up.</p><p><strong>Methods: </strong>This exploratory secondary analysis included data from two prospective stroke cohorts conducted at Copenhagen University Hospital Rigshospitalet, Denmark. Adults with ischaemic stroke or intracerebral haemorrhage who completed a 16-item sleep questionnaire at admission and follow-up were included. Regression models were adjusted for age, sex, previous stroke or transient ischaemic attack, and depression; follow-up models were additionally adjusted for the corresponding admission outcome.</p><p><strong>Results: </strong>Among 133 participants, the median age was 70 years, 36.8% were women, and 90.2% had ischaemic stroke. Median follow-up was 167 days. Pre-stroke unintended leg movements during sleep, sleep-maintenance insomnia, and nocturia were associated with higher follow-up NIHSS (adjusted β 1.27, 95% confidence interval [CI] 0.41-2.12; β 0.93, 95% CI 0.21-1.66; and β 0.98, 95% CI 0.25-1.72, respectively). Hypnagogic hallucinations were associated with higher admission NIHSS (adjusted β 2.22, 95% CI 0.61-3.83), lower admission BI (adjusted β -17.83, 95% CI -27.98 to -7.69), NIHSS > 4 (adjusted odds ratio 3.06, 95% CI 1.40-6.67), and BI < 80 (adjusted odds ratio 2.18, 95% CI 1.03-4.65).</p><p><strong>Conclusion: </strong>Several self-reported pre-stroke sleep symptoms were associated with neurological and functional outcomes after stroke. These pre-stroke symptoms may identify vulnerability phenotypes warranting further investigation.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnea severity associates with reduced phase-lag index functional connectivity during N2 sleep.","authors":"Hyunjo Lee, Eunmi Lee","doi":"10.1007/s11325-026-03822-9","DOIUrl":"10.1007/s11325-026-03822-9","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is increasingly recognized as a risk factor for cognitive impairment and dementia. We investigated stage- and frequency-specific associations between OSA severity and both conventional spectral measures and phase-lag index (PLI)-based functional connectivity.</p><p><strong>Methods: </strong>We retrospectively analyzed polysomnography data from 50 patients (mean age 51.7 ± 14.3 years, 70% male) diagnosed with OSA or primary snoring. Six-channel EEG data were analyzed using conventional spectral power ratios (alpha+beta/theta+delta) and PLI-based functional connectivity across delta, theta, alpha, and beta bands. Pearson correlations assessed associations between apnea-hypopnea index (AHI) and EEG parameters across wakefulness, N2 sleep, and REM sleep.</p><p><strong>Results: </strong>Median AHI was 25.7 [IQR: 7.2-48.3]. Conventional spectral measures showed no significant AHI correlations in any sleep stage. PLI analysis revealed stage- and frequency-specific associations: during N2 sleep, AHI negatively correlated with delta-band PLI (r = -0.335, 95% CI -0.588 to -0.021, p = 0.037) and theta-band PLI (r = -0.326, 95% CI -0.582 to -0.012, p = 0.043). No significant associations were observed during wakefulness or REM sleep.</p><p><strong>Conclusion: </strong>Functional connectivity analysis identified stage-specific associations with OSA severity that were not observed with conventional spectral measures, suggesting that PLI-based connectivity may provide complementary information on OSA-related neural network alterations.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preceding night sleep time and multiple sleep latency test outcomes.","authors":"Nicholas T Vozoris, Jenna Sykes, Clodagh M Ryan","doi":"10.1007/s11325-026-03818-5","DOIUrl":"10.1007/s11325-026-03818-5","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence supporting how much sleep the night before a multiple sleep latency test (MSLT) is required to generate valid results is lacking. We evaluated the association between preceding night total sleep time (TST) and next-day MSLT outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed MSLT and preceding overnight diagnostic polysomnogram (PSG) data from January 1, 2008 until December 31, 2018 from St. Michael's Hospital (Toronto, Ontario, Canada). TST on the preceding overnight PSG was categorized as follows: ≥7.0 h vs. 6.00-6.99 h vs. 5.00-5.99 h vs. ≤5.00 h. Descriptive statistics at the univariate level were largely used.