Sleep medicine最新文献

{"title":"Exercise as a therapeutic strategy for insomnia: Current mechanisms and clinical relevance","authors":"Mohamed J. Saadh ,&nbsp;Ahmed Yakdhan Saleh ,&nbsp;Radhwan Abdul Kareem ,&nbsp;R.S.K. Sharma ,&nbsp;R. Roopashree ,&nbsp;Girish Chandra Sharma ,&nbsp;Rajni Verma ,&nbsp;Bhanu Juneja ,&nbsp;Hayder Naji Sameer ,&nbsp;Ahmed Yaseen ,&nbsp;Zainab H. Athab ,&nbsp;Mohaned Adil","doi":"10.1016/j.sleep.2025.108681","DOIUrl":"10.1016/j.sleep.2025.108681","url":null,"abstract":"<div><div>Insomnia affects 10–30 % of adults, with higher prevalence among older individuals, women, and those with comorbid medical or psychiatric conditions. It disrupts cognitive function, emotional regulation, and physical health, elevating risks for depression, cardiovascular disease, and diminished quality of life. Although pharmacological treatments have offered short-term symptom relief, their use has been constrained by side effects, dependency potential, and limited long-term efficacy, underscoring the need for effective non-pharmacological alternatives. Exercise has emerged as a well-supported, low-risk intervention, with moderate-intensity aerobic exercise, resistance training, and mind–body modalities (e.g., yoga, tai chi) demonstrating consistent benefits in sleep improvement. These interventions have been found to reduce sleep onset latency (SOL), increase total sleep time (TST), enhance sleep efficiency (SE), and improve subjective sleep satisfaction, as measured by validated tools such as the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Objective assessments via polysomnography (PSG) and actigraphy have corroborated these findings, showing decreased wake after sleep onset (WASO) and increased slow-wave sleep (SWS). Mechanistically, exercise has been shown to modulate the hypothalamic-pituitary-adrenal (HPA) axis, elevate brain-derived neurotrophic factor (BDNF), regulate circadian rhythms, attenuate systemic inflammation, and increase availability of sleep-related neurotransmitters. Multiple randomized controlled trials have confirmed that moderate-intensity exercise significantly improves sleep parameters, supporting its incorporation into insomnia treatment frameworks. Nonetheless, further large-scale, rigorously designed studies are needed to refine exercise protocols and clarify population-specific responses. This review aimed to elucidate the physiological mechanisms underlying exercise-induced sleep improvements and assess its potential as a sustainable, low-risk alternative to pharmacotherapy in insomnia management.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"138 ","pages":"Article 108681"},"PeriodicalIF":3.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616857","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}

{"title":"Altered sleep EEG spectral dynamics across the menstrual cycle in premenstrual dysphoric disorder","authors":"Christophe Moderie ,&nbsp;Philippe Boudreau ,&nbsp;Rafael Pérez Medina Carballo ,&nbsp;Diane B. Boivin","doi":"10.1016/j.sleep.2025.108679","DOIUrl":"10.1016/j.sleep.2025.108679","url":null,"abstract":"<div><h3>Introduction</h3><div>Premenstrual Dysphoric Disorder (PMDD) is frequently associated with luteal-phase (LP) insomnia. Although the mechanisms underlying insomnia remain unclear, prior evidence suggests paradoxically increased N3 sleep in PMDD across the menstrual cycle. This study investigated potential alterations in sleep microarchitecture in women with PMDD.</div></div><div><h3>Methods</h3><div>Six women diagnosed with PMDD (32.0 ± 5.7years), along with five healthy controls (30.4 ± 8.2 years) completed polysomnographic sleep recordings (PSGs) every third night throughout one menstrual cycle. EEG spectral analysis (C3–A2) was performed on NREM sleep using Fast Fourier Transform with a 4-s Hamming window and 50 % overlap, and a sleep spindle detector was used. Within-group changes were reported relative to the follicular phase (set at 100 %), and between-group differences relative to controls (set at 100 %), with 95 % confidence intervals for significance. Mixed-model ANOVA was used for spindles parameters. Correlations examined the relationships among EEG frequency bands, core body temperature (Tcore), urinary 6-sulfatoxymelatonin (aMT6), and self-reported mood and sleep quality.</div></div><div><h3>Results</h3><div>Relative to their FP, the PMDD group showed decreased theta and increased spindle frequency activity (SFA) in the LP. Between-group comparisons indicated higher SFA (∼60 %) and spindle density in PMDD across both phases, as well as lower slow wave activity (SWA; ∼40 %). Moreover, SWA correlated with aMT6 and subjective sleep quality, while elevated SFA was associated with Tcore and mood symptoms.</div></div><div><h3>Conclusions</h3><div>This study revealed alterations in sleep microarchitecture in PMDD, particularly regarding spindle activity and SWA. The previously observed increase in N3 sleep may reflect a compensatory mechanism in response to disrupted homeostatic processes, warranting further investigation into targeted interventions for insomnia in PMDD.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"138 ","pages":"Article 108679"},"PeriodicalIF":3.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606091","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}

