Journal of Sleep Research最新文献

The aim of this paper is to review the phenomenon of bistability, a basic working mode of NREM sleep. The perpetual oscillations between two opposite states in sleep slow waves, K-complexes as well as in the Cyclic Alternating Pattern (CAP) on a different time scale; appear spontaneously and can also be elicited by sensory stimulation, representing a response of the sleeping brain. Although there is extensive literature on bistability, its significance remains obscure. In this paper, spontaneous and elicited bistable patterns are reviewed and the global presence of bistable oscillations in NREM sleep is highlighted. We discuss the relationship of bistability with sleep homeostasis and the overlap with the CAP, with emphasis on A1 phase. We collect data along the hypothesis that bistability would provide a perpetual and flexible interface between the sleeping brain and the environment across the night, protecting the continuity of sleep and, in parallel, preserving the brain's adaptive connection with the environment.

Obstructive sleep apnea (OSA) is a common condition linked to increased cardiovascular risk. Continuous positive airway pressure (CPAP) therapy is the standard treatment; however, poor mask fit-due to limited size options-often reduces patient adherence. This study explores the feasibility of developing a fully customised CPAP mask prototype using accessible 3D scanning, computer-aided design, and 3D printing technologies. A high-resolution facial scan was obtained using a Structure Sensor (ST01) attached to an iPad and imported into Autodesk Fusion 360 to generate a personalised nasal mask design. The masks were fabricated using desktop masked stereolithography (MSLA) printers (Elegoo Saturn 3 12K) with standard resin. To enhance comfort and prevent direct skin contact with rigid surfaces, a medical-grade foam lining was added. The prototype underwent key safety evaluations, including exhaust flow rate, pressure drop, and CO₂ rebreathing. The estimated production cost per mask was approximately $25. These findings highlight the potential for in-office fabrication of custom-fit CPAP masks using affordable tools and materials. With further biocompatibility testing and user feedback, this approach may offer a practical and scalable solution for improving comfort, fit, and adherence in CPAP therapy.

Having nightmares can contribute to poor sleep quality, and having sleep problems can be accompanied by increased nightmare frequency. The etiological models of insomnia and nightmare disorder also show some parallels. The present cross-sectional study included 654 participants (509 women, 144 men, 1 non-binary) with mild to moderate sleep problems (mean age: 41.19 ± 12.95 years). As expected, nightmare frequency was elevated compared to previously published findings of a representative sample (large effect size). Moreover, waking-life stress level moderated-at least partially-the relationship between poor sleep quality and nightmare frequency. Like previous studies, gender and waking-life stress contributed significantly to nightmare distress-after controlling for the effect of nightmare frequency on nightmare distress. Overall, the present study emphasises the close link between sleep problems and nightmares. Based on previous studies, it seems very beneficial to offer nightmare sufferers additional modules of cognitive-behavioural therapy for insomnia and similarly offer patients with insomnia disorder who also reported elevated nightmare distress a nightmare treatment module like Imagery Rehearsal Therapy.

Many behaviours which promote sleep overlap with the reported benefits of pet ownership. Research on pet ownership and sleep has predominately focused on co-sleeping with pets, leaving other pet ownership factors largely unexamined. The present study aimed to examine the relation between pet ownership and sleep as well as moderators and mediators of this relation. Participants (N = 1256; 80.8% White; 50.5% men) residing in the United States completed an online survey which included assessment of sleep disturbances, physical activity, perceived stress, anxiety symptoms, and light exposure. Participants were categorised into one of four pet ownership groups: non-pet owners, cat-only owners, dog-only owners, and owners of both a dog and cat. Data analyses included analysis of covariance, moderation, parallel mediation, and conditional process modelling. Key findings included that pet ownership was significantly related to sleep, with non-pet owners sleeping worse than pet owners. Those that owned both a dog and cat reported the best sleep of all four pet ownership groups. The relation between pet ownership and sleep did not vary by gender. The relation was significantly mediated by anxiety symptoms, perceived stress, light exposure, and sleep-wake timing. Anxiety symptoms and perceived stress were the most robust mediators of the relation between pet ownership and sleep. Walking regularity did not moderate these effects. These pre-clinical findings provide a foundation for future research examining how the integration of pet ownership and sleep-promoting behaviours can improve adherence to sleep health recommendations, thus improving owners' sleep.

