Latest in Sleep Medicine News

Maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnea (OSA) after tracheotomy. However, the influence of patient characteristics such as age and gender on MMA outcomes remains understudied. This meta-analysis evaluates MMA outcomes stratified by age and gender.

Platelet-rich plasma (PRP) is increasingly used for treatment of knee osteoarthritis, but there is limited understanding regarding which patients will benefit most. The impact of lifestyle-related chronic diseases, which are linked to systemic inflammation, and behavioral factors, such as agreed-upon out-of-pocket costs, have been underevaluated as predictors of PRP response.

Sleep medicine relies on patient-reported outcome measures (PROMs) to complement clinical interviews and objective sleep tests. Available sleep questionnaires focus on isolated symptoms or single disorders, limiting their ability to capture the complexity of sleep conditions. Also, many PROMs remain poorly validated. The European Sleep Questionnaire (ESQ) is being developed as a generic transdiagnostic sleep PROM designed to address these limitations. By integrating relevant interview components, it aims to streamline clinical assessment and better reflect real-world phenotypes across the full spectrum of sleep disorders. The ESQ has been initiated within the EU-funded Sleep Revolution project and is still being developed through an iterative process. Its design is informed by a comprehensive literature review as well as expert and patient input. The ESQ prototype contains 119 items organized into nine sections and uses Likert-type scales to assess symptom severity, frequency, and bothersomeness over the past month. It is equipped with an additional module for follow-up assessment. It is translated into 17 languages and is digitally implemented to support multicenter studies. Initial validation includes cognitive interviews and evaluation of psychometric properties in patients with various sleep disorders. Item refinement and scoring key creation will guide the further development of the ESQ, after which it will be made available for public use. The ESQ aims to support personalized clinical diagnosis and appraisal of treatment results. Future research will extend into other sleep disorders and specific populations, strengthening the ESQ as a comprehensive tool for clinical practice, research, and preventive strategies.

Seizure forecasting has progressed from theoretical aspiration to a rapidly advancing research domain, yet clinical translation remains limited. Over the past decades, advances in algorithm development, chronic electroencephalography (EEG), wearable sensors, and the characterization of seizure cycles have demonstrated that seizure risk is not random but fluctuates according to identifiable biological rhythms and patient-specific patterns. Forecasting algorithms have shown promising performance across diverse retrospective datasets, including intracranial EEG, subscalp recordings, wearable physiological signals, and even self-reported diaries. However, the clinical value of forecasting is contentious. Prospective real-world validation and regulatory approval of patient-facing forecasting systems remain rare. This review incorporates perspectives presented at the 5th International Congress on Mobile Health and Digital Technology in Epilepsy (2025). We examine barriers impeding clinical translation and current attempts to address them. Crucially, forecasting performance cannot be evaluated in isolation from intended use. Applications range from low-risk uses, like scheduling diagnostic monitoring or visualization of historical trends, to higher risk interventions, including medication titration and adaptive neuromodulation. Each application entails distinct performance thresholds, ethical considerations, and regulatory requirements. Translational challenges include reliable seizure annotation, nonstationarity dynamics of biological cycles, and practical constraints for real-time deployment. Ethical concerns center on miscalibrated reliance on low-risk states, potential anxiety associated with high-risk advisories, and the heterogeneity of patient preferences and risk tolerance. Regulatory pathways are likely to depend on clearly defined use cases and clinically meaningful endpoints, which may extend beyond seizure counts to include quality of life, anxiety, locus of control, and other patient-reported outcomes. Ultimately, translation will require rigorous prospective evaluation against transparent benchmarks, sustainable scientific-commercial partnerships, and integration of probabilistic risk information into clinical workflows. With careful implementation, seizure forecasting may evolve from proof-of-concept research into a clinically meaningful component of epilepsy management, and we remain cautiously optimistic.

Evidence linking sleep and circadian disruptions to the course of dementias, particularly Alzheimer's disease, has expanded. Such alterations are detectable from preclinical stages and parallel the disease progression. Assessing and managing sleep and circadian disturbances in patients with dementia remains challenging. New technologies are emerging, but their validation is still pending. We prepared a clinical review outlining a stepped-care, gradual, and sustainable approach aimed at achieving the most accurate possible diagnosis of different sleep disturbances. This review encompasses diagnostic methods ranging from questionnaires to instrumental assessments, progressing from simpler to more complex techniques including biological evaluations of circadian rhythm alterations. This work reflects a scientific consensus within the "Sleep" study group of the Italian Association for Dementia (SINdem), supported by certified sleep specialists. The document aims to support clinicians in adopting a tailored approach to the evaluation of sleep disturbances in dementia offering a dynamic framework balancing complexity and feasibility.

