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        <title>Frontiers in Sleep | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/sleep</link>
        <description>RSS Feed for Frontiers in Sleep | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-10-04T22:01:21.40+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1993629</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1993629</link>
        <title><![CDATA[Correction: Seafarer Fatigue: a qualitative study of customer-facing staff working on UK ferries]]></title>
        <pubdate>2026-09-29T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Frontiers Production Office </author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1922807</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1922807</link>
        <title><![CDATA[Homeopathy for the treatment of insomnia: a systematic review and meta-analysis]]></title>
        <pubdate>2026-09-28T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Abhijit Dutta</author><author>Dewan Md. Sumsuzzman</author><author>Daniel Wrzałko</author><author>Robbert van Haselen</author><author>Petra Weiermayer</author><author>Katharina Gaertner</author><author>J. A. D. S Lakshani</author><author>Sabine Klein</author><author>Stephan Baumgartner</author><author>Martin Loef</author>
        <description><![CDATA[BackgroundInsomnia is a prevalent disorder associated with substantial impairment. Homeopathy has been proposed as a complementary treatment for insomnia, but its clinical effects remain uncertain. This systematic review assessed the efficacy, effectiveness, and safety of homeopathic treatments for insomnia.MethodsProspective comparative studies evaluating any homeopathic preparation for insomnia were included. Searches in MEDLINE, EMBASE, seven additional databases, and three trial registries were conducted through August 2025. Risk of bias, intervention complexity, model validity, and pragmatism were assessed using respectively RoB 2, ROBINS-I, iCAT, MVHT, and RITES. Data were synthesized using random-effects meta-analyses, and certainty of evidence was evaluated using GRADE.ResultsEight randomized controlled trials (RCTs; n = 364 participants) and four non-randomized studies on interventions (NRSIs; n = 517) met the inclusion criteria. In adults, sleep quality (MD = −2.6 points; 95% CI −5.5 to 0.26; low certainty) and insomnia severity (MD = −3.2; 95% CI −5.68 to −0.72, moderate certainty) were reported in one RCT each. For total sleep time, the pooled MD of three RCTs was 0.65 hours (95% CI −0.9 to 2.2; low certainty). In children, one open-label RCT suggested a difference in insomnia severity, but certainty of evidence was very low. Adverse events were rarely reported, resulting in low certainty evidence.ConclusionsThe current evidence is mainly limited by imprecision and risk of bias. The available evidence does not allow firm conclusions regarding the effects of homeopathy for insomnia. High-quality, replicated trials with systematic adverse-event monitoring are needed.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1930803</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1930803</link>
        <title><![CDATA[Chronic pain in narcolepsy reflects interacting neurobiological and psychological mechanisms: a mini-review]]></title>
        <pubdate>2026-09-25T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Maria Munch-Menzer</author><author>Birgitte Rahbek Kornum</author>
        <description><![CDATA[Chronic pain prevalence is increased in the sleep disorder narcolepsy, but the underlying reason for this remains debated. This mini review summarizes and discusses current evidence on links between narcolepsy type 1 (NT1) and type 2 (NT2) and chronic pain, exploring whether pain is best understood as a consequence of the pathophysiology or secondary to its manifestations and comorbidities. Registry-based and self-reported data indicate a high prevalence of chronic pain in NT1, while objective pain tests show inconsistent differences between NT1 and healthy individuals. This discrepancy suggests involvement of secondary mechanisms not readily captured by experimental pain testing. Comparable pain prevalence in NT1 and NT2 also speaks against orexin deficiency as a sole driver of chronic pain in NT1. Alternatively, altered dopaminergic signaling downstream of orexin could be a shared contributor to pain in NT1 and other fatigue-related conditions. Finally, the presence of activating autoantibodies in NT1 suggests a possible immune-mediated component for some patients. Overall, chronic pain is highly prevalent in both NT1 and NT2. It likely arises from a combination of neurobiological and psychological factors, with immune mechanisms as a possible additional contributor, rather than, in NT1, orexin dysfunction alone. This perspective highlights the clinical need for more holistic treatment approaches and for future studies with improved case-control matching, larger NT1 samples, especially among patients with chronic pain, and more detailed comparisons with NT2.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1923070</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1923070</link>
        <title><![CDATA[Association of a stellate ganglion block-based care pathway with hypnotic medication reduction in chronic insomnia with anxiety symptoms: a real-world retrospective cohort study]]></title>
        <pubdate>2026-09-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Dongze Wang</author><author>Xiaohan Wang</author><author>Wenyuan Wang</author><author>Yanyong Wang</author>
