Behavioral Sleep Medicine最新文献

Objectives: To investigate the relationship between short and long sleep duration and subjective cognitive decline (SCD) in a diverse cohort of cognitively normal mid- to older-age adults.

Methods: We conducted a cross-sectional analysis of the 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, including 63,948 adults aged 40-70. SCD was assessed using BRFSS survey queries. Multivariable logistic regression models examined the association between sleep duration ( < 7, 7, ≥8 hours) and SCD, adjusting for age, sex, race/ethnicity, education, and history of depression.

Results: Both short and long sleep durations were associated with higher odds of SCD. The association between short sleep and SCD was strongest among individuals in their 40s at the start of midlife. Findings were consistent across all ages for non-Hispanic Whites (NHW) and for Hispanics/Latinos in their 50s and 70s. Black/African American (B/AA) adults exhibited a stronger relationship between both short and long sleep duration and SCD as they aged from midlife into their 80s, compared to NHWs.

Conclusions: Short sleep duration is more strongly associated with subjective cognitive decline in midlife, particularly among B/AA adults. Addressing sleep disparities may help mitigate the risk of SCD.

Objectives: Much research on risk factors of poor sleep in adolescence has focussed on stressful life events, but without explicitly investigating the role of family-wide (rather than personal) events. We carried out this study to explore the role of stressful family-wide events in sleep problems in adolescence in the general population.

Method: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the role of recent family-wide stressors (at ages 12-16 years) in sleep problems (at age 17 years), while controlling for previous exposure to personal and family-wide stressors and other confounders (N = 4,561). Our list of recent family-wide stressors included not only major and rare adversities (such as death of a parent) but also relatively common events (such as death of a family pet) and normative transitions (such as birth of a sibling).

Results: Our results showed a small but significant relation between number of recent family-wide stressors and adolescent sleep problems (b = 0.06, 95% CI: 0.04-0.09). This association was robust to confounder adjustment and similar for males and females.

Conclusions: Our findings suggest that interventions aiming to protect or improve the sleep of adolescents could target those experiencing a large number of recent family events even if these events were relatively minor.

Introduction: Circadian rhythms are biological rhythms that are repeated every 24 hours, and are reflected in circadian typology, a variable that has been related to different aspects of mental health, such as resilience, optimism, and emotional intelligence.

Objectives: This study aims to analyze the relationships between circadian typology and perceived social support, self-esteem, and life satisfaction, considering the possible influence of sex.

Method: 345 participants (200 women), aged 16-76 years (31.77 ± 16.14 years), completed the reduced Morningness-Eveningness Questionnaire, the MOS Social Support Survey, the Rosenberg Self-Esteem Scale and the Satisfaction with Life Scale.

Results: Morning-type participants scored higher than evening-type participants on emotional support, instrumental support, global support, and life satisfaction. Also, morning-type participants scored higher on global self-esteem, and on positive and negative dimensions of self-esteem, which is consistent with the bifactorial model's view of these as related but independent dimensions of self-esteem.

Conclusions: These results suggest that morning typology could be considered as a protective factor for the development of psychological problems and mental disorders, as is associated with variables indicative of better mental health (greater self-esteem, life satisfaction and perceived social support), while evening typology is associated with factors considered to be risk factors for mental health.

Objectives: Ethnic and racial discrimination stress is a key social determinant of sleep health, yet its day-to-day influence on Mexican-origin adolescents remains underexplored. This study focused on Mexican-origin adolescents and examined the negative effects of daily ethnic and racial discrimination stress on sleep.

Method: The analytic sample included 256 Mexican-origin adolescents (48.8% female, 49.7% male, 1.56% non-binary; mean age = 13.50; SD = 1.11; range = 12-16 years old) residing in a suburban area in the United States Midwest. Using multi-level models that disentangle between- and within-person effects, this study assessed daily ethnic and racial discrimination stress and self-reported same-night sleep using a 21-day daily report method. Daily sleep indicators included nighttime duration, onset latency, and quality.

