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Purpose: To examine nocturnal sleep patterns, napping behaviors, and subjective wellness responses of elite water polo players within an in-season week and to identify whether sleeping patterns differ between men and women. Methods: Sleep characteristics of 10 male and 17 female professional water polo players were objectively assessed during 1 week of the in-season period, including 5 training days, 1 match day, and 1 day of rest. Internal load (rating of perceived exertion × duration of training or match) was assessed 30 minutes posttraining or postmatch, and the total quality of recovery was recorded every morning. A series of multilevel models were used to analyze the data. Results: Time in bed and wake-up time were earlier on both training (P <.001) and rest days (P <.001) than on the day of the match. Internal workload did not predict any of the players' sleeping patterns. Midday naps predicted less time in bed (P =.03) and likely less sleep time (P =.08). The total quality of recovery was predicted only by the total sleep time (P <.01). Women exhibited higher sleep efficiency (P <.001), less waking after sleep onset (P =.01), and a lower number of awakenings (P =.02) than men. Conclusions: The current results indicate that the nocturnal sleep patterns of elite water polo players are not associated with internal load and that women display better nocturnal sleep quality compared with men. As long naps interfere with nocturnal sleep, and total nocturnal sleep time predicts total quality of recovery, we suggest that athletes follow hygiene sleep strategies to facilitate adequate nocturnal sleep and next-day recovery. [ABSTRACT FROM AUTHOR]

Purpose: Few data are available on sleep characteristics of elite track-and-field athletes. Our study aimed to assess (1) differences in sleep between sexes and among different track-and-field disciplines, (2) the effect of individualized sleep-hygiene strategies on athletes' sleep parameters, and (3) daytime nap characteristics in track-and-field athletes. Methods: Sleep characteristics of 16 elite Olympic-level track-and-field athletes (male: n = 8; female: n = 8) were assessed during the preseason period, at baseline (T0), and during the in-season period, after the adoption of individualized sleep-hygiene strategies (T1). Sleep parameters were objectively monitored by actigraphy for a minimum of 10 days, for each athlete, at both T0 and T1. A total of 702 nights were analyzed (T0 = 425; T1 = 277). Results: Female athletes displayed better sleep efficiency (88.69 [87.69–89.68] vs 91.72 [90.99–92.45]; P =.003, effect size [ES]: 0.44), lower sleep latency (18.99 [15.97–22.00] vs 6.99 [5.65–8.32]; P <.001, ES: 0.65), higher total sleep time (07:03 [06:56–07:11] vs 07:18 [07:10–07:26]; P =.030, ES: 0.26), earlier bedtime (00:24 [00:16–00:32] vs 00:13 [00:04–00:22]; P =.027, ES: 0.18), and lower nap frequency (P <.001) than male athletes. Long-distance runners had earlier bedtime (00:10 [00:03–00:38] vs 00:36 [00:26–00:46]; P <.001, ES: 0.41) and wake-up time (07:41 [07:36–07:46] vs 08:18 [08:07–08:30]; P <.001, ES: 0.61), higher nap frequency, but lower sleep efficiency (88.79 [87.80–89.77] vs 91.67 [90.95–92.38]; P =.013, ES: 0.44), and longer sleep latency (18.89 [15.94–21.84] vs 6.69 [5.33–8.06]; P <.001, ES: 0.67) than athletes of short-term disciplines. Furthermore, sleep-hygiene strategies had a positive impact on athletes' total sleep time (429.2 [423.5–434.8] vs 451.4 [444.2–458.6]; P <.001, ES: 0.37) and sleep latency (14.33 [12.34–16.32] vs 10.67 [8.66–12.68]; P =.017, ES: 0.19). Conclusions: Sleep quality and quantity were suboptimal at baseline in Olympic-level track-and-field athletes. Large differences were observed in sleep characteristics between sexes and among different track-and-field disciplines. Given the positive effect of individualized sleep-hygiene strategies on athlete's sleep, coaches should implement sleep education sessions in the daily routine of top-level athletes. [ABSTRACT FROM AUTHOR]

