Search

Background: Emotional eating is a prevalent maladaptive coping mechanism among college students, which is associated with mental health and sleep concerns. Though previous studies have established a link between sleep quality, depression and emotional eating, most of these have been in Western populations. In addition, few existing studies have taken physical activities into account, and the underlying mechanisms between these four variables remain to be further studied. Therefore, our study investigated the mediating role of depression and the moderating role of physical activity levels in the relationship between sleep quality and emotional eating among Chinese college students. Our study can help to understand the characteristics of this population and provide guidance on the intervention pathways for emotional eating. Methods: A convenience sampling method was employed to select eligible participants for investigation. The General Information Questionnaire, the Pittsburgh Sleep Quality Index Scale, the Patient Health Questionnaire, the Dutch Eating Behavior Scale, and the International Physical Activity Questionnaire were employed to measure the general condition, sleep quality, depression, emotional eating, and physical activity. A total of 813 college students (Mage = 19.14, SD = 1.12, range = 17 ~ 25 years old, 71.1% females) completed the survey. The moderated mediation analysis was carried out using the SPSS PROCESS macro. Results: After controlling for sex, age, and body mass index (BMI), sleep quality positively predicted emotional eating. Depression primarily mediated the association between them. Besides, physical activity levels moderated the relationship between sleep quality and emotional eating via depression. Depression significantly predicted emotional eating among students with low levels of physical activity; however, it was not significant among students with moderate or high levels of physical activity. Conclusions: The role of depression mediates the link between sleep quality and emotional eating. Regular exercise can ease the symptoms of emotional eating through depression. This implies the importance of offering more sleep hygiene education and physical activity in university settings. Plain English summary: College students often experience poor sleep quality and negative emotions due to different kinds of pressure, which can lead to emotional eating. But the mediating or moderating mechanism is not fully understood between them. Our research looked at how depression might explain this connection and whether physical activity can help. We surveyed 813 college students about their sleep quality, depression, emotional eating, and physical activity levels. The results showed that students with poor sleep were more likely to eat emotionally, which was totally mediated by depression. However, students who were physically active were less affected by this pattern. This means that regular exercise can weaken the impact of poor sleep and depression on emotional eating. Our findings suggest that encouraging good sleep habits and physical activity in colleges can help prevent emotional eating. [ABSTRACT FROM AUTHOR]

Background: The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x'common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators. Methods: Forty-four overweight/obese T2DM women with insomnia, aged 30–65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed. Discussion: The use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions. Trial registration: IRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772 [ABSTRACT FROM AUTHOR]

The article "Rxercise: Maintaining Exercise Throughout Residency" explores the difficulties faced by medical residents, such as stress, lack of sleep, and long work hours, which can negatively impact their well-being and lead to burnout. The authors propose the concept of "Rxercise," which presents exercise as a solution to these challenges. Research suggests that exercise can reduce burnout rates, improve quality of life, and enhance patient counseling on exercise benefits. The article provides a framework for promoting exercise in residency, including personalized and program-based interventions, while emphasizing the importance of consulting healthcare professionals and practicing safe exercise. It acknowledges the obstacles to incorporating exercise into residency training but emphasizes the need for individual and institutional efforts to encourage exercise among residents. The article also calls for further research on effective strategies for implementing exercise into residents' routines. [Extracted from the article]

Aims: To consolidate adolescents' perspectives regarding various aspects of sleep and offer insights to promote healthier sleep habits during their critical developmental years. Methods/Data Sources: Six electronic databases (PubMed, CINAHL, Embase, Scopus, PsycINFO and Web of Science) were searched from their inception dates to June 2023. Data were extracted and meta‐summarised using Sandelowski and Barroso's approach and synthesised using Thomas and Harden's thematic analysis framework. Results: Meta‐synthesis from 11 peer‐reviewed published studies identified four main themes: (1) Awareness and understanding of sleep's significance, (2) The shadows and radiance of slumber, (3) Traversing the sleepscape: trouble bubbles and (4) Illuminating the path: Guiding lights to enhanced sleep. Conclusion/Implications: Our review findings suggest a lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Identified barriers to adequate sleep encompass various factors, including overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. Strategies to improve adolescents' sleep health involve multiple sleep strategies, including sleep education, workshops/seminars, parental involvement, incorporating digital well‐being practices, the promotion of relaxation techniques and the provision of essential resources. Prioritising sleep health and implementing targeted interventions are key steps to empower adolescents, create supportive environments and shape a healthier future generation. Future research endeavours should focus on evaluating the effectiveness of interventions and exploring the influence of cultural factors. Impact: There exists a notable lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents.Barriers to achieving adequate sleep among adolescents include overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities.The collaboration between healthcare institutions, professionals and educational institutions is crucial to facilitate (1) the implementation of sleep education workshops/seminars targeting adolescents, (2) increased parental involvement and role‐modelling to instil good sleep practices among adolescents and (3) enhanced integration of digital well‐being practices, the promotion of relaxation techniques and accessibility to essential sleep hygiene resources. Reporting Method: Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Patient or Public Contribution: No patient or public contribution. Trial and Protocol Registration: This review was registered on the Prospective Register of Systematic Reviews (CRD42023403775). [ABSTRACT FROM AUTHOR]

Sleep is a vital but overlooked and undervalued part of our overall health and well-being. Striving to optimize productivity and meet numerous daily demands often means that sleep is not prioritized. As sleep stewardship's importance gains wider recognition, clinical and ethical management of sleep resources and practices will likely be key features of health professionalism. This article considers how sleep stewardship should be advanced as a clinical, ethical, and cultural priority. [ABSTRACT FROM AUTHOR]

Primary care clinicians are well-equipped to screen for sleep concerns, help some patients, and refer patients whose sleep troubles are more complex to specialists. Poor sleep affects nearly every organ system and influences many morbidity and mortality causes, so screening for sleep sufficiency and quality should be prioritized in primary care settings. This commentary on a case suggests strategies for more fully supporting primary care clinicians' compensation and capacity for conducting effective conversations with patients experiencing sleep trouble. [ABSTRACT FROM AUTHOR]

Background: Sleep hygiene behaviours are a suggested set of behaviours people can engage in to improve sleep. However, there are numerous issues relating to the measurement of sleep hygiene, primarily, the lack of consensus as to which behaviours impact sleep and should therefore be included in scales. Method: Cross-sectional correlational methods were used to assess the association between sleep quality, a highly inclusive range of sleep hygiene behaviours, and individual perceptions of those behaviours in a non-clinical sample of 300 participants. Results: Of the 35 sleep hygiene behaviours assessed, 18 were independently associated with sleep quality. Post-hoc factor analysis revealed that behaviours clustered together across four factors. A 'routine' factor included behaviours such as going to bed and waking up at the same time each night, and were important predictors of sleep quality, as were behaviours belonging to the 'perseverative cognition' and 'negative emotionality' factor. Other behaviours related to physiological processes like exposure to sunlight during the day and going to bed hungry were also significantly associated with sleep. Negative perceptions moderated the relationship between daytime exposure to sunlight and sleep. Conclusions: Although certain behaviours were significantly related to sleep, almost half were not, supporting the need to examine the association between sleep and behaviours used for sleep hygiene recommendations more critically. Reframing sleep hygiene recommendations into a condensed set of shared underlying mechanisms may be of benefit for the development of sleep hygiene scales and interventions in non-clinical populations. [ABSTRACT FROM AUTHOR]

Objective: Sleep disorders are widespread and constitute a major public health risk. The present study thus aims to investigate the effect of a facial cosmetic self‐massage daily routine on women's sleep and well‐being. Methods: The present pilot study was conducted on 62 middle‐aged women declaring daily tiredness and sleep troubles. We examined the effect of a regular facial cosmetic self‐massage routine on sleep patterns, daytime sleepiness, and well‐being over the course of 2 months. Results: After 1 and 2 months, our results show improved sleep quality (Pittsburgh Sleep Quality Index, PSQI – −20.2% after 2 months), reduced daytime sleepiness (Epworth Sleepiness Scale, ESS, −31.2% after 2 months), and increased well‐being measures. The number of participants with abnormal sleep (PSQI >5) decreased over the course of the experiment as well, from 71.9% to 49.2% at the end of the 2 months [odds ratio 95% CI for decrease: 0.38 (0.18–0.81)]. Similarly, the number of participants with excessive daytime sleepiness (>10 on the ESS) decreased over the course of the study from 44.3% to 21% after 1 month [95% CI: 0.33 (0.15–0.73)] and to 16.1% after 2 months [95% CI: 0.24 (0.10–0.56)]. Conclusions: These results suggest that a facial cosmetic self‐massage routine may improve sleep patterns and is likely to be a useful addition to a standard sleep hygiene routine. [ABSTRACT FROM AUTHOR]

