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To prospectively investigate the associations of longitudinal changes in sleep score and LTPA and their combination with all-cause mortality. Among 12,543 participants (mean age: 66.1 years) from the Dongfeng-Tongji cohort, we calculated sleep score (range, 0–4, integrating bedtime, sleep duration, sleep quality, and midday napping, higher score indicating healthier sleep) and LTPA at baseline (2008–2010) and the first follow-up (2013) surveys and their 5-year changes (defining stable sleep score as no change and stable LTPA as change within 150 min/week). We prospectively documented deaths from the first follow-up survey (2013) through December 31, 2018. During a mean 5.5-year follow-up, 792 deaths occurred. The 5-year changes in sleep score and LTPA were inversely associated with all-cause mortality risk, regardless of their initial values. When assessing 5-year changes in sleep score and LTPA jointly, compared with the stable sleep score-stable LTPA group, the decreased sleep score-decreased LTPA group had a 40 % (5–85 %) higher all-cause mortality risk, whereas the increased sleep score-increased LTPA group had a 34 % (9–52 %) lower risk. The direction of the joint association was mainly driven by sleep score change. Participants maintaining sleep scores ≥ 3 and LTPA ≥ 150 min/week over 5 years had a 44 % (28–56 %) lower all-cause mortality risk. Promoting sleep hygiene and LTPA together may benefit efforts in reducing mortality risk, with particular attention to monitoring long-term sleep health. • The 5-year changes in sleep score and LTPA were inversely associated with all-cause mortality risk. • Decreased sleep scores combined with decreased LTPA were associated with a higher all-cause mortality risk. • Increased sleep scores combined with increased LTPA were associated with a lower all-cause mortality risk. • The joint association of changes in sleep score and LTPA with all-cause mortality was driven by the sleep score change. • Maintaining healthy sleep habits and sufficient LTPA together over time may benefit reducing mortality risk. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the effect of the circadian timing program (SİZAP) developed for evening-chronotype individuals with obesity on obesity management and sleep quality. This single-site, randomized controlled trial with an experimental research design was registered in ClinicalTrials.gov. It was reported in accordance with the "Consolidated Standards of Reporting Trials" (CONSORT) randomized controlled trial guidelines. The study sample consisted of 38 evening-chronotype individuals with first-degree obesity, with 19 individuals in each study group. The intervention group's sleep hygiene training was conducted and their lifestyle changes were ensured through SİZAP. The control group followed their normal daily lifestyle. No intervention was made in terms of the dietary practices of both groups. Study data were collected using the personal information form, the anthropometric measurement form, the Horne and Ostberg Morning and Evening Questionnaire (MEQ), the Impact of weight on quality of life–lite (IWQOL-lite), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the sleep diary, and the data tracked via the website and smart bracelets. It was determined that the participants in the SİZAP group had a statistically significant decrease in the anthropometric measurements and daytime sleepiness (p < 0.05). The sleep quality scores and the scores of the bodily functions sub-dimension of the quality of life scale were significantly better in the intervention group than in the control group (p < 0.05). It was found that SİZAP is effective in obesity management in evening-chronotype individuals and increases weight loss success and sleep quality. • Circadian misalignment and late timing of food intake reduce weight loss success. • Evening-chronotype individuals with obesity are less successful in adapting to weight loss treatments. • Circadian timing program according to chronotypes can be applied in obesity management. • Circadian timing program support weight loss in evening-chronotype individuals with obesity. • Circadian timing program contribute to improvement of sleep quality in evening-chronotype individuals with obesity. [ABSTRACT FROM AUTHOR]

