Pub Date : 2026-02-09DOI: 10.3390/clockssleep8010007
Carina Fernandes, Ema Leite, Joana E Coelho, Cátia Reis
Sleep and circadian research in real-life environments is challenging but essential. This study presents the design and implementation of a data-collection protocol in a highly challenging real-life setting over 56 days, examining both researchers' and participants' perspectives on its strengths, limitations, and key challenges, and highlighting the lessons learned relevant to future studies in similar contexts. Thirty military submariners completed a questionnaire after the 56-day pre-mission, mission, and post-mission data collection to assess their views on the study and each task. Compliance with measurements (questionnaires, diaries, actigraphy, and blood collections) was quantified and correlated with participants' answers. Mean global satisfaction was 3.57 ± 0.77 (0-5 scale) and declined across study phases, with a significant change only in the post-mission phase (p < 0.001). Higher work satisfaction correlated with better global study satisfaction (ρ = 0.396; p = 0.030). Diaries were rated the most burdensome task, while blood collections generated the most polarized responses. Compliance with continuous measurements was high, but these also decreased in the third phase of the study, significantly for actigraphy (p < 0.001), although without clear predictors, including satisfaction. In this extreme setting, satisfaction and compliance declined significantly in the final phase of the study, without clear predictive factors. Having different engagement strategies for different work shifts is also an important consideration for future studies.
在现实环境中进行睡眠和昼夜节律研究具有挑战性,但也很重要。本研究介绍了一项数据收集方案的设计和实施,该方案在一个高度具有挑战性的现实环境中进行了56天,研究人员和参与者对其优势、局限性和主要挑战的看法,并强调了与类似背景下的未来研究相关的经验教训。在为期56天的任务前、任务中和任务后数据收集后,30名军事潜艇艇员完成了一份调查问卷,以评估他们对研究和每个任务的看法。对测量(问卷调查、日记、活动记录仪和血液采集)的依从性进行了量化,并与参与者的回答相关联。平均整体满意度为3.57±0.77(0-5量表),在各个研究阶段均有所下降,仅在任务后阶段有显著变化(p < 0.001)。较高的工作满意度与较高的整体学习满意度相关(ρ = 0.396; p = 0.030)。日记被认为是最繁重的任务,而采血则产生了最两极分化的反应。对连续测量的依从性很高,但在研究的第三阶段也有所下降,尤其是在活动描记术中(p < 0.001),尽管没有明确的预测因素,包括满意度。在这种极端情况下,满意度和依从性在研究的最后阶段显著下降,没有明确的预测因素。针对不同的工作班次制定不同的敬业策略也是未来研究的重要考虑因素。
{"title":"Implementation of Research Protocols Assessing Sleep and Circadian Rhythms in Challenging Real-Life Settings: A Critical Appraisal of a Study Protocol, Including Researchers' Reflections and Participants' Perspectives.","authors":"Carina Fernandes, Ema Leite, Joana E Coelho, Cátia Reis","doi":"10.3390/clockssleep8010007","DOIUrl":"10.3390/clockssleep8010007","url":null,"abstract":"<p><p>Sleep and circadian research in real-life environments is challenging but essential. This study presents the design and implementation of a data-collection protocol in a highly challenging real-life setting over 56 days, examining both researchers' and participants' perspectives on its strengths, limitations, and key challenges, and highlighting the lessons learned relevant to future studies in similar contexts. Thirty military submariners completed a questionnaire after the 56-day pre-mission, mission, and post-mission data collection to assess their views on the study and each task. Compliance with measurements (questionnaires, diaries, actigraphy, and blood collections) was quantified and correlated with participants' answers. Mean global satisfaction was 3.57 ± 0.77 (0-5 scale) and declined across study phases, with a significant change only in the post-mission phase (<i>p</i> < 0.001). Higher work satisfaction correlated with better global study satisfaction (ρ = 0.396; <i>p</i> = 0.030). Diaries were rated the most burdensome task, while blood collections generated the most polarized responses. Compliance with continuous measurements was high, but these also decreased in the third phase of the study, significantly for actigraphy (<i>p</i> < 0.001), although without clear predictors, including satisfaction. In this extreme setting, satisfaction and compliance declined significantly in the final phase of the study, without clear predictive factors. Having different engagement strategies for different work shifts is also an important consideration for future studies.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.3390/clockssleep8010006
