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Sleep disorders are bidirectionally linked with eating behaviors and glucose metabolism, which could be clinically relevant in type 1 diabetes (T1D). We investigated the relationship between dietary habits and sleep quality in individuals with T1D on insulin pumps and continuous glucose monitoring (CGM). In a cross-sectional study, dietary habits (7-day food diary, EPIC questionnaire) and sleep quality (Pittsburgh Sleep Quality Index questionnaire) were assessed in 59 men and 58 women with T1D, aged 19–79 years, using CGM and insulin pump. Differences in dietary habits and blood glucose after dinner (6 h) between participants differing in sleep quality, sleep duration, and sleep onset latency were evaluated. Bad Sleepers (n = 81) were twice as prevalent as Good Sleepers (n = 36) and had a significantly higher intake of fat than Good Sleepers (dinner: 30.7 ± 10.7 vs. 24.0 ± 10.5 g, p = 0.004). Short sleepers had a significantly higher usual intake (g/1000 kcal) of coffee and tea (90.4 ± 71.7 vs. 62.0 ± 35.6), alcoholic (47.8 ± 51.1 vs. 28.9 ± 31.5) and carbonated beverages (21.8 ± 38.1 vs. 9.3 ± 17.2) (p < 0.05 for all) than Long Sleepers. Long Sleep Onset Latency was associated with a significantly higher fat intake at dinner (41.8 ± 7.4 vs. 38.1 ± 9.1 % total energy, p = 0.029) than Short Sleep Onset Latency. No significant differences in post-dinner blood glucose levels were detected between participants with good or bad sleep quality. Sleep disruption is common in T1D and is associated with unhealthy dietary choices, especially at dinner, independently of post-dinner blood glucose control. • Sleep disruption is common in patients with type 1 diabetes. • Bad sleep quality is associated with high intake of saturated fat and alcoholic, carbonated, and caffeinated drinks, especially at dinner. • This association is independent of overall and post-dinner blood glucose control. [ABSTRACT FROM AUTHOR]

Jianghao Xiao, Dengkai Chen, Suihuai Yu, Hui Wang, Yiwei Sun, Hanyu Wang, Zhiming Gou, Jingping Wang Key Laboratory of Industrial Design and Ergonomics, Ministry of Industry and Information Technology, Northwestern Polytechnical University, Xi’an, 710072, People’s Republic of ChinaCorrespondence: Jianghao Xiao, Key Laboratory of Industrial Design and Ergonomics, Ministry of Industry and Information Technology, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, 710072, People’s Republic of China, Tel +86 15528076860, Email xiaojianghao@mail.nwpu.edu.cnPurpose: Exposure to artificial light influences human performance, which is essential for maintaining healthy work and sleep. However, existing research has not explored the intrinsic links between sleep performance and human states over time under prebedtime light exposure interventions (LEIs).Methods: To investigate the time-dependent effects of altered prebedtime light exposure, four LEI groupings (&num;L1 - &num;L4) and a Time factor (D8, D9, and D10) were chosen for sleep experiments in enclosed spaces. Forty-eight young adults recruited were available for data analysis. Subjective alertness (SA), negative affect (NA), subjective sleep, and objective sleep were measured via the Karolinska Sleepiness Scale, Positive and Negative Affect Schedule, Next-day Self-assessment Sleep Quality, and joint assessment of wrist actigraphy and sleep diaries, respectively. Statistical analysis was used for the effects of light exposure on the human states (corresponding to the SA and NA) and sleep performance, while the process model helped construct the associations between the two.Results: The statistical effects revealed that the Time had a significant main effect on subjective sleep and changes in prebedtime alertness; the LEI had a significant main effect only on sleep onset latency (SOL). After undergoing altered prebedtime light exposure, the mean SA increased at prebedtime of D9 (p = 0.022) and D10 (p = 0.044); No significant effect on the NA was observed; Mean subjective sleep had a significant increase from D8 to D10. Moreover, five actigraphy-estimated sleep parameters were interrelated. In light of this, a chained pathway relationship was identified. The SOL played a mediating predictor between prebedtime state and objective sleep, which was linked to the awakening state through subjective sleep.Conclusion: Our study suggests that time-dependent effects of altered prebedtime light exposure on sleep performance are associated with human states at prebedtime and awakening, with implications for its prediction of sleep health.Keywords: prebedtime light exposure, sleep performance, non-visual effects, alertness, negative affect, sleep onset latency

To evaluate sleep quality, it is necessary to monitor overnight sleep duration. However, sleep monitoring typically requires more than 7 hours, which can be inefficient in termxs of data size and analysis. Therefore, we proposed to develop a deep learning-based model using a 30 sec sleep electroencephalogram (EEG) early in the sleep cycle to predict sleep onset latency (SOL) distribution and explore associations with sleep quality (SQ). We propose a deep learning model composed of a structure that decomposes and restores the signal in epoch units and a structure that predicts the SOL distribution. We used the Sleep Heart Health Study public dataset, which includes a large number of study subjects, to estimate and evaluate the proposed model. The proposed model estimated the SOL distribution and divided it into four clusters. The advantage of the proposed model is that it shows the process of falling asleep for individual participants as a probability graph over time. Furthermore, we compared the baseline of good SQ and SOL and showed that less than 10 minutes SOL correlated better with good SQ. Moreover, it was the most suitable sleep feature that could be predicted using early EEG, compared with the total sleep time, sleep efficiency, and actual sleep time. Our study showed the feasibility of estimating SOL distribution using deep learning with an early EEG and showed that SOL distribution within 10 minutes was associated with good SQ.

Background: Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. Methods: A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. Results: More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. Conclusions: Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.

Background: Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. Methods: A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. Results: More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. Conclusions: Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation. [ABSTRACT FROM AUTHOR]

Objective: Prolonged sleep onset latency (PSOL) and age have been linked to ischemic stroke (IS) severity and the production of chemokines and inflammation, both of which contribute to IS development. This study aimed to explore the relationship between chemokines, inflammation, and the interplay between sleep onset latency (SOL) and age in influencing stroke severity. Methods: A cohort of 281 participants with mild to moderate IS was enrolled. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and SOL was recorded. Serum levels of macrophage inflammatory protein-1alpha (MIP-1a), macrophage inflammatory protein-1beta (MIP-1ß), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-a) were measured. Results: NIHSS scores of middle-aged participants with PSOL were significantly higher than those with normal sleep onset latency (NSOL) (p = 0.046). This difference was also observed when compared to both the elderly with NSOL (p = 0.022), and PSOL (p < 0.001). Among middle-aged adults with PSOL, MIP-1ß exhibited a protective effect on NIHSS scores (ß = -0.01, t = -2.11, p = 0.039, R2 = 0.13). MIP-1a demonstrated a protective effect on NIHSS scores in the elderly with NSOL (ß = -0.03, t = -2.27, p = 0.027, R2 = 0.12). Conclusion: This study reveals a hitherto undocumented association between PSOL and IS severity, along with the potential protective effects of MIP-1ß in mitigating stroke severity, especially among middle-aged patients. [ABSTRACT FROM AUTHOR]

