To examine the relationships between subjective sleep quality, chronotype and social jetlag with perceived psychological stress in a sample of Irish adults. An observational cross-sectional study of 400 adults. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index, chronotype and social jetlag were assessed with the Munich Chronotype Questionnaire, and psychological stress was measured with the Perceived Stress Scale. Correlational, groupwise and path analyses were applied to the data to examine the relationships between perceived stress and sleep variables, age and sex. Bivariate correlation analyses revealed statistically significant associations between both social jetlag and mid-sleep on free days and perceived stress (small effects), and moderate associations between subjective sleep quality and perceived stress. Groupwise analysis revealed that individuals in the high perceived stress group displayed greater social jetlag and poorer sleep quality, but no difference in chronotype, when compared to those with low or moderate stress. Path analysis revealed a moderate reciprocal relationship between subjective sleep quality and perceived stress, no direct effects of chronotype or social jetlag on perceived stress and a small indirect effect of average nightly sleep duration on perceived stress mediated through subjective sleep quality. Chronotype and social jetlag have minimal relationships with perceived stress, whilst subjective sleep quality has a moderate reciprocal relationship with perceived stress.

Nonrestorative sleep (NRS) refers to the subjective experience of not feeling refreshed after sleeping. Although associations between NRS and mental and physical health have been reported, their relationship with long-term healthcare costs has not been examined. This study investigated whether NRS is associated with increased long-term healthcare costs using a large-scale cohort dataset from Japan. We analyzed the annual health screening and medical claims data of 117,049 individuals enrolled in a health insurance association for civil engineering and construction workers. NRS was assessed in the 2018 health screening using a single item: "Do you feel refreshed after a typical night's sleep?" Annual healthcare costs were calculated using medical claims data from fiscal years (FY) 2018 to 2023. Mixed-effects models for repeated measures, including interaction terms, were used to examine the association between NRS and healthcare costs over time. Sex-stratified analyses were also performed. At baseline, 45.7% of participants reported NRS. From FY 2020 onward, healthcare costs were significantly higher in the NRS group than in the restorative sleep (RS) group. In FY 2023, the cost difference was JPY 18,468 (95% CI: 7,306 to 29,630). Interaction analysis revealed that the cost gap between the NRS and RS groups widened significantly over time. Similar trends were observed in the sex-stratified analysis. NRS is significantly associated with increased long-term healthcare costs, suggesting an important medical and economic impact. Screening for NRS during routine health checkups and providing early interventions may be beneficial in reducing healthcare costs.

This study investigated factors associated with possible consultation behavior (PCB) for obstructive sleep apnea (OSA; together, PCB-OSA) among male Japanese workers to promote early intervention and treatment. Data from 20,063 male employees were retrospectively analyzed. PCB-OSA was identified by the presence of at least one of the following medical procedure codes in the medical claim records from April 1, 2018, to March 31, 2019: polysomnography, home sleep apnea test, or percutaneous arterial blood oxygen saturation with an OSA diagnosis. Binomial logistic regression was used to assess factors related to PCB-OSA and the initiation of continuous positive airway pressure treatment in both the overall cohort and the OSA risk groups, defined by our objective measure-based OSA risk scale. Age (odds ratio [OR] = 1.01, 95% confidence interval [CI] [1.00, 1.02]), hypertension (OR = 1.38, 95% CI [1.10, 1.74]), heart disease (OR = 2.17, 95% CI [1.31, 3.58]), subjective sleepiness (OR = 1.49, 95% CI [1.16, 1.92]), habitual snoring (OR = 1.41, 95% CI [1.12, 1.77]), and witnessed apnea (OR = 2.13, 95% CI [1.63, 2.80]) were significantly and positively associated with PCB-OSA. Meanwhile, blue-collar workers (OR = 0.65, 95% CI [0.51, 0.82]) were significantly and negatively associated with the behavior. In the OSA high-risk group, working 6 or more days per week (OR = 0.62, 95% CI [0.40, 0.96]) was significantly and negatively associated with PCB-OSA. The study population showed a low rate of PCB-OSA. Obesity was not associated with PCB-OSA, and blue-collar workers exhibited a negative association, highlighting the need for disease education in this population.

Current research provides limited evidence for connections between metal exposure, as an emerging environmental risk factor, and obstructive sleep apnea (OSA) risk. This study aimed to examine the associations between blood and urine metal exposure and OSA risk. This cross-sectional study recruited participants and extracted data from the 2017-2020 round survey of the National Health and Nutrition Examination Survey. OSA was ascertained using the STOP questionnaire. Eight metals in blood samples were detected in 3,857 participants, and seven metals in urine samples from 1,902 participants. The combined effects of blood or urinary metal mixtures on OSA were assessed using Weighted Quantile Sum (WQS) regression and Quantile-based g-computation (Qgcomp) models. Odds ratio (OR) with 95% confidence interval (CI) was estimated using a weighted logistic regression model. Restricted cubic spline (RCS) models were applied to display the nonlinear associations. Both the WQS model (OR: 1.362, 95% CI: 1.123-1.652) and the Qgcomp models (OR: 1.259, 95% CI: 1.070-1.483) revealed that urinary metal mixtures were positively associated with OSA, with mercury and nickel contributing the highest weights. For each metal, RCS models were applied but significant nonlinear associations were only observed between blood mercury and urinary chromium and OSA risk. In single-metal models, most individual metals did not show significant associations after adjustment. This study identified nonlinear associations between blood mercury and urinary chromium concentrations and OSA risk, and exposure to mixtures of urinary metals was associated with an increased OSA risk.