Purpose: Short sleep duration and poor sleep quality are common in swimmers. Sleep-hygiene strategies demonstrated beneficial effects on several sleep parameters. The present study assessed the impact of a multisession sleep-hygiene training course on sleep in elite swimmers. Methods: Twenty-eight elite swimmers (17 [2] y) participated. The sleep-hygiene strategy consisted of 3 interventions. Sleep was measured by actigraphy for 7 days before the beginning of the intervention (baseline), after the first collective intervention (postintervention), after the second collective intervention (postintervention 2), and, finally, after the individual intervention (postintervention 3). The Epworth Sleepiness Scale (ESS) was completed concurrently. Swimmers were classified into 2 groups: nonsomnolent (baseline ESS score ≤ 10, n = 13) and somnolent (baseline ESS score ≥ 11, n = 15). Results: All swimmers had a total sleep time of <8 hours per night. Sixty percent of swimmers were moderately morning type. Later bedtime, less time in bed, and total sleep time were observed in the somnolent group compared with the nonsomnolent group at baseline. An interaction between training course and group factors was observed for bedtime, with a significant advance in bedtime between baseline, postintervention 2, and postintervention 3 for the somnolent group. Conclusions: The present study confirms the importance of implementing sleep-hygiene strategies, particularly in athletes with an ESS score ≥11. A conjunction of individual and collective measures (eg, earlier bedtime, napping, and delaying morning training session) could favor the total sleep time achieved. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of a sleep hygiene strategy on parameters of sleep quality and quantity in youth elite rugby union players. Method: Eleven male players (age: 19.0 [1.4] y) undertook a sleep hygiene strategy composed of 2 theoretical sessions and 3 practical sessions over a 4-week period. Sleeping time, time in bed, total sleep time, sleep latency (SL), sleep efficiency (SE), wake after sleep onset, and wake bouts were recorded with an actigraphic device during the 4-week sleep hygiene strategy (baseline) and during 4 weeks after the last intervention (postintervention). Results: At baseline, the overall group reported poor sleep quantity (total sleep time = 6:27 [0:30] min), but sleep quality was considered acceptable (SL = 0:18 [0:08] min and SE = 77.8% [5.8%]). Postintervention, the overall group showed a small improvement in SL (d = −0.23 [−0.42 to −0.04], P =.003) and SE (d = 0.30 [0.03 to 0.57], P =.0004). For individual responses, sleeping time, time in bed, and total sleep time were positively influenced in only 4, 3, and 5 players, respectively. For parameters of sleep quality, SL and SE were positively influenced in a majority of players (n = 7 and 8, respectively). The magnitude of difference between baseline and postintervention was strongly associated with baseline values in SE (r = −.86; P =.0005) and wake after sleep onset (r = −.87; P =.0007). Conclusion: A sleep hygiene strategy is efficient to improve sleep quality but not sleep quantity in young rugby union players. The strategy was more efficient in players with lower initial sleep quality and should be implemented prior to a high cumulative fatigue period. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To describe sudden unexpected infant deaths (SUIDs) occurring in safe sleep environments and explore differences in selected characteristics. METHODS: We examined SUID from 22 jurisdictions from 2011 to 2020 and classified them as unexplained, no unsafe sleep factors (U-NUSF). Data were derived from the Sudden Unexpected Infant Death and Sudden Death in the Young Case Registry, a population-based Centers for Disease Control and Prevention surveillance system built on the National Center for Fatality Review and Prevention's child death review program. SUID classified as U-NUSF included infants who were (1) awake, under supervision, and witnessed to become unresponsive or (2) found unresponsive in a safe sleep environment after sleep (unwitnessed). We calculated frequencies and percentages for demographics, birth and environmental characteristics, medical history, and death investigation findings. RESULTS: Most of the 117 U-NUSF SUID occurred before 4 months of age. Witnessed deaths most commonly occurred at <1 month of age (28%), whereas unwitnessed deaths most commonly occurred at ages 2 to 3 months (44%) Among all U-NUSF, 69% occurred in the infant's home (62% witnessed, 77% unwitnessed). All unwitnessed deaths occurred in a crib; most witnessed deaths occurred while being held (54%) or in a car seat traveling (18%). Most infants (84%) had no history of abuse or neglect. Abnormal autopsy findings were reported in 46% of deaths (49% witnessed, 42% unwitnessed). CONCLUSIONS: Characterizing these deaths is key to advancing our knowledge of SUID etiology. Our study revealed a heterogeneous group of infants, suggesting physiologic, genetic, or environmental etiologies. [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]

