Sleep advances : a journal of the Sleep Research Society最新文献

Study objectives: The relationship between Coronavirus disease 2019 (COVID-19) and sleep health is unclear; therefore, we examined the association between SARS-CoV-2 infection and sleep impairment in Military Health System (MHS) beneficiaries.

Methods: The Epidemiology, Immunology, and Clinical Characteristics of Emerging Infections of Pandemic Potential study enrolled MHS beneficiaries through Military Treatment Facilities and an online pathway. Eligibility criteria included those who were Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or negative. A subset of participants completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire in addition to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) instruments. Bivariate analyses of PSQI score with COVID-19 history were extended by multivariable regression models to adjust for confounders. Sensitivity analyses adjusted for GAD-7, PHQ-9, and prior sleep disorders.

Results: A total of 1228 Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential participants completed a PSQI questionnaire. Over half were males (64%), white (77%), and Active-Duty Service Members (ADSM) (80%). The median age was 37 years, and 41% of the participants had a history of SARS-CoV-2 infection prior to completing the PSQI. Those with prior infection were more likely to have poor sleep health (PSQI > 10) compared to those without (32% vs 21%, p < .001). After adjusting for sex, race, age, BMI, and history of obstructive sleep apnea, those with a history of SARS-CoV-2 infection had higher risk of poor sleep [PSQI > 10: RR = 1.41, p < .001]. Results were similar across all sensitivity analyses.

Conclusions: Prior SARS-CoV-2 infection is associated with poor sleep in ADSM and MHS beneficiaries. Further prospective and mechanistic studies are required to further understand this association.

Study objectives: While recovery sleep can ameliorate the negative impacts of total sleep deprivation (TSD) on cognitive functioning, the effects of post-TSD sleep on different forms of emotional functioning remain unknown. Here, we investigated the effects of TSD and post-TSD recovery sleep on emotional memory processing.

Methods: Participants viewed scenes with negative or neutral central objects overlain on neutral backgrounds. The scene components were then presented separately for recognition testing. Participants in the TSD (n = 46) and Sleep (n = 22) conditions encoded the scenes the morning after the sleep manipulation (~10:00) and recognition memory was tested for half of the scene components after a short delay (Recog_1, ~10:45). Twenty of the TSD participants then received a 90-min nap opportunity (TSD_Nap). All participants then completed a second recognition test on the remaining images (Recog_2, ~14:00).

Results: At Recog_1, all TSD participants showed worse overall memory compared to sleep participants. Specifically, memory was significantly worse for every scene component except neutral objects during Recog_1. At Recog_2, while memory deteriorated further for all scene components in the TSD_NoNap group, the TSD_Nap group showed no memory decline and had improved memory for negative objects, matching the sleep group at Recog_2.

Conclusions: Post-TSD recovery sleep preserves and restores memory functioning to the level seen in typically rested individuals. But extending TSD leads to continued memory deterioration, highlighting the importance of sleep in healthy emotional memory functioning. This paper is part of the Festschrift in honor of Dr. Robert Stickgold.

Study objectives: To assess the performance of a portable electroencephalography device for sleep monitoring against polysomnography.

Method: Fifty-six adults underwent one night of in-laboratory sleep recording with the Muse-S headband and simultaneous level 1 polysomnography. Muse-S data were scored by an automated sleep staging algorithm. A registered technologist, blind to the Muse-S automated sleep scoring, scored the polysomnography data.

Results: Good quality data were available for 47 (84 per cent) participants (53 per cent females; 20-71 years old; 17 per cent with sleep-related breathing disorder). Epoch-by-epoch analyses showed substantial agreement between the Muse-S and polysomnography (full night Cohen's Kappa = 0.76). Cohen's Kappa were in the fair agreement range for non-rapid eye movement (NREM) 1, substantial agreement range for NREM2 and NREM3, and near-perfect agreement range for rapid eye movement sleep and wake. Accuracy ranged from 88 per cent to 96 per cent across all sleep stages, with a sensitivity of 79-92 per cent and a specificity of 90-99 per cent. Similar results were observed in the subgroup with sleep-related breathing disorder. On average, the Muse-S had higher mean values than polysomnography for total sleep time (+6 min), NREM3 (+15 min), rapid eye movement sleep (+6 min), and sleep efficiency (+1.5 per cent), and lower mean values for sleep latency (-3 min), wake after sleep onset (-3 min), and light sleep (-14 min).

