Journal of Sleep Research最新文献

Comorbid sleep difficulties and posttraumatic stress disorder are common amongst military service members and veterans. Additionally, poor sleep quality following trauma-focused treatment has been linked to posttreatment hyperarousal, a core symptom of posttraumatic stress disorder. However, causal relationships between the two remain unknown. We conducted a hypothetical randomised control trial based on the Rubin Causal Model following Bind and Rubin's four-step method. Participants included 747 veterans and servicemembers that participated in an intensive outpatient programme for posttraumatic stress disorder and related conditions, who were matched into two hypothetical treatment groups where both groups were clinically and demographically similar except for their posttreatment hyperarousal levels. We used Student's test statistics (t) and estimated regression coefficients ( $\hat{\beta }$ ) as test statistics to assess whether posttreatment hyperarousal was related to poor posttreatment sleep quality. The final matched sample included 244 total participants. Results showed that following trauma-focused treatment, veterans with high hyperarousal had poorer global sleep quality ( $\hat{\beta }$  = 1.97, Fisher p < 0.001), a shorter sleep duration ( $\hat{\beta }$  = 0.36, Fisher p≈0.001), increased sleep disturbance ( $\hat{\beta }$  = 0.28, Fisher p < 0.001) and increased daytime dysfunction ( $\hat{\beta }$  = 0.10, Fisher p≈0.047) in comparison to veterans with low posttreatment hyperarousal. These findings further suggested a relationship between post-trauma-focused treatment hyperarousal and poor sleep quality. Further research is needed to investigate post-trauma-focused treatment psychological health in relation to sleep quality.

Obstructive sleep apnea (OSA), marked by intermittent hypoxia, is associated with obesity, type 2 diabetes and metabolic associated fatty liver disease. In pregnancy, it remains underdiagnosed despite links to gestational diabetes, hypertension, and foetal growth restriction. Intermittent hypoxia may alter foetal programming and increase the risk of long-term metabolic issues in offspring. This study evaluates the effects of gestational OSA on offspring metabolic function, focusing on weight gain, glucose homeostasis, insulin sensitivity, hepatic glucose metabolism, inflammation and oxidative stress. Experiments were performed on pregnant female Wistar rats submitted to a chronic intermittent hypoxia (CIH) protocol during the last 2 weeks of pregnancy. Offspring were evaluated for body weight, glucose tolerance and insulin sensitivity at 1, 3, and 12 months of age. Liver western blot analysis was performed to assess markers of glucose metabolism (glucokinase, pyruvate kinase and glucose-6-phosphatase), inflammation (NF-kB, IL-1R, IL-6R, TNF-ɑR and NRLP3) and antioxidant enzymes (catalase, SOD-1 and iNOS). CIH did not modify body weight, glucose tolerance and insulin sensitivity at 1, 3 and 12 months of age, except for a transient increase in glucose intolerance observed in 3-month-old females, which was attenuated by 12 months. Moreover, no evidence was found of modifications caused by gestational CIH on markers of hepatic glucose metabolism, inflammation or antioxidant defence. However, there was a gradual increase in inflammation with age. No sexual dimorphism was observed. Overall, these findings suggest that gestational CIH does not predispose offspring to long-term metabolic dysfunction later in life and does not affect biological ageing, regardless of sex.

Slow wave sleep plays a crucial role in overnight memory consolidation, with slow oscillations serving as a critical mechanism. Recent studies have identified closed-loop auditory stimulation as an effective method to enhance slow oscillatory activity during slow wave sleep, thereby facilitating memory consolidation. However, few studies have applied this technique in ecological settings, with inconsistent findings. The present study investigated the short- and long-term effects of closed-loop auditory stimulation on declarative memory performance and vigilance. Additionally, we examined potential sleep microstructural changes. A between-subjects design was employed on 34 participants who were divided into a Control group and a Stimulation group, the latter receiving one night of closed-loop auditory stimulation in a home environment. While stimulation successfully enhanced slow oscillation amplitude, no behavioural effects on memory performance or vigilance were observed. However, these findings should be interpreted with caution, as our limited sample size may have been insufficient to detect a potential effect of CLAS on memory.

