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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>2026-07-08T09:36:56.631+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1837234</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1837234</link>
        <title><![CDATA[Sleep, PTSD, and suicide risk in U.S. veterans]]></title>
        <pubdate>2026-06-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sara Kintzle</author><author>Leonidas Marin</author><author>Eva Alday</author><author>Nicholas Barr</author>
        <description><![CDATA[IntroductionThe stresses of military service can contribute independently to mental health and sleep problems in military personnel that persist after leaving military service. Understanding how sleep and mental health challenges contribute to behavioral health outcomes is key to supporting this population. To advance these goals, this study examined associations among PTSD, sleep disturbance, and suicide risk in U.S. veterans.MethodsOnline survey data using valid and reliable measures were collected from3,188 veterans living in Southern California as part of a large needs assessment; suicide risk was measured by the SBQ-R, which assess ideation, behaviors and attempts. A structural equation modeling approach was used to test the direct effects of PTSD on sleep problems and suicide risk, the direct effect of sleep on suicide risk, and an indirect effect of PTSD on suicide risk through the sleep pathway.ResultsFindings demonstrated significant direct effects for PTSD (B = 0.05, p < 0.001) and sleep problems (B = 0.74, p < 0.001) on suicide risk, as well as a significant indirect effect for PTSD on suicide risk through the sleep pathway (B = 0.05, p < 0.05). The structural model explained 55.3% of the variance in sleep difficulties and 29.9% of the variance in suicide risk.DiscussionResults advance the understanding of how sleep problems may be associated with the risk of suicide in U.S. veterans, both directly through its effects on suicide risk and indirectly through the effects on PTSD symptomatology. Practitioners and policy makers may consider ensuring the assessment and treatment of sleep problems in veterans are included in suicide prevention models.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1812535</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1812535</link>
        <title><![CDATA[Targeted dream incubation at sleep onset can influence later dream content in REM sleep: a pilot study]]></title>
        <pubdate>2026-06-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Adam Haar Horowitz</author><author>Karen R. Konkoly</author><author>Michelle Carr</author><author>Robert Stickgold</author><author>Pattie Maes</author>
        <description><![CDATA[Targeted dream incubation (TDI) is a highly effective method for eliciting hypnagogic dreams related to specific topics through the presentation of verbal prompts and serial awakenings at sleep onset. In this pilot study, we tested whether TDI at sleep onset can effectively direct dream content in subsequent rapid eye movement (REM) sleep. We allowed participants a daytime nap opportunity following TDI at sleep onset. Serial awakenings were performed both at sleep onset and after entry into REM sleep. Our primary objective was to assess whether the TDI protocol during the sleep onset period would continue to affect dream content in REM sleep, producing dreams of the target content (“tree”) in the first REM awakening. Our second objective was to assess incorporation when participants received additional TDI prompts following REM awakenings. All 11 participants successfully incubated the target theme at sleep onset, and eight subsequently obtained REM sleep. Four of these participants (50%) incorporated the target theme into their first REM dream, and five incorporated the target theme in subsequent REM dreams (63%). Results provide preliminary evidence that TDI may impact dreams in REM sleep. This method of engineering dreams across sleep stages may be useful for understanding how dream generation and function may be continuous or different across sleep stages.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1748727</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1748727</link>
        <title><![CDATA[The return to normal life: sleep, anxiety upon awakening, and nightmares following the crisis caused by the COVID-19 pandemic]]></title>
        <pubdate>2026-06-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Inigo Saez-Uribarri</author>
        <description><![CDATA[IntroductionThe return to normal life following the COVID-19 pandemic was evaluated in terms of anxiety upon awakening, sleep quality indicators, and dream characteristics.MethodsThe sample comprised 394 women and 107 men who completed an online self-report questionnaire between August 15, 2022, and December 8, 2022 about their sleep and dream experience from the previous night. Respondents completed the Anxiety upon Awakening Assessment Questionnaire (CEAD, as per the Spanish acronym) and evaluated their experiences of the pandemic. The data were compared to those obtained before the pandemic and those collected during lockdown in a previous study.ResultsAfter the return to normal life, 46.5% of respondents recalled at least one dream scene, and nightmares were recorded in 4.6% of cases. This percentage did not differ significantly from those observed during lockdown or before the pandemic. Compared with the previous periods, participants also reported more dreams with anxious content and greater dream recall. A return to a sleep duration of between 6 and 7 h was observed. However, anxiety upon awakening was higher, suggesting that full normalization had not yet occurred at the time of this study.ConclusionIn this sample, nightmare frequency was less sensitive than anxiety upon awakening to post-pandemic sleep-related emotional activation. The findings may be compatible with emotional-processing accounts of dreaming and with a homeostatic interpretation of sleep in which emotional dream content did not translate into more awakenings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1827400</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1827400</link>
