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Background: Chronotype refers to individual variations in diurnal preferences that manifest as everyday behaviors, including sleep patterns. Traditionally, the Horne & Östberg Morningness-Eveningness Questionnaire (MEQ), which comprises of 19 items, has been the standard for determining chronotype. However, its length makes it cumbersome for widespread application. To address this issue, the reduced MEQ (rMEQ), a concise version containing only five items from the MEQ, was developed for a more practical approach to chronotype assessment. This study aimed to evaluate the validity and reliability of Korean version of rMEQ in a sample from the general Korean population., Methods: The Korean version of the rMEQ comprises of items 1, 7, 10, 18, and 19 of the original MEQ. The validity of the rMEQ was assessed by correlating its scores with those of the MEQ and Munich Chronotype Questionnaire (MCTQ). Its reliability was determined by calculating internal consistency., Results: A total of 3,030 individuals participated in the study, yielding an average rMEQ score of 14.0 ± 3.4. There was a substantial positive correlation between the rMEQ and MEQ scores ( r = 0.859, P < 0.001). Furthermore, the rMEQ scores were significantly negatively correlated with the midpoint of sleep on free days corrected for sleep debt as measured by the MCTQ ( r = -0.388, P < 0.001), indicating a robust association with chronotype. The internal consistency of rMEQ, measured using Cronbach's alpha, was 0.609., Conclusion: This study finds the Korean version of the rMEQ to be a valid and reliable instrument for assessing chronotype in the general population., Competing Interests: The authors declare the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MKC was a site investigator for a multicenter trial sponsored by Biohaven Pharmaceuticals, Allergan Korea, and Ildong Pharmaceutical Company. He has received lecture honoraria from Eli Lilly and Company, Handok-Teva, and Ildong Pharmaceutical Company over the past 24 months. He received grants from the Yonsei University College of Medicine (6-2021-0229) and the Korea Health Industry Development Institute (HV22C0106) and a National Research Foundation of Korea grant from the Korean Government (MSIT;2022R1A2C1091767). The other authors declare no conflicts of interest., (© 2024 The Korean Academy of Medical Sciences.)

Insufficient light exposure is assumed to be related to a wide array of health problems, though few studies focus on the role of whole-day light exposure in the habitual setting in the development of these health problems. The current review aims to describe the association between personal light exposure in the habitual setting and sleep-wake rhythm and mood in healthy adults from the general population. Five databases (Embase, Medline Epub, Web of Science, PsycINFO, and Google Scholar) were searched in June 2019. The inclusion criteria included: assessment directly of light exposure on the participants for at least one full day; reporting on both individual personal light exposure and outcomes. The quality of the papers was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung and Blood Institute. The current review followed the PRISMA guidelines. In total, 8140 papers were identified in the database search. Twenty-five papers were eventually included in this review. All included studies were cross-sectional, and individual light exposure was usually measured with a wrist-worn device. Five studies received a "good" quality rating, 16 received a "fair" rating, and the remaining 4 a "poor" quality rating. The overall quality of the included studies was considered low because of the lack of intervention studies and the fact that light exposure was measured on the wrist. Given the low quality of the included studies, the current review can only provide a first exploration on the association between light exposure and sleep-wake rhythm and mood in healthy adults from the general population. Limited evidence is presented for a positive relationship between the amount and timing of light exposure on the one hand and rest-activity rhythm and some estimates of sleep architecture on the other. The evidence on an association between light exposure and circadian phase, sleep estimates, sleep quality, and mood is conflicting. Data from intervention studies are needed to gain insight into the causal mechanism of the relationship between light exposure and sleep-wake rhythm and mood., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Sleep is severely impaired in patients with Alzheimer's disease. Amyloid-β deposition in the brain of Alzheimer's disease patients is a key event in its pathogenesis and is associated with disrupted sleep, even before the appearance of cognitive decline. Because soluble amyloid-β oligomers are the key mediators of synaptic and cognitive dysfunction in Alzheimer's disease and impair long-term memory in rodents, the first aim of this study was to test the hypothesis that amyloid-β oligomers would directly impair sleep in mice. The cellular prion protein is a cell surface glycoprotein of uncertain function. Because cellular prion protein binds oligomeric amyloid-β with high affinity and mediates some of its neurotoxic effects, the second aim of the study was to test whether amyloid-β oligomer-induced sleep alterations were mediated by cellular prion protein. To address these aims, wild-type and cellular prion protein-deficient mice were given acute intracerebroventricular injections (on different days, at lights on) of vehicle and synthetic amyloid-β oligomers. Compared to vehicle, amyloid-β oligomers significantly reduced the amount of time spent in non-rapid eye movement sleep by wild-type mice during both the light and dark phases of the light-dark cycle. The amount of time spent in rapid eye movement sleep was reduced during the dark phase. Sleep was also fragmented by amyloid-β oligomers, as the number of transitions between states increased in post-injection hours 9-24. No such effects were observed in cellular prion protein-deficient mice. These results show that amyloid-β oligomers do inhibit and fragment sleep, and that these effects are mediated by cellular prion protein., (© 2020 European Sleep Research Society.)