Conclusions: When compared to standard polysomnography, the Muse-S performed well to measure sleep macroarchitecture. This portable device shows great potential as an accessible tool for sleep electroencephalography monitoring. More work is required to validate this tool in more diverse populations to ensure robustness across age, sex, neurological conditions, and sleep profiles.This article is part of the Consumer Sleep Technology Special Collection.

Traumatic brain injury (TBI) is associated with sleep disturbances and cognitive impairment, with limited effective therapeutic strategies. Our previous work showed dietary supplementation with branched chain amino acids (BCAAs; isoleucine, leucine, valine), the primary substrate for de novo glutamate/GABA synthesis in the CNS, restored normal sleep-wake patterns and improved cognitive function in rodents. Our recent pilot work in humans showed preliminary feasibility/acceptability and limited efficacy for BCAAs to improve sleep in Veterans with TBI. However, these pilot data were limited in sample size, treatment dosages/duration, and therefore unable to establish efficacy or provide insight into dosing/duration parameters. The present study, SmART-TBI (supplementation with amino acid rehabilitative therapy in TBI: NCT04603443), represents a placebo-controlled, double-masked randomized clinical trial (target n = 120). Covariate adaptive randomization controlling for age, sex, TBI recency, pain, depression, and PTSD, allocated participants 1:1:1:1 to four groups comprising 3 BCAA doses b.i.d. ("high" 30 g; "medium" 20 g; and "low" 10 g) and one placebo-control (rice protein, 10 g b.i.d.). Outcomes were assessed following a 2-week baseline period; after 4 weeks, 8 weeks, and 12 weeks of intervention; and after 4 weeks and 12 weeks post-intervention. The primary outcomes are overall feasibility/acceptability metrics, and secondarily, preliminary efficacy for BCAAs to improve subjective sleep as assessed by the Insomnia Severity Index. Additional sleep measures were obtained for future analyses using a combination of actigraphy, mattress-sensors, sleep diaries, as well as pre-/post-BCAA overnight polysomnography. Additional exploratory outcomes included sweat-based biomarkers. Analyses of primary outcome measures indicated high feasibility and acceptability for this fully protocol.

Study objectives: Millions of Americans obtain insufficient sleep daily, yet it is unknown the relationship between sleep and life expectancy by county across the United States.

Methods: Using the 2019-2025 Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System surveys, we tested the associations between insufficient sleep and life expectancy at the county level while controlling for common adverse health behaviors (i.e. smoking, diet, and inactivity) across multiple years (2019-2025).

Results: Insufficient sleep was significantly negatively correlated with life expectancy in most states from 2019 to 2025, such that lower sleep insufficiency was associated with longer life expectancy. Moreover, sleep insufficiency was significantly associated with lower life expectancy when controlling for traditional predictors of mortality, with only smoking displaying a stronger association.

Conclusions: These findings demonstrate the importance of adequate sleep in all communities regardless of income level, access to health care services, or geographical classification.

Study objectives: Evaluate the effect and safety of alpha rhythm-guided repetitive transcranial magnetic stimulation (α-rTMS) on sleep difficulties in children with autism spectrum disorder (ASD).

Methods: Twenty children (6-12 years old; 16 males; 4 females) with ASD level 2 were randomly assigned (1:1 ratio) to a treatment group (TG) or a waitlist control group (WLCG) (T1). The TG received ten α-rTMS sessions over two weeks, while the WLCG acted as control for that period (T2). Next, the WLCG received α-rTMS for two weeks (T3). All study participants were followed up at one (T4) and four (T5) months. Sleep difficulties were measured using the Children's Sleep Habit Questionnaire (CSHQ), Actigraphy, and Polysomnography (PSG).

