Objective: Positive airway pressure (PAP) therapy effectively treats obstructive sleep apnea (OSA), yet adherence to the therapy presents significant challenges. This study identifies demographic and sleep study factors that influence short-term adherence to PAP therapy among patients with OSA by comparing data from adherent and non-adherent groups. Methods: Patients diagnosed with OSA via polysomnography who commenced PAP therapy after titration were divided into adherent and non-adherent groups. We employed propensity score matching in a 1:1 ratio based on age, gender, and body mass index (BMI), including a total of 150 patients in the analysis. Logistic regression analyses were conducted on all pertinent variables, excluding those with high multicollinearity. Non-significant variables were omitted from the final model, whose performance was evaluated using a receiver operating characteristic (ROC) curve, calculating the area under the curve (AUC). Results: Data from 150 participants (mean age 49.56 ± 14.31 years, 79% males, mean BMI 28.96 ± 5.11) were analyzed. Significant predictors of adherence included smoking status (odds ratio [OR] 0.267; 95% confidence interval [CI], 0.116–0.580; p = 0.001), Epworth sleepiness scale (OR 1.080; 95% CI, 1.004–1.166; p = 0.042), oxygen desaturation index (ODI) during titration (OR 0.906; 95% CI, 0.829–0.975, p = 0.015), and optimal PAP levels (OR 1.240; 95% CI, 1.007–1.119; p = 0.029). The ROC curve analysis indicated an AUC of 0.765, confirming the model’s effectiveness in distinguishing between adherent and non-adherent patients. Conclusions: Adherence is negatively affected by smoking, whereas higher daytime sleepiness, optimal PAP levels, and a lower ODI during titration are associated with better adherence, underscoring the importance of personalized treatment approaches.

Bedtime procrastination (BP) has been identified as a significant factor contributing to poor sleep health. While previous studies have examined its behavioral and psychological correlates, its functional role in individuals with clinical insomnia remains unclear. This study aims to investigate the primary functions of BP in individuals with insomnia and examine its relationship with smartphone use. A total of 80 young adults (mean age 22.3 ± 2.4 years, 80% female) with clinical insomnia participated in the study. BP, insomnia severity, and emotion regulation were assessed using self-report questionnaires. Additionally, sleep patterns were monitored using a daily sleep diary and actigraphy. A structured interview using functional analysis was conducted to analyze the individual functions of BP, classifying responses into seven categories based on antecedents, behaviors, and consequences. Participants spent an average of 95.9 (SD = 38.3) minutes per day using their smartphones in the three hours before bedtime. Most participants used their phones every day during this window (78.6%). The most common functions of BP were emotion regulation (49.3%), reward (14.3%), and sleep induction (10.7%). In addition, adaptive emotion regulation strategies significantly moderated the relationship between BP and smartphone use in the three hours before bedtime (β = 0.34, 95%CI = [0.02 ~ 0.23]). Our findings suggest that for individuals with clinical insomnia, BP, which is largely driven by smartphone use, can serve as a tool for emotion regulation. Interventions targeting BP should incorporate strategies considering individual functions of BP, rather than merely restricting media use.

