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  • New
  • Open Access Icon
  • Research Article
  • 10.3390/clockssleep8010004
Prevalence of Obstructive Sleep Apnea and Adherence to CPAP for TAXI Drivers
  • Jan 7, 2026
  • Clocks & Sleep
  • Yik Hin Chan + 6 more

We investigated the effects of Continuous Positive Airway Pressure (CPAP) on blood pressure (BP) and vigilance in taxi drivers with obstructive sleep apnea (OSA). This pilot study recruited taxi drivers aged ≥60 years to undergo polysomnography. Those diagnosed with OSA underwent 6 months of CPAP therapy. Baseline and follow-up assessments included 24 h ambulatory blood pressure monitoring (ABPM) and the psychomotor vigilance test (PVT). Among the 32 participants, 22 (68.8%) were diagnosed with OSA (median age 63.0 [62.0–65.0] years; 21 males). The average CPAP adherence was 3.1 ± 2.3 h per night, with 23.5% using CPAP for more than 4 h per night. There were no significant changes in 24 h mean systolic ABPM (125.9 [116.8–134.9] mmHg to 126.0 [118.3–133.7] mmHg; p = 0.93) or reaction times measured by PVT (2.0 [0.0–3.0] lapses to 2.0 [1.0–3.0] lapses; p = 0.82) after CPAP therapy. A high prevalence of OSA was observed among taxi drivers. CPAP adherence was suboptimal and did not result in significant improvements in BP or vigilance.

  • New
  • Open Access Icon
  • Research Article
  • 10.3390/clockssleep8010003
People Living in Places with Limited Illuminance Declare Better Health and Higher Quality of Life in Environmental and Physical Domains
  • Jan 5, 2026
  • Clocks & Sleep
  • Jolanta Malinowska-Borowska + 3 more

Background. Exposure to artificial light at night can lead to circadian disruption and health risks. It can cause mood swings, confusion, and depression. The aim of this cross-sectional study was to assess the relationship between the illuminance of urban lighting and the health of residents. Methods: This study was carried out among residents of two similar towns, one with typical street lighting and a Dark Sky Park characterized by reduced lighting. A total of 272 respondents participated in this study. A self-administered questionnaire and the WHOQOL-BREF were used among the respondents. Results. People living in the Dark Sky Park were more likely to be satisfied with their sleep (p < 0.001). In fact, 58.7% of Dark Sky Park residents reported no sleep problems. In the control town, only 49.25% did (p = 0.04). The sleep duration was similar in the two towns, but Dark Sky Park residents were statistically less likely to use sleeping pills and window blinds. People exposed to typical street lighting at night reported suffering from eye diseases, cardiovascular diseases, and mood changes more often than those living in the Dark Sky Park. The environmental and physical quality of life, as measured by the WHOQOL-BREF, were significantly higher in the Dark Sky Park residents than in the control town (p < 0.05). Conclusions. People living in places with limited illuminance declare better health and a higher quality of life in the physical and environmental domains.

  • New
  • Open Access Icon
  • Abstract
  • 10.3390/clockssleep8010002
Thirty-Sixth Annual Meeting of the Society for Light, Rhythms, and Circadian Health (SLRCH), 14-16 June, Boston, MA, USA.
  • Dec 31, 2025
  • Clocks & sleep
  • Corrado Garbazza

It is my pleasure to present this collection of abstracts from the 36th Annual Meeting of the Society for Light, Rhythms, and Circadian Health (SLRCH), held in Boston, Massachusetts, at Simmons University and Brigham and Women's Hospital [...].

  • Open Access Icon
  • Supplementary Content
  • 10.3390/clockssleep8010001
Late-Night Feeding, Sleep Disturbance, and Nocturnal Congestion Mediated by Hyperglycemia, Renal Sodium Retention, and Cortisol: A Narrative Review
  • Dec 24, 2025
  • Clocks & Sleep
  • Ronald B Brown

