Sleep medicine最新文献_第3页

Impact of sleep apnea on direct societal and healthcare expenses in elderly patients: A nationwide register-based case-control study 睡眠呼吸暂停对老年患者直接社会和医疗费用的影响：一项基于全国登记的病例对照研究

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-30 DOI: 10.1016/j.sleep.2025.108762

Mads Hashiba , Christine Benn Christiansen , Michael Ibsen , Sebastian Kinnberg Nielsen , Jeppe Suusgaard , Jakob Kjellberg , Morten Kjøbek Lamberts , Poul J. Jennum

Background

The demographic shift toward an aging population in Western societies increases healthcare demands. Obstructive sleep apnea (OSA), frequently underdiagnosed, is associated with health consequences. However, its broader economic impact on welfare and healthcare systems is inadequately quantified.

Objective

To examine the direct societal and healthcare-related expenses following a diagnosis of OSA in elderly individuals.

Methods

In this nationwide, register-based case-control study, individuals aged ≥65 years diagnosed with OSA between 2002 and 2019 were identified and matched 1:4 to controls by age, sex, cohabitation status, and municipality. Societal costs were defined as income from employment and public transfers. Healthcare costs were assessed using national healthcare registries. All financial data was adjusted to 2020 values.

Results

A total of 21,555 elderly with OSA (mean age 71 years, 29.1 % female) were included and matched to 86,212 controls. During the year of diagnosis, 11.8 % of cases were employed, whereas 76.3 % received public pension. Compared to controls, OSA patients had significantly lower employment income (€23,102 vs. €23,810; p < 0.001 prior to, and €4381 vs €4486 (p < 0.001 after diagnosis) and higher public transfers. Healthcare costs nearly doubled in the index year compared to the preceding year, resulting in a net cost difference of €5219 per patient-year (p < 0.001)

Conclusions

Elderly patients with OSA incur substantially increased societal and healthcare-related costs compared to matched controls. Our findings underscore the need for early identification and treatment of OSA to potentially mitigate economic burden.

背景：西方社会人口向老龄化的转变增加了医疗保健需求。阻塞性睡眠呼吸暂停（OSA）经常被误诊，与健康后果有关。然而，它对福利和医疗体系的更广泛的经济影响还没有得到充分的量化。目的：探讨老年人OSA诊断后的直接社会和医疗相关费用。方法：在这项全国性的、基于登记的病例对照研究中，在2002年至2019年期间，年龄≥65岁被诊断为OSA的个体被确定，并按年龄、性别、同居状况和所在城市与对照组进行1:4匹配。社会成本被定义为来自就业和公共转移的收入。使用国家医疗保健登记处评估医疗保健费用。所有财务数据调整为2020年的数值。结果：共纳入21,555例OSA老年患者（平均年龄71岁，29.1%为女性），对照86,212例。在诊断年度，11.8%的病例受雇，而76.3%的病例领取公共养恤金。与对照组相比，OSA患者的就业收入明显较低(23,102欧元对23,810欧元；p

{"title":"Impact of sleep apnea on direct societal and healthcare expenses in elderly patients: A nationwide register-based case-control study","authors":"Mads Hashiba , Christine Benn Christiansen , Michael Ibsen , Sebastian Kinnberg Nielsen , Jeppe Suusgaard , Jakob Kjellberg , Morten Kjøbek Lamberts , Poul J. Jennum","doi":"10.1016/j.sleep.2025.108762","DOIUrl":"10.1016/j.sleep.2025.108762","url":null,"abstract":"<div><h3>Background</h3><div>The demographic shift toward an aging population in Western societies increases healthcare demands. Obstructive sleep apnea (OSA), frequently underdiagnosed, is associated with health consequences. However, its broader economic impact on welfare and healthcare systems is inadequately quantified.</div></div><div><h3>Objective</h3><div>To examine the direct societal and healthcare-related expenses following a diagnosis of OSA in elderly individuals.</div></div><div><h3>Methods</h3><div>In this nationwide, register-based case-control study, individuals aged ≥65 years diagnosed with OSA between 2002 and 2019 were identified and matched 1:4 to controls by age, sex, cohabitation status, and municipality. Societal costs were defined as income from employment and public transfers. Healthcare costs were assessed using national healthcare registries. All financial data was adjusted to 2020 values.</div></div><div><h3>Results</h3><div>A total of 21,555 elderly with OSA (mean age 71 years, 29.1 % female) were included and matched to 86,212 controls. During the year of diagnosis, 11.8 % of cases were employed, whereas 76.3 % received public pension. Compared to controls, OSA patients had significantly lower employment income (€23,102 vs. €23,810; p < 0.001 prior to, and €4381 vs €4486 (p < 0.001 after diagnosis) and higher public transfers. Healthcare costs nearly doubled in the index year compared to the preceding year, resulting in a net cost difference of €5219 per patient-year (p < 0.001)</div></div><div><h3>Conclusions</h3><div>Elderly patients with OSA incur substantially increased societal and healthcare-related costs compared to matched controls. Our findings underscore the need for early identification and treatment of OSA to potentially mitigate economic burden.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108762"},"PeriodicalIF":3.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Circadian rest-activity rhythm in patients with narcolepsy following modafinil treatment: Outcomes and predictive markers 莫达非尼治疗后发作性睡病患者的昼夜作息节律：结果和预测指标。

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-29 DOI: 10.1016/j.sleep.2025.108756

Wei-Chih Chin , Si-Yu Chu , Tsun-Yi Roan , Pin-Yi Lee , I. Tang , Chen Lin , Yu-Shu Huang

Objectives

Hypersomnolence of narcolepsy is commonly treated with modafinil, but its impacts on circadian rhythm remain unclear. Compared with standard parametric analyses, the non-parametric analysis of actigraphy offers more details to observe sleep-wake patterns. This study monitored narcolepsy patients' rest-activity patterns before and after modafinil treatment by actigraphy. Data were analyzed with non-parametric methods to evaluate outcomes and investigate the potential predictive markers for treatment response.

Methods

We prospectively recruited participants with type 1 and 2 narcolepsy. Participants received 200–400 mg of modafinil daily for six months and actigraphy was worn for 7–14 days before and after treatment. We used paired sample t-tests for pre- and post-treatment comparisons and independent sample t-tests and chi-square tests to assess group differences. Correlation analyses were conducted using Pearson's correlation test.

