Sleep Medicine Reviews最新文献

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Predictors and moderators of treatment outcomes from cognitive behavioural interventions for insomnia in adults: A systematic review. 成人失眠症认知行为干预治疗结果的预测因素和调节因素：一项系统综述。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-03-10 DOI: 10.1016/j.smrv.2026.102269

Monique L Smith, Erin Oldenhof, Jamie Byrne, Ilona McNeill, Alexander Sweetman, Petra K Staiger

Insomnia is a heterogeneous disorder, for which cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment. However, CBT-I is not effective for all patients. It is important to identify pre-treatment predictors and moderators of treatment-response to CBT-I and its variants to guide precision insomnia management approaches. This systematic review (PROSPERO: CRD42023476013) aimed to synthesise evidence on pre-treatment characteristics that predict or moderate insomnia outcomes following CBT-I. Peer-reviewed papers that reported such analyses from randomised and non-randomised studies of adults with insomnia were eligible. Four databases and citations of included reports were searched until April 2025. From 7325 unique records, 1494 full-text records were screened, of which 103 reports were included. Among 195 unique predictors/moderators identified from 1208 results, 92.3% were infrequently studied and/or rarely demonstrated statistical significance as predictors of insomnia improvement. The most consistent predictors of improvement included shorter insomnia duration, more severe insomnia, longer objective sleep duration, positive attitudes towards treatment, lower depression severity, and the absence of comorbid mental disorders, fatigue and pain. Further high-quality research using sufficiently powered samples and theoretically-justified moderators is needed to establish characteristics related to differential outcomes between cognitive behavioural interventions.

失眠是一种异质性疾病，失眠认知行为疗法（CBT-I）是推荐的一线治疗方法。然而，CBT-I并不是对所有患者都有效。确定CBT-I治疗反应的治疗前预测因子和调节因子及其变体对指导精确失眠管理方法非常重要。本系统综述（PROSPERO: CRD42023476013）旨在综合有关预测或调节CBT-I后失眠结局的治疗前特征的证据。对成人失眠症进行随机和非随机研究的同行评议论文均符合条件。到2025年4月为止检索了四个数据库和所收录报告的引文。从7325条唯一记录中筛选了1494条全文记录，其中包括103份报告。从1208个结果中确定的195个独特的预测因子/调节因子中，92.3%很少被研究和/或很少显示出作为失眠改善预测因子的统计学意义。最一致的改善预测包括失眠持续时间缩短，失眠更严重，客观睡眠时间更长，对治疗的积极态度，抑郁严重程度较低，没有共病精神障碍，疲劳和疼痛。需要使用足够有力的样本和理论上合理的调节因子进行进一步的高质量研究，以确定与认知行为干预之间差异结果相关的特征。

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引用次数: 0

Insomnia among hospitalized inpatients: A systematic review and network meta-analysis 住院患者失眠：系统回顾与网络荟萃分析

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.smrv.2025.102210

Dario Bottignole , Giulia Balella , Matteo Minetti , Luca Gambolò , Francesco Rausa , Giorgio Ughetti , Andrea Melpignano , Marcello Giuseppe Maggio , Liborio Parrino , Carlotta Mutti

Insomnia affects up to 50% of hospitalized patients and is strongly associated with longer hospital stays and higher mortality rates, especially among vulnerable individuals. Despite its prevalence, it's often overlooked in clinical practice and research. Our systematic review analyzed and compared pharmacological interventions for insomnia in hospitalized patients. We searched five major databases for randomized controlled trials published before January 2024. A total of 29 trials (1913 patients, mean age 58.4 ± 9.66) were finally included. Different drug classes were evaluated, including benzodiazepines, Z-drugs, melatonin receptor agonists, antidepressants, antihistamines, alpha-2 adrenergic agonists, and dietary supplements. We conducted a network meta-analysis on drugs' efficacy across subjective sleep quality, sleep latency, total sleep duration, and nocturnal awakenings. Notably, only a minority of studies focused on fragile populations, such as geriatric and critically ill patients. Results are also discussed according to potential moderating factors (i.e., gender, age, admission setting). Our review provides a framework for the pharmacologic treatment of insomnia disorder in inpatients. Differences in study methodologies limit the generalizability of findings, highlighting the urgent need for standardized research to fill existing gaps. We therefore propose a concise protocol to guide the design of future studies on this clinically important topic.

