Frontiers in sleep最新文献

{"title":"Correction: Seafarer Fatigue: a qualitative study of customer-facing staff working on UK ferries.","authors":"","doi":"10.3389/frsle.2026.1993629","DOIUrl":"https://doi.org/10.3389/frsle.2026.1993629","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frsle.2026.1906714.].</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1993629"},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186531","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":"Homeopathy for the treatment of insomnia: a systematic review and meta-analysis.","authors":"Abhijit Dutta, Dewan Md Sumsuzzman, Daniel Wrzałko, Robbert van Haselen, Petra Weiermayer, Katharina Gaertner, J A D S Lakshani, Sabine Klein, Stephan Baumgartner, Martin Loef","doi":"10.3389/frsle.2026.1922807","DOIUrl":"10.3389/frsle.2026.1922807","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is a prevalent disorder associated with substantial impairment. Homeopathy has been proposed as a complementary treatment for insomnia, but its clinical effects remain uncertain. This systematic review assessed the efficacy, effectiveness, and safety of homeopathic treatments for insomnia.</p><p><strong>Methods: </strong>Prospective comparative studies evaluating any homeopathic preparation for insomnia were included. Searches in MEDLINE, EMBASE, seven additional databases, and three trial registries were conducted through August 2025. Risk of bias, intervention complexity, model validity, and pragmatism were assessed using respectively RoB 2, ROBINS-I, iCAT, MVHT, and RITES. Data were synthesized using random-effects meta-analyses, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Eight randomized controlled trials (RCTs; <i>n</i> = 364 participants) and four non-randomized studies on interventions (NRSIs; n = 517) met the inclusion criteria. In adults, sleep quality (MD = -2.6 points; 95% CI -5.5 to 0.26; low certainty) and insomnia severity (MD = -3.2; 95% CI -5.68 to -0.72, moderate certainty) were reported in one RCT each. For total sleep time, the pooled MD of three RCTs was 0.65 hours (95% CI -0.9 to 2.2; low certainty). In children, one open-label RCT suggested a difference in insomnia severity, but certainty of evidence was very low. Adverse events were rarely reported, resulting in low certainty evidence.</p><p><strong>Conclusions: </strong>The current evidence is mainly limited by imprecision and risk of bias. The available evidence does not allow firm conclusions regarding the effects of homeopathy for insomnia. High-quality, replicated trials with systematic adverse-event monitoring are needed.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1922807"},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167813","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":"Chronic pain in narcolepsy reflects interacting neurobiological and psychological mechanisms: a mini-review.","authors":"Maria Munch-Menzer, Birgitte Rahbek Kornum","doi":"10.3389/frsle.2026.1930803","DOIUrl":"https://doi.org/10.3389/frsle.2026.1930803","url":null,"abstract":"<p><p>Chronic pain prevalence is increased in the sleep disorder narcolepsy, but the underlying reason for this remains debated. This mini review summarizes and discusses current evidence on links between narcolepsy type 1 (NT1) and type 2 (NT2) and chronic pain, exploring whether pain is best understood as a consequence of the pathophysiology or secondary to its manifestations and comorbidities. Registry-based and self-reported data indicate a high prevalence of chronic pain in NT1, while objective pain tests show inconsistent differences between NT1 and healthy individuals. This discrepancy suggests involvement of secondary mechanisms not readily captured by experimental pain testing. Comparable pain prevalence in NT1 and NT2 also speaks against orexin deficiency as a sole driver of chronic pain in NT1. Alternatively, altered dopaminergic signaling downstream of orexin could be a shared contributor to pain in NT1 and other fatigue-related conditions. Finally, the presence of activating autoantibodies in NT1 suggests a possible immune-mediated component for some patients. Overall, chronic pain is highly prevalent in both NT1 and NT2. It likely arises from a combination of neurobiological and psychological factors, with immune mechanisms as a possible additional contributor, rather than, in NT1, orexin dysfunction alone. This perspective highlights the clinical need for more holistic treatment approaches and for future studies with improved case-control matching, larger NT1 samples, especially among patients with chronic pain, and more detailed comparisons with NT2.