Background Sleep–wake disturbances are common and disabling in primary brain tumor (PBT) patients but studies exploring longitudinal data are limited. This study investigates the feasibility and relationship between longitudinal patient-reported outcomes (PROs) and physiologic data collected via smart wearables. Methods Fifty-four PBT patients ≥ 18 years wore Fitbit smart-wearable devices for 4 weeks, which captured physiologic sleep measures (eg, total sleep time, wake after sleep onset [WASO]). They completed PROs (sleep hygiene index, PROMIS sleep-related impairment [SRI] and Sleep Disturbance [SD], Morningness-Eveningness Questionnaire [MEQ]) at baseline and 4 weeks. Smart wearable use feasibility (enrollment/attrition, data missingness), clinical characteristics, test consistency, PROs severity, and relationships between PROs and physiologic sleep measures were assessed. Results The majority (72%) wore their Fitbit for the entire study duration with 89% missing < 3 days, no participant withdrawals, and 100% PRO completion. PROMIS SRI/SD and MEQ were all consistent/reliable (Cronbach's alpha 0.74–0.92). Chronotype breakdown showed 39% morning, 56% intermediate, and only 6% evening types. Moderate-severe SD and SRI were reported in 13% and 17% at baseline, and with significant improvement in SD at 4 weeks (P  = .014). Fitbit-recorded measures showed a correlation at week 4 between WASO and SD (r  = 0.35, P  = .009) but not with SRI (r  = 0.24, P  = .08). Conclusions Collecting sleep data with Fitbits is feasible, PROs are consistent/reliable, > 10% of participants had SD and SRI that improved with smart wearable use, and SD was associated with WASO. The skewed chronotype distribution, risk and impact of sleep fragmentation mechanisms warrant further investigation. Trial Registration NCT04 669 574 [ABSTRACT FROM AUTHOR]

There is growing enthusiasm towards the role of smartphone app-based interventions in the management of insomnia and related sleep problems. A considerable number of apps designed to address insomnia have been developed in recent years, and randomized controlled trials (RCTs) have begun to explore their efficacy. We conducted a meta-analysis investigating the effectiveness of apps for insomnia and sleep disturbances. From 19 RCTs, we identified significant pooled effect sizes for the primary outcomes of self-reported insomnia (g = 0.60; 05 % CI = 0.44, 0.76; NNT = 4.8) and sleep disturbances (g = 0.70; 95 % CI = 0.58, 0.83; NNT = 4.1) in favour of apps over control conditions. These effects remained robust when restricting the analyses to trials that delivered a placebo control, received a lower risk of bias rating, and had a larger sample size. Significant pooled effects in favour of apps were also observed for secondary outcomes of night time awakenings (g = 0.56), total sleep time (g = 0.33), and sleep onset latency (g = 0.32), but non-significant effects emerged for daytime sleepiness, dysfunctional beliefs about sleep, sleep efficiency, sleep hygiene, and wake after sleep onset. The pooled dropout rate from app conditions was 13.1 % (95 % CI = 8.3, 20.0), which was significantly higher than control conditions (OR = 1.78, 95 % CI = 1.39, 2.28). Findings suggest that stand-alone app-based interventions can effectively address insomnia and sleep disturbances, and may play an important role in the management of these symptoms. • Conducted a meta-analysis of 19 randomized trials of app-based interventions for insomnia. • Apps produced medium-large effects over controls on insomnia and sleep disturbances. • Apps may play an important role in the management of sleep disturbances. [ABSTRACT FROM AUTHOR]

Summary A randomised, placebo‐controlled, parallel‐group study was conducted to examine the effect of periocular skin warming before bedtime on sleep and anxiety in female workers with mild sleep difficulty. A total of 64 participants were included in the study, which consisted of a 1‐week baseline period and a 4‐week intervention period. They were randomly assigned to either the Warm group (N = 32) or the Sham group (N = 32) and were instructed to wear eye masks (warming or sham) before their habitual bedtime during the intervention period. The study found that the Athens Insomnia Scale score after the intervention was significantly lower in the Warm group compared to the Sham group. Additionally, participants in the warm condition showed a decrease in subjective sleep onset latency, better restorative sleep, and improved subjective anxiety before bedtime. A significant reduction in wake after sleep onset was observed in the Warm group at 4 weeks, and this decrease was significantly associated with the degree of improvement in subjective anxiety before bedtime. Furthermore, regular periocular skin warming before bedtime decreased sleep reactivity and improved well‐being. In conclusion, the study suggests that periocular skin warming may be an effective approach for female workers with sleep problems, as it can easily be incorporated into daily life. [ABSTRACT FROM AUTHOR]

Summary Utilizing a randomized control design, 42 healthy adults (22.5 ± 2.8 years) participated in alternate‐day modified fasting over a 12‐day treatment period. Assessments of sleep included sleep time, efficiency, latency and wake after sleep onset, and assessments of physical activity included steps, energy expenditure, sedentary time, time spent in light physical activity and time spent in moderate‐to‐vigorous activity. Additional measurements included body composition and mood. The alternate‐day modified fasting group consumed 25.8% ± 0.3% fewer calories compared with the control group (p = 0.03). There were no differences between groups for change in body mass index (p = 0.87), total fat mass (p = 0.91) or total lean mass (p = 0.88). Daily energy expenditure did not differ between groups (p = 0.11). On fast days, participants spent 34.5 ± 12.7 more minutes sedentary (p = 0.01), took 1100 ± 362 fewer steps (p < 0.01), and engaged in 27.2 ± 8.4 fewer minutes of moderate‐to‐vigorous physical activity (p = 0.00) compared with non‐fasting days. Sleep duration, efficiency, latency or wake after sleep onset were not different between conditions (p = 0.92, p = 0.10, p = 0.09 and p = 0.66, respectively). We conclude that alternate‐day modified fasting does not alter sleep time, efficiency, latency or wake after sleep onset in people reporting poor sleep quality, and does not alter overall physical activity. Although average daily physical activity is not altered, fasting in this manner does tend to result in more sedentary time and less physical activity with compensation on non‐fasting days. [ABSTRACT FROM AUTHOR]

AbstractThe objectives of this prospective study were to explore the health-related lifestyle of police cadets and assess changes in their health behaviors following entry into the police force. To do so, 190 police cadets completed an online questionnaire assessing their physical activity level, sedentary behaviors, diet quality, sleep hygiene, alcohol consumption, cigarette smoking, and stress level. One year following their graduation from the police training program, participants were invited to, once again, complete the questionnaire. Our results suggest that police cadets generally display healthy lifestyles, with very few cadets being physically inactive, smokers, reporting insufficient sleep duration, and displaying obesity. Nevertheless, paired-sample comparisons highlighted significant decreases in physical activity, fruit and vegetable intake, sleep duration, and sleep quality at the follow-up. Likewise, significant increases in fast-food consumption and BMI were observed. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions The aim of the study was to examine the relationship between sleep problems and executive functions in pre‐school children as reported by parents/caregivers.This cross‐sectional study of caregiver‐child dyads was conducted in a public kindergarten school in Northern Thailand. Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ), whereas executive functions were assessed using the Behavioural Rating Inventory of Executive Function – pre‐school version (BRIEF‐P). T‐scores greater than 65 of the BRIEF‐P were defined as deficits in executive functions. Multiple linear regressions were performed to assess the association between the executive function components and the total CSHQ scores.Participants included 356 children, with a mean age of 5.04 (0.54) years. The total CSHQ scores of the executive dysfunction group were significantly higher than those of the group with executive functions below the cutoff (P < 0.001), which indicated more of sleep problems, including sleep‐onset delay, night waking and daytime sleepiness. However, the duration of night sleep, night awake, afternoon nap and total sleep time reported by parents did not differ between the two groups. Weak positive correlations between the total CSHQ and subscale scores and the Global Executive Composite score of the BRIEF‐P were noted. After adjusting for confounding variables, including child's age, gender, prematurity, maternal age and education, family income and media viewing time from the multiple linear regression analysis, the total CSHQ scores were significantly correlated with worse Global Executive Composite scores, which is the summary of five domains of executive functions (P < 0.001).This study highlights the association between sleep problems and deficits in executive functions in healthy pre‐school children. Health‐care providers are encouraged to consistently advocate for proper sleep hygiene and practices to enhance executive functions in pre‐schoolers. [ABSTRACT FROM AUTHOR]

