Frontiers in sleep最新文献

Introduction: Sleeping hot is a common barrier to good sleep. Characteristics of the sleep environment may impact temperature regulation and sleep. We tested the effectiveness of one brand of bed sheets that advertise cooling properties on sleep and vasomotor symptoms.

Methods: Participants were recruited through multiple channels that included potential customers of the intervention sheets and targeted online advertisements. Participants completed a baseline questionnaire, daily electronic diary for 6 weeks, and an end-of-study questionnaire. Assessments included the Pittsburgh Sleep Quality Index and Restorative Sleep Questionnaire. Daily diaries assessed sleep, mood, and perceived temperature during sleep. Within-person responses were compared before and after use of the intervention bed sheets.

Results: 64 participants provided 2,627 total days of data. The study sample was 89% female, mean age 48 (SD 12). Sixty-nine percent of participants reported improved sleep quality after implementing the intervention. Mean improvement on the Pittsburgh Sleep Quality Index was 1.9 (95% CI 1.3-2.6), from 8.0 (SD 3.0) to 6.1 (SD 2.5) at end-of-study. The proportion of participants reporting trouble sleeping due to feeling too hot was reduced from 82.5 to 39.7%. Reported sleep duration increased 26 min (95% CI 14-38 min), from 6.5 h (SD 1.0) to 7.0 h (SD 0.8). Participants also reported improvements in night sweats, restorative sleep, mood, and alertness.

Conclusion: Individuals reported improvements on several dimensions of sleep health, reductions in night sweats, and less sleep disruption due to sleeping too hot after implementing the intervention bed sheets. These findings warrant replication in a randomized, placebo-controlled design.

Aims: Type 2 diabetes and sleep disorders are closely connected. We have evaluated a 4-day concentrated transdiagnostic, micro choice-based and interdisciplinary group treatment for patients with type 2 diabetes, with the aim of improving patient activation. We wanted to explore whether sleep problems would decrease after this intervention.

Methods: Patients were assessed pre - post the intervention by Insomnia Severity Index (ISI), Bergen Insomnia Scale (BIS), Epworth Sleepiness Scale (ESS), Berlin Questionnaire (BQ) at baseline, 3-, 6- and 12 months follow-up, to measure symptoms related to insomnia, Obstructive Sleep Apnoea (OSA) and daytime sleepiness. Seventy-five patients with type 2 diabetes were included in our sample.

Results: At baseline, 41% and 25% had symptoms of insomnia, as defined by the BIS and ISI, respectively. Another 56% were likely to suffer from OSA using the BQ. At follow-up, the intervention was associated with reduction in symptoms of sleep disorders, and the reduction was still significant at 12 months follow-up.

Conclusions: Although the study was not designed to disentangle how much of the improvement was due to sleep education and medication, the outcome still shows the usefulness of the format also in terms of sleep disorders in type 2 diabetes.

This article explores the concepts in sleep medicine associated with mental health symptoms. A brief overview of key sleep factors is stated, followed by a presentation of empirical research findings on how poor sleep influences mental health conditions. Some specific information on mental health conditions like insomnia, depression, and schizophrenia symptoms are provided. Tables and figures present common sleep conditions associated with mental health conditions. Additionally, a figure by the author proposes a pathway explaining the link between poor sleep quality and mental health conditions.

Introduction: The Odds Ratio Product (ORP) is a validated EEG-based measure of sleep depth, more sensitive than traditional metrics. While it has been studied in healthy individuals and those with sleep-wake disorders, its relevance in psychiatric conditions remains unclear. This study examined ORP during sleep and its association with depressive symptoms in a large cohort referred to multiple U.S. sleep centers.

Methods: We retrospectively analyzed data from 829 adults (48.85% female; mean age 43.49 ± 13.74 years) enrolled in two multicenter studies. Each participant completed the Patient Health Questionnaire-9 (PHQ-9) and underwent overnight polysomnography (PSG), with ORP calculated from central EEG channels. Mean and standard deviation ORP values were derived for the full night and Wake, stages 1, 2, 3, and REM sleep. Associations between ORP metrics and depression severity (PHQ-9 total and PHQ-9 ≥10) were tested using linear and logistic regressions, adjusting for age and sex. Model fit was assessed with the Akaike Information Criterion (significance level α = 0.05).

Results: Fixed-effects models outperformed mixed-effects models. Mean ORP during the full night and light sleep (stages 1 + 2) showed a significant U-shaped association with depression, indicating both high and low ORP values relate to greater depressive burden. In stage 3, higher mean ORP was linearly associated with more severe symptoms. Lower ORP variability across the night also correlated with higher depression scores.

Conclusions: ORP shows potential as a non-invasive biomarker for depressive symptoms, with distinct associations depending on sleep depth. Integrating ORP into clinical PSG analyses could improve detection of depression-related sleep patterns.

Background: REM sleep behavior disorder (RBD) is characterized by loss of normal muscle atonia during REM sleep, often associated with dream enactment behaviors, and is typically a prodromal neurodegenerative condition in middle-aged and older adults. However, emerging case reports and case series suggest that not all RBD presentations follow this trajectory, particularly in younger individuals.