Sumin Bae, Eunji Hwang, Ki-Young Jung
Light exposure profoundly influences human emotions and physiology. Yet, adolescents spend considerable time under artificial indoor lighting. Reduced daytime light exposure delays the circadian clock, negatively affecting sleep, cognition, and mood. This pilot study examined whether 470-490 nm enhanced LED lighting modulates mood, sleep quality, and attention among 65 male Korean high school students (mean age = 15.4 years) who participated in a two-week intervention. Both groups were exposed to natural daylight, but the experimental group additionally used LED lighting enriched in the 470-490 nm wavelength range, whereas the control group used LED lighting without modified spectral characteristics. Students were exposed to the assigned lighting from 08:00 to 17:00 during regular school hours for two consecutive weeks. To evaluate the effects of the two-week intervention, pre- and post-assessments included the Beck Depression Inventory (BDI-II), the Richards-Campbell Sleep Questionnaire (RCSQ), the Epworth Sleepiness Scale (ESS), the Perceived Stress Scale (PSS), and the Frankfurter Attention Inventory (FAIR), administered twice at each assessment point. The linear mixed-effect model showed a significant time × group interaction for line errors in the first FAIR trial (F (1, 52) = 5.21, p = 0.027, η2 partial = 0.09), suggesting a greater relative reduction in attentional errors in the experimental group compared with the control group. No significant effects were observed for sleep- or mood-related outcomes. These results indicate the potential relevance of wavelength-optimized lighting in educational settings where sustained attention is critical. Future studies with larger samples and longer interventions are required to confirm and extend these findings.
{"title":"Real-World Effects of Melanopic-Enhanced Classroom Lighting on Sleep, Mood, and Cognition in Male Korean Adolescents: A Field-Based Pilot Study.","authors":"Sumin Bae, Eunji Hwang, Ki-Young Jung","doi":"10.3390/clockssleep8010006","DOIUrl":"10.3390/clockssleep8010006","url":null,"abstract":"<p><p>Light exposure profoundly influences human emotions and physiology. Yet, adolescents spend considerable time under artificial indoor lighting. Reduced daytime light exposure delays the circadian clock, negatively affecting sleep, cognition, and mood. This pilot study examined whether 470-490 nm enhanced LED lighting modulates mood, sleep quality, and attention among 65 male Korean high school students (mean age = 15.4 years) who participated in a two-week intervention. Both groups were exposed to natural daylight, but the experimental group additionally used LED lighting enriched in the 470-490 nm wavelength range, whereas the control group used LED lighting without modified spectral characteristics. Students were exposed to the assigned lighting from 08:00 to 17:00 during regular school hours for two consecutive weeks. To evaluate the effects of the two-week intervention, pre- and post-assessments included the Beck Depression Inventory (BDI-II), the Richards-Campbell Sleep Questionnaire (RCSQ), the Epworth Sleepiness Scale (ESS), the Perceived Stress Scale (PSS), and the Frankfurter Attention Inventory (FAIR), administered twice at each assessment point. The linear mixed-effect model showed a significant time × group interaction for line errors in the first FAIR trial (F (1, 52) = 5.21, <i>p</i> = 0.027, η<sup>2</sup> partial = 0.09), suggesting a greater relative reduction in attentional errors in the experimental group compared with the control group. No significant effects were observed for sleep- or mood-related outcomes. These results indicate the potential relevance of wavelength-optimized lighting in educational settings where sustained attention is critical. Future studies with larger samples and longer interventions are required to confirm and extend these findings.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.3390/clockssleep8010005
Maria Dalmau I Ribas, Geoffroy Solelhac, José Haba-Rubio, Julien Elowe, Véronique Griffith