To investigate the relationship between both self-reported and objective sleep variables and low-grade inflammation in children and adolescents with major depressive disorder (MDD) of moderate to severe symptom severity. In this cross-sectional study, we examined twenty-nine children and adolescents diagnosed with MDD and twenty-nine healthy controls (HC). Following a one-week actigraphy assessment, comprehensive sleep evaluations were conducted, including a one-night sleep EEG measurement and self-reported sleep data. Plasma high-sensitivity C-reactive protein (hsCRP) was employed as a marker to assess low-grade inflammation. No significant difference in hsCRP levels was observed between participants with MDD and HC. Furthermore, after adjusting for sleep difficulties, hsCRP exhibited no correlation with the severity of depressive symptoms. In HC, levels of hsCRP were not linked to self-reported and objective sleep variables. In contrast, depressed participants showed a significant correlation between hsCRP levels and increased subjective insomnia severity (Insomnia Severity Index; r = 0.41, p < 0.05), increased time spent in the N2 sleep stage (r = 0.47, p < 0.01), and decreased time spent in slow-wave sleep (r = − 0.61, p < 0.001). Upon additional adjustments for body mass index, tobacco use and depression severity, only the inverse association between hsCRP and time spent in slow-wave sleep retained statistical significance. Moderation analysis indicated that group status (MDD vs. HC) significantly moderates the association between slow-wave sleep and hsCRP. Our findings suggest that alterations in the architecture of slow-wave sleep may have a significant influence on modulating low-grade inflammatory processes in children and adolescents with MDD. • Evidence for a relationship between sleep and inflammation in adolescents with MDD. • Inverse association between C-reactive protein and slow-wave sleep in MDD patients. • In healthy controls, low-grade inflammation is not linked to self-reported and objective sleep. [ABSTRACT FROM AUTHOR]

Background: Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. Objectives: This study had two aims: (1) to compare the rhythmic masticatory muscle activity (RMMA) index in supine position (RMMA_sup) and in non‐supine positions (RMMA_nsup) in adults with OSA; and (2) to determine the associations between RMMA index in both supine position and non‐supine positions on the one hand, and several demographic and polysomnographic variables on the other hand. Methods: One hundred OSA participants (36 females and 64 males; mean age = 50.3 years (SD = 10.5)) were selected randomly from among patients with a full‐night polysomnographic recording. RMMA_sup index and RMMA_nsup index were compared using Mann–Whitney U‐test. Multivariate linear regression analyses were used to predict RMMA index both in supine and non‐supine positions based on several demographic and polysomnographic variables. Results: In patients with OSA, the RMMA_sup index was significantly higher than the RMMA_nsup index (p <.001). RMMA_sup index was significantly associated with the arousal index (p =.002) and arousal index in supine position (p <.001). RMMA_nsup index was only significantly associated with the arousal index in non‐supine positions (p =.004). Conclusion: Within the limitations of this study, RMMAs occur more frequently in supine position than in non‐supine positions in patients with OSA. In both sleep positions, RMMAs are associated with arousals. [ABSTRACT FROM AUTHOR]

Background: An 8-month-old male was presented for Chiropractic care with parental concerns primarily related to sleep, muscle strength and digestion. In addition to these stated concerns, his parents were concerned about sleep, excessive gagging and vomiting on solid food, hypersensitivity to touch and a regression in skill levels. Hypotonicity and breastfeeding issues were also flagged as problematic. Intervention: The infant was placed on a Chiropractic care plan, whereby he was managed using Diversified and Activator methods, in addition to spinal adjusting and peripheral adjusting, all modified to be appropriate for his age and tensile strength. Outcomes: Significant positive changes were noted across all the stated areas of concern, concomitant with Chiropractic care. While the infant continued under Chiropractic care after the period of the initial care plan, the changes meant parents were able to work with the chiropractor to resolve issues relating to hypersensitivities, hypertonicity, feeding, sleeping, mood and more. Conclusion: This case report shows multi-system improvements in the infant's physiology and development, and no other interventions were introduced during his time under care. This may provide a rationale for future studies examining sympathetic and specifically vagal tone, in infants under Chiropractic care and how this might contribute to mood, digestion and development.! [ABSTRACT FROM AUTHOR]