Case presentation: A case of 7-year history of vivid, immersive dreaming perceived as continuous with waking life, accompanied by persistent dream-reality confusion, is described. The patient frequently engaged in reality-testing behaviors and reported significant cognitive fatigue. Video-polysomnography confirmed REM sleep without atonia and a concordant dream re-enactment episode. Neuropsychiatric evaluation ruled out dissociative or psychotic disorders, and no evidence of neurodegenerative disease was observed.

Conclusion: This presented case illustrates a potentially distinct, non-neurodegenerative REM parasomnia phenotype that underscores the need to expand current parasomnia classifications to better capture the diverse cognitive and metacognitive dimensions of REM sleep disorders. Moreover, potential mechanisms underlying the main features of this case, including immersive dreaming and persistent dream-reality confusion, are discussed in relation to hypothesized dysfunction in melanin-concentrating hormone (MCH) signaling.

Introduction: Insomnia and obstructive sleep apnea (OSA) are each linked to elevated risks of depression. When comorbid (COMISA), these risks increase further, highlighting the need for effective depression screening. This study evaluated the screening accuracy of a novel software, MEB-001, for detecting current major depressive episode (cMDE) in individuals identified as with and without suspected COMISA (sCOMISA).

Methods: We conducted a retrospective sub-analysis from a prospective multicenter study at U.S. sleep clinics, including 296 adults who underwent routine polysomnography (PSG). Electrocardiogram and electroencephalogram signals, along with items 1 and 2 of the self-report depression screener Patient Health Questionnaire, 9 items (PHQ-9), were used to generate MEB-001 screening output. The Mini International Neuropsychiatric Interview (MINI) served as the diagnostic reference for cMDE. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for MEB-001 and PHQ-9 (cut-off ≥10), with subgroup comparisons conducted using Fisher's exact and McNemar's tests (p < 0.05).

Results: MINI identified cMDE in 15.5% of participants (16.9% in sCOMISA; 14.2% in non-COMISA). Against the MINI, MEB-001 achieved 84.8% sensitivity, 72.0% specificity, 35.8% PPV, and 96.3% NPV in the full cohort; PHQ-9 ≥10 showed similar performance (89.1, 68.4, 34.2, and 97.2%, respectively). MEB-01's performance did not differ between sCOMISA and non-sCOMISA (all p ≥ 0.68), and no significant McNemar differences were found in the subgroups (p > 0.19).

Discussion: MEB-001 demonstrated consistent cMDE screening performance comparable to the PHQ-9, supporting its potential utility in sleep clinic settings.

Sleep is a critical neurobiological process essential for brain maturation, emotional regulation, cognitive development, and overall organ system homeostasis. In the pediatric intensive care unit (PICU), sleep architecture is frequently disrupted by environmental stimuli, sedation, and clinical interventions, resulting in sleep fragmentation. Unlike sleep deprivation, sleep fragmentation preserves sleep duration but impairs its continuity and depth, disproportionately affecting slow-wave sleep, that is essential for growth, healing, in addition to immune function and REM sleep, that is fundamental for synaptic plasticity, neurogenesis, and memory consolidation. These disruptions are particularly concerning in children, who require more sleep than adults due to ongoing neurogenesis and rapid somatic growth, rendering them uniquely vulnerable to adverse effects. Emerging evidence links fragmented sleep in the PICU to altered neurodevelopmental trajectories and increased risk of Pediatric Post-Intensive Care Syndrome (PICS-p), with delirium serving as a key mediator. Despite promising adult studies on sleep-promoting interventions and EEG-based monitoring, pediatric research remains limited. Future research should prioritize objective sleep monitoring, developmental tailoring of care protocols, and longitudinal studies to clarify the impact of sleep fragmentation on recovery and neurodevelopment. This narrative review highlights the urgent need to recognize and preserve sleep as a modifiable determinant of neurocognitive outcomes in critically ill children.

The anatomy of the upper airway can influence the risk of obstructive sleep apnea (OSA). However, there is limited evidence supporting the link between scalloped tongue (ST) and nocturnal intermittent hypoxia. This study aimed to investigate if ST could serve as a clinical indicator of OSA, particularly severe OSA. Over a 4-month period from October 2023 to January 2024, 160 patients underwent level 1 polysomnography at a sleep laboratory in Brazil. Demographics, body mass index (BMI), neck circumference (NC), presence of ST, Epworth Sleepiness Scale score, apnea hypopnea index, oxygen desaturation index (ODI) and time under 90% of oxygen saturation were included in a database. Logistic and multiple linear regression models were performed. A p-value <0.05 was considered as the lower threshold of significance. Most (90%) patients had OSA, 41% classified as severe. Older age and a wider NC significantly increased the risk of OSA. Older age, higher BMI, wider NC, and ST significantly increased the risk of severe OSA, and there was a statistically significant positive correlation between the presence of ST and ODI (p = 0.001). The presence of ST increased ODI by 6.723/h, adjusted for age, BMI, and NC. The combined presence of NC ≥ 40 cm and ST significantly increased the risk of severe OSA (OR 4.210, p < 0.001), and significantly impacted ODI estimates. Incorporating tongue and NC assessment in OSA screening, both objective and easily observable clinical signs, may help physicians in the prompt identification of severe cases that benefit from early positive airway pressure therapy.