Insomnia symptoms are very common among psychiatric inpatients and can increase the risk of suicide in this population. However, little is known about how psychiatrists and nurses manage insomnia symptoms in psychiatric inpatients. This study aimed to investigate the views, opinions, and experiences of psychiatrists and nurses regarding inpatients' sleep complaints in a Swiss psychiatric hospital. This qualitative study used individual semi-structured interviews with a purposive sample of psychiatrists and nurses working in a Swiss psychiatric hospital. Interviews were audio-recorded, transcribed verbatim, and analysed manually using inductive thematic analysis. Ten participants (six psychiatrists and four nurses) were interviewed. Three overarching themes were identified: identifying and classifying sleep complaints, the decision-making process, and the actions taken to respond to the complaint. Insomnia symptoms were approached by psychiatrists and nurses in a highly heterogeneous, non-evidence-based manner, with a lack of adaptation of CBT-I leading to overmedication. This heterogeneity may be explained by the diversity of underlying problems associated with insomnia symptoms, the lack of hospital-specific guidelines, and the fact that current guidelines focus mainly on chronic insomnia and do not fully account for the complexity of psychiatric inpatients.
{"title":"Sleep Complaints in the Psychiatric Hospital: A Qualitative Study of Nurses and Psychiatrists' Approaches to Sleep Management in a Swiss Psychiatric Hospital.","authors":"Maria Dalmau I Ribas, Geoffroy Solelhac, José Haba-Rubio, Julien Elowe, Véronique Griffith","doi":"10.3390/clockssleep8010005","DOIUrl":"10.3390/clockssleep8010005","url":null,"abstract":"<p><p>Insomnia symptoms are very common among psychiatric inpatients and can increase the risk of suicide in this population. However, little is known about how psychiatrists and nurses manage insomnia symptoms in psychiatric inpatients. This study aimed to investigate the views, opinions, and experiences of psychiatrists and nurses regarding inpatients' sleep complaints in a Swiss psychiatric hospital. This qualitative study used individual semi-structured interviews with a purposive sample of psychiatrists and nurses working in a Swiss psychiatric hospital. Interviews were audio-recorded, transcribed verbatim, and analysed manually using inductive thematic analysis. Ten participants (six psychiatrists and four nurses) were interviewed. Three overarching themes were identified: identifying and classifying sleep complaints, the decision-making process, and the actions taken to respond to the complaint. Insomnia symptoms were approached by psychiatrists and nurses in a highly heterogeneous, non-evidence-based manner, with a lack of adaptation of CBT-I leading to overmedication. This heterogeneity may be explained by the diversity of underlying problems associated with insomnia symptoms, the lack of hospital-specific guidelines, and the fact that current guidelines focus mainly on chronic insomnia and do not fully account for the complexity of psychiatric inpatients.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.3390/clockssleep8010004
Yik Hin Chan, Anastasya Maria Kosasih, Venetia Kok, Yi-Hui Ou, Yun Jing Crystal Chng, Joshua J Gooley, Chi-Hang Lee
We investigated the effects of Continuous Positive Airway Pressure (CPAP) on blood pressure (BP) and vigilance in taxi drivers with obstructive sleep apnea (OSA). This pilot study recruited taxi drivers aged ≥60 years to undergo polysomnography. Those diagnosed with OSA underwent 6 months of CPAP therapy. Baseline and follow-up assessments included 24 h ambulatory blood pressure monitoring (ABPM) and the psychomotor vigilance test (PVT). Among the 32 participants, 22 (68.8%) were diagnosed with OSA (median age 63.0 [62.0-65.0] years; 21 males). The average CPAP adherence was 3.1 ± 2.3 h per night, with 23.5% using CPAP for more than 4 h per night. There were no significant changes in 24 h mean systolic ABPM (125.9 [116.8-134.9] mmHg to 126.0 [118.3-133.7] mmHg; p = 0.93) or reaction times measured by PVT (2.0 [0.0-3.0] lapses to 2.0 [1.0-3.0] lapses; p = 0.82) after CPAP therapy. A high prevalence of OSA was observed among taxi drivers. CPAP adherence was suboptimal and did not result in significant improvements in BP or vigilance.