Late-night feeding, defined in the present review as feeding after 8:00 pm when evening insulin secretion and sensitivity are low, is increasingly prevalent in Western society and is recognized as a disruptor of metabolic homeostasis. Yet health problems related to late-night feeding are largely ignored in time-restricted feeding studies that generally do not extend past an 8:00 pm feeding window. This paper proposes a novel cascade linking late-night hyperglycemia with sleep disturbances and nasal congestion mediated by renal sodium retention, increased plasma osmolarity, and stress hormone release by hypothalamic–pituitary–adrenal axis activation. The narrative describes the circadian decline in insulin sensitivity, which amplifies postprandial glucose surges following late-night feeding. Elevated glucose levels drive renal glucose reabsorption via sodium–glucose cotransporters, promoting sodium retention independent of insulin. Increased sodium retention raises extracellular osmolarity, activating hypothalamic osmoreceptors and stimulating the hypothalamic–pituitary–adrenal axis. Cortisol release promotes alertness, while fluid retention and mucosal edema contribute to nasal congestion and early waking. Supine fluid redistribution during sleep further exacerbates airway narrowing, increasing the risk of sleep fragmentation and obstructive sleep apnea. The present paper fills a gap in current time-restricted feeding literature by integrating renal, osmotic, and neuroendocrine pathways that may be overlooked as underlying mechanisms of dysregulated glucose control and hormone dysfunction. Reviewed evidence suggests that symptoms such as nocturnal congestion and sleep disruption are not merely incidental to late-night feeding but frame late night feeding as a risk factor with underlying physiological stressors that could contribute to cardiometabolic risk.

  • Open Access Icon
  • Research Article
  • 10.3390/clockssleep7040069
Effects of Digital Cognitive Behavioral Therapy for Insomnia on Self-Reported Sleep Parameters: Systematic Review and Meta-Analysis.
  • Dec 8, 2025
  • Clocks & sleep
  • Ingrid Porto Araújo Leite + 4 more

Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) is an effective alternative to therapist-delivered CBT-I. However, there is a lack of meta-analyses assessing its effects on other sleep-related outcomes. We aimed to conduct a meta-analysis of randomized controlled trials (RCTs) evaluating dCBT-I in adults with insomnia through polysomnography (PSG) and sleep diary. Systematic searches were performed in PubMed and Web of Science. The outcomes considered were total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO), and number of awakenings (NWAK). Meta-analyses were performed using random-effects models to compare dCBT-I with active (in-person or telehealth CBT-I) or inactive (waiting list, no treatment, or minimal intervention) control groups. Of the fourteen RCTs included, only three employed an active control. As no trials used PSG, the analyses relied solely on sleep diary data. DCBT-I showed no statistically significant differences from active controls, indicating comparable effects with therapist-delivered CBT-I. In contrast, it demonstrated statistically significant effects against inactive controls; TST increased by 0.20 h, SOL decreased by 15.53 min, SE improved by 7.91%, WASO reduced by 15.61 min, and NWAK decreased by 0.53. Future research should prioritize comparisons with therapist-delivered CBT-I and incorporate PSG for measuring these parameters.

  • Research Article
  • 10.3390/clockssleep7040070
Designing Infant Mattresses Tailored to Developmental Sleep Characteristics: A Comprehensive Review.
  • Dec 8, 2025
  • Clocks & sleep
  • Yasunori Oka + 2 more

This paper reviews existing research on infant mattress design to promote safe and comfortable sleep and proposes evidence-based design recommendations. Focusing on safety related to Sudden Unexpected Infant Death (SUID) and comfort associated with infant development and thermoregulation, we examine mattress firmness, pressure distribution, breathability, and thermal properties. Since infants have difficulty turning over and possess immature thermoregulatory functions, mattress characteristics directly influence sleep quality and safety. Based on international studies, we clarify the requirements for infant mattresses and provide insights into future product development and evaluation standards.

  • Research Article
  • 10.3390/clockssleep7040068
Anticipation of Stress and Relaxation Dynamically Impacts Sleep.
  • Dec 3, 2025
  • Clocks & sleep
  • Sandrine Baselgia + 2 more

Anticipation of stressful events can impair sleep quality. In a recent study, we reported that anticipating a stressful task before a nap led to negative changes in sleep parameters, particularly at the end of the nap. In our previous study, we compared stress anticipation with the anticipation of relaxation; thus, the observed effects may have been amplified by sleep quality improvements in the relaxation condition. In the current study, we aimed to replicate these findings using an alternative neutral control condition. The data from a newly collected sample (n = 31) were compared with the data from our previous study (n = 33) using identical analyses. The results reveal an opposite pattern from our previous study: participants in the neutral control condition showed poorer sleep (longer sleep onset latency, reduced slow-wave sleep, and lower SWA/beta ratio) compared to those anticipating stress. In a direct comparison of both studies, sleep parameters in the stress conditions were highly similar across the two studies, suggesting that the divergent outcomes are driven by differences in the control conditions. The temporal dynamic changes observed in our previous study could not be replicated. These findings highlight the importance of carefully considering control conditions in experimental sleep research and suggest that even "neutral" instructions can evoke anticipatory effects. Moreover, the observed benefits of anticipating post-sleep relaxation highlight opportunities for relaxation-based interventions to improve sleep quality.

