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The possible impact of periodic limb movements during sleep in restless legs syndrome on cognitive function in older adults. 不宁腿综合征患者睡眠期间周期性肢体运动对老年人认知功能的可能影响。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-10 DOI: 10.1093/sleep/zsaf364
Maria P Mogavero, Brian B Koo
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引用次数: 0
Mamba-based Deep Learning Approach for Sleep Staging on a Wireless Multimodal Wearable System Without Electroencephalography. 基于mamba的无脑电图无线多模态可穿戴系统睡眠分期深度学习方法。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-06 DOI: 10.1093/sleep/zsag022
Andrew H Zhang, Alex He-Mo, Richard Fei Yin, Chunlin Li, Yuzhi Tang, Dharmendra Gurve, Veronique van der Horst, Aron S Buchman, Nasim Montazeri Ghahjaverestan, Maged Goubran, Bo Wang, Andrew S P Lim

Study objectives: We investigate a Mamba-based deep learning approach for sleep staging on signals from ANNE One (Sibel Health, Chicago, IL), a non-intrusive dual-module wireless wearable system measuring chest electrocardiography (ECG), triaxial accelerometry, and chest temperature, and finger photoplethysmography and finger temperature.

Methods: We obtained wearable sensor recordings from 357 adults undergoing concurrent polysomnography (PSG) at a tertiary care sleep lab. Each PSG recording was manually scored and these annotations served as ground truth labels for training and evaluation of our models. PSG and wearable sensor data were automatically aligned using their ECG channels with manual confirmation by visual inspection. We trained a Mamba-based recurrent neural network architecture on these recordings. Ensembling of model variants with similar architectures was performed.

Results: After ensembling, the model attains a 3-class (wake, non rapid eye movement [NREM] sleep, rapid eye movement [REM] sleep) balanced accuracy of 84.02%, F1 score of 84.23%, Cohen's κ of 72.89%, and a Matthews correlation coefficient (MCC) score of 73.00%; a 4-class (wake, light NREM [N1/N2], deep NREM [N3], REM) balanced accuracy of 75.30%, F1 score of 74.10%, Cohen's κ of 61.51%, and MCC score of 61.95%; a 5-class (wake, N1, N2, N3, REM) balanced accuracy of 65.11%, F1 score of 66.15%, Cohen's κ of 53.23%, MCC score of 54.38%.

Conclusions: Our Mamba-based deep learning model can successfully infer major sleep stages from the ANNE One, a wearable system without electroencephalography (EEG), and can be applied to data from adults attending a tertiary care sleep clinic.

研究目标:我们研究了一种基于曼巴的深度学习方法,用于根据来自ANNE One (Sibel Health, Chicago, IL)的信号进行睡眠分期,ANNE One是一种非侵入式双模块无线可穿戴系统,可测量胸部心电图(ECG)、三轴加速度计、胸部温度,以及手指光体积脉搏图和手指温度。方法:我们获得了357名在三级保健睡眠实验室接受并发多导睡眠描记术(PSG)的成年人的可穿戴传感器记录。每个PSG记录都是手动评分的,这些注释作为训练和评估模型的基础真实值标签。PSG和可穿戴传感器数据使用其ECG通道自动对齐,并通过目视检查手动确认。我们在这些录音上训练了一个基于曼巴的循环神经网络架构。对具有相似体系结构的模型变体进行了集成。结果:经整合后,该模型达到了清醒、非快速眼动(NREM)睡眠、快速眼动(REM)睡眠3个等级的平衡准确率为84.02%,F1得分为84.23%,Cohen’s κ得分为72.89%,Matthews相关系数(MCC)得分为73.00%;4个等级(wake、轻度NREM [N1/N2]、深度NREM [N3]、REM)的平衡准确率为75.30%,F1评分为74.10%,Cohen’s κ评分为61.51%,MCC评分为61.95%;5类(wake、N1、N2、N3、REM)平衡准确率65.11%,F1评分66.15%,Cohen’s κ评分53.23%,MCC评分54.38%。结论:我们基于曼巴的深度学习模型可以成功地从没有脑电图(EEG)的可穿戴系统ANNE One中推断出主要的睡眠阶段,并且可以应用于三级保健睡眠诊所的成年人的数据。
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引用次数: 0
Effect of electronic nicotine delivery systems for smoking cessation on sleep quality: secondary analysis of a randomized controlled trial. 戒烟用电子尼古丁输送系统对睡眠质量的影响:一项随机对照试验的二次分析
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-05 DOI: 10.1093/sleep/zsag028
Tamara Scharf, Anna Rihs, Anna Schoeni, Micheline Maire, Kali Tal, Julian Jakob, Isabelle Jacot-Sadowski, Jean-Paul Humair, Aurélie Berthet, Martin Brutsche, Anja Frei, Lucy Bolt, Ramin Khatami, Reto Auer, Stéphanie Baggio