Results

A total of 103 participants (mean age: 23.95 ± 10.14 years; 53.4 % male) were recruited, including 64 with NT1 and 39 with NT2. After modafinil treatment, significant increases in daytime activity were observed, along with an earlier shift in the midpoint time of daytime activity. Patients with NT1 showed more improvements than those with NT2. Correlation analysis showed that subjective sleepiness and quality of life were associated with circadian parameters, and patients with a higher REM percentage and those with nocturnal sleep onset REM period demonstrated greater improvements in circadian parameters.

Conclusion

Modafinil improves circadian rest-activity rhythms in narcolepsy patients, especially those with NT1. The role of REM percentage and nocturnal SOREMP as predictive markers for treatment outcomes warrant further investigation.

目的：嗜睡症的嗜睡通常用莫达非尼治疗，但其对昼夜节律的影响尚不清楚。与标准参数分析相比，活动图的非参数分析提供了更多的细节来观察睡眠-觉醒模式。本研究通过活动描记术监测发作性睡病患者在莫达非尼治疗前后的休息-活动模式。采用非参数方法对数据进行分析，以评估结果并研究治疗反应的潜在预测指标。方法：我们前瞻性地招募1型和2型发作性睡病患者。参与者每天服用200-400毫克莫达非尼，持续6个月，并在治疗前后佩戴活动记录仪7-14天。我们使用配对样本t检验进行治疗前后比较，使用独立样本t检验和卡方检验评估组间差异。采用Pearson相关检验进行相关分析。结果：共纳入103例患者（平均年龄：23.95±10.14岁，男性53.4%），其中NT1患者64例，NT2患者39例。在莫达非尼治疗后，观察到白天活动显著增加，同时白天活动中点时间提前。NT1患者比NT2患者表现出更多的改善。相关性分析表明，主观嗜睡和生活质量与昼夜节律参数相关，REM睡眠率较高的患者和夜间睡眠开始的REM睡眠期患者的昼夜节律参数改善更大。结论：莫达非尼可改善发作性睡病患者的昼夜休息-活动节律，尤其是NT1患者。REM百分比和夜间SOREMP作为治疗结果的预测指标的作用值得进一步研究。

{"title":"Circadian rest-activity rhythm in patients with narcolepsy following modafinil treatment: Outcomes and predictive markers","authors":"Wei-Chih Chin , Si-Yu Chu , Tsun-Yi Roan , Pin-Yi Lee , I. Tang , Chen Lin , Yu-Shu Huang","doi":"10.1016/j.sleep.2025.108756","DOIUrl":"10.1016/j.sleep.2025.108756","url":null,"abstract":"<div><h3>Objectives</h3><div>Hypersomnolence of narcolepsy is commonly treated with modafinil, but its impacts on circadian rhythm remain unclear. Compared with standard parametric analyses, the non-parametric analysis of actigraphy offers more details to observe sleep-wake patterns. This study monitored narcolepsy patients' rest-activity patterns before and after modafinil treatment by actigraphy. Data were analyzed with non-parametric methods to evaluate outcomes and investigate the potential predictive markers for treatment response.</div></div><div><h3>Methods</h3><div>We prospectively recruited participants with type 1 and 2 narcolepsy. Participants received 200–400 mg of modafinil daily for six months and actigraphy was worn for 7–14 days before and after treatment. We used paired sample t-tests for pre- and post-treatment comparisons and independent sample t-tests and chi-square tests to assess group differences. Correlation analyses were conducted using Pearson's correlation test.</div></div><div><h3>Results</h3><div>A total of 103 participants (mean age: 23.95 ± 10.14 years; 53.4 % male) were recruited, including 64 with NT1 and 39 with NT2. After modafinil treatment, significant increases in daytime activity were observed, along with an earlier shift in the midpoint time of daytime activity. Patients with NT1 showed more improvements than those with NT2. Correlation analysis showed that subjective sleepiness and quality of life were associated with circadian parameters, and patients with a higher REM percentage and those with nocturnal sleep onset REM period demonstrated greater improvements in circadian parameters.</div></div><div><h3>Conclusion</h3><div>Modafinil improves circadian rest-activity rhythms in narcolepsy patients, especially those with NT1. The role of REM percentage and nocturnal SOREMP as predictive markers for treatment outcomes warrant further investigation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108756"},"PeriodicalIF":3.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Images in Sleep Medicine Title: Is positional therapy the adequate therapy for all positional OSA (POSA) patients? 标题：体位疗法是否适用于所有体位性OSA （POSA）患者？

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-29 DOI: 10.1016/j.sleep.2025.108761

Arie Oksenberg

Background

Positional Therapy (PT) is a behavioral treatment of choice for many Obstructive Sleep Apnea (OSA) patients who suffer from positional OSA (POSA), i.e.patients who show apneas and hypopneas related mainly to a specific sleep posture, which in most of the cases is the supine position.

Case Presentation

Here we report the poslysomnographic data of a 36 years old patient with severe POSA with a clear positional effect on the occurrence of apneas and with continuous and loud snoring in the lateral postures.

Discussion

This particular case calls into question if PT is the right solution for this patient. Here we discussed the pro - and - con arguments for using PT in this particular patient and we also offer a few possible treatment alternatives.

背景：体位疗法（position Therapy， PT）是许多阻塞性睡眠呼吸暂停（OSA）患者的行为治疗选择，这些患者患有体位性睡眠呼吸暂停（POSA），即主要与特定睡眠姿势相关的呼吸暂停和呼吸不足的患者，大多数情况下是仰卧位。病例介绍：我们报告一名36岁的严重POSA患者，其呼吸暂停的发生有明显的体位影响，并且在侧卧位时持续且大声打鼾。讨论：这个特殊的病例引起了对PT是否适合这个病人的质疑。在这里，我们讨论了支持和反对在这个特殊的病人中使用PT，我们也提供了一些可能的治疗方案。

引用次数: 0

Effects of a partner-assisted insomnia intervention on couples’ relationships: A qualitative study 伴侣辅助失眠干预对夫妻关系的影响：一项定性研究。

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-29 DOI: 10.1016/j.sleep.2025.108746

Aislinn F. Lalor , Melodi Durukan , Kellie Hamill , Alix Mellor , Sean P.A. Drummond

Background

Insomnia is typically considered an individual-level disorder, just as sleep is considered an individual-level behavior. However, data indicate sleep in one bedpartner influences sleep in the other, and poor sleep affects daytime functioning and interpersonal relationships. Bedpartners can also influence outcomes of Cognitive Behavioral Therapy for Insomnia (CBTI). Therefore, incorporating the bedpartner into CBTI may benefit both individuals and their relationships.

