Pub Date : 2025-09-27DOI: 10.1016/j.smrv.2025.102179
Alberto Potenzieri , Andrea Escelsior , Gianluca Serafini , Antonio Uccelli , Antoine Adamantidis , Lino Nobili
Sleep disturbances are highly prevalent in people with major depressive disorder (MDD) and contribute to a vicious cycle that exacerbates both conditions. Electroencephalographic (EEG)-based sleep features of people with MDD are well described in systematic reviews and meta-analyses. However, sleep abnormalities in mouse models of MDD remain poorly characterized. We conducted a systematic review to evaluate the face validity of mouse models of MDD in relation to sleep alterations. Among the 22 articles we identified, the most consistently represented features of sleep disturbances in mouse models were increased rapid eye movement (REM) sleep and non-REM (NREM) sleep fragmentation. A blunted response to sleep deprivation was reported but only in a few studies and requires further investigation. Data regarding delta and theta power were limited and showed heterogeneous results. By providing a comprehensive summary of all mouse models in the field, our study serves as a resource to confirm the utility of animal models and guide researchers in studying sleep alterations in MDD.
{"title":"Sleep abnormalities in mouse models of depression: a systematic review","authors":"Alberto Potenzieri , Andrea Escelsior , Gianluca Serafini , Antonio Uccelli , Antoine Adamantidis , Lino Nobili","doi":"10.1016/j.smrv.2025.102179","DOIUrl":"10.1016/j.smrv.2025.102179","url":null,"abstract":"<div><div>Sleep disturbances are highly prevalent in people with major depressive disorder (MDD) and contribute to a vicious cycle that exacerbates both conditions. Electroencephalographic (EEG)-based sleep features of people with MDD are well described in systematic reviews and meta-analyses. However, sleep abnormalities in mouse models of MDD remain poorly characterized. We conducted a systematic review to evaluate the face validity of mouse models of MDD in relation to sleep alterations. Among the 22 articles we identified, the most consistently represented features of sleep disturbances in mouse models were increased rapid eye movement (REM) sleep and non-REM (NREM) sleep fragmentation. A blunted response to sleep deprivation was reported but only in a few studies and requires further investigation. Data regarding delta and theta power were limited and showed heterogeneous results. By providing a comprehensive summary of all mouse models in the field, our study serves as a resource to confirm the utility of animal models and guide researchers in studying sleep alterations in MDD.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102179"},"PeriodicalIF":9.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221439","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 : 2025-09-27DOI: 10.1016/j.smrv.2025.102182
Erren Thomas C, Morfeld Peter, Lewis Philip
{"title":"Chronotype and circadian epidemiology","authors":"Erren Thomas C, Morfeld Peter, Lewis Philip","doi":"10.1016/j.smrv.2025.102182","DOIUrl":"10.1016/j.smrv.2025.102182","url":null,"abstract":"","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102182"},"PeriodicalIF":9.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221438","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 : 2025-09-18DOI: 10.1016/j.smrv.2025.102170
Sarfraz Ahmed , David Gozal , Abdelnaby Khalyfa
Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway obstruction during sleep, triggering physiological changes that resemble key features of cellular senescence—oxidative stress, mitochondrial dysfunction, and systemic inflammation. While senescence plays roles in tissue repair, its accumulation also drives chronic inflammation and immune dysregulation. The connection between OSA, senescence, and aging remains complex and underexplored. Mechanisms like the senescence-associated secretory phenotype (SASP), impaired immune surveillance, and reduced regenerative capacity may contribute to OSA-related morbidity. This review examines how senescence influences immune and molecular pathways in OSA, with a focus on cardiometabolic dysfunction, SASP-driven tissue remodeling, and hypoxia-induced damage. We also highlight emerging therapies targeting senescence, proposing that it acts not only as a byproduct of aging but as an active driver of OSA pathology, shaped by hypoxia, sleep disruption, comorbidities, and immune profiles.
