Journal of Sleep Research最新文献

Wake/sleep-related changes in cerebral hemodynamic oscillations are well established, but similar changes in peripheral hemodynamics remain largely understudied. Moreover, how the relationship between cerebral and peripheral hemodynamics varies across sleep-wake states is not well understood, despite evidence that these oscillations in the low-frequency range are strongly coupled during wakefulness. In this study, we investigated the temporal and spectral characteristics of cerebral and peripheral hemodynamics, as well as their low-frequency coupling, across sleep and wake states. To this end, we simultaneously measured cerebral hemodynamics using functional magnetic resonance imaging (fMRI) of the brain and peripheral hemodynamics using near-infrared spectroscopy (NIRS) of the fingertips in 10 healthy participants (6 females; age 19-24 years, mean ± SD: 20.90 ± 1.59 years) during wakefulness and non-rapid eye movement (NREM) sleep. Our results show that during sleep, cerebral hemodynamics differ markedly from peripheral hemodynamics in both oscillation amplitude and spectral power. Furthermore, low-frequency coupling between cerebral and peripheral hemodynamics becomes desynchronized during NREM3 sleep. These findings support the notion that NREM3 sleep plays a key role in the optimal restoration of cerebral vasomotion.

Insomnia is associated with risk for cognitive deficits. However, the literature assessing cognitive impairments in insomnia is replete with conflicting findings; it is unclear whether individuals with insomnia exhibit impaired cognition or whether specific sleep features consistently predict cognitive performance in insomnia. Disturbance in rest-activity rhythms may be more directly associated with cognitive deficits in insomnia. In a sample of older adults with (n = 30) and without insomnia (n = 33), we examined (1) whether insomnia diagnosis was associated with differences in rest-activity rhythms and cognition, and (2) whether rest-activity rhythms were associated with cognition across domains. We used a remote comprehensive cognitive battery to test four domains of cognition: attention, inhibition, cognitive flexibility, and episodic memory. Compared to older adults without insomnia, older adults with insomnia exhibited attenuated rest-activity rhythms, indicated by lower relative amplitude (F _1,59 = 6.96, p = 0.01) with greater activity during the rest period (F _1,59 = 7.96, p = 0.01). No group differences were found in cognition. Better attention performance was associated with greater amplitude (relative amplitude: β = -0.38, p = 0.02; amplitude: β = -0.45, p = 0.01), activity (M10: β = -0.38, p = 0.01) and less fragmentation of rest-activity rhythms (intradaily variability: β = 0.34, p = 0.03), irrespective of insomnia diagnosis. No other cognitive domains were associated with rest-activity rhythms. Future studies should develop and test interventions to improve rest-activity rhythms and cognitive outcomes in older adults with and without insomnia.

Poor sleep may heighten adolescent risk-taking and impair executive functioning (EF). Circadian misalignment (CM)-the gap between internal circadian timing and 24-h behavioural cycles-might also impact EF and risk-taking. However, the link between circadian factors and EF/risk-taking remains underexplored. This study investigates the relationships between sleep duration, circadian timing, morningness/eveningness preference and CM with adolescent EF and risk-taking behaviour. Participants (N = 52), aged 14-18, provided demographic information and completed the Morningness/Eveningness Questionnaire and Pubertal Development Scale. They wore Actiwatches for 11 days and attended a dim-light melatonin onset (DLMO) appointment, completing the Youth Risk Behavior Survey and Behavior Rating Inventory of Executive Function. Independent samples t-tests compared EF and risk-taking across four sleep health aspects: circadian timing (DLMO), morningness/eveningness preference, CM, and sleep duration. Evening preference significantly predicted higher risk-taking (g = 0.991), worsened EF (g = 0.75) and reduced metacognition and behavioural regulation (g's > 0.60). Inadequate sleep duration trended towards predicting reduced EF and inhibition (g's > 0.55). DLMO and CM were not associated with EF or risk-taking (Hedge's g < 0.5). Eveningness preference and lower sleep duration may increase risky behaviour and worsen EF in adolescents. Future research should explore whether increasing sleep duration and advancing sleep schedule preferences reduce risky behaviour and improve cognitive function.

