Pub Date : 2025-08-05DOI: 10.1016/j.smrv.2025.102145
Erika L. English , James M. Krueger
We posit that organism sleep is regulated from the interactions between two semi-autonomous regulatory systems, the classic sleep/wake regulatory circuits and a local cell activity-driven system. Sleep regulatory circuits mold local sleep into a species’ niche but are not required for sleep. In contrast, local sleep mechanisms initiate sleep-like states in small networks and are responsive to microbial pattern recognition receptors. Local sleep-like phenomena manifest in brain in vivo and in vitro. Sleep regulatory substances e.g., cytokines and adenosine, are released by cell activity and as such provide an index of neural network activity. They are evolutionary ancient molecules existing prior to the evolution of complex vertebrate sleep. Further, bacterial cell wall components can initiate sleep in insomniac mammals lacking key hypothalamic regulatory circuits, suggesting our ancient holobiont condition underlies sleep regulation. We review how interleukin-1 promotes sleep/sleep-like states at various tissue organization levels. We provide a basis for understanding sleep as an emergent property of cellular networks and a process beginning at the cellular level and progressing as modified by multiple physiological regulatory circuits to whole animal sleep. We conclude; sleep mechanisms are shared across various levels of tissue organization and are part of interspecies regulatory networks.
{"title":"Local and niche-adapted sleep regulatory mechanisms encompass the holobiont condition","authors":"Erika L. English , James M. Krueger","doi":"10.1016/j.smrv.2025.102145","DOIUrl":"10.1016/j.smrv.2025.102145","url":null,"abstract":"<div><div>We posit that organism sleep is regulated from the interactions between two semi-autonomous regulatory systems, the classic sleep/wake regulatory circuits and a local cell activity-driven system. Sleep regulatory circuits mold local sleep into a species’ niche but are not required for sleep. In contrast, local sleep mechanisms initiate sleep-like states in small networks and are responsive to microbial pattern recognition receptors. Local sleep-like phenomena manifest in brain <em>in vivo</em> and <em>in vitro</em>. Sleep regulatory substances e.g., cytokines and adenosine, are released by cell activity and as such provide an index of neural network activity. They are evolutionary ancient molecules existing prior to the evolution of complex vertebrate sleep. Further, bacterial cell wall components can initiate sleep in insomniac mammals lacking key hypothalamic regulatory circuits, suggesting our ancient holobiont condition underlies sleep regulation. We review how interleukin-1 promotes sleep/sleep-like states at various tissue organization levels. We provide a basis for understanding sleep as an emergent property of cellular networks and a process beginning at the cellular level and progressing as modified by multiple physiological regulatory circuits to whole animal sleep. We conclude; sleep mechanisms are shared across various levels of tissue organization and are part of interspecies regulatory networks.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102145"},"PeriodicalIF":9.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-31DOI: 10.1016/j.smrv.2025.102144
Miguel Meira e Cruz , Meir Kryger
{"title":"Oximetry at the crossroads of innovation and equity in sleep apnea diagnosis","authors":"Miguel Meira e Cruz , Meir Kryger","doi":"10.1016/j.smrv.2025.102144","DOIUrl":"10.1016/j.smrv.2025.102144","url":null,"abstract":"","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102144"},"PeriodicalIF":9.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronotype has been defined according to an individual's preference regarding the timing for daily activities and behaviors such as waking up, eating, exercising and going to bed. These behavioral preferences have been related to genetic, endocrine, behavioral, and other biological, psychological, environmental, and social traits. Research in chronobiology has linked the "morning" vs. "evening" preference to different risk for several health problems. The assessment of our current knowledge of chronotype and its influence on the development and persistence of the current pandemic of obesity and metabolism-related chronic diseases is timely and relevant. The present narrative review aims to examine the available evidence regarding chronotype and metabolic health. We also discuss the potential use of chronotype-based therapeutic approaches in clinical practice and describe literature gaps to propose future research directions in this field. Understanding molecular, physiological, psychological, and social mechanisms underlying differences between "larks" and "owls" will provide the opportunity to translate this knowledge into clinical practice and may be vital to implementing and/or improving individualized treatment outcomes.