Objective

To explore experiences of insomnia clients and their bedpartners during a novel partner-assisted insomnia intervention.

Method

An exploratory qualitative design was undertaken. Individuals 18+ years-old, with a DSM-5 diagnosis of Insomnia Disorder and a stable (≥ one month) bedpartner were eligible to participate. Data were collected by in-depth semi-structured interviews with participants and their partners following the completion of either individual CBTI (I-CBTI) or partner-assisted CBTI (PA-CBTI) (n = 30 couples (15 per treatment condition)). Interviews were audio-recorded, transcribed verbatim and thematically analyzed.

Results

Four themes were identified: (1) partners providing emotional support is paramount; (2) partner-assisted treatment enables couples to spend more time together; (3) partner help with treatment is significant; and (4) better understanding of the client by their partner through learning is important. The first two themes were only identified in the partner-assisted condition.

Discussion

These data provide insight into how bedpartners can play a role in CBTI. They also suggest including bedpartners in treatment may have positive benefits for the intimate relationship, as well. This study helps advance our understanding of sleep, and the treatment of insomnia, as dyadic, social behaviors.

背景：失眠通常被认为是一种个体层面的疾病，就像睡眠被认为是一种个体层面的行为一样。然而，数据表明，睡在一张床上会影响另一张床上的睡眠，而睡眠不佳会影响白天的功能和人际关系。床伴也会影响失眠认知行为治疗（CBTI）的结果。因此，将床伴纳入CBTI可能对个人和他们的关系都有益。目的：探讨失眠症患者及其床伴在一种新型伴侣辅助失眠干预中的体验。方法：进行探索性定性设计。18岁以上、诊断为DSM-5失眠且有稳定（≥1个月）床伴的个体符合参与条件。在完成个体CBTI （I-CBTI）或伴侣辅助CBTI （PA-CBTI）后，通过对参与者及其伴侣的深度半结构化访谈收集数据（n = 30对夫妇（每种治疗条件15对））。采访录音，逐字抄录，并按主题进行分析。结果：确定了四个主题：(1)伴侣提供情感支持至关重要；(2)伴侣辅助治疗使夫妻有更多的时间在一起；(3)伴侣帮助治疗效果显著；(4)合作伙伴通过学习更好地了解客户是很重要的。前两个主题仅在伴侣辅助条件下被确定。讨论：这些数据为床伴如何在CBTI中发挥作用提供了见解。他们还建议，将床伴纳入治疗可能对亲密关系也有积极的好处。这项研究有助于提高我们对睡眠的理解，以及作为二元社会行为的失眠治疗。

{"title":"Effects of a partner-assisted insomnia intervention on couples’ relationships: A qualitative study","authors":"Aislinn F. Lalor , Melodi Durukan , Kellie Hamill , Alix Mellor , Sean P.A. Drummond","doi":"10.1016/j.sleep.2025.108746","DOIUrl":"10.1016/j.sleep.2025.108746","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is typically considered an individual-level disorder, just as sleep is considered an individual-level behavior. However, data indicate sleep in one bedpartner influences sleep in the other, and poor sleep affects daytime functioning and interpersonal relationships. Bedpartners can also influence outcomes of Cognitive Behavioral Therapy for Insomnia (CBTI). Therefore, incorporating the bedpartner into CBTI may benefit both individuals and their relationships.</div></div><div><h3>Objective</h3><div>To explore experiences of insomnia clients and their bedpartners during a novel partner-assisted insomnia intervention.</div></div><div><h3>Method</h3><div>An exploratory qualitative design was undertaken. Individuals 18+ years-old, with a DSM-5 diagnosis of Insomnia Disorder and a stable (≥ one month) bedpartner were eligible to participate. Data were collected by in-depth semi-structured interviews with participants and their partners following the completion of either individual CBTI (I-CBTI) or partner-assisted CBTI (PA-CBTI) (n = 30 couples (15 per treatment condition)). Interviews were audio-recorded, transcribed verbatim and thematically analyzed.</div></div><div><h3>Results</h3><div>Four themes were identified: (1) partners providing emotional support is paramount; (2) partner-assisted treatment enables couples to spend more time together; (3) partner help with treatment is significant; and (4) better understanding of the client by their partner through learning is important. The first two themes were only identified in the partner-assisted condition.</div></div><div><h3>Discussion</h3><div>These data provide insight into how bedpartners can play a role in CBTI. They also suggest including bedpartners in treatment may have positive benefits for the intimate relationship, as well. This study helps advance our understanding of sleep, and the treatment of insomnia, as dyadic, social behaviors.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108746"},"PeriodicalIF":3.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring sleep outcomes in youth across settings: Are there differences based on rurality or medically underserved status in the ECHO cohort? 探索不同环境下青少年的睡眠结果：在ECHO队列中是否存在基于农村或医疗服务不足状况的差异？

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-27 DOI: 10.1016/j.sleep.2025.108754

Brittany D. Lancaster , Anna Wallisch , Emily A. Knapp , Xuan Li , Lacey A. McCormack , Kelly A. Hirko , Traci A. Bekelman , Christine W. Hockett , for the ECHO Cohort Consortium

Objective

To evaluate associations between rurality and medically underserved status with sleep outcomes (e.g., duration, bed and wake times, latency) among youth in the United States.

Methods

The study sample included 22,234 youth (aged 1–17 years) from the Environmental influences on Child Health Outcomes (ECHO) Program. Sleep was measured by parent-report questionnaire for children ages 7 and under and child-report for older children. Residential addresses and Federal Information Processing Standards codes were utilized to classify participants into two binary exposure variables: rural vs. nonrural and medically underserved vs. not medically underserved. Differences between groups for each developmental period were compared using t-tests and chi-squared tests.

