Pub Date : 2025-08-29DOI: 10.1016/j.smrv.2025.102156
Giovanna Hanike Santos da Silva , Eduardo Cerchi Barbosa , Fernanda Ribeiro de Lima , Douglas Carneiro Barroso , Loyná Euá Flores E. Paez , Felipe Bandeira de Melo Guimarães , Saulo Bernardo Lança , Stephanie Brito Ceolin de Faria , Arthur Bezerra Cavalcanti Petrucci , Alicja Garbacka , Jennifer H. Walsh
Study objectives
This systematic review and meta-analysis assessed the efficacy of cannabinoids compared to placebo for improving sleep quality.
Methods
Searches were conducted in MEDLINE, Embase, and Cochrane databases for randomised controlled trials comparing cannabinoids vs. placebo for improving sleep quality in adults with or without insomnia or poor sleep. The primary outcome was self-reported sleep quality (PROMIS, PSQI, LSEQ, Sleep Diary). Secondary outcomes included actigraphy parameters, anxiety (GAD-7, STAI-T), well-being (WHO-5 index), and insomnia severity (ISI). Additional analyses focused on sleep quality in (1) participants with insomnia or poor sleep, and (2) cannabidiol (CBD) vs. non-CBD interventions. Statistical analysis was performed using RevMan 5.4.1, with p < 0.05 considered significant.
Results
Six trials (1077 patients) were included. Cannabinoids significantly improved sleep quality compared to placebo [SMD 0.53; 95 % CI 0.03–1.02; p = 0.04; I2 = 88 %], particularly in those with insomnia or poor sleep [SMD 0.60; 95 % CI 0.09–1.11; p = 0.02; I2 = 89 %]. Non-CBD cannabinoids demonstrated greater efficacy [SMD 0.82; 95 % CI 0.24–1.40; p = 0.005], whereas CBD-only therapies showed no significant effect [SMD 0.13; 95 % CI -0.38-0.65; p = 0.61].
Conclusion
Cannabinoids, particularly non-CBD formulations, improve sleep quality, justifying further investigation as therapeutic options for insomnia or poor sleep.
本系统综述和荟萃分析评估了大麻素与安慰剂在改善睡眠质量方面的疗效。方法在MEDLINE、Embase和Cochrane数据库中进行随机对照试验，比较大麻素与安慰剂在改善有或无失眠或睡眠差的成年人睡眠质量方面的作用。主要终点是自我报告的睡眠质量（PROMIS、PSQI、LSEQ、睡眠日记）。次要结局包括活动参数、焦虑（GAD-7, STAI-T）、幸福感（WHO-5指数）和失眠严重程度（ISI）。其他的分析集中在(1)失眠或睡眠不好的参与者的睡眠质量，(2)大麻二酚（CBD）与非CBD干预。采用RevMan 5.4.1进行统计学分析，p <； 0.05为差异有统计学意义。结果共纳入6项试验（1077例）。与安慰剂相比，大麻素显著改善睡眠质量[SMD = 0.53；95% ci 0.03-1.02；p = 0.04；[2 = 88%]，尤其是那些失眠或睡眠质量差的人[SMD = 0.60；95% ci 0.09-1.11；p = 0.02；[2 = 89%]。非cbd大麻素表现出更大的疗效[SMD 0.82；95% ci 0.24-1.40；p = 0.005]，而仅使用cbd治疗无显著效果[SMD = 0.13；95% ci -0.38-0.65；p = 0.61]。结论大麻素，特别是非cbd制剂，可以改善睡眠质量，值得进一步研究作为失眠或睡眠不良的治疗选择。
{"title":"Effectiveness of cannabinoids on subjective sleep quality in people with and without insomnia or poor sleep: A systematic review and meta-analysis of randomised studies","authors":"Giovanna Hanike Santos da Silva , Eduardo Cerchi Barbosa , Fernanda Ribeiro de Lima , Douglas Carneiro Barroso , Loyná Euá Flores E. Paez , Felipe Bandeira de Melo Guimarães , Saulo Bernardo Lança , Stephanie Brito Ceolin de Faria , Arthur Bezerra Cavalcanti Petrucci , Alicja Garbacka , Jennifer H. Walsh","doi":"10.1016/j.smrv.2025.102156","DOIUrl":"10.1016/j.smrv.2025.102156","url":null,"abstract":"<div><h3>Study objectives</h3><div>This systematic review and meta-analysis assessed the efficacy of cannabinoids compared to placebo for improving sleep quality.</div></div><div><h3>Methods</h3><div>Searches were conducted in MEDLINE, Embase, and Cochrane databases for randomised controlled trials comparing cannabinoids vs. placebo for improving sleep quality in adults with or without insomnia or poor sleep. The primary outcome was self-reported sleep quality (PROMIS, PSQI, LSEQ, Sleep Diary). Secondary outcomes included actigraphy parameters, anxiety (GAD-7, STAI-T), well-being (WHO-5 index), and insomnia severity (ISI). Additional analyses focused on sleep quality in (1) participants with insomnia or poor sleep, and (2) cannabidiol (CBD) vs. non-CBD interventions. Statistical analysis was performed using RevMan 5.4.1, with p < 0.05 considered significant.