Excessive napping may be a warning sign of underlying or developing health conditions in older adults

Mass General Brigham prospective cohort study of older adults found excessive napping, especially in the morning, was associated with higher mortality rates

Brigham and Women's Hospital

Facebook

XLinkedIn

MessageWhatsAppEmail

• Mass General Brigham prospective cohort study of older adults found excessive napping, especially in the morning, was associated with higher mortality rates

• Results signal a clinical opportunity for tracking health conditions and preventing decline 

New research reveals that as people age, naps may be an easily trackable warning sign of underlying conditions or declining health. A new study by investigators from Mass General Brigham and Rush University Medical Center followed 1,338 older adults for up to 19 years to track napping habits and associated mortality rates. They found longer, more frequent, and morning naps were associated with higher mortality rates. Their results are published in JAMA Network Open.

“Excessive napping later in life has been linked to neurodegeneration, cardiovascular diseases and even greater morbidity, but many of those findings rely on self-reported napping habits and leave out metrics like when and how regular those naps are,” said lead author Chenlu Gao, PhD, an investigator in the Department of Anesthesiology in the Mass General Brigham, who is also an affiliated research fellow in the Division of Sleep and Circadian Disorders in the Department of Medicine. “Our study is one of the first to show an association between objectively measured nap patterns and mortality and suggests there is immense clinical value in tracking napping patterns to catch health conditions early.”

Between 20 and 60% of older adults take naps. While infrequent napping can be restorative, excessive daytime napping in old age has been linked to a wide range of health issues. Despite these associations, the relationship between napping and health in older individuals has been understudied, and those that have been conducted lack objective napping pattern data, time of day naps took place, and changes in napping patterns from day-to-day.

To close this knowledge gap, Mass General Brigham researchers turned to data from the Rush Memory and Aging Project, which began in 1997 as a cohort study primarily centered on the cognition and neurodegeneration of older, mainly white individuals in northern Illinois. Beginning in 2005, participants wore wrist activity monitors for 10-days to measure rest-activity data. The team extracted sleep patterns from the extensive rest-activity data and mapped nap length, frequency, time of day, and day-to-day variability.

By 2025, 19 years’ worth of data were collected from 1,338 total participants. The researchers analyzed the data for associations between napping patterns at the initial assessment and all-cause mortality during the 19-year follow-up, finding that longer, more frequent, and morning naps were all associated with higher mortality. Each additional hour of daytime napping per day was associated with around 13% higher mortality risk; each extra nap per day was associated with around 7% higher mortality risk; and morning nappers had 30% higher mortality risk compared to afternoon nappers. Irregular napping patterns were not associated with any increased mortality risk.

“It is important to note that this is correlation not causation. Excessive napping is likely indicating underlying disease, chronic conditions, sleep disturbances, or circadian dysregulation,” said Gao. “Now that we know there is a strong correlation between napping patterns and mortality rates, we can make the case to implement wearable daytime nap assessments to predict health conditions and prevent further decline.”

Authorship: In addition to Gao and Li, Mass General Brigham authors include Ruixue Cai, Xi Zheng, Arlen Gaba, Lei Gao, and Kun Hu. Additional authors include Lei Yu, Aron S. Buchman, and David A. Bennett.

Disclosures: Li has received a monetary gift to support research from iFutureLab. Li serves on the iFutureLab-HEKA Scientific Advisory Board as the Chair of Cardiac Dynamics and Honorary Life-Time Co-Founder and has received consulting fees. Li has also received honorarium for lecturing from Shandong University. Hu serves on the iFutureLab-HEKA Scientific Advisory Board as the Chair of Medical Biodynamics and Honorary Life-Time Co-Founder and has received consulting fees. The interests of Li and Hu were reviewed and managed by Mass General Brigham following their conflict of interest policies. These interests are not related to the current work.

Funding: This study is supported by the American Academy of Sleep Medicine Foundation (290-FP-22), the Alzheimer’s Association Research Fellowship to Promote Diversity (AARFD-22-928372), the National Institution on Aging (RF1AG064312; R01AG083799). Gao C. is additionally supported by the National Heart Lung and Blood Institute (5T32HL007901). Li is additionally supported by the BrightFocus Foundation (A2020886S) and a start-up fund from the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital. Hu is additionally supported by a start-up fund from the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital. Gao L. is additionally supported by the Alzheimer’s Association (AACSF-23-1148490), National Institute on Aging (R03AG087439), American Academy of Sleep Medicine (352-DS-24), and National Institute of General Medical Sciences (R35GM160254). The Rush Memory and Aging Project is supported by the National Institutes of Health (R01AG056352 and R01AG017917). The funders had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Paper cited: Gao C et al. “Objectively Measured Daytime Napping and All-cause Mortality in Older Adults” JAMA Network Open DOI: 10.1001/jamanetworkopen.2026.7938

###

About Mass General Brigham

Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.