Insomnia and excessive daytime sleepiness (EDS) often co-occur, despite involving distinct physiological mechanisms. The KANOPÉE application, a fully autonomous virtual agent that collects sleep-related data and delivers personalised behavioural recommendations over a 17-day period, offers a unique opportunity to better understand this unexpected phenotype. Our primary aim was to characterise these 'sleepy insomniacs', and our secondary aim was to evaluate their response to this digital sleep intervention. Among 21,590 participants, individuals with an Epworth Sleepiness Scale score ≥ 11 and an Insomnia Severity Index score ≥ 15 were classified as 'sleepy insomniacs'. Comorbidities (i.e., obstructive sleep apnea syndrome, restless legs syndrome, depression, and sleep medication use) were first described and then excluded for further analyses. At baseline, 4843 (47.9%) of the 10,114 participants with insomnia also reported EDS and were categorised as 'sleepy insomniacs'. Half of this subgroup reported at least one comorbidity, with depression being the most common. After excluding participants with comorbidities, 3239 individuals (44.3%) remained in the 'sleepy insomniacs' category. These individuals were more likely to experience middle or late insomnia symptoms compared to those with insomnia without EDS but responded similarly to the digital sleep intervention. In conclusion, EDS is highly prevalent among individuals with insomnia symptoms. While comorbidities, particularly depression, explained the co-occurrence in approximately half of the sample, a substantial proportion of participants without comorbidities also exhibited this unexpected phenotype. The association with specific insomnia subtypes highlights the need for further investigation. Notably, a 17-day digital sleep intervention proved effective in treating 'sleepy insomniacs'.

Sleep deprivation (SD) affects the gut microbiome, but findings across studies vary in terms of microbiota changes, SD induction methods and gut measurements. The effects of SD on the gut microbiome in humans and rodents have not been comprehensively reviewed. This meta-analysis investigated SD-related factors and their effects on the gut microbiome in human and rodent models. We analysed data from studies published before February 28, 2024, and calculated standardised mean differences (SMDs). Subgroup analyses were conducted for rodents and humans. A total of 20 studies (4 human, 5 rat, 8 mouse and 3 combined human and rodent) were included. SD significantly reduced alpha diversity (Shannon and Simpson indices) and increased the Firmicutes-to-Bacteroidetes ratio. In rodents, the Shannon index was lower (SMD = -1.27, 95% CI: -2.20 to -0.34), and the Firmicutes/Bacteroidetes ratio was higher (SMD = 2.60, 95% CI: 1.61-3.59). Human studies showed nonsignificant trends, limited by small sample sizes. Analysis at the phylum, family and genus levels showed a modest decrease in Actinobacteria and Tenericutes and a minor increase in Bacteroidetes, Firmicutes and Proteobacteria. Reductions in Lactobacillaceae and Erysipelotrichaceae and increases in Ruminococcaceae and Lachnospiraceae were observed. A2, Lactobacillus and Ruminococcus_1 were less abundant in the SD group. Overall, SD alters gut microbiome composition. Standardised human studies are needed to clarify translational relevance.

Partial sleep deprivation (SD), a common phenomenon in modern life, is known to impair cognitive and linguistic processes. This study investigates its selective effect on metaphor generation, differentiating between conventional and novel metaphors. Twenty-five healthy young adults underwent two sessions involving either regular sleep or partial SD conditions. Participants completed tasks evaluating metaphor generation, cognitive flexibility (Stroop Test), and executive function (Wisconsin Card Sorting Test). Results revealed that partial SD increased the production of conventional metaphors, associated with bottom-up processes and default mode network (DMN) activation. However, it did not significantly affect novel metaphor generation, which relies on top-down cognitive control and frontoparietal network (FPN) activity. Furthermore, Stroop Test findings showed slower reaction times under incongruent conditions after partial SD, indicating reduced cognitive control. These results suggest that partial SD selectively impairs top-down processes while enhancing bottom-up retrieval, leading to a shift in metaphor generation patterns. This research highlights the distinct neural mechanisms underlying different types of metaphor generation and their differential sensitivity to partial SD, providing theoretical and psycholinguistic insights into the cognitive effects of SD.