        <description><![CDATA[BackgroundChronic insomnia with anxiety symptoms is frequently accompanied by sustained hypnotic or sedative medication use. Evidence regarding procedure-based adjuncts to structured medication reduction remains limited.ObjectiveTo evaluate whether participation in a stellate ganglion block (SGB)-based care pathway, compared with contemporaneous routine care without SGB, was associated with hypnotic or sedative medication reduction at 1 month.MethodsThis single-center retrospective cohort study screened 420 records from 1 January 2022 to 31 December 2025 and included 160 adults with chronic insomnia, anxiety symptoms, and baseline hypnotic or sedative use. Eighty patients received a standardized four-session SGB-based pathway and 80 routine-care controls were selected by outcome-blinded, 1:1 calendar-time risk-set sampling without replacement. The pragmatic 1 month composite outcome was achievement of at least one of the following: a ≥50% reduction in the exploratory operational medication-burden score, transition from combination therapy to monotherapy, or complete discontinuation maintained for ≥2 weeks. Components and class-specific benzodiazepine and Z-drug outcomes were analyzed separately. The primary adjusted model was restricted to age, sex, baseline operational burden, and baseline medication count. Robust Poisson, Firth logistic, marginal standardization, bootstrap, propensity-score matching, overlap weighting, and trimmed stabilized inverse probability weighting were used.ResultsThe composite outcome occurred in 32/80 patients (40.0%) in the SGB-based pathway group and 12/80 (15.0%) under routine care (crude risk difference, 25.0 percentage points; 95% CI, 11.7–38.3; crude RR, 2.67; 95% CI, 1.48–4.79). The core robust Poisson model yielded an adjusted RR of 2.43 (95% CI, 1.32–4.46), and marginal standardization yielded adjusted risks of 38.0% vs. 16.7% and an adjusted risk difference of 21.3 percentage points (95% CI, 8.9–32.3). The association was primarily driven by ≥50% operational-burden reduction (33.8% vs. 11.2%; adjusted RR, 2.77; 95% CI, 1.34–5.75). Transition to monotherapy and complete discontinuation were numerically more frequent but imprecisely estimated. Class-specific analyses supported an association with ≥50% benzodiazepine dose reduction; Z-drug analyses were directionally similar but less precise. Three month maintained response remained more frequent after conservative and censoring-weighted analyses. Fifteen of 80 SGB-treated patients had a recorded procedure-related event; no serious event was recorded.ConclusionParticipation in an SGB-based care pathway was associated with a higher probability of short-term medication reduction, particularly substantial dose reduction, but evidence for complete discontinuation was inconclusive. Because treatment allocation and co-interventions were nonrandomized, the results do not establish an independent causal effect of SGB.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1927453</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1927453</link>
        <title><![CDATA[Artificial intelligence for sleep-disordered breathing: a taxonomy of methods, data modalities, and clinical applications]]></title>
        <pubdate>2026-09-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Tai Dinh</author><author>Daniil Lisik</author><author>Philippe Fournier-Viger</author><author>Dat Tran</author><author>Philip S. Yu</author><author>Huynh Van Hong</author><author>Ding Zou</author>
        <description><![CDATA[Sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), is a highly prevalent group of disorders associated with disrupted sleep, intermittent hypoxemia, excessive daytime sleepiness, neurocognitive impairment, and cardiometabolic morbidity. Although laboratory polysomnography remains central to diagnosis, conventional sleep testing can be costly, labor-intensive, and difficult to scale. Recent advances in data mining, machine learning, deep learning, wearable sensing, mobile health, multimodal analytics, and large language models are creating new opportunities for more accessible, personalized, and efficient SDB care. This review examines recent advances in artificial intelligence for SDB diagnosis and management, with emphasis on polysomnography and home sleep apnea testing, wearable and contactless screening, audio and physiological-signal analysis, imaging and anatomical risk prediction, phenotyping and endotyping, treatment monitoring, continuous positive airway pressure adherence, and clinically deployable explainable AI. We also discuss the emerging role of large language models in patient education, sleep-report summarization, clinical documentation, and decision-support workflows. Finally, we identify major challenges related to data heterogeneity, external validation, interpretability, privacy, fairness, reproducibility, regulation, and real-world integration into sleep medicine. This review aims to provide an evidence-based framework for researchers and clinicians to understand current AI applications and identify future directions for precision diagnosis and management of SDB.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1928518</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1928518</link>
        <title><![CDATA[Association between meeting sleep guidelines and anxiety symptoms among Physician assistants in Ghana: a cross-sectional study]]></title>
        <pubdate>2026-09-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Richard Armah Danyi</author><author>Patrick Kwame Akwaboah</author>