The burden of dementia is increasing globally. In the absence of curative treatment, preventive strategies to delay or reduce progression of dementia are crucial. This relies on the identification of modifiable risk factors. The effects of dementia on sleep are well recognized; however, there is now growing evidence suggesting a bidirectional relationship between sleep pathologies and dementia. SDB, poor quality sleep and extremes of sleep duration are commonly experienced by both middle-aged and older populations. All have been associated with increased risk of dementia and cognitive decline in a number of observational studies, albeit inconsistently. The mechanisms by which these sleep disorders may contribute to neurodegeneration are manifold, and include impacts of fragmented sleep on the clearance of neurotoxins, and in SDB by the additive effects of intermittent hypoxia on beta-amyloid production, hypoxic cell death, neuroinflammation and damage to cerebral vasculature. Untangling the mechanisms by which sleep pathologies may impact risk of dementia is a challenge. Many insights into the pathophysiology of these relationships have been derived from animal- and population-based studies. Neuroimaging modalities offer important opportunities to further understand the link between sleep pathologies and dementia risk in vivo, especially in the critical preclinical phase of AD. In this review, we canvas updates in dementia pathophysiology, the evidence linking sleep pathologies with dementia and outline the advances in determining this potential pathophysiological link that have eventuated from the application of neuroimaging., (© 2019 Asian Pacific Society of Respirology.)

An estimated 45 million persons in Europe are annually subjected to sleep-wake disorders. State-of-the-art polysomnography provides sophisticated insights into sleep (patho)physiology. A drawback of the method, however, is the obtrusive setting dependent on a clinical-based sleep laboratory with high operational costs. A contact-less prototype was developed to monitor limb movements and vital signs during sleep. A dual channel K-band Doppler radar transceiver captured limb movements and periodic chest wall motion due to respiration and heart activity. A wavelet transform based multi-resolution analysis (MRA) approach isolated limb movements, respiration, and heart rate from the demodulated signal. A test bench setup characterized the prototype simulating near physiological chest wall motions caused by periodic respiration and heartbeats in humans. Single- and multi-tone test bench simulations showed extremely low relative percentage errors of the prototype for respiratory and heart rate within -2 and 1%. The performance of the prototype was validated in overnight comparative studies, involving two healthy volunteers, with polysomnography as the reference. The prototype has successfully classified limb movements, with a sensitivity and specificity of 88.9 and 76.8% respectively, and has achieved accurate respiratory and heart rate measurement performance with overall absolute errors of 1 breath per minute for respiration and 3 beats per minute for heart rate. This pilot study shows that K-band Doppler radar and wavelet transform MRA seem to be valid for overnight sleep marker assessment. The contact-less approach might offer a promising solution for home-based sleep monitoring and assessment.

Objective: The Sleep Condition Indicator (SCI) and Insomnia Severity Index (ISI) are commonly used instruments to assess insomnia. We evaluated their psychometric properties, particularly their discriminant validity against structured clinical interview (according to DSM-5 and ICSD-3), and their concurrent validity with measures of sleep and daytime functioning., Methods: A total of 158 young adults, 16% of whom were diagnosed with DSM-5 insomnia disorder and 13% with ICSD-3 Chronic Insomnia by structured interview, completed the ISI and SCI twice in 7-14 days, in addition to measures of sleep and daytime function., Results: The Chinese version of the SCI was validated with good psychometric properties (ICC = 0.882). A cutoff of ≥8 on the ISI, ≤5 on the SCI short form, and ≤21 on the SCI achieved high discriminant validity (AUC > 0.85) in identifying individuals with insomnia based on both DSM-5 and ICSD-3 criteria. The SCI and ISI had comparable associations with subjective (0.18 < r < 0.51) and actigraphic sleep (0.31 < r < 0.43) and daytime functioning (0.34 < r < 0.53)., Conclusion: The SCI, SCI short form, and ISI were found to correctly identify individuals with DSM-5- and ICSD-3-defined insomnia disorder. Moreover, they showed good concordance with measures of daytime dysfunction, as well as subjective and objective sleep. The SCI and ISI are recommended for use in clinical and research settings., (Copyright © 2016 Elsevier B.V. All rights reserved.)

In recent years, evidence has emerged for a bidirectional relationship between sleep and neurological and psychiatric disorders. First, sleep-wake disorders (SWDs) are very common and may be the first/main manifestation of underlying neurological and psychiatric disorders. Secondly, SWDs may represent an independent risk factor for neuropsychiatric morbidities. Thirdly, sleep-wake function (SWF) may influence the course and outcome of neurological and psychiatric disorders. This review summarizes the most important research and clinical findings in the fields of neuropsychiatric sleep and circadian research and medicine, and discusses the promise they bear for the next decade. The findings herein summarize discussions conducted in a workshop with 26 European experts in these fields, and formulate specific future priorities for clinical practice and translational research. More generally, the conclusion emerging from this workshop is the recognition of a tremendous opportunity offered by our knowledge of SWF and SWDs that has unfortunately not yet entered as an important key factor in clinical practice, particularly in Europe. Strengthening pre-graduate and postgraduate teaching, creating academic multidisciplinary sleep-wake centres and simplifying diagnostic approaches of SWDs coupled with targeted treatment strategies yield enormous clinical benefits for these diseases., (© 2015 EAN.)

