Sleep advances : a journal of the Sleep Research Society最新文献

{"title":"Circadian rhythm amplification in diabetic retinopathy: a pilot study.","authors":"Sirimon Reutrakul, J Jason McAnany, Jason C Park, Andrew Cross, Kirstie K Danielson, Eve Van Cauter, Erin C Hanlon, Julie Law, Sarida Pratuangtham, Felix Y Chau, Kelly G Baron, Medha Priyadarshini, Jennifer Duffecy","doi":"10.1093/sleepadvances/zpag091","DOIUrl":"10.1093/sleepadvances/zpag091","url":null,"abstract":"<p><strong>Study objectives: </strong>Data suggested that diabetic retinopathy (DR) may be associated with a dysregulated melatonin rhythm and disturbed sleep. This pilot study explored the effects of a novel behavioral intervention \"Amplify-RHYTHM\" in type 2 diabetes (T2D) with DR.</p><p><strong>Materials and methods: </strong>Eight T2D persons (5M/3F, mean age 57.2 years) with DR participated in a 6-week \"Amplify-RHYTHM\" intervention, consisting of sleep stability (remote weekly coaching and educational content), and timed light exposure (morning bright light exposure, evening blue light reduction, and nightly light-blocking sleep mask). Data were collected before and after the intervention. Primary outcomes were insomnia symptoms and 14-day actigraphy-derived sleep parameters. Circadian-related parameters included rest-activity rhythm parameters, dim light melatonin onset (<i>n</i> = 5), and overnight urinary 6-sulfatoxymelatonin. Cardiometabolic parameters included glucose levels from a 14-day continuous glucose monitor, high sensitivity C-reactive protein, resting blood pressure, and heart rate. Statistical analysis was performed using paired <i>t</i>-tests or Wilcoxon signed rank tests.</p><p><strong>Results: </strong>Compared to baseline, after Amplify-RHYTHM intervention, insomnia symptoms significantly decreased (<i>p</i> = .041), variability of sleep midpoint reduced (0.90 [0.27] vs. 1.33 [0.39] h, <i>p</i> = .018), and intradaily variability decreased (0.82 [0.13] vs. 0.95 [0.21], <i>p</i> = .049). Urinary 6-sulfatoxymelatonin remained low and the dim light melatonin onset was unchanged. High sensitivity C-reactive protein significantly decreased, 1.58 (2.29) versus 2.36 (3.3) mg/L, <i>p</i> = .011, but heart rate change was nonsignificant (<i>p</i> = .065). Continuous glucose monitor glucose levels and blood pressure did not change.</p><p><strong>Conclusion: </strong>Amplify-RHYTHM resulted in less insomnia symptoms, more regular sleep, reduced behavioral circadian fragmentation, and reduced systemic inflammation. These pilot data should be confirmed in a larger, randomized study.</p><p><strong>Clinical trials: </strong>The study was registered at www.clinicaltrials.gov, NCT06183476.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag091"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972636","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":"Novel sleep metrics derived from chest-worn accelerometers are associated with dementia risk: the Atherosclerosis Risk in Communities neurocognitive study.","authors":"Keran W Chamberlin, Lacey H Etzkorn, Adam P Spira, Kening Jiang, Lin Yee Chen, Ciprian Crainiceanu, Vadim Zipunnikov, Jennifer A Schrack","doi":"10.1093/sleepadvances/zpag093","DOIUrl":"10.1093/sleepadvances/zpag093","url":null,"abstract":"<p><strong>Study objectives: </strong>(1) To develop an open-source method to identify time in bed (TIB) and related sleep parameters from chest-worn accelerometers. (2) To quantify the associations between derived sleep parameters and dementia risk.</p><p><strong>Materials and methods: </strong>Sleep parameters were estimated using new methods applied to movement and posture information extracted from the Zio® XT onboard accelerometer worn on the chest by participants in the Atherosclerosis Risk in Communities (ARIC) Study (2016-2017). Methods were (1) calibrated based on published methods applied to data collected simultaneously using hip-worn actigraphy in a subset of the ARIC participants (n = 405, age 78.5 ± 4.6 years); and (2) applied to all ARIC participants free of dementia (n = 2316, age 79.0 ± 4.5 years). Cause-specific Cox regressions were used to evaluate associations of these estimated parameters with incident dementia.