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1930803"},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170293","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 of a stellate ganglion block-based care pathway with hypnotic medication reduction in chronic insomnia with anxiety symptoms: a real-world retrospective cohort study.","authors":"Dongze Wang, Xiaohan Wang, Wenyuan Wang, Yanyong Wang","doi":"10.3389/frsle.2026.1923070","DOIUrl":"https://doi.org/10.3389/frsle.2026.1923070","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic insomnia with anxiety symptoms is frequently accompanied by sustained hypnotic or sedative medication use. Evidence regarding procedure-based adjuncts to structured medication reduction remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate whether participation in a stellate ganglion block (SGB)-based care pathway, compared with contemporaneous routine care without SGB, was associated with hypnotic or sedative medication reduction at 1 month.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort study screened 420 records from 1 January 2022 to 31 December 2025 and included 160 adults with chronic insomnia, anxiety symptoms, and baseline hypnotic or sedative use. Eighty patients received a standardized four-session SGB-based pathway and 80 routine-care controls were selected by outcome-blinded, 1:1 calendar-time risk-set sampling without replacement. The pragmatic 1 month composite outcome was achievement of at least one of the following: a ≥50% reduction in the exploratory operational medication-burden score, transition from combination therapy to monotherapy, or complete discontinuation maintained for ≥2 weeks. Components and class-specific benzodiazepine and Z-drug outcomes were analyzed separately. The primary adjusted model was restricted to age, sex, baseline operational burden, and baseline medication count. Robust Poisson, Firth logistic, marginal standardization, bootstrap, propensity-score matching, overlap weighting, and trimmed stabilized inverse probability weighting were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The composite outcome occurred in 32/80 patients (40.0%) in the SGB-based pathway group and 12/80 (15.0%) under routine care (crude risk difference, 25.0 percentage points; 95% CI, 11.7-38.3; crude RR, 2.67; 95% CI, 1.48-4.79). The core robust Poisson model yielded an adjusted RR of 2.43 (95% CI, 1.32-4.46), and marginal standardization yielded adjusted risks of 38.0% vs. 16.7% and an adjusted risk difference of 21.3 percentage points (95% CI, 8.9-32.3). The association was primarily driven by ≥50% operational-burden reduction (33.8% vs. 11.2%; adjusted RR, 2.77; 95% CI, 1.34-5.75). Transition to monotherapy and complete discontinuation were numerically more frequent but imprecisely estimated. Class-specific analyses supported an association with ≥50% benzodiazepine dose reduction; Z-drug analyses were directionally similar but less precise. Three month maintained response remained more frequent after conservative and censoring-weighted analyses. Fifteen of 80 SGB-treated patients had a recorded procedure-related event; no serious event was recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Participation in an SGB-based care pathway was associated with a higher probability of short-term medication reduction, particularly substantial dose reduction, but evidence for complete discontinuation was inconclusive. Because treatment allocation and co-interventions were nonrand","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1923070"},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170363","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":"Artificial intelligence for sleep-disordered breathing: a taxonomy of methods, data modalities, and clinical applications.","authors":"Tai Dinh, Daniil Lisik, Philippe Fournier-Viger, Dat Tran, Philip S Yu, Huynh Van Hong, Ding Zou","doi":"10.3389/frsle.2026.1927453","DOIUrl":"https://doi.org/10.3389/frsle.2026.1927453","url":null,"abstract":"<p><p>Sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), is a highly prevalent group of disorders associated with disrupted sleep, intermittent hypoxemia, excessive daytime sleepiness, neurocognitive impairment, and cardiometabolic morbidity. Although laboratory polysomnography remains central to diagnosis, conventional sleep testing can be costly, labor-intensive, and difficult to scale. Recent advances in data mining, machine learning, deep learning, wearable sensing, mobile health, multimodal analytics, and large language models are creating new opportunities for more accessible, personalized, and efficient SDB care. This review examines recent advances in artificial