        <title><![CDATA[Feasibility and acceptability of Nenne Navi-AI: family-tailored intervention to improve sleep in young Japanese children]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Arika Yoshizaki</author><author>Manabu Saito</author><author>Ai Terui</author><author>Kanako Kawamura</author><author>Emi Murata</author><author>Sanae Tanaka</author><author>Ikuko Hirata</author><author>Ikuko Mohri</author><author>Kazunori Komatani</author><author>Masako Taniike</author>
        <description><![CDATA[IntroductionDespite advancements in sleep medicine, inadequate sleep habits among young children persist. Establishing appropriate sleep habits in early childhood is essential for supporting physical, emotional, and cognitive development. However, scalable and personalized behavioral interventions for caregivers in community settings remain scarce, particularly AI-enabled systems designed for real-world implementation.MethodsThis study evaluated adherence, perceived usefulness, and feasibility of Nenne Navi-AI among 50 caregivers recruited in Hirosaki City, Japan, through community health checkups, childcare facilities, and public advertisements. The culturally tailored application integrates supervised machine-learning models with rule-based algorithms to provide personalized guidance and ongoing support for promoting healthier sleep habits.ResultsDuring the 6-month intervention, only 3 of 50 caregivers (6%) experienced continuous 3-month data-entry lapses, with no withdrawals. Significant pre-post improvements were observed in children's number of awakenings after sleep onset and subjective sleep quality ratings. Subgroup analyses suggested improvements among children with poorer baseline sleep habits (≥0.5 SD worse than the sample mean). Post-intervention assessments confirmed high caregiver acceptability, satisfaction, and reduced parenting stress.ConclusionsNenne Navi-AI demonstrates high feasibility with excellent 6-month adherence and favorable usability feedback. The system shows promise for improving early childhood sleep (night-waking), enhances caregiving experiences, reduces negative parenting emotions, and provides a scalable framework for future AI-enabled pediatric sleep interventions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1764378</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1764378</link>
        <title><![CDATA[Good nights sleep program: design and preliminary findings from a randomized clinical trial to improve child and parent sleep in low-income families]]></title>
        <pubdate>2026-06-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Brian T. Gillis</author><author>Ben Hinnant</author><author>Olivia Martín-Piñón</author><author>Elise L. Neuhoff</author>
        <description><![CDATA[IntroductionSleep is essential for human health. For low-income individuals and families, sufficient, high-quality, regular sleep can be difficult to obtain due to two main barriers: factors that prevent optimum sleep hygiene behaviors and aspects of the bedroom environment, such as noise and temperature, that reduce sleep. This article describes the rationale and design of the Good Nights Sleep Program, a pilot of a randomized clinical trial (clinicaltrials.gov/study/NCT06249217) that combines education with behavior change strategies that lead children and their parents to select, implement, and track changes to their sleep behaviors and environments. Following the conceptual description of the interventions, descriptive statistics from the pilot study are presented.MethodsThe study enrolled parent-child dyads with a mean family income-to-needs ratio of 1.68 (75% Black; 25% White).ResultsFindings provided proof of concept for the intervention and descriptive preliminary evidence. Children receiving the intervention had longer actigraphy-derived sleep hours compared to waitlist control-arm participants, and parents had shorter self-reported usual sleep latency and more consistent actigraphic wake times.DiscussionThe Good Nights Sleep Program offers a promising model for empowering children and parents to make attainable changes that yield benefits for their sleep.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1847000</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1847000</link>
        <title><![CDATA[Sexsomnia - a detailed approach to evaluation]]></title>
        <pubdate>2026-06-11T00:00:00Z</pubdate>
        <category>Conceptual Analysis</category>
        <author>Colin M. Shapiro</author><author>Persis F. Yousef</author><author>Julian A. Gojer</author><author>Naheed K. Hossain</author><author>Chris Y. Kim</author>
