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The mismatch between rising sleep need and the fluctuating ability to fall asleep underlies insomnia-the most common sleep disorder-yet remains poorly understood. While sleep need increases steadily with time awake, sleep propensity-the likelihood of transitioning from wake to sleep-follows a bimodal pattern, peaking in the mid-afternoon, dipping in the evening, and rising again near bedtime. Building on our previously developed wave model of sleep dynamics, we extend this homeostatic framework to the waking period and show that it predicts the observed bimodal sleep propensity curve. This pattern emerges from two interacting factors: wake-state instability, which increases exponentially across the day, and interaction strength between states, which follows a biphasic trajectory. Together, they produce a daily profile of sleep propensity that closely aligns with experimental data. Notably, the empirical curve demonstrates a deeper evening dip than the model alone predicts-reflecting the known circadian modulation of sleep propensity. The model reveals that the mid-afternoon peak reflects maximal interaction at the homeostatic equilibrium threshold, while the evening dip results from minimal coupling between sleep and wake states, counteracting high instability. A late-day rise in both factors facilitates sleep onset at bedtime and beyond. Experimental data from sleep deprivation further support these predictions. This work provides a mechanistic foundation for understanding daily sleep propensity and may inform strategies to improve sleep and performance in both health and disease.
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http://dx.doi.org/10.1093/sleepadvances/zpaf046 | DOI Listing |
Diabetes Obes Metab
September 2025
Phase I Clinical Trial Research Ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health concern, and its presence increases the risk of multi-system diseases. This study aimed to investigate the multimorbidity trajectories of chronic diseases in people living with MASLD.
Methods: We identified 137 859 MASLD patients in UK Biobank and used 'propensity score matching' to match an equal number of non-MASLD controls.
Sleep Adv
July 2025
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, United States.
The mismatch between rising sleep need and the fluctuating ability to fall asleep underlies insomnia-the most common sleep disorder-yet remains poorly understood. While sleep need increases steadily with time awake, sleep propensity-the likelihood of transitioning from wake to sleep-follows a bimodal pattern, peaking in the mid-afternoon, dipping in the evening, and rising again near bedtime. Building on our previously developed wave model of sleep dynamics, we extend this homeostatic framework to the waking period and show that it predicts the observed bimodal sleep propensity curve.
View Article and Find Full Text PDFPulm Ther
September 2025
Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA, USA.
Introduction: Pulmonary arterial hypertension (PAH) is a rare, progressive disease resulting from elevated pulmonary arterial pressure leading to right ventricular failure and death. Optimal adherence and persistence to medical therapy are necessary to improve outcomes. The objective of this study was to characterize adherence and persistence to first-line PAH therapies in patients newly initiating treatment.
View Article and Find Full Text PDFBackground: Older adults with heart disease experience higher rates of depression and insomnia compared with heart disease-free peers. Aside from these psychological disturbances, overall health satisfaction, as a key indicator of subjective health status, may be affected by heart disease status. In spite of these overall associations, symptom-level relationships between depression, insomnia, and health satisfaction remain unclear.
View Article and Find Full Text PDFMedicine (Baltimore)
August 2025
Department of Spinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
Hip fractures in the elderly are frequently associated with complications and unfavorable outcomes. Managing postoperative delirium, pain, sleep disturbances, and overall quality of life presents significant challenges in clinical care. This study aimed to explore the effectiveness of refined nursing interventions in improving postoperative recovery and patient satisfaction among elderly patients undergoing hip fracture surgery.
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