---

Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2026.7938 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Objectively Measured Daytime Napping and All-cause Mortality in Older Adults

Article Publication Date

20-Apr-2026

COI Statement

Li has received a monetary gift to support research from iFutureLab. Li serves on the iFutureLab-HEKA Scientific Advisory Board as the Chair of Cardiac Dynamics and Honorary Life-Time Co-Founder and has received consulting fees. Li has also received honorarium for lecturing from Shandong University. Hu serves on the iFutureLab-HEKA Scientific Advisory Board as the Chair of Medical Biodynamics and Honorary Life-Time Co-Founder and has received consulting fees. The interests of Li and Hu were reviewed and managed by Mass General Brigham following their conflict of interest policies. These interests are not related to the current work

 

Video game improves emergency doctor trauma triage decision making

University of Pittsburgh

Facebook

XLinkedInWeChat
WhatsAppEmail

 

image: 

Deepika Mohan, M.D., M.P.H., associate professor of surgery and critical care medicine at the University of Pittsburgh School of Medicine and trauma surgeon at UPMC

view more 

Credit: University of Pittsburgh

Emergency physicians who play a video game about trauma triage outperform their peers who only receive standard education when it comes to properly caring for severely injured older adults. The findings are published today in JAMA.

The video game – developed by a team of UPMC and University of Pittsburgh surgeon-scientists – could be an effective alternative to costly and time-consuming recertification courses, while also improving adherence to life-saving triage guidelines.

“An increasing proportion of seriously injured patients are older than 65 and, unfortunately, when they come into the emergency department, they are under-triaged because their injuries are more insidious,” said lead author Deepika Mohan, M.D., M.P.H., associate professor of surgery and critical care medicine at Pitt’s School of Medicine and trauma surgeon at UPMC. “People may not think a rib fracture is a big deal. But if an older person falls and suffers four rib fractures, their risk of dying is the same as a young person shot in the liver.”

Triaging seriously injured patients can involve split-second decisions, where doctors quickly consider everything they know about a patient and their injuries, and then use their knowledge of medicine to decide the right level of care. This could mean putting the patient on a medical helicopter for transfer to a hospital with more trauma expertise and resources. Or it could mean discharging them to recover in the comfort of their home. Older adults are under-triaged as much as 70% of the time.

Mohan became interested in improving appropriate triage practices after a frustrating night at work consulting on patients who didn’t need to be there. She then saw a patient who was under-triaged and had a long delay in transferring to her trauma center for appropriate care.

She was witnessing the outcome of ingrained decision-making behaviors, sometimes called mental shortcuts or heuristics, which are notoriously hard to change. After talking with decision scientist Baruch Fischhoff, Ph.D., at Carnegie Mellon University, Mohan hit on the idea to build a video game that could let emergency physicians subconsciously learn from their decisions without impacting real patients.

In 2016 she created the first version of the game Night Shift with Schell Games, a Pittsburgh-based educational and entertainment game development company. The game features a young emergency physician triaging trauma patients in a high-stakes, emotional setting. The player’s decisions garner reinforcing praise or admonishment. The game also has puzzles that the player must solve in under 90 seconds with limited clinical information.

For a year starting in 2024, Mohan and her colleagues followed 800 physicians who staffed the emergency departments of non-trauma centers in the U.S. Half were randomized to play the game for two hours and then quarterly for 20 minutes, and the other half simply attended regularly scheduled continuing education, which physicians are required to receive to maintain certification.

Physicians who played the game had lower rates of under-triaging severely injured older patients, at 49%, compared to a 57% under-triage rate in those who did not play the game. Conversely, playing the game was not associated with over-triaging; both groups over-triaged at the same rate.

Mohan said this provides some reassurance that playing the game didn’t just increase physician willingness to transfer injured patients – rather, it may have improved diagnostic abilities. This indicates that the way the game leverages storytelling to tap into emotions or uses puzzles to shape decision rules may be rewiring heuristics and effectively changing behavior.