Summary The present study examined the relationship between subjective sleep onset latency (SOL), sleep structure, changes in skin and body temperature, and subjective evaluation of sleep in healthy young adults to elucidate the pathophysiological mechanisms of insomnia. A total of 28 participants (age 21.54 [0.50] years) with no sleep problems participated in a 1‐h polysomnographic recording that obtained objective sleep parameters during the daytime while skin and body temperatures were recorded. The distal–proximal skin temperature gradient (DPG) was calculated. Subjective parameters, such as subjective SOL, sleep time, and restorative sleepiness, were evaluated before and after sleep. Most participants estimated their sleep latency as being longer than their actual SOL (13.7 versus 7.6 min). Objective SOL was significantly correlated with each sleep stage parameter whereas subjective SOL was negatively correlated with Stage N2 sleep duration (Rho = −0.454, p = 0.020), slow‐wave activity and delta power (Rho = −0.500, p = 0.011 and Rho = −0.432, p = 0.031, respectively), and ΔDPG (the degree of reduction of heat loss before and after lights‐off). Stepwise regression analysis showed that ΔDPG was the strongest predictive factor in explaining the length of subjective SOL. The degree of heat dissipation before and after lights‐off contributed most to the sensation of falling asleep in healthy young adults. This finding may be helpful for elucidating the physiological mechanisms of insomnia and its treatment. [ABSTRACT FROM AUTHOR]

The relationship between sleep duration, sleep quality, and race completion time during each stage of a 3-day ultra-endurance triathlon (stage 1: 10-km swim, 146-km cycle; stage 2: 276-km cycle; and stage 3: 84.4-km run) was investigated. Seventeen triathletes partook in sleep analysis throughout the ultra-endurance multiday triathlon using an actigraphy wristband. The participants wore the band to record objective sleep outcomes for approximately 4 days (1–2 d prerace, 3 race days, and 1 d postrace), except while racing. The total sleep time (TST; prerace: 414.1 [95.3] min, prestage 1: 392.2 [138.3] min, prestage 2: 355.6 [62.5] min, and prestage 3: 299.7 [107.0] min) significantly decreased over time (P <.05). Significant Pearson moment–product correlations were found between TST and subsequent race–day performance for race stage 1 (r = −.577; P =.019) and stage 3 (r = −.546; P =.035), with further analysis revealing that TST explained 33% and 30% of the variation in performance for stages 1 and 3, respectively. During a 3-day ultra-endurance triathlon, the TST was reduced and had a significant negative correlation to exercise performance, indicating that sleep loss was associated with slower performances. Sleep onset latency, wake episodes, and sleep efficiency did not significantly change over the course of this investigation, which may stem from the close proximity of exercise to sleep. [ABSTRACT FROM AUTHOR]

The physiological processes governing sleep regulation show maturational changes during adolescent development. To date, data are available to specify when delays in circadian timing occur; however, no longitudinal data exist to characterize the maturation of the accumulation of sleep pressure across the evening. The aim of this longitudinal study was to test whether this change in evening sleep propensity can be identified during early adolescence. Twenty pre-pubescent boys' (M age = 10.3, SD = 0.4 years) evening sleep homeostats were assessed using a series of sleep latency tests every hour (7:30 p.m. to 3:30 a.m.) at 6-month intervals across four waves. While results revealed shorter sleep onset latencies with increasing wakefulness (p <.001), this effect was not moderated by study wave (p =.79). Evening sleep propensity thus appears to remain stable in boys during early adolescence. Future studies should expand upon these findings by using larger samples of girls as well as boys across an extended age range during the teenage years. • Sleep onset latency declined with increasing wakefulness in boys aged 10–11. • Decreases in sleep onset latency across wakefulness were not moderated by age. • Evening sleep propensity remains stable in boys during early adolescence. [ABSTRACT FROM AUTHOR]

Abstract Background Passive body heating before sleep is well known to lead to improved sleep. However, the effects of the degree of change in body temperature by bathing on sleep quality are unclear. The present study aimed to clarify the effects on sleep of bathing-induced changes in body temperature. Methods Twenty-three healthy males and females in their 20 s to 50 s bathed in their homes 1.5–2 h before bedtime under three bathing conditions: showering only; short bathing in a bathtub; and long bathing in a bathtub. Sublingual and skin temperatures and thermal sensation before and after bathing, sleep indices such as sleep onset latency, time in bed, sleep efficiency, and wake after sleep onset, all of which were evaluated using an actimeter, and subjective evaluations of sleep were compared among conditions. Results Sublingual temperature just after bathing was significantly higher with long bathing than with other conditions, and the fall in sublingual temperature from after bathing to before sleep was significantly larger with long bathing than with short bathing. Sleep onset latency by actimeter was significantly reduced with long bathing compared to showering. In addition, subjective evaluations of falling asleep and sleep quality were better with long bathing than with showering or short bathing. Conclusions In conclusion, bathing conditions that produce a 0.9 °C increase in sublingual temperature appear effective for falling asleep and sleep quality, because core temperature shows a greater drop to before sleep than those producing an increase of about 0.3 °C increase in sublingual temperature.

Background: Passive body heating before sleep is well known to lead to improved sleep. However, the effects of the degree of change in body temperature by bathing on sleep quality are unclear. The present study aimed to clarify the effects on sleep of bathing-induced changes in body temperature. Methods: Twenty-three healthy males and females in their 20 s to 50 s bathed in their homes 1.5–2 h before bedtime under three bathing conditions: showering only; short bathing in a bathtub; and long bathing in a bathtub. Sublingual and skin temperatures and thermal sensation before and after bathing, sleep indices such as sleep onset latency, time in bed, sleep efficiency, and wake after sleep onset, all of which were evaluated using an actimeter, and subjective evaluations of sleep were compared among conditions. Results: Sublingual temperature just after bathing was significantly higher with long bathing than with other conditions, and the fall in sublingual temperature from after bathing to before sleep was significantly larger with long bathing than with short bathing. Sleep onset latency by actimeter was significantly reduced with long bathing compared to showering. In addition, subjective evaluations of falling asleep and sleep quality were better with long bathing than with showering or short bathing. Conclusions: In conclusion, bathing conditions that produce a 0.9 °C increase in sublingual temperature appear effective for falling asleep and sleep quality, because core temperature shows a greater drop to before sleep than those producing an increase of about 0.3 °C increase in sublingual temperature. [ABSTRACT FROM AUTHOR]

Introduction: This systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown. Methods: The protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed. Results: Sixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17-0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30-0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24-1.61). Moreover, 57.3% (95% CI 50.01-61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27-40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption. Discussion: Timely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed. [ABSTRACT FROM AUTHOR]

Resumen: Los trastornos del sueño son altamente prevalentes en la población pediátrica con trastornos del neurodesarrollo, con consecuencias relevantes en el paciente y su familia. En esta revisión se describirán las alteraciones del sueño más frecuentes presentes en las etiologías prevalentes de trastornos del neurodesarrollo y como enfrentarlas del punto de vista diagnóstico y terapéutico de acuerdo a la evidencia actual. Abstract: Sleep disorders are highly prevalent in the pediatric population with neurodevelopmental disorders, with important consequences for the patient and their family. This review describes the most frequent sleep disorders present in prevalent etiologies of neurodevelopmental disorders and how to deal with them from a diagnostic and therapeutic point of view according to current evidence.