Results: On days when adolescents reported higher levels of discrimination stress, they also reported longer sleep onset latency. At the between-person level, youth who reported higher levels of discrimination stress reported poorer sleep quality. Possible reciprocal dynamics between stress and sleep were tested. Results showed that at the within-person level, sleep behaviors were not associated with next-day racial discrimination. At the between-person level, adolescents who reported higher sleep quality or longer sleep duration the prior night also reported lower levels of next-day discrimination, suggesting that sleep disturbances may be associated with stress experiences.

Conclusion: This study highlights the importance of targeted support for Mexican-origin adolescents' sleep health especially on days when they experience ethnic and racial discrimination.

Background: Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with cardiovascular, metabolic, and psychological complications. Data on its prevalence in Arab countries remain scarce. This study aimed to estimate the pooled prevalence of OSA in Egypt, Jordan, Oman, and Iraq, and to explore sources of heterogeneity.

Methods: A systematic search of major scientific databases was conducted to identify studies up to 2025. Pooled prevalence was calculated using a random-effects model and Heterogeneity was assessed. Subgroup analyses were performed by country and diagnostic tool, and meta-regression examined temporal trends. Publication bias was evaluated with Egger's and Begg's tests, and adjusted using the trim-and-fill method.

Results: Fifty studies with 58 prevalence estimates involving 881,184 participants were included. The pooled prevalence of OSA was 33.0% (95% CI: 28.3%-37.8%), with marked heterogeneity (I² = 99.8%). Subgroup analysis showed higher prevalence in Egypt (39%) compared with Jordan (28%) and other Arab countries (24%). No significant differences were observed between diagnostic tools, and heterogeneity persisted across subgroups. Meta-regression revealed no significant change in prevalence over time. Evidence of small-study effects was found; after trim-and-fill adjustment, the pooled prevalence rose to 37.1%.

Conclusion: OSA prevalence in Arab countries is higher than in many Western populations, representing a significant public health concern. The persistent heterogeneity and stable prevalence suggest that risk factors such as obesity, sedentary lifestyle, and genetic predisposition remain unchanged. These findings underscore the need for targeted prevention, systematic screening, and improved diagnostic standards to reduce the disease burden.

Introduction: Women are less adherent to continuous positive airway pressure (CPAP) treatment than men, but the reasons remain unclear. This study explored women's unique challenges, experiences, and support needs during CPAP initiation and adherence.

Methods: Semi-structured interviews were conducted with 27 women who initiated CPAP for obstructive sleep apnea (OSA). Questions elicited detailed accounts of their challenges and perceptions of support. Responses were thematically analyzed by two independent reviewers to identify key conceptual categories.

Results: Participants initiated CPAP a median of 2 years prior. Mean age was 51 ± 15 years; 29% were Black, 71% White. OSA severity included 40% mild, 21% moderate, 25% severe, and 14% unknown. Three themes emerged: women desired more practical and social support, social and personal factors acted as barriers and facilitators, and persistence and self-advocacy were key to success. Support from durable medical equipment companies, healthcare providers, friends, family, and social media was inconsistent. Women who faced frustration or significant barriers were less successful, while persistence and self-advocacy were critical for those who succeeded.

Conclusion: Tailored support addressing women's personal circumstances and motivations may help overcome challenges during CPAP therapy initiation.

Objectives: Insomnia often involves physiological hyperarousal, particularly autonomic dysregulation. Although Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective, some patients do not achieve complete remission. This preliminary study evaluated whether combining CBT-I with heart rate variability (HRV) biofeedback could enhance treatment effects by improving autonomic regulation.

Methods: Forty-four adults with insomnia were randomized to either a CBT-I group or a combined group that received HRV biofeedback (HRV-BF) and CBT-I (CBT-I+BF group). Both groups received seven weekly CBT-I sessions, with HRV-BF introduced in session four in the CBT-I+BF group. The primary outcome measure was the Insomnia Severity Index (ISI). Other outcome measures included the Pre-Sleep Arousal Scale (PSAS), sleep diaries, and HRV metrics. Assessments were conducted at baseline, post-treatment, and six-month follow-up. ISI and PSAS were also assessed at week 4 before the introduction of HRV-BF.

Results: Both groups significantly improved in insomnia severity, pre-sleep arousal, and some sleep diary variables.The CBT-I+BF group showed unique and significant improvement in subjective total sleep time. While overall autonomic balance only showed a trend-level improvement in the CBT-I+BF group, sensitivity analyses on participants with more severe objective sleep disturbance suggested greater autonomic balance improvement for the CBT-I+BF group.

