Sleep Medicine Reviews最新文献

英文中文

Evaluating the endothelial and metabolic effects of CPAP therapy in obstructive sleep apnea patients: Insights from a comprehensive meta-analysis 评估CPAP治疗对阻塞性睡眠呼吸暂停患者的内皮和代谢影响：来自综合荟萃分析的见解

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-29 DOI: 10.1016/j.smrv.2025.102187

Sara Daneshvar , Ensiyeh Seyedrezazadeh , Maryam Seyyedi , Sevda Jafari , Atefeh Ansarin , Neda Gilani , Babak Mokhlesi , Khalil Ansarin

Across a growing body of research, continuous positive airway pressure (CPAP) therapy has been consistently explored as a treatment for obstructive sleep apnea (OSA) due to its potential to mitigate vascular and metabolic risk factors. While the primary benefit of CPAP is its ability to alleviate symptoms of OSA, the broader physiological impacts, particularly on vascular health and metabolic profiles, have garnered increasing attention. This summary evaluates the effect of CPAP on endothelial function, as well as on lipid and glucose metabolism.

Across 74 studies, CPAP therapy in adults with OSA was associated with a significant improvement in endothelial function (FMD) and modest, favorable shifts in lipid and glucose profiles. Total cholesterol, LDL-C, and triglycerides decreased; HDL-C showed no meaningful change. Fasting blood sugar declined, whereas HbA1c, insulin, and HOMA-IR generally showed directionally favorable but non-significant pooled effects. Publication bias appeared limited overall (more likely for HbA1c), and sensitivity analyses supported the robustness of the FMD benefit. Study-level moderators (age, sex, BMI, AHI, follow-up) did not consistently explain heterogeneity, although an exploratory ecological meta-regression suggested greater HbA1c reductions tracked with larger FMD gains.

在越来越多的研究中，持续气道正压（CPAP）治疗一直被探索作为阻塞性睡眠呼吸暂停（OSA）的治疗方法，因为它有可能减轻血管和代谢危险因素。虽然CPAP的主要益处是其缓解OSA症状的能力，但其更广泛的生理影响，特别是对血管健康和代谢谱的影响，已引起越来越多的关注。本综述评估了CPAP对内皮功能以及脂质和葡萄糖代谢的影响。在74项研究中，CPAP治疗与成人OSA患者内皮功能（FMD）的显着改善以及脂质和葡萄糖谱的适度有利变化相关。总胆固醇、LDL-C和甘油三酯降低；HDL-C无明显变化。空腹血糖下降，而HbA1c、胰岛素和HOMA-IR总体上表现出方向有利但不显著的综合效应。发表偏倚总体上有限（更可能是HbA1c），敏感性分析支持FMD获益的稳健性。研究水平的调节因子（年龄、性别、BMI、AHI、随访）并不能一致地解释异质性，尽管探索性生态元回归表明，HbA1c降低越多，FMD增加越多。

{"title":"Evaluating the endothelial and metabolic effects of CPAP therapy in obstructive sleep apnea patients: Insights from a comprehensive meta-analysis","authors":"Sara Daneshvar , Ensiyeh Seyedrezazadeh , Maryam Seyyedi , Sevda Jafari , Atefeh Ansarin , Neda Gilani , Babak Mokhlesi , Khalil Ansarin","doi":"10.1016/j.smrv.2025.102187","DOIUrl":"10.1016/j.smrv.2025.102187","url":null,"abstract":"<div><div>Across a growing body of research, continuous positive airway pressure (CPAP) therapy has been consistently explored as a treatment for obstructive sleep apnea (OSA) due to its potential to mitigate vascular and metabolic risk factors. While the primary benefit of CPAP is its ability to alleviate symptoms of OSA, the broader physiological impacts, particularly on vascular health and metabolic profiles, have garnered increasing attention. This summary evaluates the effect of CPAP on endothelial function, as well as on lipid and glucose metabolism.</div><div>Across 74 studies, CPAP therapy in adults with OSA was associated with a significant improvement in endothelial function (FMD) and modest, favorable shifts in lipid and glucose profiles. Total cholesterol, LDL-C, and triglycerides decreased; HDL-C showed no meaningful change. Fasting blood sugar declined, whereas HbA1c, insulin, and HOMA-IR generally showed directionally favorable but non-significant pooled effects. Publication bias appeared limited overall (more likely for HbA1c), and sensitivity analyses supported the robustness of the FMD benefit. Study-level moderators (age, sex, BMI, AHI, follow-up) did not consistently explain heterogeneity, although an exploratory ecological meta-regression suggested greater HbA1c reductions tracked with larger FMD gains.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102187"},"PeriodicalIF":9.7,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466359","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}

