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Changes in quality of life in patients with atrial fibrillation and central sleep apnea treated with transvenous phrenic nerve stimulation 经静脉膈神经刺激治疗心房颤动和中枢性睡眠呼吸暂停患者生活质量的变化。
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-02-02 DOI: 10.1016/j.sleep.2026.108824
Shahrokh Javaheri , Scott W. McKane , Robin E. Germany

Background

It is well-known patients with atrial fibrillation (AF) have significant fatigue and impaired quality of life (QoL). Because central sleep apnea (CSA) could be associated with AF, CSA could be a contributory but treatable comorbidity.

Objectives

Retrospective assessment of the impact of CSA treatment with transvenous phrenic nerve stimulation (TPNS) on sleep and QoL in a subgroup of patients with CSA and AF from the remedē® System pivotal trial.

Methods

Patients were implanted with a TPNS device and randomized to treatment or control. Therapy was activated in the treatment arm and remained off in control for 6 months, when TPNS was also activated. Patients were followed through 12 months.

Results

Sixty-four of 151 implanted participants had AF, including 32 per arm. The apnea hypopnea index and central apnea index decreased significantly from medians of 49 and 20 events/hour of sleep at baseline to 21 and 1/hour after 6 months of TPNS therapy (p < 0.001 for each), respectively. In parallel, changes in arousal index (48 at baseline vs. 25/hour of sleep at 6 months, p < 0.001) and percent of sleep time with oxygen saturation less than 90% (8% vs. 4%, p = 0.071) improved. Compared to the control group, Patient Global Assessment and Epworth Sleepiness Scale improved significantly with treatment. Improvements were sustained for 12 months and results were similar in the control group after therapy activation.

Conclusions

AF was highly prevalent in patients with CSA. TPNS therapy may significantly improve sleep metrics, QoL, and daytime sleepiness in patients with CSA and AF.

Registration

ClinicalTrials.gov identifier NCT01816776.
背景:众所周知,心房颤动(AF)患者有明显的疲劳和生活质量(QoL)下降。由于中枢性睡眠呼吸暂停(CSA)可能与房颤相关,因此CSA可能是一种可治疗的合并症。目的:回顾性评估经静脉膈神经刺激(TPNS)治疗CSA对来自rememedi®System关键试验的CSA和AF患者亚组睡眠和生活质量的影响。方法:患者植入TPNS装置,随机分为治疗组和对照组。治疗组启动治疗,对照组保持6个月,TPNS也被激活。患者随访12个月。结果:151名植入的参与者中有64人患有房颤,每只手臂32人。在TPNS治疗6个月后,呼吸暂停低通气指数和中枢呼吸暂停指数的中位数从基线时的49次和20次/小时睡眠下降到21次和1次/小时睡眠(结论:房颤在CSA患者中非常普遍)。TPNS治疗可能显著改善CSA和af患者的睡眠指标、生活质量和白天嗜睡。注册:ClinicalTrials.gov标识号NCT01816776。
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引用次数: 0
Left hand sleep masturbation in a right-handed male patient with sexsomnia 右撇子男性睡眠性交症患者的左手睡眠手淫。
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-02-02 DOI: 10.1016/j.sleep.2026.108823
Mathilde Brice , Ana-Zenovia Gales , Valérie Attali , Mahaut Chauvin , Isabelle Arnulf
Sexsomnia is a NREM parasomnia characterized by involuntary sexual behavior during confusional arousal. Video examples are rare. Here we present the case of a man who was accused of sexually assaulting his girlfriend during the night but had no memory of doing so. During a video polysomnography, he masturbated in his sleep with his left hand during the N2 and N3 sleep stages, confirming sexsomnia. However, he always masturbated with his right hand when awake. Treatment with gabapentin did not alleviate sexsomnia and triggered obstructive sleep apnea, which improved when the treatment was replaced with paroxetine. The effect of paroxetine on sexsomnia was unknown. This case supports the concept of automatic behavior in sexsomnia.
睡眠性交症是一种非快速眼动睡眠异常症,其特征是在迷乱觉醒期间不自主的性行为。视频例子很少。在这里,我们提出一个案例,一个男人被指控在夜间性侵犯他的女朋友,但没有记忆。在一段多导睡眠录像中,他在N2和N3睡眠阶段用左手在睡梦中手淫,证实了睡眠性交症。然而,他总是在醒着的时候用右手自慰。加巴喷丁治疗并不能缓解睡眠性交症,还会引发阻塞性睡眠呼吸暂停,当用帕罗西汀替代治疗后,情况有所改善。帕罗西汀对睡眠性交症的作用尚不清楚。这个案例支持了睡眠性交症中自动行为的概念。
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引用次数: 0
Many types of comorbidities are associated with clinically diagnosed insomnia in United States military service members 许多类型的合并症与临床诊断失眠在美国军人
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.sleep.2026.108820
Joseph J. Knapik , Ryan A. Steelman , John A. Caldwell , Daniel W. Trone , Harris R. Lieberman

