Study objectives: Maternal reports are a primary source of information regarding infant sleep and temperament, yet these perceptions may be influenced by maternal psychological factors. Prior research suggests complex relationships between maternal mood and perceptions of infant behavior, but longitudinal data remain scarce.
Methods: This longitudinal study examined how maternal sleep quality and depressive symptoms relate to perceived infant temperament and sleep difficulties. A community sample of 76 mothers with healthy full-term infants completed questionnaires at approximately 6 and 12 months postpartum. Measures included the Infant Sleep Questionnaire, the Infant Behavior Questionnaire, the Pittsburgh Sleep Quality Index, and the Edinburgh Postnatal Depression Scale. Seemingly unrelated regression models and Shapley value decomposition were used to assess predictors of perceived infant sleep and temperament.
Results: Perceived sleep difficulties and negative temperament were significantly correlated (at 6 months: R = .243, P = .040; at 12 months: R = .364, P = .002). However, Infant Sleep Questionnaire scores at 12 months were best predicted by temporally proximal nighttime awakenings, accounting 40.8% of the variance explained by the model, whereas Infant Behavior Questionnaire negative affectivity was predicted by earlier maternal depressive symptoms (24.9%), sleep difficulties (11.3%), and infant awakenings at 6 months (32.4% of explained variance).
Conclusions: These findings suggest distinct cognitive bases for maternal perceptions of infant sleep and temperament. While infant sleep behaviors largely drive perceived sleep problems, maternal psychological well-being significantly influences perceptions of temperament. Understanding the differential impact of maternal factors can inform assessment strategies and interventions aimed at promoting infant well-being.
Citation: Hairston IS, Handelzalts JE. Decoding maternal perceptions: divergent predictors of perceived infant sleep problems and temperament. J Clin Sleep Med. 2025;21(12):2081-2090.
{"title":"Decoding maternal perceptions: divergent predictors of perceived infant sleep problems and temperament.","authors":"Ilana S Hairston, Jonathan E Handelzalts","doi":"10.5664/jcsm.11880","DOIUrl":"10.5664/jcsm.11880","url":null,"abstract":"<p><strong>Study objectives: </strong>Maternal reports are a primary source of information regarding infant sleep and temperament, yet these perceptions may be influenced by maternal psychological factors. Prior research suggests complex relationships between maternal mood and perceptions of infant behavior, but longitudinal data remain scarce.</p><p><strong>Methods: </strong>This longitudinal study examined how maternal sleep quality and depressive symptoms relate to perceived infant temperament and sleep difficulties. A community sample of 76 mothers with healthy full-term infants completed questionnaires at approximately 6 and 12 months postpartum. Measures included the Infant Sleep Questionnaire, the Infant Behavior Questionnaire, the Pittsburgh Sleep Quality Index, and the Edinburgh Postnatal Depression Scale. Seemingly unrelated regression models and Shapley value decomposition were used to assess predictors of perceived infant sleep and temperament.</p><p><strong>Results: </strong>Perceived sleep difficulties and negative temperament were significantly correlated (at 6 months: <i>R =</i> .243, <i>P</i> = .040; at 12 months: <i>R =</i> .364, <i>P</i> = .002). However, Infant Sleep Questionnaire scores at 12 months were best predicted by temporally proximal nighttime awakenings, accounting 40.8% of the variance explained by the model, whereas Infant Behavior Questionnaire negative affectivity was predicted by earlier maternal depressive symptoms (24.9%), sleep difficulties (11.3%), and infant awakenings at 6 months (32.4% of explained variance).</p><p><strong>Conclusions: </strong>These findings suggest distinct cognitive bases for maternal perceptions of infant sleep and temperament. While infant sleep behaviors largely drive perceived sleep problems, maternal psychological well-being significantly influences perceptions of temperament. Understanding the differential impact of maternal factors can inform assessment strategies and interventions aimed at promoting infant well-being.</p><p><strong>Citation: </strong>Hairston IS, Handelzalts JE. Decoding maternal perceptions: divergent predictors of perceived infant sleep problems and temperament. <i>J Clin Sleep Med</i>. 2025;21(12):2081-2090.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2081-2090"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Safwan Badr, Rami N Khayat, J Shirine Allam, Suzanne Hyer, Reem A Mustafa, Matthew T Naughton, Susheel Patil, Grace W Pien, Winfried Randerath, Christine Won