{"title":"The efficacy of cognitive behavioral therapy for sleep disorders following acquired brain injury: a systematic review and meta-analysis","authors":"Huanhuan Zhu ,&nbsp;Qinghua Wen ,&nbsp;Fengyin Zhang ,&nbsp;Simin Li ,&nbsp;Xiaoyue Wang ,&nbsp;Juan Li","doi":"10.1016/j.sleep.2025.108678","DOIUrl":"10.1016/j.sleep.2025.108678","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are highly prevalent among individuals with acquired brain injury (ABI)and pose a significant barrier to both functional recovery and long-term quality of life. Cognitive Behavioral Therapy (CBT), a widely validated non-pharmacological intervention, has demonstrated robust efficacy in managing sleep disorders across diverse populations. However, its therapeutic effectiveness in individuals with brain injuries has yet to be systematically evaluated.</div></div><div><h3>Objective</h3><div>This study aimed to systematically evaluate and meta-analyze the efficacy of CBT for sleep disturbances following ABI, with a specific focus on its effectiveness across distinct sleep domains and the influence of intervention modalities.</div></div><div><h3>Methods</h3><div>A comprehensive and systematic search of the Cochrane Library, Embase, OVID, PubMed, Web of Science, and CINAHL databases was conducted to identify randomized controlled trials (RCTs) evaluating the efficacy of CBT for sleep disturbances in individuals with ABI. Meta-analyses were performed using RevMan version 5.4, calculating pooled effect sizes as standardized mean differences (SMD) or mean differences (MD), with evaluation of heterogeneity and subsequent sensitivity and subgroup analyses.</div></div><div><h3>Results</h3><div>Eight RCTs were included in the analysis. The pooled results demonstrated that CBT significantly alleviated sleep disturbances in individuals with ABI (SMD = −0.95, 95 % CI: –1.47 to −0.43, P = 0.0003). In specific sleep domains, CBT improved subjective sleep quality (MD = −2.34, 95 % CI: −3.23 to −1.45, P &lt; 0.00001), reduced insomnia symptoms (MD = −3.46, 95 % CI: −4.27 to −2.64, P &lt; 0.00001), and increased objective sleep efficiency (SMD = −0.38, 95 % CI: −0.67 to −0.09, P = 0.01). Subgroup analyses indicated that both traditional CBT and eCBT yielded significant improvements, with no statistically significant differences observed between the two modalities.</div></div><div><h3>Conclusions</h3><div>CBT appears to be an effective and safe intervention for improving sleep disturbances in individuals with ABI, with considerable potential for broader clinical adoption. Both face-to-face and digital CBT modalities may be recommended as viable therapeutic strategies for this population. Future research involving larger sample sizes and extended follow-up periods is warranted to further validate the effectiveness of CBT and refine intervention protocols.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"138 ","pages":"Article 108678"},"PeriodicalIF":3.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606118","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}

{"title":"Maternal sleep during the first ten years of the child's life","authors":"Natalia Schwarzkopf ,&nbsp;Mayda Rivas ,&nbsp;Florencia Peña ,&nbsp;Andrea Devera ,&nbsp;Pablo Torterolo ,&nbsp;Ana Hernández ,&nbsp;Luciana Benedetto","doi":"10.1016/j.sleep.2025.108677","DOIUrl":"10.1016/j.sleep.2025.108677","url":null,"abstract":"<div><div>Main sleep disturbances during motherhood occur during the first weeks after childbirth, but sleep continues to be affected until the baby sleeps through the night. However, most studies focus their attention up to 18 months after delivery. It is our interest to determine sleep quality among mothers of children aged 0–10 years, and the sociocultural factors associated with it. We designed a cross-sectional quantitative study consisting of an anonymous online survey that included the Pittsburgh Sleep Quality Index (PSQI), sociodemographic data and questions on nocturnal family dynamic. The main findings reveal that the quality of maternal sleep was poor for all mothers regardless of the child's age. Specifically, during the first two years after childbirth maternal sleep quality was particularly low, with a significant improvement towards age 3, worsening again when children were 4 and 5 years old, to finally improve towards the ages of 8–10. Additionally, higher levels of education and performing physical activity increased the probability of having good sleep quality. Conversely, child nocturnal awakenings consistently increased the odds of the mother having poor sleep quality at all stages of the child, and the strength of this association was greater for mothers of older children. For mothers with younger children, additional aspects of their children's sleep and social and nocturnal family dynamic (sleeping arrangements, family composition and collaboration of another adult during the nocturnal care of the child) also predicted their sleep quality. The current results expose that maternal sleep disturbances extend far beyond the postpartum period. To the best of our knowledge, this is the first report that focuses on maternal sleep until the age of 10 years of the child.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"138 ","pages":"Article 108677"},"PeriodicalIF":3.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606105","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}