{"title":"Mechanistic links between obstructive sleep apnea, cellular senescence and aging: The role of cardiometabolic dysfunction","authors":"Sarfraz Ahmed , David Gozal , Abdelnaby Khalyfa","doi":"10.1016/j.smrv.2025.102170","DOIUrl":"10.1016/j.smrv.2025.102170","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway obstruction during sleep, triggering physiological changes that resemble key features of cellular senescence—oxidative stress, mitochondrial dysfunction, and systemic inflammation. While senescence plays roles in tissue repair, its accumulation also drives chronic inflammation and immune dysregulation. The connection between OSA, senescence, and aging remains complex and underexplored. Mechanisms like the senescence-associated secretory phenotype (SASP), impaired immune surveillance, and reduced regenerative capacity may contribute to OSA-related morbidity. This review examines how senescence influences immune and molecular pathways in OSA, with a focus on cardiometabolic dysfunction, SASP-driven tissue remodeling, and hypoxia-induced damage. We also highlight emerging therapies targeting senescence, proposing that it acts not only as a byproduct of aging but as an active driver of OSA pathology, shaped by hypoxia, sleep disruption, comorbidities, and immune profiles.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102170"},"PeriodicalIF":9.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208136","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 : 2025-09-17DOI: 10.1016/j.smrv.2025.102177
Sara Fattinger , Sven Leach , Reto Huber
Slow waves and spindles, key electrophysiological markers of non-rapid eye movement (NREM) sleep, are thought to play a causal role in sustaining brain functions. While their association with these functions has been recognized for decades, the underlying mechanisms remain elusive. Emerging evidence suggests that their functional role is defined not only by individual oscillations but also by the interplay of spatiotemporal neuronal synchronization. Recent studies modulating NREM sleep oscillations through auditory input have demonstrated direct behavioral effects, enabling new diagnostic and therapeutic tools for psychiatric and neurological disorders. However, clinical translation remains limited due to an incomplete understanding of the neuronal mechanisms. Here, we propose a new conceptual framework for auditory stimulation during NREM sleep, outlining how key stimulation parameters influence the spatiotemporal coordination of network activities underlying specific oscillations. This framework provides a foundation for interpreting the effects of auditory stimulation, formulating hypotheses on neuronal mechanisms, and identifying which synchronization processes to target for specific functions. Such foundational understanding is a prerequisite for establishing the causal role of distinct synchronization processes of NREM sleep oscillations in driving diverse brain functions - a critical step toward effectively applying and clinically translating brain stimulation techniques beyond auditory stimulation during NREM sleep.
{"title":"The dual-process model: Unlocking the potential of auditory stimulation to modulate brain oscillations during sleep","authors":"Sara Fattinger , Sven Leach , Reto Huber","doi":"10.1016/j.smrv.2025.102177","DOIUrl":"10.1016/j.smrv.2025.102177","url":null,"abstract":"<div><div>Slow waves and spindles, key electrophysiological markers of non-rapid eye movement (NREM) sleep, are thought to play a causal role in sustaining brain functions. While their association with these functions has been recognized for decades, the underlying mechanisms remain elusive. Emerging evidence suggests that their functional role is defined not only by individual oscillations but also by the interplay of spatiotemporal neuronal synchronization. Recent studies modulating NREM sleep oscillations through auditory input have demonstrated direct behavioral effects, enabling new diagnostic and therapeutic tools for psychiatric and neurological disorders. However, clinical translation remains limited due to an incomplete understanding of the neuronal mechanisms. Here, we propose a new conceptual framework for auditory stimulation during NREM sleep, outlining how key stimulation parameters influence the spatiotemporal coordination of network activities underlying specific oscillations. This framework provides a foundation for interpreting the effects of auditory stimulation, formulating hypotheses on neuronal mechanisms, and identifying which synchronization processes to target for specific functions. Such foundational understanding is a prerequisite for establishing the causal role of distinct synchronization processes of NREM sleep oscillations in driving diverse brain functions - a critical step toward effectively applying and clinically translating brain stimulation techniques beyond auditory stimulation during NREM sleep.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102177"},"PeriodicalIF":9.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103104","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 : 2025-09-15DOI: 10.1016/j.smrv.2025.102165
Hui Chen , Junyan Gao , Jianwei Liu , Ghizlane Aarab , Shaohua Ge , Frank Lobbezoo , Nelly Huynh , Carlos Flores Mir
Various designs of mandibular advancement appliances (MAAs) have been proposed for managing obstructive sleep apnea (OSA) in children. However, the difference in efficacy between various MAA designs remain unclear. A deeper understanding of the effectiveness of various MAA designs could help refine their design and improve treatment outcomes. This systematic review evaluates the efficacy of different available MAA designs. PubMed, EMBASE, and the Cochrane Library were searched for eligible studies published up to January 2025. A total of 1098 studies were initially identified, from which three randomized controlled trials (RCTs) and five Non-RCTs assessing the efficacy of MAAs in pediatric OSA patients were included. The results showed that MAAs were associated with increased minimal oxygen saturation (SpO2) (CI: 17.67 to −0.82, p=0.03) and mean SpO2 (CI: 1.07 to −0.09, p=0.02) in pediatric OSA patients. The Twin-block appliance did not significantly reduce the apnea-hypopnea index (AHI) (CI: 0.11 to 8.63, p=0.06), while the Mono-block appliance was found to reduce AHI significantly (CI:2.21 to 6.79, p=0.0001). Additionally, unlike the Twin-block appliance, the Mono-block appliance improved both minimal and mean SpO2. With limitation of selected studies, the impact of MAA design on pediatric OSA varied. However, it cannot be concluded that one specific MAA design is superior to others for managing pediatric OSA.