{"title":"The human chronotype: A multidimensional construct at the crossroad of physiology and behavior, with important health implications","authors":"Gabriela Yuri , Rodrigo Chamorro , Nicolás Tobar , Mariana Cifuentes","doi":"10.1016/j.smrv.2025.102142","DOIUrl":"10.1016/j.smrv.2025.102142","url":null,"abstract":"<div><div>Chronotype has been defined according to an individual's preference regarding the timing for daily activities and behaviors such as waking up, eating, exercising and going to bed. These behavioral preferences have been related to genetic, endocrine, behavioral, and other biological, psychological, environmental, and social traits. Research in chronobiology has linked the \"morning\" vs. \"evening\" preference to different risk for several health problems. The assessment of our current knowledge of chronotype and its influence on the development and persistence of the current pandemic of obesity and metabolism-related chronic diseases is timely and relevant. The present narrative review aims to examine the available evidence regarding chronotype and metabolic health. We also discuss the potential use of chronotype-based therapeutic approaches in clinical practice and describe literature gaps to propose future research directions in this field. Understanding molecular, physiological, psychological, and social mechanisms underlying differences between \"<em>larks</em>\" and \"<em>owls</em>\" will provide the opportunity to translate this knowledge into clinical practice and may be vital to implementing and/or improving individualized treatment outcomes.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102142"},"PeriodicalIF":9.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-26DOI: 10.1016/j.smrv.2025.102140
Grace Oscullo , Jose Daniel Gómez-Olivas , David Gozal , Miguel Angel Martinez-Garcia
{"title":"Is the composite MACE outcome an optimal measure for assessing the impact of CPAP on cardiovascular disease?","authors":"Grace Oscullo , Jose Daniel Gómez-Olivas , David Gozal , Miguel Angel Martinez-Garcia","doi":"10.1016/j.smrv.2025.102140","DOIUrl":"10.1016/j.smrv.2025.102140","url":null,"abstract":"","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102140"},"PeriodicalIF":9.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The paper explores the impact of religious practices on sleep among Muslim patients and develops strategies for delivering religio-culturally conscious sleep care. We aim to enhance understanding among healthcare providers to improve patient outcomes through tailored sleep interventions. A quasi-scoping, narrative review of clinical perspectives, existing empirical studies, and patient-reported experiences from relevant literature, including empirical studies in PubMed, on the influence of Islamic practices such as the five daily prayers, Ramadan fasting, and Qailulah (midday naps) on sleep patterns was conducted. These practices were analyzed for their contribution to circadian misalignment, sleep deprivation, and alterations in sleep architecture. Strategies for integrating cultural and religious practices into sleep care are proposed, focusing on education, collaboration, and personalized care. Findings suggest that Islamic practices, such as early pre-dawn prayers, late-night worship, and fasting, can impact sleep architecture, reduce total sleep time, delay bedtimes, and increase daytime sleepiness, as well as contribute to reduced REM sleep and increased sleep latency during Ramadan, though evidence is mixed. Incorporating culturally relevant practices like Qailulah in a Muslim patient's sleep care can mitigate negative effects such as sleep deprivation and circadian misalignment. Additionally, adapting cognitive-behavioral therapy for insomnia to consider religious norms could be beneficial to Muslim patients. Religiously conscious sleep care may improve health outcomes for Muslim patients. Understanding Islamic practices allows healthcare providers to deliver effective, personalized sleep care interventions. Future efforts should focus on enhancing education, refining these strategies and examining their broader applicability, and conducting research on the cultural and religious determinants of sleep health.