IntroductionThis systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown.MethodsThe protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed.ResultsSixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17–0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30–0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24–1.61). Moreover, 57.3% (95% CI 50.01–61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27–40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption.DiscussionTimely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256378, identifier CRD42021256378.

Epidemiology studies have indicated that polyphenol consumption was more likely to have higher sleep quality, but some results remain controversial. A general overview of polyphenol-rich interventions on sleep disorders still lacks in the existing literature. Eligible randomized controlled trials (RCT's) literature retrieval was performed in six databases. Sleep efficiency, sleep onset latency, total sleep time, and PSQI were included as objective measures to compare the effects of placebo and polyphenols in patients with sleep disorders. Subgroup-analyses were performed based on treatment duration, geographic location, study design, and sample size. The mean differences (MD) with 95% confidence intervals (CI) were adopted for four continuous variable data of outcomes in pooled analysis. This study is registered on PROSPERO, number CRD42021271775. In total, 10 studies of 334 individuals were included. Pooled data demonstrated that administration of polyphenols decreases sleep onset latency (MD, −4.38 min; 95% CI, −6.66 to −2.11; P = 0.0002) and increases total sleep time (MD, 13.14 min; 95% CI, 7.54 to 18.74; P＜0.00001), whereas they have no effect on sleep efficiency (MD, 1.04; 95% CI, −0.32 to 2.41; P = 0.13) and PSQI (MD, −2.17; 95% CI, −5.62 to 1.29; P = 0.22). Subgroup analyses further indicated that treatment duration, study design, and number of participants appeared to be responsible for the largest proportion of accountable heterogeneity. Polyphenols' potential importance is highlighted by these findings in treating sleep disorders. The development of large-scale, randomized, controlled trials is recommended to providing further evidence for therapeutic use of polyphenols in a variety of sleep difficulties.

Summary: The sleep–wake cycle is regulated by circadian Process C and homeostatic Process S. Selective thermal stimulation (STS) of the cervical spine region enhances glabrous skin blood flow (GSBF) and augments body heat dissipation to increase distal‐to‐proximal skin gradient (DPG) causing decrease of core body temperature (CBT), which can shorten sleep onset latency (SOL) and improve sleep quality. A total of 11 young healthy/normal sleeper males challenged to go to bed (lights‐off) 2 h earlier than usual were subjected in a randomised order to non‐consecutive treatment and control night‐time sleep sessions. The treatment night entailed activation of a dual‐temperature zone mattress with a cooler centre and warmer periphery plus STS pillow that applied mild heating to the cervical spinal skin for 30 min after lights‐off for sleep. During the first 30 min after lights‐off, GSBF (mean [standard error (SE)] Δ = 49.77 [19.13] perfusion units, p = 0.013) and DPG (mean [SE] Δ = 2.05 [0.62] °C, p = 0.005) were significantly higher and CBT (mean [SE] Δ = –0.15 [0.07] °C, p = 0.029) was significantly lower in the treatment than control night, while there was no significant difference in these variables during the 45 min prior to lights‐off (baseline). Moreover, SOL was significantly reduced (mean [SE] Δ = –48.6 [23.4] min, p = 0.032) and subjective sleep quality significantly better (p < 0.001) in the treatment than control night. In conclusion, the novel sleep facilitating system comprised of the STS pillow plus dual‐temperature zone mattress induced earlier increase in GSBF and DPG and earlier decline in CBT. This resulted in statistically significant shortened SOL and improved overall sleep quality, thereby reducing sleep pressure of Process S, even under the challenging investigative protocol requiring participants to go to sleep 2 h earlier than customary. [ABSTRACT FROM AUTHOR]

The potential effect of early intervention for anxiety on sleep outcomes was examined in a sample of adolescents with anxiety (N = 313, mean 14.0 years, SD = 0.84, 84% girls, 95.7% Norwegians). Participants were randomized to one of three conditions: a brief or a standard-length cognitive-behavioral group-intervention (GCBT), or a waitlist control-group (WL). Interventions were delivered at schools, during school hours. Adolescents with elevated anxiety were recruited by school health services. Questionnaires on self-reported anxiety symptoms, depressive symptoms, and sleep characteristics were administered at pre- and post-intervention, post-waitlist, and at 1-year follow-up. Adolescents reported reduced insomnia (odds ratio (OR) = 0.42, p < 0.001) and shorter sleep onset latency (d = 0.27, p < 0.001) from pre- to post-intervention. For insomnia, this effect was maintained at 1-year follow-up (OR = 0.54, p = 0.020). However, no effect of GCBT on sleep outcomes was found when comparing GCBT and WL. Also, no difference was found in sleep outcomes between brief and standard-length interventions. Adolescents defined as responders (i.e., having improved much or very much on anxiety after GCBT), did not differ from non-responders regarding sleep outcomes. Thus, anxiety-focused CBT, delivered in groups, showed no effect on sleep outcomes. Strategies specifically targeting sleep problems in adolescents should be included in GCBT when delivered as early intervention for adolescents with elevated anxiety. Trial registry Clinical trial registration: School Based Low-intensity Cognitive Behavioral Intervention for Anxious Youth (LIST); http://clinicalrials.gov/; NCT02279251, Date: 11.31. 2014 [ABSTRACT FROM AUTHOR]