        <description><![CDATA[BackgroundSleep is an important determinant of mental health, yet evidence among healthcare professionals in sub-Saharan Africa remains limited. This study examined the association between adherence to recommended sleep duration guidelines and anxiety symptoms among Physician Assistants in Ghana.MethodsWe conducted a secondary analysis of primary data collected from 439 Physician Assistants in Ghana between October and December 2024. Anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), with scores ≥8 indicating anxiety symptoms. Sleep duration was self-reported and categorized as meeting (7–9 h/night) or not meeting (< 7 h/night) recommended sleep guidelines. Multivariable logistic regression was used to examine associations while adjusting for sociodemographic, behavioral, environmental, and climatic factors.ResultsOverall, 31.9% of participants met the recommended sleep duration guideline, while 23.5% reported anxiety symptoms. In adjusted analyses, meeting the recommended sleep guidelines (aOR = 0.45, 95% CI: 0.26–0.78) was associated with lower odds of anxiety symptoms. This was confirmed in a sensitivity analysis of sleep duration (hours/day) and anxiety symptoms scores (β = −0.69, 95% CI: −1.01, −0.38). Conversely, practicing in urban settings was associated with higher odds of anxiety symptoms (aOR = 2.17, 95% CI: 1.13–4.16).ConclusionsAdequate sleep may be an important modifiable factor associated with mental health among Physician Assistants in Ghana. Efforts to support healthy sleep behaviors and create supportive environments may contribute to improved mental health among this population. Future research should include diverse cadres of healthcare professionals and consider a 24-h movement behavior approach.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1895831</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1895831</link>
        <title><![CDATA[Sex-associated circadian signaling signatures in the lateral hypothalamus]]></title>
        <pubdate>2026-09-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sara K. Pintwala</author><author>Patrick M. Fuller</author>
        <description><![CDATA[IntroductionThe lateral hypothalamus (LH) is a central integrative hub coordinating arousal, feeding, metabolism, stress responsiveness, and sleep-wake state transitions. These functions are not static across the 24-hour cycle, but instead are dynamically gated according to circadian phase and internal physiological state. Although sex differences have been documented across many homeostatic and behavioral domains linked to LH function, the molecular substrates underlying these differences within defined LH neuronal populations remain poorly understood.MethodsHere, using single-nucleus RNA sequencing, we examined the expression patterns of core clock genes and circadian signaling-associated pathways across transcriptionally resolved populations of female- and male-derived LH neurons.ResultsWhile the overall cellular architecture of the LH was highly conserved between sexes, we identified distributed and cell-type-specific differences in the expression of genes associated with intrinsic circadian regulation and sensitivity to canonical circadian neuromodulatory pathways, including vasoactive intestinal peptide, arginine vasopressin, neuromedin signaling, and melatonin receptors. These differences were observed across glutamatergic, GABAergic, orexinergic, and melanin-concentrating hormone-associated neuronal populations, suggesting that female and male LH circuits may differentially integrate temporal and physiological information despite preserving shared cellular organization.DiscussionRather than indicating sex-specific neuron classes, our findings support a model in which subtle but coordinated shifts in molecular signaling architectures are linked to female- and male-derived LH neurons. These data provide a framework for understanding how temporal regulation of competing homeostatic drives may differ between sexes and underscore the importance of incorporating sex as a biological variable in transcriptomic analyses of hypothalamic circuits.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1941767</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1941767</link>
        <title><![CDATA[Sleep medicine in Saudi Arabia: evolution, current landscape, and future directions a state-of-the-art review with an embedded health-services analysis of Ministry of Health sleep centers, 2022 to 2025]]></title>
        <pubdate>2026-09-15T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Mana Alshahrani</author><author>Ashah Jman</author><author>Abdallah Alsoheimi</author><author>Salim Baharoon</author>
        <description><![CDATA[BackgroundSleep medicine in Saudi Arabia has developed from a single academic laboratory in the late 1990s into an emerging national service. That development has played out against a heavy and still under-recognized burden of obstructive sleep apnea (OSA), low public awareness, and rising national attention to prevention, access, road safety, and value-based care.ObjectiveTo describe the evolution and current landscape of sleep medicine in Saudi Arabia, document the Ministry of Health (MOH) National Sleep Medicine Program delivered during 2022 to 2025, and interpret remaining service gaps against Vision 2030 priorities and international benchmarks.MethodsWe conducted a state-of-the-art narrative review and an ecological health-services analysis of routinely collected MOH cluster sleep-center returns. The operational dataset included 26 cluster-year observations across eight clusters and 41 standardized indicators. We summarized trends using counts, proportions, population-adjusted rates, and the compound annual growth rate (CAGR) defined as (ending value / beginning value)∧(1/years) minus 1. Spearman rank correlations explored associations between