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The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p =.01), nitric oxide (p =.01), and maximal oxygen uptake (VO2max; p =.002) increased, and glucose (p =.001), insulin (p =.001), insulin resistance (p =.01), systolic blood pressure (p =.01), and sleep disorders (p =.01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p =.01 and r = −.55) and glucose (p =.01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Purpose: Prediction of athlete wellness is difficult—or, many sports-medicine practitioners and scientists would argue, impossible. Instead, one settles for correlational relationships of variables gathered at fixed moments in time. The issue may be an inherent mismatch between usual methods of data collection and analysis and the complex nature of the variables governing athlete wellness. Variables such as external load, stress, muscle soreness, and sleep quality may affect each other and wellness in a dynamic, nonlinear, way over time. In such an environment, traditional data-collection methods and statistics will fail to capture causal effects. If we are to move this area of sport science forward, a different approach is required. Methods: We analyzed data from 2 different soccer teams that showed no significance between player load and wellness or among individual measures of wellness. Our analysis used methods of attractor reconstruction to examine possible causal relationships between GPS/accelerometer-measured external training load and wellness variables. Results: Our analysis showed that player self-rated stress, a component of wellness, seems a fundamental driving variable. The influence of stress is so great that stress can predict other components of athlete wellness, and, in turn, self-rated stress can be predicted by observing a player's load data. Conclusion: We demonstrate the ability of nonlinear methods to identify interactions between and among variables to predict future athlete stress. These relationships are indicative of the causal relationships playing out in athlete wellness over the course of a soccer season. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods: Sleep was assessed for a minimum of 25 nights (range = 25–31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results: There was a significant relationship between sleep duration and the day of the menstrual cycle (P =.042) and total symptoms reported that day (P <.001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P =.004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P =.950), wake after sleep onset (P =.217), and subjective sleep quality (P =.080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P =.220), subjective sleep quality (P =.502), or sleep latency (P =.740) but did significantly relate to wake after sleep onset (P <.001), with a significant day × symptom interaction (P <.001). Conclusions: Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics. [ABSTRACT FROM AUTHOR]

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]

Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate acute psychophysiological responses to repeated-sprint training in hypoxia (RSH) combined with whole-body cryotherapy (WBC). Method: Sixteen trained cyclists performed 3 sessions in randomized order: RSH, WBC-RSH (WBC pre-RSH), and RSH-WBC (WBC post-RSH). RSH consisted of 3 sets of 5 × 10-second sprints with 20-second recovery at a simulated altitude of 3000 m. Power output, muscle oxygenation (tissue saturation index), heart-rate variability, and recovery perception were analyzed. Sleep quality was assessed on the nights following test sessions and compared with a control night using nocturnal ActiGraphy and heart-rate variability. Results: Power output did not differ between the conditions (P =.27), while the decrease in tissue saturation index was reduced for WBC-RSH compared to RSH-WBC in the last set. In both conditions with WBC, the recovery perception was higher compared to RSH (WBC-RSH: +15.4%, and RSH-WBC: +21.9%, P <.05). The number of movements during the RSH-WBC night was significantly lower than for the control night (−18.7%, P <.01) and WBC-RSH (−14.9%, P <.05). RSH led to a higher root mean square of the successive differences of R-R intervals and high-frequency band during the first hour of sleep compared to the control night (P <.05) and RSH-WBC (P <.01). Conclusions: Inclusion of WBC in an RSH session did not modify the power output but could improve prolonged performance in hypoxia by maintaining muscle oxygenation. A single RSH session did not deteriorate sleep quality. WBC, particularly when performed after RSH, positively influenced recovery perception and sleep. [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 investigate the influence of menstrual-cycle (MC) phase on measures of recovery status, that is, resting heart rate, perceived sleep quality, and physical and mental readiness to train, among female endurance athletes. Methods: Daily data were recorded during 1 to 4 MCs (ie, duration ≥21 and ≤35 d, ovulatory, luteal phase ≥10 d) of 41 trained-to-elite-level female endurance athletes (mean [SD]: age 27 [8] y, weekly training: 9 [3] h). Resting heart rate was assessed daily using a standardized protocol, while perceived sleep quality and physical and mental readiness to train were assessed using a visual analog scale (1–10). Four MC phases (early follicular phase [EFP], late follicular phase, ovulatory phase, and midluteal phase [MLP]) were determined using the calendar-based counting method and urinary ovulation-prediction test. Data were analyzed using linear mixed-effects models. Results: Resting heart rate was significantly higher in MLP (1.7 beats·min−1, P =.006) compared with EFP without significant differences between the other MC phases. Perceived sleep quality was impaired in MLP compared with late follicular phase (−0.3, P =.035). Physical readiness to train was lower both in ovulatory phase (−0.6, P =.015) and MLP (−0.5, P =.026) compared with EFP. Mental readiness to train did not show any significant differences between MC phases (P >.05). Conclusions: Although significant, the findings had negligible to small effect sizes, indicating that MC phase is likely not the main determinant of changes in measures of recovery status but, rather, one of the many possible stressors. [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]

Purpose: To examine the effect of match schedule on self-reported wellness and sleep in rugby union referees during the 2019 Rugby World Cup. Methods: Following an observational design, 18 international-level male referees participating in the 2019 Rugby World Cup completed a daily questionnaire to quantify wellness status (sleep quality, mood, stress, fatigue, muscle soreness, and total wellness) and sleep characteristics (bedtime, wake-up time, and time in bed) from the previous night across the tournament. Linear mixed models and effect sizes (Hedges gav) assessed differences in wellness and sleep characteristics between prematch and postmatch days surrounding single-game and 2-game congested match schedules (prematch1, postmatch1, prematch2, and postmatch2 days). Results: During regular schedules, all self-reported wellness variables except stress were reduced (gav = 0.33–1.05, mean difference −0.32 to −1.21 arbitrary units [AU]) and referees went to bed later (1.08, 1:07 h:min) and spent less time in bed (−0.78, 00:55 h:min) postmatch compared with prematch days. During congested schedules, only wellness variables differed across days, with total wellness reduced on postmatch1 (−0.88, −3.56 AU) and postmatch2 (−0.67, −2.70 AU) days, as well as mood (−1.01, −0.56 AU) and fatigue (−0.90, −1.11 AU) reduced on postmatch1 days compared with prematch days. Conclusion: Referees were susceptible to acute reductions in wellness on days following matches regardless of schedule. However, only single-game regular match schedules negatively impacted the sleep characteristics of referees. Targeted strategies to maximize wellness status and sleep opportunities in referees considering the match schedule faced should be explored during future Rugby World Cup competitions. [ABSTRACT FROM AUTHOR]