Background: Validity of the Pittsburgh Sleep Quality Index (PSQI) has not been established for midlife women before menopause, and evidence suggests that two-factor or three-factor models may be more informative than the PSQI global score derived from its seven components. We hypothesized that the PSQI and its factor structure would be valid in premenopausal women. Materials and Methods: We performed a validation study of the PSQI against wrist actigraphy in a community-based convenience sample of 71 healthy premenopausal women (aged 40–50 years). For convergent validity, PSQI and its component scores were compared with homologous actigraphy measures. For discriminant validity, characteristics known to affect sleep quality were compared, including body mass index, exercise, menopausal status, menopausal symptoms, and depressive symptoms measured with the Center for Epidemiological Studies–Depression (CES-D) Scale. Results: The PSQI global score and Components 1 (quality) and 5 (disturbance) were correlated (p < 0.05) with actigraphy-measured wake after sleep onset. The PSQI global score and Components 1 (quality) and 7 (daytime dysfunction) were correlated with CES-D scores. PSQI Components 2 (onset latency) and 4 (efficiency) were not congruent with homologous actigraphy measures, while component 3 (duration) was congruent with actigraphy duration. The single-factor PSQI global score had a higher McDonald's omega (0.705) and Cronbach's alpha (0.702) than the two-factor or three-factor models. Conclusions: The PSQI global score is a valid measure of sleep quality in healthy midlife women, performing better than two-factor or three-factor models. However, overlapping CES-D and PSQI scores warrant further clinical assessment and research to better differentiate poor sleep quality from depression. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between sleep and memory has been well documented. However, it remains unclear whether a mind-body exercise, i.e., Tai Chi exercise, can improve memory performance in older adults by improving their subjective and objective sleep., Method: A randomized controlled trial was conducted with participants (M = 67.36, 56-79 years) randomly assigned to Tai Chi and control groups. The primary outcomes were sleep, both subjectively reported and objectively assessed by actigraphy, and memory performance, as well as the mediating role of sleep in memory improvement with Tai Chi practice., Results: Tai Chi exercise led to improvements in subjective sleep, as indicated by ISI (p < 0.001, Cohen's d = 0.62) and daytime dysfunction of the PSQI (p = 0.02, Cohen's d = 0.80), and in actigraphy-assessed sleep onset latency (p < 0.01, Cohen's d = 0.61), as well as improved memory performance on digit span forward (p < 0.001, Cohen's d = 1.20) and visual spatial memory tasks (p < 0.01, Cohen's d = 0.83) compared to the control group. Importantly, Tai Chi practice improved digit span forward memory performance through parallel mediation of both subjective sleep (i.e., daytime dysfunction of the PSQI) and objective sleep (i.e., sleep onset latency; b = 0.29, p < 0.01)., Discussion: Our findings uncovered the potential benefits of Tai Chi exercise in relation to both subjective and objective sleep in older adults, in turn, how sleep changes played a role in the link between Tai Chi exercise and memory changes in older adults., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The Maintenance of Wakefulness Test (MWT) is a widely accepted objective test used to evaluate daytime somnolence and is commonly used in clinical studies evaluating novel therapeutics for excessive daytime sleepiness. In the latter, sleep onset latency (SOL) is typically the sole MWT endpoint. Here, we explored microsleeps, sleep probability measures derived from automated sleep scoring, and quantitative electroencephalography (qEEG) features as additional MWT biomarkers of daytime sleepiness, using data from a phase 1B trial of the selective orexin receptor 2 agonist danavorexton (TAK-925) in people with narcolepsy type 1 (NT1) or type 2 (NT2). Danavorexton treatment reduced the rate and duration of microsleeps during the MWT in NT1 (days 1 and 7; p ≤ 0.005) and microsleep rate in NT2 (days 1 and 7; p < 0.0001). Use of an EEG-sleep-staging-derived measure to determine the probability of wakefulness for each minute revealed a novel metric to track changes in daytime sleepiness, which were consistent with the θ/α ratio, a known biomarker of drowsiness. The slopes of line-fits to both the log-transformed sleepiness score or log-transformed θ/α ratio correlated well to (inverse) MWT SOL for NT1 (R = 0.93 and R = 0.83, respectively) and NT2 (R = 0.97 and R = 0.84, respectively), suggesting that individuals with narcolepsy have increased sleepiness immediately after lights-off. These analyses demonstrate that novel EEG-based biomarkers can augment SOL as predictors of sleepiness and its response to treatment and provide a novel framework for the analysis of wake EEG in hypersomnia disorders., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)

The stress of family caregiving may affect many health-related variables, including sleep. We evaluated differences in self-reported sleep quality between incident caregivers and matched non-caregiving controls from a national population-based study. Caregivers and controls were identified in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and matched on seven different demographic and health history factors. Caregivers reported significantly longer sleep onset latency than controls, before and after adjusting for covariates (ps <.05). No differences were found on measures of total sleep time or sleep efficiency. Among caregivers only, employed persons reported less total sleep time and number of care hours was a significant predictor of total sleep time. Dementia caregivers did not differ from other caregivers. This is one of the few population-based studies of sleep quality in family caregivers. Additional research is needed to examine whether sleep disturbance contributes to greater health problems among caregivers. [ABSTRACT FROM AUTHOR]

We aimed to investigate whether higher light intensity in the morning is associated with better nocturnal sleep quality and whether higher light intensities in the evening or night have the opposite effect. Light intensity was recorded for 7 consecutive days across the year among 317 indoor and outdoor daytime workers in Denmark (55–56° N) equipped with a personal light recorder. Participants reported sleep quality after each nocturnal sleep. Sleep quality was measured using three parameters; disturbed sleep index, awakening index, and sleep onset latency. Associations between increasing light intensities and sleep quality were analyzed using mixed effects models with participant identity as a random effect. Overall, neither white nor blue light intensities during morning, evening, or night were associated with sleep quality, awakening, or sleep onset latency of the subsequent nocturnal sleep. However, secondary analyses suggested that artificial light during the morning and day contrary to solar light may increase vulnerability to evening light exposure. Altogether, we were not able to confirm that higher morning light intensity significantly improves self-reported sleep quality or that higher evening or night light intensities impair self-reported sleep quality at exposure levels encountered during daily life in a working population in Denmark. This suggests that light intensities alone are not important for sleep quality to a degree that it is distinguishable from other important parameters in daily life settings. [ABSTRACT FROM AUTHOR]

Poor sleep is prevalent among caregivers of persons living with dementia and increases their risk for cognitive impairment and decline. In this cross-sectional, correlational study, we compared the cognitive function scores of caregivers with poor sleep with the demographically adjusted normed scores of the National Institutes of Health Toolbox Cognition Battery. Caregivers completed a 14-day sleep diary. On average, caregivers (n = 28) were 65.14 (±10.08) years, female, and White. Their average crystallized cognitive function composite score was significantly higher and their average fluid cognitive function composite score was significantly lower than the normative scores. Caregivers performed significantly worse on the processing speed domain measure. Poor sleep may affect how caregivers, including highly educated caregivers, process and respond to information, thus can influence how they safely perform complex caregiving tasks. Health care providers should consistently assess caregivers' sleep and cognitive abilities to promptly identify changes and provide timely interventions. [ABSTRACT FROM AUTHOR]

