BACKGROUND Sexsomnia, a subtype of non-REM (NREM) parasomnia, consists of atypical sexual behaviors during sleep and presents with diagnostic and therapeutic challenges due to its under-recognition and overlap with other sleep and psychiatric disorders. Thus, its early diagnosis is quite challenging and important. CASE REPORT A 29-year-old man presented with a 2-year history of abnormal nocturnal sexual behaviors including pelvic thrusting, masturbation, and attempted intercourse during sleep reported by his partner, consistent with sexsomnia. All episodes occurred with complete amnesia. The symptoms intensified during periods of anxiety, occupational stress, and long work hours. The behaviors caused distress for his partner, resulting in a strain on their relationship. The patient reported a history of childhood sleep terrors and a family history of parasomnia. He exhibited no significant medical comorbidities or signs of obstructive sleep apnea, as supported by low STOP-BANG and Epworth Sleepiness Scale scores. Polysomnography and neurological imaging results were unremarkable. Initial therapy with fluoxetine (20 mg/day), melatonin (3 mg nightly), and clomipramine (25 mg nightly) was unsuccessful, but self-administered valerian root supplementation achieved a 90% reduction in symptoms due to its GABAergic effects. Subsequent treatment with vortioxetine (20 mg daily) led to complete remission, continued during a 3-month follow-up period. CONCLUSIONS This report emphasizes the importance of individualized approaches in diagnosing and managing sexsomnia. The patient's positive response to valerian root highlights the potential role of natural supplements in managing selected cases. It further highlights the need for increased clinical awareness and future research into natural and behavioral interventions for sleep-related sexual disorders.

Restless legs syndrome (RLS) is a common sensorimotor disorder with limited treatment options and incompletely understood pathophysiology. Genome-wide association studies have identified numerous risk loci, but translating these findings into causal genes and therapeutic targets remains challenging. We performed a proteome-wide association study (PWAS) integrating RLS genome-wide association study (GWAS) data from FinnGen with two brain pQTL datasets (ROSMAP and Banner). We validated the identified proteins using TWAS, SMR, and colocalization analyses using brain pQTL and eQTL datasets. To further investigate peripheral protein associations, we performed SMR using plasma pQTL data from the UK Biobank Pharma Proteomics Project (UKB-PPP). We also conducted a phenome-wide association study (PheWAS) to screen for potential off-target effects of the prioritized genes, followed by drug prediction using DSigDB and molecular docking. PWAS identified GLO1, along with GRWD1 and MAP2K5, as significantly associated with RLS. GLO1 was identified by brain-based SMR (p = 0.0001), colocalization (PP.H4 = 0.96), TWAS (p = 0.048), and was confirmed by plasma-based SMR (p = 3.16 × 10-9) as the only protein associated with RLS. PheWAS analysis, without associations for 783 non-RLS phenotypes, confirmed the specificity of GLO1. Among 27 predicted GLO1-targeting compounds, Gambierol had the strongest binding affinity (-8.3 kcal/mol). This proteogenomic study identifies GLO1 as a prioritized causal gene and promising drug target for RLS, combining brain and plasma data to provide new insights into pathogenesis and candidate drug development.

Comorbid neuropsychiatric conditions, including major depressive disorder, anxiety, bipolar disorder, and psychosis, are reported among children with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD). The association of ROHHAD with parasomnias is poorly understood. We describe the presentation and management of night terrors superimposed on delirium in a child with presumed ROHHAD. The child developed an acute altered mental status and increased anxiety during a hospitalization for sepsis and pulmonary emboli, three years after initial rapid-onset obesity. She also had nocturnal-onset limb thrashing and distress beginning an hour after falling asleep and lasting up to several hours, diagnosed as night terrors. Delirium and anxiety improved with quetiapine and clonidine, while the severity of her night terrors improved with anticipatory awakening and haloperidol. Children with ROHHAD may be at risk for night terrors, and their symptoms may present atypically. Early recognition and individualized management may improve safety and quality of life for these children.

Restless legs syndrome (RLS) affects about 1 in 4 pregnant women, typically emerging in the second or third trimester and resolving after delivery. Iron deficiency, family history, and multiparity are consistent risk factors, with transient RLS conferring increased long-term risk of chronic disease. Management prioritizes nonpharmacologic measures and iron repletion, reserving medication for severe, refractory cases. Oral or intravenous iron remains the safest and most effective therapy, while dopamine agonists, gabapentinoids, opioids, and benzodiazepines are last-line options. Collaborative care ensures maternal comfort while minimizing fetal exposure.

