Journal of Sleep Research最新文献

Sleep is an essential physiological function regulated by circadian rhythm and homeostatic regulation for emotional and physical health. Conversely, sleep deprivation (SD) is associated with weakened immune system function and overall health, which potentially leads to chronic diseases such as heart disease and diabetes. In this study, we aimed to investigate the role of regulatory T cells (Tregs) in the immune response to SD and the potential therapeutic effect of melatonin in modulating this response. For this purpose, 24 8-week-old male C57BL/6J mice were distributed into 4 groups: control, control with melatonin, SD, and SD with melatonin. Treg levels were assessed in peripheral blood and spleen samples with flow cytometry. According to the data, SD decreases the CD3⁺ T cells in blood but not in spleen samples. Moreover, Helios transcription factor expressing Treg cell levels are increased in both blood and spleen in the SD group, which indicates a possible immunosuppressive occurrence. Melatonin administration affected the numbers of total Tregs and particularly the numbers of Helios⁺ Tregs and restored the T cell population similar to the normal levels. Our results suggest melatonin as a key regulatory component for SD-induced immunological imbalance as well as reduced memory and effector Tregs and increased naïve Tregs. According to these findings, they highlight the immunological consequences of SD and the therapeutic promise of melatonin in restoring immune function.

This longitudinal study of Arctic residents investigates how physical activity and sleep, known to be affected by extreme Arctic photoperiods, are linked to blood lipid profiles and thus cardiovascular disease risk in this particularly vulnerable population. We analyzed parametric and non-parametric actigraphy data of physical activity (PA) and sleep measures across three distinct photoperiods (winter solstice, spring equinox, and summer solstice) in a cohort of Arctic residents. Multiple regression models, adjusted for photoperiod, were employed to determine independent associations of PA and sleep parameters with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Robust circadian rhythms in PA were significantly associated with improved lipid profiles. Specifically, lower intra-daily variability IV (β = 0.423, p < 0.001) and higher inter-daily stability IS (β = -0.263, p = 0.019) of PA, indicating stable and predictable daily activity patterns, were associated with lower TG and TG/HDL-C ratios. A greater amplitude of PA rhythms was also associated with lower TG (β = -0.345, p = 0.002). An earlier timing of daily activity (acrophase) was associated with higher TC and LDL-C (β = -0.492, p < 0.001), while earlier wake times (β = -0.309, p = 0.009) and higher sleep efficiency (β = 0.237, p = 0.011) were associated with higher HDL-C. These findings highlight the relevance of circadian rhythmicity in dyslipidemia management, particularly in extreme photoperiods, suggesting that lifestyle interventions promoting stable daily activity and sleep patterns may be associated with improved metabolic health and reduced cardiovascular risk.

Driver fatigue poses a severe risk to road safety, contributing to approximately 20% of fatal accidents worldwide. While EEG signals are the gold standard for detecting fatigue, existing methods struggle to capture the complex spatiotemporal patterns in EEG data. We propose MSDA-Net, a multiscale spatiotemporal dual-attention network that integrates multiscale CNNs, GRUs and dual-attention mechanisms to dynamically prioritise spatial channels and temporal segments, which are critical for fatigue detection. The model processes EEG data through three blocks: a multidimensional signal encoding block, which transforms raw signals into 4D differential entropy features; a multiscale spatial attention block, which extracts local and global spatial patterns; and a temporal modelling block, featuring a GRU and temporal attention. Finally, a fully connected layer and sigmoid activation are used to classify fatigue states. Evaluated on the SEED-VIG dataset, MSDA-Net achieves state-of-the-art performance, significantly outperforming existing methods. This study can provide new insights into brain fatigue research and play a significant role in advancing the field's development.