</p><p><strong>Results: </strong>Participants contributed an average of 5.7 days to the calibration process. Incorporating postural information from the accelerometer reduced the misclassification of sedentary status as TIB, especially during early nighttime hours. During a median 5.2 years (Q1:Q3: 4.5-5.7) of follow-up, 326 participants (14.1 per cent) developed dementia. Both TIB and total sleep time (TST) showed U-shaped associations with dementia risk. The lowest tertile of interdaily variability in TIB midpoint was associated with a lower dementia hazard. Dementia risk was not significantly associated with TIB midpoint, wake after sleep onset, or sleep efficiency.</p><p><strong>Conclusions: </strong>Chest-worn accelerometers provide promising estimates of sleep parameters because they combine activity intensity and postural information. Derived TIB, TST, and variability in the timing of TIB across days are associated with dementia risk.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag093"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009498","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":"Chronotype-specific associations of sleep-wake schedule with behavioral, physiological, and psychological parameters.","authors":"Toko Haga, Seitaro Iwama, Junichi Ushiba, Junichi Ushiyama","doi":"10.1093/sleepadvances/zpag087","DOIUrl":"10.1093/sleepadvances/zpag087","url":null,"abstract":"<p><p>Diurnal variations in human performance are known to be associated with chronotype, which reflects individual differences in preferred sleep-wake cycles. Early chronotypes (ECs) exhibit superior motor and cognitive functions in the morning, whereas late chronotypes (LCs) tend to perform better in the evening. However, previous studies have examined these patterns under socially imposed nighttime sleep schedules, without considering individuals' preferred sleep timing. Thus, it remains unclear whether these chronotype-dependent performance peaks persist when individuals follow their preferred sleep schedules. To address this question, we measured subjective states, sleep pressure (using electroencephalography), and motor and cognitive functions at 1.5 and 12.5 hours after awakening under two conditions: the Clock-Time condition (10:30 p.m.-6:30 a.m. sleep aligned with social rhythms) and the Self-Time condition (8 hours of sleep aligned with individual preferences). The results revealed distinct chronotype-specific patterns. ECs exhibited increases in fatigue and sleepiness dependent on awake duration, showing typical sleep pressure accumulation. LCs were more affected by sleep timing and showed atypical patterns of sleep pressure accumulation compared with ECs. Motor ability tended to improve in the afternoon in both chronotypes, irrespective of sleep-wake schedule, whereas cognitive performance peaked at different stages of wakefulness-earlier for ECs and later for LCs-independent of the time of day. These findings suggest that chronotype-aligned sleep-wake schedules could help optimize fatigue management, cognitive performance, and motor control. Diurnal variations in performance cannot be attributed to clock time alone but emerge from the combined effects of chronotype, awake duration, and sleep-wake regulation.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag087"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957506","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 health differences and night-to-night variability in people with and without HIV in Mwanza, Tanzania: insights from actigraphy and sleep diaries.","authors":"Godfrey A Kisigo, Martha Oshosen, Vanessa Nyamkomola, Ezekiel Mgema, Megan Willkens, Shelley Lees, Robert N Peck, Ana C Krieger, Saidi Kapiga, Kathy Baisley","doi":"10.1093/sleepadvances/zpag092","DOIUrl":"10.1093/sleepadvances/zpag092","url":null,"abstract":"<p><strong>Study objectives: </strong>This study had two objectives: (1) to compare objectively and subjectively measured sleep health between people living with HIV (PLWH) and people without HIV (PWoH) in Mwanza, Tanzania, and (2) to determine the number of nights of actigraphy and sleep diary monitoring required to obtain reliable estimates of habitual sleep.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study among participants enrolled in the Mwanza HIV and CVD Cohort. Participants completed seven consecutive nights of wrist actigraphy and daily sleep diaries. Sleep health parameters were compared between PLWH and PWoH using linear mixed-effects models for repeated measures and linear regression for participant-level variability measures<b>.