Summary The decrease in sleep quality leads to an increased risk of cardiovascular disease and is closely related to the prognosis of various diseases. However, the relationship between preoperative sleep quality and postoperative clinical outcomes in patients with acute aortic dissection is still unclear. We aimed to assess the relationship between sleep quality and the clinical outcomes of acute aortic dissection. We assessed participants' sleep quality and the clinical outcomes of acute aortic dissection, which included prolonged mechanical ventilation, postoperative delirium, in‐hospital death, continuous renal replacement therapy, intensive care unit stay time, and length of stay. Patients were divided into good sleep quality group (n = 103) and poor sleep quality group (n = 113). Postoperative delirium, in‐hospital death, prolonged mechanical ventilation and intensive care unit stay time were significantly increased in the poor sleep quality group when compared with the good sleep quality group (p < 0.05). Multivariate regression analysis showed that the poorer sleep quality, the greater the risk of in‐hospital death (odds ratio = 3.451, 95% confidence interval 1.19–10.004) and prolonged mechanical ventilation (odds ratio = 6.302, 95% confidence interval 3.105–12.791), and the longer intensive care unit stay time (β = 62.37, 95% confidence interval 22.411–102.329). In addition, the higher the incidence of smoking history (odds ratio = 7.417, 95% confidence interval 2.425–22.684), poor sleep quality (odds ratio = 11.59, 95% confidence interval 3.844–34.942) and postoperative delirium (odds ratio = 5.1, 95% confidence interval 1.793–14.504), the greater the risk of prolonged mechanical ventilation. Our findings revealed that poor sleep quality may be a risk factor for adverse clinical outcomes of acute aortic dissection. Rapid assessment of self‐reported sleep quality may be a simple and effective way to identify patients with acute aortic dissection who are at high risk for prolonged mechanical ventilation. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is prevalent in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Although biological treatment has been shown to improve overall patient-reported sinonasal symptoms in CRSwNP, the treatment impact on individual sleep quality remains less explored. The purpose of this study is to investigate the effect of dupilumab treatment on sleep quality in patients with CRSwNP. Methods: A single-institutional, retrospective chart review was conducted on adult patients who received biological treatment (dupilumab) for CRSwNP. Patients' condition was assessed before treatment and 3–12 months after continuous treatment. The assessment included the 22-item Sino-Nasal Outcome Test (SNOT-22), Nasal Obstruction Symptom Evaluation (NOSE) scale, Nasal Polyp Score (NPS), as well as perception for anosmia and hyposmia using Visual Analog Scale (VAS) for smell. Sleep-related symptoms and treatment outcomes were assessed using the Pittsburg sleep quality index (PSQI) global score, sleep domain questions within SNOT-22, and sleep-related question in the NOSE scale. Subjects with a PSQI global score of > 5 were considered poor sleepers. Results: A total of 15 charts were included in this study. There were 12 males (80%) and 3 females (20%). Sixty percent of them were having bronchial asthma. The mean follow-up duration was around 6.7 months. The patients showed significant improvement in nasal assessment using the median values for SNOT-22, NOSE scale, NPS, and VAS for smell (P-value ≤ 0.001). As well, there was a significant improvement in the median scores for global PSQI, sleep domain questions within SNOT-22, and sleep-related question in the NOSE scale (P-value 0.04, < 0.001, and 0.001, respectively). Eight subjects (53.3%) had poor sleep quality before treatment. Four out of them improved from being poor sleepers to good sleepers after using the treatment. Conclusion: This study indicates that dupilumab is an effective treatment for CRSwNP and it improves sleep quality parameters in some patients. [ABSTRACT FROM AUTHOR]

Background: Recent research has shown significant individual differences in COVID-19 psychosomatic symptoms. However, there has been a lack of studies investigating the influence of physical and psychological factors on these symptoms and their underlying mechanisms. This study aims to fill this gap by investigating the predictive role of self-compassion and social support on COVID-19 psychosomatic symptoms, as well as the potential mediating role of sleep quality. Methods: Data were collected from 636 participants infected with COVID-19 during the early post-pandemic reopening phase in China. The measurement tools used in the current study included the Self-Compassion Scale, the Perceived Social Support Scale, Self-Rating Scale of Sleep, and a COVID-19 Psychosomatic Symptom Diary. Results: A structural equation model revealed that: (1) social support directly predicts COVID-19 psychosomatic symptoms; (2) sleep quality fully mediates the relationship between self-compassion and COVID-19 psychosomatic symptoms; and (3) sleep quality partially mediates the relationship between social support and COVID-19 psychosomatic symptoms. Conclusions: These findings not only confirm previous research but also provide new insights into the intricate interplay between psychological and physical factors and their influence on COVID-19 psychosomatic symptoms. The implications of these findings may inform the development of targeted rehabilitation programs in the post-pandemic era of the "new normal". Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Anxiety is being increasingly linked to circadian rhythms, including chronotype, in addition to its intricate links with sleep quality. Emotional competence is thought to be a strong predictor of wellbeing and mental health. This study aimed to examine whether a combination of chronotype, sleep quality, and intrapersonal emotional competence can predict anxiety in emerging adults (aged 18–29), who have the greatest prevalence of adult anxiety. One hundred and seventeen participants completed self-report measures of chronotype, sleep quality, emotional competence, and anxiety. A multiple linear regression, with anxiety as the criterion variable, showed that while all predictors were significant, sleep quality was the strongest predictor of anxiety. A later chronotype, poorer sleep quality and lower intrapersonal emotional competence were related to higher anxiety. Thus, integrating intrapersonal emotional competence and chronotype considerations into interventions may address the interplay between sleep quality and anxiety in emerging adults more effectively. [ABSTRACT FROM AUTHOR]

Using the Broaden and Build theory, this study examines the relationship between servant leadership and flow and the mechanisms through which the relationship takes place (i.e. meaningfulness, empowerment, and sleep quality). A diary study was conducted in 2021 among 175 employees in three companies in China who completed two daily surveys for five days, one in the morning and one in the evening. While this design precludes causal inferences, the results show that people’s sense of meaningfulness is enhanced through servant leadership, which encourages a positive spiral that makes one more perceptive to a leader’s encouraging behavior, contributing to a greater experience of empowerment and flow. The study finds that servant leadership positively influences sleep quality, which is related to more psychological empowerment. This study expands our understanding of the impact of servant leadership on employees’ well-being and the interconnections among servant leadership, meaningfulness, empowerment, sleep quality, and flow. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Methods and Results Conclusions This study aimed to determine the relationship between sleep problems, shock pain, and shock anxiety in patients with implantable cardioverter defibrillator (ICD) and the affecting factors.The population of this descriptive cross‐sectional study consisted of all patients who underwent ICD implantation in university hospital (N = 200), and the sample consisted of patients who met the inclusion criteria of the study (n = 132). Data were obtained using a “General Information Form”, the “Florida Shock Anxiety Scale (FSAS)”, the “Epworth Sleepiness Scale (ESS)”, the “Pittsburgh Sleep Quality Index (PSQI)”, and the “Visual Pain Scale (VPS)”. The mean age of the patients was 66.13 years. The VPS was 6.40 ± 3.36; the mean FSAS score was 29.98 ± 8.46; the mean PSQI score was 8.02 ± 3.81; the mean ESS score was 7.59 ± 4.10. PSQI had a statistically significant correlation with the total FSAS score (p < 0.001) and a statistically insignificant correlation with ESS (p > 0.001). Age, sex, marital status, smoking status, cohabitants, previous ICD shocks, the status of lying on ICD, and fear of dislocation of ICD affected the total FSAS score; sex, employment status, history of heart attack, defined sleep disorder, awakening from sleep due to nightmares, and cessation of breathing during sleep affected the total PSQI score; history of previously defined sleep disorder, history of heart attack, use of medication for a sleep disorder, the pain felt when lying on ICD, and pain experienced during ICD shocks affected the total ESS score. The mean shock VPS scores differed between patients who received an ICD shock during sleep and those who were awakened by nightmares.It was found that the shock anxiety and shock pain scores of ICD patients were above average, that they had poor sleep quality, and that their sleepiness was at the level of “normal but increased daytime sleepiness”. [ABSTRACT FROM AUTHOR]