Abstract Background Sleep has been known to affect childhood development. Sleep disturbance is likely more common in children with developmental delay (DD) than in typical development. There are few studies on the correlation between sleep disturbance and developmental features in children with DD. Therefore, this study aimed to evaluate the associations between the two in children with DD. Methods A total of 45 children (age range 27.0 ± 11.1) with DD were recruited and evaluated using the Sleep Disturbance Scale for Children (SDSC) and Bayley Scales of Infant and Toddler Development (BSID-III). The outcomes are expressed as means and standard deviations. The correlation between SDSC and BSID-III was assessed using Spearman’s rank correlation test. Multiple regression analysis was performed to investigate the relationship between BSID-III domains and SDSC questionnaire subscales. Statistical significance was set at p

Background: Sleep has been known to affect childhood development. Sleep disturbance is likely more common in children with developmental delay (DD) than in typical development. There are few studies on the correlation between sleep disturbance and developmental features in children with DD. Therefore, this study aimed to evaluate the associations between the two in children with DD. Methods: A total of 45 children (age range 27.0 ± 11.1) with DD were recruited and evaluated using the Sleep Disturbance Scale for Children (SDSC) and Bayley Scales of Infant and Toddler Development (BSID-III). The outcomes are expressed as means and standard deviations. The correlation between SDSC and BSID-III was assessed using Spearman's rank correlation test. Multiple regression analysis was performed to investigate the relationship between BSID-III domains and SDSC questionnaire subscales. Statistical significance was set at p < 0.05. Results: Based on the correlation analysis and subsequent hierarchical regression analysis, cognition and socio-emotional domains of BSID-III were significantly associated with the DOES subscale of the SDSC questionnaire. In addition, the expressive language domain of the BSID-III was found to be associated with the DA subscale of the SDSC questionnaire. It seems that excessive daytime sleepiness might negatively affect emotional and behavioral problems and cognitive function. Also, arousal disorders seem to be related to memory consolidation process, which is thought to affect language expression. Conclusion: This study demonstrated that DA and DOES subscales of the SDSC questionnaire were correlated with developmental aspects in preschool-aged children with DD. Sleep problems in children with DD can negatively affect their development, thereby interfering with the effectiveness of rehabilitation. Identifying and properly managing the modifiable factors of sleep problems is also crucial as a part of comprehensive rehabilitation treatment. Therefore, we should pay more attention to sleep problems, even in preschool-aged children with DD. [ABSTRACT FROM AUTHOR]

Objective:In this study, it was aimed to examine the risk of sleep disturbance in children and its relationship with computer game addiction during the Coronavirus disease-2019 lock down.Materials and Methods:In our cross-sectional observational study, 343 children and their mothers who applied family medicine clinics of a tertiary hospital between 1 October 2020 and 1 January 2021 were included. A structured questionnaire including the socio-demographic data of the mother and the child, and the Children’s Sleep Disturbance Scale and the Children’s Computer Game Addiction Scale were applied.Results:One-hundred sixty-five (48.1%) girls and 178 (51.9%) boys aged 8-12 years and their mothers participated in the study. The risk of sleep disturbance was observed at a rate of 74.1% (n=254) and it was strongly correlated with computer game addiction (p

Objective: In this study, it was aimed to examine the risk of sleep disturbance in children and its relationship with computer game addiction during the Coronavirus disease-2019 lock down. Materials and Methods: In our cross-sectional observational study, 343 children and their mothers who applied family medicine clinics of a tertiary hospital between 1 October 2020 and 1 January 2021 were included. A structured questionnaire including the socio-demographic data of the mother and the child, and the Children's Sleep Disturbance Scale and the Children's Computer Game Addiction Scale were applied. Results: One-hundred sixty-five (48.1%) girls and 178 (51.9%) boys aged 8-12 years and their mothers participated in the study. The risk of sleep disturbance was observed at a rate of 74.1% (n=254) and it was strongly correlated with computer game addiction (p<0.001, r=0.787). Game addiction scores of boys (58.66±16.68) and primary school children (60.37±16.41) were higher than game addiction of girls (52.91±17.57), and of secondary school children (55.06±17.39) (p=0.023, p=0.040, respectively). Computer game addiction score (61.89±14.77) of children with sleep disturbance risk was significantly higher (p<0.001) than children without sleep disturbance risk (38.79±11.84). Among the children with a risk of sleep disturbance, the proportion of time spent on the computer compared to the pre-pandemic period (70.1%), the proportion of going late to bed-time (70.0%), and the proportion of being own computer or tablet (71.7%) were found to be higher than the proportions in children (48.3%, 58.4%, 37.1%, respectively) without sleep disturbance (p<0.001, p=0.004, p<0.001, respectively). The level of computer game addiction was significantly increased in children who spent less time with their mothers (58.68±16.97) and less time for games (58.05±18.11) compared to other children (p=0.002). In the logistic regression analysis, it was shown that the game addiction score was 1.128 times higher in children with sleep disturbance risk [Odds ratio=1.128 (1.094-1.162; p<0.001)]. Conclusion: Our study showed that three of four children had a risk of sleep disorders during the pandemic period and were associated with an increased level of computer game addiction and drew attention to the importance of the time spent with the mother. [ABSTRACT FROM AUTHOR]

The knowledge of the distribution of sleep and wake over a 24-h day is essential for a comprehensive image of sleep-wake rhythms. Current sleep-wake scoring algorithms for wrist-worn actigraphy suffer from low specificities, which leads to an underestimation of the time staying awake. The goal of this study (ClinicalTrials.gov Identifier: NCT03356938) was to develop a sleep-wake classifier with increased specificity. By artificially balancing the training dataset to contain as much wake as sleep epochs from day- and nighttime measurements from 12 subjects, we optimized the classification parameters to an optimal trade-off between sensitivity and specificity. The resulting sleep-wake classifier achieved high specificity of 80.4% and sensitivity of 88.6% on the balanced dataset containing 3079.9 h of actimeter data. In the validation on night sleep of separate adaptation recordings from 19 healthy subjects, the sleep-wake classifier achieved 89.4% sensitivity and 64.6% specificity and estimated accurately total sleep time and sleep efficiency with a mean difference of 12.16 min and 2.83%, respectively. This new, device-independent method allows to rid sleep-wake classifiers from their bias towards sleep detection and lay a foundation for more accurate assessments in everyday life, which could be applied to monitor patients with fragmented sleep-wake rhythms. [ABSTRACT FROM AUTHOR]