{"title":"Active conservative interventions for obstructive sleep apnea: An umbrella review and meta-meta-analysis of systematic reviews","authors":"Cristian Justribó-Manion ,&nbsp;Eleuterio A. Sánchez-Romero ,&nbsp;Juan-Nicolás Cuenca-Zaldivar ,&nbsp;Arnau Cerdà-Ribó ,&nbsp;Natalia Felipe-Spada ,&nbsp;Jordi Tomàs-Aliberas ,&nbsp;Jordi Padrós-Augé","doi":"10.1016/j.sleep.2025.108665","DOIUrl":"10.1016/j.sleep.2025.108665","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is a prevalent condition with significant health consequences and limited adherence to standard treatments, such as Continuous Positive Airway Pressure (CPAP). Active conservative interventions, such as exercise and myofunctional training, may offer alternative or complementary options.</div></div><div><h3>Objective</h3><div>To evaluate and compare the effectiveness and certainty of the evidence of active conservative interventions for OSA through an umbrella review of meta-analyses.</div></div><div><h3>Methods</h3><div>A systematic search of six databases was conducted. Meta-analyses assessing moderate aerobic exercise (MAE), concurrent exercise (CE), respiratory muscle training (RMT), and oropharyngeal myofunctional therapy (OMT) were also included. Methodological quality was assessed using AMSTAR-2, evidence certainty using GRADE, and overlap with the Corrected Covered Area (CCA).</div></div><div><h3>Results</h3><div>Ten meta-analyses were included in this study CE showed the most consistent effect in reducing The Apnea-Hypopnea Index (AHI), followed by OMT. These improvements occurred independently of Body Mass Index (BMI) changes and were often accompanied by better sleep quality and reduced daytime sleepiness. MAE showed variable results, and evidence for RMT was limited owing to methodological exclusion criteria. The overall certainty of the evidence was very low, with only one comparison (OMT vs. sham) reaching low certainty.</div></div><div><h3>Conclusions</h3><div>CE and OMT showed consistent but limited benefits among active conservative interventions for OSA. These findings, based on very low-certainty evidence, suggest that they may serve as adjuncts to standard care in selected patients. Further high-quality trials and systematic reviews are needed to confirm their clinical utility.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"138 ","pages":"Article 108665"},"PeriodicalIF":3.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570902","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}

{"title":"Association between obstructive sleep apnea and coronary inflammation: A coronary CT angiography study","authors":"Zhenjia Wang ,&nbsp;Lei Xu ,&nbsp;Mi Lu ,&nbsp;Wei Yu","doi":"10.1016/j.sleep.2025.108674","DOIUrl":"10.1016/j.sleep.2025.108674","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between obstructive sleep apnea (OSA) and coronary inflammation measured by fat attenuation index (FAI), and to examine potential gender differences in this relationship.</div></div><div><h3>Methods</h3><div>We consecutively enrolled patients who underwent both sleep study and coronary computed tomography angiography (CTA). Multivariable linear regression models were constructed to assess the relationship between objective OSA severity metrics— including moderate-to-severe OSA, apnea-hypopnea index (AHI), and oxygen desaturation indices— and coronary FAI. Stratified analyses by sex were performed to evaluate potential gender-specific differences in this association. Additionally, we explored whether moderate-to-severe OSA correlated with elevated coronary inflammation (FAI &gt; −70.1 Hounsfield units).</div></div><div><h3>Results</h3><div>A total of 526 patients (72.1 % male; mean age 54.7 ± 11.2 years) were finally analyzed. Of these, 307 (58.4 %) patients had moderate-to-severe OSA. Compared to patients with no or mild OSA, those with moderate-to-severe OSA exhibited significantly elevated FAI value in the right coronary artery (RCA) (<em>P</em> &lt; 0.001). In contrast, no differences were observed in the left anterior descending artery (LAD) (<em>P</em> = 0.523) or left circumflex artery (LCX) (<em>P</em> = 0.379). The association between moderate-to-severe OSA and FAI in the RCA remained significant after multivariable adjustment (Model 1: β ± SE = 5.940 ± 0.680, <em>P</em> &lt; 0.001; Model 2: β ± SE = 5.941 ± 0.694, <em>P</em> &lt; 0.001). Furthermore, FAI_RCA showed significant correlations with AHI (<em>P</em> &lt; 0.001), ODI (<em>P</em> &lt; 0.001), and lowest SpO₂ (<em>P</em> &lt; 0.001), but not T90 (<em>P</em> = 0.429), consistently across gender subgroups. Moderate-to-severe OSA was correlated with 5.33-fold increased odds of high FAI_RCA (95 % CI: 2.05–13.86, <em>P</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>OSA severity was significantly associated with FAI around the RCA distribution, suggesting increased risk of coronary inflammation.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"137 ","pages":"Article 108674"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564161","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}