<p><strong>Introduction: </strong>This guideline establishes clinical practice recommendations for treatment of central sleep apnea (CSA) syndromes in adults.</p><p><strong>Methods: </strong>The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. The task force provided a summary of the relevant literature and the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations.</p><p><strong>Good practice statement: </strong>The following good practice statement is based on expert consensus, and its implementation is necessary for the appropriate and effective management of patients with CSA. The optimal approach to CSA treatment should incorporate clinical features, comorbid conditions, and polysomnographic findings in an individualized manner. Specifically, clinicians must prioritize optimizing therapy for the conditions contributing to central apneas and improving patient-reported outcomes rather than solely focusing on eliminating disordered breathing events. Once therapy for CSA has been initiated, persistence of central respiratory events should prompt re-evaluation of the underlying risk factors and consideration of alternative treatment options.</p><p><strong>Recommendations: </strong>The following recommendations are intended as a guide for clinicians in choosing a specific treatment for adults with CSA. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend …") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest …") is one that clinicians should offer to most patients if clinically appropriate. Some recommendations include remarks that provide additional context to guide clinicians with the implementation of this recommendation.</p><p><p>1. The AASM suggests using continuous positive airway pressure over no continuous positive airway pressure in adults with CSA due to the following etiologies: primary CSA, CSA due to heart failure, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, low certainty of evidence).</p><p><p>2. The AASM suggests using bilevel positive airway pressure <i>with a backup rate</i> over no bilevel positive airway pressure with a backup rate in adults with CSA due to the following etiologies: primary CSA, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, very low certainty of evidence).</p><p><p>3. Th
{"title":"Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine clinical practice guideline.","authors":"M Safwan Badr, Rami N Khayat, J Shirine Allam, Suzanne Hyer, Reem A Mustafa, Matthew T Naughton, Susheel Patil, Grace W Pien, Winfried Randerath, Christine Won","doi":"10.5664/jcsm.11858","DOIUrl":"10.5664/jcsm.11858","url":null,"abstract":"<p><strong>Introduction: </strong>This guideline establishes clinical practice recommendations for treatment of central sleep apnea (CSA) syndromes in adults.</p><p><strong>Methods: </strong>The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. The task force provided a summary of the relevant literature and the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations.</p><p><strong>Good practice statement: </strong>The following good practice statement is based on expert consensus, and its implementation is necessary for the appropriate and effective management of patients with CSA. The optimal approach to CSA treatment should incorporate clinical features, comorbid conditions, and polysomnographic findings in an individualized manner. Specifically, clinicians must prioritize optimizing therapy for the conditions contributing to central apneas and improving patient-reported outcomes rather than solely focusing on eliminating disordered breathing events. Once therapy for CSA has been initiated, persistence of central respiratory events should prompt re-evaluation of the underlying risk factors and consideration of alternative treatment options.</p><p><strong>Recommendations: </strong>The following recommendations are intended as a guide for clinicians in choosing a specific treatment for adults with CSA. Each recommendation statement is assigned a strength (\"Strong\" or \"Conditional\"). A \"Strong\" recommendation (ie, \"We recommend …\") is one that clinicians should follow under most circumstances. A \"Conditional\" recommendation (ie, \"We suggest …\") is one that clinicians should offer to most patients if clinically appropriate. Some recommendations include remarks that provide additional context to guide clinicians with the implementation of this recommendation.</p><p><p>1. The AASM suggests using continuous positive airway pressure over no continuous positive airway pressure in adults with CSA due to the following etiologies: primary CSA, CSA due to heart failure, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, low certainty of evidence).</p><p><p>2. The AASM suggests using bilevel positive airway pressure <i>with a backup rate</i> over no bilevel positive airway pressure with a backup rate in adults with CSA due to the following etiologies: primary CSA, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, very low certainty of evidence).</p><p><p>3. Th","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2181-2191"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristin N Sheehan, Kang Rui Xiang, Courtney L Rowland, Amit K Saha, Marissa J Millard, Laura S Dean, Samantha Shirk, Melissa Kozakiewicz, David W Carter, Adam R Schertz, Jonathan D Prest, Daniel Forest, Stephanie N Cedeno, Stephen P Peters, Edward F Haponik, Abigail L Koch, Andrew M Namen
Study objectives: Obstructive sleep apnea (OSA) is an underrecognized risk factor for pregnancy complications. Sleep questionnaires vary in their ability to predict pregnant patients at risk for OSA. We aimed to assess the fidelity of the DoISnorePreg questionnaire, compare its performance with the Berlin Questionnaire, and assess the impact of the Epworth Sleepiness Scale in high-risk obstetric patients.
