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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>2026-07-28T20:52:40.394+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1876293</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1876293</link>
        <title><![CDATA[Sleep health in black families: bedtime routines and sleep patterns among young children]]></title>
        <pubdate>2026-07-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Alicia Chung</author><author>Monica Stanton-Koko</author><author>Willa Johnson</author><author>Azizi Seixas</author><author>Debbie Chung</author><author>Iheoma U. Iruka</author><author>Laurie Brotman</author><author>Keng-Yen Huang</author><author>Girardin Jean-Louis</author>
        <description><![CDATA[IntroductionYoung Black children experience poorer sleep health than children from other racial/ethnic groups. Tailored family-centered interventions are needed to improve sleep health among young Black children. Tailoring requires information about parent perceptions, practices and context. The purpose of this study was to (1) understand the contextual definition of sleep health for Black families; (2) bedtime routines and sleep practices among Black families; and (3) parent preferences that may inform intervention design.MethodsWe engaged 30 Black parents of 3–8-year-old children with mild sleep problems (e.g., child takes >30 min to fall asleep at bedtime) in this study. Parents completed three ratings scales about sleep health practices and child bedtime behavior and a semi-structured interview. Statistical analysis included descriptive statistics and correlations. We used an implementation science rapid qualitative analysis approach to analyze qualitative data from the interviews.ResultsThe final sample identified as 52% African-American, 14% Jamaican, 10% Haitian, and 26% mixed multi-ethnic groups. Parent mean age was 41 years and child mean age were 5 years old. About 80% of responders were women. About one-third of the sample held a doctoral degree, and half the sample had a bachelor's or Master's degree. Parents answered 56% of sleep knowledge questions accurately (ranging from 32 to 100%) and reported an average of two sleep problems. Parents described healthy sleep as involving flexibility in sleep timing and bedtime routines. More than half of parents reported co-sleeping practices, with reasons ranging from a strategy to address night wakings, to a way to preserve bonding. Later child bedtime (after 9 pm) was associated with bedtime resistance, permissive parenting, and parent stress. Many parents reported that they had poor sleep quality and duration.DiscussionFindings elucidate a range of factors to consider in tailoring sleep health interventions for Black families of young children. These include the common practice of co-sleeping, parents' value for flexibility related to bedtime and bedtime routines, and parents' own challenges with getting enough and good quality sleep. Tailored family-centered interventions will benefit from considering these factors.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1866589</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1866589</link>
        <title><![CDATA[Short sleep, lifestyle, cardiovascular risk, and health awareness among Polish final-year secondary school students: findings from a nationwide study]]></title>
        <pubdate>2026-07-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Dorota Godzina</author><author>Agnieszka Doryńska</author><author>Ludmiła Podgórska-Stawiecka</author><author>Anna Mizerska</author><author>Witold Smigielski</author><author>Piotr Dobrowolski</author><author>Aleksander Prejbisz</author>
        <description><![CDATA[BackgroundSleep is an important regulator of metabolic and cardiovascular health. Insufficient sleep is associated with adverse health behaviors and increased cardiovascular risk in young adults. Understanding sleep patterns and risk awareness in this group is essential for prevention.MethodsA nationally representative cross-sectional survey was conducted among 9,874 final-year Polish secondary school students. The questionnaire assessed sleep duration, physical activity, diet, alcohol and tobacco use, screen time, body mass index (BMI) and blood pressure. Associations between weekday sleep duration and lifestyle factors and cardiovascular risk were analyzed.ResultsOver 46% of students reported sleeping less than 7 h on weekdays, with longer sleep on weekends (6.7 ± 1.3 vs. 9.0 ± 1.5 h, p < 0.001). Short sleep was associated with higher consumption of processed foods, alcohol use, tobacco smoking, lower winter physical activity, and greater screen time. Students sleeping <7 h were more often underweight or obese. Awareness of short sleep as a cardiometabolic risk factor was limited.ConclusionsInsufficient sleep is common among Polish young adults and is associated with an unfavorable behavioral and cardiometabolic risk profile.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1818620</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1818620</link>
        <title><![CDATA[Efficacy of sleep promotion strategies in childcare settings and sleep outcomes in young children: a systematic review]]></title>
        <pubdate>2026-07-22T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Belinda O'Hagan</author><author>Sumner Chmielewski</author><author>Naomi Deokule</author><author>Alexandra Josephson</author><author>Tayla Von Ash</author>
