ABSTRACT Background Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with cardiovascular, metabolic, and psychological complications. Data on its prevalence in Arab countries remain scarce. This study aimed to estimate the pooled prevalence of OSA in Egypt, Jordan, Oman, and Iraq, and to explore sources of heterogeneity. Methods A systematic search of major scientific databases was conducted to identify studies up to 2025. Pooled prevalence was calculated using a random-effects model and Heterogeneity was assessed. Subgroup analyses were performed by country and diagnostic tool, and meta-regression examined temporal trends. Publication bias was evaluated with Egger’s and Begg’s tests, and adjusted using the trim-and-fill method. Results Fifty studies with 58 prevalence estimates involving 881,184 participants were included. The pooled prevalence of OSA was 33.0% (95% CI: 28.3%–37.8%), with marked heterogeneity (I2 = 99.8%). Subgroup analysis showed higher prevalence in Egypt (39%) compared with Jordan (28%) and other Arab countries (24%). No significant differences were observed between diagnostic tools, and heterogeneity persisted across subgroups. Meta-regression revealed no significant change in prevalence over time. Evidence of small-study effects was found; after trim-and-fill adjustment, the pooled prevalence rose to 37.1%. Conclusion OSA prevalence in Arab countries is higher than in many Western populations, representing a significant public health concern. The persistent heterogeneity and stable prevalence suggest that risk factors such as obesity, sedentary lifestyle, and genetic predisposition remain unchanged. These findings underscore the need for targeted prevention, systematic screening, and improved diagnostic standards to reduce the disease burden.

ABSTRACT Objectives This study assessed public knowledge about insomnia treatments, particularly Cognitive Behavioral Therapy for Insomnia (CBT-I), and examined whether familiarity varied by gender or race. The primary aim was to quantify what proportion of adults in the United States are familiar with and use CBT-I. Methods A nationally representative sample of 3080 U.S. adults (Mage = 39.5 years, SDage = 12.9) was surveyed. Approximately 48.3% identified as women. Participants reported their familiarity with various insomnia treatments, including pharmacological and behavioral options, and whether they had used prescription medications, over-the-counter sleep aids, or CBT-I within the past year or at any point in their lifetime. Results Participants were substantially more familiar with pharmacological treatments than behavioral therapies, with notably low recognition of CBT-I. Treatment utilization patterns supported that people tend to have a greater reliance on pharmacological interventions, particularly over-the-counter options, than CBT-I. Demographic differences emerged, with women and White participants reporting greater awareness of insomnia treatments than men and individuals from other racial groups. Age related differences were also observed, though, these varied by treatment approach. Conclusions This study identified major gaps in public awareness of CBT-I and highlighted disparities in treatment knowledge. Addressing these gaps is critical for improving treatment access and promoting CBT-I as a first-line, evidence-based treatment for insomnia.

ABSTRACT Vamping refers to the intentional delay of sleep to engage in late-night activities, often involving technology use, which may impair sleep and well-being. This study adapted the Vamping Scale into Turkish and examined its psychometric properties and relationships with sleep effort, bedtime procrastination, psychological distress, and well-being. Methods In Study 1, 349 Turkish-speaking adults (57% female; M = 24.05 years, range = 18–68) completed the translated Vamping Scale with related sleep and procrastination measures. CFA, item-total correlations, and IRT assessed factor structure and item properties, while reliability was evaluated with α, ω, and λ6. In Study 2, 342 adults (56% female; M = 26.65 years, range = 18–56) completed the Vamping Scale with mental health and well-being measures. Pearson correlations and SEM tested whether psychological distress mediated the relationship between vamping and well-being. Results A revised 10-item, two-factor model showed acceptable fit (CFI = .901; SRMR = .0562) and high internal consistency (α = .890). Vamping was positively related to bedtime procrastination, sleep effort, and psychological distress, and negatively to life satisfaction and well-being. SEM confirmed psychological distress mediated the link between vamping and well-being. Conclusion The Turkish Vamping Scale is a psychometrically sound instrument for assessing late-night technology use behaviors in adult populations. The findings underscore the detrimental associations between vamping, sleep-related difficulties, and psychological distress, supporting the need for targeted interventions. Future research should incorporate longitudinal designs and objective sleep measures to clarify causal pathways.