Methods: Patients without history of preeclampsia or gestational diabetes were recruited from a high-risk obstetric clinic, completed sleep questionnaires, and underwent a home sleep apnea test at 28 weeks of gestation. Patients were followed through pregnancy to assess maternal and neonatal outcomes. The predictive value of the questionnaires for OSA was assessed using C-statistics.
Results: Thirty-nine percent of participants had an apnea-hypopnea index ≥ 5, among whom 29% had moderate or severe OSA. Patients with OSA had higher body mass indexes, older ages, higher sleepiness scores, more profound oxygen desaturations, longer postpartum lengths of stay, and newborns with increased neonatal intensive care unit admissions. DoISnorePreg outperformed the Berlin Questionnaire with an area under the receiver operating curve of 0.74 vs 0.58. The Epworth Sleepiness Scale did not enhance the performance of either questionnaire. A threshold of ≥ 4 positive responses on DoISnorePreg best predicted patients at risk for OSA with 89% sensitivity and 43% specificity (P < .01).
Conclusions: Prevalence of OSA among high-risk obstetric patients is high. Clinical implications of oxygen desaturations, longer hospital stays, and neonatal intensive care unit admissions highlight the need for screening. DoISnorePreg is a valid predictive tool that helps fill a gap in screening this high-risk population.
Citation: Sheehan KN, Xiang KR, Rowland CL, et al. Validation of obstructive sleep apnea questionnaires in high-risk pregnancy. J Clin Sleep Med. 2025;21(12):2155-2163.
{"title":"Validation of obstructive sleep apnea questionnaires in high-risk pregnancy.","authors":"Kristin N Sheehan, Kang Rui Xiang, Courtney L Rowland, Amit K Saha, Marissa J Millard, Laura S Dean, Samantha Shirk, Melissa Kozakiewicz, David W Carter, Adam R Schertz, Jonathan D Prest, Daniel Forest, Stephanie N Cedeno, Stephen P Peters, Edward F Haponik, Abigail L Koch, Andrew M Namen","doi":"10.5664/jcsm.11906","DOIUrl":"10.5664/jcsm.11906","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is an underrecognized risk factor for pregnancy complications. Sleep questionnaires vary in their ability to predict pregnant patients at risk for OSA. We aimed to assess the fidelity of the DoISnorePreg questionnaire, compare its performance with the Berlin Questionnaire, and assess the impact of the Epworth Sleepiness Scale in high-risk obstetric patients.</p><p><strong>Methods: </strong>Patients without history of preeclampsia or gestational diabetes were recruited from a high-risk obstetric clinic, completed sleep questionnaires, and underwent a home sleep apnea test at 28 weeks of gestation. Patients were followed through pregnancy to assess maternal and neonatal outcomes. The predictive value of the questionnaires for OSA was assessed using C-statistics.</p><p><strong>Results: </strong>Thirty-nine percent of participants had an apnea-hypopnea index ≥ 5, among whom 29% had moderate or severe OSA. Patients with OSA had higher body mass indexes, older ages, higher sleepiness scores, more profound oxygen desaturations, longer postpartum lengths of stay, and newborns with increased neonatal intensive care unit admissions. DoISnorePreg outperformed the Berlin Questionnaire with an area under the receiver operating curve of 0.74 vs 0.58. The Epworth Sleepiness Scale did not enhance the performance of either questionnaire. A threshold of ≥ 4 positive responses on DoISnorePreg best predicted patients at risk for OSA with 89% sensitivity and 43% specificity (<i>P</i> < .01).</p><p><strong>Conclusions: </strong>Prevalence of OSA among high-risk obstetric patients is high. Clinical implications of oxygen desaturations, longer hospital stays, and neonatal intensive care unit admissions highlight the need for screening. DoISnorePreg is a valid predictive tool that helps fill a gap in screening this high-risk population.</p><p><strong>Citation: </strong>Sheehan KN, Xiang KR, Rowland CL, et al. Validation of obstructive sleep apnea questionnaires in high-risk pregnancy. <i>J Clin Sleep Med.</i> 2025;21(12):2155-2163.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2155-2163"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaël A Schmuziger, Maamed Mademilov, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Konstantinos Bitos, Lara Muralt, Julian Müller, Azamat Akylbekov, Gulzada Mirzalieva, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch, Michael Furian
Study objectives: Patients with chronic obstructive pulmonary disease may experience cerebral tissue deoxygenation during altitude travel, especially during sleep. We quantified nocturnal cerebral (CTO) and arterial oxygenation (SpO2) in patients with chronic obstructive pulmonary disease during a stay at 3,100 m and evaluated the effects of preventive acetazolamide therapy.