BackgroundSleep disturbance is a common issue among rotating night shift workers and is closely related to health risks. The present study aimed to determine the effectiveness of pharmacological and non-pharmacological sleep interventions for the management of sleep disturbance among rotating night shift workers.MethodsFor this systematic review and meta-analysis, we searched six electronic databases—EMBASE, CINAHL, Cochrane Library, PubMed, Scopus, and Web of Science—for randomized controlled trials and clinical trials published from January 1990 to June 2022. The quality of eligible studies was independently assessed by three authors using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. The meta-analysis was performed based on the random effects model using the Comprehensive Meta-Analysis software. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsOf the 1019 studies retrieved, 30 met the inclusion criteria for the systematic review; 25 were selected for the meta-analysis. Sleep interventions were categorized as follows: pharmacological approach (n = 7), light therapy (n = 9), cognitive behavioral approach (n = 7), aroma or alternative therapy (n = 4), and shift schedule modification (n = 3). The overall mean effect size of the interventions was moderate (Hedges' g = 0.59; 95% confidence interval = 0.33–0.84, z = 4.50, p < 0.001).ConclusionSleep interventions were effective in promoting sleep or reducing sleep disturbance among rotating night shift workers. These findings provide evidence of the effectiveness of various pharmacological and non-pharmacological sleep interventions for managing sleep health in the work environment of rotating night shift workers.

Tayside Children's Sleep Questionnaire (TCSQ) is a simple tool for screening the disorders of initiating and Maintaining Sleep among children aged between 1 and 5 years. This study aimed to translate TCSQ into Persian and evaluate its validity and reliability of TCSQ among Persian speakers. This cross-sectional study was conducted among 311 children aged 1–5 years in Isfahan. After permission, the forward–backward translation method was used to develop the Persian version. Finally, 311 children participated in this survey, which 30 were repeated a second time. Google Forms, SPSS16, and STATA14 were used for data collection, descriptive statistics, and factor analysis. BEARS questionnaire was used to assess concurrent validity. Three expert opinions were used for content validity. In this study, 404 mothers of children in Isfahan volunteered to participate in the survey, of which 311 remained. The mean and standard deviation age of their children were 3.47 ± 1.91 years. Cronbach Alpha of the Persian version of TCSQ was 0.76 CI (0.78–0.66). The intra-class correlation coefficient was 0.67 CI (0.60–0.74). The content validity index was 0.88, and three factors (disturbance, nighttime, parents) with a specific value greater than 0.4 is determined by factor analysis. The current study results indicate that TCSQ has good reliability and validity among Persian speakers. [ABSTRACT FROM AUTHOR]

Context: The coronavirus disease 2019 (COVID-19) outbreak has led to several psychological symptoms among frontline doctors of which sleep disturbances are common. Stress due to isolation and disease-related factors are known to be associated with sleep disturbances. Aim: The aim of this study is to establish the prevalence of poor sleep and its association with psychological symptoms among doctors working in COVID-19 tertiary hospital. Settings and Design: A cross-sectional online survey was conducted among 150 doctors who were treating COVID-19 patients. Materials and Methods: The survey contained a semi-structured questionnaire including sociodemographic details, Depression Anxiety Stress Scale 21, and Pittsburgh Sleep Quality Index scale. Analysis was done using the SPSS v20. Results: Of 150 doctors, we found 67 (44.67%) and 83 (55.33%) doctors were poor sleepers and good sleepers, respectively. Those who were married (P = 0.001), had higher working hours per month (P = 0.001), the presence of family history of psychiatric illness (P = 0.008), and history of substance use (P = 0.007) were associated with poor sleep. Furthermore, poor sleep was associated with higher stress (P = 0.001), anxiety (P = 0.001), and depression (P = 0.001). A multiple logistic regression revealed that family history of psychiatric illness (odds ratio [OR]-5.44, P = 0.01) and the presence of substance use (OR-7.77, P = 0.01) predicted poor sleep. Conclusion: Sleep pattern abnormalities were present in 45% of the frontline COVID-19 doctors studied. Family history of psychiatric illness and substance use was associated with higher chances of having poor sleep. It is important to recognize and manage sleep abnormalities as these could be initial signs of a psychiatric disorder or manifestations of underlying stress, especially in the vulnerable population.

Background: In-depth investigation of the factors that exacerbate sleep disturbance among night-shift workers is essential to develop a successful implementation strategy to improve sleep. Although some characteristics of work associated with sleep disturbances have been investigated, there are inconsistencies in the findings. This study aimed to assess the influence of working time and work characteristics on sleep disturbance among night-shift workers.Methods: This study was a secondary data analysis of a nationally representative sample of data from the fifth Korean Working Condition Survey in 2017. A total of 1,790 wage workers aged between 19 and 64 years with night shift schedules were selected and analyzed. A multiple logistic regression analysis was conducted to analyze the influences of working time characteristics, including shift type, frequency of night shift, and extended work; as well as work characteristics, including physical work demands, workload, emotional work demands, social support, and communication, on sleep disturbance among night-shift workers.Results: Of those analyzed, 8.4% of night-shift workers experienced sleep disturbances. Night-shift workers with extended work, higher workloads, and emotional work demands were more likely to experience sleep disturbances (OR = 1.53, 95% CI = 1.05 to 2.23; OR = 1.01, 95% CI = 1.01 to 1.03; OR = 1.03, 95% CI = 1.02 to 1.05; respectively).Conclusion: Extended work, higher workload, and emotional work demands were significant factors for sleep disturbance among night-shift workers. These findings highlight the importance of adjusting work demands and mitigating extended work to reduce sleep disturbance in night-shift workers. [ABSTRACT FROM AUTHOR]