Background: Hospitalized children need adequate sleep to favor early recovery. Methods: To study the sleep pattern of children admitted to a pediatric inpatient unit, a cross-sectional study was carried out at a reference hospital in northern Spain. The main study variables were medical specialty of admission, sleep-inducing treatment, hours of sleep at home and during admission, number of nocturnal awakenings, and reasons for awakening. Differences in the hours of sleep and nighttime awakenings between the initial period and at six months were calculated using the Student's t-test. Results: We included 100 baseline patients and 100 post-intervention patients. Up to 4% of the baseline sample and 3% of the six-month sample had been prescribed a sleep-promoting drug. Regarding awakenings, 79% of the children in the baseline sample suffered awakenings, with a mean of 1.98 awakenings (range 1–13). At six months, the percentage of children who experienced awakenings decreased by 17%, with a mean of 1.34 (range 1–5). In the baseline sample, 48% were caused by nursing care, decreasing to 34% after the intervention. Conclusions: An educational intervention with the implementation of targeted evidence-based practices is a useful measure for improving the sleep pattern by decreasing the number of awakenings. [ABSTRACT FROM AUTHOR]

A follow-up study was designed to assess correlations among physical signs, quality of sleep, common mental symptoms, and health-related quality of life after moderate to severe COVID-19 pneumonia. Daily changes in dyspnoea and pulse oximetry were recorded (200 days), and four evaluations (in >2 years) were performed on quality of sleep, mental symptoms, cognitive performance, and health-related quality of life. In a single center, 72 adults participated in the study (52.5 ± 13.7 years old), with no psychiatry/neurology/chronic lung/infectious diseases, chronic use of corticosteroids/immunosuppressive therapy, or pregnancy. Daily agendas showed delayed decreases in dyspnoea scores compared to pulse oximetry and heart rate recordings; however, changes in pulse oximetry were minimal. Slight changes in cognitive performance were related to the general characteristics of the participants (obesity and tobacco use) and with the severity of acute disease (MANCOVA, p < 0.001). Health-related quality of life gradually improved (MANCOVA, p < 0.004). During recovery, bad quality of sleep and mental symptoms (mainly attention/concentration) contributed to the subscores on health perception and vitality in the health-related quality of life assessment. Early mental support services including sleep hygiene could be beneficial during rehabilitation after acute COVID-19. [ABSTRACT FROM AUTHOR]

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Objectives Cancer-related cognitive impairment (CRCI) refers to a cognitive decline associated with cancer or its treatments. While research into CRCI is expanding, evidence remains scattered due to differences in study designs, methodologies, and definitions. The present umbrella review aims to provide a comprehensive overview of the current evidence regarding the impact of different breast cancer therapies on cognitive functioning, with a particular focus on the interplay among objective cognitive deficits (ie, measured with standardized tests), subjective cognitive concerns, (ie, self-reported), and other mediating psycho-physical factors. Methods The search was made in Pubmed, Embase, and Scopus for articles published until July 2023, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis protocol. Results Chemotherapy and endocrine therapy appear consistently associated with CRCI in patients with breast cancer, primarily affecting memory, attention/concentration, executive functioning, and processing speed. Subjective cognitive concerns were often found weakly or not associated with neuropsychological test results, while overall CRCI seemed consistently associated with psychological distress, fatigue, sleep quality, and inflammatory and biological factors. Conclusion Current evidence suggests that CRCI is common after chemotherapy and endocrine therapy for breast cancer. However, heterogeneity in study designs and the scarcity of studies on more recent treatments such as targeted therapies and immunotherapies, highlight the need for more systematic and harmonized studies, possibly taking into account the complex and multifactorial etiology of CRCI. This may provide valuable insights into CRCI's underlying mechanisms and potential new ways to treat it. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionThis population-based study aimed to evaluate the association of mental health and several sleep conditions with Social Frailty (SF) in a sample of Iranian middle-aged and older adults.This cross-sectional study was conducted using data from the Ardakan Cohort Study on Aging (ACSA). SF was assessed by five questions: inability to help others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to (HALFT). Based on the responses, the participants were divided into three groups: social robust (a score of 0), pre-SF (a score of 1-2), and SF (a score of ≥3). Mental health factors included depression and anxiety. Within the domain of sleep conditions, considerations included sleep duration, quality, subjective sleep health, and daytime sleepiness. The logistic regression models were employed to analyze the data.A total of 5782 subjects participated in the study, with females comprising 50.7% of the sample. This study revealed the total prevalence of pre-SF and SF were 76.4 and 9.3%, respectively. After adjusting for age, sex, marital status, education, number of comorbidities, and mental health, in the age group of 50-60 years, anxiety (borderline and abnormal compared to normal, OR = 1.49, 95% CI: 1.05–2.11 and OR = 1.98, 95% CI: 1.26–3.12, respectively) were associated with SF. Similarly, in the age group of 60 years and above, only depression was associated with SF (OR = 2.24, 95% CI: 1.45–3.44).These findings imply that mental health might contribute to SF in the middle-aged and older Iranian population. [ABSTRACT FROM AUTHOR]