Methods: Patients with moderate-to-severe chronic obstructive pulmonary disease, living at an altitude < 800 m, underwent nocturnal pulse oximetry and cerebral tissue oximetry by near-infrared spectroscopy at 760 m and during the first night at 3,100 m. Patients were randomized to 375 mg/d acetazolamide or placebo starting 24 hours before ascent and while staying at 3,100 m. Altitude and acetazolamide effects on CTO and other outcomes were evaluated by mixed linear regression analysis.
Results: Fifty-two patients, 9 female, mean ± standard deviation age 55.4 ± 8.9 years, forced expiratory volume in 1 second 60 ± 13% predicted, were included in the analyses. When ascending from 760 to 3,100 m, in those taking placebo (n = 17) CTO and SpO2 decreased from 66.5 ± 1.0% to 63.4 ± 1.0% (P < .05) and from 90.8 ± 0.4% to 83.7 ± 0.4% (P < .05), respectively; cerebral and arterial oxygen desaturation indices (≥ 4% dips in CTO or SpO2, respectively) increased by a mean (95% confidence interval) of 6.2/h (4.0-8.5) and 19.5/h (13.2-25.9) (P < .05). Compared to placebo, the mean CTO (+2.3% [2.2-2.5]) and SpO2 (+2.1% [2.1-2.2]) were higher and the mean cerebral oxygen desaturation index (-4.4/h [-7.3 to -1.5]) and arterial oxygen desaturation index (-15.0/h [-23.1 to -6.9]) were lower in the acetazolamide group (P < .05 all effects).
Conclusions: Patients with chronic obstructive pulmonary disease traveling to 3,100 m experienced sustained and intermittent nocturnal cerebral deoxygenation related to hypoxemia. Acetazolamide mitigated these altitude-related deoxygenations, albeit not to lowland values.
Clinical trial registration: Registry: ClinicalTrials.gov; Name: Effect Of Acetazolamide On Altitude Related Illness In Patients With Respiratory Disease; URL: https://clinicaltrials.gov/study/NCT03156231; Identifier: NCT03156231.
Citation: Schmuziger YA, Mademilov M, Buergin A, et al. Nocturnal cerebral oxygenation in patients with COPD at altitude: data from a randomized clinical trial of acetazolamide. J Clin Sleep Med. 2025;21(12):2051-2061.