Introduction and purpose: The impact of electronic devices on our daily lives is becoming increasingly significant. The contemporary generation of young people is growing up in a world where smartphones, tablets, computers, and other electronic devices are widely available and utilized. Scientists are contemplating the challenges posed by excessive exploitation of electronics on the health of young individuals. The aim of the article is to present the harmful effects of using electronic devices before sleep in young people, considering medical aspects such as sleep disorders and their influence on overall psychophysical health. Summary: Electronic devices negatively affect the sleep of young people by reducing sleep time and delaying the sleep onset phase. The main problem is the use of electronic devices without time limits. In the era of technology, it is significantly important to raise awareness among young people about the importance of sleep hygiene and how blue light emitted by electronic devices affects its quality. Materials and Evidence: A literature review was conducted in the PubMed database using [ABSTRACT FROM AUTHOR]

Background: Healthcare workers often encounter inadequate sleep conditions. However, limited research has examined the underlying sleep patterns among healthcare workers. This study aimed to identify sleep patterns in healthcare workers, explore predictors associated with various sleep patterns, and investigate the relationship between sleep patterns and psychiatric symptoms. Methods: This cross-sectional study was conducted in Shenzhen, China, from April 2023 to June 2023. In total, data from 1,292 participants were included using a convenience sampling method. A latent profile analysis was conducted to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Multinomial logistic regression analysis was conducted to investigate the influence of socio-demographic variables on each profile. A one-way ANOVA test was employed to examine the relationships between sleep patterns and psychiatric symptoms. Results: Three distinct profiles were identified: good sleepers (63.9%), inefficient sleepers (30.3%), and poor sleepers (5.7%). Multinomial logistic regression analysis indicated that gender and marital status were predictors of various sleep patterns. The ANOVA revealed significant differences in psychiatric symptoms scores among the three sleep patterns; poor sleepers exhibited the highest levels of mental distress. Conclusion: This study identified three distinct sleep patterns in healthcare workers and their significant associations with psychiatric symptoms. These findings contribute to the development of targeted intervention strategies aimed at improving sleep and reducing psychiatric symptoms among healthcare workers. [ABSTRACT FROM AUTHOR]