Results

Across children ages 1–12, rural youth went to bed significantly earlier (mean differences [MD] range from 18 to 52 min) and woke earlier (MD range 15–52 min) compared to non-rural youth. Children aged 1–12 living in medically underserved areas were significantly less likely to meet sleep recommendations (MD range 3.2 %–6.6 % less), and youth of all ages tended to have later bedtimes (MD range 7–30 min) compared to youth not living in medically underserved areas.

Discussion

This study is novel because it evaluates differences in youth sleep health based on rurality and medically underserved status in the United States. Multiple variations in children's sleep health were identified based on living in medically underserved areas while minimal differences were noted based on rurality. Future research should focus on the development or dissemination of effective programs into pre-established resources (e.g., daycares, community centers) for youth in medically underserved areas.

目的：评估美国青少年的乡村性和医疗服务不足状况与睡眠结果（如持续时间、卧床和醒着时间、潜伏期）之间的关系。方法：研究样本包括22234名来自环境影响儿童健康结局（ECHO）项目的青少年（1-17岁）。7岁及以下儿童采用家长报告问卷，7岁及以上儿童采用儿童报告问卷。使用居住地址和联邦信息处理标准代码将参与者分为两个二元暴露变量：农村与非农村以及医疗服务不足与非医疗服务不足。各组各发育时期的差异采用t检验和卡方检验进行比较。结果：在1-12岁的儿童中，与非农村青少年相比，农村青少年睡得更早（平均差异[MD]范围为18 -52分钟），醒得更早（MD范围为15-52分钟）。生活在医疗服务不足地区的1-12岁儿童明显不太可能满足睡眠建议（MD范围低3.2% - 6.6%），与没有生活在医疗服务不足地区的青少年相比，所有年龄段的青少年往往有更晚的就寝时间（MD范围7-30分钟）。讨论：这项研究是新颖的，因为它评估了基于美国农村和医疗服务不足状况的青少年睡眠健康的差异。根据生活在医疗服务不足的地区，确定了儿童睡眠健康的多种差异，而农村地区的差异很小。未来的研究应侧重于为医疗服务不足地区的青少年开发或传播有效的方案，使其进入预先建立的资源（如日托、社区中心）。

{"title":"Exploring sleep outcomes in youth across settings: Are there differences based on rurality or medically underserved status in the ECHO cohort?","authors":"Brittany D. Lancaster , Anna Wallisch , Emily A. Knapp , Xuan Li , Lacey A. McCormack , Kelly A. Hirko , Traci A. Bekelman , Christine W. Hockett , for the ECHO Cohort Consortium","doi":"10.1016/j.sleep.2025.108754","DOIUrl":"10.1016/j.sleep.2025.108754","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate associations between rurality and medically underserved status with sleep outcomes (e.g., duration, bed and wake times, latency) among youth in the United States.</div></div><div><h3>Methods</h3><div>The study sample included 22,234 youth (aged 1–17 years) from the Environmental influences on Child Health Outcomes (ECHO) Program. Sleep was measured by parent-report questionnaire for children ages 7 and under and child-report for older children. Residential addresses and Federal Information Processing Standards codes were utilized to classify participants into two binary exposure variables: rural vs. nonrural and medically underserved vs. not medically underserved. Differences between groups for each developmental period were compared using t-tests and chi-squared tests.</div></div><div><h3>Results</h3><div>Across children ages 1–12, rural youth went to bed significantly earlier (mean differences [MD] range from 18 to 52 min) and woke earlier (MD range 15–52 min) compared to non-rural youth. Children aged 1–12 living in medically underserved areas were significantly less likely to meet sleep recommendations (MD range 3.2 %–6.6 % less), and youth of all ages tended to have later bedtimes (MD range 7–30 min) compared to youth not living in medically underserved areas.</div></div><div><h3>Discussion</h3><div>This study is novel because it evaluates differences in youth sleep health based on rurality and medically underserved status in the United States. Multiple variations in children's sleep health were identified based on living in medically underserved areas while minimal differences were noted based on rurality. Future research should focus on the development or dissemination of effective programs into pre-established resources (e.g., daycares, community centers) for youth in medically underserved areas.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108754"},"PeriodicalIF":3.4,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Subjective sleep quality predict clinical pain severity more strongly than polysomnographic parameters: Machine learning findings from a cross-sectional study 主观睡眠质量比多导睡眠图参数更能预测临床疼痛严重程度：一项横断面研究的机器学习发现。

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-27 DOI: 10.1016/j.sleep.2025.108753

Nandini Raghuraman , Eric Duan , Rachel Massalee , Yang Wang

Poor sleep quality amplifies pain experience. However, it remains uncertain regarding whether subjectively or physiologically assessed sleep parameters better predict pain, given reported discrepancies between the subjective and physiological measures of sleep quality.

This secondary analysis examined data from 556 adults in the Cleveland Family Study. Clinical pain severity was assessed using the two-item SF-36 pain subscale. Subjective sleep quality was measured by the Functional Outcomes of Sleep Questionnaire, and physiological sleep quality was assessed via polysomnography. To examine complex sleep-pain relationships, machine learning (ML) models were utilized. The dataset was split into training (70 %) and testing (30 %) subsets. After feature selection, Gradient Boosted Regression (GBR) was applied to develop a predictive model, validated by Random Forest (RF) and Elastic Net Regression (ENR).

Results indicated similar prediction accuracy and feature importance across GBR, RF, and ENR. Sociodemographic, clinical, and anthropometric factors explained 32 % of the variance in clinical pain using GBR; inclusion of sleep profiles increased explained variance to 35 %. Analysis of the feature importance revealed subjective experiences of post-sleep activity and vigilance as the strongest predictors of pain severity, rather than physiologically measured sleep quality. We further confirm this finding using K-means clustering analysis.

These findings highlight the significant role of subjective sleep quality compared to physiological sleep measures in influencing clinical pain severity. They also suggest the potential value of further investigating whether interventions aimed at improving perceived sleep quality may more effectively improve pain outcomes.