引用次数: 0

Maternal sleep disorders during pregnancy: Potential threats to offspring metabolism and possible interventions 怀孕期间母亲睡眠障碍：对后代代谢的潜在威胁和可能的干预措施

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-29 DOI: 10.1016/j.smrv.2025.102188

Haiyan Chen, Yaolin Ren, Yuan Zeng, Yifan Wu, Jie Yu, Qian Zhang, Xinhua Xiao

The uterine microenvironment exerts a significant and lasting influence on metabolic health later in life. The incidence of sleep disorders during pregnancy is high. Sleep disorders not only increase the risk of maternal complications during pregnancy but also may lead to increased susceptibility to metabolic diseases in offspring during adulthood by influencing the fetal development environment. In this review, we explored the effects of maternal sleep disorders during pregnancy on the metabolic health of offspring, the potential mechanisms, and intervention measures, with the aim of providing more scientific guidance for pregnancy care and promoting the health of mothers and offspring.

子宫微环境对生命后期的代谢健康具有显著而持久的影响。怀孕期间睡眠障碍的发生率很高。睡眠障碍不仅增加妊娠期产妇并发症的风险，而且还可能通过影响胎儿发育环境导致后代成年后对代谢性疾病的易感性增加。本文就妊娠期产妇睡眠障碍对子代代谢健康的影响、可能的机制及干预措施进行综述，以期为孕期护理提供更科学的指导，促进母婴健康。

引用次数: 0

Sleep disturbance in children with prenatal alcohol exposure: a systematic review and meta-analysis 产前酒精暴露儿童的睡眠障碍：系统回顾和荟萃分析

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-28 DOI: 10.1016/j.smrv.2025.102186

Emma Louise Gale , Chloe Anna Hunt

Background

Sleep disturbances are prevalent in children with prenatal alcohol exposure (PAE), including those with Fetal Alcohol Spectrum Disorders (FASD), potentially exacerbating behavioural and cognitive deficits. Despite this, no review has systematically assessed the timing or severity of these sleep disturbances. The aim of this review was to identify sleep disturbances in children with PAE.

Methods

A systematic search across seven databases followed PRISMA guidelines. Studies included children aged 3–10 with PAE and provided quantitative sleep data. Two reviewers independently screened articles. A meta-analysis of subjective sleep outcomes used a random-effects model, with heterogeneity assessed via I².

Results

Fourteen studies met inclusion criteria. Children with PAE had consistently worse sleep than typically developing peers, including longer sleep onset, shorter duration, more awakenings, lower sleep efficiency, and greater sleep variability. Higher PAE levels were linked to earlier onset and persistence of sleep disturbances, with more severe issues in early pregnancy exposure. Meta-analysis of seven studies showed high heterogeneity (I² = 0.91) with medium to large effect sizes, particularly for night awakenings (d = 1.04) and sleep duration (d = 0.89).

Conclusions

Children with PAE face persistent sleep disturbances, worsening with heavier or earlier exposure, highlighting the need for early screening and interventions.

背景：睡眠障碍在产前酒精暴露（PAE）儿童中很普遍，包括那些患有胎儿酒精谱系障碍（FASD）的儿童，可能会加剧行为和认知缺陷。尽管如此，还没有研究系统地评估这些睡眠障碍的时间和严重程度。本综述的目的是确定PAE患儿的睡眠障碍。方法按照PRISMA指南对7个数据库进行系统检索。研究对象包括3-10岁患有PAE的儿童，并提供定量睡眠数据。两位审稿人独立筛选文章。主观睡眠结果的荟萃分析使用随机效应模型，通过I2评估异质性。结果14项研究符合纳入标准。与正常发育的同龄人相比，患有PAE的儿童睡眠质量一直较差，包括睡眠开始时间更长、持续时间更短、醒来次数更多、睡眠效率更低、睡眠变异性更大。较高的PAE水平与更早的睡眠障碍和持续的睡眠障碍有关，在怀孕早期暴露更严重。7项研究的荟萃分析显示高异质性（I2 = 0.91），具有中等到较大的效应量，特别是夜间醒来（d = 1.04）和睡眠持续时间（d = 0.89）。结论PAE患儿存在持续性睡眠障碍，且随着暴露时间的增加和加重而加重，需要进行早期筛查和干预。