Background: Digital therapeutics (DTx) in the form of mobile health (mHealth) self-management programs have demonstrated effectiveness in reducing disease activity across various diseases, including fibromyalgia and arthritis. However, the content of online self-management programs varies widely, making them difficult to compare. Aim: This study aims to employ generative artificial intelligence (AI)-based knowledge graphs and network analysis to categorize and structure mHealth content at the example of a fibromyalgia self-management program. Methods: A multimodal mHealth online self-management program targeting fibromyalgia and post-viral fibromyalgia-like syndromes was developed. In addition to general content, the program was customized to address specific features and digital personas identified through hierarchical agglomerative clustering applied to a cohort of 202 patients with chronic musculoskeletal pain syndromes undergoing multimodal assessment. Text files consisting of 22,150 words divided into 24 modules were used as the input data. Two generative AI web applications, ChatGPT-4 (OpenAI) and Infranodus (Nodus Labs), were used to create knowledge graphs and perform text network analysis, including 3D visualization. A sentiment analysis of 129 patient feedback entries was performed. Results: The ChatGPT-generated knowledge graph model provided a simple visual overview with five primary edges: "Mental health challenges", "Stress and its impact", "Immune system function", "Long COVID and fibromyalgia" and "Pain management and therapeutic approaches". The 3D visualization provided a more complex knowledge graph, with the term "pain" appearing as the central edge, closely connecting with "sleep", "body", and "stress". Topical cluster analysis identified categories such as "chronic pain management", "sleep hygiene", "immune system function", "cognitive therapy", "healthy eating", "emotional development", "fibromyalgia causes", and "deep relaxation". Gap analysis highlighted missing links, such as between "negative behavior" and "systemic inflammation". Retro-engineering of the self-management program showed significant conceptual similarities between the knowledge graph and the original text analysis. Sentiment analysis of free text patient comments revealed that most relevant topics were addressed by the online program, with the exception of social contacts. Conclusion: Generative AI tools for text network analysis can effectively structure and illustrate DTx content. Knowledge graphs are valuable for increasing the transparency of self-management programs, developing new conceptual frameworks, and incorporating feedback loops. [ABSTRACT FROM AUTHOR]

Background: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. Methods: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. Results: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). Conclusion: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents. [ABSTRACT FROM AUTHOR]

Summary Several studies have demonstrated the relevance of cognitive factors in the development of insomnia complaints, but very few have investigated how these factors influence the development of insomnia complaints over time. In this study we set out to investigate key factors associated with present insomnia severity and the development of insomnia complaints over time. We employed a two‐wave longitudinal design where we measured insomnia severity, pre‐sleep arousal, dysfunctional beliefs about sleep, sleep‐related worry and safety‐behaviours in a sample of students at baseline and 1 year later. At baseline, 353 respondents filled in the questionnaires and 79 completed these a year later. In the cross‐sectional analyses, pre‐sleep arousal and sleep‐related worry were unique contributors to insomnia severity. Using baseline data to predict insomnia severity 1 year later, only sleep‐related safety emerged as a predictor. These findings suggest that sleep‐related worry and pre‐sleep arousal are the primary factors influencing current severity. In terms of development and/or persistence, sleep safety may constitute a potentially underestimated factor. [ABSTRACT FROM AUTHOR]

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]

Background: Sleep distrurbances involves daytime preoccupation about sleep, which plays a critical role in perpetuating sleep disturbances. Recent cognitive models highlight the importance of daytime processes, like processing sleep-related information and interpretations during waking hours, in influencing sleep quality and quantity. The Sleep Preoccupation Scale (SPS) quantifies this daytime cognitive activity related to sleep. This study aimed to translate and validate an Arabic version of the SPS for assessing sleep preoccupation among Arabic speakers. Methods: 523 Arabic speakers (mean age 23.6 years, 75% female) from four countries completed the Arabic SPS alongside the Athens Insomnia Scale, Generalized Anxiety Disorder-7 Scale, and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ). The sample repeated the SPS after two weeks for test-retest reliability. Confirmatory factor analysis evaluated the SPS's two-factor structure. Internal consistency, item response theory, and convergent validity with the other scales were examined. Results: Confirmatory factor analysis supported the two-factor model's fit. Measurement invariance results suggest that the SPS exhibits a similar basic factor structure across both insomnia and non-insomnia groups. The Arabic SPS demonstrated good internal consistency (Cronbach's α = 0.92, McDonald's ω = 0.92) and two-way mixed effects, consistency, single rater/measurement intraclass correlation coefficient (ICC) test-retest reliability (ICC = 0.95). Most items exhibited satisfactory item response theory fit statistics and discrimination. The SPS total score showed strong positive correlations with insomnia severity (r = 0.48, p < 0.001), generalized anxiety (r = 0.57, p < 0.001), and sleep-related anxiety/preoccupation (r = 0.79, p < 0.001), demonstrating convergent validity. Conclusion: The Arabic version of the SPS demonstrated good psychometric properties and validity, supporting its use for assessing sleep preoccupation among Arabic speakers. This culturally-adapted version enhances sleep assessment capabilities for improving insomnia understanding and treatment within Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity represents a major public health issue worldwide. Evidence showed the need to implement prevention strategies mainly focused on lifestyle habits. Sleep hygiene is a variable of great interest and this review systematically examined the effects of sleep duration in increasing childhood obesity risk Methods: A systematic literature review was conducted from December 2023 to February 2024. Study selection and data extraction procedures were performed in accordance with Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines and Statement, and risk of publication bias was assessed by the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results: Original works in English were eligible for review and eleven studies that met the inclusion criteria were included. Studies collected were heterogeneous in terms of duration, sample characteristics, hours of sleep manipulation, anthropometric and hematological parameters collected, therefore it was not possible to perform a meta-analysis. A narrative synthesis of the reported evidence highlighted the impact of sleep duration above all on food intake, eating habits and hormone levels and consequently on the risk of childhood obesity development. Conclusion: This finding suggests the need to consider sleep hygiene as a modifiable lifestyle habit like diet and physical activity, in order to early prevent childhood obesity. Poor sleep hygiene can significantly contribute to weight gain and exacerbation of metabolic disorders linked to childhood obesity. Although more rigorous studies are needed, clinicians need to be aware of the role of sleep hygiene in reducing childhood obesity risk. [ABSTRACT FROM AUTHOR]