睡眠质量差会放大疼痛体验。然而，考虑到主观和生理睡眠质量测量之间的差异，主观或生理评估的睡眠参数是否能更好地预测疼痛仍不确定。这项二次分析检查了克利夫兰家庭研究中556名成年人的数据。临床疼痛严重程度采用两项SF-36疼痛量表进行评估。主观睡眠质量采用睡眠功能结局问卷测量，生理睡眠质量采用多导睡眠描记仪评估。为了研究复杂的睡眠-疼痛关系，使用了机器学习（ML）模型。数据集被分成训练子集（70%）和测试子集（30%）。在特征选择后，应用梯度增强回归（Gradient boosting Regression， GBR）建立预测模型，并通过随机森林（Random Forest， RF）和弹性网络回归（Elastic Net Regression， ENR）进行验证。结果表明，GBR、RF和ENR的预测精度和特征重要性相似。社会人口学、临床和人体测量因素解释了使用GBR的临床疼痛差异的32%；包括睡眠情况将解释方差增加到35%。对特征重要性的分析显示，睡眠后活动和警惕性的主观体验是疼痛严重程度的最强预测因素，而不是生理上测量的睡眠质量。我们使用K-means聚类分析进一步证实了这一发现。这些发现强调了主观睡眠质量与生理睡眠测量在影响临床疼痛严重程度方面的重要作用。他们还建议进一步研究旨在改善感知睡眠质量的干预措施是否能更有效地改善疼痛结果的潜在价值。

{"title":"Subjective sleep quality predict clinical pain severity more strongly than polysomnographic parameters: Machine learning findings from a cross-sectional study","authors":"Nandini Raghuraman , Eric Duan , Rachel Massalee , Yang Wang","doi":"10.1016/j.sleep.2025.108753","DOIUrl":"10.1016/j.sleep.2025.108753","url":null,"abstract":"<div><div>Poor sleep quality amplifies pain experience. However, it remains uncertain regarding whether subjectively or physiologically assessed sleep parameters better predict pain, given reported discrepancies between the subjective and physiological measures of sleep quality.</div><div>This secondary analysis examined data from 556 adults in the Cleveland Family Study. Clinical pain severity was assessed using the two-item SF-36 pain subscale. Subjective sleep quality was measured by the Functional Outcomes of Sleep Questionnaire, and physiological sleep quality was assessed via polysomnography. To examine complex sleep-pain relationships, machine learning (ML) models were utilized. The dataset was split into training (70 %) and testing (30 %) subsets. After feature selection, Gradient Boosted Regression (GBR) was applied to develop a predictive model, validated by Random Forest (RF) and Elastic Net Regression (ENR).</div><div>Results indicated similar prediction accuracy and feature importance across GBR, RF, and ENR. Sociodemographic, clinical, and anthropometric factors explained 32 % of the variance in clinical pain using GBR; inclusion of sleep profiles increased explained variance to 35 %. Analysis of the feature importance revealed subjective experiences of post-sleep activity and vigilance as the strongest predictors of pain severity, rather than physiologically measured sleep quality. We further confirm this finding using K-means clustering analysis.</div><div>These findings highlight the significant role of subjective sleep quality compared to physiological sleep measures in influencing clinical pain severity. They also suggest the potential value of further investigating whether interventions aimed at improving perceived sleep quality may more effectively improve pain outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108753"},"PeriodicalIF":3.4,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between sleep disturbances and circulating inflammatory markers in depressive and bipolar disorders: a systematic review and meta-analysis 抑郁症和双相情感障碍患者睡眠障碍与循环炎症标志物之间的关联：一项系统综述和荟萃分析。

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-26 DOI: 10.1016/j.sleep.2025.108735

Valeria Fiori, Caterina Lombardo, Andrea Ballesio

Evidence of a connection between sleep disturbances (i.e., difficulties in sleep onset or sleep maintenance) and inflammation in major depression (MDD) and bipolar (BD) disorders is still under debate. Here, we report a systematic review and meta-analysis on the correlation between sleep disturbances and peripheral proinflammatory markers in adult individuals with MDD or BD. The review followed the PRISMA guidelines and was registered in PROSPERO (CRD42025638037). Pubmed, Scopus, PsycInfo, Web of Science, MEDLINE, and CINAHL were searched up to January 2025. Of the 5694 articles retrieved, 21 studies met the inclusion criteria and were considered for the systematic review; 13 reported data for meta-analysis. DerSimonian and Laird random effect models showed that subjective sleep disturbances were significantly associated with pooled inflammatory markers (k = 13, n = 5261, r = .12, 95 % CI = .056 to .175, p < .001) and specifically C-reactive protein (CRP) levels (k = 8, n = 4949, r = .08, 95 % CI = .018 to .147, p = .012) in MDD patients. Meta-regressions revealed no evidence of moderation by BMI and sex. Analysis on interleukins (IL-6, IL-1β, IL-8), and tumour necrosis factor-α (TNF-α), did not reach statistical significance. The number of studies in BD patients did not suffice meta-analysis. While results may suggest a sleep-immune cross-talk in the pathophysiology of MDD, findings should be interpreted in light of the substantial meta-analytic heterogeneity.

关于睡眠障碍（即睡眠开始或睡眠维持困难）与重度抑郁症（MDD）和双相情感障碍（BD）的炎症之间的联系的证据仍在争论中。在此，我们报告了一项关于睡眠障碍与成年MDD或BD患者外周促炎标志物相关性的系统综述和荟萃分析。该综述遵循PRISMA指南，并在PROSPERO （CRD42025638037）中注册。Pubmed、Scopus、PsycInfo、Web of Science、MEDLINE和CINAHL的检索截止到2025年1月。在检索到的5694篇文章中，有21篇研究符合纳入标准，被纳入系统评价；13例报告数据进行meta分析。DerSimonian和Laird随机效应模型显示，主观睡眠障碍与综合炎症标志物显著相关(k = 13, n = 5261, r = 0.12, 95% CI = 0.056 ~。175页