Background: This study aims to examine the relationships between sleep onset latency and multiple sleep-related factors of seventh and tenth graders during the transition from childhood to adolescence. Methods: Regarding sleep onset latency, we examined the short-term associations in Phase IV (2002) and long-term associations in Phase V (2005) of the Toyama Birth Cohort Study. In total, 4,673 boys and 4,694 girls in Phase IV and 2,969 boys and 3,108 girls in Phase V answered the questionnaire items regarding sleep, physical and mental health, lifestyle, socioeconomic status, and family and school factors. Considering sleep onset latency as the outcome and 13 sleep-related factors as independent variables, we calculated the odds ratio using binary logistic regression. The longitudinal study was conducted with 1,703 boys and 1,919 girls whose sleep onset latency was within 30 min in Phase IV. Results: The following factors were found to be related to longer sleep onset latency in the short term: sleep duration, physical activity, game time, and self-esteem in boys and sleep duration, bedroom environment, game time, abdominal pain, long-standing illness, onset of puberty, mental health difficulties, and school avoidance feelings in girls. Regarding its long-term effects, having a single parent and self-esteem in boys and breakfast, game time, long-standing illness, obesity, onset of puberty, and school avoidance feelings in girls were associated with longer sleep onset latency. Conclusions: Education of adolescent health and sleep hygiene at home and school should include both short-term and long-term associations between sleep and a healthy lifestyle by gender. [ABSTRACT FROM AUTHOR]

Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period. Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study. Results: Over the first 3months, the INT group had significant (p <0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p <0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency. Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical evidence is required about the long-term efficacy and safety of melatonin treatment for sleep problems in children with neurodevelopmental disorders (NDDs) who underwent adequate sleep hygiene interventions. Methods We conducted a 26-week, multicenter, collaborative, uncontrolled, open-label, phase III clinical trial of melatonin granules in children 6 to 15 years of age who had NDDs and sleep problems. The study consisted of the 2-week screening phase, the 26-week medication phases I and II, and the 2-week follow-up phase. Children received 1, 2, or 4 mg melatonin granules orally in the medication phases. Variables of sleep status including sleep onset latency (SOL), aberrant behaviors listed on the Aberrant Behavior Check List-Japanese version (ABC-J), and safety were examined. The primary endpoint was SOL in the medication phase I. Results Between June 2016 and July 2018, 99 children (80 males and 19 females, 10.4 years in mean age) were enrolled at 17 medical institutions in Japan—74, 60, 22, 9, 6, and 1 of whom had autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disabilities, motor disorders, specific learning disorder, and communication disorders, respectively, at baseline. Fifteen children received the maximal dose of 4 mg among the prespecified dose levels. SOL recorded with the electronic sleep diary shortened significantly (mean ± standard deviation [SD], − 36.7 ± 46.1 min; 95% confidence interval [CI], − 45.9 to − 27.5; P

Introduction: COVID-19 has resulted in major life changes to the majority of the world population, particularly adolescents, with social-distancing measures such as home-based schooling likely to impact sleep quality. Increased worry is also likely considering the substantial financial, educational and health concerns accompanying COVID-19. White matter (WM) integrity has been shown to be associated with anxiety and depression symptoms, including worry, as well being closely associated with sleep quality. This study aimed to investigate the associations between pre-COVID sleep quality, WM structural integrity and levels of worry and rumination about COVID.Methods: N = 30 adolescent participants from Queensland, Australia, completed diffusion tensor imaging (DTI) scanning pre-COVID, the Pittsburgh Sleep Quality Index (PSQI) pre and during COVID, and 9 items designed to measure 3 constructs, perceived impact of COVID, general worry, and COVID-specific worry and rumination.Results: Sleep quality (PSQI total) was significantly poorer during COVID compared with pre-COVID. Sleep onset latency measured pre-COVID was significantly associated with COVID-specific worry and rumination. While the structural integrity of a number of WM tracts (measured pre-COVID) were found to be significantly associated with COVID-specific worry and rumination. Follow-up regression analysis using a model including pre-COVID sleep onset latency, structural integrity of the posterior limb of the internal capsule (PLIC), gender and change in PSQI explained a significant 47% of the variance in COVID-specific worry and rumination.Conclusions: These findings suggest that adolescents with poor sleep quality and perturbed WM integrity may be at risk of heightened reactivity to future stressful events and interventions should focus on improving sleep onset latency. [ABSTRACT FROM AUTHOR]

There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents (12–16 years; mean age 14.0, SD = 0.84, 84.0% girls) referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration (

Rationale: The mechanisms underlying impaired sleep quality in insomnia are not fully known, but an important role for sleep fragmentation has been proposed. Objectives: The aim of this study is to explore potential mechanisms of sleep fragmentation influencing alterations of perceived sleep quality. Methods: We analyzed polysomnography (PSG) recordings from a double-blind crossover study with zopiclone 7.5 mg and placebo, in elderly participants with insomnia complaints and age-matched healthy controls. We compared survival dynamics of sleep and wake across group and treatment. Subsequently, we used a previously proposed model to estimate the amount of sleep onset latency (SOL) misperception from PSG-defined sleep fragmentation. Self-reported and model-estimated amount of SOL misperception were compared across group and treatment, as well as model prediction errors. Results: In the zopiclone night, the average segment length of NREM sleep was increased (group F = 1.16, p = 0.32; treatment F = 8.89, p< 0.01; group x treatment F = 0.44, p = 0.65), while the segment length of wake was decreased (group F = 1.48, p = 0.23; treatment F = 11.49, p< 0.01; group x treatment F = 0.36, p = 0.70). The self-reported and model-estimated amount of SOL misperception were lower during the zopiclone night (self-reported group F = 6.08, p< 0.01, treatment F = 10.8, p< 0.01, group x treatment F = 2.49, p = 0.09; model-estimated F = 1.70, p = 0.19, treatment F = 16.1, p< 0.001, group x treatment F = 0.60, p = 0.55). The prediction error was not altered (group F = 1.62, p = 0.20; treatment F = 0.20, p = 0.65; group x treatment F = 1.01, p = 0.37). Conclusions: Impaired subjective sleep quality is associated with decreased NREM stability, together with increased stability of wake. Furthermore, we conclude that zopiclone-induced changes in SOL misperception can be largely attributed to predictable changes of sleep architecture. [ABSTRACT FROM AUTHOR]

Extended sleep onset latency (SOL), or "sleep onset insomnia," can decrease total sleep time, increasing risk for many health conditions, including heart disease, stroke, and all-cause mortality. Sleep disorders persist in the United States despite current behavioral/pharmaceutical remedies, with 10% to 15% of the population suffering from insomnia. Mind-body therapies offer additional solutions, as meditation has been correlated with decreased SOL. More research on use of mind-body practices for insomnia is needed. This study investigates the guided meditation practice of Yoga Nidra (yogic sleep) as a promising intervention for sleep disorders because of its purported ability to induce mental, physical, and emotional relaxation. In this pilot study, we address the feasibility of Yoga Nidra for insomnia, appropriateness of our selected measurement systems, and effect of Yoga Nidra on brainwaves, sleep onset, and the autonomic nervous system. Our study sample includes 22 adults, ages 18–45, with insomnia. The design includes two clinic visits (V1, lying quietly for 90 min; V2, randomization to 90-min lying quietly vs. 30-min Yoga Nidra plus 60-min lying quietly), taking place 1 to 14 days apart. Outcomes measured during/after Yoga Nidra (vs. control) include sleep onset, electroencephalography (EEG) power, heart rate variability (HRV), and respiratory rate. Self-reported mood and anxiety will be measured before/after each visit. Resulting physiological, psychological, and feasibility data will be used to inform future clinical studies of Yoga Nidra for sleep and relaxation. [ABSTRACT FROM AUTHOR]