</div></div><div><h3>Results</h3><div>Six trials (1077 patients) were included. Cannabinoids significantly improved sleep quality compared to placebo [SMD 0.53; 95 % CI 0.03–1.02; p = 0.04; I2 = 88 %], particularly in those with insomnia or poor sleep [SMD 0.60; 95 % CI 0.09–1.11; p = 0.02; I2 = 89 %]. Non-CBD cannabinoids demonstrated greater efficacy [SMD 0.82; 95 % CI 0.24–1.40; p = 0.005], whereas CBD-only therapies showed no significant effect [SMD 0.13; 95 % CI -0.38-0.65; p = 0.61].</div></div><div><h3>Conclusion</h3><div>Cannabinoids, particularly non-CBD formulations, improve sleep quality, justifying further investigation as therapeutic options for insomnia or poor sleep.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"84 ","pages":"Article 102156"},"PeriodicalIF":9.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020948","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 : 2025-08-19DOI: 10.1016/j.smrv.2025.102153
Elisabeth Hertenstein , Marie Angelillo , Pauline Henckaerts , Carlotta L. Schneider , Kristoffer D. Fehér , Dieter Riemann , Bernd Feige , Kai Spiegelhalder , Anna Johann , Cagdas Türkmen , Christoph Nissen
Insomnia disorder is a prevalent health problem with adverse consequences for mental health and quality of life. Although insomnia disorder is defined in diagnostic systems as a subjective complaint about sleep, this understanding is not consistently applied in clinical settings. There remains a lack of clarity regarding the mechanisms underlying subjective sleep complaints and associated daytime impairments.
This systematic umbrella review of meta-analyses aimed to compare subjective and objective health-related variables between patients with insomnia disorder and controls, characterizing insomnia comprehensively. After a systematic literature search, we included six meta-analyses comparing patients with insomnia disorder and controls in terms of subjective sleep (sleep diaries), objective sleep (polysomnography), peripheral brain-derived neurotrophic factor, cortisol, objective cognitive performance, blood pressure and EEG spectral power.
The pattern of results suggests that differences between patients with insomnia disorder and healthy controls are largest and most consistent for subjective sleep. Objective between-group effect sizes were largest for unspecific stress markers such as brain-derived neurotrophic factor and cortisol. Variables expected to be abnormal in those with objective sleep deprivation, such as objective attention and alertness, showed minimal group differences. Also in terms of sleep, effect sizes for subjective variables were consistently larger than those for objective variables. Critical appraisal of the quality of the included meta-analyses using the AMSTAR 2 tool suggested moderate overall confidence in the results, whereby shortcomings in several critical domains such as pre-registration of the study protocol and justification for the inclusion of individual studies have been identified.
Our findings highlight that insomnia disorder is characterized by large reductions in subjective sleep quality, in the absence of large objective alterations. This body of evidence supports a biopsychosocial conceptualization of chronic insomnia disorder with a strong psychological component.