{"title":"Religious and culturally conscious sleep care for Muslim patients: Clinical considerations and recommendations","authors":"Bilal Irfan , Hrayr Attarian , Muna Irfan , Abdulghani Sankari , Denise Kirschner , Meena Khan","doi":"10.1016/j.smrv.2025.102138","DOIUrl":"10.1016/j.smrv.2025.102138","url":null,"abstract":"<div><div>The paper explores the impact of religious practices on sleep among Muslim patients and develops strategies for delivering religio-culturally conscious sleep care. We aim to enhance understanding among healthcare providers to improve patient outcomes through tailored sleep interventions. A quasi-scoping, narrative review of clinical perspectives, existing empirical studies, and patient-reported experiences from relevant literature, including empirical studies in PubMed, on the influence of Islamic practices such as the five daily prayers, Ramadan fasting, and <em>Qailulah</em> (midday naps) on sleep patterns was conducted. These practices were analyzed for their contribution to circadian misalignment, sleep deprivation, and alterations in sleep architecture. Strategies for integrating cultural and religious practices into sleep care are proposed, focusing on education, collaboration, and personalized care. Findings suggest that Islamic practices, such as early pre-dawn prayers, late-night worship, and fasting, can impact sleep architecture, reduce total sleep time, delay bedtimes, and increase daytime sleepiness, as well as contribute to reduced REM sleep and increased sleep latency during Ramadan, though evidence is mixed. Incorporating culturally relevant practices like <em>Qailulah</em> in a Muslim patient's sleep care can mitigate negative effects such as sleep deprivation and circadian misalignment. Additionally, adapting cognitive-behavioral therapy for insomnia to consider religious norms could be beneficial to Muslim patients. Religiously conscious sleep care may improve health outcomes for Muslim patients. Understanding Islamic practices allows healthcare providers to deliver effective, personalized sleep care interventions. Future efforts should focus on enhancing education, refining these strategies and examining their broader applicability, and conducting research on the cultural and religious determinants of sleep health.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102138"},"PeriodicalIF":9.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.smrv.2025.102139
Eder Leandro da Silva Dantas , Fernando Gustavo Stelzer , Wanderley Marques Bernardo , Alan Luiz Eckeli
Obstructive sleep apnea (OSA) is a common disorder, associated with significant morbidity and mortality. Recently, several oximetry-based devices have been developed to assist with diagnosing OSA. Therefore, this study aims to evaluate the diagnostic performance of these tools compared to PSG. We included studies that evaluated oximetry-based devices in comparison to PSG for OSA diagnosis in adults. 18 selected studies were divided into two subgroups: consumer wearable and medical devices. Overall sensitivity was 97 % (95 % Confidence Interval [CI]: 96–97 %) and specificity, 63 % (95 % CI: 61–65. In the consumer wearable devices subgroup, sensitivity was 93 % (95 % CI: 90 – 96) and specificity, 63 % (95 % CI: 53 – 71). In the medical devices subgroup, sensitivity was also high as 97 % (95 % CI: 96–97) with a specificity of 63 % (95 % CI: 61–65). Accuracy measured by area under the curve and post-test probability were both 90 %. Oximetry-based devices demonstrate high sensitivity for ruling out OSA in high-risk adults. However, their low specificity raises concerns regarding potential unnecessary healthcare costs. Therefore, these devices may be considered for screening in high-risk individuals, provided that all positive results are confirmed by a gold-standard diagnostic method.
{"title":"Oximetry-based devices in diagnosis of obstructive sleep apnea: A systematic review and meta-analysis","authors":"Eder Leandro da Silva Dantas , Fernando Gustavo Stelzer , Wanderley Marques Bernardo , Alan Luiz Eckeli","doi":"10.1016/j.smrv.2025.102139","DOIUrl":"10.1016/j.smrv.2025.102139","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) is a common disorder, associated with significant morbidity and mortality. Recently, several oximetry-based devices have been developed to assist with diagnosing OSA. Therefore, this study aims to evaluate the diagnostic performance of these tools compared to PSG. We included studies that evaluated oximetry-based devices in comparison to PSG for OSA diagnosis in adults. 18 selected studies were divided into two subgroups: <em>consumer wearable</em> and medical devices. Overall sensitivity was 97 % (95 % Confidence Interval [CI]: 96–97 %) and specificity, 63 % (95 % CI: 61–65. In the <em>consumer wearable devices subgroup, sensitivity was 93 % (95 % CI: 90 – 96) and specificity, 63 % (95 % CI: 53 – 71). In the</em> medical devices subgroup, sensitivity was also high as 97 % (95 % CI: 96–97) with a specificity of 63 % (95 % CI: 61–65). Accuracy measured by area under the curve and post-test probability were both 90 %. Oximetry-based devices demonstrate high sensitivity for ruling out OSA in high-risk adults. However, their low specificity raises concerns regarding potential unnecessary healthcare costs. Therefore, these devices may be considered for screening in high-risk individuals, provided that all positive results are confirmed by a gold-standard diagnostic method.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102139"},"PeriodicalIF":9.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-19DOI: 10.1016/j.smrv.2025.102136