{"title":"Sleep disturbance in children with prenatal alcohol exposure: a systematic review and meta-analysis","authors":"Emma Louise Gale , Chloe Anna Hunt","doi":"10.1016/j.smrv.2025.102186","DOIUrl":"10.1016/j.smrv.2025.102186","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are prevalent in children with prenatal alcohol exposure (PAE), including those with Fetal Alcohol Spectrum Disorders (FASD), potentially exacerbating behavioural and cognitive deficits. Despite this, no review has systematically assessed the timing or severity of these sleep disturbances. The aim of this review was to identify sleep disturbances in children with PAE.</div></div><div><h3>Methods</h3><div>A systematic search across seven databases followed PRISMA guidelines. Studies included children aged 3–10 with PAE and provided quantitative sleep data. Two reviewers independently screened articles. A meta-analysis of subjective sleep outcomes used a random-effects model, with heterogeneity assessed via I<sup>2</sup>.</div></div><div><h3>Results</h3><div>Fourteen studies met inclusion criteria. Children with PAE had consistently worse sleep than typically developing peers, including longer sleep onset, shorter duration, more awakenings, lower sleep efficiency, and greater sleep variability. Higher PAE levels were linked to earlier onset and persistence of sleep disturbances, with more severe issues in early pregnancy exposure. Meta-analysis of seven studies showed high heterogeneity (I<sup>2</sup> = 0.91) with medium to large effect sizes, particularly for night awakenings (d = 1.04) and sleep duration (d = 0.89).</div></div><div><h3>Conclusions</h3><div>Children with PAE face persistent sleep disturbances, worsening with heavier or earlier exposure, highlighting the need for early screening and interventions.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102186"},"PeriodicalIF":9.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416870","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}

引用次数: 0

Should you get MAD with kids? 你应该对孩子们疯狂吗？

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-28 DOI: 10.1016/j.smrv.2025.102191

David Gozal

引用次数: 0

Positive airway pressure therapies improve sleep architecture in patients with chronic hypercapnic respiratory failure: A systematic review and meta-analysis 气道正压治疗改善慢性高碳酸血症性呼吸衰竭患者的睡眠结构：一项系统回顾和荟萃分析

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-03 DOI: 10.1016/j.smrv.2025.102168

Pierre Tankéré , Léa Razakamanantsoa , Charles Khouri , Maxime Patout , Emeric Stauffer , Sebastien Baillieul , Thierry Petitjean , Jean Louis Pépin , Renaud Tamisier , Laure Peter Derex

Positive airway pressure therapies (PAP) are the standard of care for chronic hypercapnic respiratory failure (CHRF), and include continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) for obesity hypoventilation syndrome (OHS), and NIV for chronic obstructive pulmonary disease (COPD) and neuromuscular disease (NMD). The effects of PAP on sleep reflect a balance between correcting CHRF-induced sleep disturbances and the potential for therapy itself to disrupt sleep. Given the critical role of sleep in overall health, there are relevant concerns about the effects of PAP usage on sleep architecture. We performed a systematic review and meta-analysis of polysomnographic parameters, using a random-effects model for quantitative analyses. Forty studies were included (n = 1099; 438 OHS, 350 NMD, 175 COPD, 136 unspecified CHRF; 58 % male, age 56.6 ± 8.9 years, body mass index 36.5 ± 11.3 kg/m², arterial carbon dioxide pressure 51.8 ± 5.0 mmHg). Significant improvements (estimate [confidence interval]) in sleep efficiency (+6.30 [3.00, 9.60]%), slow-wave sleep (+4.74 [3.08, 6.41]%), rapid-eye-movement sleep (+4.39 [2.84, 5.94]%), arousal index (−12.97 [–19.65, −6.28]/h), and apnea-hypopnea index (−15.13 [–22.34, −7.92]/h) were seen during PAP. Overall, PAP improved sleep architecture in CHRF. The prognostic significance of these changes warrants further investigation.

