Sleep Medicine

PTSD is strongly associated with REM sleep behavior disorder and worse psychopathology

This systematic review of seven studies (4,152 participants) found higher prevalence of probable or confirmed REM sleep behavior disorder (RBD) among individuals with PTSD, particularly veterans. Patients with isolated RBD were more likely to report comorbid PTSD than those with other parasomnias, suggesting a bidirectional relationship. PTSD-related RBD was linked with more severe psychopathology, including greater depressive symptoms, recurrent nightmares, and emotional dysregulation. Clinically, PTSD patients with parasomnia or dream-enactment symptoms should be evaluated for possible RBD, and RBD patients screened for trauma history and PTSD. 1

Inferior hyoid position correlates with higher OSA severity; sagittal position adds little

This systematic review of 22 cephalometric studies examined associations between hyoid position and obstructive sleep apnea (OSA) severity. A lower hyoid position correlated positively with apnea–hypopnea index, indicating higher AHI with inferior hyoid displacement. The vertical metric H–MP (hyoid to mandibular plane distance) provided the strongest predictive signal for OSA severity. Anteroposterior hyoid position did not show a consistent association with AHI, limiting its utility for severity prediction. These data support emphasizing vertical hyoid measures in imaging reports and when planning upper-airway surgeries. 2

3D-printed custom PAP interfaces underperform standard masks in PAP-naïve OSA

In this single-site randomized trial, 160 PAP-naïve adults with sleep-disordered breathing were assigned to customised 3D-printed or conventional oronasal interfaces. At 6 months, customised interfaces were associated with a 1.5 events/hour higher residual AHI, narrowly missing statistical significance (p=0.059). Custom masks produced substantially higher leak (median difference 30 L/min) and lower PAP compliance than conventional masks. These results do not support routine use of current-generation custom 3D-printed oronasal interfaces outside research or very select situations. 3

Short and extreme sleep durations associate with Alzheimer’s biomarker alterations

This systematic review of 20 studies (12,445 individuals) evaluated sleep duration against cerebrospinal fluid and blood biomarkers of Alzheimer’s disease and neurodegeneration. Short sleep duration was commonly associated with higher CSF t-tau and p-tau181 and lower CSF or blood Aβ42. Two studies reported U-shaped relationships, with both short (≤5–6 h) and long (≥8 h) sleep linking to altered biomarker profiles. Evidence was predominantly cross-sectional and heterogeneous, limiting causal inference but supporting counseling against chronically curtailed sleep. 4