Summary Prior studies evaluating sleep quality have found that women often have better polysomnography‐defined sleep quality than men, but women subjectively report a greater frequency of sleep disturbances. Although these studies can be partially attributed to study design, it is currently unclear what may be causing these discrepancies. In this study, we aim to identify potential differences in objectively assessed sleep quality between men and women with further emphasis on subgroup analysis based on age. We hypothesize that women's sleep worsens after menopause. Sleep quality was assessed by comparing the Sleep Quality Index, Arousal Index, sleep efficiency and apnea–hypopnea index, as provided by the SleepImage Ring@ 2.3.0, between men and women, with a sub‐group analysis performed by age (18–40 years, 41–50 years, 51–60 years, 61–70 years, and > 70 years), run separately for women and men. In total, 1444 subjects (704 women and 740 men) with a mean age of 53.6 ± 14.71 years were enrolled in this analysis. In women, a significant drop in Sleep Quality Index was noted after age 51 years. Regression analysis demonstrated that age, Arousal Index, sleep efficiency and apnea–hypopnea index correlated significantly with Sleep Quality Index – with age, Arousal Index and apnea–hypopnea index negatively correlated, and sleep efficiency positively correlated. The highest correlation coefficient was obtained for Arousal Index in both women and men. In women, age older than 50 years was associated with a more rapid decrease of sleep quality than men, as defined by an increase in Arousal Index and apnea–hypopnea index with a concurrent decrease in Sleep Quality Index. [ABSTRACT FROM AUTHOR]

Literature exists on the relationship between the menstrual cycle and athletic performance among female athletes. Psychological changes during phases are also investigated by researchers, yet such changes need further examination. Therefore, the purpose of this study is to simultaneously investigate perceptions of flag football players towards pre- and post-training psychophysilogical variables in different phases. In total, 19 participants filled out a survey battery for 30 days which included items regarding pre-training (fatigue, sleep quality, muscle soreness, stress, mood, training motivation) and post-training (rate of perceived exertion, and training enjoyment) variables. These variables were compared across 3 phases (menstruation, follicular, and luteal) using one-way repeated-measures analysis of variance. Results showed no significant difference between different phases in terms of the study variables, allowing coaches to plan training programs without changing them according to menstrual cyles. However, it is important to consider individual differences and constantly monitor the well-being of athletes. . [ABSTRACT FROM AUTHOR]

Sleep quality, chronotype, and mood may be closely interconnected processes. Typically, such constructs are measured independently, leaving out important information regarding their intrinsic relationships. The Sleep, Circadian Rhythms, and Mood (SCRAM) questionnaire is a promising tool for measuring sleep, chronotype, understood as diurnal preference, and depressive symptomatology, and the interrelationships between them. Anxiety has also been linked to sleep quality, chronotype, and depression, but there is currently no scale that measures these constructs together. This study aims to validate a revised version of the SCRAM questionnaire (rSCRAM), incorporating items to measure anxious mood. 486 Italian participants were involved in two studies. In Study 1, principal component analysis (PCA) identified representative anxiety elements from validated questionnaires. In Study 2, after adding the anxiety elements, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) established a 4-factor, 16-item model. The rSCRAM demonstrated excellent psychometric properties: high internal consistency (α = 0.72–0.90) and a strong test-retest reliability of the scales over 2 weeks (r = 0.73–0.82), a high correlation for convergent validity, and low correlations for divergent validity. The rSCRAM questionnaire measures the constructs for which it was created and revised. Including the anxiety scale enhances its utility in assessing mental health constructs within a single instrument. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease (CKD) is a pervasive disease of the current century that usually affects the adult population, especially people with diabetes and hypertension. According to the recent studies, inflammation, oxidative stress, apoptosis, and mitochondrial dysfunction are determining risk factors in the pathogenesis of CKD. Melatonin as a strong antioxidant is produced in various tissues including the kidneys. The present clinical trial aims to examine the efficacy of melatonin supplementation on metabolic parameters, oxidative stress, and inflammatory biomarkers in diabetic patients with CKD. Methods: This is a double-blind, randomized, placebo-controlled clinical study that will be investigated the impacts of melatonin supplementation in diabetic patients with CKD. Laboratory findings will be applied to diagnose diabetic CKD. Forty-eight eligible diabetic subjects with CKD will be selected and randomly assigned to receive 5 mg melatonin tablets or identical placebo twice daily for 10 weeks. Participants will be asked to remain on their usual diet and physical activity. The primary outcome of this study is changes in oxidative stress and inflammatory biomarkers. The secondary outcomes include changes in lipid profile, renal function indicators, fasting blood sugar and serum insulin, systolic and diastolic blood pressure (SBP and DBP), serum phosphorous concentration, sleep quality, body weight, body mass index (BMI), and waist circumference (WC). Statistical analysis will be conducted using the SPSS software (version 25). Discussion: We hypothesize that melatonin administration may be useful for treating diabetic CKD by modulating oxidative stress, inflammation, regulating lipid metabolism, and increasing insulin sensitivity through different mechanisms. The current trial will exhibit the effects of melatonin, whether negative or positive, on diabetic CKD status. Ethical aspects: The current trial received approval from Medical Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran (IR.TUMS.SHARIATI.REC.1402.072). Trial registration: This study had been registered in Iranian Registry of Clinical Trials. Registration number: IRCT20170202032367N9 on 11 August 2023. https://www.irct.ir/trial/70709. [ABSTRACT FROM AUTHOR]