Trial registration

PROSPERO (CRD42023495516)

气道正压治疗（PAP）是慢性高碳酸血症性呼吸衰竭（CHRF）的标准治疗方法，包括持续气道正压（CPAP）和无创通气（NIV）治疗肥胖低通气综合征（OHS），以及无创通气治疗慢性阻塞性肺疾病（COPD）和神经肌肉疾病（NMD）。PAP对睡眠的影响反映了在纠正chrf引起的睡眠障碍和治疗本身破坏睡眠的潜力之间的平衡。鉴于睡眠在整体健康中的关键作用，人们对PAP使用对睡眠结构的影响存在相关担忧。我们对多导睡眠图参数进行了系统回顾和荟萃分析，使用随机效应模型进行定量分析。纳入40项研究（n = 1099； OHS 438例，NMD 350例，COPD 175例，CHRF 136例；58%男性，年龄56.6±8.9岁，体重指数36.5±11.3 kg/m2，动脉二氧化碳压51.8±5.0 mmHg）。PAP治疗期间，睡眠效率（+6.30[3.00,9.60]%）、慢波睡眠（+4.74[3.08,6.41]%）、快速眼动睡眠（+4.39[2.84,5.94]%）、觉醒指数（- 12.97 [-19.65,- 6.28]/h）和呼吸暂停低通气指数（- 15.13 [-22.34,- 7.92]/h）均有显著改善（估计[置信区间]）。总的来说，PAP改善了CHRF患者的睡眠结构。这些变化的预后意义值得进一步研究。试验注册号prospero （CRD42023495516）

{"title":"Positive airway pressure therapies improve sleep architecture in patients with chronic hypercapnic respiratory failure: A systematic review and meta-analysis","authors":"Pierre Tankéré , Léa Razakamanantsoa , Charles Khouri , Maxime Patout , Emeric Stauffer , Sebastien Baillieul , Thierry Petitjean , Jean Louis Pépin , Renaud Tamisier , Laure Peter Derex","doi":"10.1016/j.smrv.2025.102168","DOIUrl":"10.1016/j.smrv.2025.102168","url":null,"abstract":"<div><div>Positive airway pressure therapies (PAP) are the standard of care for chronic hypercapnic respiratory failure (CHRF), and include continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) for obesity hypoventilation syndrome (OHS), and NIV for chronic obstructive pulmonary disease (COPD) and neuromuscular disease (NMD). The effects of PAP on sleep reflect a balance between correcting CHRF-induced sleep disturbances and the potential for therapy itself to disrupt sleep. Given the critical role of sleep in overall health, there are relevant concerns about the effects of PAP usage on sleep architecture. We performed a systematic review and meta-analysis of polysomnographic parameters, using a random-effects model for quantitative analyses. Forty studies were included (n = 1099; 438 OHS, 350 NMD, 175 COPD, 136 unspecified CHRF; 58 % male, age 56.6 ± 8.9 years, body mass index 36.5 ± 11.3 kg/m<sup>2</sup>, arterial carbon dioxide pressure 51.8 ± 5.0 mmHg). Significant improvements (estimate [confidence interval]) in sleep efficiency (+6.30 [3.00, 9.60]%), slow-wave sleep (+4.74 [3.08, 6.41]%), rapid-eye-movement sleep (+4.39 [2.84, 5.94]%), arousal index (−12.97 [–19.65, −6.28]/h), and apnea-hypopnea index (−15.13 [–22.34, −7.92]/h) were seen during PAP. Overall, PAP improved sleep architecture in CHRF. The prognostic significance of these changes warrants further investigation.</div></div><div><h3>Trial registration</h3><div>PROSPERO (CRD42023495516)</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102168"},"PeriodicalIF":9.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267606","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}

引用次数: 0

Response to Letter to Editor “Chronotype and circadian epidemiology” by T.C. Erren, P. Morfeld and P. Lewis 对T.C. Erren， P. Morfeld和P. Lewis给编辑的“时间型和昼夜流行病学”的回复。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-02 DOI: 10.1016/j.smrv.2025.102184