        <description><![CDATA[Sexsomnia is an underrecognized parasomnia with significant clinical, interpersonal and legal implications. This article proposes a comprehensive, structured framework for the evaluation of sleep-related sexual behaviors, aimed at improving diagnostic clarity and risk assessment. Rather than relying on isolated features, the approach emphasizes a multidimensional assessment across multiple domains, recognizing that no single factor is determinative and that not all indicators carry equal diagnostic weight. An indexed framework of 19 domains is presented, covering presenting complaints, levels of awareness during events, collateral reports, sleep history, environmental and physiological triggers, medical, psychiatric and family history, medication and substance use, lifestyle factors and prior investigations. Additional domains address behavioral indicators of risk, relationship and social context, safety planning and legal and forensic considerations. Overlapping features across domains are acknowledged, with emphasis placed on patterns across categories rather than cumulative scoring. This structured approach is intended to assist clinicians in identifying features that increase the likelihood of sexsomnia, distinguishing it from other conditions and addressing associated safety and legal concerns. The framework aims to support consistent clinical evaluation, facilitate interdisciplinary communication and inform risk management in both clinical and forensic contexts.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1771860</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1771860</link>
        <title><![CDATA[Assessing sleep, cognition and overnight memory performance in neurotypically developing youth in a children's hospital]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Gabrielle N. Deutsch</author><author>Emmet W. Klein</author><author>Chelsea E. Cadle</author><author>Katharine C. Simon</author><author>H. Gerry Taylor</author><author>Maninder Kalra</author><author>Paola Malerba</author>
        <description><![CDATA[Childhood and adolescence are times of significant maturation for cognitive abilities and cortical neurophysiology, and changes in sleep brain activity across development reflect these maturation trajectories. Furthermore, sleep is known to support changes in cognition across the lifespan, including in domains of memory, emotion regulation and executive functioning. Driven by our interest in establishing mechanistic links between changes in sleep neurophysiology and cognitive/mood symptoms in pediatric populations, we aim to establish research protocols for examining sleep-dependent cognition in a wide range of pediatric populations. As a first step, we have established a data acquisition protocol that pairs measurement of overnight memory changes with polysomnography involving a full electroencephalography (EEG) montage and standardized clinical assessments of cognition. While this is typical of a cognitive sleep laboratory, we are now executing it in the context of a pediatric hospital. The protocol is essential in creating an inclusive research program where children and adolescents with a range of conditions can participate in research in a context that is safe and tailored to their needs (a sleep center in a pediatric hospital). This article describes our first protocol, developed for typically developing youth aged 8–19 years, including collection of subjective and objective measures of sleep and cognition, emotion regulation and executive functioning, and overnight changes in memory performance. We also share strategies for ensuring data quality in our protocol.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1835364</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1835364</link>
        <title><![CDATA[Editorial: Revolutionizing sleep instability: advanced diagnosis and management of sleep disorders]]></title>
        <pubdate>2026-05-25T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Fábio Mendonça</author><author>Sheikh Mostafa</author><author>Antonio Ravelo-Garcia</author><author>Fernando Morgado-Dias</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1837613</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1837613</link>
        <title><![CDATA[Sleep quality as a predictor of learning engagement and academic self-efficacy among college students]]></title>
        <pubdate>2026-05-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jae Hee Kim</author>
        <description><![CDATA[Sleep disturbances among Korean college students are a persistent and escalating concern that significantly impacts learning performance. This study aimed to examine the association of sleep quality with learning engagement and academic self-efficacy among college students. The study participants were 195 second- to 4th-year students at universities in the Seoul metropolitan area, sampled through convenience sampling. An online survey was conducted from March 12 to April 8, 2025, adhering to ethical standards throughout the process. Data were analyzed using t-test, ANOVA, and simultaneous multiple regression analysis. Findings indicated that learning engagement was significantly higher among students with high academic achievement satisfaction, major satisfaction, and college life adjustment. Academic self-efficacy was greater among male students compared to female students, and among students with higher academic achievement satisfaction, major satisfaction, and college life adjustment. Regression analysis results indicated that sleep quality was a significant influencing factor for both learning engagement and academic self-efficacy. These findings suggest that sleep quality may be a modifiable factor worth targeting in future intervention research aimed at supporting learning engagement and academic self-efficacy. When developing these programs, incorporating strategies that consider gender, academic achievement satisfaction, major satisfaction, and college life adjustment may further enhance their effectiveness.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1832143</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1832143</link>