Environmental high temperatures can strongly affect sleep. Our aim was to assess the protective effect of a High Heat Conductivity Mattress topper (HHCM) on sleep duration and quality during one night's exposure to heat. HHCM efficacy was studied in a randomised double-blind crossover design in fifteen healthy young active subjects by overnight polysomnography in a temperature-controlled sleep laboratory, during 4 nights: 2 nights at 22°C (HHCM and Control Mattress, CM) and 2 nights at 32°C (HHCM and CM). Core body temperature (CBT), skin, room and mattress toppers surface temperatures were continuously recorded. We observed interactions between temperature and mattress conditions. At 22°C, we did not show any beneficial effect of HHCM compared to CM on sleep duration, but a longer N3 sleep stage duration (p = 0.03) and higher slow oscillation spectral density (p = 0.03). Heat night exposure (32°C) induced a decrease in total sleep time (TST) (-24.8 ± 7.1 min, p = 0.02), rapid eye movement (REM) duration (p = 0.03), sleep efficiency (p = 0.04), delta power spectral density (p = 0.03) and an increase of wake after sleep onset (p = 0.03) and transition between stages rate (p = 0.02). At 32°C, in comparison to CM, HHCM induced higher TST (+21.4 ± 16.1 min, p = 0.04), sleep efficiency (p = 0.04), REM duration (p = 0.03), and lower awakening duration (p = 0.03). These effects were associated with lower skin temperature and CBT. In conclusion, HHCM improves sleep quality and has a protective effect on CBT and sleep patterns during heat exposure in active healthy subjects. It could be a countermeasure for promoting sleep in particular during heat waves.

Insomnia disorder has a considerable effect on mental health, making its effective management crucial in clinical practice. An observational study was conducted on consecutive outpatients with insomnia disorder (DSM-5-TR criteria) attending the Insomnia Clinic of the Psychiatric Unit of the University Hospital of Pisa (Italy). Patients were treated according to insomnia guidelines with DORA Daridorexant. Evaluations were performed at baseline (T0), 1 month (T1) and 3 months (T2). Data collected included clinical assessments of insomnia severity (Insomnia Severity Index [ISI]), depressive and mixed symptoms (Beck Depression Inventory II [BDI-II], Young Mania Rating Scale [YMRS]) and emotional dysregulation (Difficulties in Emotion Regulation Scale [DERS], Frontal Assessment Battery [FAB]). Concurrent pharmacological treatments were collected. The study included 90 patients (mean age 53 ± 13.6 years, n° = 43 females). A significant proportion (63.3%) was comorbid with unipolar or bipolar depression and sedative-hypnotic use disorders. Repeated measures ANOVA analyses revealed a significant improvement for the ISI, DERS and FAB over time, with F-values of 24.23, 15.56 and 21.74 (p < 0.001). Additionally, BDI-II and YMRS scores showed significant decreases during the same period, with F-values of 10.24, 10.33 and 70.00 (p < 0.001). Multiple regression analyses indicated that improvements in depressive symptoms were best predicted by improvement in DERS and ISI, while mixed symptoms were predicted by ISI and FAB improvements. With the caution of a naturalistic design, this study may show that by treating insomnia comorbid to other mental disorders, it may be possible to improve not only insomnia symptoms but also emotion regulation and executive functions.

Overnight polysomnography (PSG) poses logistical and financial challenges in resource-constrained settings for the diagnosis of OSA. This study aimed to develop a simple, effective screening tool for identifying individuals at risk for OSA. Data from 1015 healthy volunteers enrolled in the BLESS cohort were analysed, all of whom underwent Level I PSG. Optimal thresholds for selected demographic, anthropometric and clinical variables were determined using a bootstrapped matrix maximisation method, with apnoea-hypopnoea index (AHI) as the reference. The dataset was split into training (n = 732) and testing (n = 244) subsets, and four predictive models were developed. A scoring system, termed SONA, was derived from coefficients of the best-performing model. Its performance was compared to existing tools. The final model incorporated four variables (AIC = 699.21, BIC = 726.79, pseudo-R ² = 0.36): waist circumference (> 93 cm in males, > 85 cm in females) and neck circumference (> 37 cm in males, > 32 cm in females) assigned 3 points each; age (> 35 years in males, > 45 years in females) assigned 2 points; and presence of snoring assigned 3 points. The total score ranged from 0 to 11. Diagnostic cut-offs were identified at scores of 5 (i.e., any two variables affirmative) in community settings and 8 (i.e., any three variables affirmative) in hospital settings. At AHI cut-off of 15, the SONA score demonstrated superior discrimination (AUC = 0.83; p value < 0.001) compared to STOPBANG (0.72), NoSAS (0.77), GOAL (0.74) and the Berlin Questionnaire (0.70). The SONA score offers a simpler, more accurate alternative for OSA screening compared to existing tools and is well-suited for implementation in primary care and resource-limited settings.

