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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 Pub 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
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 Pub Date : 2025-11-22 DOI: 10.1016/j.smrv.2025.102208
Alberto Potenzieri , Andrea Escelsior , Gianluca Serafini , Antonio Uccelli , Antoine Adamantidis , Lino Nobili
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引用次数: 0
Post-stroke sleep disordered breathing and the effect of positive airway pressure treatment: An updated systematic review and meta-analysis of randomized control trials 卒中后睡眠呼吸障碍和气道正压治疗的效果:随机对照试验的最新系统综述和荟萃分析
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-22 DOI: 10.1016/j.smrv.2025.102207
Fotios Sampsonas , Vasileios Karamouzos , Michael Doulberis , Kyriakos Karkoulias , Dimosthenis Lykouras , Paschalis Steiropoulos , Argyrios Tzouvelekis
Obstructive sleep apnea is under-diagnosed, under-reported and therefore under-treated in patients after a stroke. The aim of this meta-analysis of Randomized Control Trials (RCTs) was to investigate the effectiveness of positive airway treatment on recurrent vascular events, neurological deficit, functional independence, depression, sleepiness and cognitive function in patients post-stroke.
Records identified from Embase Elsevier Database (Embase, Medline/PubMed, Preprints, PubMed-not-Medline) were searched from inception in July 2024, up to September 2024. After screening 72387 records, 21 RCTs were included with 1457 patients with stroke. Out of these 753 patients were in the PAP arm and 704 in the conventional arm.
Metanalysis showed that PAP treatment reduced recurrent vascular events OR 0.45, (95 % Confidence Interval (CI) 0.28 to 0.78; p < 0.01), improved neurological deficit OR -0.30, (95 % CI -0.47 to −0.14; p < 0.01), reduced daytime sleepiness OR: −0.96, (95 % CI -1.47 to −0.45; p < 0.01), improved depression levels; OR: −0.58, (95 % CI -1.05 to −0.11; p = 0.02), improved cognitive function; OR1.10; (95 % CI 0.35 to 1.86; p = 0.02), but did not improve functional independence OR 0.25, (95 % CI -0.11 to 0.60; p = 0.17)
Therefore, positive airway pressure treatment is effective in patients with stroke and can reduce recurrent vascular events and improve recovery of these patients.
阻塞性睡眠呼吸暂停在中风后的患者中诊断、报告不足,因此治疗不足。这项随机对照试验(RCTs)的荟萃分析的目的是研究正气道治疗对卒中后血管事件复发、神经功能缺损、功能独立、抑郁、嗜睡和认知功能的有效性。从Embase爱思唯尔数据库(Embase, Medline/PubMed, Preprints, PubMed-not-Medline)中识别的记录从2024年7月到2024年9月进行检索。在筛选72387份记录后,纳入21项随机对照试验,纳入1457例脑卒中患者。其中753名患者在PAP组,704名患者在常规组。荟萃分析显示PAP治疗减少血管复发事件OR 0.45,(95%可信区间(CI) 0.28 ~ 0.78;p < 0.01),改善神经功能缺损OR -0.30, (95% CI -0.47至- 0.14;p < 0.01),减少白天嗜睡OR: - 0.96, (95% CI -1.47至- 0.45;p < 0.01),改善抑郁水平;OR: - 0.58, (95% CI -1.05 ~ - 0.11; p = 0.02),认知功能改善;OR1.10;(95% CI 0.35 ~ 1.86; p = 0.02),但未改善功能独立性OR 0.25, (95% CI -0.11 ~ 0.60; p = 0.17)因此,气道正压治疗对脑卒中患者有效,可减少血管事件复发,提高患者康复。
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引用次数: 0
Unpacking sleep and mental health disparities across childhood and adolescence: A meta-analytic and systematic review 儿童期和青春期的睡眠和心理健康差异:一项荟萃分析和系统回顾
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-22 DOI: 10.1016/j.smrv.2025.102206
Morgan J. Thompson , Alexandra D. Ehrhardt , Ekjyot K. Saini , Emily F. Brigham , Zeynep Su Altinoz , Tiffany Yip , Joseph A. Buckhalt , Mona El-Sheikh
Children and adolescents from racial and ethnic minority and socioeconomically disadvantaged backgrounds are at greater risk for health disparities. This meta-analysis examined the association between sleep and mental health, with attention to variations by: (a) race, ethnicity, and socioeconomic status, and (b) individual sleep parameters and mental health domains. The review included 104 studies (66 independent samples, 326,478 participants). Less optimal sleep was associated with worse mental health (r = −.20, 95% CI [–.23, −.16]). Subjective sleep quality was a stronger correlate of mental health relative to all other sleep parameters (bs ranged from .11 to .19, ps < .001). Sleep schedule was a stronger correlate than objective sleep duration and quality (bs = .08 and .07, respectively, ps < .01). Sleep consistency was also a stronger correlate than objective sleep duration (b = .05, p = .03). Socioeconomic status moderated two associations. Objective sleep quality was more strongly linked to mental health among middle- relative to mixed-SES samples (b = .11, p = .01). Sleep consistency was more strongly associated with mental health among low- compared to mixed-SES samples (b = .05, p = .002). Findings are discussed in the context of methodological challenges in studying health disparities.
来自种族和族裔少数群体和社会经济不利背景的儿童和青少年面临更大的健康差异风险。这项荟萃分析考察了睡眠和心理健康之间的关系,并注意到:(a)种族、民族和社会经济地位的差异,以及(b)个体睡眠参数和心理健康领域的差异。该综述包括104项研究(66个独立样本,326,478名参与者)。较差的最佳睡眠与较差的心理健康相关(r = -)。20, 95% ci[-]。23日,−16])。相对于所有其他睡眠参数,主观睡眠质量与心理健康的相关性更强。11 . to…19, ps < .001)。睡眠计划与客观睡眠时间和质量的相关性更强(bs = .08和。分别为(p < .01)。睡眠一致性也比客观睡眠时间更强(b = 0.05, p = 0.03)。社会经济地位调节了这两种关联。目的:相对于混合ses样本,中等ses样本的睡眠质量与心理健康的关系更强(b = .11, p = .01)。与混合ses相比,低ses样本的睡眠一致性与心理健康的关系更强(b = 0.05, p = 0.002)。在研究健康差异的方法挑战的背景下讨论了研究结果。
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引用次数: 0
Sleep regularity as an important component of sleep hygiene: a systematic review 睡眠规律是睡眠卫生的重要组成部分:一项系统综述。
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-17 DOI: 10.1016/j.smrv.2025.102203
Alexandros Kalkanis , Dierik Lenkens , Paschalis Steiropoulos , Dries Testelmans

