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Objectives Fibromyalgia is characterized by chronic widespread pain, mood, and sleep disturbance. Pharmacological treatments have modest efficacy and are associated with negative side effects, and alternative approaches are needed. Morning bright light treatment may assist in the management of fibromyalgia as it can reduce depressive symptoms, improve sleep, and advance circadian timing. Methods Sixty people with fibromyalgia (58 women, mean age 41.8 ± 13.3 years) were enrolled in a study comparing 4 weeks of a 1-hour daily morning bright light treatment (active treatment) to a morning dim light treatment (comparison treatment). Both light treatments included behavioral procedures to stabilize sleep timing. The morning bright light treatment was expected to produce larger improvements in pain and function than the dim light treatment and larger improvements in potential mediators (mood, sleep, and circadian timing). Results Both the bright and dim light treatment groups achieved significant but similar levels of improvement in pain intensity, pain interference, physical function, depressive symptoms, and sleep disturbance. Overall, the sample on average displayed a clinically meaningful improvement in the Fibromyalgia Impact Questionnaire-Revised score (mean reduction of 11.2 points), comparable to that reported following physical exercise treatments. Minimal side effects were observed. Conclusions Findings indicate that the effects of a morning bright light treatment did not exceed those of a comparison dim light treatment; yet the changes on average in both conditions revealed clinically meaningful improvements. Future research is warranted to identify what elements of this trial may have contributed to the observed effects. [ABSTRACT FROM AUTHOR]

Female shift workers are at increased risk for negative reproductive outcomes, and animal evidence suggests that manipulation of the light-dark cycle is detrimental to early gestation in female mice. Specifically, failure of implantation may be responsible for these findings. The objective of this study was to better delineate which reproductive processes are vulnerable to detrimental effects of maternal circadian disturbance. We exposed mice undergoing embryo transfer to repetitive phase advances of the photoperiod. Embryos were derived from donor sperm and eggs from mice living in normal light-dark conditions to isolate the effects of photoperiod disruption on uterine receptivity and early gestation. Twenty-eight mice receiving embryo transfer underwent an experimental light-dark condition (advance of lights on and lights off by 6 hours every 4 days). Twenty-eight mice remained in a normal light-dark condition. Animals lived in their assigned light-dark condition beginning 2 weeks prior to embryo transfer and ending the day of uterine necropsy (post-coitus day 14.5). Wilcoxon-Mann-Whitney test demonstrated no significant differences between control and experimental light-dark conditions in pups (Z=0.10, p=.92), resorptions (Z=0.20, p=.84), or implantations (Z=-0.34, p=.73). Pup and placental weights were similar between groups. In this investigation, uterine receptivity and maintenance of early gestation were preserved despite recurrent phase advances in photoperiod. This finding, in the context of the current literature, suggests that the negative effects of circadian disruption are mediated by reproductive processes upstream of implantation. [ABSTRACT FROM AUTHOR]

The article provides information related to the sleep disorders and its medicines. It is mentioned that sleep disorder has been classified by the International Classification of Disease to describe all type of sleep disorders. It is also included that the common sleep disorders involve hypersomnia, insomnia and parasomnia. It is also included that the sleep medicine has to be certified from American Board Medical Subspecialties in Anesthesiology, Internal Medicine and Neurology.

• A seven-domain framework was used to evaluate the sleep health of people with MS. • Objective sleep domains: duration, continuity, timing, regularity, rhythmicity. • Subjective sleep domains: daytime sleepiness and perception of sleep quality. • Seventy-six percent of the sample had extreme values for ≥2 sleep domains. Although sleep disturbances are common among people with Multiple Sclerosis (PwMS), understanding of their impact has been stymied by limitations in approaches to sleep measurement within this population. The aim of this study was to comprehensively phenotype sleep patterns in PwMS through application of an emerging seven-domain framework that includes sleep duration, continuity, timing, quality, rhythmicity, regularity, and sleepiness. Sleep domains were estimated from wrist-worn accelerometry, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index responses. Extreme sleep values within each domain were constructed using previously published guidelines. A composite score of extreme values was calculated for each participant. Associations between sleep domains and severity of MS symptoms were explored (pain, fatigue, depressive symptoms, and cognitive dysfunction). Among n = 49 participants, median total sleep time was 456.3 min. Median time spent awake after sleep onset was 37 min. Sleepiness, abnormal sleep timing, and poor sleep quality affected 33%, 35%, and 45% of participants, respectively. Seventy-six percent had ≥2 sleep domains in extreme ranges. PwMS had longer sleep duration and decreased sleep regularity compared to a non-MS historical cohort of older men. Greater daytime sleepiness, poorer sleep quality, and higher composite sleep health score were associated with more depressive symptoms, and lower sleep rhythmicity was associated with higher fatigue. Associations were observed between measures of cognitive function and sleep fragmentation, duration, quality, rhythmicity, and composite score. Application of a seven-domain sleep health framework that captures the dynamic and multifaceted aspects of sleep is feasible in PwMS, and offers potential for an improved understanding of the scope and impact of sleep disturbances in PwMS. [ABSTRACT FROM AUTHOR]