{"title":"Association between sleep disturbances and circulating inflammatory markers in depressive and bipolar disorders: a systematic review and meta-analysis","authors":"Valeria Fiori, Caterina Lombardo, Andrea Ballesio","doi":"10.1016/j.sleep.2025.108735","DOIUrl":"10.1016/j.sleep.2025.108735","url":null,"abstract":"<div><div>Evidence of a connection between sleep disturbances (i.e., difficulties in sleep onset or sleep maintenance) and inflammation in major depression (MDD) and bipolar (BD) disorders is still under debate. Here, we report a systematic review and meta-analysis on the correlation between sleep disturbances and peripheral proinflammatory markers in adult individuals with MDD or BD. The review followed the PRISMA guidelines and was registered in PROSPERO (CRD42025638037). Pubmed, Scopus, PsycInfo, Web of Science, MEDLINE, and CINAHL were searched up to January 2025. Of the 5694 articles retrieved, 21 studies met the inclusion criteria and were considered for the systematic review; 13 reported data for meta-analysis. DerSimonian and Laird random effect models showed that subjective sleep disturbances were significantly associated with pooled inflammatory markers (k = 13, n = 5261, r = .12, 95 % CI = .056 to .175, p < .001) and specifically C-reactive protein (CRP) levels (k = 8, n = 4949, r = .08, 95 % CI = .018 to .147, p = .012) in MDD patients. Meta-regressions revealed no evidence of moderation by BMI and sex. Analysis on interleukins (IL-6, IL-1β, IL-8), and tumour necrosis factor-α (TNF-α), did not reach statistical significance. The number of studies in BD patients did not suffice meta-analysis. While results may suggest a sleep-immune cross-talk in the pathophysiology of MDD, findings should be interpreted in light of the substantial meta-analytic heterogeneity.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108735"},"PeriodicalIF":3.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacological management of insomnia with a focus on GABAA receptor positive allosteric modulators and orexin receptor antagonists 失眠的药理学管理，重点是GABAA受体阳性变构调节剂和食欲素受体拮抗剂

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-26 DOI: 10.1016/j.sleep.2025.108743

Chelsea Unger, Kristi A. Kohlmeier

The scientific literature regarding the effectiveness of two insomnia treatments: GABA_A receptor positive allosteric modulators, and orexin receptor antagonists is reviewed. In this review, we define insomnia, present epidemiological statistics on insomnia, and provide a rationale for use of medications targeting GABA_A and orexin receptors for management of insomnia. Following this, we present results of a PRISM guideline-based literature search spanning multiple databases, including PubMed, Google Scholar, ScienceDirect as well as curated searches through Baker Library at Harvard Business School covering publications evaluating insomnia therapies based on targeting GABA_A and orexin receptors available as of March 2025. We conclude that orexin receptor antagonists, notably lemborexant, were found to be more effective, safer, and improve quality of life greater when compared to GABA_A receptor positive allosteric modulators for short and long-term treatment of insomnia. While GABA_A receptor positive allosteric modulators are effective for short-term use, which typically spans two to four weeks, they present a greater number of contraindications than orexin receptor antagonists, and orexin receptor antagonists are superior at preserving the natural sleep architecture. Adverse events are particularly exacerbated when GABA_A receptor positive allosteric modulators are used for longer treatment durations spanning months, whereas orexin receptor antagonists tend to show a more favorable profile over similar long-term use. Nevertheless, there is an observed dose-response relationship with orexin receptor antagonists that may increase the risk of abuse at higher dosages. Approval for use of orexin receptor antagonists for management of insomnia is more restrictive in European countries than that seen in other regions around the globe. Taken together, the findings advocate for increased accessibility of orexin receptor antagonists in Europe for management of primary insomnia.

本文综述了GABAA受体阳性变构调节剂和食欲素受体拮抗剂两种治疗失眠的科学文献。在这篇综述中，我们定义了失眠症，介绍了失眠症的流行病学统计数据，并为使用靶向GABAA和食欲素受体的药物治疗失眠症提供了依据。在此之后，我们展示了基于PRISM指南的文献检索结果，该检索跨越多个数据库，包括PubMed， b谷歌Scholar， ScienceDirect以及哈佛商学院Baker图书馆的精选检索，涵盖截至2025年3月基于靶向GABAA和食欲素受体评估失眠治疗的出版物。我们的结论是，与GABAA受体阳性变构调节剂相比，食欲素受体拮抗剂，特别是lemborexant，在短期和长期治疗失眠方面更有效，更安全，更能改善生活质量。虽然GABAA受体阳性变构调节剂对短期使用有效，通常持续两到四周，但它们比食欲素受体拮抗剂有更多的禁忌症，而食欲素受体拮抗剂在保持自然睡眠结构方面更优越。当使用GABAA受体阳性变构调节剂的治疗持续时间较长（跨越数月）时，不良事件尤其加剧，而在类似的长期使用中，食欲素受体拮抗剂往往表现出更有利的情况。然而，观察到与食欲素受体拮抗剂存在剂量-反应关系，这可能会增加高剂量滥用的风险。与全球其他地区相比，欧洲国家对使用食欲素受体拮抗剂治疗失眠的批准更为严格。综上所述，这些发现提倡在欧洲增加食欲素受体拮抗剂用于治疗原发性失眠的可及性。

{"title":"Pharmacological management of insomnia with a focus on GABAA receptor positive allosteric modulators and orexin receptor antagonists","authors":"Chelsea Unger, Kristi A. Kohlmeier","doi":"10.1016/j.sleep.2025.108743","DOIUrl":"10.1016/j.sleep.2025.108743","url":null,"abstract":"<div><div>The scientific literature regarding the effectiveness of two insomnia treatments: GABA<sub>A</sub> receptor positive allosteric modulators, and orexin receptor antagonists is reviewed. In this review, we define insomnia, present epidemiological statistics on insomnia, and provide a rationale for use of medications targeting GABA<sub>A</sub> and orexin receptors for management of insomnia. Following this, we present results of a PRISM guideline-based literature search spanning multiple databases, including PubMed, Google Scholar, ScienceDirect as well as curated searches through Baker Library at Harvard Business School covering publications evaluating insomnia therapies based on targeting GABA<sub>A</sub> and orexin receptors available as of March 2025. We conclude that orexin receptor antagonists, notably lemborexant, were found to be more effective, safer, and improve quality of life greater when compared to GABA<sub>A</sub> receptor positive allosteric modulators for short and long-term treatment of insomnia. While GABA<sub>A</sub> receptor positive allosteric modulators are effective for short-term use, which typically spans two to four weeks, they present a greater number of contraindications than orexin receptor antagonists, and orexin receptor antagonists are superior at preserving the natural sleep architecture. Adverse events are particularly exacerbated when GABA<sub>A</sub> receptor positive allosteric modulators are used for longer treatment durations spanning months, whereas orexin receptor antagonists tend to show a more favorable profile over similar long-term use. Nevertheless, there is an observed dose-response relationship with orexin receptor antagonists that may increase the risk of abuse at higher dosages. Approval for use of orexin receptor antagonists for management of insomnia is more restrictive in European countries than that seen in other regions around the globe. Taken together, the findings advocate for increased accessibility of orexin receptor antagonists in Europe for management of primary insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108743"},"PeriodicalIF":3.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dysregulated emotional interference processing in affective and cognitive control brain regions in insomnia disorder 失眠症中情感和认知控制脑区的情绪干扰加工失调。