{"title":"Nocturnal cerebral oxygenation in patients with COPD at altitude: data from a randomized clinical trial of acetazolamide.","authors":"Yaël A Schmuziger, Maamed Mademilov, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Konstantinos Bitos, Lara Muralt, Julian Müller, Azamat Akylbekov, Gulzada Mirzalieva, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch, Michael Furian","doi":"10.5664/jcsm.11868","DOIUrl":"10.5664/jcsm.11868","url":null,"abstract":"<p><strong>Study objectives: </strong>Patients with chronic obstructive pulmonary disease may experience cerebral tissue deoxygenation during altitude travel, especially during sleep. We quantified nocturnal cerebral (CTO) and arterial oxygenation (SpO<sub>2</sub>) in patients with chronic obstructive pulmonary disease during a stay at 3,100 m and evaluated the effects of preventive acetazolamide therapy.</p><p><strong>Methods: </strong>Patients with moderate-to-severe chronic obstructive pulmonary disease, living at an altitude < 800 m, underwent nocturnal pulse oximetry and cerebral tissue oximetry by near-infrared spectroscopy at 760 m and during the first night at 3,100 m. Patients were randomized to 375 mg/d acetazolamide or placebo starting 24 hours before ascent and while staying at 3,100 m. Altitude and acetazolamide effects on CTO and other outcomes were evaluated by mixed linear regression analysis.</p><p><strong>Results: </strong>Fifty-two patients, 9 female, mean ± standard deviation age 55.4 ± 8.9 years, forced expiratory volume in 1 second 60 ± 13% predicted, were included in the analyses. When ascending from 760 to 3,100 m, in those taking placebo (n = 17) CTO and SpO<sub>2</sub> decreased from 66.5 ± 1.0% to 63.4 ± 1.0% (<i>P</i> < .05) and from 90.8 ± 0.4% to 83.7 ± 0.4% (<i>P</i> < .05), respectively; cerebral and arterial oxygen desaturation indices (≥ 4% dips in CTO or SpO<sub>2</sub>, respectively) increased by a mean (95% confidence interval) of 6.2/h (4.0-8.5) and 19.5/h (13.2-25.9) (<i>P</i> < .05). Compared to placebo, the mean CTO (+2.3% [2.2-2.5]) and SpO<sub>2</sub> (+2.1% [2.1-2.2]) were higher and the mean cerebral oxygen desaturation index (-4.4/h [-7.3 to -1.5]) and arterial oxygen desaturation index (-15.0/h [-23.1 to -6.9]) were lower in the acetazolamide group (<i>P</i> < .05 all effects).</p><p><strong>Conclusions: </strong>Patients with chronic obstructive pulmonary disease traveling to 3,100 m experienced sustained and intermittent nocturnal cerebral deoxygenation related to hypoxemia. Acetazolamide mitigated these altitude-related deoxygenations, albeit not to lowland values.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Effect Of Acetazolamide On Altitude Related Illness In Patients With Respiratory Disease; URL: https://clinicaltrials.gov/study/NCT03156231; Identifier: NCT03156231.</p><p><strong>Citation: </strong>Schmuziger YA, Mademilov M, Buergin A, et al. Nocturnal cerebral oxygenation in patients with COPD at altitude: data from a randomized clinical trial of acetazolamide. <i>J Clin Sleep Med.</i> 2025;21(12):2051-2061.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2051-2061"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When normal isn't good enough.","authors":"Andrew R Spector","doi":"10.5664/jcsm.11912","DOIUrl":"10.5664/jcsm.11912","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2015-2016"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Wang, Brendon J Yee, Frances Chung, Ronald R Grunstein
{"title":"Ventilatory response to hypoxia is more crucial than hypercapnia in the mechanism of opioid-related central sleep apnea.","authors":"David Wang, Brendon J Yee, Frances Chung, Ronald R Grunstein","doi":"10.5664/jcsm.11840","DOIUrl":"10.5664/jcsm.11840","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2257"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breanna M Holloway, Christian D Harding, Pamela DeYoung, Crystal G Kwan, Lanna Avetisyan, Kitty K Lui, Sonia Ancoli-Israel, Sarah J Banks, Ina Djonlagic, Atul Malhotra
Study objectives: To investigate whether comorbid insomnia and sleep apnea (COMISA) is associated with poor verbal memory in older adults, and whether this relationship is moderated by sex.
Methods: A total of 110 older adults aged (65-83), all diagnosed with obstructive sleep apnea, completed overnight polysomnography and cognitive testing. COMISA was defined as obstructive sleep apnea plus an Insomnia Severity Index score ≥ 11. Verbal memory was assessed via the delayed recall component of the Alzheimer's Disease Cooperative Study Preclinical Alzheimer's Cognitive Composite. Moderation analysis examined the interaction between COMISA and sex on verbal memory performance, adjusting for age, body mass index, APOE4 status, and education. Post hoc sleep architecture differences between males and females with COMISA and females with COMISA compared to obstructive sleep apnea only were analyzed using multivariate analysis of covariance.