多达50%的住院患者患有失眠症，失眠与住院时间较长和死亡率较高密切相关，尤其是在脆弱人群中。尽管它很普遍，但在临床实践和研究中经常被忽视。我们的系统综述分析并比较了住院患者失眠的药物干预。我们在五个主要数据库中检索了2024年1月之前发表的随机对照试验。最终纳入29项试验（1913例，平均年龄58.4±9.66岁）。评估了不同的药物类别，包括苯二氮卓类药物、z型药物、褪黑激素受体激动剂、抗抑郁药、抗组胺药、α -2肾上腺素能激动剂和膳食补充剂。我们对药物在主观睡眠质量、睡眠潜伏期、总睡眠时间和夜间觉醒方面的疗效进行了网络荟萃分析。值得注意的是，只有少数研究关注脆弱人群，如老年人和危重病人。结果还根据潜在的调节因素（即性别、年龄、入院环境）进行了讨论。我们的综述为住院患者失眠的药物治疗提供了一个框架。研究方法的差异限制了研究结果的普遍性，强调了标准化研究填补现有空白的迫切需要。因此，我们提出了一个简明的方案来指导这一临床重要课题的未来研究设计。

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引用次数: 0

Bridging artificial intelligence and sleep medicine: current evidence, open challenges, and future directions 连接人工智能和睡眠医学：目前的证据、公开的挑战和未来的方向

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2026-01-18 DOI: 10.1016/j.smrv.2026.102237

Hanwen Bi , Wen Liu , Masoud Tahmasian

引用次数: 0

Implementing strategies to address the global burden of insomnia 实施解决全球失眠负担的战略

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.smrv.2025.102209

Adam V. Benjafield , Emerson M. Wickwire

引用次数: 0

Handling Editor: Monica AndersenA global perspective of parent engagement with digital sleep health interventions for young children: A scoping review 家长参与幼儿数字睡眠健康干预的全球视角：范围审查

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI: 10.1016/j.smrv.2025.102226

Alicia Chung , Laurel Deaton , Jennifer Miller , Ashley Nechyba , Jenny Liu , Menessa Metayer , Tayla von Ash , Michelle Thompson , Shayla K. Shorter , Dorice Vieira , Azizi A. Seixas , Girardin Jean-Louis

Introduction

We examined the landscape of early childhood sleep health interventions that utilized digital tools designed for parents to improve sleep health outcomes during early childhood, (ages 3–8).

Methods

We performed a scoping review of peer-reviewed articles published from inception to April 2025 from the following databases: PubMed, Embase, Web of Science, MEDLINE, Cochrane Library, Engineering Village, Global Health, citation searching, and others. Two medical science librarians conducted the extensive literature search, with strategies detailed at [osf.io/74hba]. This study was guided by the implementation science outcomes framework.

Results

Twenty-one articles met the final inclusion criteria. Included studies reported clinical sleep, behavioral and/or implementation science outcomes. Implementation science outcomes primarily focused on acceptability, appropriateness and feasibility of pediatric digital sleep and family-based tools. Mobile apps were most prominently used, followed by websites and telehealth. Websites contributed to improved child sleep duration, sleep onset, sleep efficiency, daytime sleepiness and reduced night wakings. Mobile apps reported the aforementioned child sleep outcomes, as well as improvements in parent mental health and daytime functioning.

Conclusions

Digital sleep health tools have the potential to ameliorate sleep problems in young children. Digital interventions may improve sleep and wellbeing in the family unit.

