Frontiers in sleep最新文献

{"title":"Implementation and feasibility of an interdisciplinary pediatric positive airway pressure adaptation program in a Brazilian public sleep clinic.","authors":"Ila Linares, Jeane Xavier, Caroline Borginho, Clarissa Bueno, Anna Monazzi, Simone Fagondes, Renatha E Rafihi-Ferreira, Melissa Xanthopoulos, Leticia Azevedo Soster","doi":"10.3389/frsle.2026.1791640","DOIUrl":"https://doi.org/10.3389/frsle.2026.1791640","url":null,"abstract":"<p><strong>Introduction: </strong>The early diagnosis and treatment of pediatric obstructive sleep apnea (OSA) can improve academic performance of affected children, in addition to enhancing their cognitive and social development. Since the effective use of positive airway pressure (PAP) is limited by difficulties in adherence to the device, adaptation and engagement programs may improve outcomes in pediatric patients.</p><p><strong>Objective: </strong>The aim of this study is to describe an interdisciplinary program to improve PAP adherence among children with OSA in Brazil's public health system, also assessing its feasibility, acceptability, fidelity, and scalability based on implementation science frameworks, with the goal of informing sustainable clinical practice and public policy.</p><p><strong>Method: </strong>The program is based on the CPAP Program developed and implemented by the Children's Hospital of the Philadelphia Sleep Center. This prospective study will involve patients aged 1 year to 18 years treated at the children's sleep clinic who have a diagnosis of OSA and indication for PAP treatment. The main outcome measures will include (1) percentage of patients who return for a follow-up visit within 4 months of treatment initiation, (2) the median number of days from the initial visit to the first follow-up visit, (3) task analysis questionnaire, (4) objective data obtained from the device's memory card.</p><p><strong>Conclusion: </strong>The program proposed is expected to provide an integrated clinical service, optimizing the time of adaptation to PAP, increasing adherence rates, and reducing the costs associated with medical problems of untreated OSA.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1791640"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824221","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":"Differences in sleep spindles and polysomnography in humans: a meta-analysis on the influence of age, sex, and cognitive ability.","authors":"Diana Campos-Beltrán, Shu Zhang, Lisa Marshall","doi":"10.3389/frsle.2026.1802882","DOIUrl":"https://doi.org/10.3389/frsle.2026.1802882","url":null,"abstract":"<p><p>This meta-analysis examines EEG sleep spindle and macrostructure differences in humans related to healthy aging, sex, and cognitive ability. Inclusion criteria required quantitative EEG data of healthy subjects, including sleep spindle properties and sleep polysomnography comparing younger to older subjects, females to males, and/or correlations with cognitive ability scores. The search included seven databases. The Mixed Methods Appraisal Tool (MMAT) calculated the study quality (risk of bias). Two meta-analyses used Hedges' g, and one averaged correlation (95% CI), all conducted with Meta-Essentials v1.4, with standard assessments of heterogeneity, publication bias, and meta-regression, supplemented by subgroup and sensitivity analyses. Results provide tables, forest plots, funnel plots, and bubble plots. <i>k</i> = 42 studies with <i>N</i> = 1,878 healthy subjects met our criteria. With age, sleep spindles decreased in amplitude, density, and duration. Sleep quality was reduced in older subjects showing shorter durations of both slow wave sleep (SWS) and rapid-eye movement (REM) sleep. Females revealed higher sleep spindle power (11-16 Hz), more prominent in older subjects; greater sleep efficiency, more total sleep time (TST), and longer SWS. Correlations between sleep properties and cognitive ability revealed age-dependent effects. Results yield key considerations in population comparisons and when targeting spindle activity, both for mechanistic research and for neuropsychiatric treatment. Yet further systematic investigations are warranted.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1802882"},"PeriodicalIF":0.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791205","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":"Use of hypnosis to treat chronic somniloquy (sleep talking): a Case Report.","authors":"Melvin S Marsh","doi":"10.3389/frsle.2026.1707583","DOIUrl":"https://doi.org/10.3389/frsle.2026.1707583","url":null,"abstract":"<p><strong>Introduction: </strong>This case study describes a hypnotherapeutic intervention for a 46-year-old man with chronic somniloquy that had persisted for decades, worsening during periods of stress. The patient sought treatment due to spousal complaints regarding the disturbance in her sleep.</p><p><strong>Methods: </strong>A treatment plan consisting of eight bi-weekly hypnotherapy sessions was developed and initiated. The intervention focused on clinical hypnosis as the primary therapeutic modality for addressing somniloquy.</p><p><strong>Results: </strong>The intervention yielded positive results. By the sixth scheduled session, the patient's wife reported that his sleep talking had been nearly completely eliminated, leading to an early discontinuation of treatment.</p><p><strong>Discussion: </strong>This case study suggests that clinical hypnosis may be a viable treatment option for chronic somniloquy. Further research is warranted to explore this therapeutic approach on a larger scale.