Frontiers in sleep最新文献

{"title":"Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain.","authors":"Nicole Tacugue, Jessica J Love, Jakob M Cherry, Jacqueline Lane, Joe Kossowsky","doi":"10.3389/frsle.2025.1593196","DOIUrl":"10.3389/frsle.2025.1593196","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep dysregulation is highly prevalent in pediatric chronic pain conditions and associated with poorer clinical outcomes. Interactions between underlying circadian misalignments and pain in pediatric populations remain unclear. Dim-light melatonin onset collections conducted in external lab settings are standard for measuring circadian rhythmicity by examining fluctuations in melatonin levels. However, present limitations prevent us from capturing a typical night's sleep and minimize accessibility to broader populations due to geographic, financial, and temporal barriers. We investigated a novel approach in which participants complete collections in an entirely self-directed manner using an at-home diagnostic kit.</p><p><strong>Methods: </strong>Participants included pediatric patients with diagnosed chronic pain and healthy controls. The 3-week protocol involved sleep, activity, and light tracking, self-reported sleep diaries, a survey determining morningness-eveningness chronotypes, one self-directed home dim-light melatonin onset collection with objective compliance measures, and assessment of study protocol acceptability.</p><p><strong>Results and discussion: </strong>In a sample of pediatric patients with diagnosed chronic pain (<i>N</i> = 6, M_age =14.5, SD = 2.74, 66.7% female) and a subset of healthy controls (<i>N</i> = 6, M_age =13.3, SD=2.73, 50% female), both the Hockeystick method and 3 pg/ml dim-light melatonin onset threshold were employed to calculate salivary dim-light melatonin onset times in 8 of the 12 participants. On average, dim-light melatonin onset times were 1 h and 43 min earlier than self-reported sleep onset times. Our results illustrate the feasibility and accuracy of self-directed, remote dim-light melatonin onset collections in pediatric populations. With supplementary research validating this optimized approach to measure endogenous circadian phase, more specific aspects of sleep can be targeted in pain intervention strategies to further optimize clinical outcomes in a greater population of pediatric patients.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076721","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":"From sleeplessness to solitude: emotional repair as a buffer between insomnia and loneliness in university students.","authors":"Katherine Domar Ostrow, Olivia Rieur, Robert W Moeller, Martin Seehuus","doi":"10.3389/frsle.2025.1516094","DOIUrl":"10.3389/frsle.2025.1516094","url":null,"abstract":"<p><p>Loneliness and insomnia are endemic in college students, and emotion regulation is strongly related to both. Starting with a biopsychosocial framework, the present study tested a model in which emotional repair mediated the relationship between loneliness and insomnia, with the goal of using a potential mechanism of action to address loneliness. Participants were undergraduate students (N=1,513) in the United States who completed a survey including the Trait Meta-Mood Scale, Sleep Condition Indicator, and UCLA Loneliness Scale, amongst other measures. Insomnia had a significant total negative effect on loneliness, B = -0.46, 95% CI [-0.54, -0.39]. Emotional repair partially mediated this relationship, with an indirect effect of B = 0.015, 95% CI [-0.19, -0.12]. Participants with better sleep were more able to regulate their emotions, and thus tended to experience lower levels of loneliness. Treating insomnia (e.g., CBT-I) or skills associated with emotional repair and regulation (e.g., transdiagnostic approaches to emotion regulation) could reduce overall loneliness.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712432","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":"Editorial: Women in Insomnia.","authors":"Darlynn M Rojo-Wissar, Jessica M Meers, Patricia L Haynes","doi":"10.3389/frsle.2025.1683978","DOIUrl":"10.3389/frsle.2025.1683978","url":null,"abstract":"","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076746","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":"Implementing TeleSleep at Veterans Healthcare Administration: an organizational case study of adaptation and sustainment.","authors":"Jeffrey K Belkora, Jill Reichert, Katherine Williams, Mary A Whooley, Talayeh Rezayat, Stacy Sorensen, Priyanka Chilakamarri, Elizabeth Sanders, Andrea Maas, Alexander Gomez, Philip Kurien, Liza Ashbrook, Jacque Thomas, Kathleen F Sarmiento","doi":"10.3389/frsle.2024.1444689","DOIUrl":"10.3389/frsle.2024.1444689","url":null,"abstract":"<p><p>Veteran access to sleep medicine is of paramount importance to the Veterans Health Administration (VA). To increase access, VA has created community