{"title":"Efficacy of mandibular advancement appliances with varying designs in the management of obstructive sleep apnea in children: A systematic review and meta-analysis","authors":"Hui Chen , Junyan Gao , Jianwei Liu , Ghizlane Aarab , Shaohua Ge , Frank Lobbezoo , Nelly Huynh , Carlos Flores Mir","doi":"10.1016/j.smrv.2025.102165","DOIUrl":"10.1016/j.smrv.2025.102165","url":null,"abstract":"<div><div>Various designs of mandibular advancement appliances (MAAs) have been proposed for managing obstructive sleep apnea (OSA) in children. However, the difference in efficacy between various MAA designs remain unclear. A deeper understanding of the effectiveness of various MAA designs could help refine their design and improve treatment outcomes. This systematic review evaluates the efficacy of different available MAA designs. PubMed, EMBASE, and the Cochrane Library were searched for eligible studies published up to January 2025. A total of 1098 studies were initially identified, from which three randomized controlled trials (RCTs) and five Non-RCTs assessing the efficacy of MAAs in pediatric OSA patients were included. The results showed that MAAs were associated with increased minimal oxygen saturation (SpO<sub>2</sub>) (CI: 17.67 to −0.82, p=0.03) and mean SpO<sub>2</sub> (CI: 1.07 to −0.09, p=0.02) in pediatric OSA patients. The Twin-block appliance did not significantly reduce the apnea-hypopnea index (AHI) (CI: 0.11 to 8.63, p=0.06), while the Mono-block appliance was found to reduce AHI significantly (CI:2.21 to 6.79, p=0.0001). Additionally, unlike the Twin-block appliance, the Mono-block appliance improved both minimal and mean SpO<sub>2</sub>. With limitation of selected studies, the impact of MAA design on pediatric OSA varied. However, it cannot be concluded that one specific MAA design is superior to others for managing pediatric OSA.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102165"},"PeriodicalIF":9.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109300","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 : 2025-09-15DOI: 10.1016/j.smrv.2025.102167
Jian Eu Tai , Sheila Sivam , Angela D'Rozario , David Wang , Garry Cho , Brendon J. Yee
Central disorders of hypersomnolence are currently diagnosed in clinical practice from overnight polysomnography and multiple sleep latency test (MSLT). Cerebrospinal fluid (CSF) orexin levels are also a useful confirmatory test for type 1 narcolepsy. The diagnosis and differentiation of disorders of hypersomnolence remain limited by the lack of repeatability of MSLT and the absence of any known biomarkers for type 2 narcolepsy (NT2) and idiopathic hypersomnolence (IH). There remains limited understanding of the pathophysiology and neural pathways involved in NT2 and IH. In this narrative review, we explore the research on serum and CSF testing, neuroimaging, polysomnography and other modalities in improving the sensitivity and specificity of diagnosing these disorders.