我们研究了持续气道正压通气(CPAP)对患有阻塞性睡眠呼吸暂停(OSA)的出租车司机血压(BP)和警惕性的影响。本初步研究招募年龄≥60岁的出租车司机进行多导睡眠描记术。被诊断为OSA的患者接受了6个月的CPAP治疗。基线和随访评估包括24小时动态血压监测(ABPM)和精神运动警觉性测试(PVT)。32例受试者中,22例(68.8%)被诊断为OSA(中位年龄63.0岁[62.0-65.0]岁,男性21例)。CPAP的平均依从性为每晚3.1±2.3小时,23.5%的患者使用CPAP的时间超过每晚4小时。CPAP治疗后24小时平均收缩期ABPM (125.9 [116.8-134.9] mmHg至126.0 [118.3-133.7]mmHg, p = 0.93)或PVT测定的反应时间(2.0[0.0-3.0]秒至2.0[1.0-3.0]秒,p = 0.82)无显著变化。出租车司机的阻塞性睡眠呼吸暂停患病率较高。CPAP依从性是次优的,并且没有导致血压或警惕性的显著改善。
{"title":"Prevalence of Obstructive Sleep Apnea and Adherence to CPAP for TAXI Drivers.","authors":"Yik Hin Chan, Anastasya Maria Kosasih, Venetia Kok, Yi-Hui Ou, Yun Jing Crystal Chng, Joshua J Gooley, Chi-Hang Lee","doi":"10.3390/clockssleep8010004","DOIUrl":"10.3390/clockssleep8010004","url":null,"abstract":"<p><p>We investigated the effects of Continuous Positive Airway Pressure (CPAP) on blood pressure (BP) and vigilance in taxi drivers with obstructive sleep apnea (OSA). This pilot study recruited taxi drivers aged ≥60 years to undergo polysomnography. Those diagnosed with OSA underwent 6 months of CPAP therapy. Baseline and follow-up assessments included 24 h ambulatory blood pressure monitoring (ABPM) and the psychomotor vigilance test (PVT). Among the 32 participants, 22 (68.8%) were diagnosed with OSA (median age 63.0 [62.0-65.0] years; 21 males). The average CPAP adherence was 3.1 ± 2.3 h per night, with 23.5% using CPAP for more than 4 h per night. There were no significant changes in 24 h mean systolic ABPM (125.9 [116.8-134.9] mmHg to 126.0 [118.3-133.7] mmHg; <i>p</i> = 0.93) or reaction times measured by PVT (2.0 [0.0-3.0] lapses to 2.0 [1.0-3.0] lapses; <i>p</i> = 0.82) after CPAP therapy. A high prevalence of OSA was observed among taxi drivers. CPAP adherence was suboptimal and did not result in significant improvements in BP or vigilance.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-05DOI: 10.3390/clockssleep8010003
Jolanta Malinowska-Borowska, Anna Czupryna, Marta Buczkowska, Aleksandra Kulik
Background: Exposure to artificial light at night can lead to circadian disruption and health risks. It can cause mood swings, confusion, and depression. The aim of this cross-sectional study was to assess the relationship between the illuminance of urban lighting and the health of residents.
Methods: This study was carried out among residents of two similar towns, one with typical street lighting and a Dark Sky Park characterized by reduced lighting. A total of 272 respondents participated in this study. A self-administered questionnaire and the WHOQOL-BREF were used among the respondents.