Sleep profiles, including chronotype, sleep duration and sleep-wake time, may affect glycaemic outcomes. However, their associations with plasma glycaemic outcomes and 24-h interstitial glucose levels in individuals with prediabetes remains ambiguous. This study aimed to examine the association between sleep profiles and glycaemic outcomes in adults with prediabetes. Chronotype was assessed using the Malay-translated Munich Chronotype Questionnaire. Glycaemic outcomes, including fasting plasma glucose (FPG), 2-h postprandial glucose (2hPPG), glycated haemoglobin (HbA1c) levels and 24-h glucose profiles derived from seven-day continuous glucose monitoring (CGM). Generalised linear models and generalised estimating equations were used and adjusting for potential confounders. A total of 120 participants (mean age: 54 ± 15 years) were categorised as morning (18.4%), intermediate (60.8%) or evening (20.8%) chronotypes. Evening chronotypes demonstrated greater weekday-weekend discrepancy in awake time (0.7 h [±1.1 h]), indicating higher social jet lag. Each additional hour of jet lag in awake time was associated with a 0.28 mmol/L reduction in 2hPPG levels (95% CI: -0.49, -0.08), reflecting compensatory catch-up sleep on weekends. Longer sleep time was positively associated more time spent within the target glucose range (3.9-7.8 mmol/L) (β: 0.58, 95% CI: 0.06, 1.10), while evening chronotype showed higher 24-h mean glucose levels (β: 0.65 mmol/L, 95% CI: 0.22, 1.12). Evening chronotype and shorter sleep duration were associated with adverse glycaemic outcomes, while the unexpected inverse association between awake-time jet lag and 2hPPG may reflect short-term catch-up sleep rather than a protective effect. These findings highlight the importance of addressing sleep regularity in lifestyle interventions for prediabetes management.

Poor sleep and insomnia are pervasive public health concerns, with insomnia ranking as the second most prevalent mental health disorder in the general population. Moreover, insomnia is a significant predictor of subsequent depression and is frequently co-occurring with other psychological difficulties. While both in-person and digital cognitive-behavioural treatments have proven effective as first-line strategies for managing insomnia, their accessibility remains limited, with several barriers preventing dissemination, particularly, among at-risk or hard-to-reach populations such as adolescents, university students and minority groups. Single-session interventions (SSIs) for mental health have recently emerged as a strategic asset and treatment approach, grounded in specific theoretical tenets and assumptions. The efficacy and feasibility of SSIs have been well documented, with systematic evidence highlighting their flexibility, applicability and cost-effectiveness across a wide range of clinical and subclinical conditions. However, their full implementation in the treatment of insomnia remains limited. This brief review aims to illustrate the alignment between the SSI framework and the needs of psychological treatments for insomnia and to summarise current evidence on single-session, one-shot interventions for insomnia. Notably, several one-shot interventions based on cognitive-behavioural therapy for insomnia have been tested in clinical trials with promising results, though their integration with the broader SSI approach appears partial. Further research is warranted to develop consensus-based in-person and digital SSIs for insomnia and to assess their feasibility and effectiveness within a stepped-care framework.

Excessive daytime sleepiness (EDS) is linked to adverse clinical outcomes. This study evaluated changes in a validated tool to assess EDS, the Epworth Sleepiness Scale (ESS) and mortality risk. This retrospective cohort study included Veterans receiving sleep-related services in the Department of Veterans Affairs (VA) from October 4, 1999 to August 18, 2018, with two qualifying ESS measures. ESS values were extracted from patient notes using a validated natural language processing (NLP) pipeline (96% accuracy). ESS scores were categorised as Normal (0-10) or Abnormal (11-24). Patients were grouped based on ESS changes: Normal-Normal, Normal-Abnormal, Abnormal-Abnormal and Abnormal-Normal. Cox proportional hazards models adjusted for time, age, sex, race and comorbid conditions assessed the risk of 5-year all-cause mortality. Among 17,967 qualifying Veterans (mean age: 56.3 (SD 13.5) years), 11.75% died within 5 years of the second ESS measure. At baseline, 9342 (52.0%) had EDS, for whom 2232 (12.4%) improved to normal by the second exam (Abnormal-Normal). The Normal-Abnormal group had a 25% higher adjusted all-cause mortality risk within 5 years (aHR: 1.25, 95% CI: 1.09, 1.44) compared to the Normal-Normal group, with progressively increasing risk after age 55. In contrast, neither persistent abnormal sleepiness (Abnormal-Abnormal) nor improvement from abnormal to normal (Abnormal-Normal) was associated with significantly different mortality risk compared to the Normal-Normal group. ESS can efficiently identify EDS, which may serve as a clinical marker for 5-year all-cause mortality risk, particularly among Veterans seeking VHA sleep services aged 55 and older.

Sleep and disordered eating behaviours may be linked through physiological and psychological mechanisms; yet, no review has systematically investigated the relationship between different sleep indicators and disordered eating behaviours and cognitions outside a clinical context. The present systematic review and meta-analysis addressed this research gap to gain a better understanding of associations in non-clinical populations to potentially inform future prevention and early intervention approaches in the context of both sleep and disordered eating. All studies published from 2003 onwards were included if they assessed a relationship between disordered eating and sleep in a non-clinical population. In total, 89 studies were included, of which 33 met eligibility criteria for the meta-analyses. General eating pathology, loss of control eating, and excessive exercise were most consistently significantly associated with poorer sleep quality and higher insomnia symptoms, while evening chronotypes were most consistently associated with bulimia symptoms, night eating, and body image concerns. Likely due to the limited evidence available, findings relating to restrictive eating behaviours and bulimia symptoms were largely mixed. Primarily small and non-significant effects were found for associations between disordered eating and sleep duration measures. Overall, this review identified a need for more longitudinal research, the use of validated assessment methods, and studies focusing on restrictive eating, bulimia-related behaviours, and excessive exercise. Despite the heterogeneity of study populations and designs, this review highlights sleep problems (e.g., insomnia symptoms, impaired sleep quality) as a transdiagnostic correlate of disordered eating concerns.