{"title":"Comparing subjective and objective nighttime- and daytime variables between patients with insomnia disorder and controls – a systematic umbrella review of meta-analyses","authors":"Elisabeth Hertenstein , Marie Angelillo , Pauline Henckaerts , Carlotta L. Schneider , Kristoffer D. Fehér , Dieter Riemann , Bernd Feige , Kai Spiegelhalder , Anna Johann , Cagdas Türkmen , Christoph Nissen","doi":"10.1016/j.smrv.2025.102153","DOIUrl":"10.1016/j.smrv.2025.102153","url":null,"abstract":"<div><div>Insomnia disorder is a prevalent health problem with adverse consequences for mental health and quality of life. Although insomnia disorder is defined in diagnostic systems as a subjective complaint about sleep, this understanding is not consistently applied in clinical settings. There remains a lack of clarity regarding the mechanisms underlying subjective sleep complaints and associated daytime impairments.</div><div>This systematic umbrella review of meta-analyses aimed to compare subjective and objective health-related variables between patients with insomnia disorder and controls, characterizing insomnia comprehensively. After a systematic literature search, we included six meta-analyses comparing patients with insomnia disorder and controls in terms of subjective sleep (sleep diaries), objective sleep (polysomnography), peripheral brain-derived neurotrophic factor, cortisol, objective cognitive performance, blood pressure and EEG spectral power.</div><div>The pattern of results suggests that differences between patients with insomnia disorder and healthy controls are largest and most consistent for subjective sleep. Objective between-group effect sizes were largest for unspecific stress markers such as brain-derived neurotrophic factor and cortisol. Variables expected to be abnormal in those with objective sleep deprivation, such as objective attention and alertness, showed minimal group differences. Also in terms of sleep, effect sizes for subjective variables were consistently larger than those for objective variables. Critical appraisal of the quality of the included meta-analyses using the AMSTAR 2 tool suggested moderate overall confidence in the results, whereby shortcomings in several critical domains such as pre-registration of the study protocol and justification for the inclusion of individual studies have been identified.</div><div>Our findings highlight that insomnia disorder is characterized by large reductions in subjective sleep quality, in the absence of large objective alterations. This body of evidence supports a biopsychosocial conceptualization of chronic insomnia disorder with a strong psychological component.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102153"},"PeriodicalIF":9.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888658","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 : 2025-08-13DOI: 10.1016/j.smrv.2025.102154
Debora Meneo , Chiara Baglioni
Animals do not simply fall asleep when they need rest. Without conscious effort, most animals engage in a series of sleep-preparatory behaviors, such as nesting. These are stereotypical actions performed in a temporally structured pre-sleep phase. Researchers have examined these behaviors from an evolutionary perspective, as they must provide some advantage. One hypothesis is that they have an indirect fitness benefit by facilitating de-arousal, making it easier to transition from wakefulness to sleep. In humans, regular positive bedtime routines are considered a main pediatric dimension of sleep health. In adults, difficulty in de-arousal at bedtime is a major issue for people with insomnia. Cognitive models of insomnia stress the strict association between arousal and cognitive-emotional factors driving behaviors. However, there is a lack of a unified framework to address the interplay between pre-sleep behaviors, psychological processes, and arousal levels in promoting or inhibiting evening winding down and wake-to-sleep transition. This narrative review aims to explore the role of behavioral components of sleep regulation, by focusing on the dynamical association between pre-sleep behaviors, cognitions, motivations, emotions, and arousal in relation to sleep health. We propose a framework to understand and investigate winding down behaviors as part of sleep regulation in humans.
{"title":"Winding down for sleep: How behavioral, cognitive, motivational, and emotional factors interact to influence sleep regulation and health","authors":"Debora Meneo , Chiara Baglioni","doi":"10.1016/j.smrv.2025.102154","DOIUrl":"10.1016/j.smrv.2025.102154","url":null,"abstract":"<div><div>Animals do not simply fall asleep when they need rest. Without conscious effort, most animals engage in a series of sleep-preparatory behaviors, such as nesting. These are stereotypical actions performed in a temporally structured pre-sleep phase. Researchers have examined these behaviors from an evolutionary perspective, as they must provide some advantage. One hypothesis is that they have an indirect fitness benefit by facilitating de-arousal, making it easier to transition from wakefulness to sleep. In humans, regular positive bedtime routines are considered a main pediatric dimension of sleep health. In adults, difficulty in de-arousal at bedtime is a major issue for people with insomnia. Cognitive models of insomnia stress the strict association between arousal and cognitive-emotional factors driving behaviors. However, there is a lack of a unified framework to address the interplay between pre-sleep behaviors, psychological processes, and arousal levels in promoting or inhibiting evening winding down and wake-to-sleep transition. This narrative review aims to explore the role of behavioral components of sleep regulation, by focusing on the dynamical association between pre-sleep behaviors, cognitions, motivations, emotions, and arousal in relation to sleep health. We propose a framework to understand and investigate winding down behaviors as part of sleep regulation in humans.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102154"},"PeriodicalIF":9.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880267","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 : 2025-08-12DOI: 10.1016/j.smrv.2025.102152
Yoshiyasu Takefuji
Kilic et al. reviewed machine learning (ML) and deep learning (DL) for sleep apnea detection, emphasizing explainable AI (XAI) while noting challenges like Apnea-Hypopnea Index (AHI) discrepancies. This paper extends their critique, arguing that XAI tools like SHAP inherit model biases, and high prediction accuracy does not guarantee reliable feature importances, which inherently lack ground truth validation. To overcome these limitations and build clinical trust, we advocate for a comprehensive approach combining unsupervised ML (e.g., feature agglomeration, highly variable gene selection) with nonlinear nonparametric statistical methods (e.g., Spearman's correlation). This strategy robustly evaluates variable relationships and p-values, particularly for monotonic associations, mitigating misapplications stemming from assumption violations and inadequate interpretation of model ground truth, thus fostering real-world applicability.