Background: It is unclear how primary care physicians manage insomnia after the introduction of novel hypnotics such as orexin receptor antagonists and melatonin receptor agonists. This Web-based questionnaire survey aimed to examine treatment strategies for insomnia in Japanese primary care practice. Methods: One-hundred-and-seventeen primary care physicians were surveyed on the familiarity of each management option for insomnia on a binary response scale (0 = "unfamiliar"; 1 = "familiar") and how they managed insomnia using a nine-point Likert scale (1 = "I never prescribe/perform it"; 9 = "I often prescribe/perform it"). Physicians who were unfamiliar with a management option were deemed to have never prescribed or performed it. Results: Regarding medication, most physicians were familiar with novel hypnotics. Suvorexant was the most used hypnotic, followed by lemborexant and ramelteon. These novel hypnotics averaged 4.8–5.4 points and 4.0–4.7 points for sleep onset and sleep maintenance insomnia, respectively. By contrast, most benzodiazepines were seldom used below two points. Regarding psychotherapy, only approximately 40% of the physicians were familiar with cognitive behavioral therapy for insomnia (CBT-I) and they rarely implemented it, at an average of 1.5–1.6 points. More physicians were familiar with single-component psychotherapies (i.e., relaxation, sleep restriction therapy, and stimulus control) compared to CBT-I, and 48–74% of them implemented it slightly more often, with scores ranging from 2.6 to 3.4 points. Conclusion: This study suggests that Japanese primary care physicians seldom use CBT-I to treat insomnia. In addition, they use novel sleep medications more frequently than benzodiazepines in terms of pharmacotherapy. The use and availability of CBT-I in Japanese primary care might be facilitated by: educating primary care physicians, implementing brief or digital CBT-I, and/or developing collaborations between primary care physicians and CBT-I specialists. [ABSTRACT FROM AUTHOR]

Previous studies on sleep state misperception have objectively evaluated sleep status in special environments using polysomnography. There is a paucity of data from studies that evaluated habitual sleep status in home environments. The present study aimed to investigate sleep state misperception in the home environment of patients with chronic insomnia using a lumbar-worn actigraphy to identify sleep habits associated with sleep state misperception severity. Thirty-one patients and 42 healthy volunteers were included in the insomnia and non-insomnia group, respectively. Participants recorded subjective assessments in sleep diaries, objective assessments with an actigraphy worn for 14 days, and self-assessments using questionnaires. Both groups had similar objective sleep ratings; however, insomnia group had significantly worse subjective ratings (total sleep time, wake after sleep onset, and sleep onset latency). A significant correlation was found between subjective and objective total sleep time scores in non-insomnia group but not in insomnia group. Insomnia group had earlier bedtimes, significantly longer bedtimes, and impaired daytime functioning (Sheehan Disability Scale score); additionally, they underestimated their total sleep time, particularly with earlier bedtimes and longer laying durations. Monitoring the sleep status and habits of individuals in home environments could be instrumental in identifying key points for targeted interventions on sleep hygiene and cognitive behavioral therapy for insomnia. [ABSTRACT FROM AUTHOR]