Study objectives: E-cigarettes can help smokers quit, but how e-cigarettes used for tobacco smoking cessation impact sleep is still unclear. The primary objective was to evaluate the effect of e-cigarettes for smoking abstinence on sleep quality. Secondary objectives included subscales of sleep quality.

Methods: We conducted a secondary analysis of the Efficacy, Safety, and Toxicology of electronic nicotine delivery systems for smoking cessation (ESTxENDS) randomized controlled trial, which included adult smokers in Switzerland (5 sites, 7.2018-6.2021). The intervention group received free e-cigarettes and e-liquids over 6 months plus standard-of-care smoking-cessation counseling (SOC); the control group received SOC alone. The primary outcome was overall self-reported sleep quality at 6 months, measured by the Pittsburgh Sleep Quality Index (PSQI). We considered a minimal clinically important difference (MCID) of 2.5-5. Secondary outcomes included PSQI subscales. We used adjusted linear regressions with inverse probability of attrition weights (IPAW).

Results: ESTxENDS included 1246 participants. Of these, 831 participants completed the PSQI at follow-up. For the primary outcome, there was no significant difference in PSQI score between groups (b=-0.20, p=.256, adjusted analyses with IPAW). For PSQI subscales, only sleep efficiency was significantly better in the intervention group (b=1.87, p=.018), below MCID.

Conclusion: E-cigarettes added to SOC for tobacco smoking abstinence did not significantly alter participant's self-reported sleep quality compared to SOC alone. Clinicians can inform patients willing to quit smoking with e-cigarettes that their use is not likely to disrupt their perceived sleep quality on average.

研究目标:电子烟可以帮助吸烟者戒烟,但用于戒烟的电子烟如何影响睡眠尚不清楚。主要目的是评估电子烟对戒烟者睡眠质量的影响。次要目标包括睡眠质量的子量表。方法:我们对用于戒烟的电子尼古丁传递系统(ESTxENDS)随机对照试验的有效性、安全性和毒理学进行了二次分析,该试验包括瑞士的成年吸烟者(5个站点,7.2018-6.2021)。干预组在6个月的时间里接受免费的电子烟和电子烟油,外加标准护理戒烟咨询(SOC);对照组单独接受SOC治疗。主要结果是6个月时总体自我报告的睡眠质量,用匹兹堡睡眠质量指数(PSQI)来衡量。我们认为最小临床重要差异(MCID)为2.5-5。次要结局包括PSQI量表。我们使用调整后的线性回归与逆概率的磨耗权(IPAW)。结果:ESTxENDS纳入1246名受试者。其中,831名参与者在随访时完成了PSQI。对于主要终点,两组间PSQI评分无显著差异(b=-0.20, p= 0.256,经IPAW校正分析)。对于PSQI量表,干预组只有睡眠效率显著改善(b=1.87, p= 0.018),低于MCID。结论:与单独使用SOC相比,在SOC中添加电子烟对戒烟者自我报告的睡眠质量没有显著影响。临床医生可以告诉那些愿意用电子烟戒烟的患者,电子烟的使用一般不太可能影响他们的睡眠质量。
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引用次数: 0
Tricyclic Antidepressants suppress sleep in Caenorhabditis elegans. 三环抗抑郁药抑制秀丽隐杆线虫的睡眠。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-05 DOI: 10.1093/sleep/zsag034
William J Lee, Marisa C Petticord, Joel T Woolley, Zipporah M Robinson, David C Schultz, David M Raizen

Study objectives: Sleepiness and fatigue are common symptoms during illness and may persist after the resolution of illness. To gain insight into the neurochemistry of sickness-induced sleep and to discover therapeutic candidates, we performed a high throughput chemical screen using the animal model Caenorhabditis elegans.