</b> Intraclass correlation coefficients and the Spearman-Brown formula were used to estimate the number of nights of monitoring required for reliable measurement.</p><p><strong>Results: </strong>Of the 100 participants (50 PLWH and 50 PWoH), 70% were female, and the median age was 49 years (IQR 44-54). Based on actigraphy data, PLWH had shorter mean sleep duration than PWoH (adjusted mean difference (aMD) -32.1 minutes, 95% confidence interval (CI) -52.6, -11.7). Bedtimes were slightly later (aMD 17.4 minutes, 95% CI -2.4, 37.3) and wake-up times slightly earlier (aMD -2.1 minutes, 95% CI -21.6, 17.3) among PLWH compared with PWoH. PLWH also exhibited greater night-to-night variability in sleep duration (aMD in standard deviation 13.1 minutes, 95% CI 1.2, 25.0). Actigraphy-derived sleep measures required at least 7 nights for reliable estimates, whereas self-reported sleep quality required at least 3 nights.</p><p><strong>Conclusions: </strong>These findings highlight the importance of multi-day actigraphy for accurately characterizing sleep in sub-Saharan Africa and suggest that HIV is associated with shorter, less consistent sleep without altering circadian timing.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag092"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972629","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":"Characterizing transition state in mouse vigilance with electroencephalogram-electromyogram hypnodensity.","authors":"Sadegh Rahimi, Monika Vadkertiova, Leesa Joyce, Andre Sevenius Nilsen, Carlo Mejia, Svenja L Kreis, Andreas Lieb, Taro Tezuka, Matteo Cesari, Thomas Fenzl","doi":"10.1093/sleepadvances/zpag068","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpag068","url":null,"abstract":"<p><strong>Study objectives: </strong>Vigilance-state transitions are continuous biological processes, yet conventional rodent sleep scoring relies on discrete epochs that obscure intermediate states. As no standardized framework exists for characterizing these intermediate states in rodents, this study aimed to characterize the temporal dynamics of transitions in mice and validate a machine-learning approach for objective detection.</p><p><strong>Methods: </strong>Chronic electroencephalogram (EEG) and electromyogram (EMG) recordings were obtained from male C57BL/6 N mice. We extracted 56-s windows containing stable transitions between wakefulness (WAKE), non-rapid eye movement sleep (NREMS), and rapid eye movement sleep (REMS). Eight trained experts manually annotated the onset and duration of transitions to establish ground truth and assess inter-rater reliability. Using quantitative EEG/EMG features (e.g. spectral power, complexity, and EMG variance) derived from stable states, support vector machine (SVM) classifiers were trained to predict transition midpoints in independent test animals.</p><p><strong>Results: </strong>Inter-rater agreement among experts was moderate to low, particularly for WAKE-to-NREMS and NREMS-to-REMS (N-R) transitions, reflecting inherent ambiguity in manual scoring. Temporal analysis revealed distinct dynamics across transition types; N-R transitions were significantly longer than all others, while REMS-to-NREMS transitions were the most abrupt. Despite the variability in human scoring, SVM models trained only on stable-state features successfully predicted expert-defined transition midpoints.</p><p><strong>Conclusions: </strong>Our approach not only characterizes the recognizable dynamics across transition types in mice, but also provides a reproducible framework for quantifying sleep-wake transitions, which is crucial for studying arousal stability and related impairments in disease.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag068"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763032","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":"The association of sleep health with epigenetic aging in early adolescence: exploratory insights from the Health Outcomes and Measures of the Environment study.","authors":"Smriti Maskey, Jennifer Arzu, Aimin Chen, Karl T Kelsey, Scott M Langevin, Kim M Cecil, Kimberly Yolton, Joseph M Braun, Clara G Sears","doi":"10.1093/sleepadvances/zpag090","DOIUrl":"10.1093/sleepadvances/zpag090","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep during adolescence may influence biological aging, yet few studies have examined this association using objective sleep measures. We examined the associations between accelerometry-based sleep characteristics and epigenetic age (EA), epigenetic age acceleration (EAA), and the pace of biological aging.