前言：我们研究了儿童早期睡眠健康干预措施的现状，这些干预措施利用为父母设计的数字工具来改善儿童早期（3-8岁）的睡眠健康结果。方法我们对从成立到2025年4月发表的同行评议文章进行了范围审查，这些文章来自以下数据库：PubMed、Embase、Web of Science、MEDLINE、Cochrane Library、Engineering Village、Global Health、引文搜索等。两位医学图书管理员进行了广泛的文献检索，详细策略见[osf.io/74hba]。本研究以实施科学成果框架为指导。结果21篇文章符合最终纳入标准。纳入的研究报告了临床睡眠、行为和/或实施科学的结果。实施科学成果主要集中在儿童数字睡眠和基于家庭的工具的可接受性、适当性和可行性上。使用最多的是移动应用程序，其次是网站和远程医疗。网站有助于改善儿童的睡眠时间、睡眠开始、睡眠效率、白天嗜睡和减少夜间醒来。移动应用程序报告了上述儿童的睡眠结果，以及父母心理健康和白天功能的改善。结论数字睡眠健康工具具有改善幼儿睡眠问题的潜力。数字干预可能会改善家庭的睡眠和健康。

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引用次数: 0

Artificial intelligence and sleep medicine II: A scoping review of applications, advancements, and future directions 人工智能和睡眠医学II：应用、进展和未来方向的范围审查。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-11-28 DOI: 10.1016/j.smrv.2025.102212

Haitham Jahrami , Waqar Husain , Khaled Trabelsi , Thomas Penzel , Max Hirshkowitz , Javad Razjouyan , Ahmed S. BaHammam , Amir Sharafkhaneh

Background

Artificial intelligence (AI) has rapidly advanced in sleep medicine, offering innovative solutions for sleep disorder management. The integration of AI technologies presents unprecedented opportunities to address longstanding challenges in diagnosis, monitoring, and treatment.

Methods

This scoping review summarizes current AI applications in sleep medicine following PRISMA-ScR. A comprehensive search was conducted across various databases from inception to 2024, following PRISMA-ScR guidelines. Eligible studies included original AI research, systematic reviews, and meta-analyses focusing on sleep medicine.

Results

AI models for obstructive sleep apnea (OSA) detection demonstrated accuracy between 85 % and 99 % in controlled settings, with outlier up to 99.9 %. Deep learning approaches for sleep staging and quality assessment match human expert performance. AI applications have extended to other disorders like insomnia and narcolepsy. Wearable technologies and non-contact sensors enable continuous monitoring outside laboratory settings, with some achieving sensitivity >96 % and specificity >97 % for OSA detection. Significant real-world validation gaps persist.

Conclusions

While AI shows transformative potential in sleep medicine, implementation challenges remain. Future research should prioritize multicenter validation, ethical governance, and culturally inclusive AI frameworks to ensure safe and equitable clinical translation. Addressing ethical considerations and standardizing methodological reporting are essential for widespread adoption of these technologies in clinical practice.

背景：人工智能（AI）在睡眠医学领域迅速发展，为睡眠障碍管理提供了创新的解决方案。人工智能技术的整合为解决诊断、监测和治疗方面的长期挑战提供了前所未有的机遇。方法：本文综述了prism - scr后人工智能在睡眠医学中的应用现状。根据PRISMA-ScR指南，从成立到2024年，在各种数据库中进行了全面的搜索。符合条件的研究包括原始的人工智能研究、系统综述和关注睡眠医学的荟萃分析。结果：用于阻塞性睡眠呼吸暂停（OSA）检测的人工智能模型在受控环境下的准确率在85%至99%之间，异常值高达99.9%。深度学习的睡眠分期和质量评估方法与人类专家的表现相匹配。人工智能的应用已经扩展到失眠和嗜睡症等其他疾病。可穿戴技术和非接触式传感器可以在实验室环境之外进行连续监测，其中一些检测OSA的灵敏度为bbbb96 %，特异性为bbbb97 %。显著的现实验证差距仍然存在。结论：虽然人工智能在睡眠医学中显示出变革潜力，但实施方面的挑战仍然存在。未来的研究应优先考虑多中心验证、伦理治理和文化包容性的人工智能框架，以确保安全和公平的临床翻译。解决伦理问题和标准化方法报告是在临床实践中广泛采用这些技术的必要条件。

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引用次数: 0

Sleep, cognition, and electrophysiology: Intersecting pathways in childhood cancer 睡眠、认知和电生理：儿童癌症的交叉通路。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.smrv.2025.102205