infrastructure, workforce, and output, with ties handled by mid-rank assignment. A capacity-to-demand gap model estimated annual diagnostic need under base-case and sensitivity scenarios. Program milestones were triangulated against MOH documents, Saudi Commission for Health Specialties (SCFHS) records, Saudi epidemiologic studies, AASM standards, and WHO and OECD reports.ResultsActive MOH sleep centers grew from five to eight between 2022 and 2025. PSG bed capacity rose from 8 to 20 (CAGR 35.7%), and annual sleep-study output increased from 2,290 to 5,851 (CAGR 36.7%). Pediatric in-lab PSG accounted for 557 studies in 2025, or 17% of in-lab activity. Workforce growth lagged infrastructure (CAGR 14.9%); MOH sleep-physician density reached 0.42 per million served population, far below reported international ratios. The Program delivered a national master plan, a Virtual Health Hospital sleep clinic, a readiness manual, MOH classification of eight centers, public- and private-sector regulatory frameworks, a traffic-safety proposal, public-awareness activity, and a national training workshop. Under the base case (12% adult OSA prevalence, 65% adult-population fraction, 5% annual diagnostic capture), the MOH network met about 4% of estimated annual need; sensitivity scenarios produced a coverage range of roughly 3 to 11%. The CPAP backlog-to-fulfillment ratio was 7:1, and PSG wait times varied 68-fold across centers.ConclusionsSaudi sleep medicine has moved quickly from an academic subspecialty to a nationally organized service. The next phase should shift from infrastructure expansion alone to a learning health-system model built around a national sleep registry, workforce planning, centralized PAP procurement and adherence support, standardized triage, and integration with chronic-disease, occupational-health, and road-safety programs.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1943600</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1943600</link>
        <title><![CDATA[Physical exercise as a modulator of the sleep–obesity interaction: metabolic, neuroendocrine and circadian mechanisms]]></title>
        <pubdate>2026-09-11T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Raquel M. S. Campos</author><author>Helton de Sá Souza</author><author>Carolina Machado Favaron</author><author>Guilherme Pereira Saborosa</author><author>Luciana Cervi Ferez</author><author>Sergio Tufik</author><author>Hanna Karen Moreira Antunes</author><author>Vânia D'Almeida</author><author>Marcos Mônico-Neto</author>
        <description><![CDATA[Obesity and sleep disturbances are highly prevalent chronic conditions that share multiple pathophysiological mechanisms, including chronic low-grade inflammation, neuroendocrine dysfunction, circadian misalignment, autonomic imbalance, insulin resistance, and metabolic dysregulation. These conditions establish a multidirectional relationship that contributes to the development and progression of cardiometabolic, respiratory, and psychological comorbidities. In this context, physical exercise (PE) is widely recognized as a non-pharmacological strategy for the prevention and treatment of obesity and sleep disturbances that simultaneously modulates these interconnected pathways while enhancing metabolic flexibility. Growing evidence also supports its role as a non-photic zeitgeber that synchronizes central and peripheral biological clocks, modulates clock gene expression, and influences metabolic responses according to the time of day it is performed. Through these multisystem adaptations, PE may interrupt the vicious cycle linking obesity and sleep disturbances, thereby improving metabolic health and reducing the burden of obesity-related comorbidities. This review discusses how PE modulates the multidirectional relationship between sleep and obesity through integrated multisystem adaptations, highlighting its potential to improve both sleep and overall health.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1879110</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1879110</link>
        <title><![CDATA[Responsiveness of ThymoDream® as a natural modulator of the circadian axis: a comparative RCT with melatonin supplementation employing melatonin profiling and actigraphy]]></title>
        <pubdate>2026-09-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>C. S. Harshith</author><author>Thomas V. Jestin</author><author>Das S. Syam</author><author>Prabhakaran Prathibha</author><author>Nithyanandam Allimuthu</author><author>N. Abhirami</author><author>A. Radhika</author><author>I. M. Krishnakumar</author><author>Janeesh Plakkal Ayyappan</author>
        <description><![CDATA[IntroductionNon-restorative sleep is frequently associated with disturbances in circadian regulation, impaired sleep quality, and reduced daytime functioning.MethodsThis randomized, double-blind, active-controlled, cross over study compared black cumin oil extract (TD; 200 mg) with synthetic melatonin (s-Mel; 5 mg/day) in 24 individuals with non-restorative sleep. Participants received each intervention for 7 nights separated by a 7-day washout period. Plasma melatonin was measured at fixed nighttime intervals under dim light to determine dim-light melatonin onset (DLMO), while sleep parameters were assessed using actigraphy. DLMO serves as an important physiological marker of circadian timing. Daytime sleepiness was evaluated with the Epworth Sleepiness Scale (ESS).ResultsBoth interventions significantly increased nocturnal plasma melatonin concentration under dim-light conditions (P < 0.001). TD was associated with an earlier attainment of the predefined plasma melatonin threshold of 10 pg/mL.DiscussionThe interpretation of the corresponding threshold timing in the s-Mel arm was limited due to exogenous melatonin administration. s-Mel induced a rapid early rise in melatonin followed by a sharp decline, whereas TD demonstrated a more sustained nocturnal profile. Actigraphy outcomes were generally comparable; sleep latency and total sleep time improved more with s-Mel, while TD significantly reduced cortisol levels and daytime sleepiness. Overall, TD showed earlier threshold attainment, cortisol reduction, and improved daytime alertness, supporting its potential as a natural alternative for circadian disruption and non-restorative sleep.Clinical trial registrationhttps://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTExNTY4&Enc=&userName= CTRI/2024/11/077454 dated 28/11/2024.