Introduction: NOMOPHOBIA is a term used to describe an anxiety disorder in which people fear being disconnected from their mobile phones. Strong associations between nomophobia and insomnia have previously been documented. However, there is no clear explanation for this relationship between the two disorders. The present study was designed to first determine the diagnostic precision of the Insomnia Severity Index (ISI) various components in detecting or classifying nomophobia; and second, examine the diagnostic performance of the identified ISI components in classifying nomophobia.Methods: From a previous study 549 participants completed demographic information, the Nomophobia Questionnaire (NMP-Q), and the ISI. The sample was divided into two parts so that each part represented the original sample, using a 40% (n = 209) allocation for sample 1 and 60% (n = 340) for sample 2. To determine common components between nomophobia and insomnia, an exploratory factor analysis was performed using sample 1 to determine the diagnostic precision of the ISI's various components in detecting or classifying nomophobia. A test of the ISI and a cut-off value (ISI-4 ≥2) was then conducted on Sample 2 to determine whether they would accurately identify significant nomophobia.Results: Sleep dissatisfaction was a common component of insomnia and nomophobia. Sleep dissatisfaction had excellent diagnostic accuracy in detecting individuals with nomophobia (sensitivity 75.13%, specificity 100%, Youden' index 0.75, area under curve 0.88).Conclusion: Questioning patients sleep dissatisfaction may serve as a marker for both nomophobia and insomnia, both of which may demand more comprehensive evaluation. [ABSTRACT FROM AUTHOR]

Background/Aims: Sleep disturbances are common among children with cerebral palsy, resulting in adverse consequences. Investigating the association between leisure activities and sleep disturbances could help to develop ways to promote their sleep quality. This study primarily aimed to investigate the association between leisure activities and sleep disturbances among children with and without cerebral palsy. The secondary aim was to study the prevalence of sleep disturbances and some of its associated factors. Methods: A total of 75 children with cerebral palsy (study group) (mean age 10.0 ± 2.5 years) and 75 typically developing children (control group) (mean age 10.5 ± 2.9 years) were randomly selected to completed the Children's Assessment of Participation and Enjoyment. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children. Factors associated with sleep disturbances (age, gender, school attendance, bedroom sharing, type of cerebral palsy, motor functions, eating and drinking ability and communication functions) were statistically analysed and the prevalence of sleep disturbances was calculated. Results: Overall frequency of leisure participation was strongly correlated with overall sleep disturbances (P<0.001) among both groups. The prevalence of overall sleep disturbances was 17.1% and 10.6% among the study and the control groups respectively. Eating and drinking ability and spastic quadriplegia emerged as the strongest predictors of overall negative scores on the Sleep Disturbance Scale for Children. Conclusions: Greater participation in leisure activities is associated with better sleep. Occupational therapists are encouraged to consider this association when planning for occupation-based interventions aimed at enhancing occupational performance. [ABSTRACT FROM AUTHOR]

Context: The coronavirus disease 2019 (COVID-19) outbreak has led to several psychological symptoms among frontline doctors of which sleep disturbances are common. Stress due to isolation and disease-related factors are known to be associated with sleep disturbances. Aim: The aim of this study is to establish the prevalence of poor sleep and its association with psychological symptoms among doctors working in COVID-19 tertiary hospital. Settings and Design: A cross-sectional online survey was conducted among 150 doctors who were treating COVID-19 patients. Materials and Methods: The survey contained a semi-structured questionnaire including sociodemographic details, Depression Anxiety Stress Scale 21, and Pittsburgh Sleep Quality Index scale. Analysis was done using the SPSS v20. Results: Of 150 doctors, we found 67 (44.67%) and 83 (55.33%) doctors were poor sleepers and good sleepers, respectively. Those who were married (P = 0.001), had higher working hours per month (P = 0.001), the presence of family history of psychiatric illness (P = 0.008), and history of substance use (P = 0.007) were associated with poor sleep. Furthermore, poor sleep was associated with higher stress (P = 0.001), anxiety (P = 0.001), and depression (P = 0.001). A multiple logistic regression revealed that family history of psychiatric illness (odds ratio [OR]-5.44, P = 0.01) and the presence of substance use (OR-7.77, P = 0.01) predicted poor sleep. Conclusion: Sleep pattern abnormalities were present in 45% of the frontline COVID-19 doctors studied. Family history of psychiatric illness and substance use was associated with higher chances of having poor sleep. It is important to recognize and manage sleep abnormalities as these could be initial signs of a psychiatric disorder or manifestations of underlying stress, especially in the vulnerable population. [ABSTRACT FROM AUTHOR]

Delayed sleep-wake phase disorder (DSWPD) is characterized by sleep onset times, beyond the usual schedules and social conveniences, which potentially impacts on health as well as on school and professional performance. The most common treatment for DSWPD is the light administration (light therapy), through light devices, with or without behavioral instructions. Since there is no consensus in the literature about its efficacy and how it should be processed, this study aims to evaluate the light therapy effectiveness in the delayed sleep-wake phase disorder therapeutics. A systematic review was conducted using the MEDLINE/PubMed, Virtual Health Library Brazil, PsycINFO, Web of Science and Scopus databases along with a hand search until September 2020. The included studies presented participants diagnosed with insomnia or DSWPD, over 18-years old, treated only with morning light therapy, mentioning the light intensity (lux) used, and investigations with a control group. Studies reporting individuals with neurological or psychiatric disorders, shift-workers, or evaluating other sleep disorders were excluded. Among the 411 studies identified, five were selected for this review, resulting in a total sample of 140 individuals. Only two studies produced long-term results, showing that the benefits did not persist. In most studies, there were no statistically significant differences in the variables when comparing the intervention group and the control group. However, there were substantial clinical and laboratory advances in the sleep phase using light therapy when comparing phase advances for the same group concerning baseline values of sleep variables.

