Archives of General Internal Medicine

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Perspective - Archives of General Internal Medicine (2025) Volume 9, Issue 4

Comprehensive sleep research: Disorders, therapies, health

Olivia White*

Department of Respiratory and Sleep Medicine, University of Queensland, Brisbane, Australia

*Corresponding Author:
Olivia White
Department of Respiratory and Sleep Medicine
University of Queensland, Brisbane, Australia.
E-mail: olivia.white@uq.edu.au

Received : 01-Oct-2025, Manuscript No. aaagim-309; Editor assigned : 03-Oct-2025, PreQC No. aaagim-309(PQ); Reviewed : 23-Oct-2025, QC No aaagim-309; Revised : 03-Nov-2025, Manuscript No. aaagim-309(R); Published : 12-Nov-2025 , DOI : 10.35841/aaagim-9.4.309

Citation: White O. Comprehensive sleep research: Disorders, therapies, health. aaagim. 2025;09(04):309.

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Introduction

The landscape of sleep disorder management is continuously evolving, with recent systematic reviews highlighting the efficacy of non-pharmacological interventions. For chronic insomnia disorder, Cognitive Behavioral Therapy for Insomnia (CBT-I) has been identified as the most effective primary treatment, demonstrating significant improvements in sleep onset latency, wake after sleep onset, and overall sleep efficiency when compared to other behavioral therapies and placebo. Additionally, mindfulness-based interventions and sleep restriction therapy are recognized as beneficial, offering practical guidance for clinical practice in managing chronic insomnia without medication [1].

Similarly, in addressing circadian rhythm sleep-wake disorders (CRSWD), which encompass conditions like delayed and advanced sleep phase disorders, irregular sleep-wake rhythm, and non-24-hour sleep-wake rhythm, systematic reviews underscore the efficacy of non-pharmacological approaches. Light therapy, melatonin, and chronotherapy are critical for realigning circadian clocks. These findings provide practical guidance for clinicians, emphasizing the need for individualized treatment strategies tailored to specific CRSWD types [5].

Beyond behavioral therapies, diagnostic advancements are reshaping the approach to complex conditions such as obstructive sleep apnea (OSA). Research is now exploring novel biomarkers that move beyond traditional diagnostic methods. This includes circulating biomarkers, such as inflammatory markers, oxidative stress indicators, and microRNAs, alongside genetic markers, which can predict OSA severity, identify endotypes, and monitor treatment responses. These insights are crucial for developing personalized diagnostic and therapeutic strategies, promising a more nuanced approach to managing this complex condition [2].

Understanding and treating specific sleep-related movement disorders like restless legs syndrome (RLS) is also seeing significant advancements. Recent summaries detail emerging insights into the central nervous system's iron dysregulation and various genetic factors, which refine our understanding of RLS etiology. Current best practices for managing this often debilitating disorder include updates on pharmacological strategies, such as dopamine agonists and alpha-2-delta ligands, alongside non-pharmacological interventions [7].

For narcolepsy, the focus is shifting towards novel therapeutic targets that go beyond traditional symptomatic management. Strategies aim at restoring hypocretin/orexin signaling, encompassing receptor agonists and gene therapies. Immunomodulatory approaches targeting the autoimmune origins of narcolepsy type 1 are also being explored. This forward-looking perspective offers hope for potentially disease-modifying treatments that could significantly improve patient quality of life [8].

Sleep disorders in children represent a unique challenge, with conditions like insomnia, obstructive sleep apnea, restless legs syndrome, and parasomnias requiring specialized attention. Recent updates review their prevalence, diagnosis, and management in pediatric populations, stressing the importance of early identification and intervention. Both behavioral and pharmacological approaches are tailored for developmental stages, playing a crucial role in improving children's overall health and academic performance [4].

The intricate bidirectional relationship between sleep disorders and broader health conditions is a significant area of current investigation. A notable example is the link between sleep and depression. Poor sleep quality and quantity can exacerbate depressive symptoms, while depression itself frequently disrupts sleep architecture. Neurobiological mechanisms, including neurotransmitter imbalances and inflammatory processes, underpin this intricate connection. Recognizing these interactions is vital for developing integrated treatment approaches that effectively target both sleep and mood disturbances [3].

Furthermore, the profound link between various sleep disorders and cardiovascular diseases is being increasingly elucidated. Conditions such as obstructive sleep apnea, insomnia, and restless legs syndrome are shown to contribute to hypertension, arrhythmias, heart failure, and stroke. Underlying mechanisms, including sympathetic overactivity, oxidative stress, and inflammation, highlight the critical role of sleep health in maintaining cardiovascular well-being and suggest integrated approaches for risk reduction and management [6].