Objectives

This cross-sectional investigation examined associations between clinically diagnosed insomnia (CDI) and comorbid conditions in United States military service members (SMs).

Methods

A stratified random sample of SMs completed an on-line questionnaire assessing their demographic and lifestyle characteristics. Diagnosed medical conditions for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 18 general (largely systemic) and 30 specific clinically diagnosed medical categories (CDMCs). CDMC prevalence odds was compared among those with (n = 771) and without (n = 25,909) CDI.

Results

After adjustments for potentially confounding demographic and lifestyle characteristics, CDI was associated with higher odds of a diagnosis in 17 of the general CDMCs and 26 of the specific CDMCs. The five general CDMCs with the largest differences between those with and without CDI were mental/behavioral diseases (odds ratio [OR] = 7.68, 95% confidence interval [95%CI] = 6.54–9.01), signs/symptoms/abnormal labs (OR = 4.99, 95%CI = 4.19–5.93), diseases of the musculoskeletal system (OR = 4.43, 95%CI = 3.72–5.28), endocrine/nutritional/metabolic diseases (OR = 2.97, 95%CI = 2.47–3.58), and diseases of the digestive system (OR = 2.68, 95%CI = 2.18–3.28). The five specific CDMCs with the highest adjusted odds among those with and without CDI were sleep-related movement disorder (OR = 14.68, 95%CI = 9.26–23.26), fibromyalgia (OR = 14.14, 95%CI = 5.74–34.80), post-traumatic stress disorder (OR = 12.94, 95%CI = 10.09–16.59), anxiety (OR = 9.40, 95%CI = 7.71–11.46), and traumatic brain injury (OR = 8.52, 95%CI = 5.93–12.24). Prevalence of CDI increased as the number of CDMCs increased: SMs with 0–1, 2–3, 4–5 and ≥6 general CDMCs had CDI prevalences of 0.5%, 3.2%, 6.7%, and 10.9%, respectively.

Conclusion

In a young, physically active population CDI was associated with many CDMCs involving multiple physiological systems.
目的:本横断面调查探讨美国军人临床诊断的失眠(CDI)与合并症之间的关系。方法采用分层随机抽样的方法,通过在线问卷调查的方式,对调查对象的人口统计学特征和生活方式特征进行评估。从综合军事电子医疗监测系统获得完成问卷前6个月的诊断医疗状况,并将其分为18个一般(主要是系统性)和30个特殊临床诊断医疗类别(CDMCs)。比较CDI患者(n = 771)和非CDI患者(n = 25,909)的CDMC患病率。结果在调整了可能混淆的人口统计学和生活方式特征后,CDI与17例一般CDMCs和26例特异性CDMCs的较高诊断几率相关。CDI患者与非CDI患者间差异最大的5种常见cdmc分别为精神/行为疾病(优势比[OR] = 7.68, 95%可信区间[95% ci] = 6.54-9.01)、体征/症状/实验室异常(OR = 4.99, 95% ci = 4.19-5.93)、肌肉骨骼系统疾病(OR = 4.43, 95% ci = 3.72-5.28)、内分泌/营养/代谢疾病(OR = 2.97, 95% ci = 2.47-3.58)和消化系统疾病(OR = 2.68, 95% ci = 2.18-3.28)。在有CDI和没有CDI的患者中,调整后比值最高的5种特异性cdmc分别是睡眠相关运动障碍(OR = 14.68, 95%CI = 9.26 ~ 23.26)、纤维肌痛(OR = 14.14, 95%CI = 5.74 ~ 34.80)、创伤后应激障碍(OR = 12.94, 95%CI = 10.09 ~ 16.59)、焦虑(OR = 9.40, 95%CI = 7.71 ~ 11.46)和创伤性脑损伤(OR = 8.52, 95%CI = 5.93 ~ 12.24)。CDI患病率随着cdmc数量的增加而增加:0-1、2-3、4-5和≥6个一般cdmc的SMs CDI患病率分别为0.5%、3.2%、6.7%和10.9%。结论在年轻、体力活动人群中,CDI与多种cdmc相关,涉及多个生理系统。
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引用次数: 0
Swipe for sleep - a standardized evaluation of mobile health apps for insomnia in children and adolescents 滑动睡眠-对儿童和青少年失眠的移动健康应用程序的标准化评估。
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-31 DOI: 10.1016/j.sleep.2026.108814
Laura Simon , Lena Sophia Steubl , Merritt Gossmann , Michael Stach , Yannik Terhorst , Julia Witte , Olaf Reis , Michael Kölch , Christoph Berger , Rüdiger Pryss , Harald Baumeister , Alexander Dück

