Background/Objective: Sleep is a vital determinant of human health, where both its quantity and quality directly impact physical and mental well-being. Thermoregulation plays a pivotal role in sleep quality, as the body’s ability to regulate temperature varies across different sleep stages. This study examines the effects of a novel real-time temperature adjustment (RTA) mattress, which dynamically modulates temperature to align with sleep stage transitions, compared to constant temperature control (CTC). Through polysomnographic (PSG) assessments, this study evaluates how adaptive thermal regulation influences sleep architecture, aiming to identify its potential for optimizing restorative sleep. Methods: A prospective longitudinal cohort study involving 25 participants (13 males and 12 females; mean age: 39.7 years) evaluated sleep quality across three conditions: natural sleep (Control), CTC (33 °C constant mattress temperature), and RTA (temperature dynamically adjusted: 30 °C during REM sleep; 33 °C during non-REM sleep). Each participant completed three polysomnography (PSG) sessions. Sleep metrics, including total sleep time (TST), sleep efficiency, wake after sleep onset (WASO), and sleep stage percentages, were assessed. Repeated-measures ANOVA and post hoc analyses were performed. Results: RTA significantly improved sleep quality metrics compared to Control and CTC. TST increased from 356.2 min (Control) to 383.2 min (RTA, p = 0.030), with sleep efficiency rising from 82.8% to 87.3% (p = 0.030). WASO decreased from 58.2 min (Control) and 64.6 min (CTC) to 49.0 min (RTA, p = 0.067). REM latency was notably reduced under RTA (110.4 min) compared to Control (141.8 min, p = 0.002). The REM sleep percentage increased under RTA (20.8%, p = 0.006), with significant subgroup-specific enhancements in males (p = 0.010). Females showed significant increases in deep sleep percentage under RTA (12.3%, p = 0.011). Conclusions: Adaptive thermal regulation enhances sleep quality by aligning mattress temperature with physiological needs during different sleep stages. These findings highlight the potential of RTA as a non-invasive intervention to optimize restorative sleep and promote overall well-being. Further research could explore long-term health benefits and broader applications.

Background/Objective: Sleep is a vital determinant of human health, where both its quantity and quality directly impact physical and mental well-being. Thermoregulation plays a pivotal role in sleep quality, as the body’s ability to regulate temperature varies across different sleep stages. This study examines the effects of a novel real-time temperature adjustment (RTA) mattress, which dynamically modulates temperature to align with sleep stage transitions, compared to constant temperature control (CTC). Through polysomnographic (PSG) assessments, the study evaluates how adaptive thermal regulation influences sleep architecture, aiming to identify its potential for optimizing restorative sleep. Methods: A prospective longitudinal cohort study involving 25 participants (13 males, 12 females; mean age 39.7 years) evaluated sleep quality across three conditions: natural sleep (Control), CTC (33 °C constant mattress temperature), and RTA (temperature dynamically adjusted: 30 °C during REM sleep, 33 °C during non-REM sleep). Each participant completed three polysomnography (PSG) sessions. Sleep metrics, including total sleep time (TST), sleep efficiency, wake after sleep onset (WASO), and sleep stage percentages, were assessed. Repeated-measures ANOVA and post-hoc analyses were performed. Results: RTA significantly improved sleep quality metrics compared to Control and CTC. TST increased from 356.2 min (Control) to 383.2 min (RTA, p = 0.030), with sleep efficiency rising from 82.8% to 87.3% (p = 0.030). WASO decreased from 58.2 min (Control) and 64.6 min (CTC) to 49.0 min (RTA, p = 0.067). REM latency was notably reduced under RTA (110.4 min) compared to Control (141.8 min, p = 0.002). REM sleep percentage increased under RTA (20.8%, p = 0.006), with significant subgroup-specific enhancements in males (p = 0.010). Females showed significant increases in deep sleep percentage under RTA (12.3%, p = 0.011). Conclusions: Adaptive thermal regulation enhances sleep quality by aligning mattress temperature with physiological needs during different sleep stages. These findings highlight the potential of RTA as a non-invasive intervention to optimize restorative sleep and promote overall well-being. Further research could explore long-term health benefits and broader applications.

Background and Objectives: Adherence to positive airway pressure (PAP) is often suboptimal, and current monitoring relies on device logs that, by design, cannot detect respiratory events outside the therapy window. This creates a physiological blind spot during periods of non-usage. This study aimed to demonstrate the clinical necessity of independent, continuous monitoring using a smartphone-based home sleep apnea test (S-HSAT) by validating treatment effectiveness on adherent nights and quantifying the untreated apnea burden caused by partial adherence. Methods: We prospectively monitored 63 obstructive sleep apnea (OSA) patients commencing PAP therapy. Nightly apnea–hypopnea index (AHI) and usage time were recorded simultaneously by an S-HSAT (ApnoTrack) and the PAP device over a 30-day period. Nights were categorized by the duration discrepancy between S-HSAT and PAP (full-use, ≤5 min; intermediate-use, 5–30 min; partial-use, >30 min) using physiologically and operationally derived thresholds. Results: Final analysis included 39 participants contributing 667 nights (24 participants excluded due to non-use of one or both devices). Full-use nights (46.2%) showed close agreement between S-HSAT and PAP mean AHI (2.8 ± 4.3 vs. 2.5 ± 2.0 events/h; p = 0.13). On intermediate-use and partial-use nights (20.7% and 33.1%, respectively), substantial AHI discrepancies emerged (7.3 ± 5.5 vs. 3.8 ± 3.3 and 11.0 ± 7.4 vs. 2.8 ± 2.5 events/h, respectively; both p < 0.001). Conclusions: Independent S-HSAT monitoring quantified an untreated apnea burden that is invisible to PAP logs alone, while confirming therapeutic efficacy on well-adherent nights. These findings suggest that continuous independent monitoring may help bridge the gap between prescribed therapy and actual physiological outcomes in OSA care.