        <title><![CDATA[A multilevel CPAP support strategy implemented within a large stroke clinical trial (sleep SMART)]]></title>
        <pubdate>2026-05-25T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Devin L. Brown</author><author>Jeffrey S. Durmer</author><author>Mark Aloia</author><author>Rebecca M. Hankla</author><author>Kayla Novitski</author><author>Joelle B. Sickler</author><author>Shannon Considine</author><author>Emerson Delacroix</author><author>Jason C. Ong</author><author>Alp Sinan Baran</author><author>Craig S. Anderson</author><author>Dawn M. Bravata</author><author>H. Klar Yaggi</author><author>Valerie Durkalski-Mauldin</author><author>Ronald D. Chervin</author>
        <description><![CDATA[IntroductionContinuous positive airway pressure (CPAP) clinical trials require integrated CPAP support programs, especially in challenging patient populations. Herein, we describe the CPAP support program devised and implemented within the largest CPAP trial to date in patients with recent acute stroke, the Sleep for Stroke Management and Recovery Trial (Sleep SMART).MethodsWe developed a comprehensive, primarily remote, multi-level and -component automatically-adjusting CPAP (APAP) use support strategy for application across diverse enrollment sites with varied resources. Although many components were pre-planned, some were developed during the conduct of the trial, reflecting innovation and adaption to new technologies. Sites received training and guidance on APAP during the inpatient setting, and a robust telemedicine-based support program was implemented to maximize participant convenience and access. The APAP support program included patient-level behavioral and educational strategies, technical support, objective monitoring and feedback, social support, and system-level facilitation to address the complex determinants of APAP use.ResultsAmong the 146 sites across the United States, 138 enrolled at least one participant, and 129 sites randomized at least one participant. Overall, 1,892 participants were equally randomized (1:1) between the two treatment arms from 2019 to 2025, and outcome assessments are ongoing.DiscussionIn this large multicenter clinical trial of APAP in stroke patients, a range of APAP support components were implemented at site- and participant-levels. A comprehensive and standardized APAP support program can be delivered, using a combination of centralized and non-centralized tools, without reliance on local sleep medicine expertise for a clinically complex and difficult-to-treat population.Clinical trial registrationclinicaltrials.gov, identifier NCT03812653.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1719668</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1719668</link>
        <title><![CDATA[The association between perceived bedtime autonomy, sleep patterns, and daytime functioning in adolescents]]></title>
        <pubdate>2026-05-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sarah Hartley</author><author>Sylvie Royant-Parola</author><author>Sylvain Dagneaux</author><author>Frédérique Aussert</author><author>Catherine Tobie</author><author>Sandrine Launois</author><author>Marta Fernandez-Bolanos</author><author>Amandine Rey</author><author>Stéphanie Mazza</author>
        <description><![CDATA[IntroductionSleep duration in adolescents is determined by bedtime as weekday getting up times are fixed by school starting times. The impact of adolescents' choice of bedtime (bedtime autonomy) during the week and at the weekend on sleep duration and sleep timing has been little studied.MethodsA cross sectional questionnaire survey of adolescents responding to an online survey recorded sleep habits on school nights and weekends, screen use and daytime repercussions. Bedtime autonomy (determining one's own bedtime) on weeknights and at weekends, sleep deprivation (< 7 h in bed/night), school night sleep restriction (≥2 h difference in time in bed on school nights vs. weekends), social jetlag (midpoint of time in bed variation >2 h between school nights and weekends), difficulty waking, level of anxiety/depression hospital anxiety and depression scale (HAD), sleepiness (FSSA-8 sleepiness scale), duration of screen use and timing of screen use (evening, after bedtime, during the night) were determined.ResultsTwo thousand eight hundred ninety-five questionnaires were returned of which 2,512 were completed by adolescents (70% female, mean age 14.46 ± 2.08). Fourteen percent were non autonomous (NA), 21% were autonomous at the weekend only weekend autonomy (WA) and 65% at the weekend and on weeknights total autonomy (TA). Autonomy increased with age (p < 0.001) and female sex (p < 0.001). Weekend autonomy is granted to younger children than weeknight autonomy (13.61 ± 2.0 vs. 16.4 ± 2.8): nearly all participants were totally autonomous by the age of 18. In a model adjusting for age, sex, mood, and sleepiness potential sleep deprivation was linked to WA and more strongly to TA while social jetlag was only associated with WA.ConclusionBedtime autonomy is an important factor in determining bed time duration and sleep rhythms in adolescents.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1800391</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1800391</link>