Background: Insomnia is common in patients with psychiatric disorders. However, patients' awareness of sleep has seldom been examined in detail. In this study, we investigated sleep awareness in outpatients at the psychiatry department of a university hospital. Methods: The participants (n = 241) were recruited at the psychiatry department of Ehime University Hospital between 11 October and 5 November 2021. The following questionnaires were used: Clinical Global Impression Scale of Severity (CGI-S), Global Assessment of Functioning (GAF), General Health Questionnaire (GHQ-30), Athens Insomnia Scale (AIS), and Epworth Sleepiness Scale (ESS). Psychiatric disorders were diagnosed by certified psychiatrists using the International Statistical Classification of Diseases and Related Health Problems 10. Participants with an AIS score of ≥6 were allocated to the insomnia group for statistical analysis. A logistic regression analysis was conducted to identify which items of sleep hygiene the patients with insomnia practiced using the Sleep Guidelines for Health Promotion. Results: Of 241 participants, 133 (55.2%) were allocated to the insomnia group. The mean scores for the CGI were significantly higher and the GAF scores were significantly lower in the insomnia group than in the healthy sleep group (p < 0.01). Of the 12 sleep guidelines proposed by the Japanese Government, "Do not go to bed until you are sleepful, do not delay getting up", was the item that maximally influenced insomnia. Conclusions: The insomnia group had worse scores on various medical assessment scales compared to the healthy sleep group. Based on a survey of outpatients at the psychiatry department of the university hospital, appropriate stimulus control techniques may help clinicians to treat outpatients with insomnia. [ABSTRACT FROM AUTHOR]

Background: Exogenous melatonin, a nutraceutical for maintaining a healthy sleep–wake cycle and managing sleep disorders, requires large, repeated doses due to its low bioavailability and short half-life. This necessitates the development of a sustained-release formulation with a longer half-life and sustained plasma concentration. Therefore, exogenous novel 5 mg sustained-release melatonin capsules (Melatonin-SR, test product) were formulated. Methods: This open-label cross-over study compared the pharmacokinetics (maximum concentration [Cmax], time to reach Cmax [Tmax], area under the curve [AUC], and elimination half-life [t1/2]) and the safety of Melatonin-SR with 5 mg immediate-release melatonin capsules (Melatonin-IR, reference product) after single-dose oral administration in healthy fasting adults. Results: Sixteen participants (aged 18–45 years) were randomized (1:1) to receive either Melatonin-SR or Melatonin-IR in two periods with a 7-day washout period. Melatonin-SR reported a lower Cmax (11,446.87 pg/mL) compared to Melatonin-IR (22,786.30 pg/mL). The mean Tmax of Melatonin-SR and Melatonin-IR was 1.26 h and 0.87 h, respectively. The mean t1/2 of Melatonin-SR (5.10 h) was prolonged by five-fold compared to Melatonin-IR (1.01 h). One adverse event (vomiting) was reported following the administration of the Melatonin-IR. Conclusions: Melatonin-SR resulted in higher and sustained plasma melatonin concentrations for an extended period and was well-tolerated. Hence, Melatonin-SR may be a promising nutraceutical for maintaining healthy sleep. [ABSTRACT FROM AUTHOR]