Background

Beyond sleep duration and efficiency, the day-to-day regularity of bed- and wake-times is increasingly recognized as a distinct dimension of sleep health. Whether irregular schedules independently predict adverse health outcomes remains unclear.

Objective

To synthesize evidence on the association between objectively or diary-quantified sleep regularity and mental, cardiometabolic, inflammatory, cognitive, lifestyle, sleep-disorder, and mortality outcomes in adults.

Methods

A protocol registered with PROSPERO (CRD420251101936) guided the review. MEDLINE (PubMed), Cochrane Library, PsycINFO, and Google Scholar were searched from inception to July 1, 2025 using a comprehensive strategy incorporating validated regularity metrics (Sleep Regularity Index, interdaily stability, composite phase deviation, social jetlag, night-to-night standard deviations). After duplicate removal, 3140 unique records underwent title/abstract screening; 147 full texts were reviewed. Risk of bias was appraised with the Newcastle–Ottawa Scale. Heterogeneity of metrics and outcomes precluded meta-analysis; evidence was synthesized narratively following SWiM guidelines and graded with van Tulder's best-evidence taxonomy.

Results

Fifty-nine primary studies met all criteria. Consistent, moderate-certainty evidence linked greater sleep-timing irregularity to higher depressive and anxiety symptoms, elevated body mass index, insulin resistance, hypertension, and incident cardiovascular events. Limited but directionally uniform evidence indicated higher inflammatory markers and poorer lifestyle indices in irregular sleepers. Prospective biobank data associated low Sleep Regularity Index with smaller hippocampal volume and a 26–53 % increase in dementia risk. Five low-bias cohorts showed 20–88 % higher all-cause mortality for the least regular sleepers, independent of sleep duration and quality. Mechanistic pathways implicated circadian misalignment, autonomic imbalance, and systemic inflammation.