Gabriela Yuri , Rodrigo Chamorro , Nicolás Tobar , Mariana Cifuentes

引用次数: 0

Botulinum toxin therapy for neurological disorders: Serendipitous benefits on sleep quality and underlying mechanisms 肉毒杆菌毒素治疗神经系统疾病：对睡眠质量的偶然益处及其潜在机制

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.smrv.2025.102181

Guiying Kuang , Qinwei Yu , Danfang Yu , Long Liu , Xinyu Hu , Hanshu Liu , Xinyi Wang , Jingwen Li , Jinsha Huang , Tao Wang , Allison J. Cash , Zhicheng Lin , Nian Xiong

Botulinum toxin (BoNT) remains the gold standard treatment for focal and segmental dystonia and is widely used in managing hyperkinetic disorders, chronic pain, and glandular hypersecretion. Extensive clinical trials demonstrate that BoNT effectively ameliorates both the core symptoms of these neurological conditions and their frequently associated comorbidities, including depression, anxiety, and diminished quality of life. Notably, many BoNT-treated neurological disorders co-occur with sleep disturbances, yet sleep outcomes remain underexplored. This review synthesizes current evidence on sleep outcomes following BoNT treatment of both established neurological indications (e.g., neuropathic pain, chronic migraine, dystonia, spasticity, sialorrhea, hemifacial spasm, bladder dysfunction) and primary sleep disorders (e.g., restless legs syndrome, sleep bruxism, insomnia). As a result, BoNT treatment improves sleep outcomes across both categories, potentially through mechanisms involving modulation of vasomotor tone, hormonal secretion, neural activity, mood, and pain perception. However, larger, rigorously designed randomized controlled trials are essential to definitively confirm these therapeutic effects and elucidate the underlying neurobiological mechanisms.

肉毒杆菌毒素（BoNT）仍然是局灶性和节段性肌张力障碍的金标准治疗方法，广泛用于治疗多动障碍、慢性疼痛和腺体分泌亢进。大量的临床试验表明BoNT有效地改善了这些神经系统疾病的核心症状及其经常相关的合并症，包括抑郁、焦虑和生活质量下降。值得注意的是，许多bont治疗的神经系统疾病与睡眠障碍同时发生，但睡眠结果仍未得到充分研究。本综述综合了BoNT治疗已建立的神经系统适应症（如神经性疼痛、慢性偏头痛、肌张力障碍、痉挛、唾液分泌、面肌痉挛、膀胱功能障碍）和原发性睡眠障碍（如不宁腿综合征、睡眠磨牙症、失眠）后睡眠结果的现有证据。因此，BoNT治疗可以通过调节血管舒缩张力、激素分泌、神经活动、情绪和疼痛感知等机制改善两类患者的睡眠结果。然而，更大规模、严格设计的随机对照试验对于明确证实这些治疗效果和阐明潜在的神经生物学机制至关重要。

{"title":"Botulinum toxin therapy for neurological disorders: Serendipitous benefits on sleep quality and underlying mechanisms","authors":"Guiying Kuang , Qinwei Yu , Danfang Yu , Long Liu , Xinyu Hu , Hanshu Liu , Xinyi Wang , Jingwen Li , Jinsha Huang , Tao Wang , Allison J. Cash , Zhicheng Lin , Nian Xiong","doi":"10.1016/j.smrv.2025.102181","DOIUrl":"10.1016/j.smrv.2025.102181","url":null,"abstract":"<div><div>Botulinum toxin (BoNT) remains the gold standard treatment for focal and segmental dystonia and is widely used in managing hyperkinetic disorders, chronic pain, and glandular hypersecretion. Extensive clinical trials demonstrate that BoNT effectively ameliorates both the core symptoms of these neurological conditions and their frequently associated comorbidities, including depression, anxiety, and diminished quality of life. Notably, many BoNT-treated neurological disorders co-occur with sleep disturbances, yet sleep outcomes remain underexplored. This review synthesizes current evidence on sleep outcomes following BoNT treatment of both established neurological indications (e.g., neuropathic pain, chronic migraine, dystonia, spasticity, sialorrhea, hemifacial spasm, bladder dysfunction) and primary sleep disorders (e.g., restless legs syndrome, sleep bruxism, insomnia). As a result, BoNT treatment improves sleep outcomes across both categories, potentially through mechanisms involving modulation of vasomotor tone, hormonal secretion, neural activity, mood, and pain perception. However, larger, rigorously designed randomized controlled trials are essential to definitively confirm these therapeutic effects and elucidate the underlying neurobiological mechanisms.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102181"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267605","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}