Excessive daytime sleepiness (EDS) as well as insomnia have been associated with a higher risk for cardiovascular disease in patients with obstructive sleep apnoea (OSA). The link is not fully understood but may involve dyslipidaemia. The aim of the study was to analyse if the EDS and insomnia phenotypes were associated with deranged serum lipid values in patients with OSA recruited from a European real-world cohort. Patients with OSA and a full lipid profile participating in the ESADA database were analysed (n = 12,153). Based on their symptoms, they were categorised into EDS (n = 3123), EDS + insomnia (n = 2091), insomnia (n = 2862) and non-EDS non-insomnia (n = 4077) subgroups. Nonparametric ANCOVA adjusted for age, body mass index, smoking, alcohol, study site, apnoea-hypopnoea index and time spent with saturation below 90%, followed by Dunn's test and Bonferroni correction, was used to compare lipid values between the groups. The analyses were also performed in predefined subgroups. There were significant differences in total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and triglyceride (TG) values between the four groups (all p < 0.01). Patients with EDS had the highest TC (5.11 ± 1.08 vs. 5.00 ± 1.10, 5.03 ± 1.12, 5.04 ± 1.10 mmol/L, EDS vs. EDS + insomnia, insomnia, non-EDS non-insomnia, respectively), LDL-C (3.12 ± 0.97 vs. 3.01 ± 0.98, 3.02 ± 1.00, 3.09 ± 0.98 mmol/L) and TG (1.86 ± 1.04 vs. 1.76 ± 0.97, 1.69 ± 0.90, 1.75 ± 0.93 mmol/L) values and the lowest HDL-C results (1.18 ± 0.33 vs. 1.21 ± 0.34, 1.26 ± 0.38, 1.20 ± 0.34). Interestingly, patients with insomnia had the highest HDL-C values. EDS is significantly associated with dyslipidaemia in patients with OSA. Further studies are warranted to understand the link in detail and to translate it into clinical practice.

Androgenetic alopecia (AGA) is a common hair loss condition. Iron deficiency contributes to hair loss; and sleep disorders, particularly obstructive sleep apnea (OSA), have systemic effects, especially hypoxia OSA-induced that links hair loss with iron metabolism. The study aimed to investigate how iron markers relate to OSA severity in AGA. Data from the 4th edition of the São Paulo Epidemiological Sleep Study (EPISONO) were analysed. Participants self-reported AGA, underwent polysomnography, and provided blood samples. Propensity score matching (PSM) was used to control for age, sex, and metabolic syndrome. From 769 participants, 747 self-reported AGA status; 81 were enrolled in the AGA group (17 women and 64 men) and 666 in the Non-AGA group (423 women and 243 men). After PSM, 160 individuals (80 matched pairs) were retained, including 34 women (n = 17 per group) and 126 men (n = 63 per group). In the AGA group, serum iron was significantly correlated with the apnea-hypopnea index (AHI) in both sexes, particularly in women. Ferritin levels were positively associated with AHI and desaturation index in women. Serum iron was negatively correlated with the desaturation index in men. In Non-AGA men, transferrin was positively correlated with AHI and negatively correlated with sleep efficiency. These associations remained significant even after PSM. In conclusion, serum components of iron metabolism, particularly iron and ferritin, can have an association with OSA severity in AGA. This highlights the importance of considering iron profiles in the management of OSA, including AGA. Further examinations are warranted to explore the mechanisms underlying these metabolic associations.

Sleep is a fundamental process supporting the dynamic regulation of neural function. Emerging methods have proposed that the aperiodic components of brain signals (such as the spectral slope, spectral intercept, and spectral knee), in addition to entropy-based measures, offer robust empirical markers of neural states. The present study investigates the sensitivity of these broadband spectral metrics in comparison to classical band-limited measures, specifically slow wave activity (SWA; 0.75-4.5 Hz), in a 9-day mouse sleep deprivation paradigm involving baseline, sleep restriction, and recovery phases (open-source database). Spectral parameters were computed using the FOOOF algorithm. Results indicate that SWA differentiates between baseline and rebound sleep only during NREM episodes. In contrast, both the spectral slope and spectral intercept capture sleep deprivation-related changes during both REM and NREM sleep, suggesting these fractal measures reflect sleep homeostasis across stages. Given the shift of the spectral knee towards higher frequencies in mice (~8-10 Hz) as compared to humans (generally around 1 Hz), eliminating the overlap of the spectral slope with the traditional SWA range in these rodents, homeostatic regulation appears to be not strictly bounded to the lower frequencies (0.75-4.5 Hz). Normalised spectral entropy did not differentiate between baseline and recovery sleep, potentially due to its sample size sensitivity. These findings support the empirical utility of broadband spectral parameters in assessing sleep-wake dynamics and highlight their potential to complement or surpass traditional band-limited metrics.