This study aimed to assess whether the sense of coherence (SOC) moderates the association between self-reported sleep bruxism (SB) and self-reported awake bruxism (AB) on oral health-related quality of life (OHRQoL). A cross-sectional analysis was conducted with a random sample of 406 adolescents aged 11 to 17 years from Southern Brazil. OHRQoL was measured using the Child Perception Questionnaire (CPQ11-14). Both SB and AB were assessed by self-report (weekly frequency). SOC was measured using the 13-item Sense of Coherence Scale (SOC-13). Demographic, socioeconomic, and clinical variables were included as potential confounders. Poisson regression models were used to test interaction effects. Adolescents with bruxism behaviour-either SB or AB-presented significantly higher CPQ11-14 scores, indicating poorer OHRQoL. SOC moderated this association: adolescents with SB and low SOC reported worse OHRQoL than those with high SOC. Similar results were observed for AB. In addition, the moderating effect was stronger for AB, with a greater difference in predicted CPQ11-14 scores across SOC levels. These findings suggest that SOC may buffer the psychosocial and functional effects of bruxism. Strengthening SOC could be a promising avenue for interventions aimed at minimizing the quality-of-life burden of bruxism in adolescents.

This study assessed medically relevant symptoms of sleep disorders in elite athletes across all sport types in a large-scale Swiss sample. In late fall 2023, a total of 2293 out of 5188 members of a national squad at junior or elite level participated in an anonymous online survey (Mage = 22.05 years; SD = 7.5, 46.4% female, 53.6% male), stemming from up to 100 different sports, including alpine skiing, athletics, football, and tennis. A total of 25.8% of athletes exhibited symptoms suggestive of sleep disorders requiring clinical evaluation. The most commonly reported conditions were insomnia (7.5%), sleep apnea (3.4%), restless legs syndrome (6.6%), nightmares (6.3%), and non-REM parasomnias, including sleepwalking and night terrors (8.7%). Furthermore, 18.3% of athletes perceived their sleep as non-restorative, and 20.1% showed poor sleep efficiency. Regular use of sleep medication was reported by 3.1% of athletes. Overall, 17.7% of athletes demonstrated poor sleep health, failing in at least two of the six assessed domains. It appears that one in four elite athletes suffers from medically relevant sleep disorders that may impair performance and increase the risk of mental health problems, particularly depression and anxiety disorders. Routine screening and treatment of the causes of sleep disorders might effectively improve performance among athletes.

We report a patient experiencing episodes of night terrors who, after 24-h ECG monitoring and polysomnography, was diagnosed with obstructive sleep apnoea-induced atrioventricular block. His symptoms resolved following continuous positive airway pressure therapy. This case may indicate that night terrors can be an atypical manifestation of hypopnoea or arrhythmia. Therefore, it may be reasonable for physicians to conduct appropriate screening and diagnostic tests to diagnose underlying treatable diseases like obstructive sleep apnoea in individuals presenting with suggestive symptoms.

Poor sleep quality is common in patients receiving maintenance hemodialysis (MHD) and may worsen symptom burden and outcomes. This study evaluated Pittsburgh sleep quality index (PSQI)-defined poor sleep quality and its associated factors in a single-center MHD cohort. This single-center cross-sectional study included 143 patients receiving MHD at the Fifth People's Hospital of Jinan from June to December 2024. Sleep quality was assessed using the PSQI. Patients were categorized as having good sleep quality (PSQI < 5) or poor sleep quality (PSQI ≥ 5). Demographic, clinical, dialysis-related, and laboratory variables were collected, including dialysis vintage, residual urine volume, weekly dialysis frequency, and dialysis adequacy assessed by standard weekly Kt/V (stdKt/V). An exploratory subgroup analysis was also performed in patients with diabetes mellitus. Of the 143 patients, 76 (53.1%) had poor sleep quality. Significant between-group differences were observed for age, diabetes mellitus, restless legs syndrome (RLS), and dialysis adequacy (all P < .05). In univariable logistic regression, older age (odds ratio [OR] 1.044, 95% CI: 1.013-1.076, P = .005), diabetes mellitus (OR 3.041, 95% CI: 1.518-6.096, P = .002), RLS (OR 3.717, 95% CI: 1.647-8.392, P = .002), and stdKt/V < 2.1 (OR 2.562, 95% CI: 1.218-5.389, P = .013) were associated with poor sleep quality. In multivariable model 1, older age (per 1-year increase; OR 1.041, 95% CI: 1.005-1.079, P = .027), diabetes mellitus (OR 2.625, 95% CI: 1.194-5.772, P = .016), and stdKt/V < 2.1 (OR 2.875, 95% CI: 1.264-6.542, P = .012) remained independently associated with poor sleep quality, whereas female sex was not significant (OR 1.801, 95% CI: 0.775-4.185, P = .171). In model 2, diabetes mellitus (OR 2.609, 95% CI: 1.184-5.749, P = .017), stdKt/V < 2.1 (OR 2.346, 95% CI: 1.039-5.296, P = .040), and RLS (OR 3.002, 95% CI: 1.175-7.668, P = .022) remained significant. In an exploratory subgroup analysis of patients with diabetes mellitus, calcium-phosphorus product > 55 mg2/dL2 was associated with poor sleep quality. Poor sleep quality was common in this MHD cohort and was associated with older age, diabetes mellitus, RLS, and lower dialysis adequacy. In patients with diabetes mellitus, the calcium-phosphorus product finding should be interpreted as exploratory.