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1714511</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1714511</link>
        <title><![CDATA[Association between sleep duration and co-existing chronic conditions in adults: insights from the 2017–2018 Canadian Community Health Survey]]></title>
        <pubdate>2026-09-09T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shirmin Bintay Kader</author><author>Jubayer Mumin</author><author>Nahin Shakurun</author><author>Sumsun Nahar Zinia</author><author>Zoe Schipper</author><author>Nusrat Sharmin Ritu</author><author>Sheikh Ahmedul Haque</author><author>Md. Marufur Rahman</author>
        <description><![CDATA[BackgroundSleep duration plays a crucial role in overall health, with far-reaching implications for individuals globally. Although research has extensively explored the association between sleep and chronic conditions, few studies have investigated the association between multiple co-existing chronic conditions on sleep duration. This study examines the association between sleep duration and the prevalence of chronic conditions in the Canadian adults from four provinces and two territories.MethodologyCanadian Community Health Survey (CCHS) 2017–2018, a population-based cross-sectional survey, was used for this study. The outcome variable, sleep duration, was assessed based on the question “Number of hours per night usually spent sleeping?” and categorized into three groups: “In between 7 and 9 h,” “Short sleep duration (< 7 h),” and “Long sleep duration (>9 h).” The primary predictor, chronic conditions, was aggregated with a response of “yes” and subsequently categorized into no chronic condition, one chronic condition, two chronic conditions, and three or more chronic conditions, based on 12 recorded chronic conditions.ResultsApproximately 41% of respondents reported short sleep duration, while 7.73% reported long sleep duration. Compared with respondents with fewer or no chronic conditions, those with three or more co-existing chronic conditions had significantly higher odds of reporting abnormal sleep duration. Specifically, respondents with three or more chronic conditions were 1.70 times more likely to report short sleep duration (95% CI: 1.52–1.91) and 2.58 times more likely to report long sleep duration (95% CI: 1.96–3.41). The odds of both short and long sleep duration increased progressively with a higher number of chronic conditions, indicating a graded association between chronic conditions and abnormal sleep duration.ConclusionThe study underscores a strong association between the number of chronic conditions and sleep duration among adults, highlighting that multimorbidity is associated with abnormal sleep patterns.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1882890</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1882890</link>
        <title><![CDATA[EEG correlates of sleep stages, sleep discrepancy, and insomnia: a comparative analysis of people with insomnia and healthy sleepers using spectral power and sample entropy]]></title>
        <pubdate>2026-09-09T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Joseph T. LeCheminant</author><author>Daniel B. Kay</author><author>Brent Feland</author><author>Chongming Yang</author><author>Jonathan Blotter</author>
        <description><![CDATA[This study investigated neurophysiological differences between individuals with and without insomnia across sleep stages and sleep discrepancy conditions using electroencephalography (EEG). EEG band powers (Delta, Beta) and entropy metrics (Sample Entropy and Multiscale Sample Entropy) were analyzed from each epoch of overnight polysomnography in 64 participants. Linear mixed-effects modeling was used to examine the influence of insomnia status, sleep stage, and electrode location on these EEG metrics. Results indicated that the EEG metrics were strongly correlated with physiological sleep stages but did not effectively distinguish self-reported sleep perception within the same polysomnographic sleep stage. Additionally, these metrics did not consistently differentiate individuals with insomnia from good sleeper controls across all conditions. Rather, individuals with insomnia exhibited regional patterns of Delta power during wakefulness, increased sample entropy during REM sleep, and decreased Beta power during positive discrepancy. These findings highlight physiological features associated with sleep stages, insomnia, and sleep discrepancy while emphasizing their complexity and the limitations of standard EEG metrics alone. Future work integrating physiological measures with self-report data may provide enhanced characterization of insomnia-related neurophysiological changes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1937989</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1937989</link>