{"title":"Beyond explainable AI: Enhancing trust and robustness in machine learning for sleep apnea diagnosis","authors":"Yoshiyasu Takefuji","doi":"10.1016/j.smrv.2025.102152","DOIUrl":"10.1016/j.smrv.2025.102152","url":null,"abstract":"<div><div>Kilic et al. reviewed machine learning (ML) and deep learning (DL) for sleep apnea detection, emphasizing explainable AI (XAI) while noting challenges like Apnea-Hypopnea Index (AHI) discrepancies. This paper extends their critique, arguing that XAI tools like SHAP inherit model biases, and high prediction accuracy does not guarantee reliable feature importances, which inherently lack ground truth validation. To overcome these limitations and build clinical trust, we advocate for a comprehensive approach combining unsupervised ML (e.g., feature agglomeration, highly variable gene selection) with nonlinear nonparametric statistical methods (e.g., Spearman's correlation). This strategy robustly evaluates variable relationships and p-values, particularly for monotonic associations, mitigating misapplications stemming from assumption violations and inadequate interpretation of model ground truth, thus fostering real-world applicability.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102152"},"PeriodicalIF":9.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852758","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 : 2025-08-12DOI: 10.1016/j.smrv.2025.102151
Lili Yi
{"title":"Commentary on \"The impact of maternal sleep during pregnancy on childhood health: A systematic review\"","authors":"Lili Yi","doi":"10.1016/j.smrv.2025.102151","DOIUrl":"10.1016/j.smrv.2025.102151","url":null,"abstract":"","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102151"},"PeriodicalIF":9.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830695","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 : 2025-08-09DOI: 10.1016/j.smrv.2025.102150
Ann Rosén , Maria Cassel , Johanna Stjernberg , Joel Stenfalk , Kerstin Blom , Sandra Tamm , Torbjörn Åkerstedt , Rickard Carlsson , Susanna Jernelöv
Cognitive behavioural therapy for insomnia includes methods to adjust bedtimes and risetimes. The most well-known is sleep restriction therapy, but alternatives like sleep compression therapy and bedtime regularization also exist. Instructions and terminology vary. This scoping review uses "time-in-bed manipulation therapy" to encompass all such interventions, aiming to synthesize information on their implementation in adult populations, focusing on different instructions found in the literature.
We searched five electronic databases. Two independent reviewers screened full-text papers, followed by data extraction. Both quantitative (e.g., instruction frequencies) and qualitative (e.g., analysis of content) syntheses were conducted.
Of 7474 citations and 500 full-text papers, 52 studies met inclusion criteria, covering 60 therapies. Most interventions were termed sleep restriction therapy, but other names, such as sleep compression and bedtime restriction, were also used. Nine different methods for calculating the initial sleep window were identified, with further variation in other instructions. About half of the studies were randomized controlled trials.
This review provides a comprehensive overview of time-in-bed manipulation therapies, aiding researchers and clinicians in selecting appropriate approaches. It highlights the need for clearer reporting, increased direct comparisons, and suggests a new model, The Restriction and Flexibility Model, describing key dimensions of these interventions.