Purpose: Fibromyalgia is a chronic disease that mainly affects women, deteriorating the quality of life of these patients. Resistance exercise (RE) has been shown to be beneficial in this disease. The objective of this study is to evaluate the effectiveness of RE for depression, fatigue, and sleep quality in women with fibromyalgia. Design and Methods: A systematic review with meta‐analysis was conducted until September 1, 2024. Seven databases were searched as follows: PubMed, Cochrane Library, Web of Science, Scopus, Physiotherapy Evidence Database, Dialnet, and Cumulative Index to Nursing and Allied Health Literature. Randomized clinical trials were conducted in women with a diagnosis of fibromyalgia, including RE as the only intervention in any of the groups and to assess depression, fatigue, and sleep quality. For meta‐analyses, we calculated the standardized difference of means and its standard error. A random‐effects model was used. The risk of bias was assessed using the Cochrane risk‐of‐bias tool for randomized trials (RoB 2). PROSPERO Registration: CRD42021256162. Findings: Eleven trials were included in the systematic review and eight in the meta‐analysis (n = 664). RE showed statistically significant improvements in depression (SMD = −0.54; 95% CI [−0.92, −0.16], p = 0.005) and fatigue (SMD = −0.83; 95% CI [−1.41–0.25], p = 0.005). No significant differences were found in sleep quality (SMD = −0.99; 95% CI [−2.40, 0.43], p = 0.17). In general, the methodological quality of the included trials was good. Practice Implication: RE is an effective tool to improve depression and fatigue in women with fibromyalgia, achieving clinically relevant improvements of more than 50% in symptoms related to depression. RE did not show benefits for sleep quality, although this finding may be due to a lack of studies. More studies are needed to determine the effectiveness of RE on sleep quality. [ABSTRACT FROM AUTHOR]

Background: Transcranial direct current stimulation (tDCS) might modulate neural activity and promote neural plasticity in patients with fibromyalgia (FM). This multi-group randomized clinical trial compared home-based active tDCS (HB-a-tDCS) on the left dorsolateral prefrontal cortex (l-DLPFC) or home-based sham tDCS (HB-s-tDCS), and HB-a-tDCS or HB-s-tDCS on the primary motor cortex (M1) in the connectivity analyses in eight regions of interest (ROIs) across eight resting-state electroencephalography (EEG) frequencies. Methods: We included 48 women with FM, aged 30 to 65, randomly assigned to 2:1:2:1 to receive 20 sessions during 20 minutes of HB-a-tDCS 2mA or HB-s-tDCS, over l-DLPFC or M1, respectively. EEG recordings were obtained before and after treatment with eyes open (EO) and eyes closed (EC). Results: In the EC condition, comparing pre to post-treatment, the HB-a-tDCS on l-DLPFC decreased the lagged coherence connectivity in the delta frequency band between the right insula and left anterior cingulate cortex (ACC) (t = -3.542, p =.048). The l-DLPFC HB-a-tDCS compared to HB-s-tDCS decreased the lagged coherence connectivity in the delta frequency band between the right insula and left ACC (t = -4.000, p =.017). In the EO condition, the l-DLPFC HB-a-tDCS compared to M1 HB-s-tDCS increased the lagged coherence connectivity between the l-DLPFC and left ACC in the theta band (t = -4.059, p =.048). Regression analysis demonstrated that the HB-a-tDCS effect on the l-DLPFC was positively correlated with sleep quality. On the other hand, the HB-a-tDCS on l-DLPFC and HB-s-tDCS on M1 were positively correlated with pain catastrophizing. Conclusions: These results show that HB-a-tDCS affects the neural connectivity between parts of the brain that control pain's emotional and attentional aspects, which are most noticeable at lower EEG frequencies in a rest state. This effect on neural oscillations could serve as a neural marker associated with its efficacy in alleviating fibromyalgia symptoms. Clinical trial registration: identifier [NCT03843203]. [ABSTRACT FROM AUTHOR]

Background: Both night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia. Case presentation: The current paper presents a case report of a Dutch woman in her 40's receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course of treatment, cognitive behavioral therapy-insomnia interventions were also implemented. Her comorbid complaints were insomnia, childhood trauma, a depressive mood disorder, and cluster B and C personality traits. She had a history of bariatric surgery, as well as alcohol addiction, and received various treatments in the past, aiming to become abstinent from binge eating. Conclusions: Post-treatment, she was abstinent from binge eating and, her scores of various eating disorder measures were below clinical cut-points. However, it is unclear if she would show earlier symptom reduction if she received cognitive behavioral therapy-insomnia, prior to cognitive behavioral therapy-enhanced. In addition, the patient reported an increase in her depressive mood and commenced schema therapy after cognitive behavioral therapy- enhanced. Although common, the underlying cause of symptom shifts in patients with an eating disorder remains largely unknown. [ABSTRACT FROM AUTHOR]

Summary Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single‐arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post‐trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real‐world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions. [ABSTRACT FROM AUTHOR]