        <title><![CDATA[Psychometric evaluation of the Values Inventory: structural validity, internal consistency, and the integration with sleep value in a U.S. adult online sample]]></title>
        <pubdate>2026-05-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Dustin Sherriff</author><author>Abby Woolley</author><author>Brandon Pattillo</author><author>Chongming Yang</author><author>Kara M. Duraccio</author><author>Daniel B. Kay</author>
        <description><![CDATA[Personal values shape health behaviors, yet the role of sleep value within broader value systems remains unknown. This study aimed to validate the Values Inventory, a novel measure assessing individual life values, and examine how sleep value fits into broader these value orientations. An online sample of U.S. adults (N = 455) completed the Values Inventory and the Sleep Valuation Item Bank 2.0 (SVIB-2.0), along with demographic and sleep-related surveys. Exploratory factor mixture modeling and confirmatory factor analysis supported a five-factor structure of the Values Inventory: Health/Wellbeing, Fundamental Human Values, Social Status, Personal Accomplishment/Global Advancement, and Community/Belonging. Internal consistency was high across factors (ω ≥ 0.88). Structural equation modeling revealed significant associations between demographic characteristics and value endorsements. Sleep health, along with mental and physical health, formed the core of the Health/Wellbeing factor, supporting the common belief that sleep is a pillar of health. Age was significantly associated with higher valuing of Health/Wellbeing and Fundamental Human Values. Multivariate analysis of variances comparing Values Inventory factors across previously established sleep value profiles (Unconcerned, Appreciative, Devalue, Ambivalent Priority, and Concerned) revealed distinct value patterns. The Appreciative profile showed the highest valuation of Health/Wellbeing. The Ambivalent Priority profile showed the highest valuation of Social Status and Community/Belonging. Findings support the Values Inventory as a psychometrically sound tool for assessing individual value systems and highlight the complex role of sleep. These results suggest the need for future research determining whether aligning sleep health interventions with individuals' broader values may enhance effectiveness and relevance.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1828583</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1828583</link>
        <title><![CDATA[Weight and sleep health in OSA: exploring their link]]></title>
        <pubdate>2026-05-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Caroline J. Beatty</author><author>Shane A. Landry</author><author>Dwayne L. Mann</author><author>Simon A. Joosten</author><author>Kaitlin Day</author><author>Maxine P. Bonham</author><author>Denise M. O'Driscoll</author><author>Alan Young</author><author>Ladan Ghazi</author><author>Chiara Murgia</author><author>Terry P. Haines</author><author>Garun S. Hamilton</author><author>Bradley A. Edwards</author>
        <description><![CDATA[ObjectivesWeight loss is often recommended for individuals with obesity and OSA, however, weight loss is particularly hard for this population. This study investigates how weight and weight change are associated with sleep health in people with OSA.MethodsSleep data were analyzed from participants (n = 28) newly diagnosed with OSA over 12-months during which time they underwent a 6-month weight-loss intervention in a step-wedge design. Sleep duration, sleep regularity, and sleep efficiency were calculated for each participant based on Fitbit data. Linear mixed-effects models were used to examine the relationships between each sleep variable and weight and weight change over the intervention period.ResultsParticipants were middle-aged (51 ± 10 years), living with obesity (32.6 ± 4.4 kg/m2), and severe OSA (AHI 30.5[26.6, 49.8] events/h). There was no association between changes in weight and sleep duration or sleep efficiency. The higher an individual's weight (kg), the more likely they were to have irregular sleep (estimate = 0.81, 95% CI [0.29, 1.32] min, and p = 0.002). Conversely, weight changes (kg) were not associated with changes in sleep regularity (estimate = −0.10, 95% CI [−1.51, 1.31] min, and p = 0.884).ConclusionsHigher weight was associated with worse sleep regularity. However, weight change was not associated with improvements in sleep regularity. Our findings demonstrate an association between weight and poor sleep in people with OSA, but the relationship is likely complex.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1787776</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1787776</link>