Interestingly, Mohan noted that physicians assigned to the game had the best adherence to the trauma triage guidelines within 30 days of playing it, with the effect fading until they played the game again.

“Quarterly exposure for 20 minutes may not be the best ‘dose,’” she said. “Perhaps playing the game more frequently and for less time would be better – maybe even a ‘microdose’ of 90 seconds each week.”

Next steps involve testing that hypothesis, along with an ambitious project to tackle decision making across the spectrum of trauma care, from emergency medical services to non-trauma hospitals to clinical teams at top level trauma centers.

“It would be a multi-component behavioral intervention at multiple levels,” she said. “With the ultimate objective of saving lives.”

Additional authors on this research are co-senior authors Douglas B. White, M.D., M.A.S., and Derek C. Angus, M.D., M.P.H., as well as Chung-Chou H. Chang, Ph.D., Jonathan Elmber, M.D., M.S., Kimberly J. Rak, Ph.D., Jacqueline L. Barnes, Ph.D., Andrew B. Peitzman, M.D., Raquel M. Forsythe, M.D., and Frank X. Guyette, M.D., M.P.H., all of Pitt; Baruch Fischhoff, Ph.D., of Carnegie Mellon University; Brad Bendesky, M.D., of Drexel College of Medicine and Trinity Health System; Casey Carr, M.D., of INTEGRIS Baptist Medical Center; Allyson C. Chapman, M.D., the University of California San Francisco; Jonathan J. Oskvarek, M.D., M.B.A., of US Acute Care Solutions and Summa Health System; Scott D. Weingart, M.D., of Nassau University Medical Center; and Michael B. Weinstock, M.D., of Adena Regional Medical Center and the Wexner Medical Center at The Ohio State University.

This research was funded by the National Institutes of Health (R01 AG 076499, K23 NS097629 and K24 HL148314).

Screenshot of the adventure portion of the game Night Shift, showing the consequences of under-triage.

Screenshots of the adventure portion of the game Night Shift. These frames show the consequences of under-triage, exemplifying the behavior change strategy of “emotional consequences of actions.”

Credit

Night Shift 2024

---

Journal

JAMA

DOI

10.1001/jama.2026.4079 

Article Title

Using Serious Games to Increase the Implementation of Trauma Triage Guidelines: A Randomized Clinical Trial

Article Publication Date

20-Apr-2026

 

Scientists at Stevens Institute of Technology reveal that time can go quantum in ion clock experiments

Physicists show that atomic clocks can probe time ticking both faster and slower simultaneously, revealing how time itself unfolds in quantum superposition.

Stevens Institute of Technology

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Trapped ions are versatile platforms used for quantum computing and ultra-precise timekeeping. New results now show that combining these capabilities can reveal a deeper layer of physical reality: quantum superpositions of the passage of time. 

view more 

Credit: Igor Pikovski

HOBOKEN, NJ., April 20, 2026 — Few concepts in physics are as familiar, yet as enigmatic, as time. In Einstein’s theory of relativity, time is not absolute: its passage depends on motion and gravity. But when combined with quantum physics, this relativistic form of time becomes even more counterintuitive. According to quantum theory, the flow of time itself may exist in a genuine quantum superposition, ticking faster and slower at the same time. Now, a new paper titled Quantum signatures of proper time in optical ion clocks, published on April 20, 2026 in Physical Review Letters, the premier physics research journal, shows that this striking possibility may soon be tested in the laboratory.

In this work, a team led by Assistant Professor of theoretical physics Igor Pikovski at Stevens Institute of Technology, in collaboration with experimental groups of Christian Sanner at Colorado State University and Dietrich Leibfried at the National Institute of Standards and Technology (NIST), explores quantum aspects of the flow of time and how they can be accessed with atomic clocks. Their results suggest that the same quantum technologies being developed for next-generation clocks and quantum computers may soon probe something far more fundamental: When a clock’s motion obeys quantum mechanics, its movement can exist in superposition, and with it the recorded passage of time itself. This is analogous to Schrödinger’s famous thought experiment, where the counterintuitive nature of quantum superposition is illustrated by a cat being both alive and dead; here it is the passage of time itself that is in superposition, like a cat that is both young and old at once.

“Time plays very different roles in quantum theory and in relativity,” says Pikovski. “What we show is that bringing these two concepts together can reveal hidden quantum signatures of time-flow that can no longer be described by classical physics.” 