</p><p><strong>Study methods: </strong>For this preliminary analysis, we used data from the Health Outcomes and Measures of the Environment Study (Cincinnati, OH). At age 12 years (2016-2019), we used accelerometers to assess total sleep time, sleep efficiency, the number of awakenings, and sleep fragmentation. Using DNA methylation data at the same age, we estimated EA and EAA using the skinbloodHorvath, Hannum, and Wu clocks, and the pace of biological aging using DunedinPACE. We used multivariable linear regression to estimate covariate-adjusted associations between sleep and epigenetic aging. We also evaluated sex modification by including product interaction terms and examined sex-stratified models.</p><p><strong>Results: </strong>Among 138 adolescents (59 per cent female; mean age 12.29 ± 0.64 years), general trends suggested that poorer sleep quality was associated with higher EA and EAA. However, all effect estimates were imprecise, and confidence intervals (CIs) included the null. Notably, we found that sex modified these relationships: higher sleep fragmentation was associated with elevated EAA among males (Hannum <i>β</i> = 0.885, 95% CI: 0.132, 1.638; interaction <i>p</i> = .005), but not females (<i>β</i> = -0.325, 95% CI: -0.866, 0.217). These associations were consistent across first-generation clocks.</p><p><strong>Conclusions: </strong>Overall, we did not find consistent evidence of associations between sleep characteristics and epigenetic aging in this preliminary analysis. However, sex-stratified analyses suggested that poorer sleep quality may be associated with greater EAA among males.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag090"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957509","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 electroencephalography-derived brain health and long-term cognitive decline in community-dwelling adults.","authors":"Francesca R Marino, Wolfgang Ganglberger, Haoqi Sun, Yulin Liu, Huitong Ding, Robert Joseph Thomas, Rhoda Au, M Brandon Westover","doi":"10.1093/sleepadvances/zpag089","DOIUrl":"10.1093/sleepadvances/zpag089","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep electroencephalography (EEG) is linked with cognitive function and dementia risk. Integrated EEG-derived scores, such as the Brain Health Score (BHS), trained to jointly reflect cognitive function and disease risk, and the Brain Age Index (BAI), which estimates brain aging, also correlate with neuropsychological (NP) performance. Yet, it remains unclear whether these sleep scores are associated with the rate of future cognitive decline.</p><p><strong>Methods: </strong>This study included 639 Framingham Heart Study Generation 2 and Omni 1 participants with sleep EEG in mid-to-late life and ≥ 2 NP tests over an average of 14.3 years. Linear mixed effects models estimated associations between BHS and annual changes in memory, executive function, or language. We also evaluated associations between BAI and cognitive decline among 509 Generation 2 participants with BAI values.</p><p><strong>Results: </strong>Participants were, on average, 58.4 years at sleep assessment, 54 per cent female, and 86 per cent non-Hispanic white. Each 1-SD higher BHS was associated with 0.015 SD/year slower memory decline (95% CI: 0.009-0.021), a 0.009 SD/year slower executive function decline (95% CI: 0.005-0.014), and a 0.011 SD/year slower language decline (95% CI: 0.005-0.017). In contrast, BAI was not associated with changes in any cognitive domain.</p><p><strong>Conclusions: </strong>Higher sleep EEG-derived brain health in mid-to-late life was associated with a slower decline in multiple cognitive domains over more than a decade of follow-up, whereas an EEG-based measure of brain aging was not. These findings suggest that sleep EEG-derived, data-driven brain health metrics may have value as novel biomarkers for the risk of cognitive decline.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag089"},"PeriodicalIF":0.