Aim Methodology Results Conclusion Lifestyle factors significantly influence the development of inflammatory diseases, and emerging evidence suggests they may also impact oral health. However, no studies have explored their role in apical periodontitis (AP) amongst adults. This study aimed to assess the association between adherence to the Mediterranean diet (MD), physical activity, perceived stress, and sleep quality with the periapical and caries status in a university‐based cohort.A total of 149 periodontally healthy patients were included in the study. Clinical assessments and radiographic examinations [Orthopantomography (opt) and periapical radiographs] were conducted to evaluate the periapical status. Data on their periapical index (PAI) score and the decayed, missing and filled teeth (DMFT) index were recorded. Validated questionnaires were used to investigate patient's lifestyles. A final logistic regression model was performed for the multivariable analysis to evaluate the predictive ability of adherence to Mediterranean lifestyle on the presence of AP; other local, systemic and environmental factors were included as independent factors in the model.Significant associations were observed between AP and high/low adherence to the MD (p = .00), high/low‐moderate physical activity (p = .00), high/low sleep quality (p = .00) and high/low perceived stress (p = .00). The final multivariable regression model showed that low adherence to MD (OR = 3.68; 95% confidence interval [CI]: 1.24–10.83; p = . 01) and reduced sleep quality (OR = 3.04; 95% CI: 1.42–6.50; p = .00) were identified as potential risk factors for AP development. On the other hand, the DMFT index showed no significant association with lifestyle factors (OR = 1.0; CI: 1.01–1.14; p = .02) but was correlated with the development of AP (OR = 1.07; CI: 1.01–1.14; p = .02).Results from the present study suggest a potential association between low adherence to MD and reduced sleep quality with the development of AP. Individuals with low adherence to MD and inadequate sleep quality faced respectively 4‐fold and 3‐fold increased odds of developing periapical lesions. Further research is essential to elucidate the causal mechanisms underlying these associations and to determine whether lifestyle adjustments could improve endodontic success rate. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionWe investigated the relationship between irregular sleep-wake patterns and other aspects of sleep and mental health among adolescents.Community-based sample of adolescents (n = 200, mean age 16.8; 61.7% female) completed baseline assessment (i.e. sleep quality, daytime sleepiness, depressive symptoms, social anhedonia, problematic alcohol use), and 7–8 consecutive days of wearing wrist actigraphy. Irregular sleep-wake patterns were assessed via two methods, both based on actigraphy, to capture day-to-day irregularity (intraindividual variability, IIV) and weekly irregularity (social jet lag, SJL). The Bayesian variability method was performed to calculate IIV in total sleep time (TST), sleep onset, and offset time. SJL was quantified as the actual difference in the sleep midpoint on school days versus non-school days.Greater IIV in TST was associated with poorer sleep quality (B = 1.66, 95% CI, 0.14, 3.31, p < .05), and greater depressive symptoms (B = 0.72, 95% CI, 0.17, 1.35, p < .05), while greater IIV in sleep offset time was associated greater depressive symptoms (B = 0.63, 95% CI, 0.03, 1.28, p < .05), and greater problematic alcohol use (B = 0.70, 95% CI, 0.12, 1.35, p < .05), all after adjusting for age, sex, family SES, alcohol drinks, and SJL. No significant association was found with sleep onset time. Greater SJL was associated with poorer sleep quality (B = 0.40, 95% CI, 0.27, 0.54, p < .001) and fewer problematic alcohol uses (B = −0.05, 95% CI, −0.09, −0.00, p < .05), when adjusting for age, sex, family SES, and alcohol drinks.Our findings add to a growing body of research on irregularity in sleep-wake patterns and clinical implications. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusions Impact Patient or Public Contribution To explore the stability of resilience among frontline nurses and to analyse the predictive role of internal and external factors on the patterns of resilience transformation in China during public health emergencies.The study used a longitudinal design and surveyed 258 frontline nurses at three different time points: February–March 2020 (T1), May–June 2020 (T2) and May–June 2022 (T3). The survey included the 10‐item Connor–Davidson resilience scale, the Emotion Regulation Questionnaire and the Simple Coping Style Questionnaire. Latent profile analysis and latent transition analysis were used to examine the potential classes and changes. Multivariate logistic regression analysis was applied to evaluate the predictors of resilience transitions.The resilience of frontline nurses was divided into three categories: fragile group, general group and high resilience group. From T1 to T2, the general group exhibited the least stability, with a probability of maintaining its original latent state at 72.9%. Marriage and positive coping styles significantly impacted the transition between resilience categories. From T2 to T3, the fragile group showed the lowest stability, with a 74.9% likelihood of retaining its initial latent state. In this context, supportive hospital management (including psychological counselling, restful environments, and both spiritual and material incentives) and individuals' emotional regulation and sleep quality significantly affected the transition between resilience categories.These findings emphasise the necessity for early intervention. For frontline nurses, conducting initial assessments of resilience coupled with sustained hospital support is crucial for maintaining mental health and improving the quality of nursing care in public health emergencies.This study offers a fresh perspective for understanding the resilience of frontline nurses during public health emergencies. At the same time, it reveals the factors that promote or hinder the change in resilience among frontline nurses at both individual and organisational levels. This provides a theoretical basis for future resilience interventions and helps us formulate effective crisis management strategies to respond to future public health emergencies. For frontline nurses with diverse resilience characteristics and relevant transformation factors, a personalised multi‐mode resilience improvement plan can be developed to mitigate public health emergencies' potential adverse psychological impact on frontline nurses, especially those in the fragile group.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is known to cause psychological problems. Psychological rehabilitation can be performed to reduce anxiety, depression, and insomnia. Facing patients with infectious diseases can be difficult for medical staff. Therefore, this study compared the effects of psychiatric tele-rehabilitation (TR) and conventional psychiatric rehabilitation (CR) in isolated patients with COVID-19. Methods: This randomized controlled study, conducted at a single community-based hospital, included 40 patients (24 in the psychiatric tele-rehabilitation group [TRG] and 16 in the conventional psychiatric rehabilitation group [CRG]) with COVID-19 were recruited from November 18, 2021, to April 7, 2022. Psychiatric rehabilitation is an occupation-based intervention in which patients perform meaningful activities and tasks. Patients in the TRG selected activities, received counseling, and underwent monitoring over the phone, while those in the CRG participated in face-to-face sessions. The interventions were conducted for 50 min each day during an isolation period of 7 days in both groups, and all participants received the interventions individually. The primary outcome was anxiety assessed using the Visual Analog Scale (VAS) and the Zung Self-Rating Anxiety Scale (SAS). Secondary outcomes include the Visual Analog Scale (VAS) and the Patient Health Questionnaire-9 (PHQ-9) to evaluate depression, the Multidimensional State Boredom Scale-8 (MSBS-8) to assess boredom. The Korean version of the Insomnia Severity Index (ISI-K) was used to assess the quality of sleep, and the World Health Organization Quality of Life Assessment Instrument-BRIEF (WHOQOL-BREF) was used to evaluate quality of life. Questionnaires were administered at admission, discharge, and at the 6-month follow-up. Results: In the time × group analysis, the SAS total score (p =.033) and the VAS score for depression (p =.012) in the CRG were significantly lower than those in the TRG at the time of discharge. The VAS score for anxiety (p =.007), total SAS score (p =.050), and VAS score for depression (p =.003) in the CRG were also significantly lower than those in the TRG at the 6-month follow-up. The PHQ-9, MSBS-8, ISI-K, and WHOQOL-BREF scores showed no significant interactions in the time × group analysis. Conclusions: TR was effective in reducing anxiety and improving quality of life during hospitalization, but had no remained effects after discharge. Otherwise, CR was more effective than TR for anxiety and depression during hospitalization and had remained effects at 6-month follow-up. However, considering the characteristics of infectious conditions that involve risk in contact, TR will still play an important role, and efforts will be needed to improve the effect that remained. Trial registration: The trial was registered with the Korea Clinical Trials Registry (KCT0006714, Date of registration 08/11/2021). [ABSTRACT FROM AUTHOR]

Background: Social anxiety symptoms are common and harmful psychological illness in college students. Although some studies have illustrated that physical activity could reduce social anxiety symptoms, the specific mechanism is still unclear. Based on theoretical studies on resilience and sleep, this study constructed a serial mediation model to explore whether they mediate between physical activity and social anxiety symptoms among college students. Methods: This study surveyed 9,530 college students from three colleges in China to explore the mediating effect of physical activity and sleep problems between physical activity and social anxiety symptoms. Participants were investigated with the International Physical Activity Questionnaire, Connor-Davidson Resilience Scale, Sleep-related problems, and the Social Interaction Anxiety Scale and the Social Phobia Scale. Correlations between variables were analysed using Pearson correlation analysis and mediation analyses were performed using SPSS PROCESS macro 3.3 software. Result: The study found that physical activity was negatively associated with social anxiety symptoms and sleep problems, but positively with psychological resilience. After controlling for sociodemographic variables, physical activity can not only indirectly alleviate social anxiety symptoms through the separate mediation of psychological resilience and sleep problems, but also through the serial mediation of psychological resilience and sleep problems. Conclusion: These results suggest that improving physical activity levels could reduce social anxiety scores by increasing psychological resilience and sleep quality. This is of great reference significance for the prevention and intervention of college students' mental health. [ABSTRACT FROM AUTHOR]