引用次数: 0

A paediatric group neglected in research: A systematic review on the sleep patterns, chronotype, latitude and ethnicity. 在研究中被忽视的儿科群体：一项关于睡眠模式、生物钟、纬度和种族的系统综述。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI: 10.1016/j.smrv.2025.102143

Sandra Figueiredo, Genta Kulari, Ana Gomes

This study presents a systematic review design aiming to explore how chronotype features are assessed in school-aged children (ages 4-11) and how chronotype is related to sleep habits, household dynamics, ethnicity, and geographical latitude. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-one studies were identified as eligible and reviewed by three independent researchers. The main findings indicate that chronotype is often under-assessed in school-aged children, with both professionals and parents reporting limited knowledge of children's sleep patterns. Additionally, there is a lack of information in the literature regarding how chronotype, sleep patterns, and vigilance are influenced by latitude and sociocultural factors. Most research on the relationship among the aforementioned variables is focused on adults rather than children. Furthermore, the methods for measuring sleep quality and chronotype were found to be inconsistent, with chronotype and sleep quality often used interchangeably. Based on these findings, further research is needed to explore how chronotype, sleep habits, and cultural or latitudinal factors might predict mental health and cognitive development in children. In terms of practical implications, there is an urgent need for re-education of parents on establishing healthy sleep and wake routines for their children.

本研究采用系统回顾设计，旨在探讨如何评估学龄儿童（4-11岁）的睡眠类型特征，以及睡眠类型与睡眠习惯、家庭动态、种族和地理纬度之间的关系。该评价遵循了系统评价和荟萃分析的首选报告项目（PRISMA）指南。31项研究被确定为符合条件，并由三名独立研究人员进行了审查。主要研究结果表明，学龄儿童的睡眠类型往往被低估，专业人士和家长都表示对儿童睡眠模式的了解有限。此外，关于生物钟、睡眠模式和警惕性如何受到纬度和社会文化因素的影响，文献中缺乏相关信息。大多数关于上述变量之间关系的研究都集中在成年人身上，而不是儿童身上。此外，测量睡眠质量和睡眠类型的方法也不一致，睡眠类型和睡眠质量经常互换使用。基于这些发现，需要进一步的研究来探索时间类型、睡眠习惯和文化或纬度因素如何预测儿童的心理健康和认知发展。就现实意义而言，迫切需要对父母进行再教育，为孩子建立健康的睡眠和醒来习惯。

{"title":"A paediatric group neglected in research: A systematic review on the sleep patterns, chronotype, latitude and ethnicity.","authors":"Sandra Figueiredo, Genta Kulari, Ana Gomes","doi":"10.1016/j.smrv.2025.102143","DOIUrl":"10.1016/j.smrv.2025.102143","url":null,"abstract":"<p><p>This study presents a systematic review design aiming to explore how chronotype features are assessed in school-aged children (ages 4-11) and how chronotype is related to sleep habits, household dynamics, ethnicity, and geographical latitude. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-one studies were identified as eligible and reviewed by three independent researchers. The main findings indicate that chronotype is often under-assessed in school-aged children, with both professionals and parents reporting limited knowledge of children's sleep patterns. Additionally, there is a lack of information in the literature regarding how chronotype, sleep patterns, and vigilance are influenced by latitude and sociocultural factors. Most research on the relationship among the aforementioned variables is focused on adults rather than children. Furthermore, the methods for measuring sleep quality and chronotype were found to be inconsistent, with chronotype and sleep quality often used interchangeably. Based on these findings, further research is needed to explore how chronotype, sleep habits, and cultural or latitudinal factors might predict mental health and cognitive development in children. In terms of practical implications, there is an urgent need for re-education of parents on establishing healthy sleep and wake routines for their children.</p>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"102143"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812552","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}