Adequate sleep health is critical for surgical recovery. Disrupted sleep can impede wound healing and cognitive performance and contribute to poor surgical outcomes. Preoperative intervention aimed at improving surgical outcomes is often referred to as prehabilitation and commonly uses exercise, nutrition or psychological intervention. Sleep prehabilitation interventions have not yet been studied. This randomised assessor-blinded trial will measure the effect of a personalised sleep prehabilitation (PSP) intervention in addition to standard of care prehabilitation (PREHAB) on participant sleep health compared to PREHAB alone (Clinicaltrials.gov ID: NCT06762639). One hundred fifty-four English-speaking patients from the University Health Network's Prehabilitation Program with sleep disturbance and a surgery within 4-12 weeks will be recruited. Patients will be excluded if they are participating in PREHAB remotely, have an existing sleep disorder, are a shift worker, have travel plans outside of their usual time zone or have a cognitive disability that precludes participation. Study assessments occur at baseline, 1 week before surgery and 6 weeks after surgery. PREHAB consists of individualised exercise and nutrition support as well as psychological intervention. The PSP consists of a baseline sleep assessment, brief behavioural treatment for insomnia (BBTI), sleep hygiene and behaviour-change support. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI). The primary analysis will be an ANCOVA to detect differences in PSQI between groups 1 week before surgery whilst controlling for baseline scores. The proposed study will be the first to explore the effect of a personalised preoperative sleep intervention.

Meditation practice has been shown to impact resting-state EEG activity in expert meditators, but its benefits on sleep, which is particularly affected with age, are poorly understood. Our aim was to better understand the effects of long-term meditation practice on resting-state EEG and sleep in older adults. Twenty-seven elderly expert meditators (mean age ± SD: 70.7 ± 5.0 years) were compared to meditation-naive controls (69.3 ± 3.8 years) for sleep questionnaires (n = 135), polysomnography (n = 47) and resting-state EEG (n = 73). Sleep microstructure (slow waves and spindles) and EEG features (power, Kolmogorov complexity and permutation entropy (PE)) during resting-state, NREM, and REM sleep were compared between groups. Correlations were tested between the metrics that differed between the two groups and the level of meditation expertise within the meditator group. At rest, expert meditators exhibited lower delta power and higher delta PE than controls. Self-reported sleep quality did not differ between groups, but expert meditators slept longer, had reduced %N1, and higher %N2. During NREM sleep, they exhibited reduced delta power, increased alpha power, and greater theta PE. During REM sleep, they tended to show greater theta power. Finally, the composite score of meditation expertise was negatively associated with %N1, and tended to be positively associated with %N2 and REM sleep theta power. Overall, these results suggest that expert meditators showed more preserved brain activity at rest and sleep architecture, and exhibited EEG features suggesting higher cognitive states during NREM sleep. Clinical Trial Information: Name: Study in Cognitively Intact Seniors Aiming to Assess the Effects of Meditation Training (Age-Well). Registration: EudraCT: 2016-002441-36; IDRCB: 2016-A01767-44; ClinicalTrials.gov Identifier: NCT02977819. (https://clinicaltrials.gov/ct2/show/NCT02977819?term=Age-Well&draw=2&rank=1).

Sleep-wake disturbances and cognitive decline are among the most common nonmotor symptoms of Parkinson's disease (PD). Deep brain stimulation (DBS) can successfully alleviate motor symptoms. However, the impact on sleep-wake disturbances and cognitive decline, and their interaction, is yet unclear. We aim to investigate changes in and interaction between subjective sleep and cognition following DBS. We performed a study on data from the Amsterdam-PD-DBS database with assessments at baseline and at 6 months post-operative. Subjective sleep was assessed with the sleep and sleepiness items of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale. Cognition was assessed with neuropsychological tests for the domains of language, processing speed, executive functioning, and memory. Three hundred and sixty-five PD patients were included. Subjective sleep and sleepiness significantly improved after DBS. The proportion of patients with clinically relevant sleep disturbances dropped significantly from 76.4% to 50.1% (p < 0.001). Significant declines were observed in verbal fluency (p < 0.001, p = 0.005), processing speed (p < 0.001), and executive function (p < 0.001, p = 0.013), while delayed memory showed a significant improvement (p = 0.025). Significant associations were found for reduction in sleepiness and less decline in category fluency (p = 0.014) while no significant relationship between changes in sleep and changes in cognitive outcomes was present. This study provides strong evidence for the beneficial effects of DBS on sleep and sleepiness. No evidence was found for an association between reduction in subjective sleep disturbances following DBS and change in cognition.