Introduction

Access to cognitive behavioral therapy for insomnia (CBT-I) in children and adolescents is limited. Mobile health applications (MHAs) available in app stores may provide an accessible and scalable option for delivering CBT-I. This study systematically evaluated the quality of MHAs targeting insomnia in children and adolescents and examined their evidence base and treatment components.

Methods

In November 2024, a systematic search of the Google Play and Apple App Stores was conducted to identify MHAs targeting insomnia in children and adolescents. MHAs were screened for eligibility in a two-level process: first based on app store descriptions, then after downloading the MHA. Eligible MHAs were independently evaluated using the German Mobile Application Rating Scale (MARS-G), which rates MHAs from 1 (inadequate) to 5 (excellent) across the subscales engagement, functionality, aesthetics, and information. Additionally, the featured treatment components and supporting scientific evidence were assessed.

Results

Of 2341 MHAs initially identified, eight MHA products met the inclusion criteria. The overall quality was moderate (mean = 3.5, SD = 0.4). Among the subscales, functionality was rated highest (mean = 3.8, SD = 0.6), followed by aesthetics (mean = 3.6, SD = 0.6), engagement (mean = 3.3, SD = 0.4), and information (mean = 3.1, SD = 0.8). Sleep hygiene was the most commonly featured treatment component (seven MHA products). While scientific evidence was identified for five MHA products, none specifically evaluated insomnia in the target population.