The critical interplay between sleep and metabolic health also receives significant attention. Insufficient or disrupted sleep profoundly impacts glucose regulation, insulin sensitivity, appetite hormones (ghrelin and leptin), and energy expenditure. This directly increases the risk for obesity, type 2 diabetes, and metabolic syndrome. Recent findings emphasize that adequate sleep is a fundamental pillar of metabolic well-being, necessitating targeted interventions for at-risk populations [9].

Finally, the intricate relationship between sleep disturbances and Alzheimer's Disease (AD) is a burgeoning area of research. Disrupted sleep can accelerate AD pathology, including amyloid-beta accumulation and tauopathy, while AD itself compromises sleep quality. Mechanistic understanding, such as impaired glymphatic clearance and neuroinflammation, is bridging the gap to potential therapeutic interventions targeting sleep to modify AD progression. Sleep is clearly recognized as a crucial modifiable risk factor and therapeutic target for AD [10].

 

Conclusion

Recent research provides comprehensive insights into various sleep disorders and their broader health implications. Cognitive Behavioral Therapy for Insomnia (CBT-I) stands out as the most effective non-pharmacological treatment for chronic insomnia, with other behavioral therapies like mindfulness and sleep restriction also showing benefit. For circadian rhythm sleep-wake disorders, interventions such as light therapy, melatonin, and chronotherapy are vital for realignment. The field is advancing in diagnosing and managing conditions like Obstructive Sleep Apnea (OSA) through novel biomarkers, offering personalized strategies. Restless Legs Syndrome (RLS) research highlights progress in understanding its pathophysiology, including iron dysregulation and genetic factors, leading to improved pharmacological and non-pharmacological treatments. Narcolepsy is seeing promising developments in therapeutic targets aimed at restoring hypocretin/orexin signaling and immunomodulation. Beyond primary sleep disorders, the intricate connections between sleep and overall health are increasingly recognized. Poor sleep quality profoundly impacts mental health, exhibiting a bidirectional link with depression, where each can exacerbate the other. Sleep disturbances also significantly contribute to cardiovascular diseases, with OSA, insomnia, and RLS linked to hypertension, arrhythmias, heart failure, and stroke. Furthermore, disrupted sleep is a critical factor in metabolic health, affecting glucose regulation and increasing risks for obesity and type 2 diabetes. The review also emphasizes sleep's crucial role as a modifiable risk factor and therapeutic target for Alzheimer's Disease, impacting amyloid-beta accumulation and tauopathy. Pediatric sleep disorders, including insomnia and OSA in children, require early identification and tailored interventions to support development and academic performance. This body of work underscores the multifaceted nature of sleep health and its profound impact on physical and cognitive well-being across all ages.

References

  1. Jana R, Philipp CD, Lars G. Non-pharmacological treatments for chronic insomnia disorder: An updated systematic review and network meta-analysis.. Sleep Med Rev. 2024;74:101899.

    2. Indexed at, Google Scholar, Crossref

  2. Youn HK, Hyun JK, Dae HL. Emerging Biomarkers in Obstructive Sleep Apnea.. J Clin Med. 2023;12(17):5698.

    3. Indexed at, Google Scholar, Crossref

  3. Yang M, Hua L, Zhenyu C. The bidirectional relationship between sleep disorders and depression: a narrative review.. Front Psychiatry. 2023;14:1109918.

    4. Indexed at, Google Scholar, Crossref

  4. Samuele C, Thomas EB, Sufyan E. Sleep disorders in children: an update.. Minerva Pediatr. 2023;75(6):641-654.

    5. Indexed at, Google Scholar, Crossref

  5. Lars G, Mario FJ, Philipp CD. Nonpharmacological treatments for circadian rhythm sleep-wake disorders: A systematic review.. Sleep Med Rev. 2024;74:101898.

    6. Indexed at, Google Scholar, Crossref

  6. Yingjie Z, Shiyan L, Qing D. The relationship between sleep disorders and cardiovascular diseases: a review of the current evidence.. Sleep Breath. 2023;27(4):1479-1487.

    7. Indexed at, Google Scholar, Crossref

  7. Marco Z, Federica P, Raffaele F. Recent advances in understanding and treating restless legs syndrome.. Curr Opin Neurol. 2023;36(6):512-518.

    8. Indexed at, Google Scholar, Crossref

  8. Thomas ES, Clifford BS, Seiji N. Novel therapeutic targets for narcolepsy: current perspectives and future directions.. Sleep. 2023;46(10):zsad199.

    9. Indexed at, Google Scholar, Crossref

  9. Orfeu MB, Hans PAVD, David FD. Sleep and metabolic health: an updated review.. Curr Opin Pulm Med. 2023;29(6):569-577.

    10. Indexed at, Google Scholar, Crossref

  10. Bianca Z, Katrin Z, Daniel A. Sleep and Alzheimer's Disease: Bridging the Gap From Mechanisms to Therapies.. Neurotherapeutics. 2023;20(4):864-878.

    11. Indexed at, Google Scholar, Crossref

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