Background: Sleep is vital for maintaining individuals' physical and mental health and is particularly challenged during pregnancy. More than 70% of women during the gestational period report insomnia symptoms. Sleep dysfunction in the peripartum increases the risk for a cascade of negative health outcomes during late pregnancy, birth, and postpartum. While psychological interventions are considered the first line treatment for sleep difficulties, they are still scarcely offered during pregnancy and there is a lack of longitudinal research combining psychological and physiological indices. Methods: The present protocol outlines a randomized controlled trial aimed at testing the long-term effectiveness of an automatized digitalized psychoeducational intervention for insomnia for expectant mothers complaining insomnia symptoms without comorbidity. Outcomes include physiological, hormonal, and subjective indices of maternal psychopathology, stress, and emotional processes, and sleep and wellbeing of the family system. The trial is part of a longitudinal study evaluating expectant mothers from early pregnancy (within the 15th gestational week) to 6-months postpartum through 6 observational phases: baseline (BSL), 6- and 12-weeks from BSL (FU1-FU2), 2-to-4 weeks after delivery (FU3), and 3- and 6-months after delivery (FU4-5). We plan to recruit 38 women without sleep difficulties (Group A) and 76 women with sleep difficulties (Group B). Group B will be randomly assigned to digital psychological control intervention (B1) or experimental psychoeducational intervention targeting insomnia (B2). At 3 time points, an ecological-momentary-assessment (EMA) design will be used to collect data on sleep and emotions (diaries), sleep-wake parameters (actigraphy) and stress reactivity (salivary cortisol). We will also test the DNA methylation of genes involved in the stress response as biomarkers of prenatal poor sleep. Information on partner's insomnia symptoms and new-borns' sleep will be collected at each stage. Discussion: The proposed protocol aims at testing an easily accessible evidence-based psychoeducational intervention for expectant mothers to help them improving sleep, health, and wellbeing in the peripartum. The results could improve the understanding and management of sleep difficulties and peripartum depression. Trial registration: The study protocol has been registered on 22 April 2024 with ClinicalTrials.gov Protocol Registration and Results System (PRS), ID: NCT06379074. Protocol version: April 23, 2024. [ABSTRACT FROM AUTHOR]

The prevalence of locomotive syndrome naturally increases with age, but approximately half of nonelderly individuals also meet the criteria for locomotive syndrome, suggesting that even younger people need to pay attention to their own health status. Sleep is important for physical, cognitive, and psychological health. Some individuals with poor sleep quality may be at risk of developing negative health status. Although the effects of sleep hygiene strategies for elderly individuals have been well investigated, optimal nonpharmacological sleep hygiene strategies for improving sleep quality in nonelderly individuals has not been identified. We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials aimed to elucidate the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals and to identify the optimal intervention. Cochrane Central Register of Controlled Trials, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Scopus were comprehensively searched. We identified 27 studies focusing on the effects of various nonpharmacological sleep hygiene strategies in nonelderly individuals, and 24 studies were applied into NMA. The present results showed that resistance training was the most effective intervention for improving sleep quality in nonelderly individuals. In addition, this study revealed the effects of nonpharmacological interventions, such as physical activity, nutritional intervention, as well as exercise interventions. This is the first report that utilized NMA to compare the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals. [ABSTRACT FROM AUTHOR]

Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants' typical sleep–wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals. [ABSTRACT FROM AUTHOR]