Conclusions

Across diverse populations and measurement approaches, unstable sleep timing consistently portends poorer mental, metabolic, vascular, cognitive, and survival outcomes. Because sleep regularity is modifiable and objectively trackable with wearables, schedule stabilization merits elevation to a core public-health recommendation and a priority target for randomized intervention trials.
背景:除了睡眠时间和睡眠效率,每天的作息规律越来越被认为是睡眠健康的一个重要方面。不规律的作息是否能独立预测不良的健康结果尚不清楚。目的:综合客观或日记量化的睡眠规律与成人精神、心脏代谢、炎症、认知、生活方式、睡眠障碍和死亡率结局之间的关联证据。方法:在PROSPERO注册的方案(CRD420251101936)指导了本综述。MEDLINE (PubMed)、Cochrane图书馆、PsycINFO和谷歌Scholar从研究开始到2025年7月1日进行了检索,采用了一种综合策略,包括经过验证的规律指标(睡眠规律指数、每日间稳定性、复合相位偏差、社交时差、夜间标准差)。删除重复记录后,对3140条唯一记录进行标题/摘要筛选;审查了147个全文。偏倚风险用纽卡斯尔-渥太华量表评估。指标和结果的异质性妨碍了meta分析;证据是按照SWiM指南以叙述的方式合成的,并根据van Tulder的最佳证据分类法进行分级。结果:59项初步研究符合所有标准。一致的、中等确定性的证据表明,睡眠时间不规律与抑郁和焦虑症状加重、体重指数升高、胰岛素抵抗、高血压和心血管事件有关。有限但方向一致的证据表明,不规律睡眠者的炎症标志物较高,生活方式指数较差。前瞻性生物库数据表明,低睡眠规律指数与较小的海马体积和26- 53%的痴呆风险增加有关。五个低偏倚队列显示,不规律睡眠者的全因死亡率高出20- 88%,与睡眠时间和质量无关。机制途径涉及昼夜节律失调、自主神经失衡和全身炎症。结论:在不同的人群和测量方法中,不稳定的睡眠时间始终预示着较差的精神、代谢、血管、认知和生存结果。由于睡眠规律是可以改变的,而且可以用可穿戴设备客观地跟踪,因此稳定睡眠时间应该被提升为一项核心公共卫生建议,并成为随机干预试验的优先目标。
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引用次数: 0
Remission, treatment response, and treatment adherence across the delivery methods of cognitive behavioral therapy for insomnia: A systematic review and meta-analysis of randomized controlled trials 失眠认知行为疗法的缓解、治疗反应和治疗依从性:随机对照试验的系统回顾和荟萃分析
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-14 DOI: 10.1016/j.smrv.2025.102204
Yuta Takano , Isa Okajima , Masumi Osao , Rui Ibata , Naho Machida , Koyo Higami , Shunsuke Takagi , Yuichi Inoue
This study aimed to clarify the clinically meaningful outcomes and treatment adherence across different delivery methods of cognitive behavioral therapy for insomnia (CBT-I). CBT-I was defined as incorporating both sleep restriction and stimulus control techniques. This study included individual, group, fully automated Internet-based, and supported Internet-based formats. Remission from insomnia increased significantly across all delivery methods compared with the control group (individual: k = 36, n = 1696, odds ratio [OR] = 8.36; group: k = 22, n = 2356, OR = 4.65; fully automated Internet-based: k = 50, n = 15590, OR = 3.87; supported Internet-based: k = 19, n = 1759, OR = 8.35). After adjusting for comorbidities and types of control group, meta-regression analysis showed that the individual and supported Internet-based formats were significantly associated with higher odds of remission from insomnia compared with the fully automated Internet-based format. The completion rate for all sessions was significantly higher in the individual format (k = 8, 83.8%) than in the Internet-based formats (supported Internet-based: k = 15, 70.7%; fully automated Internet-based: k = 26, 58.4%). CBT-I is robustly effective in managing insomnia, although relatively lower treatment adherence continues to be a major challenge for Internet-based CBT-I.