{"title":"Central disorders of hypersomnolence – A narrative review on current and potential biomarkers","authors":"Jian Eu Tai , Sheila Sivam , Angela D'Rozario , David Wang , Garry Cho , Brendon J. Yee","doi":"10.1016/j.smrv.2025.102167","DOIUrl":"10.1016/j.smrv.2025.102167","url":null,"abstract":"<div><div>Central disorders of hypersomnolence are currently diagnosed in clinical practice from overnight polysomnography and multiple sleep latency test (MSLT). Cerebrospinal fluid (CSF) orexin levels are also a useful confirmatory test for type 1 narcolepsy. The diagnosis and differentiation of disorders of hypersomnolence remain limited by the lack of repeatability of MSLT and the absence of any known biomarkers for type 2 narcolepsy (NT2) and idiopathic hypersomnolence (IH). There remains limited understanding of the pathophysiology and neural pathways involved in NT2 and IH. In this narrative review, we explore the research on serum and CSF testing, neuroimaging, polysomnography and other modalities in improving the sensitivity and specificity of diagnosing these disorders.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102167"},"PeriodicalIF":9.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106716","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 : 2025-09-12DOI: 10.1016/j.smrv.2025.102164
Rob Velzeboer , Adeeb Malas , Sabrina Wei , Renee Berger , Varinder Parmar , Wayne W.K. Lai
Cannabis use for sleep is increasingly prevalent, yet its effects on sleep architecture remain unclear. This systematic review and meta-analysis examined polysomnographic evidence on cannabis’ impact on sleep parameters. Eighteen studies were identified, with nine suitable for meta-analysis. Findings indicate that cannabis administration does not consistently alter sleep duration, latency, wake time, efficiency, or sleep staging. While early studies suggested reductions in rapid eye movement sleep, these were primarily based on small-scale trials with high tetrahydrocannabinol doses and significant methodological limitations. More recent studies using larger samples and lower therapeutic doses of tetrahydrocannabinol have reported mixed (and often no) evidence of rapid eye movement (REM) suppression, and the evidence base remains very limited. However, withdrawal from active cannabis use was consistently associated with sleep disturbances, including reduced total sleeping times and prolonged sleep onset latency, as well as REM rebounds. Variability in study outcomes highlights the influence of factors such as dosage, cannabinoid composition, prior cannabis use, and health conditions. Further research using standardised protocols and larger samples is needed to clarify the relationship between cannabis and sleep architecture and to address the discrepancies between subjective sleep improvements and objective sleep metrics.
{"title":"Cannabis and sleep architecture: A systematic review and meta-analysis","authors":"Rob Velzeboer , Adeeb Malas , Sabrina Wei , Renee Berger , Varinder Parmar , Wayne W.K. Lai","doi":"10.1016/j.smrv.2025.102164","DOIUrl":"10.1016/j.smrv.2025.102164","url":null,"abstract":"<div><div>Cannabis use for sleep is increasingly prevalent, yet its effects on sleep architecture remain unclear. This systematic review and meta-analysis examined polysomnographic evidence on cannabis’ impact on sleep parameters. Eighteen studies were identified, with nine suitable for meta-analysis. Findings indicate that cannabis administration does not consistently alter sleep duration, latency, wake time, efficiency, or sleep staging. While early studies suggested reductions in rapid eye movement sleep, these were primarily based on small-scale trials with high tetrahydrocannabinol doses and significant methodological limitations. More recent studies using larger samples and lower therapeutic doses of tetrahydrocannabinol have reported mixed (and often no) evidence of rapid eye movement (REM) suppression, and the evidence base remains very limited. However, withdrawal from active cannabis use was consistently associated with sleep disturbances, including reduced total sleeping times and prolonged sleep onset latency, as well as REM rebounds. Variability in study outcomes highlights the influence of factors such as dosage, cannabinoid composition, prior cannabis use, and health conditions. Further research using standardised protocols and larger samples is needed to clarify the relationship between cannabis and sleep architecture and to address the discrepancies between subjective sleep improvements and objective sleep metrics.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102164"},"PeriodicalIF":9.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087849","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 : 2025-09-12DOI: 10.1016/j.smrv.2025.102169
Steven Luu , Daryl Emery Chee Yeow Chan , Nathaniel S. Marshall , Craig L. Phillips , Ronald R. Grunstein , Brendon J. Yee
Positive airway pressure therapy remains the gold standard treatment for obstructive sleep apnea (OSA), but challenges with adherence, acceptability, and side effects persist. Interest in pharmacological therapies has grown, culminating in the recent U.S. Food and Drug Administration approval of tirzepatide as the first pharmacotherapy for OSA. Our review critically examines the efficacy of pharmacologic treatments for OSA and highlights current limitations and future research directions.