Summary: Short sleep appears to elevate obesity risk in youth; however, sleep is a multidimensional construct, and few studies have investigated parameters beyond duration. The objective of this study was to investigate if sleep onset time, duration, latency and night waking frequency are independently associated with adiposity and weight status in UK adolescents. This was a cross‐sectional observational study of 10,619, 13–15 years olds. Adjusted linear and logistic regressions were used to investigate associations of self‐reported sleep characteristics with adiposity markers (body mass index z‐score and percent body fat) and weight status. Compared with a sleep onset before 10pm, later sleep timing was associated with higher adiposity and higher likelihood of overweight and obesity in boys (after midnight, odds ratio [95% confidence interval]: 1.76 [1.19–2.60]) and girls (between 11pm and 11:59pm: 1.36 [1.17–1.65]). Sleeping ≤ 8 hr, compared with > 9–10 hr, was associated with higher odds of overweight and obesity in both sexes (boys: 1.80 [1.38–2.35]; girls: 1.38 [1.06–1.79]), and so too was sleeping > 10 hr in girls (1.31 [1.06–1.62]), indicating evidence for a U‐shaped association. Also in girls, compared to a sleep latency of 16‐30 min, sleep latencies ≥ 46 min were associated with higher adiposity (46–60 min, beta coefficient [95% confidence interval], percent body fat: 1.47 [0.57–2.36]) and higher likelihood of overweight and obesity (46–60 min: 1.39 [1.05–1.83]), and often as opposed to never waking in the night was associated with higher adiposity (body mass index z‐score: 0.24 [0.08–0.41]; percent body fat: 1.44 [0.44–2.44]). Sleep duration and timing in both sexes, and sleep quality in girls, appear to be independently associated with adiposity and weight status in adolescence, and may be important targets for obesity prevention. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the effects of allergic rhinitis (AR) on sleep quality (SQ). Methods: This prospective study evaluated the AR symptoms and skin prick tests (SPT) in all participants. The AR group was composed of 65 male patients with AR symptoms and positive SPT, whereas the control group was composed of 65 healthy male individuals. SQ was evaluated using the Sleep Quality Scale (SQS). The AR group was asked whether AR affects their sleep, and those who answered yes were asked for the symptoms that affect their SQ. The SQS scores and the effect of symptoms on SQ were statistically compared. Results: The mean SQS score of the groups was 68.68±13.15 in the AR group and 47.72±9.3 in the control group. The SQS score was significantly higher in the AR group compared to that of the control group (p=0.002, p<0.05). Of the patients, 30 (46.1%) had their sleep affected. The distribution of symptoms, which affect the SQ of these patients, was determined. Congestion is the most common symptom that affects the SQ, which was statistically significantly higher compared to other symptoms (p=0.0001, p<0.05). Conclusion: AR is a risk factor for poor SQ. Patients with sleep disturbances should be questioned for AR and they should be provided with necessary treatment. [ABSTRACT FROM AUTHOR]

Sleep paralysis is an inability to move at sleep onset or upon awakening. It is often a distressing experience that can be associated with significant clinical consequences. Few studies have focussed on pleasant sleep paralysis episodes. The present study aimed to determine the relative prevalence of pleasant episodes of sleep paralysis as well as variables that may make them more likely to occur. Participants (N = 172) with recurrent episodes of sleep paralysis completed a battery of questionnaires investigating sleep paralysis episodes, trauma symptoms, life satisfaction, and Big Five personality traits. Pleasant sleep paralysis was found to be a fairly common experience (i.e. 23%). Episodes were emotionally complex, with pleasant episodes often involving some admixture of fear. In terms of hallucinations, pleasant episodes were more likely to involve vestibular‐motor sensations (i.e. illusory body movements) and some individuals reported an ability to induce these hallucinations. Contrary to expectation, neither lower trauma symptomatology nor higher levels of reported life satisfaction predicted pleasant sleep paralysis. However, the ability to lucid dream and higher levels of trait openness to new experiences appeared to make pleasant episodes more likely. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Previous research on sleep debt has neglected considering sleep duration on weekdays as a contributing factor. Objectives: This cross-sectional study investigated the relationship between sleep debt and mental health in school-age adolescents, taking weekday sleep deficits under consideration. Methods: We identified 1,392 students who had provided data on sleep duration from the 2016 - 2017 for Korea National Health and Nutrition Examination Survey (KNHANES). A stepwise multivariate logistic regression analysis was used to examine the independent effect of sleep debt on perceived stress or depressive mood. Results: Individuals with poor mental health sleep less on weekdays, resulting in more sleep debt. Final regression models that were adjusted for potential covariates revealed that poor mental health was associated with shortened sleep on weekdays but was not associated with overall sleep debt. Conclusions: Our result suggests that efforts should be made to lengthen sleep on weekdays, not on weekends, to lower stress or depressive mood among adolescents. [ABSTRACT FROM AUTHOR]