Results: People living in the Dark Sky Park were more likely to be satisfied with their sleep (p < 0.001). In fact, 58.7% of Dark Sky Park residents reported no sleep problems. In the control town, only 49.25% did (p = 0.04). The sleep duration was similar in the two towns, but Dark Sky Park residents were statistically less likely to use sleeping pills and window blinds. People exposed to typical street lighting at night reported suffering from eye diseases, cardiovascular diseases, and mood changes more often than those living in the Dark Sky Park. The environmental and physical quality of life, as measured by the WHOQOL-BREF, were significantly higher in the Dark Sky Park residents than in the control town (p < 0.05).
Conclusions: People living in places with limited illuminance declare better health and a higher quality of life in the physical and environmental domains.
{"title":"People Living in Places with Limited Illuminance Declare Better Health and Higher Quality of Life in Environmental and Physical Domains.","authors":"Jolanta Malinowska-Borowska, Anna Czupryna, Marta Buczkowska, Aleksandra Kulik","doi":"10.3390/clockssleep8010003","DOIUrl":"10.3390/clockssleep8010003","url":null,"abstract":"<p><strong>Background: </strong>Exposure to artificial light at night can lead to circadian disruption and health risks. It can cause mood swings, confusion, and depression. The aim of this cross-sectional study was to assess the relationship between the illuminance of urban lighting and the health of residents.</p><p><strong>Methods: </strong>This study was carried out among residents of two similar towns, one with typical street lighting and a Dark Sky Park characterized by reduced lighting. A total of 272 respondents participated in this study. A self-administered questionnaire and the WHOQOL-BREF were used among the respondents.</p><p><strong>Results: </strong>People living in the Dark Sky Park were more likely to be satisfied with their sleep (<i>p</i> < 0.001). In fact, 58.7% of Dark Sky Park residents reported no sleep problems. In the control town, only 49.25% did (<i>p</i> = 0.04). The sleep duration was similar in the two towns, but Dark Sky Park residents were statistically less likely to use sleeping pills and window blinds. People exposed to typical street lighting at night reported suffering from eye diseases, cardiovascular diseases, and mood changes more often than those living in the Dark Sky Park. The environmental and physical quality of life, as measured by the WHOQOL-BREF, were significantly higher in the Dark Sky Park residents than in the control town (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>People living in places with limited illuminance declare better health and a higher quality of life in the physical and environmental domains.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.3390/clockssleep8010002
Corrado Garbazza
It is my pleasure to present this collection of abstracts from the 36th Annual Meeting of the Society for Light, Rhythms, and Circadian Health (SLRCH), held in Boston, Massachusetts, at Simmons University and Brigham and Women's Hospital [...].
{"title":"Thirty-Sixth Annual Meeting of the Society for Light, Rhythms, and Circadian Health (SLRCH), 14-16 June, Boston, MA, USA.","authors":"Corrado Garbazza","doi":"10.3390/clockssleep8010002","DOIUrl":"https://doi.org/10.3390/clockssleep8010002","url":null,"abstract":"<p><p>It is my pleasure to present this collection of abstracts from the 36th Annual Meeting of the Society for Light, Rhythms, and Circadian Health (SLRCH), held in Boston, Massachusetts, at Simmons University and Brigham and Women's Hospital [...].</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.3390/clockssleep8010001
Ronald B Brown
Late-night feeding, defined in the present review as feeding after 8:00 pm when evening insulin secretion and sensitivity are low, is increasingly prevalent in Western society and is recognized as a disruptor of metabolic homeostasis. Yet health problems related to late-night feeding are largely ignored in time-restricted feeding studies that generally do not extend past an 8:00 pm feeding window. This paper proposes a novel cascade linking late-night hyperglycemia with sleep disturbances and nasal congestion mediated by renal sodium retention, increased plasma osmolarity, and stress hormone release by hypothalamic-pituitary-adrenal axis activation. The narrative describes the circadian decline in insulin sensitivity, which amplifies postprandial glucose surges following late-night feeding. Elevated glucose levels drive renal glucose reabsorption via sodium-glucose cotransporters, promoting sodium retention independent of insulin. Increased sodium retention raises extracellular osmolarity, activating hypothalamic osmoreceptors and stimulating the hypothalamic-pituitary-adrenal axis. Cortisol release promotes alertness, while fluid retention and mucosal edema contribute to nasal congestion and early waking. Supine fluid redistribution during sleep further exacerbates airway narrowing, increasing the risk of sleep fragmentation and obstructive sleep apnea. The present paper fills a gap in current time-restricted feeding literature by integrating renal, osmotic, and neuroendocrine pathways that may be overlooked as underlying mechanisms of dysregulated glucose control and hormone dysfunction. Reviewed evidence suggests that symptoms such as nocturnal congestion and sleep disruption are not merely incidental to late-night feeding but frame late night feeding as a risk factor with underlying physiological stressors that could contribute to cardiometabolic risk.