In relativity theory, every clock experiences its own flow of time, which in turn depends on velocity and position. For example, a clock moving at 10 m/s for 57 million years would lag behind another clock at rest by just one second. This has been observed and confirmed with ultraprecise clocks, such as aluminum-ion clocks at NIST. 

The effect is often illustrated as the “twin paradox”: two identical twins will age differently, if one of them takes a high-speed roundtrip. Yet there is a more counterintuitive version: the “quantum twin paradox.” Can a single clock experience two different times in a quantum superposition, and become both younger and older simultaneously? According to quantum theory, as outlined by Pikovski and collaborators over a decade ago, that should happen. So far, such subtle effects have been beyond experimental reach, however, the team’s new theoretical study shows that atomic clocks are now up to the task.

The authors of the now published paper investigated the interplay of relativistic time and quantum effects in atomic clocks, such as those developed at NIST and at Colorado State University where scientists trap single ions (such as aluminum or ytterbium), cooling them to near absolute zero temperature and manipulate their quantum states with laser pulses. The results of their study show that by combining the rapidly improving clock technology with quantum information techniques developed for trapped-ion quantum computing, unique and yet undetected quantum features of time can be observed. 

“Atomic clocks are now so sensitive, they can detect tiny differences in time caused by just the thermal vibrations at miniscule temperatures,” says Gabriel Sorci, a PhD candidate at Stevens Institute of Technology and co-author of the paper. “But even at the absolute zero temperature, the ground state, the ticking rate will still be affected by just the quantum fluctuations alone.” 

The team went one step further. Rather than just cooling the atoms, they show that one can instead manipulate the vacuum itself, creating so-called squeezed states in which the position and velocity of the clock exhibit subtle quantum behavior. The result is a new manifestation of relativistic time in the quantum regime, where superpositions and entanglement of time arise: a single clock can measure how it ticks both faster and slower simultaneously, and entangle with the squeezed motion. The team now aims to demonstrate the effects in the laboratory.    

“We have the technology to generate the required squeezing and a path to reach the clock precision needed in ion clocks to observe such effects for the first time,” says Sanner of Colorado State. 

Looking ahead, Pikovski, whose recent work includes showing that single gravitons can be detected using quantum technology, points to the bigger picture. “Physics is still full of mysteries at the most fundamental level. Quantum technologies are now giving us new tools to shed light on them.”

 

About Stevens Institute of Technology

Stevens is a premier, private research university situated in Hoboken, New Jersey. Since our founding in 1870, technological innovation has been the hallmark of Stevens’ education and research. Within the university’s three schools and one college, more than 8,000 undergraduate and graduate students collaborate closely with faculty in an interdisciplinary, student-centric, entrepreneurial environment. Academic and research programs spanning business, computing, engineering, the arts and other disciplines actively advance the frontiers of science and leverage technology to confront our most pressing global challenges. The university continues to be consistently ranked among the nation’s leaders in career services, post-graduation salaries of alumni and return on tuition investment.

---

Journal

Physical Review Letters

Article Title

Quantum signatures of proper time in optical ion clocks

Article Publication Date

20-Apr-2026

Water simulation of famous quantum effect reveals unexpected wave patterns

A new study reveals how a spinning vortex causes system-wide, counter-rotating wave patterns, mimicking effects that occur, but cannot be seen, in the quantum realm.

Okinawa Institute of Science and Technology (OIST) Graduate University

Facebook

WeChatBlueskyMessageWhatsAppEmail

 

video: 

Lines of momentarily flat water extend outward and rotate, in the opposite direction to the flow of the vortex. The left video shows the pattern from the experiment, while the right video shows the same effect in a simulation model.

view more 

Credit: Singh et. al., (2026) Commun Phys.

In the quirky, quantum world, particles can be affected by forces that they never directly encounter. A classic example is the Aharonov–Bohm (AB) effect, where electrons are affected by a magnetic field, despite not passing through it. Although predicted in 1959, it took more than two decades to confirm this effect experimentally, as the specific changes to the electrons’ wave properties could only be inferred indirectly, and with great difficulty.

Now, physicists from the Okinawa Institute of Science and Technology (OIST), in collaboration with the University of Oslo and Universidad Adolfo Ibáñez, have used a classical fluid analogue that mimics and extends the AB effect using a simple platform: a water tank. Published today in Communications Physics, the researchers have revealed that when water waves are sent towards a swirling vortex from opposite directions, it causes a striking pattern, with one or more lines of momentarily still water radiating outward and rotating in an almost hypnotic way.