We conducted a search of Medline and Embase for randomized controlled trials published from January 2005 to February 2025, identifying 41 studies investigating 37 different drugs or drug combinations.
Weight-loss therapies showed the most consistent and substantial improvements in OSA severity. Tirzepatide produced the largest reduction in apnea-hypopnea index and improved patient-reported outcomes and cardiometabolic risk factors. Other pharmacotherapies demonstrated modest and inconsistent effects on OSA severity, sometimes with side-effects that contradict the treatment goal to reduce daytime sleepiness.
Weight-loss agents, particularly tirzepatide, represent a promising and now clinically viable treatment option. While endotype-targeted approaches are conceptually attractive, many agents were too early in their testing/re-purposing phase to demonstrate improvements in sleepiness, quality of life or sustained reductions of OSA severity; or were insufficiently targeted at the endotype they might best treat.
{"title":"Pharmacotherapy for obstructive sleep apnea: a critical review of randomized placebo-controlled trials","authors":"Steven Luu , Daryl Emery Chee Yeow Chan , Nathaniel S. Marshall , Craig L. Phillips , Ronald R. Grunstein , Brendon J. Yee","doi":"10.1016/j.smrv.2025.102169","DOIUrl":"10.1016/j.smrv.2025.102169","url":null,"abstract":"<div><div>Positive airway pressure therapy remains the gold standard treatment for obstructive sleep apnea (OSA), but challenges with adherence, acceptability, and side effects persist. Interest in pharmacological therapies has grown, culminating in the recent U.S. Food and Drug Administration approval of tirzepatide as the first pharmacotherapy for OSA. Our review critically examines the efficacy of pharmacologic treatments for OSA and highlights current limitations and future research directions.</div><div>We conducted a search of Medline and Embase for randomized controlled trials published from January 2005 to February 2025, identifying 41 studies investigating 37 different drugs or drug combinations.</div><div>Weight-loss therapies showed the most consistent and substantial improvements in OSA severity. Tirzepatide produced the largest reduction in apnea-hypopnea index and improved patient-reported outcomes and cardiometabolic risk factors. Other pharmacotherapies demonstrated modest and inconsistent effects on OSA severity, sometimes with side-effects that contradict the treatment goal to reduce daytime sleepiness.</div><div>Weight-loss agents, particularly tirzepatide, represent a promising and now clinically viable treatment option. While endotype-targeted approaches are conceptually attractive, many agents were too early in their testing/re-purposing phase to demonstrate improvements in sleepiness, quality of life or sustained reductions of OSA severity; or were insufficiently targeted at the endotype they might best treat.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102169"},"PeriodicalIF":9.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103143","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 : 2025-09-11DOI: 10.1016/j.smrv.2025.102163
Yixuan Cao , Tian Xie , Ning Ma
This meta-analysis quantified the impact of sleep loss (including both total sleep deprivation and partial sleep restriction) on core components of executive function: working memory, inhibitory control, and cognitive flexibility. A systematic search of Scopus, Web of Science, and PubMed identified 79 relevant publications. Using random-effects models, pooled effect sizes for reaction time and accuracy metrics were estimated separately within each task category. All reaction time metrics, except for cognitive flexibility, increased significantly following sleep loss, with medium to near-large effect sizes. Analysis of accuracy metrics revealed medium to large effect sizes on task-switching and task-repeat performance of cognitive flexibility, as well as on working memory maintenance, whereas a small effect size was observed on resolving interference inhibition. These findings highlight pervasive damage to all executive function components and suggest that the impaired common factor of executive functions may underpin sleep loss–related deterioration. Furthermore, the discrepancies between reaction time and accuracy effect sizes indicate opposite speed-accuracy trade-offs following sleep loss between interference inhibition and cognitive flexibility. This study provides essential evidence for understanding how sleep loss affects different components of executive function, emphasizing the importance of exploring sleep loss–related impairments from a comprehensive perspective.