Background: Due to work commitments, shiftworkers often obtain inadequate sleep, consequently experiencing negative health, wellbeing, and safety outcomes. Given shiftworkers may have limited control over their work commitments, lifestyle and environmental factors within their control may present an intervention opportunity. However, such interventions require tailoring to ensure applicability for this sleep-vulnerable population. Methods: A randomised waitlist control pilot trial investigated the effectiveness of mobile health application Sleepfit, which delivered a tailored sleep health intervention aimed at improving sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. Outcome measures of self-reported sleep health (sleep need, duration, and quality, fatigue, Insomnia Severity Index, Fatigue Severity Scale, and Epworth Sleepiness Scale scores) and sleep hygiene (Sleep Hygiene Index score) were collected at baseline, post-intervention, and 3-month follow-up. Results: Fifty-eight paramedics (aged 33.4 ± 8.0 years; 50% male) were recruited, and trialed Sleepfit for a 14-day intervention period between August 2021–January 2022. For all participants, there was a significant reduction in Insomnia Severity Index and Sleep Hygiene index scores after intervention engagement. Regression models demonstrated no significant intervention effect on sleep health or sleep hygiene outcomes (intervention versus waitlist control group). A high study drop-out rate (91.4%) prevented assessment of outcomes at 3-month follow-up. Conclusions: Pilot trial findings demonstrate that Sleepfit may elicit improvements in sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. However, low enrolment and retention means that findings should be interpreted with caution, further highlighting potential engagement challenges, especially among paramedics who are particularly in need of support for improved sleep. Trial registration: Prospectively registered with the Australian New Zealand Clinical Trial Registry 24/01/2020 (reference no. ACTRN12620000059965). [ABSTRACT FROM AUTHOR]

Introduction Rotating shiftwork schedules are known to disrupt sleep in a manner that can negatively impact safety. Consumer sleep technologies (CSTs) may be a useful tool for sleep tracking, but the standard feedback provided by CSTs may not be salient to shift-working populations. SleepTank is an app that uses the total sleep time data scored by a CST to compute a percentage that equates hours of sleep to the fuel in a car and warns the user to sleep when the "tank" is low. Royal Australian Navy aircraft maintenance workers operating on a novel rotational shift schedule were given Fitbit Versa 2s to assess sleep timing, duration, and efficiency across a 10-week period. Half of the participants had access to just the Fitbit app while the other half had access to Fitbit and the SleepTank app. The goal of this study was to evaluate differences in sleep behavior between shifts using an off-the-shelf CST and to investigate the potential of the SleepTank app to increase sleep duration during the 10-week rotational shift work schedule. Materials and Methods Royal Australian Navy volunteers agreed to wear a Fitbit Versa 2 with the SleepTank app (SleepTank condition), or without the SleepTank app (Controls), for up to 10 weeks from May to July 2023 during the trial of a novel shift rotation schedule. Participants from across 6 units worked a combination of early (6:00 AM to 2:00 PM), day (7:30 AM to 4:30 PM), late (4:00 PM to 12:00 AM), and night shifts (12:00 AM to 6:00 AM) or stable day shifts (6:00 AM to 4:00 PM). Differences in sleep behavior (time in bed, total sleep time, bedtime, wake time, sleep efficiency [SE]) between conditions and shift types were tested using Analysis of Variance. This study was approved by the Australian Departments of Defence and Veterans' Affairs Human Research Ethics Committee. Results Thirty-four participants completed the full study (n  = 17 Controls; n  = 17 SleepTank). There was a significant effect of shift type on 24-hour time in bed (TIB24; F(4,9) = 8.15, P  < .001, η2 = 0.15) and total sleep time (TST24; F(4,9) = 8.54, P  < .001, η2 = 0.18); both were shorter in early shifts and night shifts compared to other shift types. TIB24 and TST24 were not significantly different between conditions, but there was a trend for greater SE in the SleepTank condition relative to Controls (F(1,9) = 2.99, P  = .08, η2 = 0.11). Conclusions Sleep data collected by Fitbit Versa 2s indicated shorter sleep duration (TIB24, TST24) for Royal Australian Navy workers during early and late shifts relative to stable day shifts. Access to the SleepTank app did not greatly influence measures of sleep duration but may be protective against fatigue by affecting SE. Further research is needed to evaluate the utility of the SleepTank app as a means of improving sleep hygiene in real-world, shift-working environments. [ABSTRACT FROM AUTHOR]

Sleep disorders increase with age and are known risk factors for several mental and physical diseases. They also significantly contribute to a lower quality of life. Nonpharmaceutical approaches, such as cognitive behavioral therapy for insomnia, sleep hygiene advice, relaxation exercises, and physical activity programs, can be delivered directly to patients via mHealth technologies, thereby increasing the accessibility of such interventions and reducing health care-related costs. This scoping review aims to evaluate the effectiveness of mHealth interventions for improving sleep quality among older adults. Published studies in the last 10 years (2013–2023) were identified by searching electronic medical databases (PubMed, PsycINFO, CINAHL, and Scopus) in July 2023 and were independently reviewed by two different authors. The analysis of the data was performed in 2023. The research retrieved 693 records; after duplicates were removed, 524 articles were screened based on their title and abstract, and 28 of them were assessed in full text. A total of 23 studies were excluded because they did not meet the inclusion criteria in terms of population age (60 years or over) or type of intervention (mHealth-based) or because they addressed secondary insomnia. A total of five studies were included in this review, and all of them reported improvements in subjective sleep quality after the application of the mHealth interventions. Two studies also conducted objective assessments of sleep outcomes using actigraphy, reporting improvements only in some of the variables considered. Despite the limited number of available studies, these results are promising and encourage further research. [ABSTRACT FROM AUTHOR]

College students often experience sleep–wake alterations. Different factors can contribute to insomnia symptoms in this population. The present study aims at investigating pre-sleep behaviours and strategies used to aid sleep onset in young college students and their association with insomnia symptoms. A total of 548 Italian college students (mean age = 23.48 years, range = 19–30 years, 80.5% female) completed a web-based survey on pre-sleep behaviours and sleep-onset facilitators, insomnia symptoms and sleep hygiene, anxiety and depression, and coping strategies. The use of electronic devices at bedtime and as a sleep-onset facilitator was predominant. Students using specific behaviours as sleep-onset facilitators were characterised by more psychological difficulties and poorer sleep. In multivariable linear regression analysis, the frequency of using medications and melatonin, regardless of motivations, was associated with higher insomnia symptoms. The use of specific sleep-onset facilitators positively correlated with the severity of insomnia symptoms. Many students engage in behaviours that are considered sleep-interfering and that are often employed in an attempt to facilitate sleep onset without benefits. Overall, the motivational factors behind pre-sleep behaviours need to be addressed in preventive programs targeting young college students. [ABSTRACT FROM AUTHOR]

Purpose: Previous research has established that food intake is a biological regulator of the human sleep–wake cycle. As such, the timing of eating relative to sleep may influence the quality of sleep, including daytime naps. Here, we examine whether the timing of lunch (1 h vs. 2 h interval between lunch and a napping opportunity) impacts the quality of an afternoon nap. Methods: Using a randomized within-subject design over two separate experimental sessions (7 days apart), participants (n = 40, mean age = 25.8 years) consumed lunch 1 h and 2 h prior to an afternoon nap opportunity. Polysomnography and subjective self-reports were used to assess sleep architecture, sleepiness levels, and nap quality. Results: Results revealed no significant differences in subjective ratings of sleep quality and sleepiness, or in sleep architecture (total sleep time, sleep efficiency, sleep onset latency, sleep stages) between the 1 h and 2-h lunch conditions. Conclusions: All sleep measures were similar when napping followed eating by either 1 h or 2 h, suggesting that eating closer to nap onset may not negatively impact sleep architecture and quality. Future research should continue to identify conditions that improve nap quality, given the well-documented benefits of naps to reduce sleep pressure and improve human performance. [ABSTRACT FROM AUTHOR]