        <title><![CDATA[Bedtime Stories: a sleep health education protocol for primary care clinicians, caregivers, and school-age children]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Jessica M. Page</author><author>Grace Wang</author><author>Rebecca Robbins</author><author>Pallas Snider Ziporyn</author><author>Monica Ordway</author><author>Judith Owens</author>
        <description><![CDATA[ObjectivesTo examine the feasibility of Bedtime Stories, a sleep health education program designed to promote equitable pediatric sleep health among pediatric primary care clinicians (PCCs), caregivers, and school-aged children in community-based practice settings.MethodThe Bedtime Stories program is informed by the socioecological model developed using the Consolidated Framework for Implementation Research, principles of social learning, and guidelines for feasibility pilot studies. The program includes three single-arm, pre–post pilot studies that will be conducted using: (1) a web-based provider sleep health education course (NCT06455579), (2) a digital caregiver sleep health intervention (NCT06618040), and (3) a children's book, My Sleep Recipe. The program's primary outcomes include benchmarks for participant recruitment and retention, along with metrics to evaluate feasibility and acceptability. Exploratory outcomes include providers' and caregivers' knowledge, self-efficacy, and changes in child sleep. Statistical analyses will focus on descriptive statistics and 95% confidence intervals.ResultsResults will provide data on feasibility, engagement, and satisfaction for PCCs, caregivers, and school-aged children. Furthermore, they will provide preliminary insights into implementation barriers and facilitators for supporting sleep health practices, especially in underserved pediatric populations.ConclusionsThis protocol outlines a scalable, multilevel framework for promoting pediatric sleep health. Findings will inform refinements and larger-scale trials to address sleep health practices through coordinated, equity-centered approaches that foster healthy sleep practices and reduce sleep health disparities across diverse communities.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1731331</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1731331</link>
        <title><![CDATA[A multi-method pilot exploration of a brief behavioral sleep intervention for school-aged children: feasibility, acceptability, and initial evaluation]]></title>
        <pubdate>2026-05-05T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Isabella Delores Wright</author><author>Gracie Crandall</author><author>Scott Baldwin</author><author>Kara McRae Duraccio</author>
        <description><![CDATA[ObjectivesParents often lack knowledge regarding healthy sleep practices, and little is known about whether a brief behavioral intervention emphasizing mastery, personalization, motivation, and modeling can increase parental knowledge of childhood sleep and promote child sleep health outcomes. This multi-method pilot study aimed to (1) assess parental knowledge of healthy child sleep practices, (2) determine the preliminary efficacy of a brief, personalized sleep intervention on parental self-efficacy and child sleep behaviors, and (3) examine the feasibility, acceptability, and parent-perceived impact of the intervention on child sleep health and parental knowledge.Methods54 Parent-child dyads in a community sample participated in a 7-day baseline sleep assessment before attending a brief behavioral intervention appointment designed to improve child sleep. Two weeks later, parents completed an additional sleep assessment, participated in a qualitative interview, and reviewed actigraphy data to evaluate changes in child sleep.ResultsParental knowledge of healthy child sleep practices improved significantly following the intervention (p < 0.001, ηp2 = 0.245). Self-reported child sleep disturbance (p = 0.041, ηp2 = 0.084), pediatric insomnia severity (p < 0.001, ηp2 = 0.213), and parental self-efficacy (p = 0.036, ηp2 = 0.088) also significantly improved. Objective sleep measures (sleep duration, onset latency) did not change (p's > 0.05), and sleep efficiency declined (p = 0.001). Qualitative feedback indicated the intervention was acceptable and feasible.DiscussionThe pilot brief behavioral intervention improved parents' perception of child sleep health, parental self-efficacy, and parental sleep knowledge. Despite limited changes in objective sleep measures, findings from this predominantly subclinical, community-based sample suggest that brief, personalized behavioral interventions may be a feasible and acceptable approach for promoting sleep health and supporting families. Future investigations, including randomized control trials and longer follow-up periods, are warranted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1819496</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1819496</link>
        <title><![CDATA[The role of nasal patency in obstructive sleep apnea: an expert consensus]]></title>
        <pubdate>2026-04-28T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Andrew M. Vahabzadeh-Hagh</author><author>Patrick J. Strollo</author><author>Masayoshi Takashima</author><author>Kathleen Yaremchuk</author><author>Thomas Heineman</author><author>Ofer Jacobowitz</author><author>Yi Cai</author><author>Jolie Chang</author><author>Maria Suurna</author><author>Carol Yan</author><author>Atul Malhotra</author>