Conclusions: Incorporating HRV-BF into CBT-I did not significantly enhance the benefits of CBT-I alone in this study. However, it offers additional advantages for individuals with more objective sleep disturbance, particularly in improving autonomic balance. Future research should identify optimal treatment intensity and explore the utility of HRV-BF in various insomnia sub-populations.

Objectives: This study assessed public knowledge about insomnia treatments, particularly Cognitive Behavioral Therapy for Insomnia (CBT-I), and examined whether familiarity varied by gender or race. The primary aim was to quantify what proportion of adults in the United States are familiar with and use CBT-I.

Methods: A nationally representative sample of 3080 U.S. adults (M_age = 39.5 years, SD_age = 12.9) was surveyed. Approximately 48.3% identified as women. Participants reported their familiarity with various insomnia treatments, including pharmacological and behavioral options, and whether they had used prescription medications, over-the-counter sleep aids, or CBT-I within the past year or at any point in their lifetime.

Results: Participants were substantially more familiar with pharmacological treatments than behavioral therapies, with notably low recognition of CBT-I. Treatment utilization patterns supported that people tend to have a greater reliance on pharmacological interventions, particularly over-the-counter options, than CBT-I. Demographic differences emerged, with women and White participants reporting greater awareness of insomnia treatments than men and individuals from other racial groups. Age related differences were also observed, though, these varied by treatment approach.

Conclusions: This study identified major gaps in public awareness of CBT-I and highlighted disparities in treatment knowledge. Addressing these gaps is critical for improving treatment access and promoting CBT-I as a first-line, evidence-based treatment for insomnia.

Objectives: Sleep and depression are known to be related in patients with fibromyalgia but the strength of this association is not well defined. Hence, this study aimed to investigate the association between subjective and objective sleep parameters with depression and to quantitatively summarize the results.

Methods: Five English databases (PubMed, Web of Science, Scopus, Science Direct, Google Scholar) were systematically searched for studies published between January 2000 and March 2025. Statistical analyses were performed using MedCalc software.

Results: 28 studies matched the inclusion criteria, with a total sample size of 3,027 patients. Of these, 14 studies were included in the meta-analysis evaluating the association between PSQI and depression, which revealed a weakly positive association [pooled correlation coefficient r = 0.353 (95% CI: 0.264 to 0.435)]. In the meta-analysis of two PSG studies, TST showed a weak, non-significant inverse relationship with depression (r = -0.09). Other parameters WASO, sleep latency, sleep efficiency and % REM sleep also showed no significant associations. These PSG related findings remain non-conclusive and warrant further investigation.

Conclusion: This meta-analysis highlights that there is a weak to moderate level of positive association between subjective sleep quality and depression in patients with fibromyalgia. High-quality PSG studies are needed to clarify the relationship of PSG parameters with depression.

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment over medication. However, its use among Veterans in the Polytrauma/Traumatic Brain Injury System of Care (PSC) - a high-riskgroup for insomnia and medication complications - remains unclear. We describe CBT-I utilization in the PSC and identify predictors of receiving CBT-I.

Method: We analyzed medical records of Veterans who initiated PSC services after 10/1/2019 and received either first-line CBT-I or sleep medications within one year. We modeled the likelihood of receiving first-line CBT-I vs. medications based on sociodemographic, clinical, spatial access (e.g. drive time), and facility-level factors (e.g. patient-reported access).

Results: Veterans who received insomnia treatment after initiating PSC services (N = 18,293) were 85% male, 61% White, 21% Black or African American,14% Hispanic, and 8% age 65 or older. Only 11% received first-line CBT-I. Older Veterans; Native Hawaiian/Pacific Islander and Hispanic Veterans; those with bipolar disorder, depression, and alcohol use or other substance use disorders; and those with extended drive times were less likely to receive CBT-I. Findings were consistent in the sensitivity analysis.

Conclusions: Veterans were approximately eight times more likely to receive medications than CBT-I. Implementation strategies that overcome barriers toguideline-concordant care in the PSC are needed.