{"title":"Late-Night Feeding, Sleep Disturbance, and Nocturnal Congestion Mediated by Hyperglycemia, Renal Sodium Retention, and Cortisol: A Narrative Review.","authors":"Ronald B Brown","doi":"10.3390/clockssleep8010001","DOIUrl":"10.3390/clockssleep8010001","url":null,"abstract":"<p><p>Late-night feeding, defined in the present review as feeding after 8:00 pm when evening insulin secretion and sensitivity are low, is increasingly prevalent in Western society and is recognized as a disruptor of metabolic homeostasis. Yet health problems related to late-night feeding are largely ignored in time-restricted feeding studies that generally do not extend past an 8:00 pm feeding window. This paper proposes a novel cascade linking late-night hyperglycemia with sleep disturbances and nasal congestion mediated by renal sodium retention, increased plasma osmolarity, and stress hormone release by hypothalamic-pituitary-adrenal axis activation. The narrative describes the circadian decline in insulin sensitivity, which amplifies postprandial glucose surges following late-night feeding. Elevated glucose levels drive renal glucose reabsorption via sodium-glucose cotransporters, promoting sodium retention independent of insulin. Increased sodium retention raises extracellular osmolarity, activating hypothalamic osmoreceptors and stimulating the hypothalamic-pituitary-adrenal axis. Cortisol release promotes alertness, while fluid retention and mucosal edema contribute to nasal congestion and early waking. Supine fluid redistribution during sleep further exacerbates airway narrowing, increasing the risk of sleep fragmentation and obstructive sleep apnea. The present paper fills a gap in current time-restricted feeding literature by integrating renal, osmotic, and neuroendocrine pathways that may be overlooked as underlying mechanisms of dysregulated glucose control and hormone dysfunction. Reviewed evidence suggests that symptoms such as nocturnal congestion and sleep disruption are not merely incidental to late-night feeding but frame late night feeding as a risk factor with underlying physiological stressors that could contribute to cardiometabolic risk.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.3390/clockssleep7040069
Ingrid Porto Araújo Leite, Viviane Akemi Kakazu, Lucca Andrade Teixeira de Carvalho, Sergio Tufik, Gabriel Natan Pires
Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) is an effective alternative to therapist-delivered CBT-I. However, there is a lack of meta-analyses assessing its effects on other sleep-related outcomes. We aimed to conduct a meta-analysis of randomized controlled trials (RCTs) evaluating dCBT-I in adults with insomnia through polysomnography (PSG) and sleep diary. Systematic searches were performed in PubMed and Web of Science. The outcomes considered were total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO), and number of awakenings (NWAK). Meta-analyses were performed using random-effects models to compare dCBT-I with active (in-person or telehealth CBT-I) or inactive (waiting list, no treatment, or minimal intervention) control groups. Of the fourteen RCTs included, only three employed an active control. As no trials used PSG, the analyses relied solely on sleep diary data. DCBT-I showed no statistically significant differences from active controls, indicating comparable effects with therapist-delivered CBT-I. In contrast, it demonstrated statistically significant effects against inactive controls; TST increased by 0.20 h, SOL decreased by 15.53 min, SE improved by 7.91%, WASO reduced by 15.61 min, and NWAK decreased by 0.53. Future research should prioritize comparisons with therapist-delivered CBT-I and incorporate PSG for measuring these parameters.