Study objective: To elucidate the contribution of time estimation and pre sleep arousal to the component of sleep onset misperception not explained by sleep fragmentation. Methods: At-home ambulatory polysomnograms (PSGs) of 31 people with insomnia were recorded. Participants performed a time estimation task and completed the Pre Sleep Arousal Scale (PSAS). Based on previous modelling of the relationship between objectively measured sleep fragmentation and sleep onset misperception, the subjective sleep onset was estimated for each participant as the start of the first uninterrupted sleep bout longer than 30 min. Subsequently, the component of misperception not explained by sleep fragmentation was calculated as the residual error between estimated sleep onset and perceived sleep onset. This residual error was correlated with individual time estimation task results and PSAS scores. Results: A negative correlation between time estimation task results and the residual error of the sleep onset model was found, indicating that participants who overestimated a time interval during the day also overestimated their sleep onset latency (SOL). No correlation was found between PSAS scores and residual error. Conclusions: Interindividual variations of sleep architecture possibly obscure the correlation of sleep onset misperception with time estimation and pre sleep arousal, especially in small groups. Therefore, we used a previously proposed model to account for the influence of sleep fragmentation. Results indicate that time estimation is associated with sleep onset misperception. Since sleep onset misperception appears to be a general characteristic of insomnia, understanding the underlying mechanisms is probably important for understanding and treating insomnia.

Objective: Prolonged sleep onset latency (PSOL) and age have been linked to ischemic stroke (IS) severity and the production of chemokines and inflammation, both of which contribute to IS development. This study aimed to explore the relationship between chemokines, inflammation, and the interplay between sleep onset latency (SOL) and age in influencing stroke severity., Methods: A cohort of 281 participants with mild to moderate IS was enrolled. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and SOL was recorded. Serum levels of macrophage inflammatory protein-1alpha (MIP-1α), macrophage inflammatory protein-1beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured., Results: NIHSS scores of middle-aged participants with PSOL were significantly higher than those with normal sleep onset latency (NSOL) ( p  = 0.046). This difference was also observed when compared to both the elderly with NSOL ( p  = 0.022), and PSOL ( p  < 0.001). Among middle-aged adults with PSOL, MIP-1β exhibited a protective effect on NIHSS scores (β = -0.01, t  = -2.11, p  = 0.039, R 2  = 0.13). MIP-1α demonstrated a protective effect on NIHSS scores in the elderly with NSOL (β = -0.03, t  = -2.27, p  = 0.027, R 2  = 0.12)., Conclusion: This study reveals a hitherto undocumented association between PSOL and IS severity, along with the potential protective effects of MIP-1β in mitigating stroke severity, especially among middle-aged patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhou, Han, Mu, Xing, Wu, Li, Liu and Wang.)

Insomnia, i.e., difficulties initiating and/or maintaining sleep, is one of the most common sleep disorders. To study underlying mechanisms for insomnia, we studied autonomic activity changes around sleep onset in participants without clinical insomnia but with varying problems with initiating or maintaining sleep quantified as increased sleep onset latency (SOL) and wake after sleep onset (WASO), respectively. Polysomnography and electrocardiography were simultaneously recorded in 176 participants during a single night. Cardiac autonomic activity was assessed using frequency domain analysis of RR intervals and results show that the normalized spectral power in the low frequency band (LFnu) after sleep onset was significantly higher in participants with long SOL compared to participants with short SOL. Furthermore, the normalized spectral power in the high frequency band (HFnu) was significantly lower in participants with long SOL as compared to participants with short SOL over 3 time periods (first 10 min in bed intending to sleep, 10 min before, and 10 min after sleep onset). These results suggest that participants with long SOL are more aroused in all three examined time periods when compared to participants with short SOL, especially for young adults (20–40 years). As there is no clear consensus on the cutoff for an increased WASO, we used a data-driven approach to explore different cutoffs to define short WASO and long WASO groups. LFnu, HFnu, and LF/HF differed between the long and the short WASO groups. A higher LFnu and LF/HF and a lower HFnu was observed in participants with long WASO for most cutoffs. The highest effect size was found using the cutoff of 66 min. Our findings suggest that autonomic cardiac activity has predictive value with respect to sleep characteristics pertaining to sleep onset and maintenance.

Qian Tong,1,2,* Wanzhen Wu,2,* Qing Wu,2 Yanbo Yu,3 Xiaoling Lv,2 Bozhong Wang,2 Guofu Wang1,2 1Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China; 2Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China; 3Wenzhou Medical University, Wenzhou, 325035 Zhejiang, China *These authors contributed equally to this work Purpose: Inconsistent outcome about association between insufficient sleep and bone mineral density (BMD) has been reported. The present study aimed to determine whether BMD was associated with score of Pittsburgh Sleep Quality Index (PSQI).Methods: A total of 410 patients (mean age 81.6±5.9 years) attending our hospital for evaluation of sleep were retrospectively studied. Dual-Energy X-ray Absorptiometry was used to measure BMD and T-score at femoral neck and lumbar spines over L2–L4 regions. Subjective sleep status was evaluated by the PSQI questionnaires. The Mann–Whitney U test and chi-square analysis were used to compare continuous variables and categorical variables, respectively. Spearman correlation test was conducted to find the relationship between BMD and other clinical factors. Multinomial logistic regressions analysis was performed to analyze independent factors predicting BMD.Results: Majority of the participants with osteoporosis (OP) were female and had lower body mass index (BMI) and higher sleep onset latency score. Spearman correlation test showed that gender, BMI, score of total PSQI, and sleep onset latency were significantly related to BMD and T-score in femoral neck and lumbar region L2–L4. Finally, multinomial logistic regression analysis demonstrated that gender and age were independent factors for OP and osteopenia and that after adjustment for gender, age, and BMI, sleep onset latency of