Results: COMISA was associated with significantly worse verbal memory performance, with this effect driven by females (b = -2.82, standard error = 0.94, t = -3.01, P = .003) and absent in males (b = 0.62, standard error = 0.97, t = 0.63, P = .528). Post hoc analyses revealed that females with COMISA showed reduced rapid eye movement sleep and increased slow wave sleep compared to males with COMISA.
Conclusions: COMISA is linked to sex-specific cognitive vulnerability, with older females showing worse verbal memory than males. Post hoc analyses revealed differences in sleep architecture by sex within COMISA, warranting further investigation into stage-specific sleep contributions to cognitive risk. These findings highlight the importance of sex-informed approaches to assessing and managing cognitive risk in aging populations.
Clinical trial registration: Registry: ClinicalTrials.gov; Name: Is Obstructive Sleep Apnea Important in the Development of Alzheimer's Disease?; URL: https://clinicaltrials.gov/study/NCT05094271; Identifier: NCT05094271.
Citation: Holloway BM, Harding CD, DeYoung P, et al. Comorbid insomnia and sleep apnea is associated with worse verbal episodic memory in older females. J Clin Sleep Med. 2025;21(12):2129-2138.
{"title":"Comorbid insomnia and sleep apnea is associated with worse verbal episodic memory in older females.","authors":"Breanna M Holloway, Christian D Harding, Pamela DeYoung, Crystal G Kwan, Lanna Avetisyan, Kitty K Lui, Sonia Ancoli-Israel, Sarah J Banks, Ina Djonlagic, Atul Malhotra","doi":"10.5664/jcsm.11902","DOIUrl":"10.5664/jcsm.11902","url":null,"abstract":"<p><strong>Study objectives: </strong>To investigate whether comorbid insomnia and sleep apnea (COMISA) is associated with poor verbal memory in older adults, and whether this relationship is moderated by sex.</p><p><strong>Methods: </strong>A total of 110 older adults aged (65-83), all diagnosed with obstructive sleep apnea, completed overnight polysomnography and cognitive testing. COMISA was defined as obstructive sleep apnea plus an Insomnia Severity Index score ≥ 11. Verbal memory was assessed via the delayed recall component of the Alzheimer's Disease Cooperative Study Preclinical Alzheimer's Cognitive Composite. Moderation analysis examined the interaction between COMISA and sex on verbal memory performance, adjusting for age, body mass index, <i>APOE4</i> status, and education. Post hoc sleep architecture differences between males and females with COMISA and females with COMISA compared to obstructive sleep apnea only were analyzed using multivariate analysis of covariance.</p><p><strong>Results: </strong>COMISA was associated with significantly worse verbal memory performance, with this effect driven by females (<i>b</i> = -2.82, standard error = 0.94, <i>t</i> = -3.01, <i>P</i> = .003) and absent in males (<i>b</i> = 0.62, standard error = 0.97, <i>t</i> = 0.63, <i>P</i> = .528). Post hoc analyses revealed that females with COMISA showed reduced rapid eye movement sleep and increased slow wave sleep compared to males with COMISA.</p><p><strong>Conclusions: </strong>COMISA is linked to sex-specific cognitive vulnerability, with older females showing worse verbal memory than males. Post hoc analyses revealed differences in sleep architecture by sex within COMISA, warranting further investigation into stage-specific sleep contributions to cognitive risk. These findings highlight the importance of sex-informed approaches to assessing and managing cognitive risk in aging populations.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Is Obstructive Sleep Apnea Important in the Development of Alzheimer's Disease?; URL: https://clinicaltrials.gov/study/NCT05094271; Identifier: NCT05094271.</p><p><strong>Citation: </strong>Holloway BM, Harding CD, DeYoung P, et al. Comorbid insomnia and sleep apnea is associated with worse verbal episodic memory in older females. <i>J Clin Sleep Med</i>. 2025;21(12):2129-2138.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2129-2138"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Safwan Badr, Rami N Khayat, J Shirine Allam, Suzanne Hyer, Reem A Mustafa, Matthew T Naughton, Susheel Patil, Grace W Pien, Winfried Randerath, Christine Won
Introduction: This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central sleep apnea syndrome in adults.