本研究旨在阐明不同认知行为疗法治疗失眠症(CBT-I)的临床意义结果和治疗依从性。CBT-I被定义为结合睡眠限制和刺激控制技术。这项研究包括个人、团体、全自动基于互联网和支持的基于互联网的格式。与对照组相比,所有给药方式的失眠缓解均显著增加(个体:k = 36, n = 1696,优势比[OR] = 8.36;组:k = 22, n = 2356, OR = 4.65;全自动互联网:k = 50, n = 15590, OR = 3.87;支持互联网:k = 19, n = 1759, OR = 8.35)。在调整了合并症和对照组的类型后,meta回归分析显示,与全自动网络治疗相比,个人和支持的网络治疗与更高的失眠缓解几率显著相关。个人模式下所有课程的完成率(k = 8,83.8%)明显高于基于互联网的模式(支持的基于互联网的模式:k = 15,70.7%;完全自动化的基于互联网的模式:k = 26,58.4%)。CBT-I在治疗失眠方面非常有效,尽管相对较低的治疗依从性仍然是基于互联网的CBT-I的主要挑战。
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引用次数: 0
Corpus callosum agenesis: does sleep matter? 胼胝体发育:睡眠重要吗?
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-11 DOI: 10.1016/j.smrv.2025.102202
Ludovica Pasca , Helene Vitali , Sara Uccella , Carlo Alberto Quaranta , Lia Macina , Lynn K. Paul , Valentina De Giorgis , Valentina Franco , Renato Borgatti , Romina Romaniello
Agenesis of the corpus callosum is a brain malformation that can lead to intellectual, behavioural, social and emotional impairments, with outcomes varying based on severity. Sleep disturbances are common in children with this disorder, and some studies have evidenced the role of corpus callosum in interhemispheric synchronisation that may influence sleep patterns. This narrative review attempted to intercept available information on sleep in patients with isolated Agenesis of the corpus callosum, partial and complete, across different ages. Since literature about this issue is underdeveloped, knowledge on callostomized individuals has been included. Corpus callosum disruption is linked to sleep disturbances, especially in early life, though the corpus callosum specific contribution remains unclear. Studies on callostomized individuals suggest that the corpus callosum plays a role in slow-wave transmission across hemispheres, which may affect sleep architecture and plasticity. The impaired transfer of brain activity between the hemispheres also seems to influence their dream experiences. The discussion pointed out that sleep problems in patients with Agenesis of the corpus callosum should be systematically assessed, as they may impact neurodevelopment and overall well-being, highlighting the need for further research and sleep interventions.
胼胝体发育不全是一种大脑畸形,可导致智力、行为、社交和情感障碍,其结果因严重程度而异。睡眠障碍在患有这种疾病的儿童中很常见,一些研究已经证明胼胝体在半球间同步中的作用可能会影响睡眠模式。这篇叙述性的综述试图在不同年龄的孤立性胼胝体发育不全和完全性胼胝体发育不全患者中截取可用的睡眠信息。由于关于这个问题的文献不发达,关于胼胝质的个体的知识也被包括在内。胼胝体的破坏与睡眠障碍有关,尤其是在生命早期,尽管胼胝体的具体贡献尚不清楚。对胼胝体个体的研究表明,胼胝体在跨半球的慢波传输中起作用,这可能影响睡眠结构和可塑性。大脑活动在两个半球之间的转移受损似乎也会影响他们的梦境体验。讨论指出,应系统评估胼胝体发育不全患者的睡眠问题,因为它们可能影响神经发育和整体健康,强调需要进一步研究和睡眠干预。
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引用次数: 0
Guest editorial: Obstructive sleep apnea, cellular senescence, and aging: A convergence of pathways driving cardiometabolic risk 客座评论:阻塞性睡眠呼吸暂停、细胞衰老和衰老:驱动心脏代谢风险的途径趋同。