Background: The 3P model proposes that predisposing, precipitating, and perpetuating factors all play a role in sleep disturbance.Objective: The purpose of the current study is to investigate social determinants of sleep disturbance by applying the 3P model to a safety-net primary care setting, specifically by evaluating the role of classism and unmet needs as precipitating factors for sleep disturbance, and anxiety as a perpetuating factor for sleep disturbance.Methods: Participants (N = 210) were a convenience sample of racially/ethnically diverse adults over the age of 18 (age M = 44.7 years) recruited from a safety-net primary care clinic in an urban area. The study employed a cross-sectional design. Participants completed a survey assessing sleep disturbances, anxiety, unmet needs, classism, social support, and a researcher-generated demographic form.Results and Conclusions: The unmet need for affordable long-term housing and greater experiences of classism were associated with more sleep disturbance, suggesting that both acted as precipitating factors. In a structural equation model with adequate fit indices, anxiety mediated the relationships with sleep disturbance for both the unmet need for affordable long-term housing and classism, suggesting that it serves as a perpetuating factor. Medical providers are recommended to explore these potential needs in safety-net primary care when patients present with sleep disturbance or anxiety. Assisting with connections to long-term housing and helping patients counteract and cope with classist discrimination may be effective in improving sleep in safety-net primary care. [ABSTRACT FROM AUTHOR]

Sleep disturbances are highly prevalent in older adults; little is known about sleep in those w ho remain living in the community despite qualifying fo r nursing home placement. W e conducted a co ncurrent, nested, mixed-methods study to describe sleep characteristics and sleep disturbances in this population. Our final sample (n = 40) was Black (100%), female (85%) older adults with a mean (±SD) age of 72 ± 9.5 years. of these, 35 had objectively measured short or long sleep duration, and 30 had subjectively reported poor sleep quality. Our evidence suggests that sleep disturbances are common in this group, and these older adults had adjusted their expectations and adapted to their sleep disturbances. Given that at-risk older adults may not perceive their sleep disturbances as problematic, clinicians must proactively assess sleep and educate about the importance of sleep. These results reveal modifiable factors w ith potential to improve health outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. We aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances.Methods: We performed a prospective cohort study of 78 children aged ≥3 years with acquired brain injury within three months of critical care hospitalization. Diagnoses included traumatic brain injury (n = 40), stroke (n = 11), infectious or inflammatory disease (n = 10), hypoxic-ischemic injury (n = 9), and other (n = 8). Sleep Disturbances Scale for Children standardized T scores measured sleep-wake disturbances. Overall sleep-wake disturbances were dichotomized as any total or subscale T score ≥60. Any T score ≥70 defined severe sleep-wake disturbances. Subscale T scores ≥60 identified sleep-wake disturbance phenotypes.Results: Sleep-wake disturbances were identified in 44 (56%) children and were classified as severe in 36 (46%). Sleep-wake disturbances affected ≥33% of patients within each diagnosis and were not associated with severity of illness measures. The most common phenotype was disturbance in initiation and maintenance of sleep (47%), although 68% had multiple concurrent sleep-wake disturbance phenotypes. One third of all patients had preadmission chronic conditions, and this increased risk for sleep-wake disturbances overall (43% vs 21%, P = 0.04) and in the traumatic brain injury subgroup (52% vs 5%, P = 0.001).Conclusions: Over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. Most of these children have severe sleep-wake disturbances independent of severity of illness measures. Many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep. Our study underscores the importance of evaluating sleep-wake disturbances after acquired brain injury. [ABSTRACT FROM AUTHOR]

Insomnia is a common complaint in outpatient clinics. It usually affects quality of life negatively, especially in severe cases. Nowadays, routine medical interventions comprise pharmacological approaches and cognitive behavioral therapy. Common medications used by afflicted patients are not competent enough in addition to their annoying side effects. It would naturally denote the need for considering novel strategies for treating insomniac patients. Approach to insomnia in traditional Persian medicine (TPM) has been cited in a scrutinized manner focusing on its main causes. Accordingly, its treatment is tailored based on the constitution of the patient, intensity of the disease, and type of the cause. In this paper we have discussed the causes of insomnia, diagnostic approach, and various medical interventions proposed in valid sources of TPM. [ABSTRACT FROM AUTHOR]

Background and purpose: The purpose of this study was to identify whether or not sleep behaviors mediated bioecological predictors of weight-related behaviors among college students. Methods: This descriptive, quantitative, cross-sectional study, guided by Bronfenbrenner's bioecological model, examined bioecological characteristics and path analysis to assess model fit. Conclusions: The fit indices indicated excellent fit of the final model to the data ([chi]2 (24) = 30.33, p =.17, root-mean-square error approximation = 0.04, comparative fit index = 0.96, standardized root-mean-square residual = 0.03). Sleep duration mediated significant bioecological predictors of weight-related behaviors, but sleep quality did not. Having children significantly predicted increased sugar-sweetened beverage (SSB) consumption and decreased physical activity (PA) among college students. Conversely, eating the majority of meals at home significantly predicted decreased consumption of SSBs and increased PA. Implications for practice: Findings support inclusion of sleep duration and use of the bioecological model, when providing patient-centered healthcare focused on weight-related behaviors and weight management in college students. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore whether associations between self‐reported sleep duration, depressive symptoms, anxiety, fatigue and daytime sleepiness differed in older community‐dwelling men and women. Design: Cross‐sectional. Methods: A community‐dwelling sample of 675 older men and women (mean age 77.7 years, SD 3.8 years) was used. All participants underwent a clinical examination by a cardiologist. Validated questionnaires were used to investigate sleep duration, depressive symptoms, anxiety, fatigue and daytime sleepiness. Subjects were divided into short sleepers (≤6 hours), n = 231; normal sleepers (7–8 hours), n = 338; and long sleepers (≥9 hours), n = 61. ancovas were used to explore sex‐specific effects. Results: Depressive symptoms were associated with short sleep in men, but not in women. Fatigue was associated with both short and long sleep duration in men. No sex‐specific associations of sleep duration with daytime sleepiness or anxiety were found. Conclusion: Nurses investigating sleep duration and its correlates, or effects, in clinical practice need to take sex into account, as some associations may be sex specific. Depressive symptoms and fatigue can be used as indicators to identify older men with sleep complaints. [ABSTRACT FROM AUTHOR]