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-26 DOI: 10.1016/j.sleep.2025.108745

Shuo Wang , Yun Tian , Linzhe Zhong , Xu Lei

Study objectives

This study investigated the behavioral and neural responses underlying affective and cognitive control during emotional interference and their association with sleep disturbance in insomnia disorder (ID) patients.

Methods

Forty-three ID patients and 43 aged- and sex-comparable healthy controls (HC) completed an emotional interference task (EIT) while undergoing functional magnetic resonance imaging (fMRI) scanning. Sleep disturbance was assessed using self-report questionnaires. Analyses of variances (ANOVAs) were conducted on behavioral measures and brain activations. Correlations were used to examine the relationships between sleep disturbance and the significantly activated brain regions.

Results

Behaviorally, after controlling for trait anxiety, the ANOVA on reaction times (RTs) revealed a significant group × attention × emotion interaction. Specifically, compared with HC, ID patients exhibited significantly slower RTs when attending to neutral faces and ignoring fearful faces. For accuracy, a significant main effect of group indicated lower accuracy in ID patients than HC. Whole-brain ANOVA analysis revealed that under the ignore-fear condition, ID patients showed increased right dorsolateral prefrontal cortex (DLPFC) activation and reduced caudate nucleus activation, whereas under the attend-fear condition they showed reduced DLPFC and heightened caudate responses related to HC. Exploratory analyses indicated that, in ID patients, greater sleep disturbance was associated with less right caudate nucleus deactivation under the ignore-fear condition.

Conclusions

These findings suggest attention-dependent alterations in prefrontal control and striatal processing of emotional salience during emotional interference in ID, which may help explain how sleep disturbance is related to disrupted cognitive–emotional regulation in this condition.

研究目的：探讨失眠症患者情绪干扰时情绪和认知控制的行为和神经反应及其与睡眠障碍的关系。方法：43例ID患者和43例年龄和性别相当的健康对照（HC）在接受功能磁共振成像（fMRI）扫描的同时完成情绪干扰任务（EIT）。采用自我报告问卷对睡眠障碍进行评估。对行为测量和脑激活进行方差分析（anova）。相关性被用来检验睡眠障碍和显著激活的大脑区域之间的关系。结果：在控制特质焦虑后，反应时间（RTs）的方差分析显示显著的群体×注意×情绪交互作用。具体而言，与HC相比，ID患者在关注中性面孔和忽视恐惧面孔时表现出明显较慢的RTs。在准确性方面，组间主效应显著，表明ID患者的准确性低于HC患者。全脑方差分析显示，在忽视恐惧条件下，ID患者表现出右侧背外侧前额叶皮质（DLPFC）激活增加和尾状核激活减少，而在参与恐惧条件下，他们表现出与HC相关的DLPFC减少和尾状核反应增强。探索性分析表明，在忽视恐惧条件下，ID患者的睡眠障碍越大，右侧尾状核失活越少。结论：这些发现表明，在ID的情绪干扰过程中，前额叶控制和纹状体处理的情绪显著性发生了注意依赖性改变，这可能有助于解释睡眠障碍如何与这种情况下的认知-情绪调节中断有关。

{"title":"Dysregulated emotional interference processing in affective and cognitive control brain regions in insomnia disorder","authors":"Shuo Wang , Yun Tian , Linzhe Zhong , Xu Lei","doi":"10.1016/j.sleep.2025.108745","DOIUrl":"10.1016/j.sleep.2025.108745","url":null,"abstract":"<div><h3>Study objectives</h3><div>This study investigated the behavioral and neural responses underlying affective and cognitive control during emotional interference and their association with sleep disturbance in insomnia disorder (ID) patients.</div></div><div><h3>Methods</h3><div>Forty-three ID patients and 43 aged- and sex-comparable healthy controls (HC) completed an emotional interference task (EIT) while undergoing functional magnetic resonance imaging (fMRI) scanning. Sleep disturbance was assessed using self-report questionnaires. Analyses of variances (ANOVAs) were conducted on behavioral measures and brain activations. Correlations were used to examine the relationships between sleep disturbance and the significantly activated brain regions.</div></div><div><h3>Results</h3><div>Behaviorally, after controlling for trait anxiety, the ANOVA on reaction times (RTs) revealed a significant group × attention × emotion interaction. Specifically, compared with HC, ID patients exhibited significantly slower RTs when attending to neutral faces and ignoring fearful faces. For accuracy, a significant main effect of group indicated lower accuracy in ID patients than HC. Whole-brain ANOVA analysis revealed that under the ignore-fear condition, ID patients showed increased right dorsolateral prefrontal cortex (DLPFC) activation and reduced caudate nucleus activation, whereas under the attend-fear condition they showed reduced DLPFC and heightened caudate responses related to HC. Exploratory analyses indicated that, in ID patients, greater sleep disturbance was associated with less right caudate nucleus deactivation under the ignore-fear condition.</div></div><div><h3>Conclusions</h3><div>These findings suggest attention-dependent alterations in prefrontal control and striatal processing of emotional salience during emotional interference in ID, which may help explain how sleep disturbance is related to disrupted cognitive–emotional regulation in this condition.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108745"},"PeriodicalIF":3.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sleep duration and efficiency from 6 to 18 years of age in a birth cohort 出生队列中6 - 18岁的睡眠时间和效率

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine

Pub Date : 2025-12-25 DOI: 10.1016/j.sleep.2025.108739

Iná S. Santos , Priscila Echevarria , Isabel Oliveira Bierhals , Luciana Tovo-Rodrigues , Inácio Crochemore-Silva , Alicia Matijasevich

Background

Healthy sleep comprises a multidimensional sleep-wake pattern, adapted to individual, social and environmental demands, which promotes physical and mental well-being.