Andrea Sanchez-Corzo , Zachary Loschinskey , Miguel Navarrete , Catalina A. Saini Ferron , Pankaj Pandey , Jesyin Lai , Belinda N. Mandrell , Zachary R. Abramson , Valerie McLaughlin Crabtree , Ranganatha Sitaram

Survivors of pediatric cancer are at high risk of long-term cognitive dysfunction. This problem is exacerbated as this population often reports poor sleep quality, which can negatively affect well-being. Sleep-related brain activity is known to influence cognitive development by regulating memory consolidation and cognitive functioning. However, the differences in sleep-related brain activity between healthy controls and pediatric cancer survivors are unclear. This review examines how sleep disturbances and cognitive impairments converge in survivors of childhood cancer, and proposes electrophysiology as a possible mechanistic bridge between these domains. We synthesize what is known from the general population and pediatric samples, highlight the critical need to investigate electrophysiological anomalies in pediatric cancer survivors, and suggest that neuromodulation techniques such as transcranial direct stimulation, transcranial magnetic stimulation, and sensory stimulation may be viable therapeutic interventions to enhance both sleep quality and cognitive function once possible anomalies are characterized in this population. Our review emphasizes the need for additional research to understand the complex relationship between sleep and cognition in pediatric cancer survivors to improve patient care and quality of life.

儿童癌症的幸存者长期认知功能障碍的风险很高。由于这一人群经常报告睡眠质量差，这可能会对健康产生负面影响，所以这个问题更加严重。众所周知，睡眠相关的大脑活动通过调节记忆巩固和认知功能来影响认知发展。然而，健康对照组和儿童癌症幸存者之间睡眠相关的大脑活动的差异尚不清楚。这篇综述探讨了睡眠障碍和认知障碍如何在儿童癌症幸存者中汇合，并提出电生理学作为这些领域之间可能的机制桥梁。我们综合了一般人群和儿童样本的已知信息，强调了研究儿童癌症幸存者电生理异常的迫切需要，并建议神经调节技术，如经颅直接刺激、经颅磁刺激和感觉刺激，一旦在这一人群中发现可能的异常特征，可能是提高睡眠质量和认知功能的可行治疗干预措施。我们的综述强调需要进一步的研究来了解儿童癌症幸存者睡眠和认知之间的复杂关系，以改善患者的护理和生活质量。

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引用次数: 0

Sleep apnea and substance use: a meta-analysis 睡眠呼吸暂停和物质使用：一项荟萃分析。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.smrv.2025.102228

Sibylle Mauries , Benjamin Rolland , Justine Frija-Masson , Marie-Pia d’Ortho , Sébastien Catoire , Feriel Zehani , Guillaume Davido , Michel Lejoyeux , Pierre A. Geoffroy

Introduction

Sleep apnea and substance use disorders appear to interact bidirectionally, negatively influencing each other. Obstructive sleep apnea syndrome (OSA) seems particularly prevalent among substance users.

Methods

This meta-analysis aims to evaluate the impact of the most commonly used substances (alcohol, tobacco, cannabis, opioids, and cocaine) on the apnea-hypopnea index (AHI) by comparing the mean AHI scores between users and non-users.

Results

3784 articles were identified from the PubMed search, and 28 studies were included in the meta-analysis. We found a higher AHI among alcohol users (SMD: 0.46, 95 % CI [0.21–0.71] (z = 3.62; p < 0.001)) and a higher prevalence of central sleep apnea among opioid users (SMD: 0.44 95 % CI 0.24–0.64] (z = 4.37; p < 0.001)). The AHI was also elevated among tobacco users, although this difference was not statistically significant. Regarding moderators effects, sex may influence alcohol's impact, while both age and sex could affect the relationship between opioids and AHI. No studies compared the AHI of cocaine users to non-users, and only one study comparing the AHI of cannabis users to non-users were found.

Conclusion

This study highlights the importance of diagnosing and managing sleep apnea in patients with substance use, in order to improve addiction prognosis through specific treatment approaches.