Background: Evidence-based guidelines advocate promoting sleep in intensive care unit (ICU) patients, yet many patients experience poor sleep quality. We sought to develop a collaborative evidence-based intervention with healthcare providers and assess whether evidence-based sleep interventions could improve sleep quality in awake adult ICU patients. Methods: We conducted a prospective, nonrandomized cluster control trial in two intensive care units (ICUs) at a tertiary general teaching hospital in China. Patients aged 18 years or older who stayed in the ICU for one night or more and were conscious were eligible for enrollment. We only blinded the patients, not the outcome assessors. On the basis of evidence-based practice and clinical reality, we developed intervention measures for the intervention group, which mainly included four aspects: reducing environmental noise in the ICU, adjusting nursing actions, modifying nighttime lighting, and other measures. The assessment tools used were wearable actigraphy sleep monitoring devices and the Richards-Campbell Sleep Questionnaire (RCSQ). The primary outcomes were patient sleep quality, including total sleep time, deep sleep time, light sleep time, rapid eye movement (REM) time, number of awakenings, overall sleep score, and patients' self-assessment of their sleep quality that night. The data collected were analyzed via SPSS and Mplus statistical software for between-group analysis, pre-post comparison, profile analysis, and calculation of the intervention effect size. Results: From September 1, 2023, to January 31, 2024, 713 patients underwent eligibility assessment, and ultimately 246 patients were included in the analysis, with 125 in the intervention group and 121 in the control group. Comparative analysis revealed no statistically significant differences in sleep quality between the two groups when the duration in the ICU = 1 night (P > 0.05), with a small intervention effect size. However, the intervention group had higher sleep quality scores (sleep monitoring wristband: 57.74 ± 22.55 > 57.72 ± 19.39; RCSQ questionnaire: 60.58 ± 22.14 > 57.61 ± 24.4) and total sleep time (440.42 ± 262.11 > 420.31 ± 236.89), a lower awakening frequency (3.98 ± 2.69 < 6.09 ± 4.66) and a lower awakening frequency (3.976 ± 2.693 < 6.09 ± 4.664) than did the control group. The sleep quality of patients who stayed in the ICU for > 1 night significantly improved in all the parameters except rapid eye movement time (min) according to the pre-post-test analyses (P < 0.05), with a medium to large intervention effect size and favorable intervention effects. Conclusion: Evidence-based interventions significantly improve sleep quality in ICU patients hospitalized for more than one day. However, our results do not support the improvement of sleep quality in patients admitted to the ICU for one day. Clinical trial registration: ChiCTR2300075763, Registered 14 September 2023—Retrospectively registered, https://www.chictr.org.cn/bin/userProject [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients have a heightened susceptibility to anxiety and depressive disorders, which significantly impact the effectiveness of cancer treatments and long-term quality of life. This study aimed to compare the efficacy of different antidepressants in cancer and non-cancer patients. Methods: A total of 610 patients diagnosed with depressive episodes and/or anxiety disorders were retrospectively included and divided into a cancer group and a non-cancer control group. Antidepressants used included escitalopram, duloxetine, sertraline, venlafaxine, and vortioxetine, combined with trazodone or not. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) scores were used to evaluate the efficacy after 4 weeks and 8 weeks of systematic antidepressants treatment. Results: Compared to the non-cancer group, the cancer group had higher proportions of females, older individuals, and patients with poor sleep quality, while reporting fewer somatic symptoms at baseline (all p < 0.05). PHQ-9 and GAD-7 scores in cancer patients treated with antidepressants were significantly lower than baseline at week 4 and week 8 (all p < 0.05). The sertraline group demonstrated significantly less improvement in GAD-7 scores at week 4 and in both GAD-7 and PHQ-9 scores at week 8 compared to the escitalopram group, while duloxetine, venlafaxine, and vortioxetine showed comparable efficacy to escitalopram. Antidepressants combined with trazodone showed significant improvement in PHQ-9 scores at week 4 compared to those without trazodone. The gynecological cancer group showed significantly more improvement in GAD-7 and PHQ-9 scores at week 4 and 8 compared to breast cancer patients. Conclusion: Antidepressant treatment in cancer patients with anxiety and depression is as effective as in non-cancer patients. The efficacy of escitalopram is comparable to duloxetine, venlafaxine, and vortioxetine, all of which outperformed sertraline in cancer patients. [ABSTRACT FROM AUTHOR]

Objective: Sleep disorder is a common non-motor symptom (NMS) of Parkinson's disease. However, the global research focus on Parkinson's sleep-related disorders (PDSDs) and future trends remains unclear. Currently, there is no bibliometric analysis of PDSDs. We aim to fill this gap, determine the status of current research, and predict future research hotspots. Methods: We selected 1490 publications from the Web of Science Core Collection (WoSCC) database from 2008 to 2023. Based on CiteSpace and VOSviewer, the analysis was performed from the perspectives of the trend in the number of annual publications, countries, institutions, authors, journals, and co-citations. Results: A total of 1490 publications from 590 authors from 409 institutions in 77 countries are included. The United States, China, and the United Kingdom are the leading countries. University College London (UCL) is the most prolific institution. Harvard University is the key for cooperation among institutions. Chaudhuri Kallol Ray is a leader in this field. "Movement Disorders" is the most influential journal. "A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015" is the publication with the highest co-citation intensity. Conclusion: The total volume of publications on PDSDs is on the rise, entering a relatively high-yield stage in 2020. The COVID-19 pandemic and the emergence of new keywords may be the reasons behind this phenomenon. "quality of life" and "circadian rhythm" are the mainstream topics of PDSD research. Daytime sleepiness is the PDSD subtype that has received the most attention. Sleep quality, biomarkers, and neurodegeneration are likely to become future research hotspots. [ABSTRACT FROM AUTHOR]

Background: Tai Chi and Baduanjin are nonpharmacological interventions that are widely applied among cancer patients. Objective: This meta-analysis aimed to assess the effect of Tai Chi and Baduanjin on breast cancer patients by summarizing and pooling the results of previous studies. Methods: The PubMed, Embase, Web of Science, Scopus and Cochrane Library and several databases were searched up to December 1, 2023, to identify high-quality RCTs. Relevant terms such as Tai Chi and Baduanjin were used as keywords. Stata 15.0 software and Review Manager (version 5.3; Cochrane Training) were used to screen the studies, extract the data, code the data, and perform the meta-analysis. The mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. The PICOS framework was used to develop the following eligibility criteria: (i) population - breast cancer patients; (ii) intervention - Tai Chi and Baduanjin intervention; (iii) comparison - Tai Chi and Baduanjin group and different intervention (e.g., regular intervention, routine rehabilitation training, waiting list, sham Qigong, usual care, no intervention); (iv) outcomes - cognitive ability, shoulder joint function, anxiety, depression, fatigue, sleep quality, quality of life; and (v) study design - randomized controlled trial. Results: From January 2013 to December 2023, we included a total of 16 RCTs involving 1247 patients. A total of 647 patients were in the experimental group and were treated with Tai Chi and Baduanjin, while 600 patients were in the control group and were treated with traditional methods. The results of our meta-analysis indicate that Tai Chi and Baduanjin yield outcomes that are comparable to those of traditional treatment methods. Specifically, Tai Chi and Baduanjin significantly increased cognitive function, increased shoulder joint function, improved sleep quality indicators and improved quality of life indicators. Furthermore, Tai Chi and Baduanjin significantly reduced anxiety symptoms, depression symptoms, and fatigue symptoms among breast cancer patients. Sensitivity analysis was performed, a funnel plot was constructed. No publication bias was indicated by Egger's or Begg's test. Conclusion: Overall, Tai Chi and Baduanjin are viable and effective nonpharmacological approaches for treating breast cancer patients, as they yield better results than traditional treatment methods. However, these findings should be interpreted with caution due to the limited number of controlled trials, small sample sizes, and low quality of the evidence. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42023469301. [ABSTRACT FROM AUTHOR]