Background and Objectives: Although numerous studies have explored various predictors of positive airway pressure (PAP) adherence, the potential impact of objective sleep scoring data obtained during PAP titration on adherence has not been thoroughly investigated. The objective of this study was to evaluate the association between objective sleep parameters obtained from PAP titration, including sleep efficiency (SE), wake after sleep onset (WASO), and sleep latency (SL), and short-term PAP adherence in individuals with obstructive sleep apnea (OSA). Materials and Methods: A total of 227 individuals with a confirmed diagnosis of OSA underwent overnight PAP titration and were subsequently divided into adherence and non-adherence groups. Baseline demographic characteristics, clinical data, diagnostic polysomnography results, and PAP titration data were obtained for all subjects. Paired sample t-tests were utilized to assess differences in sleep parameters between diagnostic polysomnography and PAP titration within each group. Binomial logistic regression was used to evaluate the predictive value of changes in SE, WASO, and SL for PAP adherence and to determine optimal cut-off values. A χ² analysis was conducted to assess the relationship between categorical improvements in SE and WASO and adherence to PAP therapy. Results: Among the study cohort, 176 (77.5%) participants were classified as adherent, while 51 (22.5%) participants were classified as non-adherent. SE during PAP titration (83.3 ± 12.6%) was significantly higher compared to baseline polysomnography (80.9 ± 12.4%, p = 0.020), and WASO was significantly reduced (63.9 ± 58.9 min vs. 77.7 ± 67.2 min, p = 0.016). No significant difference was observed in SL between the two groups. Logistic regression analysis indicated that increased SE (odds ratio [OR]: 1.025, p = 0.039) and decreased WASO (OR: 0.994, p = 0.027) both served as significant predictors of PAP adherence, but the overall predictive ability of these indicators was modest (area under the curve 0.60 for SE; 0.62 for WASO). The optimal thresholds distinguishing adherence were ΔSE ≥ 2.39% and ΔWASO < −1.5 min. Participants who exhibited improvements in SE (χ² = 5.296, p = 0.021) and WASO (χ² = 6.877, p = 0.009) demonstrated a significantly higher likelihood of adhering to PAP therapy. Conclusions: The findings demonstrate that objective increases in sleep quality, specifically elevated SE and decreased WASO during initial PAP titration, are significantly associated with short-term PAP adherence among patients with OSA.

Respiratory mechanic instability (RMI) is characterized by irregular chest and abdominal movements due to upper airway collapse or obstruction, frequently observed during obstructive apnea or hypopnea events. This study aims to explore the potential of RMI as a determinant of adenotonsillectomy's success in treating pediatric obstructive sleep apnea (OSA). Medical records of pediatric patients diagnosed with OSA via standard polysomnography who underwent adenotonsillectomy with subsequent follow-up evaluations were retrospectively analyzed. RMI parameters were automatically discerned during polysomnography, and comparisons of sleep scoring data, respiratory events, and RMI metrics (events, index, duration, and % of stage duration) were made pre- and post-surgery. A total of 42 consecutive pediatric patients with OSA (26 boys, 16 girls) were included in the study. Post-adenotonsillectomy, marked improvements were noted in RMI parameters (events [95.6 ± 43.7 vs 58.9 ± 34.7; p < 0.001], index [14.5 ± 7.0 vs 8.5 ± 4.5; p < 0.001], duration [81.2 ± 56.3 vs 42.1 ± 52.0; p = 0.003], and % of stage duration [20.5 ± 13.9 vs 7.6 ± 6.8; p < 0.001]), along with significant improvements in polysomnographic parameters such as arousal index, AHI, RDI, ODI3, mean oxygen saturation, and snoring duration. Significant correlations were observed between respiratory events (AHI, RDI, ODI3) and RMI metrics such as event counts and index, both before and after the procedure. This study highlights the effectiveness of adenotonsillectomy in improving sleep quality and respiratory stability in pediatric patients with OSA, underscoring the utility of RMI as a promising additional marker in conjunction with conventional polysomnographic measures.

Background and Objective Bedtime procrastination (BP) has emerged as an important sleep behavior linked to poor sleep health. While parental sleep deprivation has traditionally been attributed to external caregiving demands, the role of voluntary behaviors, such as BP, that contribute to insufficient sleep has been understudied. This study aimed to characterize BP in parents and examine multiple contributing factors, including parenting demands.Methods Two independent samples were analyzed. Study 1 characterized parental BP using daily sleep diary from 94 South Korean parents with children aged 6–24 months. Study 2 analyzed online survey data from 483 parents with children aged 0–25 months in the United States. Participants were classified into high and low BP groups based on a cutoff score of 33 on the Bedtime Procrastination Scale in Study 2. Group differences were compared, and predictors of parental BP were identified using the CatBoost model.Results In Study 1, parents reported BP on 78.6% of nights, with delays exceeding 40 minutes observed in 61.5% of BP nights. In Study 2, the CatBoost model demonstrated a good discriminative performance (area under the curve=0.805). Later child light off time, higher smartphone addiction, lower perceived reward, and greater unmet leisure time needs were identified as important predictors of greater BP.Conclusions Parental BP was a common behavior, occurring on the majority of recorded nights. Insufficient parental sleep may be partly driven by modifiable behavioral factors, including BP, rather than caregiving demands alone. Addressing BP may offer a practical behavioral intervention to improve parental sleep health.