引用次数: 0

Pharmacological impact on sleep architecture and polysomnographic measures in Restless Legs Syndrome: A systematic review. 药物对不宁腿综合征患者睡眠结构和多导睡眠图测量的影响：一项系统综述。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.smrv.2025.102147

Maria P Mogavero, Elias G Karroum, Giuseppe Lanza, Elena Antelmi, Oliviero Bruni, Rosalia Silvestri, Sara Marelli, Alessandra Castelnuovo, Luigi Ferini-Strambi, Raffaele Ferri

Restless Legs Syndrome (RLS) is a sensorimotor disorder with diverse clinical manifestations that significantly impact sleep and quality of life, particularly among women. Polysomnography (PSG) plays a key role in evaluating motor features of RLS, such as periodic leg movements during sleep (PLMS). This review examines the effects of pharmacological treatments on PSG parameters and sleep architecture in RLS. Dopamine agonists are the most studied, consistently reducing PLMS but offering limited improvements in sleep structure and carrying risks of augmentation with long-term use. In contrast, alpha-2-delta ligands (e.g., pregabalin, gabapentin) improve sleep efficiency and reduce wakefulness, particularly benefiting patients with sensory symptoms or insomnia. Research on opioids and intravenous iron remains limited, though both show potential: opioids may reduce PLMS and improve sleep but raise respiratory safety concerns, while intravenous iron has shown efficacy, especially in pregnant women and children. We also conducted a meta-analysis assessing treatment effects of dopamine agonists on total sleep time, wakefulness after sleep onset, and sleep stage percentages (N1, N2, N3, REM). Given the heterogeneity of RLS and variable treatment responses across age and sex, future research should prioritize individualized therapeutic strategies and further investigate underexplored options to support precision medicine in RLS.

不宁腿综合征（RLS）是一种感觉运动障碍，具有多种临床表现，严重影响睡眠和生活质量，尤其是女性。多导睡眠图（PSG）在评估RLS的运动特征，如睡眠期间的周期性腿部运动（PLMS）中起着关键作用。本文综述了药物治疗对RLS患者PSG参数和睡眠结构的影响。多巴胺激动剂是研究最多的，它能持续降低PLMS，但对睡眠结构的改善有限，并且长期使用有增强的风险。相比之下，α -2- δ配体（如普瑞巴林、加巴喷丁）可提高睡眠效率，减少清醒，尤其对有感觉症状或失眠的患者有益。阿片类药物和静脉注射铁的研究仍然有限，尽管两者都显示出潜力：阿片类药物可能会减少PLMS并改善睡眠，但会引起呼吸安全问题，而静脉注射铁已显示出有效性，特别是对孕妇和儿童。我们还进行了一项荟萃分析，评估多巴胺激动剂对总睡眠时间、睡眠后清醒程度和睡眠阶段百分比（N1、N2、N3、REM）的治疗效果。考虑到RLS的异质性和不同年龄和性别的治疗反应，未来的研究应优先考虑个性化的治疗策略，并进一步研究尚未开发的选择，以支持RLS的精准医疗。

{"title":"Pharmacological impact on sleep architecture and polysomnographic measures in Restless Legs Syndrome: A systematic review.","authors":"Maria P Mogavero, Elias G Karroum, Giuseppe Lanza, Elena Antelmi, Oliviero Bruni, Rosalia Silvestri, Sara Marelli, Alessandra Castelnuovo, Luigi Ferini-Strambi, Raffaele Ferri","doi":"10.1016/j.smrv.2025.102147","DOIUrl":"10.1016/j.smrv.2025.102147","url":null,"abstract":"<p><p>Restless Legs Syndrome (RLS) is a sensorimotor disorder with diverse clinical manifestations that significantly impact sleep and quality of life, particularly among women. Polysomnography (PSG) plays a key role in evaluating motor features of RLS, such as periodic leg movements during sleep (PLMS). This review examines the effects of pharmacological treatments on PSG parameters and sleep architecture in RLS. Dopamine agonists are the most studied, consistently reducing PLMS but offering limited improvements in sleep structure and carrying risks of augmentation with long-term use. In contrast, alpha-2-delta ligands (e.g., pregabalin, gabapentin) improve sleep efficiency and reduce wakefulness, particularly benefiting patients with sensory symptoms or insomnia. Research on opioids and intravenous iron remains limited, though both show potential: opioids may reduce PLMS and improve sleep but raise respiratory safety concerns, while intravenous iron has shown efficacy, especially in pregnant women and children. We also conducted a meta-analysis assessing treatment effects of dopamine agonists on total sleep time, wakefulness after sleep onset, and sleep stage percentages (N1, N2, N3, REM). Given the heterogeneity of RLS and variable treatment responses across age and sex, future research should prioritize individualized therapeutic strategies and further investigate underexplored options to support precision medicine in RLS.</p>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"102147"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805094","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}