Summary: This review examines the temporal association between nocturnal gastro‐oesophageal reflux and sleep‐arousal cycles. Most nocturnal gastro‐oesophageal reflux events occur during the awake cycle, and arousals precede most nocturnal gastro‐oesophageal reflux events, indicating that arousal from sleep predisposes to nocturnal gastro‐oesophageal reflux. This sheds light on the complex relationship between nocturnal gastro‐oesophageal reflux and sleep, and has implications for managing nocturnal gastro‐oesophageal reflux symptoms. The appearance of symptoms and the pathophysiology of nocturnal gastro‐oesophageal reflux are influenced by sleep hygiene, sleep disturbances and the misalignment of circadian rhythms. Nocturnal gastro‐oesophageal reflux and its related sleep disorders are prevalent and negatively impact the quality of life. There is conflicting evidence on whether nocturnal gastro‐oesophageal reflux and sleep disturbances are causally linked, and whether sleep disturbances drive nocturnal gastro‐oesophageal reflux. Poor sleep quality increases oesophageal hypersensitivity and overall acid exposure. The nocturnal gastro‐oesophageal reflux is linked to the more severe forms of gastro‐oesophageal reflux disease, especially with atypical/extra‐oesophageal manifestations and complications of mucosal damage such as oesophagitis and stricture, Barret's oesophagus, and oesophageal adenocarcinoma. This review highlights the role of sleep problems in presenting nocturnal gastro‐oesophageal reflux, and the potential benefits of treating sleep disturbances in enhancing patient care and quality of life. [ABSTRACT FROM AUTHOR]

Summary: Insomnia and pain disorders are among the most common conditions affecting United States adults and veterans, and their comorbidity can cause detrimental effects to quality of life among other factors. Cognitive behavioural therapy for insomnia and related behavioural therapies are recommended treatments for insomnia, but chronic pain may hinder treatment benefit. Prior research has not addressed how pain impacts the effects of behavioural insomnia treatment in United States women veterans. Using data from a comparative effectiveness clinical trial of two insomnia behavioural treatments (both including sleep restriction, stimulus control, and sleep hygiene education), we examined the impact of pain severity and pain interference on sleep improvements from baseline to post‐treatment and 3‐month follow‐up. We found no significant moderation effects of pain severity or interference in the relationship between treatment phase and sleep outcomes. Findings highlight opportunities for using behavioural sleep interventions in patients, particularly women veterans, with comorbid pain and insomnia, and highlight areas for future research. [ABSTRACT FROM AUTHOR]

The article "A call for transdiagnostic attention to insomnia and its treatment in mental healthcare" published in the Journal of Sleep Research highlights the prevalence of insomnia across various psychiatric disorders, emphasizing its impact on emotional distress and the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in treating conditions like major depressive disorder and PTSD. The study, conducted with participants recruited through the Netherlands Sleep Registry, reveals high rates of co-occurring insomnia in individuals with mental health issues, underscoring the need for a transdiagnostic approach to addressing insomnia in mental healthcare. Network analysis suggests direct links between insomnia severity and symptoms of MDD, GAD, and BPD, while indirect associations are observed with SAD, PD, and PTSD. The findings stress the importance of systematically addressing insomnia in patients with affective and emotion regulation disorders, advocating for the inclusion of CBT-I as a potential dual treatment strategy for psychiatric conditions. [Extracted from the article]