</p><p><strong>Results: </strong>A total of 141 persons underwent MSLT and they were distributed as follows by preceding overnight PSG TST category: ≥7.0 h: 24.8%; 6.00-6.99 h: 44.7%; 5.00-5.99 h: 20.6%; and, ≤ 5.00 h: 9.9%. In association with progressively longer TST on preceding overnight PSG, there were significant trends towards lower mean sleep onset latency (≥ 7.0 h: 8.22 min, 6.00-6.99 h: 8.93 min, 5.00-5.99 h: 11.12 min, ≤ 5.00 h: 9.82 min, p = 0.02) and greater frequency of severe sleepiness (≥ 7.0 h: 37.1%, 6.00-6.99 h: 20.6%, 5.00-5.99 h: 13.8%, ≤ 5.00 h: 7.1%, p = 0.008) on MSLT. No significant associations were observed between TST category and proportion fulfilling MSLT criteria for narcolepsy or idiopathic hypersomnia.</p><p><strong>Conclusions: </strong>Our exploratory study did not demonstrate significantly increased markers of hypersomnia on MSLT among persons acquiring a TST < 6.00 h the night prior to testing, potentially supporting that MSLT results following a night with a TST < 6.00 h can be considered and not disregarded.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the diagnosis and treatment of obstructive sleep apnea in 15 francophone Sub-Saharan African countries: A multicountry survey.","authors":"Abdoul Risgou Ouédraogo, Stéphane Tété Amento Adambounou, Massongo Massongo, Prudence Ablo Wachinou, Bénédicte Boka, Ulrich Davy Kombila, Khadidia Ouattara, Ghislain Bougma, Innocent Murhula Kashongwe, Fatimata Mbaye, Serge Sênan Ade, Abdoulaye Ahmet, Assiatou Issoufou Gagara, Boubacar Djelo Diallo, Med Lemine Sidi Oumar, Olivia Dotar Mbitikon, Akouvi Mawussé Ako, Esthel Lee Presley Bemba, Eric Walter Pefura Yone, Alexandre Boko Kouassi","doi":"10.1007/s11325-026-03816-7","DOIUrl":"10.1007/s11325-026-03816-7","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnoea (OSA) is underdiagnosed and undertreated in low-resource settings. This study aimed to comprehensively assess the availability, accessibility, and affordability of diagnostic and therapeutic resources for OSA across 15 francophone sub-Saharan African (FSSA) countries.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from October to December 2025 under the coordination of the Société Africaine de Pneumologie de Langue Française (SAPLF). National experts from 15 countries were purposefully selected through the SAPLF network and completed a standardized questionnaire covering infrastructure, costs, workforce, insurance coverage, and perceived barriers. Quantitative data were analyzed descriptively; qualitative responses were analyzed thematically.</p><p><strong>Results: </strong>Polysomnography (PSG) was available in 6/15 countries (40%) and respiratory polygraphy (RP) in 13/15 (86.7%), primarily concentrated in capital cities and private centers. Diagnostic costs were prohibitive: PSG ranged from €221-686 and RP from €69-259, often exceeding the statutory monthly minimum wage (SMW). Continuous positive airway pressure (CPAP) devices were available in 8/15 countries (53.3%) and mandibular advancement devices (MAD) in 5/15 (33.3%), with costs ranging from €381-3,812 and €38-305, respectively. Insurance coverage for CPAP was partial and reported in only three countries. The density of trained practitioners was critically low, with most countries reporting fewer than two per million inhabitants.</p><p><strong>Conclusion: </strong>OSA care in francophone sub-Saharan Africa is constrained by centralised diagnostic capacity, prohibitive costs, and a shortage of trained providers. Strengthening training, reducing financial barriers, and integrating sleep medicine into non-communicable disease strategies may improve equity in access.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of clear aligner-based expansion screw and nickel-titanium palatal expander on airway dimensions and sleep parameters in unilateral cleft lip and palate patients: a randomized clinical trial.","authors":"Riddhi Bansal, Puneet Batra, Nikita Mohelay, Aditya Talwar, Ashish Kumar Singh","doi":"10.1007/s11325-026-03806-9","DOIUrl":"10.1007/s11325-026-03806-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the outcomes of clear aligner-based expansion screw (CAE) and nickel-titanium palatal expanders in mixed dentition patients with elevated sleep questionnaire scores.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted on 24 UCLP patients presenting with transverse maxillary deficiency and elevated sleep questionnaire scores. Participants were allocated to treatment with either CAE or NiTi palatal expander. Cone-beam computed tomography (CBCT) and polysomnography (PSG) were performed before and after expansion. Changes in airway volume and sleep parameters were assessed. Correlation analyses were conducted to determine associations between expansion characteristics and airway or PSG outcomes.