Introduction: Nocturnal awakening which potentially impairs the quality of sleep as pregnancy progresses, may result from certain night-time habits, as well as a physiological increase in the frequency of micturition, sleep apnoea, and restless leg syndrome. Resultant poor quality of sleep may have adverse fetomaternal outcomes. This study was aimed at assessing sleep quality using validated tools among pregnant women seen in a tertiary care facility. Methods: A cross-sectional study was performed among consenting antenatal care attendees, selected via systematic random sampling technique. Interviewer-administration of Pittsburgh Sleep Quality Index (PSQI) was used, Data was analyzed using SPSS version 24.0, with Chi-square, Fisher's Exact and independent t-tests employed as an inferential statistic, and p-value set at 0.05. Results: The prevalence of low-grade sleep was 37.1%, with a mean PSQI score of 4.55 ± 1.54, The most affected sleep component with poor status was sleep disturbance (44.8%), followed by sleep latency (20.0%) and sleep duration (17.6%). Poor sleep quality was associated with each of the seven sleep components, grand multiparity, and perceived poor health status (p<0.05). Conclusion: There is a significant proportion of unsatisfactory sleep quality among expectant mothers in the study location. Sleep hygiene should be incorporated into routine and follow-up ANC clinic visits, towards prevention of adverse fetomaternal outcomes. [ABSTRACT FROM AUTHOR]

Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, Bedtime procrastination (BP) (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self‐control. N = 96 students at a German university (M = 22.2 years, SD = 4.0) wore a sleep‐tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self‐control, trait BP, and smartphone addiction. Multilevel analyses indicated that more stress experienced during the day was associated with more BP (b = 2.32, p = 0.008), shorter sleep duration (b = −3.46, p = 0.003), and lower sleep quality (b = 1.03, p = 0.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by BP. Our findings indicate that BP might be one factor that contributes to stress‐linked decreases in sleep duration and quality. Potential reasons for stress‐related later time to fall asleep—like higher physiological arousal or stress‐related worries—should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) engage in less physical activity than typically-developing peers. This can result in serious negative consequences for individual well-being and may contribute to the physical, behavioral, and emotional challenges associated with ASD. This study explored the potential benefits of trainer-led, individualized, physical fitness sessions specialized for ASD. Eleven individuals (ages 7–24 years) with ASD were assessed at baseline and following 15 fitness sessions. Participants demonstrated improvements in core and lower-body strength and reductions in restricted and repetitive patterns of behavior, along with non-significant but marked reductions in issues with daytime sleepiness. Results suggest the merit of specialized fitness programs and emphasize the need for larger and more rigorous research studies on this topic. [ABSTRACT FROM AUTHOR]

Drawing on Levinasian concepts of sleep, insomnia, and the il y a, this paper examines the liminal states of insomnia and sleep within the Palestinian-Israeli conflict. Sleep and insomnia, being proximates of death as well as displacement and anonymous existence successively, are topics that have not, to the best of our knowledge, received any critical commentary within (post)colonial studies. This paper argues that the Israeli military occupation deprives Palestinians from sleep, casting them into the horror and anonymous existence of insomnia which, like the Israeli occupation, signifies impervious dialogue and is a catalyst for both psychic and physical displacement. As the Israeli occupation deprives Palestinians of place and sleep, two terms in the words of Levinas recognised as intertwined, it is the ethical responsibility of Palestinians and Palestinian leaders to arm themselves with wakefulness so as to secure their homeland (place) and to fortify themselves against displacement and the horror of the night. Sleep reveals an ethical dimension when examined closely within the Israeli-Palestinian conflict due to its subtle proximity to death. Hence, we contend that falling asleep on the part of Palestinians is unethical due to its direct adverse effects, namely, displacement and death. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of an acceptance and commitment therapy (ACT)-based protocol and cognitive behavior therapy (CBT) for insomnia in adults. Method: The participants comprised 227 adults with insomnia. They were randomized to six weekly group sessions consisting of acceptance and commitment therapy for insomnia (n = 76), cognitive behavioral therapy for insomnia (n = 76), or waitlist (WL; n = 75). Results: Both treatment modalities significantly reduced insomnia severity with large effect sizes in the posttreatment phase. These results were maintained during the follow-up period with large effect sizes. CBT was superior to ACT in reducing the Insomnia Severity Index at posttreatment and follow-up, with a small effect size. ACT was superior to WL at posttreatment and at follow-up, with a moderate effect size. The treatment response and remission ratios were higher with CBT at posttreatment and similar at 6-month follow-up for both therapies, as ACT made further gains in response and remission. ACT had a significantly higher proportion of response and remission than WL in both periods (posttreatment and follow-up). Both therapies improved daytime functioning at both posttreatment and follow-up, with few differential changes across the groups. Conclusions: Both cognitive behavior therapy and acceptance and commitment therapy are effective, with CBT showing superiority and ACT showing delayed improvement. ACT has proven to be an effective therapy, especially in the long term, even in the absence of behavioral techniques such as stimulus control and sleep restriction, and it is a viable option for those who have difficulties adhering to behavioral techniques. What is the public health significance of this article?: This study shows that CBT and ACT are both effective for addressing insomnia. The study also shows that ACT is an effective therapy in the long term. [ABSTRACT FROM AUTHOR]