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1707583"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791211","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 quality assessment in hospitalized postoperative surgical patients: a COSMIN-based systematic review.","authors":"Nunung Nurhayati, Agung Waluyo, I Made Kariasa, Sali Rahadi Asih, Hening Pujasari, Bahrul Hayat","doi":"10.3389/frsle.2025.1714777","DOIUrl":"https://doi.org/10.3389/frsle.2025.1714777","url":null,"abstract":"<p><strong>Background: </strong>Sleep is a crucial physiological process that significantly influences recovery among hospitalized postoperative surgical patients, including those treated in intensive care units and general surgical wards. Reliable and valid instruments for assessing sleep quality are essential for guiding clinical decision-making and improving patient outcomes. However, the psychometric properties of commonly used sleep assessment tools remain inconsistent, highlighting the need for systematic evaluation.</p><p><strong>Objective: </strong>This study aimed to conduct a COSMIN-based systematic review to examine the measurement properties of sleep quality assessment instruments used in hospitalized postoperative surgical patients.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Scopus, Web of Science, CINAHL, and PsycINFO for studies published between 2010 and 2024. The methodological quality of each study was evaluated using the COSMIN Risk of Bias checklist, and a narrative synthesis was performed to summarize the psychometric evidence for each instrument.</p><p><strong>Results: </strong>Of the 210 studies initially identified, 37 met the eligibility criteria. The Pittsburgh Sleep Quality Index (PSQI) demonstrated adequate reliability and construct validity but showed limitations related to measurement error and responsiveness. The Richards-Campbell Sleep Questionnaire (RCSQ) exhibited strong reliability and construct validity, though variability was observed in interrater agreement between nurses and patients. The Epworth Sleepiness Scale (ESS) was reliable for assessing daytime sleepiness but provided limited evidence for structural validity in postoperative contexts. The Sleep Quality Questionnaire (SQQ), Verran and Snyder-Halpern Sleep Scale (VSH), and Insomnia Clinical Evaluation (ICE) showed mixed psychometric properties, indicating the need for further validation in hospitalized postoperative populations.</p><p><strong>Conclusion: </strong>The PSQI and RCSQ remain the most frequently utilized sleep assessment instruments; however, their psychometric limitations warrant cautious interpretation. This review underscores the need for further research to refine, validate, and potentially develop more robust sleep assessment tools tailored to hospitalized postoperative surgical patients.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"4 ","pages":"1714777"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791215","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":"Patterns of rest-activity rhythms from adolescence to young adulthood: a scoping review.","authors":"Camila Koike, Bridget A Nestor, Erin Sands, Danielle A Wallace, Joe Kossowsky","doi":"10.3389/frsle.2026.1779808","DOIUrl":"https://doi.org/10.3389/frsle.2026.1779808","url":null,"abstract":"<p><strong>Introduction: </strong>Rest-activity rhythms (RAR) measure daily physical activity patterns. RAR metrics correlate with biopsychosocial trajectories in adults and may represent objective biomarkers of health and risk. However, the significance of RAR to demographical, physical, and psychological factors in early adolescence and young adulthood has not been collectively evaluated, leaving gaps in understanding RAR's relevance during this developmental window.</p><p><strong>Methods: </strong>A systematic search identified peer-reviewed studies on adolescents and young adults (ages 10-19) that reported data on RAR variables and factors of interest published through April 2024. Study and participant characteristics, device characteristics, days of wearable data collected, RAR variables, and associated demographic, social, physical, and psychological factors were extracted.</p><p><strong>Results: </strong>Of 1,648 screened titles and abstracts, 19 studies with 16,717 participants met eligibility. Included studies varied widely in devices used, epoch lengths, recording duration, and RAR data compliance criteria. Seven studies reported RAR outcomes relevant to demographic or social factors, nine studies reported RAR outcomes relevant to physical health, and ten studies reported RAR results relevant to psychological factors. Across domains, findings were highly heterogeneous and differed from the more consistent and established associations observed in the adult literature. Generally, age-related decreases in stability and fragmentation were observed, as well as associations between increased fragmentation and cardiometabolic risk and between reduced peak daytime activity and poor mental health. Consistently, younger age groups exhibited higher interdaily stability and intradaily variability, and elevated cardiometabolic risk was associated with a delayed acrophase. Methodological inconsistencies and low-quality studies limit the generalizability of findings across studies.</p><p><strong>Conclusion: </strong>Standardization in RAR measurement, establishment of age- and sex-specific normative values for RAR, and longitudinal studies with more diverse samples are necessary to advance this field and better clarify clinically relevant RAR associations.