Being overweight or obese can have severe negative psychological impacts and reduce health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight or obesity, it is important to design and implement effective interventions. The aim of this study was to evaluate the effects of a 6-month family-based lifestyle intervention on HRQoL and sleep habits in Norwegian children with overweight or obesity in a primary-care setting. This 6-month, non-randomised, cluster-controlled trial included Norwegian children aged 5–13 years with overweight or obesity and their parents. A questionnaire was filled out by the parents. A total of 33 and 52 children in the control group and 41 and 78 children in the intervention group answered the HRQoL and sleep habits questions, respectively, and were included. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. The Children's Sleep Habits Questionnaire (CSHQ) and Kidscreen-10 index were used to assess sleep habits and HRQoL. At baseline, the mean average scores for HRQoL were 50.0 [standard deviation (SD) 8.1] for the intervention group and 49.0 (SD 10.1) for the control group. For sleep habits at baseline, the mean average scores were 45.2 (SD 11.8) for the intervention group and 46.0 (SD 11.9) for the control group. No significant changes in HRQoL and sleep habits after the intervention were revealed. Overall, the family-based lifestyle intervention targeting overweight and obese children in a primary-care setting showed no significant effect on HRQoL or sleep quality. [ABSTRACT FROM AUTHOR]

The article focuses on a case study of a 15-year-old girl exhibiting chronic throat-squeezing behavior as a form of nonsuicidal self-injury (NSSI) following trauma. Topics include the prevalence and implications of NSSI among adolescents, the psychological impact of negative childhood experiences on such behaviors, and the effectiveness of sertraline treatment in reducing both depressive symptoms and the frequency of throat-squeezing behavior.

Combat sports is a term applied to various competitive contact sports involving 2 competitors engaging in a bout or contest under a specific ruleset. Little is known about combat sports athletes' sleep and nutritional knowledge. This study aimed to assess (a) sleep behaviors, (b) alcohol and shiftwork disorders, and (c) the nutritional knowledge of combat sports athletes. Subjects completed various demographic questions and estimations of their weight management practices and validated surveys, including the Athlete Sleep Behavior Questionnaire, Shiftwork Disorder (SWD) Screening Questionnaire, Alcohol Use Disorders Identification Test, and the Abridged Nutrition for Sports Knowledge Questionnaire. A total of 844 combat sports athletes completed the survey, 79% male, height of 177 ± 10 (cm), and body mass of 79 ± 15 (kg). Subjects were categorized into their specific combat sport type (e.g., boxing or Brazilian jiu-jitsu [BJJ]) and by their level (professional or amateur). Sleep quality was average for all combat sport types and risk prevalence of shiftwork disorder at 11%. Mann-Whitney U tests revealed that amateurs, compared with professional strikers (p = 0.046, CLES = 0.80), boxers (p = 0.01, CLES = 0.78), and BJJ (p = 0.046, CLES = 0.61) athletes, consumed significantly more alcohol. A Friedman test showed significant (p < 0.001, W = 0.51) differences in weight between time points, with most combat sports athletes reducing weight for competition. An overall nutritional knowledge average of 55% was reported. This study highlights a critical gap in the knowledge and practices of combat sports athletes in relation to sleep behaviors and disorders, alcohol consumption, and nutritional knowledge, emphasizing the need for targeted educational interventions. [ABSTRACT FROM AUTHOR]

Racial and ethnic minority adolescents living in urban settings experience sleep disparities. Few interventions have been developed to address these disparities. Guided by principles of participatory design and inclusion, our team developed a novel intervention that combined sleep hygiene education with mind-body integrative health (MBIH) practices to improve sleep quality among adolescents in New York City. The goal of this article is to describe our iterative development and design process, the final product, and future directions. Our participatory approach incorporated information from formative work with adolescents having lived experience, practitioners, and syntheses of published literature. The final intervention—Sleeping Healthy, Living Healthy—consists of six, 40-minute group sessions and one 20-minute individual session designed for high school students. Each session has a set of learning objectives, combining instruction, group activities, and discussions on sleep hygiene and MBIH topics. Our manualized intervention includes handouts created by a graphic design team that served as a review and reminder for home practice. We describe intervention implementation to two unique cohorts and detail our methods used to fine-tune the intervention between cohorts. Our partnership with and insights from both adolescents and practitioners serve as a guide for researchers aiming to use participatory methods to develop interventions to decrease health disparities in specific populations. [ABSTRACT FROM AUTHOR]

Shorter sleep duration can negatively impact children's daytime functioning and health. Latino children living near urban areas in the Mainland U.S. and Island Puerto Rico (PR) can be exposed to urban poverty and sociocultural stressors that challenge optimal sleep outcomes. Interventions to improve urban Latino children's sleep health should consider families' cultural background and environmental context to enhance acceptability and feasibility. This work describes our stepwise, multimethod approach to adapting a culturally and contextually tailored "School Intervention to Enhance Latino Students' Time Asleep (SIESTA)" for sixth- to eighth-grade Latino children residing in Greater Providence and San Juan and findings from a pilot randomized control trial (RCT) demonstrating SIESTA's efficacy. Results indicated high acceptability and greater improvement of sleep duration and behaviors in SIESTA versus control participants. The SIESTA shows potential to improve sleep outcomes in urban Latino middle schoolers. Results will inform a large-scale RCT to evaluate SIESTA's effectiveness and barriers to implementation. [ABSTRACT FROM AUTHOR]