这项荟萃分析量化了睡眠缺失（包括完全睡眠剥夺和部分睡眠限制）对执行功能核心组成部分的影响：工作记忆、抑制控制和认知灵活性。通过对Scopus、Web of Science和PubMed的系统搜索，确定了79篇相关出版物。使用随机效应模型，在每个任务类别中分别估计反应时间和准确性指标的综合效应大小。除认知灵活性外，所有反应时间指标在睡眠不足后都显著增加，效应大小中等至接近于大。准确度指标分析显示，在认知灵活性的任务转换和任务重复表现以及工作记忆维持方面存在中等到较大的效应，而在解决干扰抑制方面存在较小的效应。这些发现强调了对所有执行功能组成部分的普遍损害，并表明执行功能受损的共同因素可能是睡眠不足相关恶化的基础。此外，反应时间和准确性效应大小之间的差异表明，睡眠不足后，干扰抑制和认知灵活性之间的速度-准确性权衡是相反的。这项研究为理解睡眠不足如何影响执行功能的不同组成部分提供了必要的证据，强调了从全面的角度探索睡眠不足相关损伤的重要性。
{"title":"The impairments of sleep loss on core executive functions: General and task-specific effects","authors":"Yixuan Cao , Tian Xie , Ning Ma","doi":"10.1016/j.smrv.2025.102163","DOIUrl":"10.1016/j.smrv.2025.102163","url":null,"abstract":"<div><div>This meta-analysis quantified the impact of sleep loss (including both total sleep deprivation and partial sleep restriction) on core components of executive function: working memory, inhibitory control, and cognitive flexibility. A systematic search of Scopus, Web of Science, and PubMed identified 79 relevant publications. Using random-effects models, pooled effect sizes for reaction time and accuracy metrics were estimated separately within each task category. All reaction time metrics, except for cognitive flexibility, increased significantly following sleep loss, with medium to near-large effect sizes. Analysis of accuracy metrics revealed medium to large effect sizes on task-switching and task-repeat performance of cognitive flexibility, as well as on working memory maintenance, whereas a small effect size was observed on resolving interference inhibition. These findings highlight pervasive damage to all executive function components and suggest that the impaired common factor of executive functions may underpin sleep loss–related deterioration. Furthermore, the discrepancies between reaction time and accuracy effect sizes indicate opposite speed-accuracy trade-offs following sleep loss between interference inhibition and cognitive flexibility. This study provides essential evidence for understanding how sleep loss affects different components of executive function, emphasizing the importance of exploring sleep loss–related impairments from a comprehensive perspective.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102163"},"PeriodicalIF":9.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049762","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 : 2025-09-11DOI: 10.1016/j.smrv.2025.102166
Yaqi Li , Tingting Zhao , Lizhuo Lin , Jingyuan Zhang , Sunliu Liu , Yueyi Wu , Carlos Flores-Mir , Fang Hua , Hong He
This umbrella review evaluated the effects of mandibular advancement devices (MADs) on pediatric obstructive sleep apnea (PedOSA). We searched six databases for systematic reviews published up to June 2025, that included children with polysomnography (PSG)-diagnosed OSA managed with MADs. The primary outcome was the change in the apnea-hypopnea index (AHI). Secondary outcomes included oxygen saturation and skeletal/dental changes. Twelve systematic reviews, including 7 meta-analyses, were included. Management with MADs resulted in a reduction in AHI and a slight improvement in sagittal mandibular position. However, significant heterogeneity was observed due to variations in device designs, treatment duration, and patient characteristics. Most findings were based on before-after studies, with limited randomized controlled trials, reducing the robustness of the results. The methodological quality of the included systematic reviews, assessed using AMSTAR 2, was predominantly low or critically low, indicating significant flaws. A corrected covered area (CCA) analysis revealed substantial overlap (20.7 %) in primary studies. While MADs show promise as an adjunctive therapy for PedOSA management in indicated cases, the low methodological quality of the included systematic reviews limits the strength of the evidence. High-quality primary studies and systematic reviews are needed to confirm the impact of MADs in PedOSA management and guide clinical practice.
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