        <title><![CDATA[Feasibility and effectiveness of a clinical model of sleep education for children with IDD: a record review]]></title>
        <pubdate>2026-09-09T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Beth A. Malow</author><author>Kasey A. Fitzpatrick</author><author>Whitney A. Loring</author>
        <description><![CDATA[IntroductionThis study was undertaken to evaluate the effectiveness and feasibility of implementing a brief community-based sleep education intervention within a collaborative clinical in academic medical setting for children with intellectual and developmental disabilities.MethodsRecord reviews were conducted from a behavioral sleep clinic serving children with IDD (age ≤ 18 years). Sixty-five children and caregiver received individualized insomnia recommendations. A follow-up visit occurred 1–3 months later. Clinical notes were evaluated using a modified Pediatric Sleep and Autism Clinical Global Impressions Scale to assess effectiveness and feasibility.ResultsAt first follow-up, 85% of caregivers reported compliance with recommendations; 85% of whom reported significant sleep improvement. Only 20% of non-compliant families reported improvement. Compliance at first follow-up was significantly associated with improvement in insomnia (Pearson chi-square and Fisher's exact test p < 0.0001).ConclusionBrief collaborative sleep education interventions are feasible and effective for improving insomnia in most children with IDD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1941077</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1941077</link>
        <title><![CDATA[Real-world reduction in nightmare frequency and distress among San Francisco first responders treated with a prescription wearable device: a 60-day open-label pilot]]></title>
        <pubdate>2026-09-09T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Brian D. Robertson</author><author>Emily F. Wargo</author><author>Joel Fay</author>
        <description><![CDATA[ObjectiveNightmares are a common, distressing condition among individuals with post-traumatic stress disorder (PTSD) and are associated with impaired sleep quality and elevated suicide risk. First responders carry a substantial burden of occupational trauma and PTSD yet are under-represented in nightmare-treatment research. NightWare is an FDA-authorized prescription wearable that monitors heart rate and movement during sleep and delivers vibrotactile feedback intended to interrupt nightmares and improve sleep quality. We evaluated the real-world response to NightWare among San Francisco first responders.MethodsFirst responders (law enforcement and fire service) prescribed NightWare in routine clinical care completed structured self-report assessments at Day 0, 30, and 60. First responders were aged 35–65, half were male and half were female. They had a PTSD diagnosis and at least 3 nightmares per week. The co-primary endpoints were nightmare frequency (self-reported nights with nightmares per week, 0–7) and nightmare-related distress (5-point ordinal scale, 0–4). Change was assessed with paired t-tests (with Cohen's d) and one-way repeated-measures analysis of variance (RM-ANOVA).ResultsOf 11 first responders who initiated treatment, 10 (91%) completed all assessments. Mean nightmare frequency decreased from 5.2 to 3.6 nights/week [mean change −1.6; 95% CI −2.7 to −0.5; t(9) = −3.21, p = 0.011; d = 1.0] and mean distress decreased from 2.9 to 1.3 [mean change −1.6; 95% CI −2.2 to −1.0; t(9) = −6.00, p = 0.0002; d = 1.9]. RM-ANOVA confirmed a significant decline across the three time points for both endpoints (frequency p = 0.009; distress p = 0.003). Seven of ten reduced nightmare frequency and nine of ten improved on distress; no participant worsened on either measure. Self-reported sleep quality and treatment satisfaction improved. The participants in this survey used the NightWare device a mean of 76% of nights (45.6 days of the 60-day survey time period). The range of usage was 55–100% (33–60 days) of the study nights.ConclusionsIn this small, open-label, real-world pilot, treatment with NightWare was associated with clinically meaningful reductions in nightmare frequency and distress and high patient acceptability among first responders. These findings are hypothesis-generating; controlled studies with validated instruments are warranted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1707437</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1707437</link>
        <title><![CDATA[Correlation of electronic gadget usage, sleep quality & daytime sleepiness with working memory in Indian young adults]]></title>
        <pubdate>2026-09-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ishan Gupta</author><author>Nasreen Akhtar</author>
        <description><![CDATA[AimTo assess the correlation of screen time, daytime sleepiness and quality of sleep with working memory in young adults.MethodsA cross sectional study of 119 young adults of the age group 18-30 years, who were administered a structured online questionnaire which collected details pertaining to basic socio denographic data, record of sleep wake activity and study habits, electronic gadget usage, working memory, as well as the standardized questionnaires Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (LSS).ResultsPoor sleep quality which is indicated by a global PSQI score of more than was noted in 72/114 (6.3%) young adults Correlation of ISS score with working nomory was statistically significant with spearman's cho of 8.2607 The fitted regression model on multiple linear regression was: Working memory 68.8 0.779 (daily average screen time) + 8.55% (global PSQT score) 0.47 (ESS score) with the overall model being statistically significant [R28.073, Γ (3, 110)2.88, p < 0.05).ConclusionsIncreased daytime sleepiness is correlated with a worse working memory among.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1881431</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1881431</link>