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1779808"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791251","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 duration and food insecurity among minority urban college students: predictors of health and academic disparity.","authors":"William Suarez-Gomez, Peter C Nwakeze, Aditi Puri, Chesley Sanchez, Latoya Callender, Collette M Brown","doi":"10.3389/frsle.2026.1759416","DOIUrl":"https://doi.org/10.3389/frsle.2026.1759416","url":null,"abstract":"<p><strong>Introduction: </strong>Synthesizing the literature on college students in urban settings, this study addresses how systemic disparities amplify food insecurity and poor sleep health in minority college students in the Bronx. We posit that their relationship is a predictor of higher body mass index (BMI) and lower grade point average to assess academic performance (GPA).</p><p><strong>Methods: </strong>This cross-sectional study investigated the association between self-reported sleep duration and food insecurity among 710 minority undergraduate students at two urban institutions in the Bronx, NY. The research used a QR-code-based survey to collect socio-demographics, food security data (US Household Food Security Module), and sleep duration (a PSQI sub-section). SPSS Version 29 was used for analysis. Multiple logistic regression was performed to examine the relationships between food security, sleep duration, demographics, BMI, and the GPA.</p><p><strong>Results: </strong>The findings reveal a high prevalence of food insecurity (52.1%) in this population. Chi-square analysis demonstrated statistically significant associations between food insecurity and household income (<i>p</i> < 0.0001), sleep duration (<i>p</i> = 0.007), and BMI (<i>p</i> = 0.037). A multiple logistic regression confirmed that obtaining the recommended sleep duration (7-9 h) was associated with 2.3 times higher odds of being food secure (<i>p</i> = 0.005, Exp(B) = 2.327). Additionally, students with a normal or overweight BMI were significantly more food secure than their obese counterparts.</p><p><strong>Conclusion: </strong>The current study highlights the interrelationship between sleep duration, food insecurity, socioeconomic status, and BMI among minority students. No correlation was observed between sleep duration, food insecurity, and GPA. However, our findings underscore the necessity for comprehensive, multifaceted interventions to effectively address these challenges faced by urban minority college students.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1759416"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791161","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":"Beyond screen use duration: the role of evening TV-timing on sleep in preschool-aged children.","authors":"Isabel M Wilder, Rebecca M C Spencer, Tracy Riggins","doi":"10.3389/frsle.2026.1783027","DOIUrl":"10.3389/frsle.2026.1783027","url":null,"abstract":"<p><p>Sleep is a critical component of early childhood health, yet many preschool-aged children fail to obtain sufficient overnight sleep. Screen use contributes to insufficient sleep. However, most research thus far has focused on total screen time rather than the timing of screen exposure, which may be especially important for evening arousal, displacement of bedtime routines, and circadian regulation. The present study examined whether the delay between evening TV use and bedtime (\"TV-to-bed delay\") and children's average daily TV use were associated with 24-h sleep duration in preschoolers. Parents of 137 typically developing 3-5-year-old children (<i>M</i> age = 3.81 years, <i>SD</i> = 0.53; 52.6% female; 62.8% White; mid- to high-SES urban sample) provided reports of their child's typical TV-to-bed delay, average TV exposure, average nap duration, and 24-h sleep duration. Partial Spearman's rho correlations were used to examine associations between TV-use variables and 24-h sleep duration while controlling for child age, average daily TV use, and average nap duration. Longer TV-to-bed delays were significantly associated with longer 24-h sleep duration (ρ = 0.20, <i>p</i> = 0.02). In contrast, average daily TV use was not significantly associated with 24-h sleep duration after adjustment (ρ = -0.14, <i>p</i> = 0.11). These findings highlight the importance of considering timing as a meaningful dimension of media exposure and suggest that simple behavioral adjustments-such as creating a longer buffer between evening TV use and bedtime-may support healthier sleep in young children.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1783027"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13079673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700882","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 disorders in children/adolescents with neurodevelopmental and neurological disorders: what evidences do we have with the use of non-pharmacological interventions?","authors":"Magda Lahorgue Nunes, Camila Dos Santos El Halal","doi":"10.3389/frsle.2026.1758539","DOIUrl":"https://doi.org/10.3389/frsle.2026.1758539","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are highly prevalent across neurological and neurodevelopmental disorders (NDDs) and often exacerbate core symptoms, impair daytime functioning, and increase caregiver burden. Despite frequent clinical use of behavioral and educational strategies, the evidence base for non-pharmacological sleep interventions in this population remains scarce.</p><p><strong>Data source: </strong>This narrative review aimed to analyze behavioral interventions that can be used for sleep problems in children and adolescents with NDDs, and synthesizes data from recent studies that examined those non-pharmacological interventions in epilepsy, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), cerebral palsy (CP), and rare genetic neurodevelopmental conditions (RGNCs).