</p><p><strong>Results: </strong>Pre- and post-expansion Cone-Beam Computed Tomography (CBCT) and polysomnography (PSG) showed that both modalities significantly improved pharyngeal airway volume and sleep parameters. Both groups demonstrated significant improvements in pharyngeal airway volume and PSG parameters. CBCT-based transverse measurements confirmed significant increases in intercanine width, intermolar width, basal bone width, and buccal tipping of molar in both groups, with group1 showing significantly greater gains in intercanine and intermolar width than group 2. Correlation analysis revealed statistically significant positive correlations between the change in intercanine width and increases in nasopharyngeal, oropharyngeal, and total pharyngeal airway volume, and between the change in intermolar width and oropharyngeal airway volume; no significant correlations were observed for J-J' width, basal bone width, or buccal tipping of molar with airway or PSG parameters. A statistically significant negative correlation was observed between skeletal expansion and Δ minimum SpO₂ in the NiTi group.</p><p><strong>Conclusion: </strong>Both CAE and NiTi palatal expanders significantly improved airway dimensions and sleep parameters in UCLP patients. Anterior transverse widening (intercanine and intermolar width) correlated positively with airway volume gains, whereas basal skeletal widening (J-J' width, basal bone width) and molar inclination did not, suggesting that the overall expansion effect rather than its mechanistic subtype may be the primary driver of functional benefit. Both appliances demonstrated comparable clinical effectiveness.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maxillomandibular atresia on the response to mandibular advancement devices in obstructive sleep apnea: a scoping review.","authors":"Izabella P Manetta, Bruno B Duarte, Michel B Cahali","doi":"10.1007/s11325-026-03783-z","DOIUrl":"10.1007/s11325-026-03783-z","url":null,"abstract":"<p><strong>Purpose: </strong>To map the existing evidence on the impact of transverse craniofacial alterations on mandibular advancement device treatment outcomes in adults with obstructive sleep apnea, with the objective of identifying knowledge gaps and informing future research and clinical decision-making.</p><p><strong>Methods: </strong>A systematic literature search was conducted in six databases. Additionally, gray literature sources were searched, and clinical trial registries, including ClinicalTrials.gov, were screened for RCT protocols. The reference lists of all included sources of evidence were also screened, and experts in the field were consulted.</p><p><strong>Results: </strong>The literature search yielded a total of 1,508 references after duplicate removal. Nine studies and one conference report were found eligible for inclusion. The literature demonstrated heterogeneous associations between transverse craniofacial characteristics and mandibular advancement device treatment outcomes. Most studies (n = 7) did not identify significant associations between isolated transverse craniofacial measurements and treatment response. Greater mandibular transverse dimensions were associated with better therapeutic outcomes in two studies, whereas one study reported better treatment response in individuals with smaller mandibular transverse dimensions. Reduced maxillary width and unfavorable anatomical balance were more frequently associated with greater obstructive sleep apnea severity or poorer treatment outcomes.</p><p><strong>Conclusions: </strong>While some studies suggest that the response to mandibular advancement devices in obstructive sleep apnea is associated with transverse mandibular dimensions, most investigations have not identified this relationship. Future standardized and well-designed studies are needed to clarify the influence of this anatomical characteristic on the outcomes of this common treatment for obstructive sleep apnea.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and impact of sleep disorders in patients with hereditary angioedema: A multicenter cross-sectional study in Latin America.","authors":"Ivan Cherrez-Ojeda, Thomas Rott, Karla Robles-Velasco, Ileana María Madrigal Beas, Sandra Nieto-Martinez, María Margarita Olivares, Gonzalo Chorzepa, Oscar Calderon, Juan José Matta Campos, Blanca Maria Morfin-Maciel, Guillermo Guidos, German Dario Ramón, Dario Josviack, Nora Alarcon Cedeño, Gabriela Rodas-Valero, Marco Faytong-Haro, Jonathan A Bernstein, Markus Magerl, Henriette Farkas, Leonie Herzog, Thomas Buttgereit","doi":"10.1007/s11325-026-03815-8","DOIUrl":"10.1007/s11325-026-03815-8","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) is a rare disease characterized by recurrent swelling episodes that may affect sleep and quality of life. Because data on sleep disorders in Latin American patients with HAE are limited, we assessed their prevalence and clinical correlates using structured sleep and HAE patient-reported outcome measures.