        <title><![CDATA[Beyond the apnea-hypopnea index: a call to action for a multidimensional evaluation in obstructive sleep apnea]]></title>
        <pubdate>2026-08-31T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Peter C. Gay</author><author>Luigi Taranto-Montemurro</author><author>Lenise J. Kim</author><author>Ali Azarbarzin</author>
        <description><![CDATA[Obstructive sleep apnea (OSA) is a highly heterogeneous chronic disease, in which the conventional measure of disease severity, the apnea–hypopnea index (AHI), correlates poorly with patient-reported symptoms and inconsistently with cardiovascular outcomes. The present perspective proposes an initial discussion of a new concept for multidimensional evaluation of patients with OSA that integrates both objective measures of upper airway obstruction (AHI) and chronic intermittent hypoxia (hypoxic burden), along with subjective assessments of nighttime and daytime symptoms burden including snoring, subjective sleep quality, daytime sleepiness, fatigue, and quality of life. This integrated approach aims to improve characterization of patients and guide more individualized therapeutic goals, including improvements in quality of life and reduction in cardiovascular and metabolic consequences. It also supports a call to action in the OSA field, encouraging the development of a more comprehensive assessment of treatment response and clinical meaningfulness in OSA.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1853970</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1853970</link>
        <title><![CDATA[Polysomnographic characteristics of excessive daytime sleepiness in postmenopausal women with obstructive sleep apnea]]></title>
        <pubdate>2026-08-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Thanida Manitchotpisit</author><author>Pansak Sugkraroek</author><author>Charnsiri Segsarnviriya</author><author>Naricha Chirakalwasan</author><author>Mart Maiprasert</author>
        <description><![CDATA[IntroductionExcessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) is linked to adverse cardiometabolic and safety outcomes, but established correlates may not apply to postmenopausal women. Data on polysomnographic determinants of EDS in this group remain limited. We examined associations between polysomnographic parameters and EDS and identified key parameters that may help discriminate EDS in postmenopausal women with OSA.MethodsIn this retrospective cross-sectional study, 216 postmenopausal women with OSA, confirmed by Level 1 polysomnography (PSG), were classified as having EDS based on the Epworth Sleepiness Scale (ESS 10; n = 110) or as non-EDS (ESS < 10; n = 106). Polysomnographic variables were compared, and multivariable logistic regression was used to build a polysomnographic multivariable model.ResultsWomen with EDS were younger and had higher BMI and neck circumference than those without EDS (p < 0.05). Higher respiratory disturbance index (RDI) values (total, supine, REM, and NREM) and lower minimum oxygen saturation were independently associated with EDS. A four-variable model (RDI, REM RDI, mean, and minimum oxygen saturation) showed moderate discrimination (AUROC 0.693).DiscussionEDS was more frequent among women with greater respiratory burden and worse nocturnal hypoxemia. Future studies using multidimensional data may improve model performance and clinical applicability.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1906714</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1906714</link>
        <title><![CDATA[Seafarer Fatigue: a qualitative study of customer-facing staff working on UK ferries]]></title>
        <pubdate>2026-08-21T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sally Maynard</author><author>Wendy Jones</author><author>Adam Asmal</author><author>Anna Anund</author><author>Andrew Pooley</author><author>Ashleigh Filtness</author>
        <description><![CDATA[IntroductionThis study explores the experiences and opinions of customer-facing seafaring staff on the subject of fatigue and how it affects their work and interactions with passengers. This group is of particular interest as were there to be an emergency at sea it is those in customer-facing roles that would take responsibility for passenger safety.MethodsData was collected from focus groups with customer-facing staff (n = 45 participants across nine discussions).ResultsFatigue was seen to be a problem, with all focus group participants having experienced sleepiness while at work and being able to detect fatigue in others. Factors identified as contributors to fatigue included: commuting, external factors such as the weather and onboard noise and shift and roster patterns. A variety of informal, self-devised (that is, not directed by a manager) countermeasures were being employed by the focus group participants, with caffeine in the form of coffee being the most common. Participating seafarers suggested that adrenaline carries them through emergency situations so that fatigue experienced after an incident was more of a concern to them than that encountered during it.DiscussionThe research represents one of the first qualitative studies to subjectively investigate fatigue amongst customer-facing staff on UK ferries, understanding their lived experience is a first step toward mitigating sleep related risks for this job role. Recommendations for ferry operating companies are made.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1883557</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1883557</link>