The American Heart Association (AHA) recently redefined cardiovascular health (CVH) with the introduction of Life's Essential 8 (LE8), which encompasses eight areas (diet, physical activity, nicotine exposure, sleep duration body mass index, non-HDL cholesterol, blood glucose, and blood pressure). This study aimed to explore the relationships between both the aggregate and individual CVH metrics, as defined by Life's Essential 8, and cognitive function in older adults in the United States. This cross-sectional, population-based study analyzed data from the National Health and Nutrition Examination Survey conducted between 2011 and 2014, focusing on individuals aged 60 years and older. CVH was categorized as low (0–49), moderate (50–79), or high (80–100). Cognitive function was assessed through the CERAD tests, Animal Fluency test, and Digit Symbol Substitution test. Multivariable logistic models and restricted cubic spline models were employed to investigate these associations. This study included a total of 2279 older adults in the United States. Only 11% of adults achieved a high total CVH score, while 12% had a low score. After further adjustment for potential confounding factors, higher LE8 scores were significantly associated with higher scores on CERAD: delayed recall score (0.02[0.01, 0.03]; P < 0.001), CERAD: total score (3 recall trials) (0.04[0.02, 0.06]; P < 0.001), animal fluency: total score (0.09[0.05, 0.12]; P < 0.001), and digit symbol: score (0.29[0.18, 0.41]; P < 0.001), demonstrating a linear dose–response relationship. Similar patterns were also observed in the associations between health behavior and health factor scores with cognitive function tests. LE8 scores exhibited positive linear associations with cognitive function. Maintaining better levels of CVH may be associated with higher levels of cognitive function in older Americans, but further research is needed to confirm the causal and temporal relationships between LE8 and cognitive function. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disrupted the daily life and routines of Americans across the United States (U.S.), including those of our active-duty service members (ADSMs). Limited movement orders enacted during this time to promote social distancing prohibited access to fitness and dining facilities for ADSMs. This study aims to expand on previous work identifying changes in body mass index (BMI) among U.S. Army service members by identifying changes in body mass index (BMI) among active-duty service members from both the Navy and Marine Corps during the same time period. Methods: We conducted a retrospective cohort study of active-duty service members from the Navy and Marine Corps using data from the Military Health System Data Repository. BMI was calculated and categorized according to CDC guidelines both before (February 2019 - January 2020) and during the pandemic (September 2020 - June 2021). Women who were pregnant or delivered during and one year prior to the study periods were excluded. Statistical analyses included paired t-tests evaluating mean BMI, percent change, and the Stuart-Maxwell test for marginal homogeneity. Results: We identified 98,330 active-duty Sailors and 55,298 active-duty Marines for inclusion in this study. During the pandemic period the percentage of Sailors with Underweight decreased by 11%, Healthy weight decreased by 11.1%, Overweight increased by 2.1%, and the percentage of Sailors with Obesity increased by 16.5%. During this same time period, Marines with Underweight decreased by 1%, Healthy weight decreased by 16%, Overweight increased by 3.0%, and Marines with Obesity increased by 51%. The largest increases in service members with overweight and obesity observed among both cohorts were among female service members, service members under age 20, and service members with a Junior Enlisted rank. Conclusions: Significant increases in obesity were observed amongst active-duty United States Navy and Marine Corps service members during DoD pandemic mitigation efforts. Increased rates of obesity likely effected fitness and force readiness. Future interventions should be targeted at younger, Junior-Enlisted Marines and Sailors to promote healthy lifestyles and provide education on nutrition, appropriate exercise, sleep hygiene, and stress management. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia is a prevalent sleep disorder that negatively impacts daytime functioning and quality of life. Breast cancer patients report higher rates of insomnia and more circadian disruption than other cancer groups. Approximately 50% of patients experience acute insomnia following breast cancer diagnosis, which often persists during cancer treatment and rehabilitation. Sleep Restriction Therapy (SRT) is a clinically effective and tolerable treatment for persistent insomnia in breast cancer survivors. However, SRT has never been tested on patients with early signs of sleep disturbance who are undergoing cancer treatment. The aim of this pilot randomised controlled trial is to explore the feasibility and preliminary effectiveness of nurse delivered SRT for newly diagnosed breast cancer patients with acute insomnia. The trial has been registered on ClinicalTrials.gov (identifier: NCT06294041). Methods: The INVEST (INvestigating the Value of Early Sleep Therapy) trial will recruit 50 newly diagnosed breast cancer patients who meet criteria for acute insomnia. Patients will be recruited from breast cancer results clinics within two Scottish health boards (NHS Grampian and NHS Greater Glasgow and Clyde) and will be block randomised (1:1) to receive nurse delivered SRT or Sleep Hygiene Education (SHE). SRT will be delivered over 4 weekly sessions comprising two face-to-face meetings (either in person or online) and two telephone calls, whereas SHE will be administered in booklet form. Outcomes will be collected at baseline, 6 weeks, and 12 weeks post-randomisation. Primary outcomes in this trial relate to the feasibility of SRT for newly diagnosed breast cancer patients with acute insomnia. Specifically, we will explore (i) rates of patient recruitment and retention, (ii) intervention fidelity, (iii) data collection procedures and outcome measure completion, (iv) intervention acceptability. Secondary outcomes will focus on preliminary evaluation of patient responses to SRT, including insomnia severity, rest-activity rhythms, and mental health. Dissemination: Our dissemination plan comprises publishing trial outcomes in high-impact, peer-reviewed journals and on breast cancer charity websites and other patient resources. The outcomes from this pilot trial will also inform the development of a full-scale, multicentre RCT of SRT for acute insomnia in newly diagnosed breast cancer patients. University of Strathclyde is the sponsor (reference: UEC23/52). Protocol version v1.2 4 October 2023. Strengths and limitations of this study: This trial is the first to explore the value of sleep prehabilitation for newly diagnosed breast cancer patients. This will be the first trial to assess the feasibility of delivering SRT during breast cancer treatment, providing valuable insight into its tolerability and preliminary effectiveness. An embedded process evaluation will assess the acceptability of SRT, providing insight into potential optimisation of the intervention and recommendations for enhancing its future scalability and translation within cancer care. Due to the nature of the SRT intervention, nurse therapists and patients cannot be blinded to treatment allocation, increasing the risk of bias. [ABSTRACT FROM AUTHOR]

Background and hypothesis Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods A systematic review of the Medline/PubMed, Embase, Cochrane Library, and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results In total, 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep durations of ≤4 hours (RR 1.41, 95% CI: 1.16 to 1.71, P < 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, P < 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, P < 0.01), and ≤7 hours (RR 1.19, 95% CI: 1.12 to 1.28, P < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep durations of ≥8 hours (RR 1.15, 95% CI: 1.03 to 1.28, P < 0.01) and ≥9 hours (RR 1.46, 95% CI: 1.28 to 1.68, P < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region, and BMI and an association with sleep duration and risk of incident chronic kidney disease. Conclusion Both short and long sleep durations were significantly associated with a higher risk of chronic kidney disease. Interventions targeted toward achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease. [ABSTRACT FROM AUTHOR]

The current descriptive study reports the sleep, diet, and exercise patterns among 114 dementia caregivers, whose mean age was 55.7 (SD: 10.4) years, with 83 (72.8%) being women. The results indicate significant sleep dysfunction: 37.2% of caregivers reported rarely or never feeling rested upon waking, and 46.5% did not get enough sleep, with 45.6% sleeping only 5 to 5.5 h on average. Sleep latency was also prevalent, as 33.3% required 16 to 30 min to fall asleep. Dietary habits showed reliance on coffee, with 69.4% consuming it daily. Meat consumption was reported by 75%, and 60.9% ate pasta, indicating common dietary preferences. While 86.2% had one to three meals per day, 100% of the caregivers supplemented their diets with vitamins. The physical activity level was low, with 62.3% of respondents reporting no exercise in the past week. These findings underscore significant health concerns among dementia caregivers, including sleep deprivation, inadequate nutrition, and physical inactivity. The report emphasizes the need for targeted interventions to promote self-care practices that can enhance caregivers' health, including better sleep hygiene, balanced nutrition, and regular exercise. [ABSTRACT FROM AUTHOR]

Purpose: Pregnancy-related psychophysiological changes are associated with the sleep alterations as the gestational weeks progress. The aim is to evaluate the effectiveness of sleep hygiene education programs during pregnancy. Methods: This prospective randomized controlled study based on pre–post-test after intervention consists of 30 studies and 30 control groups. Pregnant descriptive form, Beck Depression Index (BDI), Pittsburgh Sleep Quality Index (PSQI) and sleep hygiene index (SHI) questionnaires were used. Pregnant women with a score of 15 and above according to BDI were excluded from the study due to depression. Following the application of PSQI and SHI as a pretest, a sleep hygiene training program was applied to the intervention group twice with an interval of 15 days, and PSQI and SHI surveys were repeated as a posttest at the end of 1 month. End points with prespecified hypotheses were changes in sleep quality in different trimesters during antenatal follow-up (primary end point) and changes in sleep quality after the sleep hygiene education intervention from randomization to the end of the intervention period (secondary end point). Results: 90% of all pregnant women had poor sleep quality in the pre-test, and 93.3% in the post-test. In the intervention group, the pre-test PSQI score was 8.10 ± 1.80 and the post-test PSQI score was 8.37 ± 2.05 (p < 0.001). In the control group, the pre-test PSQI score was 8.23 ± 2.54 and the post-test PSQI score was 9.77 ± 2.54, and the worsening of sleep quality became more evident (p < 0.05). While the SHI in intervention group was 16.57 ± 5.64 in the pre-test, it was 10.30 ± 3.78 in the post-test after sleep hygiene training (p < 0.001). In the control group, the pre-test SHI scores increased from 14.50 ± 3.78 to the post-test scores of 16.60 ± 4.36, resulting in a decline in sleep hygiene and sleep quality (p < 0.05). Conclusion: As the gestational week progressed, the deterioration in sleep quality increased. The poor sleep quality improved significantly after sleep hygiene education counseling. It is recommended to add sleep-related screenings to routine pregnancy follow-ups and to provide sleep hygiene education. [ABSTRACT FROM AUTHOR]

Objective: We investigated the effect of a 7-month healthy lifestyle intervention on cardiometabolic risk factors (CMRF) among male career military firefighters (FFs). Methods: Forty-nine FFs participated in a 7-month workplace multiddisciplinary healthy lifestyle intervention designed to reduce CMRF through exercise, diet, and improved sleep. Medical assessments, accelerometry, and surveys at the beginning and end determined program effectiveness. Results: At the end of the intervention period, there was a significant improvement in measures of body composition and blood glucose. The prevalence of hypertension also decreased significantly (P < 0.01). The 57% of participants who fully adhered to the program had significantly greater improvements across multiple CMRF. Participants increased their physical activity and improved their diet following the intervention. Conclusions: This healthy lifestyle intervention was effective in changing behavior and lowering cardiometabolic risk among FFs. [ABSTRACT FROM AUTHOR]