ABSTRACT Objectives To examine the relationship between insomnia symptoms and self-injurious behaviors (SIB) among adolescents and young adults, with a focus on the mediation effects of depression and anxiety on this association. Methods An online survey among adolescents and young adults was conducted in Xiamen City, Fujian Province, from December 2022 to May 2023. SIB was assessed using two items from Health-Related Risky Behavior Inventory. Insomnia, depressive, and anxiety symptoms were evaluated by Insomnia Severity Index, Patient Health Questionnaire, and Generalized Anxiety Disorder Scale, respectively. A structural equation model was employed to explore the mediating role of depressive and anxiety symptoms in the relationship between insomnia and SIB. Results A total of 3436 participants (Mage = 18.12 years; 58.4% female) were included in final analysis, with 707 (20.6%) reporting SIB within the past 12 months. Participants with SIB exhibited higher levels of insomnia, depressive, and anxiety symptoms compared to those without SIB. Insomnia symptoms were significantly associated with SIB (β = 0.343, p < .001). Additionally, depressive (β = 0.093, p < .001) and anxiety (β = 0.026, p = .001) symptoms mediated the relationship between insomnia symptoms and SIB. Total indirect effects accounted for 79.33% of the total effects (insomnia → SIB). However, sex did not moderate the mediation effect. Sensitivity analyses yielded similar results. Conclusion Depressive and anxiety symptoms mediate the relationship between insomnia and SIB in adolescents and young adults, suggesting that insomnia may act as a transdiagnostic factor contributing to emotional dysregulation and SIB.

ABSTRACT Narcolepsy and Idiopathic Hypersomnia (IH) are chronic sleep disorders that negatively impact the Health-Related Quality of Life (HRQoL) of those who are diagnosed with the disorders. As such, Narcolepsy and IH may also impact the HRQoL of those close to the patient (e.g. partners, parents). Aim This project explored the experiences of partners of people with Narcolepsy or IH, and examined how living with someone with the diagnosis had impacted their own HRQoL. Methods In this in-depth qualitative study, semi-structured interviews were used to collect data from eight people (4 males and 4 females, aged between 21 and 53 years old) whose partners had Narcolepsy T1, T2, or IH. The data was analyzed using Reflexive Thematic Analysis (RTA) to find common themes emerging from the participants’ narratives. Self-reports for psychological distress (K10) and sleep quality (PSQI) were used. Results Five themes (and two sub-themes) were identified: 1) changes in dyadic identity; 2) negative impact on intimacy; 3) loneliness; 4) sacrifices to maintain the relationship, and 5) dissatisfaction at the lack of knowledge and information. Conclusions Partners of patients with Narcolepsy or IH reported being affected by some of the symptoms of their partners’ sleep disorder. Partners’ social and emotional HRQoL were the features most strongly impacted by the disorders. Future research should focus on developing collaborative care models that involve patients’ partners in treatment.

ABSTRACT Objectives This study examined the effects of bedroom lighting with pre-bedtime activities two hours before bedtime on sleepiness and polysomnography (PSG) sleep in community-dwelling adults with poor sleep. Methods A balanced crossover design was used with 24 healthy adults. Four lighting conditions under two activity situations (unrestricted (A1) and restricted (A2) electronic device use two hours before bedtime) were tested using adjustable LED lights: (E2: 3000K, 160 lux; E3: 5000K → 3000K, 160 → 30 lux; E4: 5000K, 160 lux) and compared to standard fluorescent lighting (E1: 5000K, 160 lux). The protocol lasted 8 nights (4 lightings × 2 activity conditions), with the whole night PSGmeasure, subjective sleep perception at wake-up, and sleepiness (Stanford Sleepiness Scale) measured hourly 2 hr before bedtime. Results Results showed that sleep latency was 10.62 min longer when exposed to 5000k LED light than to 5000k FL. Exposure to other lower color temperature lights did not have a significant difference in sleepiness and PSGsleep. However, participants felt drowsier and had a shorter PSG sleep latency of 6.08 min when the use of electronic devices was not allowed. Conclusion A 5000k LED light leads to longer sleep latency compared to a 5000k fluorescent light. Restriction of electronic device use before bedtime improves sleep onset in healthy adults. Managing ambient light exposure with lower color temperature LED light and reducing electronic device use 2 hr before bedtime may improve sleep quality in healthy adults.