Man Wang , Youngmin Cho , Junxin Li
Exposure to air pollution may negatively impact sleep health. This systematic review and meta-analysis examined the association between air pollution and sleep health in middle-aged and older adults. PubMed, Web of Science, CINAHL and Embase were searched from inception to September 11, 2024. Included studies reported at least one air pollutant (e.g., PM1 [particles < 1 μm], PM2.5 [particles < 2.5 μm], PM10 [particles < 10 μm], CO [carbon monoxide], CO2 [carbon dioxide], NO2 [nitrogen dioxide], SO2 [sulfur dioxide] and O3 [ozone]) and sleep health outcomes. All binary negative sleep health outcomes (e.g., poor sleep quality, low sleep efficiency and obstructive sleep apnea) were integrated as poor sleep health in the meta-analyses. Twenty-five studies were included, with a final sample of at least 1,262,210 middle-aged and older adults. The pooled prevalence of poor sleep health was 43.7%. We conducted random-effects meta-analyses on nine studies using the DerSimonian-Laird estimator to examine the association between air pollution and poor sleep health. Results showed that per 10 μg/m3 increase in long-term exposure to PM1 [OR (95% CI): 1.37 (1.07, 1.75)], PM2.5 [OR (95% CI): 1.27 (1.12, 1.43), PM10 [OR (95% CI): 1.10 (1.03, 1.19) and per 5 μg/m3 in NO2 [OR (95% CI): 1.07 (1.01, 1.13)] was significantly associated with poor sleep health. However, no significant association was observed between long-term O3 exposure (per 10 μg/m3 increase) and poor sleep health [OR (95% CI): 1.04 (0.88, 1.24)]. Indoor air pollution from the combustion of solid fuels was also associated with a higher risk of poor sleep health. Our findings highlight the critical roles of both indoor and outdoor air environments in promoting sleep health, underscoring the need for environmental interventions and public health policies to improve air quality and alleviate the burden of poor sleep health.
{"title":"Air pollution and sleep health in middle-aged and older adults: A systematic review and meta-analysis","authors":"Man Wang , Youngmin Cho , Junxin Li","doi":"10.1016/j.smrv.2025.102136","DOIUrl":"10.1016/j.smrv.2025.102136","url":null,"abstract":"<div><div>Exposure to air pollution may negatively impact sleep health. This systematic review and meta-analysis examined the association between air pollution and sleep health in middle-aged and older adults. PubMed, Web of Science, CINAHL and Embase were searched from inception to September 11, 2024. Included studies reported at least one air pollutant (e.g., PM<sub>1</sub> [particles < 1 μm], PM<sub>2.5</sub> [particles < 2.5 μm], PM<sub>10</sub> [particles < 10 μm], CO [carbon monoxide], CO<sub>2</sub> [carbon dioxide], NO<sub>2</sub> [nitrogen dioxide], SO<sub>2</sub> [sulfur dioxide] and O<sub>3</sub> [ozone]) and sleep health outcomes. All binary negative sleep health outcomes (e.g., poor sleep quality, low sleep efficiency and obstructive sleep apnea) were integrated as poor sleep health in the meta-analyses. Twenty-five studies were included, with a final sample of at least 1,262,210 middle-aged and older adults. The pooled prevalence of poor sleep health was 43.7%. We conducted random-effects meta-analyses on nine studies using the DerSimonian-Laird estimator to examine the association between air pollution and poor sleep health. Results showed that per 10 μg/m<sup>3</sup> increase in long-term exposure to PM<sub>1</sub> [OR (95% CI): 1.37 (1.07, 1.75)], PM<sub>2.5</sub> [OR (95% CI): 1.27 (1.12, 1.43), PM<sub>10</sub> [OR (95% CI): 1.10 (1.03, 1.19) and per 5 μg/m<sup>3</sup> in NO<sub>2</sub> [OR (95% CI): 1.07 (1.01, 1.13)] was significantly associated with poor sleep health. However, no significant association was observed between long-term O<sub>3</sub> exposure (per 10 μg/m<sup>3</sup> increase) and poor sleep health [OR (95% CI): 1.04 (0.88, 1.24)]. Indoor air pollution from the combustion of solid fuels was also associated with a higher risk of poor sleep health. Our findings highlight the critical roles of both indoor and outdoor air environments in promoting sleep health, underscoring the need for environmental interventions and public health policies to improve air quality and alleviate the burden of poor sleep health.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102136"},"PeriodicalIF":9.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-17DOI: 10.1016/j.smrv.2025.102137
Mattia Marchetti , Ahmad Mayeli , Claudio Sanguineti , Francesco L. Donati , Omeed Chaichian , Allison Kim , Katerina Piskun , Armando D'Agostino , Nicholas Meyer , James D. Wilson , Paolo Fusar-Poli , Mary L. Phillips , Fabio Ferrarelli