Androgen abuse has been suggested to adversely affect sleep-disordered breathing, but prospective real-world data in androgen abusers are lacking. The aim of this study was to evaluate the effects of androgen abuse on sleep-disordered breathing.

Male reproductive aging is characterized by gradual hormonal and metabolic deterioration, often described as late-onset hypogonadism (LOH) or "andropause". However, these terms remain controversial and insufficient to capture the multifaceted nature of this process. This narrative review provides an integrated perspective on the interconnected hormonal, metabolic, sleep-related, and sexual consequences of male aging, with particular attention to the distinction between LOH and functional hypogonadism.

Finding the associations between cohabitation status and sleep quality in caregivers of people with dementia (PLwD) was the goal of this study.

Objectives To evaluate the causal association between sleep traits and epilepsy risk using Mendelian randomization, and to investigate the mechanism of a prioritized epilepsy-risk variant through gene-level enrichment analysis and functional validation. Methods Large-scale European GWAS datasets were analysed using multiple Mendelian randomization methods, including inverse variance weighted, MR-Egger and weighted median models, with heterogeneity and sensitivity analyses. Epilepsy-associated loci were mapped to protein-coding genes and flanking regions based on GRCh37 annotation, and primary and sensitivity-analysis gene sets were constructed from gene-level summary results for functional enrichment analysis. Guided by locus-level prioritization and the biological plausibility of CACNA1A, rs2228130 was selected for functional validation in CRISPR-ABE-edited human iPSC and knock-in mouse models to assess inhibitory synaptic transmission, sleep-related phenotypes and seizure susceptibility. Results Longer sleep duration was significantly associated with lower epilepsy risk (OR = 0.9937, p < 1 × 10⁻⁵), supporting a protective genetic causal association. The association between insomnia and epilepsy showed substantial heterogeneity (Q = 9352.91) and should be interpreted cautiously. Gene-level enrichment analysis indicated that epilepsy-associated candidate genes converged primarily on broad biological regulation, developmental processes and multicellular organismal processes, without stable dominant enrichment of GABAergic synapse or circadian rhythm pathways. Functional validation showed that rs2228130 did not affect neuronal differentiation but impaired inhibitory synaptic transmission, accompanied by abnormal network activity, altered sleep-related phenotypes and increased seizure susceptibility. Knock-in mice exhibited more frequent epileptiform discharges, reduced non-rapid eye movement sleep, decreased slow-wave activity and altered expression of rhythm-related genes. Pharmacological and sleep-related interventions partially ameliorated these abnormalities. Significance This study supports a protective genetic causal association between longer sleep duration and lower epilepsy risk, and suggests that epilepsy-related genetic risk converges primarily on broad functional networks. Within this framework, functional validation of CACNA1A rs2228130 identifies inhibitory synaptic dysfunction as a key mechanistic node linking genetic risk to sleep- and epilepsy-related phenotypes, providing a rationale for epilepsy prevention and treatment through sleep optimization and targeted modulation of critical downstream pathways. Plain Language Summary We used large-scale genetic data and experimental models to examine how sleep is related to epilepsy. Genetic evidence showed that longer sleep duration was associated with lower epilepsy risk. Although broad gene-level analyses did not identify a stable dominant signal for GABAergic synapse or circadian rhythm pathways, functional studies of the epilepsy-risk variant CACNA1A rs2228130 showed that it disrupted inhibitory synaptic transmission, altered sleep-related phenotypes and increased seizure susceptibility. In mouse models, drug treatment and sleep-related intervention partly improved these abnormalities, suggesting that sleep optimization and targeted downstream regulation may help reduce epilepsy risk.

Menstrual-related migraine (MRM) is a prevalent neurological condition affecting females, with prolonged duration, severe symptoms, and poor drug response, significantly impairing their quality of life. Electroacupuncture shows promise as a nonpharmacological intervention for migraine. However, there is a deficiency in high-quality evidence-based research assessing its efficacy in MRM. To address this gap, we present a detailed protocol to evaluate electroacupuncture's therapeutic effects in MRM.