{"title":"Variants of time in bed manipulation therapy for patients with insomnia: A scoping review","authors":"Ann Rosén , Maria Cassel , Johanna Stjernberg , Joel Stenfalk , Kerstin Blom , Sandra Tamm , Torbjörn Åkerstedt , Rickard Carlsson , Susanna Jernelöv","doi":"10.1016/j.smrv.2025.102150","DOIUrl":"10.1016/j.smrv.2025.102150","url":null,"abstract":"<div><div>Cognitive behavioural therapy for insomnia includes methods to adjust bedtimes and risetimes. The most well-known is sleep restriction therapy, but alternatives like sleep compression therapy and bedtime regularization also exist. Instructions and terminology vary. This scoping review uses \"time-in-bed manipulation therapy\" to encompass all such interventions, aiming to synthesize information on their implementation in adult populations, focusing on different instructions found in the literature.</div><div>We searched five electronic databases. Two independent reviewers screened full-text papers, followed by data extraction. Both quantitative (e.g., instruction frequencies) and qualitative (e.g., analysis of content) syntheses were conducted.</div><div>Of 7474 citations and 500 full-text papers, 52 studies met inclusion criteria, covering 60 therapies. Most interventions were termed sleep restriction therapy, but other names, such as sleep compression and bedtime restriction, were also used. Nine different methods for calculating the initial sleep window were identified, with further variation in other instructions. About half of the studies were randomized controlled trials.</div><div>This review provides a comprehensive overview of time-in-bed manipulation therapies, aiding researchers and clinicians in selecting appropriate approaches. It highlights the need for clearer reporting, increased direct comparisons, and suggests a new model, The Restriction and Flexibility Model, describing key dimensions of these interventions.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102150"},"PeriodicalIF":9.7,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865998","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 : 2025-08-07DOI: 10.1016/j.smrv.2025.102149
Federico J. Blanco-García , José A. López-López , Juan R. Ordoñana , Juan J. Madrid-Valero
There is a well-established link between sleep disorders and psychological problems such as anxiety and depression. Twin studies and genome-wide association studies (GWAS) have consistently found significant genetic overlap between these traits. However, there is considerable variation among studies. The aims of this meta-analysis were therefore: 1) to estimate the mean genetic correlation between sleep problems and psychological distress; 2) to assess heterogeneity among the included studies; and 3) to search for potential moderators that could contribute to this heterogeneity. To this end, we performed several multivariate meta-analyses. The mean genetic correlations were estimated to be 0.55 (CI: 0.47–0.63) for sleep quality and depression, 0.72 (CI: 0.59–0.85) for insomnia symptoms and depression, 0.42 (CI: 0.30–0.54) for sleep quality and anxiety, and 0.75 (CI: 0.59–0.91) for insomnia symptoms and anxiety. Similar results were obtained when depression and anxiety were collapsed (0.54 [CI: 0.44–0.64] for sleep quality and 0.77 [CI: 0.63–0.91] for insomnia symptoms). Sex did not significantly moderate these associations. Study type (twin studies vs GWAS) and age, however, were significant moderators (p < 0.001). These findings highlight the substantial genetic overlap between psychological distress and sleep problems, which appears to be stronger for insomnia symptoms than for sleep quality.
{"title":"Genetic association between sleep quality, insomnia, and psychological distress: a systematic review and meta-analysis","authors":"Federico J. Blanco-García , José A. López-López , Juan R. Ordoñana , Juan J. Madrid-Valero","doi":"10.1016/j.smrv.2025.102149","DOIUrl":"10.1016/j.smrv.2025.102149","url":null,"abstract":"<div><div>There is a well-established link between sleep disorders and psychological problems such as anxiety and depression. Twin studies and genome-wide association studies (GWAS) have consistently found significant genetic overlap between these traits. However, there is considerable variation among studies. The aims of this meta-analysis were therefore: 1) to estimate the mean genetic correlation between sleep problems and psychological distress; 2) to assess heterogeneity among the included studies; and 3) to search for potential moderators that could contribute to this heterogeneity. To this end, we performed several multivariate meta-analyses. The mean genetic correlations were estimated to be 0.55 (CI: 0.47–0.63) for sleep quality and depression, 0.72 (CI: 0.59–0.85) for insomnia symptoms and depression, 0.42 (CI: 0.30–0.54) for sleep quality and anxiety, and 0.75 (CI: 0.59–0.91) for insomnia symptoms and anxiety. Similar results were obtained when depression and anxiety were collapsed (0.54 [CI: 0.44–0.64] for sleep quality and 0.77 [CI: 0.63–0.91] for insomnia symptoms). Sex did not significantly moderate these associations. Study type (twin studies vs GWAS) and age, however, were significant moderators (p < 0.001). These findings highlight the substantial genetic overlap between psychological distress and sleep problems, which appears to be stronger for insomnia symptoms than for sleep quality.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102149"},"PeriodicalIF":9.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885594","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}
Asthma and obstructive sleep apnea are complex diseases that significantly impact the health-related quality of life and overall health status of patients. Recent evidence points towards an increased prevalence of obstructive sleep apnea in asthmatic patients, especially in those with severe and uncontrolled asthma, potentially leading to worse asthma control with increased symptoms, diminished health status and more frequent exacerbations. The mechanisms underlying this association are not fully elucidated. However, because obstructive sleep apnea is treatable, screening for sleep disorders should be considered in patients with severe asthma and uncontrolled disease. The efficacy and implications of treatment with continuous positive airway pressure to improve asthma control remain unclear, although there are some promising results showing improved asthma outcomes. Further research is needed to enlighten the relationship between asthma and obstructive sleep apnea, and to better define the role of continuous positive airway pressure therapy in improving asthma control and outcomes in comorbid patients with asthma and obstructive sleep apnea. Here we review the state-of-the-art in this field.