Introduction: As highlighted by the scientific literature, music therapy (MT) represents a significant non-pharmacological intervention within neurorehabilitation programs. MT offers benefits in the recovery process and enhances the quality of life for patients with neurodevelopmental disorders. A review of the literature reveals a lack of MT models focusing on real-time personalized composition using electronic music techniques. Furthermore, studies on MT conducted within a multisensory therapeutic context are limited. Recent literature reviews on MT in telerehabilitation have highlighted that the application of the Euterpe Method (EM) is complex due to limited technical information available and the combined background required for music therapists to replicate the EM protocol. Methods: This paper presents a manual which specifies the procedures and algorithms of the EM, developed during a research program conducted in a pediatric hospital in Italy. The prerogative of the EM is the use of procedures aimed at creating personalized therapeutic compositions within a multisensory environment. Discussion: The efficacy and resilience of the EM have been demonstrated in two experimental studies. The first focused on the use of telerehabilitation in children with developmental disorders, while the second involved hospitalized children with cerebral palsy. Conclusion: This study integrates medicine, neuroscience, and MT to develop personalized interventions in pediatrics, fostering collaboration among specialists and families, enhancing patient well-being, and opening new therapeutic perspectives, while ensuring the replicability of the EM approach. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes mellitus is a metabolic condition with hyperglycemia. Literature has shown a correlation between poor sleep quality and duration with an increased incidence of insomnia in diabetic individuals. The goal of this study was to determine the magnesium and potassium supplementation effect among diabetic individuals with insomnia. Methods: A randomized controlled trial (single blind) was conducted on 320 patients with diabetes; after 2 months of follow-up, 290 patients completed the trial. The Insomnia Severity Index (ISI) was used to assess the severity and duration of insomnia, before and after the trial. Tablets containing supplements were prepared: placebo (T1), magnesium (Mg, T2), potassium (K, T3), and a combination of Mg and K (T4). Melatonin and cortisol (sleep hormones) were measured from blood (serum) using an enzyme-linked immunosorbent assay (ELISA), before and after the trial. Results: The study included 93 (32.1%) male and 197 (67.9%) female participants. According to the analysis, there was a significant association between the treatment groups and ISI after the trial (post-trial), p = 0.0001. Analysis showed that there was significant association between pre- and post-serum cortisol levels in treatment groups 2, 3, and 4 (T2, T3, and T4) as p -values are 0.001, 0.001, and 0.001 respectively. Similar findings were observed for serum melatonin. Conclusions: The study revealed that magnesium, potassium, and magnesium and potassium combined had a significant effect on serum cortisol and melatonin levels (sleep hormones). In addition, supplementation significantly decreased the severity of insomnia among patients with diabetes by improving sleep duration. [ABSTRACT FROM AUTHOR]

Background/objective: Emotional dysregulation is bidirectionally associated with sleep disturbances, with potentially critical implications for emotional reactivity, in patients with borderline personality disorder (BPD). This study evaluated subjective and objective sleep quality, emotional regulation, and emotional reactivity in 20 patients with BPD compared to 20 non-clinical individuals. Methods: Subjective and objective sleep quality was assessed using the Pittsburgh Sleep Quality Index and a 3-day actigraphic measurement. Emotional regulation was evaluated using the Difficulties in Emotion Regulation Scale and the Berkeley Expressivity Questionnaire. Furthermore, each participant underwent an emotional reactivity task selected from the International Affective Picture System. Results: Compared to control subjects, individuals with BPD reported poor subjective sleep quality and objective sleep continuity disturbances, with more sleep fragmentation and decreased sleep efficiency. Moreover, BPD patients showed emotional dysregulation and altered subjective reactivity to emotional stimuli, particularly positively valenced stimuli. Conclusion: These results suggest the importance of further clarifying the specific direction of sleep-dependent emotional modulation in individuals with BPD, with significant clinical implications for patients with co-occurring sleep disturbances. [ABSTRACT FROM AUTHOR]

Background: Many patients hospitalized for COVID-19 experience long-term health problems, but comprehensive longitudinal data up to 2 years remain limited. We aimed to (1) assess 2-year trajectories of health outcomes, including comparison between intensive care unit (ICU) treated and non-ICU-treated patients, and (2) identify risk factors for prominent health problems post-hospitalization for COVID-19. Methods: The CO-FLOW multicenter prospective cohort study followed adults hospitalized for COVID-19 at 3, 6, 12, and 24 months post-discharge. Measurements included patient-reported outcomes (a.o., recovery, symptoms, fatigue, mental health, sleep quality, return to work, health-related quality of life [HRQoL]), and objective cognitive and physical tests. Additionally, routine follow-up data were collected. Results: 650 patients (median age 60.0 [IQR 53.0–67.0] years; 449/650 [69%] male) surviving hospitalization for COVID-19 were included, of whom 273/650 (42%) received ICU treatment. Overall, outcomes improved over time. Nonetheless, 73% (322/443) of patients had not completely recovered from COVID-19, with memory problems (274/443; 55%), concentration problems (259/443; 52%), and dyspnea (251/493; 51%) among most frequently reported symptoms at 2 years. Moreover, 61% (259/427) had poor sleep quality, 51% (222/433) fatigue, 23% (102/438) cognitive failures, and 30% (65/216) did not fully return to work. Objective outcome measures showed generally good physical recovery. Most outcomes were comparable between ICU- and non-ICU-treated patients at 2 years. However, ICU-treated patients tended to show slower recovery in neurocognitive symptoms, mental health outcomes, and resuming work than non-ICU-treated patients, while showing more improvements in physical outcomes. Particularly, female sex and/or pre-existing pulmonary disease were major risk factors for poorer outcomes. Conclusions: 73% (322/443) of patients had not completely recovered from COVID-19 by 2 years. Despite good physical recovery, long-term neurocognitive complaints, dyspnea, fatigue, and impaired sleep quality persisted. ICU-treated patients showed slower recovery in neurocognitive and mental health outcomes and resumption of work. Tailoring long-term COVID-19 aftercare to individual residual needs is essential. Follow-up is required to monitor further recovery. Trial registration: NL8710, registration date 12-06-2020. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that the university environment, to improve students' health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work. Methods: This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions. Results: The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems. Conclusions: Students' report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, studies reported that restricted living conditions were associated with worse subjective sleep quality. This effect might have been caused by reduced light exposure during lockdowns. We investigated light exposure levels, subjective and objective sleep and physical activity levels in older adults during restricted and free-living conditions after the pandemic. Ninety-one participants (62.7 ± 8.4 years) recruited from the community using social media with 44 participants (63.4 ± 8.9 years) completed follow-up during free-living conditions. Participants wore an actigraphy device and completed sleep diaries for 7 days during each condition. Light values were extracted in hourly bins across the 24-h period and objective and subjective sleep were compared between the conditions. There was an increase in mean 24-h light exposure during restricted-living (1103.7 ± 1024.8 lux) compared to free-living (803.0 ± 803.6 lux; p < 0.001). This was partially related to participants spending 18 min more in bright light conditions (>1,000 lux) during wakefulness in restricted living (2.6 ± 1.9 h) compared to free-living (2.3 ± 2.0 h; p = 0.036). Despite differences in light exposure, there were no significant differences in objective and subjective sleep parameters between the two conditions. More research is required to better understand behaviours related to light exposure and how this may impact on sleep. [ABSTRACT FROM AUTHOR]