</p><p><strong>Results: </strong>Across NDDs, insomnia symptoms are highly prevalent, with circadian disturbances and sleep-disordered breathing also common in some groups. Behavioral and parent-led interventions-including psychoeducation, sleep hygiene, structured routines, and extinction-based strategies-consistently improve parent-reported sleep and often enhance daytime behavior, though objective sleep gains are smaller. In epilepsy and ASD, tailored behavioral-educational programmes are both effective and acceptable. In ADHD, behavioral sleep interventions and melatonin improve sleep, with behavioral approaches also yielding modest reductions in ADHD symptoms. Evidence for CP and RGNCs is limited but supports individualized, multimodal management targeting both behavioral and physiological contributors, while syndrome-specific chronobiological treatments offer only partial benefit.</p><p><strong>Conclusions: </strong>Behavioral and educational sleep interventions are generally safe, acceptable, and clinically useful across NDDs, particularly when embedded in multidisciplinary, condition-informed care. However, their efficacy is constrained by small, heterogeneous trials and non-standardized outcome measures. Robust, syndrome-specific randomized studies with harmonized sleep and daytime outcomes are urgently needed to guide evidence-based practice.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1758539"},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610747","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":"DARC-NESS: a mastery-based cognitive-behavioral model for treating chronic nightmares in youth.","authors":"Lisa DeMarni Cromer, Emily Kaier Cromwell, Lauren E Prince, Tara R Buck","doi":"10.3389/frsle.2026.1772987","DOIUrl":"https://doi.org/10.3389/frsle.2026.1772987","url":null,"abstract":"<p><p>Theories of chronic nightmare maintenance highlight dysfunctional beliefs about sleep and nightmares, distress and arousal, anticipatory anxiety, maladaptive sleep habits, and sleep deprivation as perpetuating factors that maintain nightmare disorder over time. Theories of nightmare treatment suggest that self-efficacy is a common factor in nightmare mitigation. The current article introduces DARC-NESS, a multi-component theory of nightmare maintenance that emphasizes nightmare self-efficacy as a central mechanism influencing the maintenance cycle at multiple points. DARC-NESS is a mnemonic for the model's components: Dream (nightmare) content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity, that interact to perpetuate nightmares. This model provides the theoretical basis for cognitive behavioral therapy (CBT) for child nightmares. The manuscript proposes treatment counterparts to each model component and presents a case illustration demonstrating how these interventions can disrupt the vicious cycle of chronic nightmares. Finally, flexible clinical applications are offered to guide clinicians in selecting and sequencing modular intervention elements to match individual case presentations.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"5 ","pages":"1772987"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469924","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":"Preschool attention and sleep support (PASS): protocol for a pilot feasibility randomized clinical trial.","authors":"Naomi O Davis, Brian Eichner, Matthew J Gibson, Jessica R Lunsford-Avery","doi":"10.3389/frsle.2025.1662221","DOIUrl":"https://doi.org/10.3389/frsle.2025.1662221","url":null,"abstract":"<p><strong>Introduction: </strong>Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms often emerge during preschool, highlighting a critical period for prevention. Preventative ADHD interventions may be most effective if they target biological mechanisms linked to core ADHD pathophysiology. Sleep dysregulation represents a potential target, yet the gold-standard behavioral intervention (behavioral parent training, BPT) focuses primarily on ameliorating daytime impairment. There is a critical need to adapt BPT to target behaviors across the 24-h period through integration with behavioral sleep medicine (BSM).</p><p><strong>Methods: </strong>This trial will randomize children ages 3-5 years who are identified as at-risk for ADHD (i.e., with elevated ADHD symptoms) and their caregivers to receive either BPT (<i>n</i> = 22) or a combined intervention that includes BPT and BSM (Preschool Attention and Sleep Support, PASS; <i>n</i> = 22). Blinded assessments will be conducted at baseline, immediately post-treatment, and 3 months post treatment. Feasibility and acceptability will be assessed.</p><p><strong>Results: </strong>Key outcomes will include changes in ADHD symptoms (measured by clinical and caregiver rating) and sleep (measured by both actigraphy and caregiver report). Changes in additional functional outcomes (e.g., comorbid symptoms, parenting stress) will be explored.</p><p><strong>Discussion: </strong>Findings from this study will provide essential data to inform a large-scale clinical trial of PASS, with the ultimate goal of improving functional outcomes among preschoolers at risk for ADHD and modifying the trajectory of this chronic condition through early preventative intervention focused on improving biological processes linked to ADHD.</p><p><strong>Trial registration: </strong>NCT05862727.</p>","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"4 ","pages":"1662221"},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272985","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}