“This was something new and unexpected,” says Aditya Singh, a PhD student in the Nonlinear and Non-equilibrium Physics Unit and co-first author of the study. “That’s what makes this fluid analogue system so valuable. It reveals topological effects — wave behaviors that occur across the whole system — that can’t be seen in quantum experiments.”

The beginnings with Berry

The team’s inspiration for this research traces back to a 1980 study by theoretical physicist Michael Berry, who first showed that the AB effect could be simulated in a classical fluid system. In the quantum version, electrons pass around a tightly coiled wire, called a solenoid. When an electric current flows through the solenoid, this generates a magnetic field that’s confined within the coil. However, electrons passing outside the solenoid, where the magnetic field is zero, are still affected, with their wave shifting in phase.

In Berry’s experiment, a vortex forming at the drain of a tank stood in for the solenoid. Instead of electrons, Berry caused water waves to travel across his tank, passing around the vortex rather than through it. The travelling waves developed a distinctive distortion — a pitchfork-like pattern centered on the vortex — marking a shift in their phase.

“With waves travelling the opposite direction, you see a mirror image pattern,” adds Jonas Rønning, co-first author and former postdoc in the OIST unit. “The question for us was: what happens if you send waves from both directions at the same time? We thought that the patterns might cancel each other out, or both pitchfork-like patterns would be visible, but our intuition was completely wrong.”

From travelling to standing waves 

In their experiment, the researchers created a vortex at the center of a large, custom-built water tank and generated waves from opposite sides of the tank so that they met and interfered. By illuminating the water’s surface from beneath and recording with a high-speed camera, the team could track how the wave pattern across the whole tank changed over time. 

Under conditions without a vortex, when opposing waves meet and interfere, this results in a predictable standing wave pattern where waves appear to be fixed in place. These patterns contain stationary lines, known as wavefronts, where the waves have the same phase.

But adding a vortex gives an unexpected twist. As the vortex causes shifts in the wave phase, this changes how the standing waves interfere with each other, resulting in rotating lines where the wave height is zero, called nodal lines.

“When we first saw these lines, we thought they were an experimental artefact,” says Singh. “But when we also saw them in our simulations, we dropped everything and quickly worked out the mathematics underlying how they arise.”

These nodal lines exhibit interesting behaviors, always rotating in the opposite direction to the vortex, and increasing in number as the researchers increased the vortex’s flow. 

At such an early stage of discovery, it’s unclear whether these nodal lines could have useful applications. But for the unit head and senior author, Professor Mahesh Bandi, the real draw is the limitless avenues now open for future research using their classical analogue system. “One direction is to make the system more complex by introducing multiple vortices and arranging them into a lattice,” says Bandi. “That setup would mirror conditions in some superconducting materials, with the water waves behaving like a supercurrent. We don’t yet know what we’ll see — and that’s exactly what makes it worth doing.”

More broadly, the team’s findings highlight the power of simple classical analogues to reveal new understanding about the quantum world. “Theorists might predict these effects, but quantum experiments wouldn’t see them,” he says. “With analogues like this, we can.”

---

Journal

Communications Physics

DOI

10.1038/s42005-026-02603-w 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Topology made visible through standing waves in a spinning fluid

Article Publication Date

20-Apr-2026

Recreation of Berry’s travelling waves [VIDEO] 

As waves travel past the vortex, they distort and form pitchfork-like patterns, that are localized around the central vortex. When the direction of the waves is changed (arrow direction), the distortion pattern is mirrored. The top two sections show simulated patterns while the bottom two sections show the patterns seen in the experiments.

Credit

Singh et. al., (2026) Commun. Phys.

 

While identical in magnitude and frequency, the blue and red waves hit their peaks and troughs at different moments in time, and therefore have different phases. 

Credit

Waurids Baskurtf, Wikimedia Commons, CC BY-SA 2.5

The research team custom-built a water tank with a high-speed camera above to detect wave patterns on the water’s surface. 

Credit

Andrew Scott / OIST

OIST PhD student Aditya Singh generates and observes surface waves that act as a classical analogue to quantum effects.

Credit

Andrew Scott / OIST

Number of nodal lines is linked to vortex flow [VIDEO] 

In both simulations (above) and experiments (below), the number of rotating nodal lines increases with a faster vortex flow.  At lower flow (left), only one nodal line is seen, whilst at a higher flow (right), two nodal lines appear. 

Credit

Singh et. al., (2026) Commun. Phys.