数字认知行为治疗失眠(dCBT-I)是一种有效的替代治疗师提供的CBT-I。然而,缺乏评估其对其他睡眠相关结果影响的荟萃分析。我们的目的是对随机对照试验(rct)进行荟萃分析,通过多导睡眠图(PSG)和睡眠日记来评估成人失眠患者的dCBT-I。在PubMed和Web of Science中进行系统搜索。考虑的结果包括总睡眠时间(TST)、睡眠开始潜伏期(SOL)、睡眠效率(SE)、睡眠开始后醒来(WASO)和醒来次数(NWAK)。使用随机效应模型进行meta分析,将dCBT-I与积极(面对面或远程医疗CBT-I)或不积极(等候名单、无治疗或最小干预)对照组进行比较。在纳入的14项随机对照试验中,只有3项采用主动对照。由于没有试验使用PSG,因此分析仅依赖于睡眠日记数据。DCBT-I与主动对照无统计学差异,表明与治疗师提供的CBT-I效果相当。相比之下,它对不活跃的对照组显示出统计学上显著的效果;TST增加0.20 h, SOL减少15.53 min, SE增加7.91%,WASO减少15.61 min, NWAK减少0.53 min。未来的研究应优先与治疗师提供的CBT-I进行比较,并纳入PSG来测量这些参数。
{"title":"Effects of Digital Cognitive Behavioral Therapy for Insomnia on Self-Reported Sleep Parameters: Systematic Review and Meta-Analysis.","authors":"Ingrid Porto Araújo Leite, Viviane Akemi Kakazu, Lucca Andrade Teixeira de Carvalho, Sergio Tufik, Gabriel Natan Pires","doi":"10.3390/clockssleep7040069","DOIUrl":"10.3390/clockssleep7040069","url":null,"abstract":"<p><p>Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) is an effective alternative to therapist-delivered CBT-I. However, there is a lack of meta-analyses assessing its effects on other sleep-related outcomes. We aimed to conduct a meta-analysis of randomized controlled trials (RCTs) evaluating dCBT-I in adults with insomnia through polysomnography (PSG) and sleep diary. Systematic searches were performed in PubMed and Web of Science. The outcomes considered were total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO), and number of awakenings (NWAK). Meta-analyses were performed using random-effects models to compare dCBT-I with active (in-person or telehealth CBT-I) or inactive (waiting list, no treatment, or minimal intervention) control groups. Of the fourteen RCTs included, only three employed an active control. As no trials used PSG, the analyses relied solely on sleep diary data. DCBT-I showed no statistically significant differences from active controls, indicating comparable effects with therapist-delivered CBT-I. In contrast, it demonstrated statistically significant effects against inactive controls; TST increased by 0.20 h, SOL decreased by 15.53 min, SE improved by 7.91%, WASO reduced by 15.61 min, and NWAK decreased by 0.53. Future research should prioritize comparisons with therapist-delivered CBT-I and incorporate PSG for measuring these parameters.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12731755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.3390/clockssleep7040070
Yasunori Oka, Akiko Tange, Yuki Maeda
This paper reviews existing research on infant mattress design to promote safe and comfortable sleep and proposes evidence-based design recommendations. Focusing on safety related to Sudden Unexpected Infant Death (SUID) and comfort associated with infant development and thermoregulation, we examine mattress firmness, pressure distribution, breathability, and thermal properties. Since infants have difficulty turning over and possess immature thermoregulatory functions, mattress characteristics directly influence sleep quality and safety. Based on international studies, we clarify the requirements for infant mattresses and provide insights into future product development and evaluation standards.