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-11 DOI: 10.1016/j.smrv.2025.102201
Yunzhou Dong, Virend K. Somers
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引用次数: 0
Sleep regularity in shiftwork: A missing metric for fatigue risk management? 轮班工作中的睡眠规律:疲劳风险管理的缺失指标?
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-11 DOI: 10.1016/j.smrv.2025.102200
M. Sprajcer, A.E. Laycock, A.M. Fauveau, S.A. Ferguson, G.E. Vincent
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引用次数: 0
Assessment tools for population sleep health surveillance in adults: A systematic review of validity and reliability 成人人群睡眠健康监测的评估工具:有效性和可靠性的系统评价。
IF 9.7 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-02 DOI: 10.1016/j.smrv.2025.102196
Joshua A.H. Way , Erin Mathieu , Josephine Chau , Peter A. Cistulli , Yu Sun Bin
Poor sleep health is a significant public health issue. Population health surveillance systems are important for gathering accurate data to inform public health responses but remain underdeveloped for sleep health assessment globally. We aimed to identify sleep assessment tools and to evaluate their validity and reliability for use in population surveillance.
Three databases (PubMed, EMBASE, and PsycINFO) were searched resulting in 12,350 publications as of July 2025; 187 studies met the inclusion criteria and 60 sleep assessment tools were evaluated for nine measurement properties: content validity, criterion validity, construct validity, internal consistency, reliability, agreement, floor and ceiling effects, responsiveness, and interpretability.
The Insomnia Severity Index had five measurement properties rated positively, the highest among all tools. Two tools assessed all sleep health domains: the Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU-SATED) scale and a 13-item composite measure of sleep health (13-SH).
Most sleep assessment tools lacked adequate validation studies in the adult general population or lacked the ability to capture all dimensions of sleep health. Demonstrating criterion and construct validity of existing tools, developing new tools to measure multidimensional sleep health, or combining items from validated measures with strong measurement properties is warranted for effective sleep health surveillance.
睡眠不健康是一个重大的公共卫生问题。人口健康监测系统对于收集准确数据为公共卫生反应提供信息很重要,但在全球睡眠健康评估方面仍不发达。我们的目的是确定睡眠评估工具,并评估其在人口监测中使用的有效性和可靠性。检索了三个数据库(PubMed, EMBASE和PsycINFO),得出截至2025年7月的12,350篇出版物;187项研究符合纳入标准,对60种睡眠评估工具进行了九项测量属性评估:内容效度、标准效度、结构效度、内部一致性、信度、一致性、下限和上限效应、反应性和可解释性。失眠症严重程度指数有五个测量属性被评为正面,在所有工具中是最高的。两种工具评估所有睡眠健康领域:规律性、满意度、警觉性、时间、效率、持续时间(RU-SATED)量表和13项睡眠健康综合测量(13-SH)。大多数睡眠评估工具缺乏对成年普通人群的充分验证研究,或者缺乏捕捉睡眠健康所有维度的能力。证明现有工具的标准和构建有效性,开发新的工具来测量多维睡眠健康,或将来自验证测量的项目与强测量特性相结合,是有效的睡眠健康监测的必要条件。
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引用次数: 0
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Sleep Medicine Reviews
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