Methods: Worms were irradiated with ultraviolet light to induce sickness and then transferred to wells of a 96-well plate each containing a different bioactive chemical dissolved in an aqueous solution. The fraction of quiescent animals was assessed via stereomicroscopic observation. We performed 12 vehicle-only controls for each 96-well plate and considered sleep-inhibiting chemicals as those with a fraction quiescent at least 3 standard deviations less than controls. We followed up the screen with dedicated mechanistic studies of the drug amitriptyline.

Results: Among 3,683 bioactive chemicals screened, 42 strongly reduced sleep behavior. We retested 26 and replicated 23 chemicals as sleep-disrupting. Among replicated compounds were amitriptyline (AMI) and other tricyclic anti-depressants (TCAs). AMI acts downstream of or in parallel to activation of sleep-promoting neurons. In addition to suppressing sleep in sickness (SIS), AMI also suppressed sleep in health and reduces survival. We tested and rejected the hypothesis that AMI acts by increasing monoaminergic tone, providing evidence that TCAs act via a novel mechanism to block sleep.

Conclusions: This is the first high-throughput screen for chemicals modulating SIS. Elucidating the mechanism by which AMI and other chemicals regulate sleep will lead to new biological insights regarding the mechanisms of sleep.

研究目的:嗜睡和疲劳是疾病期间的常见症状,并可能在疾病消退后持续存在。为了深入了解疾病诱发睡眠的神经化学并发现治疗候选物,我们使用秀丽隐杆线虫动物模型进行了高通量化学筛选。方法:用紫外光照射蠕虫引起疾病,然后将其转移到96孔板的孔中,每个孔中含有溶解在水溶液中的不同生物活性化学物质。通过体视显微镜观察静止动物的比例。我们对每个96孔板进行了12个载体对照,并将睡眠抑制化学物质视为比对照少至少3个标准差的部分。在筛选之后,我们对阿米替林进行了专门的机制研究。结果:在筛选的3683种生物活性化学物质中,有42种能显著减少睡眠行为。我们重新测试了26种干扰睡眠的化学物质,并复制了23种。复制的化合物包括阿米替林(AMI)和其他三环抗抑郁药(TCAs)。AMI在促进睡眠的神经元激活的下游或平行发生。除了在疾病中抑制睡眠(SIS)外,急性心肌梗塞还会抑制健康时的睡眠并降低生存率。我们测试并拒绝了AMI通过增加单胺能张力起作用的假设,提供了TCAs通过一种新机制阻止睡眠的证据。结论:这是第一个高通量筛选化学物质调节SIS。阐明AMI和其他化学物质调节睡眠的机制将导致关于睡眠机制的新的生物学见解。
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引用次数: 0
Neurobehavioural functions and sleep architecture during polyphasic and monophasic short sleep schedules. 多相和单相短睡眠时的神经行为功能和睡眠结构。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-05 DOI: 10.1093/sleep/zsag031
Tiffany B Koa, June C Lo

Study objectives: To investigate how sleep architecture and neurobehavioural functions change during a polyphasic short sleep schedule and to compare these responses to those of a monophasic short sleep schedule with the same total sleep opportunity, as well as to those of a well-rested control group.

Methods: Forty healthy young adults (18 males, age: 18-35) were assigned to either the monophasic short sleep group, which had a single 2-h sleep opportunity, or the polyphasic short sleep group, which followed the "Uberman" sleep schedule and had six 20-min sleep opportunities distributed evenly across 24-h (one every 4 h). Polysomnography was conducted during every sleep opportunity. Neurobehavioural functions were assessed at baseline (before the sleep opportunity manipulation started) and six times thereafter (once every 4 h).

Results: Both short sleep groups experienced greater subjective sleepiness, poorer vigilance and lower positive mood as compared to a well-rested control group. Relative to the monophasic short sleep group, the polyphasic short sleep group showed greater vigilance impairment, particularly in the morning. This was accompanied by greater reductions in total sleep time, longer total sleep onset latency and wake after sleep onset, as well as greater proportions of N1 and N2 but lower proportion of N3 sleep in the polyphasic short sleep group relative to the monophasic short sleep group.

Conclusions: In young adults, the "Uberman" polyphasic sleep schedule substantially reduces total sleep duration and sleep efficiency, even when compared to a monophasic sleep schedule with the same overall sleep opportunity, and may be associated with poorer neurobehavioural performance.