        <title><![CDATA[Personalized comfort settings in positive airway pressure machines using a causal inference approach: a retrospective observational analysis]]></title>
        <pubdate>2026-08-21T00:00:00Z</pubdate>
        <category>Technology and Code</category>
        <author>Chinh Nguyen</author><author>Himani Jayawardane</author><author>Hussein Emami</author><author>Nathan Liu</author><author>Bhavana Achary</author><author>Jeff Armitstead</author><author>Alison Wimms</author>
        <description><![CDATA[IntroductionTo evaluate whether data–driven personalization of positive airway pressure (PAP) comfort settings improves adherence by developing and evaluating a causal machine learning (ML) model for individualized recommendations.MethodsThe model was developed using AirSense 10 data and independently validated in temporally separated AirSense 10 and AirSense 11 cohorts, including 90–day and 1–year follow–up. The primary outcome was Centers for Medicare & Medicaid Services (CMS)–defined PAP adherence (device usage ≥ 4 h/night on ≥ 70% of nights during the first 90 days). Group–level average treatment effect (ATE) was estimated using backdoor adjustment methods. A causal forest model was applied to estimate the conditional average treatment effect for recommending personalized settings. A propensity score–matched analysis compared outcomes between patients whose actual settings matched model recommendations vs. those remaining on device default settings.ResultsThe model estimated ATE at the group level was 2.9 percentage points (p < 0.001), indicating that personalized settings were associated with improved CMS adherence. Covariate balance was achieved (standardized mean difference < 0.1), and model calibration was strong (expected calibration error 0.91%). Patients whose actual PAP settings matched the model–recommended configuration had higher device usage than matched controls who remained on default settings. Subgroup analyses confirmed consistent benefits across age groups, gender, apnea–hypopnea index, and mask type. SHapley Additive exPlanations analysis identified minimum pressure, start pressure and age as key drivers of personalization. Independent validation showed sustained usage benefits across AirSense 10 and AirSense 11 cohorts, with residual AHI remaining below the clinical reference threshold and no clinically meaningful deterioration in mask leak.DiscussionCausal ML–based personalization of PAP comfort settings was associated with improved CMS adherence/device usage. Integration of comfort setting personalization into setup workflows may enhance PAP therapy usage. As a retrospective observational analysis, these findings are associative and hypothesis–generating; the causal–inference framework, refutation testing, and large–scale independent validation provide robustness beyond that of conventional observational studies, although prospective randomized evaluation remains the definitive next step.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1826938</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1826938</link>
        <title><![CDATA[Adolescent circadian sleep health: a review of multimodal assessment strategies and clinical implications]]></title>
        <pubdate>2026-08-19T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Jamon M. Jex</author><author>Alyssa Larson Downs</author><author>Sarah Kamhout</author><author>Isabella D. Wright</author><author>Andrew Wright</author><author>Victoria Zhang</author><author>Kara McRae Duraccio</author>
        <description><![CDATA[The adolescent developmental period is marked by increased social and academic demands, as well as biological changes that lead to profound shifts in sleep and circadian timing. Circadian misalignment, short sleep duration, and irregular sleep patterns are prevalent among adolescents and are linked to a wide range of negative outcomes, including impaired emotional regulation, diminished academic performance, and increased cardiometabolic disease risk. While efforts to promote adolescent sleep health have grown, the multidimensional nature of circadian sleep health remains underassessed in both research and clinical contexts. This review provides conceptual definitions of key circadian sleep health concepts, synthesizing current best practices for measuring circadian sleep health in adolescents across self-report, behavioral, and physiological domains. We organize assessment strategies around three key circadian constructs—chronotype, circadian timing, and circadian alignment—and describe validated tools for each. In addition, we explore measurements of contextual factors influencing circadian function, such as light exposure, meal and exercise timing, pubertal status, and genetic predispositions. Throughout this review, we emphasize the value of a multimodal approach that combines subjective experience with objective biological and behavioral data to improve clinical utility and advance the understanding of circadian sleep health. We conclude by outlining directions for future research, including the need for validated, developmentally appropriate tools and the integration of wearable technologies to improve accessibility and clinical utility. By consolidating core concepts and methodological tools, this review aims to assist researchers and clinicians selecting appropriate assessment strategies and tailoring interventions to improve adolescent circadian sleep health.]]></description>
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