Sleep loss impairs many cognitive functions, ranging from simple attention to working memory. This study explores the extent to which people are aware of such impairments, their metacognitive accuracy, across different cognitive tests. Healthy participants (N = 182) were randomised to one night of total sleep deprivation or three nights of sufficient sleep. The next day they performed several cognitive tests, measuring simple attention, cognitive throughput, working memory, episodic memory and executive processing (using a Stroop task). After each test, participants rated how well they thought they performed. We operationalised metacognitive accuracy as the ability to correctly identify whether one performed above or below the median. We then used Bayesian methods to estimate the difference in this ability between the well-rested and sleep-deprived groups. The probability was 55% in the sleep-deprived group, and 59% in the rested group, suggesting some decrease in performance awareness during sleep loss. However, the probability that this difference in judgements is practically significant (i.e., exceeding 10 percentage points) is below 1%. Cognitive ability generally declines during sleep deprivation, and this was at least somewhat reflected in a decrease in how people rated their performance. The question remains whether and how people compensate for any sleep-loss induced cognitive impairments.

This study aimed to determine the optimal configuration of wrist actigraphy for detecting sleep-wake patterns in adults with varying categories of general motor activity (Aim 1), and to assess its validity in relation to polysomnography (Aim 2). For Aim 1, a systematic review was conducted in accordance with PRISMA and QUADAS-2 guidelines using data sources including Embase, MedlineALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, PsycINFO, Cinahl, and Google Scholar. For Aim 2, a meta-analysis was performed on mean sleep differences between actigraphy and polysomnography of studies that analysed actigraphy using the optimal configuration with similar categories of general motor activity. In total, 21 studies that investigated the Oakley algorithm (used by Actiwatch and Motionwatch) in various sleep-wake thresholds provided sufficient information to define the optimal threshold (Aim 1). Additionally, 39 studies (all using Actiwatch) validated the optimal threshold for the respective category of general motor activity and were used to determine its validity (Aim 2). Findings regarding Aim 1 indicated that for actigraphs using the Oakley algorithm, no threshold other than the default setting of 40 cpm minimised differences between actigraphy and polysomnography for adults with normal general motor activity. However, a threshold of 20 cpm enhanced accuracy for adults with reduced general motor activity. Due to the heterogeneity of the studies included for Aim 2, it was not possible to determine the validity of actigraphy, and thereby the minimum general motor activity needed for reliable actigraphy. Further research on customising actigraph configurations is needed.

Sleep problems are frequent in functional motor disorders (FMDs). Surprisingly, objective correlates of impaired sleep and its relationship to other comorbidities have been understudied, and no polysomnographic study is available. We aimed to map the polysomnographic parameters in the context of self-reported sleep and mood symptoms and search for comorbid sleep disorders in FMD and healthy controls. Thirty-seven patients (mean age [SD], 48.2 [10.6] years) with clinically definite FMD and 37 controls (48.6 [11.2] years) underwent structured medical and sleep history assessment, neurological examination and polysomnography and completed questionnaires for sleep quality, sleepiness, depression and anxiety. In FMD, specific sleep disorders were identified in our cohort, with 32% having restless legs syndrome, 38% clinically significant obstructive sleep apnoea and 8% periodic limb movements in sleep. FMD patients reported worse sleep quality (p < 0.001), higher sleepiness (p < 0.001), depression (p < 0.001) and anxiety (p < 0.001), had longer REM sleep latency (p < 0.001), worse sleep efficiency (p = 0.012) and increased wake ratio (p = 0.013). Furthermore, longer sleep latency (p = 0.030) and decreased REM sleep ratio (p = 0.027) in FMD reached nominal significance before adjustment for multiple comparisons. In FMD, subjective sleep quality positively correlated with depression (ρ = 0.54; p < 0.002) and anxiety (ρ = 0.61; p < 0.001) and subjective sleepiness correlated with depression (ρ = 0.42; p = 0.010). Self-reported measures did not correlate with any polysomnographic parameters. Polysomnography detected sleep structure changes in FMD. Sleep abnormalities, including impairments in REM sleep, should be considered in the management of FMD. Future studies should further explore the role of REM sleep disturbances in the pathophysiology of FMD.