</p><p><strong>Objective: </strong>To assess the prevalence/impact of sleep disorders in HAE patients using validated tools.</p><p><strong>Methods: </strong>This cross-sectional, multicenter online survey included adult patients (> = 18 years) with clinician-confirmed HAE from 13 reference centers in five Latin American countries. Data were collected between August and December 2023. Sleep was assessed using the Global Sleep Assessment Questionnaire (GSAQ), SATED scale, and STOP-Bang; HAE was assessed using the Hereditary Angioedema Activity Score (HAE-AS), Angioedema Control Test (AECT), and Angioedema Quality of Life questionnaire (AE-QoL). Logistic regression models were adjusted for age, sex, and BMI.</p><p><strong>Results: </strong>The final analytic sample included 139 participants. Most patients had HAE-C1INH type 1 (64.0%) and were female (68.4%). Only 6.5% had good sleep health, and the mean SATED score was 5.46 (1.87). Insomnia was reported by 54.0% of participants, and 34.5% had STOP-Bang moderate-to-high OSA risk. In age-, sex-, and BMI-adjusted models, severe HAE activity was associated with higher odds of insomnia (OR = 2.62, 95% CI: 1.28-5.35, P = 0.008), RLS/PLMD (OR = 5.85, 95% CI: 1.59-21.62, P = 0.008), and STOP-Bang moderate-to-high OSA risk (OR = 2.37, 95% CI: 1.01-5.55, P = 0.047). Higher AE-QoL fatigue/mood and fears/shame scores were associated with several sleep outcomes. AECT control status did not show a consistent independent association after simultaneous adjustment.</p><p><strong>Conclusion: </strong>In this exploratory cross-sectional study, HAE activity and quality-of-life impairment were associated with several sleep outcomes. Targeted sleep screening may be useful in HAE care pathways if these associations are confirmed in prospective studies.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between chronotype preference and sleep characteristics in insomnia patients.","authors":"Yi Wang, Menglong Dong, Xianchao Zhao, Jiafeng Ren, Liping Zhang, Mengmeng Fan, Zhifeng Lin, Yiqing Yang, Qi Wu, Jin-Xiang Cheng, Changjun Su","doi":"10.1007/s11325-026-03814-9","DOIUrl":"10.1007/s11325-026-03814-9","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between chronotype preference and subjective sleep perception, objective sleep parameters, rest-activity rhythms (RAR), as well as light exposure rhythms (LER) in insomnia patients remains insufficiently clarified. This study aimed to explore the differences in nocturnal and diurnal sleep characteristics, RAR and LER between morning-type and intermediate-type insomnia patients, and to screen subjective and objective influencing factors associated with chronotype preference.</p><p><strong>Methods: </strong>A total of 62 enrolled insomnia patients were divided into morning-type and intermediate-type groups according to the Morningness-Eveningness Questionnaire (MEQ). All participants completed relevant subjective scales including the Sleep Hygiene Practice Scale (SHPS) and underwent 7-day continuous wrist actigraphy monitoring. RAR and LER non-parametric indicators were calculated via R software. Group differences in demographic data, subjective sleep scales, and actigraphy-derived nocturnal and diurnal variables were compared, and multivariate linear regression was performed to identify predictors of MEQ scores.</p><p><strong>Results: </strong>Compared with intermediate-type patients, morning-type insomnia patients were significantly older, with poorer subjective sleep quality and more irrational sleep beliefs, and showed higher daytime rhythm stability and more regular activity patterns (all P < 0.05). No significant inter-group differences were observed in most objective sleep parameters. Multivariate linear regression analysis confirmed that SHPS score and the timing of the most active 10 h (M10) were independent influencing factors of chronotype preference.</p><p><strong>Conclusions: </strong>Chronotype preference is closely correlated with age, subjective sleep perception, sleep hygiene level and rest-activity rhythm characteristics. Attention should be paid to individual chronotype characteristics in clinical insomnia management, optimizing sleep hygiene and regulating daily activity rhythm patterns may help improve sleep status in insomnia patients.