{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T14:49:05Z","timestamp":1793026145726,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Obstructive sleep apnea (OSA) causes sleep fragmentation and excessive daytime sleepiness (EDS). OSA has been hypothesised to impair the circadian sleep\u2013wake rhythm, and this dysregulation may in turn exacerbate OSA\u2010related diurnal symptoms. Hence, this study aimed to assess the sleep\u2013wake rhythm through actigraphy, and its relationship with EDS in patients with untreated OSA. Patients with moderate\u2013severe OSA (apnea\u2013hypopnea index \u226515\/h) and healthy controls (HC) underwent a 7\u2010day actigraphic recording to evaluate the sleep\u2013wake rhythm. Participants underwent a sleep medicine visit and completed the self\u2010report questionnaires assessing EDS (Epworth sleepiness scale, ESS), sleep quality (Pittsburgh sleep quality index, PSQI), and chronotype (morningness\u2010eveningness questionnaire, MEQ). This study included 48 OSA patients (72.9% males; mean age 56.48\u2009\u00b1\u20099.53\u2009years), and 22 HC (45.5% males; mean age 53.73\u2009\u00b1\u200918.20\u2009years). After controlling for MEQ scores, actigraphic recording showed that the OSA patients present a lower sleep time (<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and sleep efficiency (<jats:italic>p<\/jats:italic>\u2009=\u20090.013), as well as a higher sleep latency (<jats:italic>p<\/jats:italic>\u2009=\u20090.047), and sleep fragmentation (<jats:italic>p<\/jats:italic>\u2009=\u20090.029) than the HC. Regarding the sleep\u2010wake rhythm actigraphic parameters, the OSA patients showed a lower average activity during the most active 10\u2010hour period (<jats:italic>p<\/jats:italic>\u2009=\u20090.036) and a lower day\/night activity ratio (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) than the HC. Patients with OSA also reported higher ESS\u00a0(<jats:italic>p<\/jats:italic>\u2009=\u20090.005) and PSQI scores (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and a chronotype less of morning type (<jats:italic>p<\/jats:italic>\u2009=\u20090.027) than the HC. In conclusion, this study documented a reduced diurnal motor activity and lower day\/night activity ratio in OSA patients than in controls. These findings suggest a dysregulation of the circadian sleep\u2013wake rhythm in OSA, possibly related to both EDS and reduced daytime motor activity.<\/jats:p>","DOI":"10.1111\/jsr.14273","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T09:15:25Z","timestamp":1718702125000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Obstructive sleep apnea may induce sleep\u2013wake cycle dysregulation: An actigraphic study"],"prefix":"10.1111","volume":"34","author":[{"given":"Greta","family":"Testone","sequence":"first","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-5675","authenticated-orcid":false,"given":"Matteo","family":"Carpi","sequence":"additional","affiliation":[{"name":"Sleep Medicine Centre, Neurology Unit University Hospital of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clementina","family":"Lupo","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola Biagio","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"},{"name":"Sleep Medicine Centre, Neurology Unit University Hospital of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2845-1332","authenticated-orcid":false,"given":"Claudio","family":"Liguori","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"},{"name":"Sleep Medicine Centre, Neurology Unit University Hospital of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"International Classification of Sleep Disorders","year":"2014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.1.111"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.4.851"},{"key":"e_1_2_10_5_1","first-page":"176","article-title":"The AASM manual for the scoring of sleep and associated events. 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