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019162","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":"Social determinants of health, clinical outcomes, and healthcare resource utilization in participants with and without narcolepsy in the <i>All of Us</i> research program.","authors":"Sarah C Markt, Caroleen Drachenberg, Anan Zhou, Katarina Irwin, Silky Beaty, Jon Michael Stroh, Martin Zagari, Jessica K Alexander, Marisa Whalen, Junko Saber, Barbara Hutchinson","doi":"10.1093/sleepadvances/zpag088","DOIUrl":"10.1093/sleepadvances/zpag088","url":null,"abstract":"<p><strong>Study objectives: </strong>Evaluate the clinical and economic burden and impact of social determinants of health (SDoH) in narcolepsy.</p><p><strong>Materials and methods: </strong>This retrospective, observational study used electronic health record and survey data from the <i>All of Us</i> Research Program (1/1/2009-7/31/2022). Participants with narcolepsy were matched 1:3 to participants without narcolepsy. Descriptive statistics and regression analyses (odds ratios [ORs]) summarized demographics, clinical comorbidities, and SDoH; hazard ratios (HRs) estimated risk of incident hypertension, hyperlipidemia, obesity, and coronary arteriosclerosis (CA); and incidence rate ratios (IRRs) estimated healthcare resource utilization (HCRU).</p><p><strong>Results: </strong>The sample comprised 2766 participants (narcolepsy, <i>n</i> = 694; non-narcolepsy, <i>n</i> = 2072; mean age, 49 years; 70 per cent female). Despite high education levels, greater proportions were out of work/the workforce in the narcolepsy versus non-narcolepsy cohort (38.5 per cent vs. 29.2 per cent). Among SDoH survey respondents, greater food insecurity, loneliness, and everyday/medical discrimination, and less social support/cohesion were reported in the narcolepsy (<i>n</i> = 259) versus non-narcolepsy (<i>n</i> = 768) cohort. Individuals with versus without narcolepsy had higher odds (OR [95 per cent confidence interval; CI]) of cardiovascular (1.76 [1.35-2.28]), cardiometabolic (2.12 [1.73-2.59]), and renal (2.47 [1.72-3.56]) comorbidities; higher risk (HR [95 per cent CI]) of developing hypertension (2.00 [1.51-2.65]), hyperlipidemia (1.96 [1.52-2.54]), obesity (2.42 [1.93-3.05]), and CA (1.75 [1.27-2.42]); and increased HCRU (IRR [95 per cent CI]) for inpatient days (2.07 [1.55-2.78]), outpatient visits (1.51 [1.35-1.70]), and emergency department visits (1.70 [1.19-2.43]).</p><p><strong>Conclusions: </strong>Narcolepsy is associated with employment barriers, SDoH-related disparities, and elevated comorbidity burden and risk. Comprehensive and timely management strategies are needed to address whole-person health.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag088"},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957547","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":"Dual homeostatic and circadian resonance shapes REM episode duration.","authors":"Irina V Zhdanova, Vasili Kharchenko, Giuseppe Barbato, Thomas A Wehr","doi":"10.1093/sleepadvances/zpag084","DOIUrl":"10.1093/sleepadvances/zpag084","url":null,"abstract":"<p><p>Rapid eye movement (REM) sleep is influenced by homeostatic and circadian processes, but why distinct REM episode-duration profiles-bell-shaped, flattened, amplified, near-linear, and bimodal-occur remains unresolved. The wave model of sleep dynamics treats REM sleep as a coherent sleep-wake mixed state stabilized by resonance between sleep and wake probability waves near their homeostatic equilibrium region. Here we extend this framework by adding a circadian REM-promoting resonance anchored to biological time. REM duration was modeled as a compound resonance generated by two fixed curve shapes: a broad homeostatic resonance and a narrower Lorentzian circadian resonance. Only amplitude, reflecting prior-wake-dependent state instability, and relative phase alignment were varied. This constrained model reproduced REM-duration profiles during regular sleep, chronic sleep extension, and post-deprivation recovery. Baseline and recovery sleep followed a conserved empirical compound resonance curve, indicating preservation of the equilibrium/resonance peak after acute sleep loss. The predicted high-instability extension and asymmetric REM profile provide a physiological estimate of accumulated sleep deficit as additional recovery time required to return toward the sleep-wake equilibrium setpoint. Independent validation came from a 525-night longitudinal extended-sleep dataset, in which reduced resonance overlap predicted mid-sleep wake clustering and sleep-continuity instability. These findings identify REM episode duration as a quantitative marker of homeostatic-circadian alignment, recovery need, and setpoint regulation.