        <description><![CDATA[Obstructive sleep apnea (OSA) is estimated to affect up to 1 billion people worldwide, although the majority of the disease remains undiagnosed and untreated. OSA has major cardiometabolic and neurocognitive sequelae, making effective treatment a public-health priority. Nasal positive airway pressure (PAP) therapy remains the most effective non-surgical therapy, and provides transformative benefits for some patients. However, tolerance and long-term adherence remain problematic for a substantial subset of patients, particularly those with nasal airway obstruction (NAO). Inadequate nasal patency increases resistance and hinders effective PAP use, prompting many patients to struggle with or abandon therapy. This challenge underscores the need to identify strategies that optimize PAP adherence through improved nasal function. A converging body of physiological evidence, large-scale observational data, and controlled clinical trials demonstrates that nasal airway obstruction, particularly at the nasal valve, can be a fundamental limitation to continuous positive airway pressure (CPAP) success. To address this challenge, a multidisciplinary expert panel of clinicians in sleep medicine, otolaryngology, and pulmonology medicine convened to review the physiologic mechanisms linking nasal resistance to upper-airway collapsibility, evaluate outcomes after restoration of nasal patency, and examine the role of minimally invasive therapies such as temperature-controlled radiofrequency (TCRF) remodeling. The group concluded that nasal obstruction management and optimization should be viewed as an integral component of OSA management, with the goal of improving CPAP adherence and patient outcomes.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1806980</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1806980</link>
        <title><![CDATA[Prevalence of different parasomnias in the general Norwegian population, and their association with insomnia, anxiety, and depression. A cross-sectional web-panel survey]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Erlend Haarr Drugli</author><author>Oskar Emil Lehmann</author><author>Ståle Pallesen</author><author>Ingvild West Saxvig</author><author>Siri Waage</author><author>Bjørn Bjorvatn</author>
        <description><![CDATA[ObjectiveTo estimate the prevalence of various parasomnias in the general Norwegian adult population and explore their associations with insomnia, anxiety, and depression.MethodsA cross-sectional online survey was conducted in September 2024 among 1002 adults (50.7% male, mean age 50.3), drawn from a large population-based sample from a national web panel. Participants reported lifetime and past 3-month (current) prevalence of eleven different parasomnias, including both NREM- and REM-related subtypes. Validated instruments assessed insomnia (Bergen Insomnia Scale), anxiety and depression (Patient Health Questionnaire-4). Associations were analyzed using chi-square tests and logistic regressions, adjusting for age, sex, educational level, and circadian preference. Response rate was 19.8%.ResultsLifetime prevalence of the parasomnias ranged from 2.3% (sleep-related eating disorder) to 47.2% (nightmares), while current prevalence ranged from 1.0% (injured somebody else during sleep) to 33.1% (nightmares). Insomnia, anxiety, and depression were associated with most of the parasomnias [e.g., nightmares-anxiety (OR 1.58; CI 1.42–1.74)]. Parasomnias were more common in younger participants, while sex differences were few.ConclusionMany of the parasomnias were commonly reported and strongly associated with insomnia and mental health symptoms. These findings underscore the need for increased clinical awareness and further research on parasomnias.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1791640</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1791640</link>
        <title><![CDATA[Implementation and feasibility of an interdisciplinary pediatric positive airway pressure adaptation program in a Brazilian public sleep clinic]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Ila Linares</author><author>Jeane Xavier</author><author>Caroline Borginho</author><author>Clarissa Bueno</author><author>Anna Monazzi</author><author>Simone Fagondes</author><author>Renatha E. Rafihi-Ferreira</author><author>Melissa Xanthopoulos</author><author>Leticia Azevedo Soster</author>
        <description><![CDATA[IntroductionThe early diagnosis and treatment of pediatric obstructive sleep apnea (OSA) can improve academic performance of affected children, in addition to enhancing their cognitive and social development. Since the effective use of positive airway pressure (PAP) is limited by difficulties in adherence to the device, adaptation and engagement programs may improve outcomes in pediatric patients.ObjectiveThe aim of this study is to describe an interdisciplinary program to improve PAP adherence among children with OSA in Brazil's public health system, also assessing its feasibility, acceptability, fidelity, and scalability based on implementation science frameworks, with the goal of informing sustainable clinical practice and public policy.MethodThe program is based on the CPAP Program developed and implemented by the Children's Hospital of the Philadelphia Sleep Center. This prospective study will involve patients aged 1 year to 18 years treated at the children's sleep clinic who have a diagnosis of OSA and indication for PAP treatment. The main outcome measures will include (1) percentage of patients who return for a follow-up visit within 4 months of treatment initiation, (2) the median number of days from the initial visit to the first follow-up visit, (3) task analysis questionnaire, (4) objective data obtained from the device's memory card.ConclusionThe program proposed is expected to provide an integrated clinical service, optimizing the time of adaptation to PAP, increasing adherence rates, and reducing the costs associated with medical problems of untreated OSA.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1802882</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1802882</link>