研究目的:研究睡眠结构和神经行为功能在多相短睡眠期间的变化,并将这些反应与具有相同总睡眠机会的单相短睡眠计划以及休息良好的对照组进行比较。方法:40名健康的年轻成年人(18名男性,年龄:18-35岁)被分配到单相短睡眠组和多相短睡眠组,前者只有一个2小时的睡眠机会,后者遵循“Uberman”睡眠计划,在24小时内平均分配6个20分钟的睡眠机会(每4小时一次)。在每个睡眠机会进行多导睡眠描记。神经行为功能在基线(睡眠机会操纵开始前)和之后6次(每4小时1次)进行评估。结果:与睡眠充足的对照组相比,两个睡眠不足的组都经历了更大的主观困倦,更差的警惕性和更低的积极情绪。与单相短睡眠组相比,多相短睡眠组表现出更大的警觉性障碍,尤其是在早晨。与单相短睡眠组相比,多相短睡眠组总睡眠时间更短,总睡眠潜伏期更长,睡眠后醒来时间更长,N1和N2睡眠比例更高,而N3睡眠比例更低。结论:在年轻人中,“Uberman”多相睡眠计划大大减少了总睡眠时间和睡眠效率,即使与具有相同整体睡眠机会的单相睡眠计划相比也是如此,并且可能与较差的神经行为表现有关。
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引用次数: 0
Effectiveness of Guided Digital CBT-I- A Reflection on Active Control Conditions, Intervention Engagement, and Circadian Components. 引导数字CBT-I的有效性——对主动控制条件、干预参与和昼夜节律成分的反思。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-05 DOI: 10.1093/sleep/zsag027
Laura M Pape, Annemieke van Straten, Sascha Y Struijs, Julian D Karch, Philip Spinhoven, Niki Antypa
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引用次数: 0
Interpreting the identification of glutamatergic inputs to the sublaterodorsal tegmental nucleus and their role in REM sleep control: Insights and limitations. 嗅觉下被盖核谷氨酸输入的识别及其在快速眼动睡眠控制中的作用:见解和局限性。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-04 DOI: 10.1093/sleep/zsag033
Pengyu Zhao, Wioletta Rozpędek-Kamińska
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引用次数: 0
Methodological Considerations in Evaluating the Effects of CPAP Therapy on Energy Balance and Body Composition. 评价CPAP治疗对能量平衡和身体成分影响的方法学考虑。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-04 DOI: 10.1093/sleep/zsag026
Ahmet Cemal Pazarlı
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引用次数: 0
Reduced coupling between global brain activity and cerebrospinal fluid flow in middle-aged and older adults with chronic insomnia: enhancement by low-frequency rTMS. 慢性失眠症中老年患者整体脑活动与脑脊液流量之间的耦合降低:低频rTMS增强
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-04 DOI: 10.1093/sleep/zsag016
Qian Lu, Hanqing Gu, Zongqing Jiang, Qianwen Yang, Wenbing Hu, Chuan He
<p><strong>Study objectives: </strong>Whether cerebrospinal fluid (CSF)-dynamics-related glymphatic alterations occur in middle-aged and older adults with chronic insomnia (CI) remains unknown. We therefore examined global and network-level blood oxygenation level-dependent (BOLD)-CSF coupling in this population and assessed the effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) during standardized hypnotic tapering.</p><p><strong>Methods: </strong>This two-stage study included a cross-sectional comparison and a randomized, double-blind, parallel-group, sham-controlled trial. In Stage 1, 43 CI patients and 40 matched healthy controls completed sleep assessments and resting-state functional magnetic resonance imaging to quantify global and network-level BOLD-CSF coupling. In Stage 2, 26 CI patients were randomized (1:1) to receive 4 weeks of active or sham LF-rTMS during hypnotic tapering. Sleep was assessed at baseline, 2 weeks, 4 weeks, and 12 months. Neuroimaging was acquired at baseline and 4 weeks.