Latest in Sleep Medicine News

Gabapentin is widely prescribed for neuropathic and radicular pain syndromes. While somnolence and dizziness are well-recognized adverse effects, severe vivid nightmares may constitute an underreported psychiatric side effect that can significantly impair quality of life and treatment adherence. We present two cases of gabapentin-induced severe vivid nightmares in patients treated for spinal pain syndromes. Management strategies included medication discontinuation and transition to pregabalin. Both patients experienced resolution of nightmares following intervention. This report reviews the existing literature on gabapentin's effects on sleep architecture and discusses potential mechanisms, clinical implications, and management approaches.

Inter-facility transfers to the pediatric intensive care unit (PICU) increase the risk of patient harm from communication breakdowns. We previously developed I-PASS-to-PICU, a structured inter-facility handoff program to improve information exchange during these transitions. However, it was not designed to optimize communication related to diagnosis (diagnostic handoff). This exploratory study evaluated how well I-PASS-to-PICU facilitated inter-facility diagnostic handoffs.

Visual Snow Syndrome (VSS) is a neurological condition characterized by the persistent perception of dynamic, flickering, dot-like visual disturbances across the entire visual field, resembling television static. Increasing evidence indicates that VSS is frequently accompanied by a broad spectrum of psychiatric symptoms, including anxiety, depression, depersonalization, fatigue, and sleep disturbances, all of which substantially impair quality of life. Although the pathogenesis of VSS remains incompletely understood, Current evidence increasingly suggests that VSS may represent a multisystem neuropsychiatric network disorder involving visual cortical hyperexcitability, thalamocortical dysrhythmia, widespread abnormalities in functional connectivity, and limbic system dysfunction. Psychiatric symptoms may partly reflect intrinsic neurobiological mechanisms of the syndrome rather than being solely secondary psychological reactions to chronic visual disturbances. Current pharmacological therapies generally show limited efficacy. Preliminary evidence suggests that non-pharmacological approaches, including neuromodulation, tinted lenses, and mindfulness-based interventions, may offer therapeutic potential with relatively favorable tolerability, although larger controlled studies are still required. Future research should adopt multidisciplinary strategies integrating neurology, psychiatry, neuroimaging, and genetics to further elucidate the mechanisms underlying VSS and facilitate the development of precision diagnostic and therapeutic approaches.

The peeled stems of Syringa pinnatifolia Hemsl. (SP) have long been used for the treatment of insomnia in Inner Mongolia, China, but their hypnotic constituents and underlying pharmacological basis remain poorly defined. In this study, we investigated the hypnotic activity of SP and identified its active fraction and major constituents using an equal mass to equivalent effect transmission (EMEET)-guided fractionation strategy. SP extracts and fractions were evaluated in pentobarbital-induced sleep tests and a PCPA-induced insomnia model in mice and rats. The phenolic fraction (Ps) significantly shortened sleep latency, prolonged sleep duration, and reduced hyperactivity in insomnia animals. Further fractionation and pharmacological evaluation identified alashinol F (F), alashinol G (G), and (-)-secoisolariciresinol (K) as major constituents contributing to the hypnotic activity of Ps. Mechanistically, Ps decreased serotonin transporter (SERT) expression and increased tryptophan hydroxylase (TPH) expression in the hypothalamus and colon. Ps treatment was also associated with decreased hypothalamic 5-HT and PLCβ1 expression, restoration of Gαq/11 expression, and alterations in gut microbial composition, including changes in Bacteroidetes, Prevotella_9, and Blautia. Collectively, these findings identify the major hypnotic fraction and active lignans of SP and suggest that its sleep-promoting effects are associated with coordinated regulation of serotonergic signaling and the gut microbiota.

Central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) are common but underrecognized forms of sleep-disordered breathing after stroke. While obstructive sleep apnea dominates post-stroke research, CSA and CSR are neglected due to the fact that they rarely appear in isolation.

Originally documented in Zhang Zhongjing's Synopsis of Prescriptions of the Golden Chamber of the Eastern Han Dynasty, Ganmai Dazao Decoction (GMDZ) is composed of three medicinal materials: Glycyrrhizae Radix et Rhizoma (GRR), Tritici Levis Fructus (TLF), and Jujubae Fructus (JF). Traditionally, it has been used to treat zangzao, a syndrome characterized by emotional disturbance and sleep disorder, and is now widely prescribed for depression, anxiety, and insomnia. Nevertheless, the effective material foundation and intrinsic therapeutic mechanisms of GMDZ are still not thoroughly clarified. Based on GMDZ, Baihe Ganmai Dazao Decoction (BGMD) was developed by adding Lilii Bulbus (LB), Poria (PO), and Ziziphi Spinosae Semen (ZSS) to strengthen its Yin-nourishing and mind-calming effects.

Air pollution is an increasingly important environmental determinant of respiratory health and has emerging relevance for obstructive sleep apnea (OSA). Although obesity, aging, sex, craniofacial anatomy, and neuromuscular factors remain established contributors to OSA, ambient and indoor pollutants, together with climate-related and meteorological factors, may influence sleep-disordered breathing through multiple biological pathways. This review summarizes recent epidemiological and mechanistic evidence linking environmental exposures with OSA risk, symptoms, and severity.

Sleep bruxism, characterized by involuntary muscle activity and classified into phasic and tonic patterns, warrants analysis with respect to physiological parameters, as this could aid in understanding its broader health implications. This observational study aimed to compare oxyhaemoglobin saturation between subjects with and without sleep bruxism.

To identify heterogeneous sleep-quality profiles among pregnant women in the third trimester and characterize profile-specific sleep quality-depressive symptom network structures.

The rapid advancement of artificial intelligence (AI) has highlighted its potential as a supportive tool in pulmonary function test (PFT) interpretation given the inherent biological variation, inter-rater variability, lack of confidence in result interpretation and restricted access within resource-constrained settings. This study aims to systematically review the published literature on the diagnostic accuracy of AI-based interpretation of PFTs and evaluate its implications for current and future clinical practice in healthcare. After screening, forty-seven publications met the inclusion criteria and were analysed to create a narrative summary. Four main over-arching themes were identified from the available literature. AI appears to consistently outperform non-specialists in diagnostic accuracy of PFTs and showed a synergistic effect when used as an adjunct in both specialist and non-specialist settings. Using AI software also had greater diagnostic accuracy than clinicians when presented with suboptimal or limited clinical information and investigations. It was also observed that the implementation of AI can address the issue of inter-rater variability by giving more consultant interpretations. Chronic obstructive pulmonary disease diagnosis saw the greatest accuracy with other conditions such as obstructive sleep apnoea showing limited evidence for the introduction of AI as a diagnostic tool. The evidence suggests that AI has the potential to play a significant role in the future of healthcare but should be used as an adjunctive tool as opposed to an independent diagnostic decision maker. One such way it could be utilised is as a triage/screening tool to help bridge the gap between primary and secondary care.