To evaluate various psychological constructs used in formulations of anorexia and bulimia nervosa, we compared 76 eating-disordered, 20 psychiatric, and 24 normal women on measures of irrational cognitions, object-relations disturbances, and defense style. The eating-disordered group exhibited more disturbance on all measures than normals and many pathological elevations relative to psychiatric controls. Despite these differences, common qualitative features were identified in all patient groups, suggesting that formulations based on the factors examined alone, while useful in providing an understanding of patients' issues, will be inadequate to account for eating-disorder development. [ABSTRACT FROM AUTHOR]

Fifty-eight women with anorexia or bulimia nervosa were compared with 24 normal women on measures of defense style and parental bonding. Results indicated that all eating-disorder subtypes exhibit more primitive defenses and fewer mature ones than controls. Eating-disorder patients uniformly recalled /ess paternal em pa- thy than controls. Thus, difficulties involving object representations of fathers may be a theme common to eating disorders. No major differences were identified among eating-disorder subtypes, suggesting that these disorders share substantial psychodynamic features. Patterns of parental bonding were associated with defense styles in a manner consistent with theories that link defense style development to early object relationships. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate that commercial activity monitoring devices (CAMDs) are practical for monitoring resident sleep while on call. Studies that have directly monitored resident sleep are limited, likely owing to both cost and difficulty in study interpretation. The advent of wearable CAMDs that estimate sleep presents the opportunity to more readily evaluate resident sleep in physically active settings and "home call," a coverage arrangement familiar to urology programs.Methods: Twelve urology residents were outfitted with Fitbit Flex devices during "home call" for a total of 57 (out of 64, or 89%) call or post-call night pairs. Residents were surveyed with the Stanford Sleepiness Scale (SSS), a single-question alertness survey. Time in bed (TIB) was "time to bed" to "rise for day." Fitbit accelerometers register activity as follows: (1) not moving; (2) minimal movement or restless; or (3) above threshold for accelerometer to register steps. Total sleep time (TST) was the number of minutes in level 1 activity during TIB. Sleep efficiency (SE) was defined as TST divided by TIB.Results: While on call, 10 responding (of 12 available, 83%) residents on average reported TIB as 347 minutes, TST as 165 minutes, and had an SE of 47%. Interestingly, SSS responses did not correlate with sleep parameters. Post-call sleep demonstrated increases in TIB, SE, and TST (+23%, +15%, and +44%, respectively) while sleepiness was reduced by 22%.Conclusion: We demonstrate that urologic residents can consistently wear CAMDs while on home call. SSS did not correlate with Fitbit-estimated sleep duration. Further study with such devices may enhance sleep deprivation recognition to improve resident sleep. [ABSTRACT FROM AUTHOR]

Wearable sleep-tracking technology is of growing use in the sleep and circadian fields, including for applications across other disciplines, inclusive of a variety of disease states. Patients increasingly present sleep data derived from their wearable devices to their providers and the ever-increasing availability of commercial devices and new-generation research/clinical tools has led to the wide adoption of wearables in research, which has become even more relevant given the discontinuation of the Philips Respironics Actiwatch. Standards for evaluating the performance of wearable sleep-tracking devices have been introduced and the available evidence suggests that consumer-grade devices exceed the performance of traditional actigraphy in assessing sleep as defined by polysomnogram. However, clear limitations exist, for example, the misclassification of wakefulness during the sleep period, problems with sleep tracking outside of the main sleep bout or nighttime period, artifacts, and unclear translation of performance to individuals with certain characteristics or comorbidities. This is of particular relevance when person-specific factors (like skin color or obesity) negatively impact sensor performance with the potential downstream impact of augmenting already existing healthcare disparities. However, wearable sleep-tracking technology holds great promise for our field, given features distinct from traditional actigraphy such as measurement of autonomic parameters, estimation of circadian features, and the potential to integrate other self-reported, objective, and passively recorded health indicators. Scientists face numerous decision points and barriers when incorporating traditional actigraphy, consumer-grade multi-sensor devices, or contemporary research/clinical-grade sleep trackers into their research. Considerations include wearable device capabilities and performance, target population and goals of the study, wearable device outputs and availability of raw and aggregate data, and data extraction, processing, and analysis. Given the difficulties in the implementation and utilization of wearable sleep-tracking technology in real-world research and clinical settings, the following State of the Science review requested by the Sleep Research Society aims to address the following questions. What data can wearable sleep-tracking devices provide? How accurate are these data? What should be taken into account when incorporating wearable sleep-tracking devices into research? These outstanding questions and surrounding considerations motivated this work, outlining practical recommendations for using wearable technology in sleep and circadian research., (© The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)