Post-operative delirium (POD) is an acute deterioration in cognitive function and highly prevalent after cardiac surgery (CS; up to 55%). Perioperative sleep disorders (PSD) are also commonly noted in surgical patients (up to 60%). The primary aim of our systematic review is to determine the association between PSD and POD in CS patients during their hospital stay. We searched five databases (PubMed, CINAHL, Web of Science, Scopus, and EMBASE) to identify studies evaluating the association between PSD and POD amongst CS (any open-heart CS) patients, without time and geographic restriction. Original articles that focused on adults undergoing cardiac surgeries and assessed sleep and POD were included. We conducted a meta-analysis using a random effects model to determine the effect of sleep quality on POD. Thirty-three studies were included (63% observational designs); most studies originated from China (33%). The most frequently used subjective and objective sleep assessment tools were the Pittsburgh Sleep Quality Index (PSQI) (33%) and polysomnography (18%). After pooling observational data, we identified an incidence of POD ranging from 3.6% to 73%. Increased PSQI scores (standard threshold > 5) were associated with a greater likelihood of POD occurrence (standardised mean difference [SMD] = 0.73, p > 0.05). Lower total sleep time (SMD = -0.68, p < 0.05) was associated with an increased risk of POD. Poor sleep quality, insomnia, and sleep-disordered breathing are prevalent forms of PSD and are major risk factors for POD following CS. Additional research is warranted to clarify when sleep quality normalises after cardiac surgery and how targeted interventions can accelerate this recovery.

Studies in mammal models show that reduced sleep is associated with increased food intake. Zebrafish (Danio rerio) is emerging as a promising model for studying sleep and feeding behaviour due to its similarities with mammals. Our goal was to investigate whether sleep restriction increases food intake in zebrafish, its potential effects on central regulation of feeding, and whether effects are similar in both sexes. Individually housed male and female adult zebrafish were exposed to nighttime (ND) or daytime (DD) vibrations and compared to a control group without vibration (n = 30 males and n = 27 females). ND, but not DD, reduced sleep during the disturbance period, with males showing a significant effect and females exhibiting an altered sleep pattern without a statistically significant reduction. ND also significantly increased food intake in males, as measured by daily milligrammes and number of pellets consumed. In contrast, ND females exhibited a decrease in the time spent feeding, suggesting a sex-specific response to sleep disruption. The whole brain expression of neuropeptide Y (npy), proopiomelanocortin (pomc), and its receptor melanocortin-4 (mc4r) were analysed by RT-qPCR. Males from ND exhibited significantly reduced pomc mRNA levels. Grouped-housed (three male and two female) zebrafish exposed to ND also exhibited increased food intake. In conclusion, sleep restriction affected food intake behaviour and the central regulation in zebrafish, with distinct sex-specific effects.

The purpose of this study was to examine associations between putting the infant to bed with a bottle and maternal-reported infant sleep problems using a 3-wave cross-lagged model. Participants included 299 mother-infant dyads. When infants were 2, 6 and 14 months old, mothers reported their feeding practices using the Infant Feeding Practices Questionnaire II and infant sleep problems using the Brief Infant Sleep Questionnaire. Over and above covariates (maternal education, race, WIC participation, depressive symptoms, maternal sleep quality, breastfeeding status and weekly work hours), concurrent associations and stability pathways, putting the infant to bed with a bottle at 2 months predicted higher infant sleep onset latency, time awake at night and frequency of night wakings at 6 months. Infant nighttime sleep duration and frequency of night wakings at 6 months predicted greater maternal use of bottle to bed at 14 months. The indirect pathway from bottle to bed at 2 months to bottle to bed at 14 months via frequency of infant night wakings at 6 months was statistically significant supporting the transactional model whereby both mothers and infants influence the other's subsequent behaviour. The importance of preventing mothers from providing a bottle to bed and strategies to do so are discussed.