Insomnia is prevalent in adolescents with co-morbid mental health problems but is often overlooked due to limited access to training for practitioners in the assessment and treatment of insomnia. Whilst Cognitive Behavioural Therapy is the recommended treatment for insomnia in adults (CBTi), there are no standard treatment guidelines for adolescents and limited research with adolescents with co-morbid mental health problems. Therefore, our aim was to develop a CBTi intervention for adolescents with co-morbid mental health problems. This study utilised an iterative expert consultation approach to develop a CBTi intervention and define the appropriate target population, components and delivery. Eighteen experts were identified from literature searches and professional networks and invited to participate. Three iterative rounds of questionnaires were conducted and included both open-ended and closed-ended questions. In total, seven experts participated (R1 = 7, R2 = 5 and R3 = 1). In R1, four main themes emerged: (1) CBTi is appropriate for early-mid adolescents with anxiety/depression, (2) the proposed content and format were appropriate but required adaptation, (3) the proposed method of delivery was appropriate (i.e., in-person, by trained practitioner) and (4) parent/caregiver involvement is necessary. In R2, the intervention protocol was reviewed and finalised. In R3, the intervention materials were reviewed. The newly developed intervention comprises 4 weekly sessions, intervention materials and a training package for non-sleep experts. To our knowledge, this is the first study to utilise an iterative expert consultation process to develop an insomnia intervention for adolescents with co-morbid mental health.

Irregular sleep is increasingly related to poorer health, with stronger links to cardiovascular disease and mortality than sleep duration. Its impact on health-related quality of life, however, remains unclear, particularly in community-based populations. This study examined whether objectively measured sleep regularity is associated with physical and mental health-related quality of life. Sleep regularity was calculated using the Sleep Regularity Index from actigraphy data in 768 middle-aged to older adults from the Raine Study (median age [range] = 57 [53-61]; 58% female). Physical and mental health-related quality of life were assessed using the 12-item Short Form Health Survey. Quantile regression was used to examine associations at the 25th, 50th, and 75th percentiles, adjusting for age, sex, comorbidity count, sleep duration, and shift work. Median sleep regularity scores declined with self-rated health, from 77.17 (excellent) to 61.49 (poor). A 10-unit increase in sleep regularity was associated with higher mental health scores at the 25th (1.80; 95% CI: 0.90-2.60), 50th (1.20; 95% CI: 0.50-1.90), and 75th (0.50; 95% CI: 0.20-0.90) percentiles. For physical health, a 10-unit increase in sleep regularity was associated with a 1.20 (95% CI: 0.30-2.20) higher score at the 25th percentile, with no evidence of association at higher percentiles. These findings suggest that poorer sleep regularity is related to lower physical and mental health-related quality of life. Future research should explore whether improving sleep regularity can enhance quality of life in middle-aged to older adults.

The 2019 coronavirus (COVID-19) pandemic and associated lockdowns significantly disrupted healthcare systems, including access to pharmacological treatments such as sleep medication. This study investigated the number of first-time dispensed hypnotic drugs during the first COVID-19 lockdown in the Netherlands, using data from the Dutch Foundation for Pharmaceutical Statistics (SFK), which covers approximately 96% of all pharmacy dispensations (5.46 million patients). First-time dispensing was defined as no use of hypnotics in the previous year and included benzodiazepines, benzodiazepine-related drugs, and melatonin receptor agonists. Data from 2020 were analysed across three periods: pre-lockdown (Weeks 1-11), lockdown (Weeks 12-19) and post-lockdown (Weeks 20-26), and were compared to the same periods in 2019. Analyses were stratified by age group (children: 0-9, adolescents: 10-19, adults: 20-64, elderly: 65+) and sex. The data revealed a significant reduction in first-time hypnotic dispensations in 2020 (155,961) compared to 2019 (168,814, p < 0.001), with declines across all three time periods (p < 0.001). During the lockdown, significant reductions were found among children, adolescents, and adults (p < 0.001), but not among the elderly. Female adults and the elderly received significantly more hypnotics than their male counterparts (p < 0.001), consistent with higher reported rates of sleep disturbances. In conclusion, the overall number of first-time dispensed hypnotics was significantly lower during the first COVID-19 lockdown in the Netherlands, except among the elderly. It remains unclear to what extent individuals self-medicated with over-the-counter sleep medication, or experienced untreated sleep complaints during the first lockdown in the Netherlands.