Methods: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of positive airway pressure therapies, non-positive airway pressure therapies, and pharmacological treatment to no treatment to improve patient-important outcomes. Statistical analyses were performed to determine the clinical meaningfulness of using various interventions to treat central sleep apnea in adults. The Grading of Recommendations Assessment, Development, and Evaluation process was used to assess the evidence for making recommendations.
Results: The literature search resulted in 6,701 articles, of which 103 articles provided data suitable for statistical analyses. The task force provided a detailed summary of the evidence along with the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.
Citation: Badr MS, Khayat RN, Allam JS, et al. Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2025;21(12):2213-2236.
{"title":"Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.","authors":"M Safwan Badr, Rami N Khayat, J Shirine Allam, Suzanne Hyer, Reem A Mustafa, Matthew T Naughton, Susheel Patil, Grace W Pien, Winfried Randerath, Christine Won","doi":"10.5664/jcsm.11860","DOIUrl":"10.5664/jcsm.11860","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central sleep apnea syndrome in adults.</p><p><strong>Methods: </strong>The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of positive airway pressure therapies, non-positive airway pressure therapies, and pharmacological treatment to no treatment to improve patient-important outcomes. Statistical analyses were performed to determine the clinical meaningfulness of using various interventions to treat central sleep apnea in adults. The Grading of Recommendations Assessment, Development, and Evaluation process was used to assess the evidence for making recommendations.</p><p><strong>Results: </strong>The literature search resulted in 6,701 articles, of which 103 articles provided data suitable for statistical analyses. The task force provided a detailed summary of the evidence along with the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.</p><p><strong>Citation: </strong>Badr MS, Khayat RN, Allam JS, et al. Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. <i>J Clin Sleep Med</i>. 2025;21(12):2213-2236.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2213-2236"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dennis H Auckley, Reena Mehra, Karin G Johnson, Martha E Billings, Gerard Carandang, Yngve Falck-Ytter, Rami N Khayat, Reem A Mustafa, Cinthya Pena-Orbea, Ashima S Sahni, Susheel P Patil, Sunil Sharma
Introduction: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on management of obstructive sleep apnea in medically hospitalized adults.
Methods: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials and observational studies that addressed interventions for the management of obstructive sleep apnea in medically hospitalized adults. Statistical analyses were performed to determine the clinical meaningfulness of critical and important outcomes. Finally, the Grading of Recommendations Assessment, Development, and Evaluation process was used to assess the evidence for making recommendations.
Results: The literature search resulted in 5,159 studies, out of which 27 studies provided data suitable for statistical analyses. The task force provided a detailed summary of the evidence along with the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.
Citation: Auckley DH, Mehra R, Johnson KG, et al. Evaluation and management of obstructive sleep apnea in adults hospitalized for medical care: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2025;21(12):2237-2256.
{"title":"Evaluation and management of obstructive sleep apnea in adults hospitalized for medical care: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.","authors":"Dennis H Auckley, Reena Mehra, Karin G Johnson, Martha E Billings, Gerard Carandang, Yngve Falck-Ytter, Rami N Khayat, Reem A Mustafa, Cinthya Pena-Orbea, Ashima S Sahni, Susheel P Patil, Sunil Sharma","doi":"10.5664/jcsm.11866","DOIUrl":"10.5664/jcsm.11866","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on management of obstructive sleep apnea in medically hospitalized adults.</p><p><strong>Methods: </strong>The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials and observational studies that addressed interventions for the management of obstructive sleep apnea in medically hospitalized adults. Statistical analyses were performed to determine the clinical meaningfulness of critical and important outcomes. Finally, the Grading of Recommendations Assessment, Development, and Evaluation process was used to assess the evidence for making recommendations.</p><p><strong>Results: </strong>The literature search resulted in 5,159 studies, out of which 27 studies provided data suitable for statistical analyses. The task force provided a detailed summary of the evidence along with the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.</p><p><strong>Citation: </strong>Auckley DH, Mehra R, Johnson KG, et al. Evaluation and management of obstructive sleep apnea in adults hospitalized for medical care: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. <i>J Clin Sleep Med.</i> 2025;21(12):2237-2256.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"2237-2256"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号