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Background: Cystic fibrosis (CF) transmembrane regulator (CFTR) protein dysfunction causes CF. Improving survival allows detection of increasingly subtle disease manifestations. CFTR dysfunction in the central nervous system (CNS) may disturb circadian rhythm and thus sleep phase. We studied sleep in adults to better understand potential CNS CFTR dysfunction.Methods: We recruited participants from April 2012 through April 2015 and administered the Munich Chronotype Questionnaire (MCTQ). We compared free-day sleep measurements between CF and non-CF participants and investigated associations with CF survival predictors.Results: We recruited 23 female and 22 male adults with CF aged 18 to 46 years and 26 female and 22 male volunteers aged 18 to 45 years. Compared with volunteers without CF, patients with CF had delayed sleep onset (0.612 h; P = .015), midsleep (1.11 h; P < .001), and wake (1.15 h; P < .001) times and prolonged sleep latency (7.21 min; P = .05) and duration (0.489 h; P = .05). Every hour delay in sleep onset was associated with shorter sleep duration by 0.29 h in patients with CF and 0.75 h in subjects without CF (P = .007) and longer sleep latency by 7.51 min in patients with CF and 1.6 min in volunteers without CF (P = .035). Among patients with CF, FEV1 % predicted, prior acute pulmonary exacerbations, and weight were independent of all free-day sleep measurements.Conclusions: CF in adults is associated with marked delays in sleep phase consistent with circadian rhythm phase delays. Independence from disease characteristics predictive of survival suggests that sleep phase delay is a primary manifestation of CFTR dysfunction in the CNS. [ABSTRACT FROM AUTHOR]

Sleep is a tranquil process that contributes substantially to our overall health and wellbeing. Yet sleep creates certain vulnerabilities. These sometimes require urgent management decisions for prehospital emergency medical services and on-call medical providers alike. Some of these emergencies may be directly due to sleep itself, whereas others may result from sleep disorders or a lack of sleep. And then some medical emergencies may occur during sleep by chance. Yet for some of these emergencies, sleep does not necessarily play a benign role. Sleep can mask the emergency--causing a delay in detection, confusion in the diagnosis, or even impede treatment. Finally, some disorders will mimic sleep and thus elude detection. Understanding these core principles will enable medical practitioners to optimize care for patients in emergency situations. [ABSTRACT FROM AUTHOR]

There is growing interest in the relationship between obsessive-compulsive disorder (OCD) and sleep problems in youth, including the development of a theoretical model proposing how these disorders maintain each other. The model suggests that OCD symptoms are proposed to interfere with sleep duration (e.g., via increased arousal and delayed bedtime), which compounds OCD symptom severity during the daytime and into the evening, feeding back into the model. Whether the recent influx of research on sleep problems in youth with OCD supports this model is unknown. The primary aim of this systematic review was to characterize sleep problems in youth with OCD and evaluate whether current research supports previous theoretical inferences. Findings across 20 studies revealed a high prevalence of sleep problems among youth with OCD and support a bidirectional relationship. Studies largely did not assess hypothesized relationships proposed by the model; support for the model is therefore preliminary. A secondary aim was to assess the impacts of comorbidity and developmental stage. Findings suggest that in childhood, comorbid anxiety disorders may initially predate sleep problems, but they become mutually maintained over time; the role of comorbid depression appears to increase with age. Limitations, future directions, and clinical implications are discussed. • Sleep problems in youth OCD are understudied compared to other anxiety disorders. • Youth with OCD exhibit more sleep problems and less total sleep time than controls. • Sleep problems are associated with more severe OCD symptoms. • Relationship between OCD & sleep problems may become mutually maintaining with age. • Findings provide guidance for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Anti-seizure medications (ASMs) may improve or be detrimental to sleep. A literature review (as an update to the 2014 review by Jain and Glauser [https://doi.org/10.1111/epi.12478]) of 25 ASMs of interest (articles from 12 ASMs included) on the effect of ASMs/non-drug treatments on sleep in patients with epilepsy was conducted. The most common objective instrument was polysomnography, and the most common subjective measures were the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. Eslicarbazepine acetate, lacosamide, and perampanel improved or had no effect on sleep. Perampanel was associated with low incidence of insomnia, and lacosamide with low incidence of daytime sleepiness adverse events. Clonazepam, felbamate, lamotrigine, oxcarbazepine, and phenobarbital worsened or had no effect on sleep. Lamotrigine may be associated with insomnia risk and phenobarbital with daytime sleepiness. Data for valproic acid were mixed. Overall, cannabidiol, carbamazepine, and levetiracetam had no effect on sleep. Epilepsy surgery may benefit sleep in patients with a good surgical outcome. Some ASMs, and, possibly, epilepsy surgery, may have positive effects on sleep, possibly linked to achieving seizure control. Nonetheless, other ASMs may worsen sleep in some settings. Clinicians should consider such observations when making treatment decisions, particularly for patients with comorbid sleep disorders. [ABSTRACT FROM AUTHOR]