intelligence for SDB diagnosis and management, with emphasis on polysomnography and home sleep apnea testing, wearable and contactless screening, audio and physiological-signal analysis, imaging and anatomical risk prediction, phenotyping and endotyping, treatment monitoring, continuous positive airway pressure adherence, and clinically deployable explainable AI. We also discuss the emerging role of large language models in patient education, sleep-report summarization, clinical documentation, and decision-support workflows. Finally, we identify major challenges related to data heterogeneity, external validation, interpretability, privacy, fairness, reproducibility, regulation, and real-world integration into sleep medicine. This review aims to provide an evidence-based framework for researchers and clinicians to understand current AI applications and identify future directions for precision diagnosis and management of SDB.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1927453"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119417","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 meeting sleep guidelines and anxiety symptoms among Physician assistants in Ghana: a cross-sectional study.","authors":"Richard Armah Danyi, Patrick Kwame Akwaboah","doi":"10.3389/frsle.2026.1928518","DOIUrl":"https://doi.org/10.3389/frsle.2026.1928518","url":null,"abstract":"<p><strong>Background: </strong>Sleep is an important determinant of mental health, yet evidence among healthcare professionals in sub-Saharan Africa remains limited. This study examined the association between adherence to recommended sleep duration guidelines and anxiety symptoms among Physician Assistants in Ghana.</p><p><strong>Methods: </strong>We conducted a secondary analysis of primary data collected from 439 Physician Assistants in Ghana between October and December 2024. Anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), with scores ≥8 indicating anxiety symptoms. Sleep duration was self-reported and categorized as meeting (7-9 h/night) or not meeting (< 7 h/night) recommended sleep guidelines. Multivariable logistic regression was used to examine associations while adjusting for sociodemographic, behavioral, environmental, and climatic factors.</p><p><strong>Results: </strong>Overall, 31.9% of participants met the recommended sleep duration guideline, while 23.5% reported anxiety symptoms. In adjusted analyses, meeting the recommended sleep guidelines (aOR = 0.45, 95% <i>CI</i>: 0.26-0.78) was associated with lower odds of anxiety symptoms. This was confirmed in a sensitivity analysis of sleep duration (hours/day) and anxiety symptoms scores (β = -0.69, 95% CI: -1.01, -0.38). Conversely, practicing in urban settings was associated with higher odds of anxiety symptoms (aOR = 2.17, 95% CI: 1.13-4.16).</p><p><strong>Conclusions: </strong>Adequate sleep may be an important modifiable factor associated with mental health among Physician Assistants in Ghana. Efforts to support healthy sleep behaviors and create supportive environments may contribute to improved mental health among this population. Future research should include diverse cadres of healthcare professionals and consider a 24-h movement behavior approach.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1928518"},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119465","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":"Sex-associated circadian signaling signatures in the lateral hypothalamus.","authors":"Sara K Pintwala, Patrick M Fuller","doi":"10.3389/frsle.2026.1895831","DOIUrl":"https://doi.org/10.3389/frsle.2026.1895831","url":null,"abstract":"<p><strong>Introduction: </strong>The lateral hypothalamus (LH) is a central integrative hub coordinating arousal, feeding, metabolism, stress responsiveness, and sleep-wake state transitions. These functions are not static across the 24-hour cycle, but instead are dynamically gated according to circadian phase and internal physiological state. Although sex differences have been documented across many homeostatic and behavioral domains linked to LH function, the molecular substrates underlying these differences within defined LH neuronal populations remain poorly understood.</p><p><strong>Methods: </strong>Here, using single-nucleus RNA sequencing, we examined the expression patterns of core clock genes and circadian signaling-associated pathways across transcriptionally resolved populations of female- and male-derived LH neurons.