Results: Group-by-time interactions indicated that the TG had greater improvements than the WLCG in total CSHQ score (p=.008) and, bedtime resistance (p=.003), sleep onset delay (p=.004), and sleep duration (p=.003) subdomain scores. When the WLCG received the α-rTMS, there were improvements in their sleep-disordered breathing (p=.001), parasomnia (p=.002) and sleep duration (p=.018) subdomain scores, while PSG data showed improved Waking After Sleep Onset (WASO) (p=.014), Sleep efficiency (p=.046), and N2 stage (p=.039). The improved CSHQ scores persisted, with actigraphy data showing significant improvement in WASO at T4 and T5. Side effects of α-rTMS were mild and transient.

Conclusions: This RCT study presents preliminary evidence on the effect and safety of α-rTMS in improving subjective sleep difficulties in children with ASD, with effects lasting up to four months post-intervention. Further studies using a larger sample size and sham-controlled group are warranted.

Clinical trial registration: The trial was registered on July 11, 2023 within the Australian New Zealand Clinical Trials Registry (ANZCTR) https://www.anzctr.org.au/TrialSearch.aspx with registration number: ACTRN12623000757617.

Study objectives: Isolated REM sleep without atonia (iRSWA) is increasingly detected on polysomnography (PSG), yet its clinical relevance remains unclear. We compared the demographic profile, sleep physiology, comorbidities, and longitudinal outcomes of people with iRSWA and isolated REM sleep behaviour disorder (iRBD).

Methods: We retrospectively reviewed PSG reports (2008-2022) from a tertiary sleep-medicine center, classifying people as iRSWA or iRBD based on self-reported dream-enactment behavior. Clinical data were extracted from charts, and PSG variables from sleep reports. Neurological and psychiatric diagnoses before the sleep examination were obtained from national registries. Comparisons used multivariable regression and Fine-Gray competing-risk models.

Results: The cohort comprised 302 participants (iRSWA = 98 and iRBD = 204). Participants with iRSWA were more often female (38.8% vs 23%, p = .004), with a younger age distribution (35-49 years; 25.5% vs 13.7%, p = .015). They reported more daytime sleepiness/fatigue (odds ratio [OR] 2.84, p < .001) despite comparable objective sleep architecture. Objective neurodegenerative signs appeared only in the iRBD group. Pre-index neurological disorders were more common in iRSWA (31.6% vs 19.1%, p = .042), while neurodegenerative conversion during follow-up occurred in 4.1 per cent of iRSWA and 8.8 per cent of iRBD. In multivariable analysis, sleepiness/fatigue and pre-existing neurological disorder were associated with iRSWA; when spouse status was included in the model, spouse status became the strongest predictor, periodic limb movements in sleep of 15 or more reached significance, and the association with sex attenuated.

Conclusions: iRSWA differs from iRBD in profile and pre-index comorbidity patterns. Our findings support the view that iRSWA may reflect mechanisms other than a uniform prodromal stage of α-synucleinopathy.

Study objectives: Sleep spindles are potential biomarkers for memory decline in aging. However, significant within-person variability in spindle attributes complicates their utility in predicting cognitive deterioration. This study aimed to uncover distinct spindle types and their relevance to memory decline using exploratory, data-driven clustering.

Methods: Polysomnography was collected from younger (n = 43, ages 20-45 years) and older cognitively healthy adults (n = 34, ages 60-81 years). Clustering analysis was performed using multiple features and spatiotemporal context, irrespective of participant age.

Results: Resulting clusters were hierarchically defined by the sleep stage, slow oscillation concurrence, and hemisphere. Stage N3 spindles (15%; predominantly coinciding with slow oscillations) formed a distinct group, followed by N2 spindles coinciding with slow oscillations (27%). Remaining N2 spindles were categorized into unilateral (41%) and bilateral clusters (17%). In older adults, there was a lower proportion of N2 bilateral spindles and a higher proportion of N2 spindles concurrent with slow oscillations. Lower proportion of N2 bilateral spindles was associated with better composite memory performance in younger adults, whereas higher spindle power, regardless of cluster belonging, was associated with reduced memory benefit from sleep compared with wakefulness.

Conclusions: Our results indicate differing expression of spatiotemporal spindle clusters in older age, as well as intertwined dynamics between spindle propagation, slow oscillation concurrence, and frequency shifts in aging. In addition, spindle heterogeneity aligned with global sleep stage dynamics. These results emphasize the interconnectedness of spindle activity with overall sleep patterns, underscoring the importance of spatiotemporal context within and across sleep stages.