The impact of mobile phone addiction (MPA) on college students' sleep quality (SQ) has received increasing attention in recent years. On this basis, the mediating roles of rumination and FOMO (fear of missing out) on MPA and SQ were examined in this study. In a cross-sectional study, preliminary data were gathered via questionnaires from 1401 college students (19.35 ± 0.81) from 5 universities in Jiangxi Province, China. Mobile Phone Addiction Tendency Scale, Rumination Response Scale, Fear of Missing Out Scale and Sleep Quality Scale were employed in the research. The mediation model was tested using SPSS 26.0, with FOMO and rumination acting as the mediating variables. Between MPA and SQ, rumination and FOMO each had their own unique mediation effect. Furthermore, rumination and FOMO function as a chain of mediators between college students' MPA and SQ. This study provided confirmation and clarification that in college students, the association between MPA and SQ was mediated by rumination and FOMO. This study improves our understanding of MPA, SQ and how MPA may affect SQ in college students. It also shows that the impact of MPA and SQ of college students should be given more consideration by educators, parents, and college students themselves. [ABSTRACT FROM AUTHOR]

Background: Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery. Methods: The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The 'Munich Chronotype Questionnaire' will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the 'Chrononutrition Profile—Questionnaire' in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained. Discussion: This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients' response to bariatric surgery. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the associations between various dimensions of social support and sleep quality in a hospital psychiatric outpatient population using canonical correlation analysis, while also investigating the potential mediating roles of anxiety and depressive symptoms. Methods: Employing a cross-sectional design, survey data were collected from 10,071 individuals visiting Hangzhou Seventh People's Hospital between October 2020 and October 2023. After excluding invalid cases, a total of 10,063 participants were included for analysis. The survey encompassed gathering basic demographic information as well as administering the Social Support Rating Scale, Self-rating Depression Scale, Self-rating Anxiety Scale, and Pittsburgh Sleep Quality Index Scale. Data analysis was conducted using SPSS 27.0 statistical software with canonical correlation analysis employed to examine the relationships. Additionally, the mediating effects of anxiety and depression symptoms were examined using the SPSS PROCESS macro. Results: Canonical correlation analysis reveals a significant positive correlation between social support dimensions and various aspects of sleep quality. The first pair of canonical variables (r = 0.586, p < 0.001) accounts for an impressive 97% of the cumulative contribution. It is found that this pair of canonical variables explains 68.9% of the variance in social support and 49.0% in sleep quality. Mediation analysis revealed that anxiety and depressive symptoms significantly mediated the relationship between social support and sleep quality, accounting for 88% of the total effect. Specifically, anxiety accounted for 47% mediation while depression accounted for 41%. Conclusion: The study findings revealed a significant positive correlation between social support and sleep quality dimensions, indicating a robust association between increased social support and enhanced individual sleep quality. Furthermore, the results indicated that anxiety and depression partially mediated the relationship between social support and sleep quality, offering novel insights into the intricate connection between mental health and sleep quality. [ABSTRACT FROM AUTHOR]

Considering the relevance for patients, economics and public health data about the course of the neurological Post-COVID Syndrome (PCS) are urgently needed. In this study 94 PCS patients (73% female, age in median 49 years) were examined in median 9.4 (T1) and for a second time 14 months (T2) after mild to moderate SARS-CoV-2 infection. Mood, sleep quality and health related quality of life (QoL) were evaluated via structured anamnesis and self-report questionnaires; attention, concentration and memory via psychometric tests. 47% of the patients reported an improvement of their symptoms over time, but only 12% full recovery. 4% noticed deterioration and 49% no change. Main disturbances at both time points were fatigue, deficits in concentration and memory. In patients with perceived improvement QoL significantly increased between T1 and T2, although their test performance as well as the fatigue score remained unchanged. In patients with persisting impairment QoL, fatigue scores and psychometric test results did not change significantly. Abnormal psychometric tests were more frequent at both time points in the group without improvement. But, significant fatigue and cognitive impairment persisted for more than 1 year after SARS-CoV-2 infection in both groups. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum. Case presentation: A 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions. Conclusion: This case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies. [ABSTRACT FROM AUTHOR]

The prevalence of portable media device (PMD) use has proliferated, potentially causing serious problems, particularly in critical situations. The main aim of the present study was to investigate the relationship between pre-sleep PMD use and cognitive performance, as well as the mediating effects of sleep quality among nurses. A cross-sectional study was designed, with 200 registered nurses voluntarily participating. The average time spent on PMDs was self-reported. The Pittsburgh Sleep Quality Index, the epworth sleepiness scale, the Occupational cognitive failures questionnaire, and the Nursing Errors Questionnaire were used to collect data. Correlation analyses and structural equation modeling were conducted. Significant relationships were found between pre-sleep PMD use and all variables of interest. Sleep quality was significantly related to daytime sleepiness and occupational cognitive failures, mediating the effect of pre-sleep PMD use on these two variables. Problematic use of PMDs at bedtime may be considered an unsafe act for healthcare workers. Healthcare providers should be aware of the potential risks induced by excessive PMD use. Creating a culture of proper smartphone use is crucial for overcoming these challenges. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Due to the unclear etiology of recurrent aphthous stomatitis (RAS), a painful and distressing condition with a high prevalence, the researchers have hypothesized a connection between sleep quality and RAS.The cross‐sectional study enrolled 10,138 Fasa Cohort Study participants aged 35–70 years. Various sleep quality factors were calculated and categorized based on the Pittsburgh Sleep Questionnaire.Among 9030 subjects finally included with RAS prevalence of 20.2%, adjusted logistic regression showed significant odds ratios (ORs) in subjects who sleep < 5 h (OR = 1.44, 95%CI 1.25, 1.66), have sleep latencies of more than 60 min (OR = 1.37, 95%CI 1.11, 1.69), have sleep efficiencies of 65%–75% (OR = 1.55, 95%CI 1.21, 1.98), or regularly go to bed after 11 p.m. (OR = 1.23, 95%CI 1.11, 1.37). Subgroup analyses indicated no significant associations between RAS and various sleep factors in individuals who worked night shifts, and stronger associations were observed in men than women.The study found a significant positive association between RAS and sleep quality factors such as shorter duration, lower efficiency, longer latency, later bedtime, and regular sleeping pill use. Establishing early and sufficient sleep and addressing sleep onset disturbances by adhering to sleep hygiene principles should be prioritized in individuals with RAS. [ABSTRACT FROM AUTHOR]