  • Open Access Icon
  • Research Article
  • 10.3390/clockssleep7040067
Estimation of the Circadian Phase Difference in Weekend Sleep and Further Evidence for Our Failure to Sleep More on Weekends to Catch Up on Lost Sleep.
  • Nov 27, 2025
  • Clocks & sleep
  • Arcady A Putilov + 17 more

The circadian phase difference between morning and evening types is a fundamental aspect of chronotype. However, results of categorizations into chronotypes based on reported sleep times show low concordance with those based on measurements of the hormonal or physiological or molecular rhythm-markers of the circadian phase. This might be partially explained by the profound individual differences in the phase angle between the sleep-wake cycle and these rhythms that depends on chronotype, age, sex, and other factors. Here, we examined the possibility of using self-reported sleep times in the condition of 5-days-on/2-days-off school/work schedule to estimate circadian phase differences between various chronotypes. In an in silico study, we determined that, for such an estimation, similarities of the compared chronotypes in weekend sleep duration and weekend-weekday gap and in risetime are required. In the following empirical and simulation studies of sleep times reported by 4940 survey participants, we provided examples of the estimation of circadian differences between chronotypes, and the model-based simulations of sleep times in morning and evening types exemplified a way to confirm such estimations. The results of in silico, empirical, and simulation studies underscore the possibility of using bedtimes and risetimes for direct estimation of the circadian phase differences between individuals in real-life situations, such as a 5-days-on/2-days-off school/work schedule. Additionally, the results of these studies on different chronotypes provided further mathematical modeling and empirical evidence for our failure to sleep more on weekends to recover/compensate/pay back/ catch up on lost sleep.

  • Open Access Icon
  • Supplementary Content
  • 10.3390/clockssleep7040066
Sleep as a Developmental Process: A Systematic Review of Cognitive, Emotional, and Behavioral Outcomes in Children Aged 6–12 Years
  • Nov 14, 2025
  • Clocks & Sleep
  • Adriana Félix + 1 more

Sleep is essential for child development, influencing cognition, emotional regulation, behavior, and physical health. Recent studies increasingly frame sleep as both a key developmental process and a modifiable factor shaped by, and shaping environmental risks—including digital screen exposure and psychosocial stress. This systematic review synthesized empirical findings from cross-sectional and cohort studies published between 2019 and 2024 on the associations between sleep duration, quality, and patterns and developmental outcomes in typically developing children aged 6–12 years. Searches were conducted in EBSCO, Scopus, and Web of Science databases, yielding 99 records, of which 20 met inclusion criteria. Methodological quality was evaluated using Joanna Briggs Institute tools. Findings show consistent associations between better sleep and enhanced cognitive performance, emotional well-being, and reduced behavioral problems. Some studies identified sleep as a mediator between screen use and behavioral difficulties, whit additional moderating effects related to gender and socioeconomic status. However, most studies used cross-sectional designs and self-reported measures, limiting causal interpretation. Overall, sleep emerge as a potentially modifiable factor influencing developmental outcomes, based on correlational evidence. Future research should prioritize longitudinal and ecologically valid designs, objective measures, and computational approaches to identify sleep-related risk profiles and guide early interventions.

  • Open Access Icon
  • Research Article
  • 10.3390/clockssleep7040064
Sleep and Psychosocial Risk Factors Associated with Social Jet Lag and Sleep Duration Among Colombian University Students
  • Nov 7, 2025
  • Clocks & Sleep
  • Andrés Camargo + 9 more

Undergraduate students and healthcare professionals often experience irregular sleep patterns, social jet lag (SJL), and rotating shifts that affect their performance. This study examined the association between SJL, sleep duration, and psychosocial factors among 1409 Colombian undergraduate students (mean age 24.4 ± 6.7 years) using data from the Ultra-Short Version of the Munich ChronoType Questionnaire collected between June and September 2023. Multivariable linear regression analysis identified factors associated with SJL. The prevalence of SJL exceeding two hours was high (84.6%), with an average magnitude of 4.4 h. Chronotype (MSFsc) was negatively correlated with SJL, indicating that students with later chronotypes tended to experience greater misalignment between biological and social time. Younger age and a higher number of working days were significantly associated with increased SJL, whereas substance use and mental health history showed no significant effects. These findings highlight that work-related demands, particularly frequent working days, play a key role in exacerbating social jet lag. The results underscore the need for institutional strategies to promote sleep health among Colombian university students and health professionals.