睡眠呼吸暂停和物质使用障碍似乎是双向互动的，相互负向影响。阻塞性睡眠呼吸暂停综合征（OSA）似乎在药物使用者中尤为普遍。方法：本meta分析旨在通过比较使用者和非使用者之间的平均AHI评分，评估最常用物质（酒精、烟草、大麻、阿片类药物和可卡因）对呼吸暂停-低通气指数（AHI）的影响。结果：从PubMed检索中确定了3784篇文章，其中28篇研究被纳入meta分析。我们发现酒精使用者的AHI较高(SMD: 0.46, 95% CI [0.21-0.71] （z = 3.62; p）。结论：本研究强调了药物使用患者诊断和管理睡眠呼吸暂停的重要性，以便通过特定的治疗方法改善成瘾预后。

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引用次数: 0

Response to commentary on “Sleep abnormalities in mouse models of depression: a systematic review” 对“抑郁症小鼠模型中的睡眠异常：一项系统综述”评论的回应

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.smrv.2025.102208

Alberto Potenzieri , Andrea Escelsior , Gianluca Serafini , Antonio Uccelli , Antoine Adamantidis , Lino Nobili

引用次数: 0

Effect of obstructive sleep apnoea treatment on sleep spindles: A systematic review and meta-analysis 阻塞性睡眠呼吸暂停治疗对睡眠纺锤波的影响：系统回顾和荟萃分析

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.smrv.2026.102231

Ainhoa Álvarez-Ruiz-Larrinaga , Jorge Ullate , Carla Pía , Angela L. D'Rozario , Carlos Egea-Santaolalla , Maria Comas

The consequences of untreated obstructive sleep apnea (OSA) on health are well established. OSA alterations to sleep microarchitecture include a reduction in sleep spindles during NREM sleep, a neurophysiological biomarker that reflects sleep stability, cognitive function and brain health. However, the effects of OSA treatment on reversing sleep spindle abnormalities remains unclear. This systematic review evaluated the effect of continuous positive airway pressure (CPAP) treatment on spindles during polysomnography in adults diagnosed with OSA. We identified five papers meeting inclusion criteria with a total of 202 participants. Two studies analyzed spindle density after 6 months of CPAP use and three analyzed spindle activity during CPAP titration. Three studies used automatic spindle detection methods. Meta-analysis showed a significant increase in spindle density after CPAP use (mean difference = 1.16 spindles/min, 95 % CI [0.27, 2.04], p = 0.010). However, heterogeneity was high due to variability in study designs, sample sizes, and methodological factors. In conclusion, CPAP treatment increased spindle density in adult patients with OSA. Future research should aim to standardize spindle detection protocols and incorporate both objective and subjective measures. Establishing whether spindle changes mediate the functional recovery seen with CPAP will be essential to investigate their potential clinical utility.

未经治疗的阻塞性睡眠呼吸暂停（OSA）对健康的影响是众所周知的。OSA对睡眠微结构的改变包括NREM睡眠期间睡眠纺锤波的减少，这是一种反映睡眠稳定性、认知功能和大脑健康的神经生理生物标志物。然而，阻塞性睡眠呼吸暂停治疗对逆转睡眠纺锤体异常的影响尚不清楚。本系统综述评估了持续气道正压（CPAP）治疗对诊断为OSA的成人多导睡眠图中纺锤体的影响。我们确定了5篇符合纳入标准的论文，共有202名受试者。两项研究分析了使用CPAP 6个月后的纺锤体密度，三项研究分析了CPAP滴定期间的纺锤体活动。三项研究采用自动主轴检测方法。meta分析显示，使用CPAP后纺锤波密度显著增加（平均差异= 1.16纺锤波/分钟，95% CI [0.27, 2.04], p = 0.010）。然而，由于研究设计、样本量和方法学因素的可变性，异质性很高。综上所述，CPAP治疗增加了OSA成人患者的纺锤体密度。未来的研究应旨在标准化主轴检测协议，并结合客观和主观的措施。确定纺锤体变化是否介导CPAP所见的功能恢复，对于研究其潜在的临床应用至关重要。

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