Sleep Medicine

Proximal hypoglossal stimulation yields high short-term response in moderate–severe OSA

In this 7-month randomized trial, 104 adults with moderate–severe OSA received proximal hypoglossal nerve stimulators and were randomized 2:1 to immediate or delayed activation. At month 7, 58.2% of active versus 13.5% of control patients met the composite response (>50% AHI reduction and AHI <20 events/h). A ≥25% reduction in oxygen desaturation index occurred in 68.7% of treated versus 37.8% of control participants. Epworth Sleepiness Scale scores improved only in the treatment arm, and no serious procedure-related adverse events were reported. 1

Brief chronotherapy advances circadian phase and extends sleep in late-sleeping teens

This randomized trial enrolled 86 high-school students aged 16–19 years with habitual weekend sleep onset after 1 am. The intervention combined a single <1-hour problem-solving session, earlier individualized bed–wake schedules, morning bright-light glasses, and evening blue-light–blocking glasses for two weeks. Compared with monitoring-only controls, intervention participants had earlier dim-light melatonin onset by about 45 minutes and gained about 47 minutes of weeknight sleep by actigraphy. Circadian alignment, measured by the DLMO–midsleep interval, improved in the intervention group versus control. 2

Large Japanese cohort links insomnia with higher incident atrial fibrillation risk

This nationwide cohort included 1,780,764 Japanese adults without prior cardiovascular disease or atrial fibrillation at baseline. Insomnia, defined by ICD-10 codes, was present in 12.2% of participants before the baseline health checkup. Over follow-up, insomnia was associated with increased incident atrial fibrillation, with an adjusted hazard ratio of 1.14 (95% CI, 1.10–1.18). The association was stronger in individuals younger than 65 years and in women, with significant interactions for age and sex. 3

Chronic sleep fragmentation weakens influenza vaccine responses and protection

In mice, two weeks of chronic sleep fragmentation before and during influenza vaccination markedly reduced neutralizing antibody titers and IgG subclass responses. Fragmented-sleep mice showed diminished protection and lower survival after lethal influenza challenge despite preserved antibody avidity. Single-cell RNA sequencing demonstrated altered B cell maturation, impaired germinal center programs, plasma cell stress, and disrupted B–T cell interactions under fragmentation. In 916,307 influenza-vaccinated adults, obstructive sleep apnea was associated with higher influenza infection risk than matched controls (0.7% vs 0.4%; risk ratio 1.70). 4