</p><p><strong>Results: </strong>While the overall cellular architecture of the LH was highly conserved between sexes, we identified distributed and cell-type-specific differences in the expression of genes associated with intrinsic circadian regulation and sensitivity to canonical circadian neuromodulatory pathways, including vasoactive intestinal peptide, arginine vasopressin, neuromedin signaling, and melatonin receptors. These differences were observed across glutamatergic, GABAergic, orexinergic, and melanin-concentrating hormone-associated neuronal populations, suggesting that female and male LH circuits may differentially integrate temporal and physiological information despite preserving shared cellular organization.</p><p><strong>Discussion: </strong>Rather than indicating sex-specific neuron classes, our findings support a model in which subtle but coordinated shifts in molecular signaling architectures are linked to female- and male-derived LH neurons. These data provide a framework for understanding how temporal regulation of competing homeostatic drives may differ between sexes and underscore the importance of incorporating sex as a biological variable in transcriptomic analyses of hypothalamic circuits.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1895831"},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119473","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":"Sleep medicine in Saudi Arabia: evolution, current landscape, and future directions a state-of-the-art review with an embedded health-services analysis of Ministry of Health sleep centers, 2022 to 2025.","authors":"Mana Alshahrani, Ashah Jman, Abdallah Alsoheimi, Salim Baharoon","doi":"10.3389/frsle.2026.1941767","DOIUrl":"10.3389/frsle.2026.1941767","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sleep medicine in Saudi Arabia has developed from a single academic laboratory in the late 1990s into an emerging national service. That development has played out against a heavy and still under-recognized burden of obstructive sleep apnea (OSA), low public awareness, and rising national attention to prevention, access, road safety, and value-based care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe the evolution and current landscape of sleep medicine in Saudi Arabia, document the Ministry of Health (MOH) National Sleep Medicine Program delivered during 2022 to 2025, and interpret remaining service gaps against Vision 2030 priorities and international benchmarks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a state-of-the-art narrative review and an ecological health-services analysis of routinely collected MOH cluster sleep-center returns. The operational dataset included 26 cluster-year observations across eight clusters and 41 standardized indicators. We summarized trends using counts, proportions, population-adjusted rates, and the compound annual growth rate (CAGR) defined as (ending value / beginning value)&lt;sup&gt;∧&lt;/sup&gt;(1/years) minus 1. Spearman rank correlations explored associations between infrastructure, workforce, and output, with ties handled by mid-rank assignment. A capacity-to-demand gap model estimated annual diagnostic need under base-case and sensitivity scenarios. Program milestones were triangulated against MOH documents, Saudi Commission for Health Specialties (SCFHS) records, Saudi epidemiologic studies, AASM standards, and WHO and OECD reports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Active MOH sleep centers grew from five to eight between 2022 and 2025. PSG bed capacity rose from 8 to 20 (CAGR 35.7%), and annual sleep-study output increased from 2,290 to 5,851 (CAGR 36.7%). Pediatric in-lab PSG accounted for 557 studies in 2025, or 17% of in-lab activity. Workforce growth lagged infrastructure (CAGR 14.9%); MOH sleep-physician density reached 0.42 per million served population, far below reported international ratios. The Program delivered a national master plan, a Virtual Health Hospital sleep clinic, a readiness manual, MOH classification of eight centers, public- and private-sector regulatory frameworks, a traffic-safety proposal, public-awareness activity, and a national training workshop. Under the base case (12% adult OSA prevalence, 65% adult-population fraction, 5% annual diagnostic capture), the MOH network met about 4% of estimated annual need; sensitivity scenarios produced a coverage range of roughly 3 to 11%. The CPAP backlog-to-fulfillment ratio was 7:1, and PSG wait times varied 68-fold across centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Saudi sleep medicine has moved quickly from an academic subspecialty to a nationally organized service. The next phase should shift from infrastructure expansion alone to a learning health-system model built around a national sleep registry, workfor","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1941767"},"PeriodicalIF":2.