        <title><![CDATA[Differences in sleep spindles and polysomnography in humans: a meta-analysis on the influence of age, sex, and cognitive ability]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Diana Campos-Beltrán</author><author>Shu Zhang</author><author>Lisa Marshall</author>
        <description><![CDATA[This meta-analysis examines EEG sleep spindle and macrostructure differences in humans related to healthy aging, sex, and cognitive ability. Inclusion criteria required quantitative EEG data of healthy subjects, including sleep spindle properties and sleep polysomnography comparing younger to older subjects, females to males, and/or correlations with cognitive ability scores. The search included seven databases. The Mixed Methods Appraisal Tool (MMAT) calculated the study quality (risk of bias). Two meta-analyses used Hedges' g, and one averaged correlation (95% CI), all conducted with Meta-Essentials v1.4, with standard assessments of heterogeneity, publication bias, and meta-regression, supplemented by subgroup and sensitivity analyses. Results provide tables, forest plots, funnel plots, and bubble plots. k = 42 studies with N = 1,878 healthy subjects met our criteria. With age, sleep spindles decreased in amplitude, density, and duration. Sleep quality was reduced in older subjects showing shorter durations of both slow wave sleep (SWS) and rapid-eye movement (REM) sleep. Females revealed higher sleep spindle power (11–16 Hz), more prominent in older subjects; greater sleep efficiency, more total sleep time (TST), and longer SWS. Correlations between sleep properties and cognitive ability revealed age-dependent effects. Results yield key considerations in population comparisons and when targeting spindle activity, both for mechanistic research and for neuropsychiatric treatment. Yet further systematic investigations are warranted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1714777</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1714777</link>
        <title><![CDATA[Sleep quality assessment in hospitalized postoperative surgical patients: a COSMIN-based systematic review]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Nunung Nurhayati</author><author>Agung Waluyo</author><author>I. Made Kariasa</author><author>Sali Rahadi Asih</author><author>Hening Pujasari</author><author>Bahrul Hayat</author>
        <description><![CDATA[BackgroundSleep is a crucial physiological process that significantly influences recovery among hospitalized postoperative surgical patients, including those treated in intensive care units and general surgical wards. Reliable and valid instruments for assessing sleep quality are essential for guiding clinical decision-making and improving patient outcomes. However, the psychometric properties of commonly used sleep assessment tools remain inconsistent, highlighting the need for systematic evaluation.ObjectiveThis study aimed to conduct a COSMIN-based systematic review to examine the measurement properties of sleep quality assessment instruments used in hospitalized postoperative surgical patients.MethodsA systematic literature search was conducted across PubMed, Scopus, Web of Science, CINAHL, and PsycINFO for studies published between 2010 and 2024. The methodological quality of each study was evaluated using the COSMIN Risk of Bias checklist, and a narrative synthesis was performed to summarize the psychometric evidence for each instrument.ResultsOf the 210 studies initially identified, 37 met the eligibility criteria. The Pittsburgh Sleep Quality Index (PSQI) demonstrated adequate reliability and construct validity but showed limitations related to measurement error and responsiveness. The Richards–Campbell Sleep Questionnaire (RCSQ) exhibited strong reliability and construct validity, though variability was observed in interrater agreement between nurses and patients. The Epworth Sleepiness Scale (ESS) was reliable for assessing daytime sleepiness but provided limited evidence for structural validity in postoperative contexts. The Sleep Quality Questionnaire (SQQ), Verran and Snyder-Halpern Sleep Scale (VSH), and Insomnia Clinical Evaluation (ICE) showed mixed psychometric properties, indicating the need for further validation in hospitalized postoperative populations.ConclusionThe PSQI and RCSQ remain the most frequently utilized sleep assessment instruments; however, their psychometric limitations warrant cautious interpretation. This review underscores the need for further research to refine, validate, and potentially develop more robust sleep assessment tools tailored to hospitalized postoperative surgical patients.]]></description>
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