referral policies and programs, as well as telehealth programs. In 2017, the Office of Rural Health (ORH) funded a TeleSleep initiative focused on reaching rural Veterans with unmet sleep needs. ORH provided 3-6 years of funding to help 19 hubs support 98 spoke sites serving rural Veterans. As ORH funding concluded, each hub identified its path to sustainment. This case study follows one TeleSleep hub in VA's western geographic region as it transitioned from ORH funding sustainment as a regional Sleep Clinical Resource Hub. This case study describes the real-world process of adaptation in care delivery strategies. One key area of adaptation revolved around whether to deliver care via the patient's home facility or the provider's home facility. In early 2021, the TeleSleep team implemented an innovative provider transfer model, where temporary reinforcements from the TeleSleep hub increased the workforce capacity of spoke sites, similar to the concept of locum tenens. In this provider transfer model, TeleSleep clinicians scheduled, documented, and billed for each encounter at the Veteran's home facility. Positioning TeleSleep clinicians as local providers facilitated communication and referrals and promoted continuity and quality of care for Veterans in their home facility. This provider transfer model reduced the administrative burden of providers and schedulers and supported patient-side-only documentation of care. While this mirrors current locum tenens practice, transferring providers did not fit VA's financial model as implemented by the western region's Sleep Clinical Resource Hub. Therefore, in December 2021, VA aligned TeleSleep with VA's preferred practice of patient rather than provider transfers. In the patient transfer model, providers schedule and document in both the provider and patient electronic health records, and bill in the provider's facility. However, reflecting on this period of innovation, TeleSleep team members concluded that the provider transfer model could improve patient safety and care coordination while reducing the administrative burden of frontline clinicians. Further research and development are needed to align the provider transfer model with VA's financial model.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592443","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":"Editorial: Insights in sleep-related movement disorders and parasomnias","authors":"Ambra Stefani, John Winkelman","doi":"10.3389/frsle.2024.1461464","DOIUrl":"https://doi.org/10.3389/frsle.2024.1461464","url":null,"abstract":"","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"23 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927322","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":"Insomnia severity and daytime sleepiness in caregivers of advanced age","authors":"Lucy A. Webster, Talha Ali, Jody Sharninghausen, Alexandra M. Hajduk, Thomas Gill, Brienne Miner","doi":"10.3389/frsle.2024.1404684","DOIUrl":"https://doi.org/10.3389/frsle.2024.1404684","url":null,"abstract":"Aging-related changes and caregiver burden may increase the risk for sleep disturbances among older caregivers, yet few studies have examined the prevalence of insomnia and daytime sleepiness in this group. We examined the relationship of caregiver status with insomnia and daytime sleepiness among persons of advanced age (>75 years of age).Cross-sectional.Community.Yale Precipitating Events Project participants (n=383, mean age 84.4 years, 67% female, 12% African American, 25% caregivers).Caregivers were persons who reported caring for another person in the past week or caring for/helping a friend or relative >4 times in the past month. We examined the correlates of caregiver status, including demographic (age, sex, race/ethnicity, education, marital status), psychosocial (living alone, Medicaid eligibility, depressive symptoms, social support, hours volunteered), and physical (obesity, chronic conditions, medication use, self-rated health status, physical activity, functional disability, cognitive impairment) factors. We used the Insomnia Severity Index (ISI) to establish insomnia severity (ISI score 0–28) or clinically significant insomnia symptoms (ISI ≥8). We used the Epworth Sleepiness Scale to establish daytime sleepiness (ESS score 0–24) or hypersomnia (ESS ≥10). In nonparametric multivariable regression analyses, we examined the relationship of caregiver status with insomnia or daytime sleepiness.Compared to non-caregivers, caregivers were younger, more educated, less likely to be Medicaid eligible and had lower rates of depression, obesity, poor self-rated health, low physical activity, functional disability, and cognitive impairment. Mean ISI and ESS scores were in the normal range and similar among non-caregivers and caregivers (ISI scores of 6.9±5.6 and 6.9±5.4, and ESS scores of 6.4±4.7 and 6.1±4.3, in non-caregivers and caregivers, respectively). Multivariable-adjusted models demonstrated no significant differences in ISI and ESS scores between non-caregivers and caregivers (regression coefficients for ISI and ESS scores of −0.01 [95% CI = −1.58, 1.21] and −0.10 [−1.05, 1.21], respectively).When compared to older non-caregivers, older caregivers had more advantageous demographic, psychosocial, and physical profiles and had similar levels of insomnia and daytime sleepiness on standardized questionnaires. Future research is needed to elucidate contextual factors (e.g., caregiving intensity and care partner disease) that may increase the risk of sleep disturbances among caregivers of advanced age.