        <description><![CDATA[ObjectivesTo summarize findings and provide methodological critique of studies examining the impact of sleep promotion strategies in childcare on young children's sleep outcomes.MethodsThe search run in PubMed, PsycINFO, and CINAHL yielded a total of 3,528 unique articles. Eligible studies included young children (under 5 years old); assessed the impact of at least one sleep promotion strategy whether structural (e.g., mandatory naptime) or behavioral (e.g., music) with both within- and between-subject designs eligible); and included at least one quantitative child sleep outcome.Results6 studies met the eligibility criteria. Identified childcare sleep promotion strategies included mandatory naptime (n = 4), music (n = 1), and massage therapy (n = 1). Findings indicated that mandatory naptime was associated with increased napping. One study found that mandatory naptime was associated with reduced nighttime sleep and total daily sleep duration. Music and massage therapy were associated with reduced nap latency.ConclusionsThere is a paucity of research on sleep promotion strategies in childcare. This is an important research gap given the established health benefits of sufficient sleep and that many children from historically disadvantaged backgrounds depend on naps to meet their sleep needs. Future studies examining the effects of sleep promotion strategies other than mandated naptime, such as the sleep environment and provider behaviors, are needed.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1858267</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1858267</link>
        <title><![CDATA[Apnea-hypopnea index estimation using overnight chest-wall accelerometry]]></title>
        <pubdate>2026-07-20T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fons Schipper</author><author>Pedro Fonseca</author><author>Angela Grassi</author><author>Marco Ross</author><author>Fokke B. van Meulen</author><author>Merel van Gilst</author><author>Pien F. N. Bosschieter</author><author>Emily Schoustra</author><author>Ruud J. G. van Sloun</author><author>Fayçal Abdenbi</author><author>Nico de Vries</author><author>Raphael Heinzer</author><author>Jean-Louis Pépin</author><author>Sebastiaan Overeem</author>
        <description><![CDATA[Rationale and study objectivesTo develop a method for apnea-hypopnea index (AHI) estimation using a chest-worn accelerometer, as an approach to obstructive sleep apnea diagnosis and long-term monitoring of treatment, for example through positional therapy.MethodsWe developed a method for AHI estimation by combining a cardiorespiratory sleep staging algorithm with an adapted neural network for detecting respiratory events. Originally based on electrocardiography and respiratory impedance plethysmography, the network was retrained using chest-wall accelerometry-based instantaneous heart rate and respiratory effort. Training and validation utilized accelerometer data from 413 participants across two centers, recorded during diagnostic overnight polysomnography (PSG), in absence of any therapy. The dataset was split equally: half was used to train the neural network, and the remaining half to evaluate its performance. This evaluation compared the accelerometry-derived overnight AHI against the reference from PSG, both overall and separately for supine and non-supine sleeping positions.ResultsSleep staging reached substantial agreement with polysomnography, achieving a Cohen's kappa coefficient of agreement of 0.67 for four-class sleep staging (Wake/REM/N1-N2/N3). AHI was estimated with highly reliable, showing an intraclass correlation coefficient of 0.90 (95% CI: 0.86–0.92) when compared to polysomnography-derived values. Performances were consistent in both supine and non-supine sleeping positions. Positive likelihood ratios were high (7.1, 16.0, and 165.7 for the mild, moderate, and severe OSA severity classes, using near-boundary double labeling). Negative likelihood ratios were low (0.095, 0.153, and 0.069 for the same cases).ConclusionAHI can be reliably estimated using chest-wall accelerometry. This approach may be used in diagnostic tests for OSA but also to assess residual AHI during positional therapy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2026.1846349</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2026.1846349</link>
        <title><![CDATA[Narcolepsy-like pathologic daytime sleepiness in a patient with obsessive-compulsive disorder and attention deficit hyperactivity disorder: a Case Report]]></title>
        <pubdate>2026-07-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Sandra Hackethal</author><author>Marco Pecorini</author><author>Francesca Duranti</author><author>Mauro Manconi</author><author>Silvia Miano</author>
        <description><![CDATA[Excessive daytime sleepiness (EDS) is a frequent complaint in the general population. Other than being a common symptom associated with various sleep disorders, EDS may be a consequence of chronic sleep deprivation or the primary symptom of central disorders of hypersomnolence (CDH). In addition to narcolepsy type 1 (NT1), the other conditions within the CDH spectrum are less well-defined and share considerable clinical and neurophysiological similarities. Herein, we describe the clinical management of a complex case that highlights several challenges in the diagnostic process of a patient with EDS and a history of obsessive-compulsive disorder (OCD). In the absence of other sleep disorders, secondary structural causes, and orexin deficiency as possible causes for EDS, the patient was initially diagnosed with NT2 based on electrophysiological criteria. However, the clinical course, which showed only a partial response to various stimulant medications for subjective and objective daytime sleepiness, led us to question the diagnosis. A detailed psychiatric and neuropsychological assessment revealed, in addition to the previously identified severe OCD and anxiety, a diagnosis of attention deficit hyperactivity disorder (ADHD), subsequently leading to a revised diagnosis of hypersomnia associated with a psychiatric disorder (HPSY). The literature regarding OCD and sleep disorders remains scarce but the connection between ADHD and hypersomnia, as well as narcolepsy, is well-established. Our case report illustrates that a psychiatric and neuropsychological assessment should be considered mandatory for patients with objective EDS.]]></description>
      </item><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.2026.1719668</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.2026.1837613</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.2026.1835364</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.2026.1800391</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>
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