In Chinese adolescents, the co-occurrence of depressive symptoms and short sleep duration constitute a serious public health issue. This study investigates the association between depressive symptoms and sleep duration of Chinese adolescents on weekdays as well as weekends. A multistage random cluster selection was utilized to select 2660 adolescents in Taiyuan, China. The survey contents included demographic characteristics, sleep duration, and depressive symptoms. About 41.95 % of students reported depressive symptoms with an average sleep duration of 7.71 ± 0.90 h. After adjusting for covariates, depressive symptoms were found to be positively correlated with sleep duration <6 h (OR = 1.88, 95 % CI: 1.20, 2.95) and 6 ~ h (OR = 1.61, 95 % CI: 1.18, 2.20) on weekdays, and sleep duration <6 h (OR = 2.10, 95 % CI: 1.17, 3.79) and 6 ~ hours (OR = 1.74, 95 % CI: 1.16, 2.62) on weekends compared with a sleep duration of 8 ~ hours. Only on weekdays, sleep duration of 7 ~ hours was positively correlated with depressive symptoms (OR = 1.39, 95%CI: 1.05, 1.84). On weekends, it was not associated with depressive symptoms (OR = 1.06, 95%CI: 0.82, 1.39). In subgroup analyses, female students (OR = 2.88, 1.97, 1.50) and middle school students (OR = 3.50, 2.07, 1.50) were more likely to experience depressive symptoms on weekdays with a sleep duration of <6 h, 6 ~ hours and 7 ~ hours. Sleep duration and depressive symptoms were self-reported measures. The study highlights that short sleep duration (< 7 h) increases the risk of depressive symptoms among adolescents regardless of weekdays or weekends. Just on weekdays, the sleep duration of 7 ~ hours was a risk factor for depressive symptoms. Further, gender, grade, and the only-child played significant modification effects between depressive symptoms and sleep duration. To conclude, this study will assist in the effective promotion of the education of adolescents' sleep health. • Depressive symptoms & short sleep duration is a serious health issue in adolescents. • A correlation exists between adolescents' depressive symptoms and sleep duration. • Short sleep increases depressive symptoms risk regardless of weekday or weekend. • Female and middle schoolers are at higher depression risk due to inadequate sleep. [ABSTRACT FROM AUTHOR]

Background: Accidental suffocation and strangulation in bed continues to be a critical issue in Black communities, despite the widespread initiatives to promote safe sleep. Doulas are in an ideal position to promote safe sleep, particularly in hard-to-reach communities that are more distrusting of conventional medical providers. Little is known about their practices and perspectives for putting infants down to rest. This study informs this gap in the literature. Purpose: The purpose of this study was to explore doulas' perspectives and practices in the field of putting infants down to sleep. The researchers aimed to determine whether Black caregivers that work with doulas are likely to encounter safe sleep education. Methods: The researchers used a descriptive approach to inquiry. They conducted three focus groups with a total of 17 Black doulas. The researchers independently and critically reviewed the transcriptions and observation notes from each group to identify codes. They then triangulated the results using Artificial Intelligence-driven tools. Findings: The study found four themes: (1) Individualized Services, (2) Cultural Sensitivity, (3) Negotiating Safety, and (4) Safe Sleep Education. Conclusions: The study concluded doulas have a commitment to promoting safe sleep. The researchers found that doulas engage in practices that help caregivers to integrate safe sleep practices into their lifestyle and to adapt them to meet their needs. The researchers also documented a desire for more information and instruction on safe sleep among practicing doulas. Significance: Scholars recognize that doulas play a vital role in infant and maternal health in Black communities, but little is known about their role in promoting safe sleep. This study contributes to this knowledge base, revealing that doulas uphold a commitment to safe sleep practices and are integral in helping Black caregivers negotiate safe sleep. [ABSTRACT FROM AUTHOR]

Poor sleep during hospitalization can negatively affect patient health, well-being, and satisfaction. This nurse-led quality improvement project aimed to promote quality sleep on an inpatient telemetry medical-surgical oncology unit. Interventions included distributing sleep hygiene kits (eye masks, earplugs, lip balm, and aromatherapy), educating patients and staff, and redesigning workflows to limit sleep interruptions at night. Hospital Consumer Assessment of Healthcare Providers and Systems Survey scores for quietness at night increased from 66% to 76%, with fewer reported cases of delirium postimplementation. [ABSTRACT FROM AUTHOR]

Investigate whether aiding sleep by online cognitive behavioral therapy for insomnia (CBT-I) can improve glycemic and metabolic control, mood, quality of life (QoL) and insomnia symptoms in people with type 2 diabetes and assess the mediating role of lifestyle factors. Adults with type 2 diabetes and insomnia symptoms were randomly assigned to CBT-I or care as usual. At baseline, three and six months we assessed HbA1c as primary outcome and glycemic control, metabolic outcomes, sleep, mood and QoL as secondary outcomes. Mixed models were used to determine within-person and between-persons differences in outcomes and mediation analysis for lifestyle factors. We randomized 29 participants to CBT-I and 28 to care as usual. Intention-to-treat analysis showed no significant differences in glycemic control, metabolic outcomes, anger, distress or QoL, but showed a significantly larger decrease in insomnia (−1.37(2.65: 0.09)) and depressive symptoms (−0.92(-1.77: 0.06)) and increase in BMI (0.29 kg/m2(0.00:0.57)) in the intervention compared to the control group. Only half of the intervention participants completed the CBT-I. Per protocol analysis showed a not statistically significant decrease in HbA1c (−2.10 mmol/l(-4.83:0.63)) and glucose (−0.39 mmol/l(-1.19:0.42)), metabolic outcomes and increase in QoL. Furthermore, the intervention group showed a significant decrease in insomnia (−2.22(-3.65: 0.78)) and depressive symptoms (−1.18(-2.17: 0.19)) compared to the control group. Lifestyle factors partially mediated the effect of the intervention. CBT-I might improve insomnia symptoms and mood, and perhaps improves glycemic control, albeit not significant, in people with type 2 diabetes and insomnia symptoms, compared to care as usual. • Insomnia symptoms are highly prevalent in people with type 2 diabetes. • Can we improve glycemic status by improving sleep through CBT-I? • CBT-I improves insomnia symptoms and mood, and might improve glycemic control and QoL. • Lifestyle factors partially mediated the effect of CBT-I. [ABSTRACT FROM AUTHOR]

Summary: We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5–12 years) wore a wrist‐based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent‐reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z‐Angle (HDCZA) algorithm (no log), and an 8 p.m.–8 a.m. window (generic log) using the R‐package 'GGIR' (version 2.6‐4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland–Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4–10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom. [ABSTRACT FROM AUTHOR]

Summary: Numerous studies have reported the negative impacts of poor sleep on work productivity in the general population. However, despite the known sleep issues that individuals living with neurological conditions experience, no study has explored its impact on their work productivity. Sleep health is a concept that includes multiple domains of sleep, measured with a combination of objective and subjective measures. Therefore, this study aimed to ascertain the associations between sleep health and its domains and work productivity in individuals with neurological conditions. Sleep health domains were determined through actigraphy data collected over 1 week and sleep questionnaires. Work productivity was assessed via the Work Productivity and Activity Impairment Questionnaire. A comparison of sleep health scores between demographic variables was performed using Mann–Whitney U and Kruskal–Wallis tests. Associations between the sleep health domains and work productivity were performed using linear regression models. There were no significant differences in sleep health scores between sex, smoking status, education level, employment status or any work productivity domain. Individuals with non‐optimal sleep timing had greater absenteeism (22.99%) than the optimal group. Individuals with non‐optimal sleep quality had an increase in presenteeism (30.85%), work productivity loss (26.44%) and activity impairment (25.81%) compared to those in the optimal group. The findings from this study highlight that self‐reported sleep quality has the largest impact on work productivity. Improving individuals' sleep quality through triage for potential sleep disorders or improving their sleep hygiene (sleep behaviour and environment) may positively impact work productivity. [ABSTRACT FROM AUTHOR]