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]

The COVID-19 pandemic has left behind mental health issues like anxiety, depression, and sleep disorders among survivors. This study assessed the efficacy of spa therapy in enhancing psychological well-being and sleep quality in individuals with chronic arthro-rheumatic, respiratory, and otorhinolaryngological diseases, including COVID-19 recoverees. Our prospective observational study included 144 Caucasian subjects from three Italian spas who underwent a 2-week spa therapy cycle, involving balneotherapy and/or inhalation treatments. Symptoms were assessed with the Visual Analogue Scale (VAS), psychological well-being with Depression Anxiety Stress Scales-21 items (DASS-21), and sleep quality with the Insomnia Severity Index (ISI). Significant reductions in VAS scores for arthro-rheumatic, respiratory, and otorhinolaryngological symptoms were observed after spa therapy, as well as for DASS-21 and ISI scores for sleep quality, transitioning to less severe insomnia categories. Females had more pronounced improvements in DASS-21 scores and sleep quality. Subjects with and without prior SARS-CoV-2 infection experienced significant reductions in anxiety, depression, and stress, with more pronounced improvements in those without prior infection. COVID-19 survivors also showed significant ISI score improvements. Spa therapy is a promising complementary treatment for improving mental health and sleep quality in chronic disease patients, including COVID-19 survivors. [ABSTRACT FROM AUTHOR]

Excessive daytime sleepiness (EDS) and insomnia (IN) complaints represent the most common sleep/wake disorders. Currently, the specific needs of these patients and their relatives, as well as the overall socio-economic burden of IN and EDS remains widely unexplored. This pilot study to be carried out in Switzerland is a retro- and prospective, national, one-center cohort observational study for the systematic evaluation of the burden of EDS and IN and its evolution 12 months after the first assessment. Patient recruitment will be organized through 7–8 primary care providers (primary/general care practitioners and pharmacies). Primary outcomes are the prevalence of EDS/IN in the primary care setting and the association between EDS/IN with health-related quality of life (QOL) as assessed with the established instruments. Secondary outcomes are the association between EDS/IN with the presence of comorbidities, number of injuries/accidents, and number of sick/leave days for the subgroup of working subjects. Calculation of direct per-patient costs will be undertaken to analyze the economic implications of sleep/wake disorders, providing valuable insights into the financial burden experienced by affected individuals within the healthcare system. This research will provide information on the feasibility of such a study and inform on aspects of the QOL most associated with EDS/IN. Based on this pilot project, a European multicenter study on the burden of sleep/wake disorders will be conducted by the European Academy of Neurology. [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]

In the construction industry, irregular schedules and long hours disrupt workers' circadian rhythms, adversely affecting their safety and health. While studies have shown that sleep timing influences safety and health, they often overlook sleep quantity, work-shift start time, and a broad range of safety and health outcomes. To fill this gap, this study examines the relationship between circadian rhythm and safety health factors, including psychological issues, wellbeing, behavioral issues, altruistic behaviors, sleep quantity, starting hours at work, and parental care in 1,400 construction workers using a questionnaire. We investigated safety health using scales for psychological issues (0-34), wellbeing (0-24), behavioral issues (0-29), and altruistic behaviors (0-27). Midsleep time on weekends estimated circadian rhythm, with multilevel regressions adjusting for sleep quantity, work start time, and various characteristics. Results showed average midsleep at 04: 11 h, with a 1 h delay associated with increased psychological issues (0.37), behavioral issues (3.0%), decreased wellbeing (0.19), and decreased altruistic behaviors (0.18). These findings highlight a correlation between early circadian rhythm and poor safety health, independent of sleep quantity and work-shift start time. Addressing circadian rhythm disruptions could be crucial for improving safety health outcomes, suggesting that work schedule adjustments and better sleep practices may mitigate adverse effects on workers' health and wellbeing. [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]