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082865","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":"Responsiveness of ThymoDream^® as a natural modulator of the circadian axis: a comparative RCT with melatonin supplementation employing melatonin profiling and actigraphy.","authors":"C S Harshith, Thomas V Jestin, Das S Syam, Prabhakaran Prathibha, Nithyanandam Allimuthu, N Abhirami, A Radhika, I M Krishnakumar, Janeesh Plakkal Ayyappan","doi":"10.3389/frsle.2026.1879110","DOIUrl":"https://doi.org/10.3389/frsle.2026.1879110","url":null,"abstract":"<p><strong>Introduction: </strong>Non-restorative sleep is frequently associated with disturbances in circadian regulation, impaired sleep quality, and reduced daytime functioning.</p><p><strong>Methods: </strong>This randomized, double-blind, active-controlled, cross over study compared black cumin oil extract (TD; 200 mg) with synthetic melatonin (s-Mel; 5 mg/day) in 24 individuals with non-restorative sleep. Participants received each intervention for 7 nights separated by a 7-day washout period. Plasma melatonin was measured at fixed nighttime intervals under dim light to determine dim-light melatonin onset (DLMO), while sleep parameters were assessed using actigraphy. DLMO serves as an important physiological marker of circadian timing. Daytime sleepiness was evaluated with the Epworth Sleepiness Scale (ESS).</p><p><strong>Results: </strong>Both interventions significantly increased nocturnal plasma melatonin concentration under dim-light conditions (<i>P</i> < 0.001). TD was associated with an earlier attainment of the predefined plasma melatonin threshold of 10 pg/mL.</p><p><strong>Discussion: </strong>The interpretation of the corresponding threshold timing in the s-Mel arm was limited due to exogenous melatonin administration. s-Mel induced a rapid early rise in melatonin followed by a sharp decline, whereas TD demonstrated a more sustained nocturnal profile. Actigraphy outcomes were generally comparable; sleep latency and total sleep time improved more with s-Mel, while TD significantly reduced cortisol levels and daytime sleepiness. Overall, TD showed earlier threshold attainment, cortisol reduction, and improved daytime alertness, supporting its potential as a natural alternative for circadian disruption and non-restorative sleep.</p><p><strong>Clinical trial registration: </strong>https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTExNTY4&Enc=&userName= CTRI/2024/11/077454 dated 28/11/2024.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1879110"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119492","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":"Physical exercise as a modulator of the sleep-obesity interaction: metabolic, neuroendocrine and circadian mechanisms.","authors":"Raquel M S Campos, Helton de Sá Souza, Carolina Machado Favaron, Guilherme Pereira Saborosa, Luciana Cervi Ferez, Sergio Tufik, Hanna Karen Moreira Antunes, Vânia D'Almeida, Marcos Mônico-Neto","doi":"10.3389/frsle.2026.1943600","DOIUrl":"10.3389/frsle.2026.1943600","url":null,"abstract":"<p><p>Obesity and sleep disturbances are highly prevalent chronic conditions that share multiple pathophysiological mechanisms, including chronic low-grade inflammation, neuroendocrine dysfunction, circadian misalignment, autonomic imbalance, insulin resistance, and metabolic dysregulation. These conditions establish a multidirectional relationship that contributes to the development and progression of cardiometabolic, respiratory, and psychological comorbidities. In this context, physical exercise (PE) is widely recognized as a non-pharmacological strategy for the prevention and treatment of obesity and sleep disturbances that simultaneously modulates these interconnected pathways while enhancing metabolic flexibility. Growing evidence also supports its role as a non-photic <i>zeitgeber</i> that synchronizes central and peripheral biological clocks, modulates clock gene expression, and influences metabolic responses according to the time of day it is performed. Through these multisystem adaptations, PE may interrupt the vicious cycle linking obesity and sleep disturbances, thereby improving metabolic health and reducing the burden of obesity-related comorbidities. This review discusses how PE modulates the multidirectional relationship between sleep and obesity through integrated multisystem adaptations, highlighting its potential to improve both sleep and overall health.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1943600"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066548","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}