引用次数: 0

Impact of sleep duration on daytime sleepiness in children: A meta-analysis 睡眠时间对儿童日间嗜睡的影响：一项荟萃分析。

IF 9.7 1区医学 Q1 CLINICAL NEUROLOGY

Sleep Medicine Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.smrv.2025.102180

Anosha Altaf, Jayne Spiller

Whilst previous reviews have identified that shorter sleep duration is associated with poorer cognition in children, it is not known whether short sleep duration increases daytime sleepiness compared with sufficient or extended sleep. A systematic search of the literature identified 17 studies to be included in the meta-analysis. When excluding two sleep deprivation studies, short sleep duration was associated with higher daytime sleepiness compared with sufficient or extended sleep duration, standardised mean difference: 0.74 (95 % CI 0.45; 1.02). There was substantial variation in the extent of sleep restriction in the short sleep duration group compared to the sufficient/extended group. This was a significant moderator, accounting for 7 % of the effect size. As the effect size was lower for children compared to adolescents, it suggests that adolescents are particularly vulnerable to the effects of short sleep. For individual studies, the standardised mean difference had wide confidence intervals, suggesting that there are substantial inter-individual differences in response to short sleep duration compared to sufficient sleep duration. Further research is needed to identify whether daytime sleepiness mediates the relationship between sleep duration and cognitive outcomes.

虽然之前的研究已经发现，较短的睡眠时间与儿童较差的认知能力有关，但尚不清楚与充足或延长的睡眠相比，较短的睡眠时间是否会增加白天的嗜睡。对文献的系统检索确定了17项研究纳入meta分析。当排除两项睡眠剥夺研究时，与充足或延长的睡眠时间相比，短睡眠时间与较高的日间嗜睡相关，标准化平均差异：0.74 （95% CI 0.45; 1.02）。与充足/延长睡眠时间组相比，短睡眠组的睡眠限制程度有很大差异。这是一个显著的调节因子，占效应量的7%。与青少年相比，儿童的效应值更低，这表明青少年特别容易受到短睡眠的影响。对于个体研究，标准化平均差异具有很宽的置信区间，这表明与充足睡眠时间相比，短睡眠时间的反应存在实质性的个体间差异。需要进一步的研究来确定白天嗜睡是否介导了睡眠持续时间和认知结果之间的关系。

{"title":"Impact of sleep duration on daytime sleepiness in children: A meta-analysis","authors":"Anosha Altaf, Jayne Spiller","doi":"10.1016/j.smrv.2025.102180","DOIUrl":"10.1016/j.smrv.2025.102180","url":null,"abstract":"<div><div>Whilst previous reviews have identified that shorter sleep duration is associated with poorer cognition in children, it is not known whether short sleep duration increases daytime sleepiness compared with sufficient or extended sleep. A systematic search of the literature identified 17 studies to be included in the meta-analysis. When excluding two sleep deprivation studies, short sleep duration was associated with higher daytime sleepiness compared with sufficient or extended sleep duration, standardised mean difference: 0.74 (95 % CI 0.45; 1.02). There was substantial variation in the extent of sleep restriction in the short sleep duration group compared to the sufficient/extended group. This was a significant moderator, accounting for 7 % of the effect size. As the effect size was lower for children compared to adolescents, it suggests that adolescents are particularly vulnerable to the effects of short sleep. For individual studies, the standardised mean difference had wide confidence intervals, suggesting that there are substantial inter-individual differences in response to short sleep duration compared to sufficient sleep duration. Further research is needed to identify whether daytime sleepiness mediates the relationship between sleep duration and cognitive outcomes.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102180"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259915","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Sleep Medicine Reviews

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