Insomnia, i.e., difficulties initiating and/or maintaining sleep, is one of the most common sleep disorders. To study underlying mechanisms for insomnia, we studied autonomic activity changes around sleep onset in participants without clinical insomnia but with varying problems with initiating or maintaining sleep quantified as increased sleep onset latency (SOL) and wake after sleep onset (WASO), respectively. Polysomnography and electrocardiography were simultaneously recorded in 176 participants during a single night. Cardiac autonomic activity was assessed using frequency domain analysis of RR intervals and results show that the normalized spectral power in the low frequency band (LF nu ) after sleep onset was significantly higher in participants with long SOL compared to participants with short SOL. Furthermore, the normalized spectral power in the high frequency band (HF nu ) was significantly lower in participants with long SOL as compared to participants with short SOL over 3 time periods (first 10 min in bed intending to sleep, 10 min before, and 10 min after sleep onset). These results suggest that participants with long SOL are more aroused in all three examined time periods when compared to participants with short SOL, especially for young adults (20–40 years). As there is no clear consensus on the cutoff for an increased WASO, we used a data-driven approach to explore different cutoffs to define short WASO and long WASO groups. LF nu , HF nu , and LF / HF differed between the long and the short WASO groups. A higher LF nu and LF / HF and a lower HF nu was observed in participants with long WASO for most cutoffs. The highest effect size was found using the cutoff of 66 min. Our findings suggest that autonomic cardiac activity has predictive value with respect to sleep characteristics pertaining to sleep onset and maintenance. [ABSTRACT FROM AUTHOR]

There is a paucity of studies investigating how sexual activity is perceived to influence sleep, despite conceptions about significant gender differences regarding this issue. In all, 4000 persons, aged between 18 and 55 years, were randomly drawn from the Norwegian Population Registry and invited to participate in a postal survey. The respondents were asked how sexual activity with another person, with or without orgasm, and how masturbation, with and without orgasm, influenced sleep latency and sleep quality. A total of 1080 persons participated (response rate 28.2%) of which 56.1% were women. The mean age of the sample was 38.7 years (SD = 10.8). Sexual activity with an orgasm was perceived to have a soporific effect by both men and women. Sexual activity with another person, with an orgasm, was perceived to have a relatively stronger effect on men compared to women in terms of sleep quality. Sexual activity without an orgasm was by men reported to have a sleep impairing effect, whereas the perceived effect reported by women was equivocal. Sexual activity with orgasms was perceived as having a soporific effect in both men and women. Sexual activity without an orgasm had an equivocal perceived effect on sleep. [ABSTRACT FROM AUTHOR]

Wrist actigraphy (ACT) may overestimate sleep and underestimate wake, and the agreement may be lower in people with chronic conditions who often have poor sleep and low activity levels. The purpose of this systematic review is to compare the agreement between ACT and polysomnographic (PSG) measures of sleep in adults without chronic conditions and sleep complaints (healthy) and with chronic conditions. We conducted a systematic review and meta-analysis using PRISMA guidelines. We searched PubMed, OVIDEMBASE, OVIDMEDLINE, OVIDPsycINFO, CENTRAL, CINAHL, ClinicalTrials.gov, International Clinical Trials Registry, and Open Grey. We included 96 studies with a total of 4134 participants, of whom 762 (18.4) were healthy adults and 724 (17.5%) were adults with chronic conditions. Among adults with chronic conditions, ACT overestimated TST, compared to PSG [M = 22.42 min (CI 95%: 11.92, 32.91 min)] and SE [M = 5.21% (CI 95%: 1.41%-9.00%)]. ACT underestimated SOL [M = -7.70 min (CI 95%: -15.22, -0.18 min)], and WASO [M = -10.90 min (CI 95%: -26.01, 4.22 min)]. These differences were consistently larger between ACT and PSG sleep measures compared to healthy adults. Research is needed to better understand factors that influence the agreement between ACT and PSG among people with chronic conditions. [ABSTRACT FROM AUTHOR]

Water-based passive body heating (PBHWB) as a warm shower or bath before bedtime is often recommended as a simple means of improving sleep. We searched PubMed, CINAHL, Cochran, Medline, PsycInfo, and Web of Science databases and extracted pertinent information from publications meeting predefined inclusion and exclusion criteria to explore the effects of PBHWB on sleep onset latency (SOL), wake after sleep onset, total sleep time, sleep efficiency (SE), slow wave sleep, and subjective sleep quality. The search yielded 5322 candidate articles of which 17 satisfied inclusion criteria after removing duplicates, with 13 providing comparable quantitative data for meta-analyses. PBHWB of 40-42.5 °C was associated with both improved self-rated sleep quality and SE, and when scheduled 1-2 h before bedtime for little as 10 min significant shortening of SOL. These findings are consistent with the mechanism of PBHWB effects being the extent of core body temperature decline achieved by increased blood perfusion to the palms and soles that augments the distal-to-proximal skin temperature gradient to enhance body heat dissipation. Nonetheless, additional investigation is required because the findings regarding PBHWB are limited by the relative scarcity of reported research, especially its optimal timing and duration plus exact mechanisms of effects. [ABSTRACT FROM AUTHOR]

Study Objective: To study sleep EEG characteristics associated with misperception of Sleep Onset Latency (SOL).Methods: Data analysis was based on secondary analysis of standard in-lab polysomnographic recordings in 20 elderly people with insomnia and 21 elderly good sleepers. Parameters indicating sleep fragmentation, such as number of awakenings, wake after sleep onset (WASO) and percentage of NREM1 were extracted from the polsysomnogram, as well as spectral power, microarousals and sleep spindle index. The correlation between these parameters during the first sleep cycle and the amount of misperceived sleep was assessed in the insomnia group. Additionally, we made a model of the minimum duration that a sleep fragment at sleep onset should have in order to be perceived as sleep, and we fitted this model to subjective SOLs of both subject groups.Results: Misperception of SOL was associated with increased percentage of NREM1 and more WASO during sleep cycle 1. For insomnia subjects, the best fit of modelled SOL with subjective SOL was found when assuming that sleep fragments shorter than 30 min at sleep onset were perceived as wake. The model indicated that healthy subjects are less sensitive to sleep interruptions and perceive fragments of 10 min or longer as sleep.Conclusions: Our findings suggest that sleep onset misperception is related to sleep fragmentation at the beginning of the night. Moreover, we show that people with insomnia needed a longer duration of continuous sleep for the perception as such compared to controls. Further expanding the model could provide more detailed information about the underlying mechanisms of sleep misperception. [ABSTRACT FROM AUTHOR]

Objective: To investigate the differences in sleep, sleepiness, and physical activity (PA) between young adults with autism spectrum disorder (ASD) and typically developing controls (TDC). Method: Actigraphic data and questionnaires on sleep, sleepiness, and PA were compared between fifteen adults with ASD (ADOS range 7-19; ages 22.8 ± 4.5 years) and TDC. Results: In comparison to the TDC group, the ASD group slept longer on average per night but took longer to fall asleep. In relationship to PA levels, the objective PA levels were lower in the ASD group than the TDC group. Fewer wake minutes during the sleep period in the ASD sample were associated with more PA the following day. Conclusion: The findings support previous research that demonstrates differences in sleep parameters and PA between ASD and TDC. Interventions aimed at increasing PA in an ASD population may be beneficial for improved sleep. [ABSTRACT FROM AUTHOR]