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"13 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658617","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":"Efficacy of a telehealth cognitive behavioral therapy for improving sleep and nightmares in children aged 6–17","authors":"L. Cromer, Sarah Beth Bell, Lauren E. Prince, Nicholas Hollman, Elissar El Sabbagh, Tara R. Buck","doi":"10.3389/frsle.2024.1401023","DOIUrl":"https://doi.org/10.3389/frsle.2024.1401023","url":null,"abstract":"This study examined the efficacy of a five-module cognitive behavioral therapy for nightmares in children (CBT-NC) and improving sleep.Forty-six youth aged 6–17 years with sleep problems and at least weekly chronic and distressing nightmares were randomized to treatment (n = 23) or waiting list (n = 23) using a block four randomized design. Among participants, 65% (n = 30) were White, 4% (n = 2) were Black/African American, 2% (n = 1) were Asian American, 13% (n = 6) were Native American or Pacific Islander, and 15% (n = 7) were multiracial. Fifty percent of participants (n = 23) were cisgender girls, 35% were cisgender boys (n = 16), 7% were transgender boys (n = 3), and 9% were gender non-binary (n = 4). The baseline nightmare persistence ranged from 6 months to 13.5 years. The treatment adapted exposure, relaxation, and rescription therapy for trauma-related nightmares in adults and added elements of cognitive behavioral therapy for insomnia in children. Psychoeducation included topics of sleep and nightmares, relaxation, anxiety management, and sleep hygiene; the youth were guided through nightmare exposure and rescription.There was a statistically significant improvement in the number of nights with awakening (Cohen's d = 1.08), the number of weekly nightmares (Cohen's d = 0.82), and nightmare distress (Cohen's d = 1.05) for the treatment group compared to the wait-list group. Parent-reported youth sleep improved for the entire group from pretreatment to posttreatment (p < 0.001) but did not reach statistical significance for between-subjects analyses of the treatment group compared to the wait-list group (p = 0.05). Between-subjects analyses saw improvement for the treatment group compared to the wait-list group on internalizing and externalizing problems and suicidal thoughts and behaviors.This study supports the efficacy of CBT-NC for improving sleep maintenance, nightmare frequency and distress, and other mental health difficulties in youth. Preliminary evidence of possibly improving suicidal thinking and behavior is also presented.https://clinicaltrials.gov/study/NCT05588739, identifier: NCT05588739.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"120 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657107","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":"Revitalizing CPAP adherence: lessons from THN study in patients with hypoglossal nerve stimulators","authors":"G. Mwenge, J. Bousata, Daniel Rodenstein","doi":"10.3389/frsle.2024.1380373","DOIUrl":"https://doi.org/10.3389/frsle.2024.1380373","url":null,"abstract":"This retrospective study aimed to address acceptance and long-term adherence to Continuous Positive Airway Pressure (CPAP) treatment among non-responder patients to ImThera THN system who initially declined this therapy.We employed a structured outpatient approach to communicate THN study results, categorize initial CPAP nonadherence reasons, and encourage CPAP trials through tailored appointments. Recorded follow-ups addressed individual concerns, providing medical guidance and acknowledging person-specific challenges. Adherence data were collected using CPAP hour meters at predetermined intervals, following Belgium's social security stipulations.Between July 2014 and October 2016, eleven participants, including one woman, with prior CPAP experience (average 2 months) were enrolled. Initial non-adherence was linked to ENT or psychological factors. Ten patients agreed to CPAP trials, where interventions included changing CPAP brand, pressure adjustments, mask changes, and additional measures like cognitive-behavioral therapy and nasal spray. After 1 year, mean adherence was 6.3 ± 2 h/day, and average CPAP usage duration was 8.67 ± 2.13 years. As of November 2023, eight out of eleven patients were still actively using CPAPIn this investigation, we challenged the concept of CPAP non-adherence, highlighting evolving adherence and the significance of continuous monitoring and personalized interventions. Our findings underscore ongoing patient education, multidisciplinary support, and dynamic intervention adaptation for enhanced adherence in challenging patient populations. The results provide insights applicable to non-adherent patients with obstructive sleep apnea, emphasizing the importance of individualized care and sustained engagement for improved CPAP acceptance.