{"title":"Asthma and obstructive sleep apnea: A complex but treatable relationship","authors":"Ignasi Español , Ebymar Arismendi , Pilar Martínez-Olondris , Concepción Ruiz , Cristina Embid , Jennifer Garcia , Alvar Agustí , Mireia Dalmases","doi":"10.1016/j.smrv.2025.102146","DOIUrl":"10.1016/j.smrv.2025.102146","url":null,"abstract":"<div><div>Asthma and obstructive sleep apnea are complex diseases that significantly impact the health-related quality of life and overall health status of patients. Recent evidence points towards an increased prevalence of obstructive sleep apnea in asthmatic patients, especially in those with severe and uncontrolled asthma, potentially leading to worse asthma control with increased symptoms, diminished health status and more frequent exacerbations. The mechanisms underlying this association are not fully elucidated. However, because obstructive sleep apnea is treatable, screening for sleep disorders should be considered in patients with severe asthma and uncontrolled disease. The efficacy and implications of treatment with continuous positive airway pressure to improve asthma control remain unclear, although there are some promising results showing improved asthma outcomes. Further research is needed to enlighten the relationship between asthma and obstructive sleep apnea, and to better define the role of continuous positive airway pressure therapy in improving asthma control and outcomes in comorbid patients with asthma and obstructive sleep apnea. Here we review the state-of-the-art in this field.</div></div>","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102146"},"PeriodicalIF":9.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888802","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 : 2025-08-05DOI: 10.1016/j.smrv.2025.102141
Pauline Henckaerts , Kristoffer D. Fehér , Elisabeth Hertenstein , Carlotta L. Schneider , Marie Angelillo , Christian Mikutta , Bernd Feige , Dieter Riemann , Christoph Nissen
Slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep is the primary marker of sleep homeostasis and proposed to reflect synaptic strength. SWA might be reduced in patients with major depressive disorder (MDD), potentially reflecting reduced synaptic strength (synaptic plasticity hypothesis of MDD). In view of inconsistent findings in the previous literature, the aim of this meta-analysis was to test the hypothesis of reduced SWA in patients with MDD compared to healthy controls. PubMed, CINAHL and PsychInfo were searched for original publications comparing SWA during NREM sleep in adult patients with MDD to healthy controls. A random-effects model for meta-analyses was calculated using Hedges' g. The study was pre-registered in the international prospective register of systematic reviews (PROSPERO CRD42024537138). Five studies comprising 229 participants were included. The meta-analysis demonstrated a significant reduction of SWA during NREM sleep in patients with MDD compared to healthy controls (p = 0.0003, g = −0.5, medium effect-size, confidence interval −0.8 to −0.2) with low heterogeneity (Q-test; p = 0.518, I2 = 0 %). This meta-analysis demonstrates a significant reduction of SWA during NREM sleep in patients with MDD compared to healthy controls, consistent with the concept of reduced synaptic strength in patients with MDD.
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Pub Date : 2025-08-05DOI: 10.1016/j.smrv.2025.102148
Andre C. Tonon , Benicio N. Frey
{"title":"Redefining sleep disturbances in bipolar disorder beyond broad constructs","authors":"Andre C. Tonon , Benicio N. Frey","doi":"10.1016/j.smrv.2025.102148","DOIUrl":"10.1016/j.smrv.2025.102148","url":null,"abstract":"","PeriodicalId":49513,"journal":{"name":"Sleep Medicine Reviews","volume":"83 ","pages":"Article 102148"},"PeriodicalIF":9.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779850","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}
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