Summary: People with heart failure (HF) experience a high symptom burden and prevalent insomnia. However, little is known about daytime symptom trajectories after cognitive behavioural therapy for insomnia (CBT‐I). In this study we describe: (1) daytime symptom trajectories among adults with insomnia and stable HF over 1 year, (2) how symptom trajectories differ between CBT‐I versus HF self‐management interventions, and (3) associations between demographic, clinical, and sleep characteristics, perceived stress, health‐related quality of life (HRQoL), functional performance and daytime symptoms trajectories. We retrospectively analysed data from a randomised controlled trial of CBT‐I versus HF self‐management (NCT0266038). We measured sleep, perceived stress, HRQoL, and functional performance at baseline and symptoms at baseline, 3, 6, and 12 months. We conducted group‐based trajectory modelling, analysis of variance, chi‐square, and proportional odds models. Among 175 participants (mean [standard deviation] age 63.0 [12.9] years, 57.1% male, 76% White), we found four daytime symptom trajectories: (A) low improving symptoms (38.3%); (B) low psychological symptoms and high improving physical symptoms (22.8%); (C) high improving symptoms (24.0%); and (D) high not improving symptoms (14.9%). The CBT‐I versus the HF self‐management group had higher odds of belonging to Group A compared to other trajectories after controlling for baseline fatigue (odds ratio = 3.27, 95% confidence interval 1.39–7.68). The difference between the CBT‐I and the HF self‐management group was not statistically significant after controlling for baseline characteristics. Group D had the highest body mass index, perceived stress, and insomnia severity and the lowest cognitive ability, HRQoL, and functional performance. Research is needed to further evaluate factors contributing to symptom trajectories. [ABSTRACT FROM AUTHOR]

Background: Delirium is a state of altered level of consciousness often leading to confusion, inattention, and changes to levels of cognition. Delirium increases average length of stay in the hospital and costs the US health care system approximately $148 billion each year in associated medical costs. Sleep hygiene is an important factor in delirium prevention for all hospitalized patients. Objectives: This quality improvement project was designed to increase implementation of an evidence-based sleep hygiene bundle in the neurocritical care population in order to decrease rates of hospital-acquired delirium. Methods: This project followed the Plan, Do, Study, Act (PDSA) framework to facilitate a continuous quality improvement intervention at amid-Atlantic academicmedical center in the neurocritical care population. The continuous quality improvement included the incorporation of "sleep" as a topic into the daily rounding checklist, thus optimizing the ability to improve adherence to a multicomponent sleep hygiene bundle. The intervention includes the preintervention-postintervention occurrences of delirium and use of the daily rounding checklist. Results: Nursing adherence to documentation of delirium assessments was high at approximately 99%. Following the intervention, there was a 41% decrease in the number of patients who screened positive for hospital-acquired delirium. Discussion: The improvement in cases of hospital-acquired delirium may be attributed to the project intervention. Recommendations for future interventions include analysis of training on sleep plans, focus on nursing education regarding delirium assessment tools, or a measure of staff and/or patient satisfaction related to the intervention. [ABSTRACT FROM AUTHOR]

Context: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. Objectives: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. Evidence Acquisition: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. Evidence Synthesis: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). Conclusions: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep. [ABSTRACT FROM AUTHOR]

Through Tanzania's National Sanitation Campaign, we study the effectiveness of two common elements of behavior change campaigns: endorsements from celebrities and testimonials. Using four experiments in Tanzania in early 2021 as part of the national campaign, we find that including endorsements and testimonials in text messages sent to individuals significantly increases self-reported hygiene behavior. These results mask important heterogeneity based on the source of endorsement or framing of the testimonial and provide insights into cost-effective approaches for changing behavior at scale. [ABSTRACT FROM AUTHOR]

Given the high prevalence of sleep problems and fine motor deficits that have been reported in persons with Down syndrome (DS), this study was to investigate the effect of sleep-related problems occurring during the day on fine motor function (i.e. manual dexterity and handgrip strength) in persons with DS. We also tested the moderating role of obstructive sleep apnoea (OSA) in the link between sleep-related problems occurring during the day and fine motor function. It was hypothesised that subtle sleep-related problems occurring during the day would significantly predict fine motor performance. Fifty-two persons with DS, aged 13–54, participated and caregivers completed a sleep questionnaire for their children with DS. Hierarchical multiple regression analyses indicated a greater frequency of sleep-related problems occurring during the day significantly predicted greater manual dexterity deficits. Results also suggested that OSA was the moderator for the association between sleep-related problems occurring during the day and manual dexterity. This study has highlighted the importance of exploring sleep problems that might impair fine motor performance for the DS population in their everyday lives. Additional studies are needed to develop effective interventions to promote sleep hygiene and fine motor development in this population. [ABSTRACT FROM AUTHOR]

Poor sleep quality and psychological distress in pregnancy are important health concerns. Serotonin and melatonin levels may underlie variation in these adverse outcomes. In this study, we examined dietary nutrients involved in serotonin and melatonin synthesis in relation to maternal sleep quality and affective symptoms during pregnancy. Pregnant women at no greater than normal medical risk at enrollment completed 24‐hour dietary recalls in mid‐late pregnancy. Usual intakes of vitamin B6, vitamin D, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), and tryptophan were estimated from dietary intake of foods and supplements using the National Cancer Institute (NCI) method. Sleep quality, depression, and anxiety were measured using validated questionnaires. Associations between nutrient intakes, sleep quality, and affective symptoms were estimated using generalized estimating equation models adjusting for potential confounding factors. In minimally adjusted models, EPA + DHA and tryptophan intakes were associated with a lower score indicating better sleep quality (b: −1.07, 95% CI: −2.09, −0.05) and (b: −12.40, 95% CI: −24.60, −0.21), respectively. EPA + DHA and tryptophan intakes were also associated with a lower odds of shorter sleep duration and sleep disturbances. In addition, tryptophan was associated with a lower odds of higher sleep latency. However, associations were attenuated and nonsignificant after adjustment for demographic and lifestyle factors. In conclusion, intakes of EPA + DHA and tryptophan were associated with improved sleep quality, but these associations were confounded by maternal demographic and lifestyle characteristics. This study highlights the need to consider dietary intake and pregnancy health in the context of demographic characteristics and lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Background Individuals may experience significant alterations in sleep hygiene during the major public health emergencies, consequently impacting their sleep quality. Objective To explore the relationship between sleep quality and sleep hygiene among adult residents during the major public health emergencies, so as to provide references for improving the sleep quality of residents during such a period. Methods A sample of 1 364 adult residents were enrolled as the research subjects from February 20 to 29, 2020. All participants were asked to complete self-administered questionnaire to obtain basic-demographic information and sleep hygiene. Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep quality. Residents were classified into poor sleepers with PSQI score ≥8 and good sleepers defined as PSQI score <8. Binary Logistic regression analysis was conducted to identify factors associated with sleep quality. Radar chart was used to visualize and compare the sleep hygiene between poor sleepers and good sleepers. Results According to PSQI score, 891 (65. 32%) residents were good sleepers, while 473 (34. 68%) residents were poor sleepers. Comparison revealed that age (χ² =3. 887), past medical history (χ² =27. 938), awareness rate of importance of sleeping before major public health emergencies (χ² =4. 337), impact of sleep quality on quality of life during the major public health emergencies (χ² =178. 138), frequency of staying up late during the major public health emergencies (χ² =139. 390), compensatory sleep behaviors (χ² =39. 257), impact of sleep problems on daytime functioning (χ² =285. 879), change of bedtime (χ² =63. 031), sleep latency (χ² =168. 672), wake-up time (χ² =59. 221), changes in sleep duration (χ² =172. 332), time spent in the bedroom (χ² =23. 071), and sum of money spent on improving sleep environment (χ² =58. 584) yielded statistical difference between poor sleepers and good sleepers (P<0. 05 or 0. 01). Logistic regression analysis denoted that past medical history (OR=1. 680, 95% CI: 1. 185~ 2. 382), negative impact of sleep quality on quality life (OR=4. 181, 95% CI: 2. 722~6. 422), staying up late 3 to 4 times per week (OR=3. 145, 95% CI: 1. 497~6. 605), staying up late almost every day (OR=4. 271, 95% CI: 1. 970~9. 260), negative impact of sleep problems on daytime functioning (OR=7. 169, 95% CI: 5. 188~9. 907), prolonged sleep latency (OR=2. 836, 95% CI: 2. 019~ 3. 982) and shortened sleep duration (OR=3. 518, 95% CI: 2. 144~5. 772) were risk factors of poor sleep quality. The sum of money spent on improving sleep environment following the major public health emergencies ≤500 RMB (OR=0. 334, 95% CI: 0. 134~ 0. 830) was related to the incidence rate of poor sleep quality. Radar chart showed that poor sleepers were characterized by extravagant concerns, excessive cleanliness and poor sleep hygiene practices during the major public health emergencies, and poor sleepers were more likely to stay up late due to stress and emotional issues. Conclusion Some residents are facing poor sleep quality during the major public health emergencies, and poor sleep hygiene practice also contributes to poor sleep quality. [ABSTRACT FROM AUTHOR]