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag084"},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876871","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":"Management of adult insomnia in Australia: a joint position statement of the Australasian Sleep Association, Sleep Health Foundation, Royal Australian College of General Practitioners, Australian Psychological Society, Pharmaceutical Society of Australia, and Australian Primary Health Care Nurses Association.","authors":"Alexander Sweetman, Stacey Putland, Hailey Meaklim, Sara Winter, Gerard Kennedy, Leon Lack, Delwyn Bartlett, James Szeto, Sarah Blunden, Henrique Salles, Vikki White, Amelia Scott, Cele Richardson, Nicole Grivell, Jenny Haycock, Daniel Sullivan, Erin Oldenhof, Shani Pickering, Moira Junge, Bianca Cannon, Linda De George-Walker, Yaqoot Fatima, Wayne Williams, Eron Cripps, Janet M Y Cheung, Camilla Hoyos, Darren Mansfield, Joel Aizenstros, David Cunnington, Melissa Ree","doi":"10.1093/sleepadvances/zpag086","DOIUrl":"10.1093/sleepadvances/zpag086","url":null,"abstract":"<p><p>This joint position statement of Australian sleep and primary care organizations provides information to healthcare providers on the management of adults with insomnia symptoms in Australia. Perspectives of sleep researchers, psychologists, sleep physicians, general practitioners, pharmacists, nurses, advocacy and implementation experts, and people with lived experience of insomnia are represented. Insomnia may present as an acute disorder (lasting up to 3 months) or a chronic disorder (lasting for 3 months or longer). Untreated insomnia is associated with lowered mood, daytime function, productivity, and quality of life. Insomnia assessment and diagnosis is based on self-reported symptoms. Insomnia occurring in the context of other conditions should be considered a \"comorbid condition\" that requires concurrent and targeted assessment and management. Recommendations about healthy sleep practices (sleep hygiene) are not an adequate stand-alone treatment for chronic insomnia. Multi-component Cognitive Behavioral Therapy for insomnia (CBTi) is the recommended \"first-line\" treatment for insomnia. There is evidence that CBTi is effective in a range of settings, in the presence of comorbid conditions, and when delivered in different modalities (e.g. individual sessions, group settings, tele-health, self-guided digital programs). Other evidence-based psychological and behavioral therapies may be appropriate for specific presentations, and in people that do not respond to CBTi. Medicines used for insomnia management are not recommended as the \"first-line\" treatment for insomnia but may be appropriate in conjunction with CBTi or as second-line treatment if CBTi is not effective or appropriate. Sleep medications may be considered in people with acute insomnia that is caused by a clear precipitant (e.g. bereavement, medical crisis, psychosocial stressors) and resulting in significant distress and/or functional impairment. If used, specific benzodiazepines and \"z-drugs\" may be indicated for up to 2-4 weeks of use at the lowest effective dose, melatonin may be used for up to 13 weeks, and dual orexin receptor antagonists are generally only recommended for chronic insomnia. Sedating antihistamines, antidepressants, antipsychotics, cannabinoids, and complementary medications are not recommended. Collaboration between people with insomnia and a range of clinicians is important for the management of insomnia and associated sleep, mental, and physical health conditions. Collaboration between sleep and primary care organizations has led to the development and implementation of healthcare provider education programs on insomnia assessment and management.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"7 3","pages":"zpag086"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042563","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}