To explore the attitudes and experiences of people with chronic low back pain (LBP) on sleep, health care, and digital health. Participants completed a survey about LBP, sleep, health care, and digital health. All data collected was self-reported by participants. Survey completers were invited for semi-structured interviews comprising open-ended questions exploring LBP and sleep interplay, health care experiences, and digital health preferences. Interviews were analyzed using a thematic framework approach. Six-hundred and sixty-nine participants completed the survey. n = 501 female, mean age = 56.7 ± 14.4 years. Most participants (90%) reported LBP-related sleep disturbance. More than half (61%) were not satisfied with their current LBP-related health care Sixty-one percent of participants were willing to use a sleep-specific digital health intervention (DHI) if recommended by a health care professional. Interviews (n = 26) revealed three themes: (i) living with LBP and poor sleep, (ii) health-seeking behaviors, and (iii) implementing sleep and back pain DHIs. Participants were concerned with the legitimacy of non-health professional advice and preferred evidence-based DHIs. Sleep disturbance and health care dissatisfaction was highly prevalentin individuals with chronic LBP. Participants were willing to use evidence-based self-directed DHIs for LBP and sleep disturbance management but wanted clinical authority. These findings reveal opportunities for clinical implementation and intervention studies for individuals with chronic LBP and sleep disturbance.

ABSTRACT Objective Research on the prevalence of bedtime procrastination (BtP) is currently focused on the breadth of BtP presentations, with limited insights into the severity of BtP in terms of its frequency, duration, and dysfunctional impacts. This study aimed to explore the BtP severity and its prevalence among Chinese college students. Moreover, correlates and outcomes of BtP were also examined. Methods A total of 20704 college students participated in a cross-sectional survey. BtP was measured by combining the bedtime procrastination scale with items related to BtP frequency, duration per episode, and dysfunctional impacts. Sociodemographics, lifestyles, trait- and state-like factors, and indicators of sleep and mental health were also evaluated. Results The prevalence of severe BtP was 10.5%. Poor family socioeconomic status, physical inactivity, alcohol use, pre-sleep media use, and perceived stress were identified as risk factors for severe BtP, while older age, self-control, and an earlier chronotype were protective factors. Moreover, severe BtP was associated with shorter sleep duration, greater social jetlag, and increased risks of daytime sleepiness and depressive symptoms. Conclusions The findings provided valuable insights for BtP screening. The associations between BtP and adverse outcomes underscore the importance of screening for severe BtP and offering appropriate interventions.

ABSTRACT Objectives Insomnia is highly comorbid with mental health conditions, yet graduate psychology students receive limited training in sleep and insomnia management. An online introductory sleep workshop focused on insomnia management with Cognitive Behavioral Therapy for Insomnia (CBT-I) was developed for Australian graduate psychology students to address this training gap. However, some students reported difficulties applying CBT-I knowledge to clinical practice. This study explored the barriers and facilitators to implementing CBT-I knowledge into graduate psychology students’ practice post-workshop. Methods Semi-structured interviews were conducted with 15 graduate psychology students who attended an online introductory sleep and CBT-I workshop. Data were analyzed using reflexive thematic analysis. Results Facilitators of CBT-I implementation included: (1) Helpful workshop resources; (2) Increased awareness of the importance of sleep’s role in mental health; (3) Enhanced self-efficacy with introductory sleep skills (e.g. sleep history taking); and (4) Knowing where to access further training. Barriers included: (1) Limited ongoing training and clinical supervision; (2) Accessibility challenges; (3) Clinical implementation challenges; and (4) Constraints of being a graduate student. Conclusion The introductory workshop facilitated the development of introductory CBT-I skills among graduate psychology students, but ongoing training and supervision are needed to enhance implementation and expand Australia’s CBT-I workforce.

ABSTRACT Objective To examine the associations between parent perceived environmental factors, nighttime sleep duration and 24-h sleep duration among an international sample of preschool-aged children. Methods Secondary analyses of cross-sectional data from preschoolers across 23 countries (19 LMICs), collected during the third pilot phase (January 2021–August 2024) of the SUNRISE Study. Parents completed a questionnaire which asked about their child’s sleep patterns and environmental factors that impacted their child’s sleep in the previous 3 days. Results Data from 2,219 children were analyzed. A significant difference was observed between nighttime sleep (F = 14.27, p = <0.0001) and nap duration (F = 9.10, p = 0.0004) across country income level. Environmental factors such as heat (−12.87, 95% CI: −11.54, −0.61) and cold (−17.70, 95% CI: −34.53, −0.85) were negatively associated with nighttime sleep duration. Conclusions Public health researchers and professionals should prioritize context-specific strategies to minimize the impact of weather conditions on sleep to promote healthy levels of sleep among preschoolers from diverse settings.