The article from the Australian Diabetes Educator discusses how short sleep duration is linked to an increased risk of developing type 2 diabetes and glucose dysregulation. Researchers analyzed data from the UK Biobank and found that healthy eating alone may not be enough to counteract the negative effects of chronic sleep loss on diabetes risk. Strategies to mitigate this risk include engaging in physical activity, improving dietary intake, and addressing coexisting conditions like obstructive sleep apnea. The study highlights the importance of sleep hygiene and adequate sleep duration in promoting metabolic well-being and reducing the risk of type 2 diabetes. [Extracted from the article]

Objective: Sleep disturbance is common among individuals with eating disorders (EDs), with approximately 50% of patients with EDs reporting sleep disturbance. Sleep problems may promote, exacerbate, or maintain ED symptoms through a variety of hypothesized mechanisms, such as impaired executive function, increased negative affect, and disruptions to appetitive rhythms. Although research investigating the role of sleep in EDs is growing, the current literature suffers from methodological limitations and inconsistencies, which reduce our ability to translate findings to improve clinical practice. The purpose of this forum is to propose a coordinated approach to more seamlessly integrate sleep research into ED research with particular emphasis on best practices in the definition and assessment of sleep characteristics. Methods: In this article, we will describe the current status of sleep‐related research and relevant gaps within ED research practices, define key sleep characteristics, and review common assessment strategies for these sleep characteristics. Throughout the forum, we also discuss study design considerations and recommendations for future research aiming to integrate sleep research into ED research. Results/Discussion: Given the potential role of sleep in ED maintenance and treatment, it is important to build upon preliminary findings using a rigorous and systematic approach. Moving forward as a field necessitates a common lens through which future research on sleep and EDs may be conducted, communicated, and evaluated. [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]

Pediatric overweight and obesity is a complex chronic medical condition with a multitude of contributing factors. Rates are now nearly double what they were before the COVID-19 pandemic and if the current trajectory holds it is anticipated that by 2050 one in every two US children will experience obesity before the age of thirty-five. Pediatric obesity guidelines emphasize referral to intensive health behavior and lifestyle therapy programs, but these are difficult to access. Front line providers caring for children can use a lifestyle medicine approach within the medical home to make lifestyle changes easier. Lifestyle Medicine can promote a family-oriented, weight-neutral approach by (1) Educating and equipping providers to assess readiness to change and providing high-quality motivational interviewing and lifestyle counseling, (2) Equipping patients and their families with tools involving the six lifestyle interventions to optimize health starting an early age, and (3) Offering a longitudinal uniform office approach to effectively prevent, manage and often reverse obesity and related comorbidities through healthy habit change. [ABSTRACT FROM AUTHOR]

Background: Sleep is a vital component of human health and well-being, significantly impacting mental health, mood, cognitive function (including memory), and overall health. It is an important aspect of a successful academic life in college, yet very little attention has been given to finding an appropriate sleeping pattern. Aims and Objectives: This study investigates the relationship between sleep patterns and academic performance among medical students. It further aims to identify other factors that may influence the academic performance of the study participants. Materials and Methods: A cross-sectional study was conducted to enroll 284 undergraduate medical students. Data were collected on sociodemographic profile, lifestyle, sleep pattern, and academic performance, by self-report questionnaire. Students were divided into six groups based on their sleeping patterns and five groups based on their academic performance. Data were analyzed using Microsoft Excel. Results: Among 284 participants, Group A demonstrated a prevalence of excellent performance (32%), followed by average performance (24%). Notably, Group B exhibited a dominance of outstanding performers (47%), followed by below average category (17%). Groups C, D, E, and F were characterized by a majority of students achieving aboveaverage outcomes. Conclusion: Sleep is a crucial factor affecting academic achievement in medical students, but not the sole determinant. Other significant influences include nutritional status, attendance at educational activities, study habits, social support, mental health, and physical activity. Conversely, excessive social media use and addictions can negatively impact academic performance. [ABSTRACT FROM AUTHOR]