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of obstructive sleep apnea on skin wound healing - from preclinical perspective to clinical evidence: A narrative review.","authors":"Łukasz Mazurek, Ewa Migacz, Marek Konop, Wojciech Kukwa","doi":"10.1007/s11325-026-03804-x","DOIUrl":"10.1007/s11325-026-03804-x","url":null,"abstract":"<p><strong>Purpose: </strong>Adequate tissue oxygenation is essential for effective skin wound healing. Hypoxia contributes to impaired healing and chronic wound formation. Obstructive sleep apnea (OSA) affects nearly one billion adults worldwide, and up to 80% of cases remain undiagnosed. OSA causes intermittent hypoxia (IH), with repetitive cycles of oxygen desaturation and reoxygenation during sleep. The molecular pathways activated by IH differ from those induced by acute and chronic hypoxia. We propose that OSA may contribute to impaired wound healing in two ways. Indirectly, by promoting comorbidities such as diabetes, hypertension, and obesity. Directly, through IH and its effects at the cellular and tissue level.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, and Web of Science were searched through August 2026 for preclinical and clinical studies on OSA, IH, and wound healing.</p><p><strong>Results: </strong>To our knowledge, this is the first review to integrate cellular mechanisms, preclinical evidence, and clinical data on this topic. We describe the IH-driven mechanisms that may contribute to impaired wound healing, including reduced antioxidant capacity, sustained inflammation, sympathetic activation, and endothelial dysfunction. Preclinical evidence is limited and mostly derives from in vitro scratch assays. It shows that IH delays wound closure, downregulates HIF-2α and VEGF, and shifts macrophages toward a pro-inflammatory phenotype. Clinical data are also limited and heterogeneous. In diabetic foot ulcers, high OSA risk doubled the risk of poor healing. Improved ulcer healing after CPAP has been described only in a small case series.</p><p><strong>Conclusion: </strong>Given its high prevalence and underdiagnosis, OSA may be an overlooked and potentially modifiable factor in impaired wound healing.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxic burden reduction after lateral pharyngoplasty in patients with obstructive sleep apnea: Beyond the apnea-hypopnea index.","authors":"André Luís Pereira Vieira, Bruno Bernardo Duarte, Aurelio Rochael Almeida, Mário Edvin Greters, Vânia Aparecida Leandro-Merhi, José Luís Braga de Aquino","doi":"10.1007/s11325-026-03808-7","DOIUrl":"10.1007/s11325-026-03808-7","url":null,"abstract":"<p><strong>Purpose: </strong>The apnea-hypopnea index (AHI), traditionally used to assess obstructive sleep apnea (OSA) severity and surgical outcomes, has limitations in reflecting cardiovascular risk and pathophysiological burden. Although lateral pharyngoplasty has demonstrated favorable outcomes regarding AHI reduction, its impact on hypoxic burden (HB) remains unknown. This study evaluated HB changes after lateral pharyngoplasty in patients with OSA, including those classified as surgical failures according to Sher's criteria.</p><p><strong>Methods: </strong>This observational, longitudinal study with a mixed retrospective and prospective design included 27 adults with OSA who underwent lateral pharyngoplasty (version 6) between 2016 and 2025, with complete preoperative and postoperative polysomnographic data for HB assessment. HB was calculated using validated commercial software. Nonparametric tests were used for intra- and intergroup comparisons. Surgical success was defined according to Sher's criteria.</p><p><strong>Results: </strong>A significant reduction in HB was observed across all variants: total sleep time (median from 97.1%·min/h to 35.0%·min/h, p < 0.0001), REM sleep, NREM sleep, and supine and non-supine positions, with a significant reduction in median AHI (median from 33.8 to 12.3 events/h, p < 0.0001). Even among surgical failures according to Sher's criteria, HB decreased significantly (median from 102.5%·min/h to 67.3%·min/h, p = 0.0107), suggesting pathophysiological improvement not captured by AHI alone.</p><p><strong>Conclusion: </strong>HB is a potentially more sensitive metric to assess therapeutic response in OSA, incorporating multiple dimensions of nocturnal hypoxemia beyond AHI. Lateral pharyngoplasty promoted consistent HB reduction, including in surgical failures, supporting HB as a complementary tool for therapeutic evaluation, with potential applications in cardiovascular risk stratification.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}