{"title":"Association between sleep disorder, sarcopenia, physical activity and clinical progression in people with Huntington's disease: A one-year longitudinal study using wearable technology","authors":"Sara Calvo-Simal ,&nbsp;Esther Cubo ,&nbsp;Fernando Vázquez-Sánchez ,&nbsp;María Carmen Lloria Gil ,&nbsp;Jéssica Rivadeneyra ,&nbsp;Lucía Simón-Vicente","doi":"10.1016/j.sleep.2025.108675","DOIUrl":"10.1016/j.sleep.2025.108675","url":null,"abstract":"<div><h3>Background</h3><div>Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor dysfunction, cognitive impairment, and psychiatric disorders. Sleep alterations are common in HD and are a significant contributor to the disease burden, affecting the quality of life and possibly exacerbating other symptoms.</div></div><div><h3>Objective</h3><div>To investigate the relationship between sleep disorders, sarcopenia parameters, physical activity, and clinical characteristics in patients with HD over a one-year period.</div></div><div><h3>Methods</h3><div>A longitudinal observational study was conducted with 28 HD patients, assessing sleep objectively (wearable activity tracker) and subjectively (Sleep Questionnaire). Sarcopenia parameters, physical activity levels, and clinical scales were measured at baseline and after 12 months. Mixed models were used to examine the associations between the variables.</div></div><div><h3>Results</h3><div>Better sleep quality at baseline was associated with younger age and a higher number of cytosine-adenine-guanine (CAG) repeats. After one year, improved sleep was linked to enhanced functional capacity, fewer behavioral symptoms, higher quality of life, and reduced fatigue. Significant differences were observed in muscle strength, indicating that patients with lower muscle strength had poorer sleep. Additionally, those with worse sleep walked fewer steps per day.</div></div><div><h3>Conclusions</h3><div>This study highlights the importance of good sleep quality in improving clinical outcomes in HD patients. Wearable devices have proven useful for screening sleep disturbances, suggesting that regular strength training may alleviate sleep problems in this population.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"137 ","pages":"Article 108675"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564191","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}

{"title":"Why do orexin antagonists improve sleep but not pain? Could COMISA provide clues?","authors":"Miguel Meira e Cruz","doi":"10.1016/j.sleep.2025.106841","DOIUrl":"10.1016/j.sleep.2025.106841","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106841"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525370","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}

{"title":"Reply to the Editor’s Letter: Orexin antagonists, COMISA, and the next steps for pain research","authors":"Alberto Herrero Babiloni ,&nbsp;Linda Sangalli ,&nbsp;F. Javier Puertas-Cuesta ,&nbsp;Charles M. Morin ,&nbsp;Gilles J. Lavigne ,&nbsp;Cibele Dal Fabbro","doi":"10.1016/j.sleep.2025.106842","DOIUrl":"10.1016/j.sleep.2025.106842","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106842"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525371","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}

{"title":"Re “Tirzepatide for sleep-disordered breathing in SURMOUNT-OSA” — Perspective on potential weight-independent effects","authors":"F.H. Van Bruggen","doi":"10.1016/j.sleep.2025.108650","DOIUrl":"10.1016/j.sleep.2025.108650","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"137 ","pages":"Article 108650"},"PeriodicalIF":3.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557321","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}