Sleep disorders are widespread. Inhaled aromatherapy has shown advantages over medication in treating insomnia. Daylily (Hemerocallis fulva) has been found to positively affect sleep either by ingestion or inhalation, but there is a lack of research on the sleep aid effect of its inhalation route. At present, the floral scent characteristics of daylily are not obvious, and the extraction rate of essential oil is low. Based on the above problems, this study developed daylily essence which replicates the natural aroma of plants and investigated the effect of inhaling daylily essence aroma on sleep activity by using Pittsburgh Sleep Quality Index (PSQI) and electroencephalogram (EEG). According to PSQI results, inhaling the aroma of daylily essence improved participants' subjective sleep quality. The difference between men and women was statistically significant (p <.05). The slow‐wave sleep activity of EEG in the experimental group was significantly stronger than that in the control group (p <.01). In addition, the frontal and central regions were more responsive to aroma stimuli (p <.05). The results of this study show that the aroma of daylily can promote the subjective and objective sleep quality of healthy college students, and the use of fragrance intervention is a potential scheme to improve sleep quality and insomnia. [ABSTRACT FROM AUTHOR]

Introduction: School burnout remains a prevalent problem among adolescents; it is associated with low academic achievement and school dropout risk, in turn linked to a whole host of deleterious developmental outcomes. The current longitudinal study sought to better understand the developmental course of school burnout by testing whether poor sleep and problematic internet use each uniquely and additively explained the variance in school burnout over time. Method: Data were collected four times over 18 months, 6 months apart from N = 405 adolescents, grades 9 to 11. Results: Sleep quality, but not quantity, was significantly associated with the school burnout intercept (β = −0.29); no effects were found for the slope. Problematic internet use was also significantly associated with the intercept (β =.44), but not the slope. In a combined model, both sleep quality and problematic internet use significantly predicted the school burnout intercept. The slope was only predicted by age (β = −0.21). Conclusions: The study found partial support for the hypotheses that both poor sleep quality and problematic internet use predicted school burnout, intercept only, not the rate of change. The evidence suggests that school burnout increased across high school; however, the rate of increase slowed with age. In contrast to some previous work, study findings highlight the importance of separately considering both poor sleep and problematic internet use in understanding the development of school burnout during adolescence. N = 229 [ABSTRACT FROM AUTHOR]

Introduction: Left‐behind adolescents are vulnerable to depressive symptoms under the context of parent‐adolescent separation. However, limited knowledge is available regarding left‐behind adolescents' depression trajectory and the protective resources against it. The aim of this longitudinal study was to investigate the depression trajectory and its association with parent‐adolescent separation (left‐behind status, age of separation and duration of separation) and parent‐adolescent cohesion (father‐adolescent cohesion, mother‐adolescent cohesion) among left‐behind adolescents. Methods: The participants were 1,107 left‐behind adolescents (Mage = 13.23 ± 0.86 years at T1; 45.17% girls; 38.48% both‐parent migrant adolescents, 61.52% father‐only migrant adolescents) from two rural areas of Shandong Province in China, who were participated in assessment at three time points with 6 months apart from November 2014 to November 2015. Results: The results indicated that the trajectory of left‐behind adolescents' depression symptoms showed a decreasing trend. Both‐parent migrant adolescents reported a higher initial level of depressive symptoms than father‐only migrant adolescents. Duration of separation positively predicted the initial level of left‐behind adolescents' depressive symptoms. Mother‐adolescent cohesion negatively predicted the initial level and positively predicted the change rate of left‐behind adolescents' depressive symptoms. Moreover, mother‐adolescent and father‐adolescent cohesion buffered the negative effect of parent‐adolescent separation on the initial level of left‐behind adolescents' depressive symptoms. Conclusions: These findings highlight the protective role of parent‐adolescent cohesion for left‐behind adolescents, having important implications for interventions targeted toward mitigating the detrimental influence of parent‐adolescent separation on left‐behind adolescents' depression trajectory. [ABSTRACT FROM AUTHOR]

Purpose: Despite the evidence of higher effectiveness of psychological interventions for insomnia compared to pharmacological ones, drug prescriptions for insomnia remain frequent. This study has assessed patterns of prescriptions of BZDs for insomnia before and after the delivery of a training in psychological interventions to professionals working in the services of a Department of Mental Health in northern Italy. Methods: The intervention consisted in two training sessions about psychological interventions for insomnia delivered to professionals of the participating services. The prevalence of users with a prescription of BZDs for insomnia in an index period after the delivery of the training was compared to the prevalence in an index period before the training. Results: Among 727 people assessed for BZDs prescription at pre-intervention, 306 (42.1%, 95% CI 0.39–0.46) had a prescription, and 344 (49.2%, 95% CI 0.45–0.53) had a prescription among 699 people assessed at post-intervention, corresponding to a significant odds ratio of 1.33 to be prescribed with BZDs in the second index period compared to the first one. Psychological interventions were offered to a small group of patients. Conclusion: Prescribing attitudes of BZDs for insomnia were not modified after the training and delivery of a psychological intervention in a mental healthcare outpatient setting. Prescribing habits should be addressed more directly in training, and professionals should be more aware of risks of BZDs assumption. The failure in changing drug prescriptions in this study should prompt more real-world studies of the application of evidence-based strategies, particularly in outpatient mental health settings. [ABSTRACT FROM AUTHOR]

Introduction: Social workers, the largest group of mental health clinicians in the United States, play a pivotal role in mental health promotion. Despite the importance of sleep for mental health, there is no empirical research on sleep education interventions for social workers. Method: We designed an online sleep health education intervention to equip social work students to promote healthy sleep practices among their clients. An interdisciplinary team of experts devised the 90 min intervention using an empirically supported behavioral change theoretical model (COM-B). The intervention discusses multi-level factors that impact sleep and emphasizes considerations for health disparities in populations commonly served by social workers (e.g., unhoused populations, clients with substance use disorders, etc.). We assessed sleep knowledge, sleep quality, and acceptability using survey and focus group data. Results: Ninety social work students (92.2% female, 38.8% non-Hispanic white) completed pre- and post-intervention assessments. Participants demonstrated significant improvements in sleep health knowledge and their personal sleep quality. Quantitative and qualitative data revealed perceived usefulness for social work practice. Conclusions: A short online sleep education intervention can improve sleep health knowledge, offering a practical method to expand social workers' understanding of healthy sleep promotion that can be readily implemented in clinical training and practice. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) of digitally delivered Cognitive Behavioral Therapy for insomnia (CBT-I) have demonstrated reductions in insomnia severity, depression symptoms, anxiety symptoms, and suicidal ideation. The present study aimed to evaluate the effectiveness of self-guided, digital CBT-I to improve sleep-specific outcomes. An RCT of Australian adults with insomnia and depressive symptoms (N = 1149) compared SHUTi, a digital CBT-I intervention, with HealthWatch, an attention-matched control internet program, at baseline, posttest (9 weeks) and at 6-, 12-, and 18-month follow-ups. Online sleep diaries were used to derive measures of sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST). Participants in the SHUTi condition had greater improvements at posttest compared with control for: SOL, WASO, SE, number of awakenings, and sleep quality. These improvements were sustained at every follow-up (p <.02 for all outcomes except TST, in which statistically significant increases were observed only at 12- and 18-months). Digitally delivered CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and depressive symptoms. Findings provide further evidence of long-term improvements associated with a digital therapeutic for insomnia, compared to an attention-control condition. [ABSTRACT FROM AUTHOR]