Sleep abnormalities are core features of bipolar disorders (BD), but they have not been thoroughly examined across mood phases. This meta-analysis investigated sleep disturbance prevalence and sleep characteristics differences in BD across mood phases. A systematic search through September 2024 identified 44 studies (7614 BD cases, 3164 controls), including 11 prevalence and 34 case-control studies. Poor sleep quality prevalence was 52% during euthymia, and insomnia prevalence was 63% during the depressive phase. Individuals with euthymic BD reported worse sleep quality and objectively measured longer total sleep time and sleep onset latency than controls. Depressive phase BD showed higher rapid eye movement percentages, while manic/mixed phase exhibited shorter total sleep time, lower sleep efficiency, and longer sleep onset latency. During euthymia, BD demonstrated greater variability in sleep duration and continuity, and more prominent sleep differences when assessed with sleep diary versus objective sleep measures, highlighting the importance of integrating objective assessments and patient-reported outcomes. Overall, these findings indicate that poor sleep quality and insomnia are highly prevalent in BD, and that some sleep parameter differences are present during euthymia, while others occur during depressive and manic phases, emphasizing the need for sleep assessments and tailored management throughout the course of BD.
{"title":"Sleep abnormalities in bipolar disorders across mood phases: A systematic review and meta-analysis","authors":"Mattia Marchetti , Ahmad Mayeli , Claudio Sanguineti , Francesco L. Donati , Omeed Chaichian , Allison Kim , Katerina Piskun , Armando D'Agostino , Nicholas Meyer , James D. Wilson , Paolo Fusar-Poli , Mary L. Phillips , Fabio Ferrarelli","doi":"10.1016/j.smrv.2025.102137","DOIUrl":"10.1016/j.smrv.2025.102137","url":null,"abstract":"<div><div>Sleep abnormalities are core features of bipolar disorders (BD), but they have not been thoroughly examined across mood phases. This meta-analysis investigated sleep disturbance prevalence and sleep characteristics differences in BD across mood phases. A systematic search through September 2024 identified 44 studies (7614 BD cases, 3164 controls), including 11 prevalence and 34 case-control studies. Poor sleep quality prevalence was 52% during euthymia, and insomnia prevalence was 63% during the depressive phase. Individuals with euthymic BD reported worse sleep quality and objectively measured longer total sleep time and sleep onset latency than controls. Depressive phase BD showed higher rapid eye movement percentages, while manic/mixed phase exhibited shorter total sleep time, lower sleep efficiency, and longer sleep onset latency. During euthymia, BD demonstrated greater variability in sleep duration and continuity, and more prominent sleep differences when assessed with sleep diary versus objective sleep measures, highlighting the importance of integrating objective assessments and patient-reported outcomes. Overall, these findings indicate that poor sleep quality and insomnia are highly prevalent in BD, and that some sleep parameter differences are present during euthymia, while others occur during depressive and manic phases, emphasizing the need for sleep assessments and tailored management throughout the course of BD.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102137"},"PeriodicalIF":11.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-17DOI: 10.1016/j.smrv.2025.102135
Allison E. Nickel , Candice Lage , Abbye Porro , Chenlu Gao , Dayna A. Johnson , Lauren Hale , Michael K. Scullin
Female and under-represented minority students (URMs) in higher education disproportionately experience sleep disturbances. Incorporating sleep education and other psychological interventions (e.g., cognitive behavioral therapy for insomnia; CBT-I) into college settings might provide a scalable solution, but it is unknown whether such psychoeducational interventions produce equivalent outcomes across groups. We addressed this question with two approaches. First, we identified 36 US-based studies that had student participants and a psychoeducational sleep intervention. Fifteen authors shared data on sleep knowledge, quality, and/or duration separated by gender and URM groups (N = 599). Hedges' g was computed for each group within each study. Second, we systematically reviewed the content of 21 available programs. We found that, relative to national collegiate data (59.4 % female, 41.5 % URM), females were over-represented (63.4 %) and URM groups were under-represented (23.7 %) in these studies. Interventions improved sleep knowledge (g = 0.69, p<.001) and sleep quality (g = 0.25, p<.001), but not sleep duration (g = 0.13, p = .18). Effect sizes were similar in males, females, URM students, and non-URM students. There were no studies that incorporated financial, social, or neighborhood-level barriers to sleep in students. Future interventions in student groups might be improved by combining individualized, CBT-I-based education while concomitantly addressing environmental/institutional barriers to sleep.