Objective/background: Mild traumatic brain injuries (mTBI) are frequently associated with long-term, self-reported sleep disruption. Objective corroboration of these self-reports is sparse and limited by small sample sizes. The purpose of this study was to report on actigraphically-measured sleep outcomes in individuals with and without a history of recent mTBI in two U.S. cities (Boston, MA and Tucson, AZ).Patients/methods: Fifty-eight individuals with a recent (within 18 months) mTBI and 35 individuals with no prior mTBI history were recruited for one of four studies across two sites. Participants completed a minimum of one week of actigraphy. Additionally, mTBI participants self-reported daytime sleepiness, sleep disruption, and functional sleep-related outcomes.Results: In Boston, mTBI participants obtained less average sleep with shorter sleep onset latencies (SOL) than healthy individuals. In Tucson, mTBI participants had greater SOL and less night-to-night SOL variability compared to healthy individuals. Across mTBI participants, SOL was shorter and night-to-night SOL variability was greater in Boston than Tucson. Sleep efficiency (SE) variability was greater in Tucson than Boston across both groups. Only SOL variability was significantly associated with daytime sleepiness (r = 0.274) in the mTBI group after controlling for location.Conclusion: Sleep quality, SOL and SE variability, are likely affected by mTBIs. Between-group differences in each site existed but went in opposite directions. These findings suggest the possibility of multiple, rather than a singular, profiles of sleep disruption following mTBI. Precision medicine models are warranted to determine whether multiple sleep disruption profiles do indeed exist following mTBI and the predisposing conditions that contribute to an individual's experience of sleep disruption. [ABSTRACT FROM AUTHOR]

Tangerine (Citrus tangerina) is one of the most important crops of Thailand with a total harvest that exceeds 100,000 tons. Citrus essential oils are widely used as aromatherapy and medicinal agents. The effect of tangerine essential oil on human brain waves and sleep activity has not been reported. In the present study, we therefore evaluated these effects of tangerine essential oil by measurement of electroencephalography (EEG) activity with 32 channel platforms according to the international 10–20 system in 10 male and 10 female subjects. Then the sleep onset latency was studied to further confirm the effect on sleep activity. The results revealed that different concentrations, subthreshold to suprathreshold, of tangerine oil gave different brain responses. Undiluted tangerine oil inhalation reduced slow and fast alpha wave powers and elevated low and mid beta wave powers. The subthreshold and threshold dilution showed the opposite effect to the brain compared with suprathreshold concentration. Inhalation of threshold concentration showed effectively decreased alpha and beta wave powers and increased theta wave power, which emphasize its sedative effect. The reduction of sleep onset latency was confirmed with the implementation of the observed sedative effect of tangerine oil.

Background: Disturbed sleep may negatively influence physical health, cognitive performance, metabolism, and general wellbeing. Nutritional interventions represent a potential non-pharmacological means to increase sleep quality and quantity. Objective: (1) Identify an optimal suite of nutritional ingredients and (2) validate the effects of this suite utilising polysomnography, and cognitive and balance tests. Methods: The optimal and least optimal combinations of six ingredients were identified utilising 55 male participants and a Box–Behnken predictive model. To validate the model, 18 healthy, male, normal sleepers underwent three trials in a randomised, counterbalanced design: (1) optimal drink, (2) least optimal drink, or (3) placebo were provided before bed in a double-blinded manner. Polysomnography was utilised to measure sleep architecture. Cognitive performance, postural sway, and subjective sleep quality, were assessed 30 min after waking. Results: The optimal drink resulted in a significantly shorter sleep onset latency (9.9 ± 12.3 min) when compared to both the least optimal drink (26.1 ± 37.4 min) and the placebo drink (19.6 ± 32.0 min). No other measures of sleep, cognitive performance, postural sway, and subjective sleep quality were different between trials. Conclusion: A combination of ingredients, optimised to enhance sleep, significantly reduced sleep onset latency. No detrimental effects on sleep architecture, subjective sleep quality or next day performance were observed.

BackgroundInsomnia is a major public health problem in western countries. Previous small pilot studies showed that the administration of constant white noise can improve sleep quality, increase acoustic arousal threshold, and reduce sleep onset latency. In this randomized controlled trial, we tested the effect of surrounding broadband sound administration on sleep onset latency, sleep architecture, and subjective sleep quality in healthy subjects.MethodsEighteen healthy subjects were studied with two overnight sleep studies approximately one week apart. They were exposed in random order to normal environmental noise (40.1 [1.3] dB) or to broadband sound administration uniformly distributed in the room by two speakers (46.0 [0.9] dB). To model transient insomnia, subjects went to bed (“lights out”) 90 min before usual bedtime.ResultsBroadband sound administration reduced sleep onset latency to stage 2 sleep (time from lights out to first epoch of non-rapid eye movement-sleep stage 2) (19 [16] vs. 13 [23] min, p = 0.011; median reduction 38% baseline). In a subgroup reporting trouble initiating sleep at home (Pittsburgh Sleep Quality Index section 2 score ≥ 1), sound administration improved subjective sleep quality (p = 0.037) and the frequency of arousals from sleep (p = 0.03).ConclusionIn an experimental model of transient insomnia in young healthy individuals, broadband sound administration significantly reduced sleep onset latency by 38% compared to normal environmental noise. These findings suggest that broadband sound administration might be helpful to minimize insomnia symptoms in selected individuals.

Objectives: Emerging work suggests that racism-related stressors may contribute to adverse sleep health, yet little is known about how culturally relevant resources may influence the relationship between racism-related stressors and adverse sleep health. The aim of this study was to examine associations between weekly reports of racial hassles and young adults' sleep health (i.e., sleep onset latency, total sleep time, sleep quality) and to determine whether various forms of parental ethnic-racial socialization would moderate these associations., Methods: Participants were 141 college students (M age = 20.7 years, standard deviation (SD) = 1.22, 70% female) who identified as either Black (n = 88; 62.4%) or Latinx (n = 53; 37.6%). Participants completed an initial 1.5-hour assessment in the laboratory and 4 weekly sleep diary surveys (assessed sleep health and depressive symptoms)., Results: Weekly racial hassles are related to greater sleep onset latency, decreased total sleep time, and poorer sleep quality. The promotion of mistrust and cultural socialization significantly moderated associations between weekly racial hassles and sleep onset latency and total sleep time, respectively., Conclusions: These results provide supportive evidence that parental ethnic-racial socialization practices, a preemptive cultural resource, may be an understudied mechanism in sleep health research. Future research is needed to clarify the role of parental ethnic-racial socialization in promoting sleep health equity among youth and young adults., (Copyright © 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)