Conclusion

Although many MHAs claim to target sleep in children and adolescents, few incorporate CBT-I components beyond sleep hygiene. The moderate quality and limited evidence base underscore the need for theory-driven, rigorously evaluated MHAs tailored to this age group.
儿童和青少年失眠的认知行为疗法(CBT-I)是有限的。应用程序商店中提供的移动健康应用程序(MHAs)可能为提供CBT-I提供可访问和可扩展的选择。本研究系统地评估了针对儿童和青少年失眠的MHAs的质量,并检查了它们的证据基础和治疗成分。方法:于2024年11月对谷歌Play和Apple App store进行系统搜索,以确定针对儿童和青少年失眠的mha。MHA的资格筛选分为两个阶段:首先是基于应用商店的描述,然后是下载MHA之后。使用德国移动应用评级量表(MARS-G)对合格的mha进行独立评估,该量表将mha在参与、功能、美学和信息的子量表上从1(不足)到5(优秀)进行评级。此外,还评估了特色治疗成分和支持科学证据。结果:在初步鉴定的2341个MHA产品中,有8个产品符合纳入标准。总体质量为中等(mean = 3.5, SD = 0.4)。在子量表中,功能性评分最高(平均3.8,SD = 0.6),其次是美学(平均3.6,SD = 0.6),参与度(平均3.3,SD = 0.4)和信息(平均3.1,SD = 0.8)。睡眠卫生是最常见的治疗成分(7种MHA产品)。虽然已经确定了五种MHA产品的科学证据,但没有一种是专门评估目标人群失眠的。结论:尽管许多MHAs声称针对儿童和青少年的睡眠,但很少有CBT-I超出睡眠卫生的成分。中等质量和有限的证据基础强调需要理论驱动,严格评估适合该年龄组的MHAs。
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引用次数: 0
Corrigendum to “Long COVID as a risk factor for hypersomnolence and fatigue: insights from the 2nd International Covid Sleep Study Collaboration (ICOSS-2)” [Sleep Med. 136 (2025) 106764] “长冠状病毒是嗜睡和疲劳的风险因素:来自第二届国际冠状病毒睡眠研究合作(ICOSS-2)的见解”的勘误表[睡眠医学]. 136 (2025)106764]
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-31 DOI: 10.1016/j.sleep.2026.108798
Tomi Sarkanen , Ilona Merikanto , Bjørn Bjorvatn , Frances Chung , Brigitte Holzinger , Charles M. Morin , Thomas Penzel , Luigi De Gennaro , Yun Kwok Wing , Christian Benedict , Pei Xue , Catia Reis , Maria Korman , Anne-Marie Landtblom , Kentaro Matsui , Harald Hrubos-Strøm , Sérgio Mota-Rolim , Michael R. Nadorff , Linor Berezin , Yaping Liu , Yves Dauvilliers
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引用次数: 0
Insomnia-LCA classifier: an open web application for insomnia subtype classification using latent class analysis 失眠- lca分类器:一个使用潜在类分析进行失眠亚型分类的开放web应用程序
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-30 DOI: 10.1016/j.sleep.2026.108813
Matteo Carpi , Daniel Ruivo Marques
The heterogeneity of insomnia presentations has long challenged research and clinical practice, motivating efforts to identify reliable disorder phenotypes. Person-centered, data-driven approaches such as latent class analysis (LCA) have provided new insights, suggesting that insomnia subtypes may differ not only in nocturnal symptoms but also in perceived impact and daytime distress. Despite this progress, LCA solutions often remain confined to the original datasets, limiting replication and applied use.
To address this gap, we developed the insomnia-LCA classifier, an open-source web application that assigns new Insomnia Severity Index (ISI) response profiles to one of four subtypes identified in a previously published LCA of Italian university students: no insomnia (NI), subthreshold insomnia (SI), high insomnia risk (HI), and predominant daytime symptoms (DS). Using the original model's class priors and item-level conditional response probabilities, the app computes posterior class probabilities from user-entered ISI responses, individually or in batch mode. Outputs include class probabilities and modal assignment, ISI total and subscale scores, and a visual comparison between the individual profile and subtype mean patterns.
Reclassification of the original dataset showed near-perfect agreement with the latent class model (accuracy = 0.999; Cohen's kappa = 0.999), and synthetic profiles behaved as expected. The insomnia-LCA classifier provides a practical, reproducible tool for deploying and testing LCA-derived phenotypes in clinical research.
失眠表现的异质性长期以来一直挑战着研究和临床实践,促使人们努力确定可靠的疾病表型。以人为中心、数据驱动的方法,如潜在分类分析(LCA),提供了新的见解,表明失眠亚型可能不仅在夜间症状上不同,而且在感知影响和白天痛苦上也不同。尽管取得了这些进展,但LCA解决方案通常仍然局限于原始数据集,限制了复制和应用。为了解决这一差距,我们开发了失眠-LCA分类器,这是一个开源的网络应用程序,它将新的失眠严重指数(ISI)反应配置文件分配给先前发表的意大利大学生LCA中确定的四种亚型之一:无失眠(NI),亚阈值失眠(SI),高失眠风险(HI)和主要白天症状(DS)。使用原始模型的类先验和项目级条件反应概率,应用程序从用户输入的ISI响应中计算后验类概率,单独或批量模式。输出包括类概率和模态分配,ISI总分和子量表分数,以及个人概况和子类型平均模式之间的视觉比较。原始数据集的重新分类显示与潜在类别模型几乎完全一致(准确率= 0.999;Cohen's kappa = 0.999),合成剖面的表现与预期一致。失眠- lca分类器为临床研究中部署和测试lca衍生表型提供了一个实用的,可重复的工具。
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引用次数: 0
Effect of melatonin enriched with L-Tryptophan and 5-Hydroxytryptophan on sleep parameters in children with neurodevelopmental disorders 富含l -色氨酸和5-羟色氨酸的褪黑素对神经发育障碍儿童睡眠参数的影响。
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-30 DOI: 10.1016/j.sleep.2026.108818
Francy Cruz-Sanabria , Giovanni Cenerini , Simone Bruno , Raffaele Ferri , Simona Fiori , Ugo Faraguna