高等教育中的女性和代表性不足的少数民族学生（urm）不成比例地经历睡眠障碍。结合睡眠教育和其他心理干预(例如，失眠的认知行为疗法；CBT-I)在大学环境中可能提供了一个可扩展的解决方案，但这种心理教育干预是否在群体中产生相同的结果尚不清楚。我们用两种方法解决了这个问题。首先，我们确定了36项美国研究，这些研究有学生参与者和心理教育睡眠干预。15位作者分享了按性别和URM组划分的睡眠知识、质量和/或持续时间的数据（N = 599）。计算每个研究中每个组的对冲系数g。其次，我们系统地审查了21个可用节目的内容。我们发现，相对于全国大学数据（59.4%为女性，41.5%为URM），在这些研究中，女性的代表性过高（63.4%），URM的代表性不足（23.7%）。干预措施改善了睡眠知识(g = 0.69, p
{"title":"Sleep program efficacy across gender and racial/ethnic groups: A content review and meta-analysis","authors":"Allison E. Nickel , Candice Lage , Abbye Porro , Chenlu Gao , Dayna A. Johnson , Lauren Hale , Michael K. Scullin","doi":"10.1016/j.smrv.2025.102135","DOIUrl":"10.1016/j.smrv.2025.102135","url":null,"abstract":"<div><div>Female and under-represented minority students (URMs) in higher education disproportionately experience sleep disturbances. Incorporating sleep education and other psychological interventions (e.g., cognitive behavioral therapy for insomnia; CBT-I) into college settings might provide a scalable solution, but it is unknown whether such psychoeducational interventions produce equivalent outcomes across groups. We addressed this question with two approaches. First, we identified 36 US-based studies that had student participants and a psychoeducational sleep intervention. Fifteen authors shared data on sleep knowledge, quality, and/or duration separated by gender and URM groups (N = 599). Hedges' g was computed for each group within each study. Second, we systematically reviewed the content of 21 available programs. We found that, relative to national collegiate data (59.4 % female, 41.5 % URM), females were over-represented (63.4 %) and URM groups were under-represented (23.7 %) in these studies. Interventions improved sleep knowledge (g = 0.69, p<.001) and sleep quality (g = 0.25, p<.001), but not sleep duration (g = 0.13, p = .18). Effect sizes were similar in males, females, URM students, and non-URM students. There were no studies that incorporated financial, social, or neighborhood-level barriers to sleep in students. Future interventions in student groups might be improved by combining individualized, CBT-I-based education while concomitantly addressing environmental/institutional barriers to sleep.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102135"},"PeriodicalIF":9.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-15DOI: 10.1016/j.smrv.2025.102134
Dario Morra, Giuseppe Barbato
A systematic review and meta-analysis of REM studies in schizophrenia were conducted using published articles researched in major databases within the period from January 1, 1955, to March 15, 2025. REM sleep parameters such as REM time, REM percentage, REM latency and REM density of drug-naive, drug-free and treated schizophrenic patients were analyzed and, where available, compared with case-control data of healthy controls and depressed patients. One hundred ninety studies were identified in the systematic review. Ninety-two case-control studies with 1845 schizophrenic patients, 1269 healthy controls and 262 depressed patients were included in the meta-analyses. The primary outcome was the standard mean difference. Data were fitted with a random-effects model. Publication bias assessment was checked by Egger's Regression and funnel plot asymmetry. Compared to healthy controls, REM time and REM latency were found respectively reduced and shortened in both drug-naive and drug-free schizophrenics, while REM density was found increased in drug-free and treated schizophrenics. No significant difference, compared to healthy control, emerged for REM percentages either in drug-naive, drug-free and treated schizophrenics. Reduced REM latency in drug-free and drug-naive schizophrenics was like that of depressed patients. Antipsychotic treatment appeared to have a normalizing effect on REM time and REM latency but not on REM density: increased density in both drug-free and treated schizophrenics suggest that this variable might be controlled by different mechanisms and/or neurotransmitters than those controlling REM occurrence.
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