Objective

To describe sleep multitrajectories from 6 to 18 years of age.

Methods

Population-based birth cohort using information from 4231 participants assessed at birth and at 6, 11, 15, and 18 years of age. Bedtime, wake-up time, sleep duration, and sleep efficiency were measured through actigraphy. Group-based multitrajectory models (GBMTM) were applied to jointly explore the longitudinal changes in bedtime, wake-up time, sleep duration, and sleep efficiency over time. Maternal and child characteristics at birth were used to describe prevalence (with 95 % confidence interval) of sleep multitrajectories.

Results

3595, 3547, 1940, and 3447, respectively, at ages 6, 11, 15, and 18 years had information on sleep parameters, and 2412 were included in the multitrajectory analysis. In the entire cohort, sleep duration decreased from 7.54 h at 6 years to 6.84, 6.14, and 6.42 h, respectively, at 11, 15, and 18 years, and sleep efficiency improved with age from 81.0 % at 6 years to 85.0 % at 18. Three multitrajectory groups containning the simultaneous analysis on the four sleep parameters were defined: G1, G2 and G3, comprising, respectively, 28.8 %, 33.8 %, and 37.4 % of the sample. At 18 years, only adolescents from G3 achieved sleep duration and efficiency within the recommended range for age (respectively, 7.60 h/day and 86.0 %). Female adolescents and those with low birth weight had a greater likelihood of belonging to G3.

Conclusions

Although adolescents from the three groups presented an acceptable sleep duration at 6 years, by the end of adolescence only 37.4 % of them achieved the recommended sleep duration and efficiency needed for a good health and well-being, as defined by the United States National Sleep Foundation.

健康的睡眠包括一个多维度的睡眠-觉醒模式，适应个人、社会和环境的需求，促进身心健康。目的探讨6 ~ 18岁儿童的睡眠多轨迹。方法以人口为基础的出生队列，使用4231名参与者在出生时以及6岁、11岁、15岁和18岁时的信息进行评估。通过活动记录仪测量就寝时间、起床时间、睡眠持续时间和睡眠效率。采用基于组的多轨迹模型（GBMTM）共同探讨就寝时间、起床时间、睡眠持续时间和睡眠效率随时间的纵向变化。使用出生时的母婴特征来描述睡眠多轨迹的患病率（95%置信区间）。结果在6岁、11岁、15岁和18岁时，分别有3595名、3547名、1940名和3447名儿童有睡眠参数信息，其中2412名被纳入多轨迹分析。在整个队列中，睡眠时间从6岁时的7.54小时分别下降到11岁、15岁和18岁时的6.84、6.14和6.42小时，睡眠效率随着年龄的增长从6岁时的81.0%提高到18岁时的85.0%。定义了同时分析4个睡眠参数的3个多轨迹组：G1、G2和G3，分别占样本的28.8%、33.8%和37.4%。在18岁时，只有G3的青少年达到了年龄推荐范围内的睡眠时间和效率（分别为7.60小时/天和86.0%）。女性青少年和出生体重低的人更有可能属于G3。结论：虽然三组青少年在6岁时的睡眠时间是可以接受的，但到青春期结束时，只有37.4%的人达到了美国国家睡眠基金会所定义的健康和幸福所需的推荐睡眠时间和效率。

{"title":"Sleep duration and efficiency from 6 to 18 years of age in a birth cohort","authors":"Iná S. Santos , Priscila Echevarria , Isabel Oliveira Bierhals , Luciana Tovo-Rodrigues , Inácio Crochemore-Silva , Alicia Matijasevich","doi":"10.1016/j.sleep.2025.108739","DOIUrl":"10.1016/j.sleep.2025.108739","url":null,"abstract":"<div><h3>Background</h3><div>Healthy sleep comprises a multidimensional sleep-wake pattern, adapted to individual, social and environmental demands, which promotes physical and mental well-being.</div></div><div><h3>Objective</h3><div>To describe sleep multitrajectories from 6 to 18 years of age.</div></div><div><h3>Methods</h3><div>Population-based birth cohort using information from 4231 participants assessed at birth and at 6, 11, 15, and 18 years of age. Bedtime, wake-up time, sleep duration, and sleep efficiency were measured through actigraphy. Group-based multitrajectory models (GBMTM) were applied to jointly explore the longitudinal changes in bedtime, wake-up time, sleep duration, and sleep efficiency over time. Maternal and child characteristics at birth were used to describe prevalence (with 95 % confidence interval) of sleep multitrajectories.</div></div><div><h3>Results</h3><div>3595, 3547, 1940, and 3447, respectively, at ages 6, 11, 15, and 18 years had information on sleep parameters, and 2412 were included in the multitrajectory analysis. In the entire cohort, sleep duration decreased from 7.54 h at 6 years to 6.84, 6.14, and 6.42 h, respectively, at 11, 15, and 18 years, and sleep efficiency improved with age from 81.0 % at 6 years to 85.0 % at 18. Three multitrajectory groups containning the simultaneous analysis on the four sleep parameters were defined: G1, G2 and G3, comprising, respectively, 28.8 %, 33.8 %, and 37.4 % of the sample. At 18 years, only adolescents from G3 achieved sleep duration and efficiency within the recommended range for age (respectively, 7.60 h/day and 86.0 %). Female adolescents and those with low birth weight had a greater likelihood of belonging to G3.</div></div><div><h3>Conclusions</h3><div>Although adolescents from the three groups presented an acceptable sleep duration at 6 years, by the end of adolescence only 37.4 % of them achieved the recommended sleep duration and efficiency needed for a good health and well-being, as defined by the United States National Sleep Foundation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"139 ","pages":"Article 108739"},"PeriodicalIF":3.4,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0