Introduction

Melatonin plays a key role in sleep regulation. Combining melatonin with its precursors, L-tryptophan (LT) and 5-Hydroxytryptophan (5HTP), may influence sleep-related outcomes, but evidence in children with neurodevelopmental disorders (NDDs) is limited. This exploratory study compares the effects of melatonin combined with 5HTP (M-5HTP) and melatonin combined with LT (M-LT) on sleep disorders in children with NDDs.

Methods

This single-center, randomized pilot comparative trial involved children under five years of age with NDDs free of sleep-inducing drugs. Baseline evaluations and actigraphy monitoring were performed. Children were randomly assigned to either M-5HTP (1 mg Melatonin +10 mg 5HTP) or M-LT (1 mg Melatonin +20 mg LT) treatment at 8 p.m. for at least four weeks. Post-treatment actigraphy monitoring assessed sleep parameters.

Results

Of 51 screened children, 26 were enrolled and 13 completed the study (M-5HTP: 9, M-LT: 4). No statistically significant between-group differences in change scores were observed. Within-group analyses showed a significant reduction in the Sleep Movement Index (SMI) from baseline to follow-up in the M-5HTP group (T0: 6.55; T1: 1.25; p=0.006), whereas no significant changes were observed in the M-LT group.

Discussion

In this exploratory pilot study, a within-group reduction in nocturnal motor activity was observed among M-5HTP completers. Given the small sample size, high attrition rate, and limited statistical power, these findings should be interpreted cautiously and considered hypothesis-generating.
褪黑素在睡眠调节中起着关键作用。将褪黑素与其前体l -色氨酸(LT)和5-羟色氨酸(5HTP)联合使用可能会影响睡眠相关的结果,但在患有神经发育障碍(ndd)的儿童中,证据有限。本探索性研究比较褪黑素联合5HTP (M-5HTP)与褪黑素联合LT (M-LT)对ndd患儿睡眠障碍的影响。方法:这项单中心、随机对照试验纳入了5岁以下无睡眠诱导药物的ndd患儿。进行基线评估和活动监测。儿童被随机分配到M-5HTP (1mg褪黑素+ 10mg 5HTP)或M-LT (1mg褪黑素+ 20mg LT)治疗,时间为晚上8点,持续至少四周。治疗后活动描记监测评估睡眠参数。结果:51名筛查儿童中,26名入组,13名完成研究(M-5HTP: 9, M-LT: 4)。组间变化评分差异无统计学意义。组内分析显示,M-5HTP组从基线到随访期间睡眠运动指数(SMI)显著降低(T0: 6.55; T1: 1.25; p=0.006),而M-LT组未观察到显著变化。讨论:在这项探索性的初步研究中,在M-5HTP完成者中观察到组内夜间运动活动的减少。考虑到样本量小,流失率高,统计能力有限,这些发现应该谨慎解释,并考虑假设生成。
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引用次数: 0
Effect of sex hormones on sleep architecture in older women 性激素对老年妇女睡眠结构的影响
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-29 DOI: 10.1016/j.sleep.2025.106915
M. Varma
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引用次数: 0
Trait-Like Slow-Wave Activities Link to Cognition: Multi-Night At-Home Wireless EEG Study in Older Adults 特征样慢波活动与认知相关:老年人在家多夜无线脑电图研究
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-29 DOI: 10.1016/j.sleep.2025.106935
S. Qin , J.L. Ong , K.F. Wong , T. Liang , E.K.K. Ng , W.-P. Koh , J.H. Zhou , M.W.L. Chee
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引用次数: 0
A Bistable Stochastic Model Quantifies Performance Degradation And Individual Vulnerability To Sleep Deprivation 双稳态随机模型量化性能退化和个体脆弱性睡眠剥夺
IF 3.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-29 DOI: 10.1016/j.sleep.2025.106937
S. Raison , P. Sanz-Leon , C. Schmidt , V. Muto , S. Postnova
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引用次数: 0
期刊
Sleep medicine
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