{"title":"Designing Infant Mattresses Tailored to Developmental Sleep Characteristics: A Comprehensive Review.","authors":"Yasunori Oka, Akiko Tange, Yuki Maeda","doi":"10.3390/clockssleep7040070","DOIUrl":"10.3390/clockssleep7040070","url":null,"abstract":"<p><p>This paper reviews existing research on infant mattress design to promote safe and comfortable sleep and proposes evidence-based design recommendations. Focusing on safety related to Sudden Unexpected Infant Death (SUID) and comfort associated with infant development and thermoregulation, we examine mattress firmness, pressure distribution, breathability, and thermal properties. Since infants have difficulty turning over and possess immature thermoregulatory functions, mattress characteristics directly influence sleep quality and safety. Based on international studies, we clarify the requirements for infant mattresses and provide insights into future product development and evaluation standards.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12731834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.3390/clockssleep7040068
Sandrine Baselgia, Jonas Beck, Björn Rasch
Anticipation of stressful events can impair sleep quality. In a recent study, we reported that anticipating a stressful task before a nap led to negative changes in sleep parameters, particularly at the end of the nap. In our previous study, we compared stress anticipation with the anticipation of relaxation; thus, the observed effects may have been amplified by sleep quality improvements in the relaxation condition. In the current study, we aimed to replicate these findings using an alternative neutral control condition. The data from a newly collected sample (n = 31) were compared with the data from our previous study (n = 33) using identical analyses. The results reveal an opposite pattern from our previous study: participants in the neutral control condition showed poorer sleep (longer sleep onset latency, reduced slow-wave sleep, and lower SWA/beta ratio) compared to those anticipating stress. In a direct comparison of both studies, sleep parameters in the stress conditions were highly similar across the two studies, suggesting that the divergent outcomes are driven by differences in the control conditions. The temporal dynamic changes observed in our previous study could not be replicated. These findings highlight the importance of carefully considering control conditions in experimental sleep research and suggest that even "neutral" instructions can evoke anticipatory effects. Moreover, the observed benefits of anticipating post-sleep relaxation highlight opportunities for relaxation-based interventions to improve sleep quality.
{"title":"Anticipation of Stress and Relaxation Dynamically Impacts Sleep.","authors":"Sandrine Baselgia, Jonas Beck, Björn Rasch","doi":"10.3390/clockssleep7040068","DOIUrl":"10.3390/clockssleep7040068","url":null,"abstract":"<p><p>Anticipation of stressful events can impair sleep quality. In a recent study, we reported that anticipating a stressful task before a nap led to negative changes in sleep parameters, particularly at the end of the nap. In our previous study, we compared stress anticipation with the anticipation of relaxation; thus, the observed effects may have been amplified by sleep quality improvements in the relaxation condition. In the current study, we aimed to replicate these findings using an alternative neutral control condition. The data from a newly collected sample (<i>n</i> = 31) were compared with the data from our previous study (<i>n</i> = 33) using identical analyses. The results reveal an opposite pattern from our previous study: participants in the neutral control condition showed poorer sleep (longer sleep onset latency, reduced slow-wave sleep, and lower SWA/beta ratio) compared to those anticipating stress. In a direct comparison of both studies, sleep parameters in the stress conditions were highly similar across the two studies, suggesting that the divergent outcomes are driven by differences in the control conditions. The temporal dynamic changes observed in our previous study could not be replicated. These findings highlight the importance of carefully considering control conditions in experimental sleep research and suggest that even \"neutral\" instructions can evoke anticipatory effects. Moreover, the observed benefits of anticipating post-sleep relaxation highlight opportunities for relaxation-based interventions to improve sleep quality.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12731430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}