</p><p><strong>Results: </strong>CI patients showed significantly reduced global BOLD-CSF coupling, particularly in frontoparietal network (FPN) and default mode network (DMN). Global and FPN coupling correlated with sleep quality. In the randomized trial, LF-rTMS produced greater improvements in sleep at 4 weeks than sham resulted in fewer participants resuming hypnotics at 12 months. LF-rTMS increased global and DMN BOLD-CSF coupling, and these changes were associated with improvements in sleep.</p><p><strong>Conclusions: </strong>Middle-aged and older adults with chronic insomnia exhibit reduced global BOLD-CSF coupling, indicating alterations in CSF dynamics that may relate to glymphatic function. LF-rTMS improved insomnia symptoms and modulated this coupling, indicating therapeutic potential for chronic insomnia.Trial Registration: ChiCTR2100049455.</p><p><strong>Clinical trial information: </strong>This trial is registered with the Chinese Clinical Trial Registry (ChiCTR; ChiCTR2100049455), titled "Application of neurodegenerative techniques for insomnia and cognitive impairment in the elderly," with the registry record available at: https://www.chictr.org.cn/bin/project/edit?pid=130047.</p><p><strong>Statement of significance: </strong>This study demonstrates that middle-aged and older adults with chronic insomnia show reduced global blood oxygenation level-dependent (gBOLD)-cerebrospinal fluid (CSF) coupling, indicating alterations in CSF-related dynamics that may reflect glymphatic-relevant processes at the cortical functional level. These alterations were most pronounced in high-order brain networks and were associated with poorer sleep quality. Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) applied to the right dorsolateral prefrontal cortex modulated gBOLD-CSF coupling and improved sleep symptoms, with benefits maintained at 12 months. These findings suggest that disrupted CSF-dynamics c
研究目的:脑脊液(CSF)动力学相关的淋巴改变是否发生在中老年慢性失眠症(CI)患者中尚不清楚。因此,我们在该人群中检查了整体和网络水平的血氧水平依赖(BOLD)-脑脊液耦合,并评估了在标准化催眠逐渐减少期间低频重复经颅磁刺激(LF-rTMS)的效果。方法:本研究分为两阶段,包括横断面比较和随机、双盲、平行组、假对照试验。在第一阶段,43名CI患者和40名匹配的健康对照者完成了睡眠评估和静息状态功能磁共振成像,以量化全局和网络级BOLD-CSF耦合。在第二阶段,26名CI患者被随机分配(1:1),在催眠逐渐减少期间接受4周的主动或假LF-rTMS。在基线、2周、4周和12个月时对睡眠进行评估。在基线和4周时进行神经影像学检查。结果:CI患者整体BOLD-CSF耦合显著降低,尤其是额顶叶网络(FPN)和默认模式网络(DMN)。全局和FPN耦合与睡眠质量相关。在随机试验中,LF-rTMS在第4周比假手术在12个月恢复催眠的参与者更少的情况下产生了更大的睡眠改善。LF-rTMS增加了整体和DMN BOLD-CSF耦合,这些变化与睡眠改善有关。结论:中老年慢性失眠症患者整体BOLD-CSF耦合降低,表明CSF动力学的改变可能与淋巴功能有关。LF-rTMS改善了失眠症状并调节了这种耦合,表明慢性失眠的治疗潜力。试验注册:ChiCTR2100049455。临床试验信息:该试验已在中国临床试验注册中心(ChiCTR;ChiCTR2100049455),题为“神经退行性技术在老年人失眠和认知障碍中的应用”,注册记录可在:https://www.chictr.org.cn/bin/project/edit?pid=130047.Statement上获得。该研究表明,慢性失眠症的中老年患者表现出全球血氧水平依赖性(gBOLD)-脑脊液(CSF)耦合降低,表明CSF相关动力学的改变可能反映了皮质功能水平上的淋巴相关过程。这些变化在高阶大脑网络中最为明显,与较差的睡眠质量有关。应用于右侧背外侧前额叶皮层的低频重复经颅磁刺激(LF-rTMS)可调节gBOLD-CSF耦合并改善睡眠症状,其益处维持12个月。这些研究结果表明,被破坏的csf -动力学耦合可能是成年后期慢性失眠的一个功能标记,并支持LF-rTMS作为一种可行的非药物方法进行长期治疗,可能实现csf -动力学相关过程的靶向调节。
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引用次数: 0
Protecting Sleep in a Noisy World. 在嘈杂的世界中保护睡眠。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2026-02-03 DOI: 10.1093/sleep/zsag032
Gary Garcia Molina
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引用次数: 0
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