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675639","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":"From macro to micro: slow-wave sleep and its pivotal health implications","authors":"Toru Ishii, P. Taweesedt, Christina F. Chick, Ruth O'Hara, Makoto Kawai","doi":"10.3389/frsle.2024.1322995","DOIUrl":"https://doi.org/10.3389/frsle.2024.1322995","url":null,"abstract":"Research on slow-wave sleep (SWS) began almost a century ago, not long after the discovery of electroencephalography. From maintaining homeostasis to memory function, the pivotal role of SWS in health has been established. The elucidation of its mechanisms and functions is directly related to the fundamental question of why people sleep. This comprehensive review first summarizes the basic science of SWS from anatomical and physiological aspects. It describes the fundamental mechanisms and functions of SWS, including hormonal regulation, developmental changes in SWS across the lifespan, and associations between SWS and optimal physical, psychological, and cognitive functions. Next, the relationship between SWS and physical and mental disorders, for which increasing knowledge has accumulated in recent years, is discussed from both research and clinical perspectives. Conditions such as memory impairment, sleep-disordered breathing, neurodevelopmental disorders, and various psychiatric disorders are of concern. The relationship between SWS and the glymphatic system, which is responsible for waste clearance in the brain, has also been explored, highlighting the potential neuroprotective role of SWS. Finally, we discuss the future direction of the field regarding whether interventions in SWS can improve health. We also address the problem of the inconsistent definitions of SWS, slow-wave activity, and slow oscillations. This review emphasizes the importance of discussing SWS from both macro- and microarchitectural perspectives and highlights its potential clinical and research impacts. By reviewing these aspects, we aim to contribute to a deeper understanding of SWS and the future development of this research field.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"32 11‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688225","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":"Māori perspectives on sleep and aging","authors":"Rosemary Gibson, Hannah Lowe, Erina Korohina, Anna Rolleston","doi":"10.3389/frsle.2024.1410856","DOIUrl":"https://doi.org/10.3389/frsle.2024.1410856","url":null,"abstract":"Sleep is vital for health in older adulthood. Ethnic disparities have been noted with regards to sleep health. However, culturally appropriate approaches to sleep as a broader social experience are lacking.Here, sleep-related group interviews were conducted in the form of hui (group meetings and discussions) with eleven participants of a health service intervention for older Māori (the Indigenous people of New Zealand) and their whānau (extended family). Notes were collated and analyzed thematically.Four key themes were constructed that represent the key conversations and ideas. These concerned the conceptualizing of sleep—including appreciation for its somatic role but also the spiritual properties of sleep states; the changing obligations around sleep and wake—including individual and communal time use and changing cultural and familial obligations with advancing age; and the barriers and facilitators for supporting sleep—including the social and spiritual nature of communal sleeping, the schedules and sleep of others, as well as holistic and environmental methods for relaxation. Findings demonstrate the multifaceted nature of sleep and aging among Māori. Culturally relevant interpretations of sleep practices and disturbances were offered and are beyond typical Western models which are predominantly medicalized.This work aids the understanding and representation of sleep as a social and cultural perspective within the New Zealand context. This provides foundations for future participatory research to design culturally appropriate approaches to assessing and supporting sleep health in forms that are meaningful for aging well across cultures.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"53 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382914","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}