To evaluate the impact of continuous positive airway pressure (CPAP) therapy on blood pressure (BP) in patients with subacute ischemic stroke and obstructive sleep apnea (OSA). This prospective, non-randomized observational study enrolled 44 patients with subacute ischemic stroke and moderate-to-severe OSA (AHI > 15/h) from a rehabilitation ward between 2015 and 2018. Patients who tolerated CPAP formed the intervention group (n = 25), while those who refused or could not tolerate CPAP served as controls (n = 19). Blood pressure was measured for three consecutive days before and two weeks after the intervention. CPAP efficacy, adherence, and BP outcomes were compared between groups. The CPAP group showed significant reductions in both morning and evening systolic and diastolic BP, with mean reductions of - 9.3 ± 14.5 mmHg (SBP) and - 4.9 ± 10.1 mmHg (DBP) in the morning, and - 11 ± 8.5 mmHg (SBP) and - 4 ± 8.6 mmHg (DBP) in the evening. In contrast, the control group exhibited BP increases. The CPAP group also demonstrated a substantial reduction in AHI (from 43.0 ± 17.3 to 6.5 ± 4.9 events/h) and high compliance (≥ 70% usage days; average 7.3 ± 1.0 h/night). CPAP therapy significantly improves blood pressure control in stroke patients with OSA. These findings support incorporating CPAP into standard post-stroke care protocols to mitigate cardiovascular risk.

[This corrects the article DOI: 10.1007/s41105-025-00612-w.].

To elucidate the role of adenosine A1 receptors (A1R) in the medial parabrachial nucleus (MPB) for bidirectional sleep-wake regulation and homeostatic control. Bilateral microinjections targeted the MPB in rats, administering: adenosine (0.5/1.5/4.5 nmol), A1R agonist CPA (1.5 nmol), A1R antagonist CPT (1.7 nmol), or adenosine deaminase inhibitor EHNA (2.0 nmol). Sleep architecture was quantified via EEG/EMG, with histological verification of MPB targeting. Adenosineergic modulation: 4.5 nmol adenosine increased NREM sleep by 149.1% (P = 0.0002) and reduced wakefulness by 47.6% (P = 0.0004). Endogenous amplification: EHNA elevated NREM sleep by 85.2% (P = 0.019), confirming physiological adenosine action. A1R-specificity: CPA mimicked adenosine (NREM ↑63.2%, P = 0.011), whereas CPT increased wakefulness by 46.3% (P = 0.021). Homeostasis disruption: Following sleep deprivation，CPT attenuated post-deprivation rebound (NREM recovery ↓43.8%, P = 0.042; REM rebound abolished). A1R in the MPB critically regulates NREM sleep and contributes to homeostatic responses through bidirectional adenosine signaling, identifying this brainstem nucleus as a novel regulatory hub. Dose-dependent efficacy (threshold: 1.5 nmol) suggests therapeutic potential for sleep disorders.

Comorbid insomnia and sleep apnea is increasingly recognized, yet detection remains challenging due to limitations of contact-based monitoring such as polysomnography (PSG) and wearable devices. Millimeter-wave radar (MWR) may provide a non-contact alternative for simultaneous assessment of sleep-disordered breathing and sleep duration. This study evaluated the accuracy of MWR in estimating the respiratory event index (REI) and sleep duration, and identified optimal post-movement exclusion windows to enhance concordance with PSG standards. Sixty-two adults underwent overnight PSG with concurrent MWR recording. REI and estimated sleep duration (ESD) were calculated after excluding data within 1, 2, or 3 min following large body movements. Agreement between REI and PSG-derived apnea-hypopnea index (AHI), and between ESD and PSG-derived total sleep time (TST), was assessed using Bland-Altman analysis. The 3-min exclusion window yielded the smallest bias and narrowest limits of agreement for REI (mean bias = + 0.1 events/h; 95% confidence interval = - 8.2 to 8.4), matching PSG-derived AHI (18.9 ± 16.9 vs. 19.0 ± 14.4 events/h). In contrast, the 1-min exclusion window provided the best agreement for sleep duration (mean bias = - 26 min; 95% confidence interval = - 72 to 20), aligning with PSG-derived TST (422 ± 80 vs. 396 ± 71 min). MWR enables simultaneous, non-contact estimation of sleep-disordered breathing and sleep duration with clinically acceptable concordance to PSG. Metric-specific optimization-3 min for REI and 1 min for ESD-supports MWR as a low-burden tool for screening and monitoring in clinical and home environments.

In this study, we examined the accuracy of sleep-wake determination using the widely employed activity monitor, MotionWatch 8 (CamNTech, Fenstanton, UK), by comparing its results with those of the gold standard for sleep measurement, polysomnography (PSG), which was conducted simultaneously. Forty-five healthy individuals participated in the experiment, in which the MotionWatch 8 and PSG were concurrently utilized in a controlled laboratory environment to measure nocturnal sleep. Sleep variables were evaluated using a Bland-Altman plot analysis, and epoch-by-epoch agreement was assessed using accuracy, sensitivity, and specificity measures. The MotionWatch 8 tended to misclassify periods such as pre-sleep onset and nocturnal awakenings, where individuals were in bed but not actually asleep, indicating relatively low precision in sleep-wake determination. Sleep-wake states from PSG and the MotionWatch 8 showed discrepancies, particularly in distinguishing between wakefulness in bed and sleep. The MotionWatch 8 cannot be used as a direct substitute for PSG-defined sleep/wake states; instead, employing its unique features in a complementary manner can provide a more comprehensive view of various aspects of sleep.