The 2015 Pelotas Birth Cohort Study in Brazil is a comprehensive research project that investigates the determinants of health and development in children. The study includes follow-ups at different ages and assesses the impact of COVID-19. The research covers various areas such as violence, psychosocial development, stress, sleep patterns, and the effects of the pandemic. The study has a diverse range of participants and has collected new biomarkers and assessments. The assessments conducted at different stages of the children's development cover a wide range of measures, including socioeconomic characteristics, health, parenting practices, child development, and mental health. The study found both positive changes and negative trends in social and environmental determinants of health over a 33-year period. The study's strengths include high response and follow-up rates, as well as comprehensive data collection, but there are limitations such as limited data from fathers and a low response rate for the COVID-19 study. The data from the study are available for collaborative research proposals. [Extracted from the article]

Background: Comorbidities and poor sleep quality are prevalent among individuals with multiple sclerosis (MS). Our understanding of the effects of comorbidities on sleep quality in MS remains limited. Objectives: The objectives were to investigate whether the number and presence of specific comorbidities have associations with sleep quality and to assess the relative contribution of comorbidity groups to sleep quality. Methods: We collected data on sleep quality (using Pittsburgh Sleep Quality Index (PSQI)) and presence of comorbidities in people with MS (n = 1597). Associations between comorbidities and sleep quality were examined using linear regression and dominance analysis. Results: Having more comorbidities was associated with poorer sleep quality (p for trend < 0.001). All 13 groups of comorbidities explained 12.9% of the variance in PSQI from which half of the variance was contributed by mental health disorders. In total, 16 of the 28 comorbidities were associated with significantly worse sleep quality, with the strongest associations seen for 'other autoimmune diseases' (β = 1.98), depression (β = 1.76), anxiety (β = 1.72) and rheumatoid arthritis (β = 1.62). Conclusions: Many individual comorbidities are associated with poorer sleep quality, with mental health disorders making the largest relative contribution. Optimal management of comorbidities that make the greatest contributions could have the largest benefit for improving sleep in MS. [ABSTRACT FROM AUTHOR]

Background: Although the importance of sleep difficulties in emotional disorders has long been acknowledged, the nature of the potential reciprocal relationship between sleep and depressive symptoms is not yet well understood. The coronavirus disease 19 pandemic provided a unique opportunity to study the interrelation of these symptoms over a period marked by increases in sleep and psychological difficulties. Methods: Using online data collection, we followed 1200 adults (59% male) through 1 year of the pandemic. Measures of sleep disturbance and depressive symptoms were assessed at eight time points. Factor analysis of the items from these two measures suggested separate insomnia and depressive symptom factors. A random intercept cross‐lagged panel model was used to assess within‐person relationships between factor analysis‐informed subscales of insomnia and depressive symptoms. Results: Depressive symptoms predicted subsequent changes in insomnia symptoms; however, insomnia did not predict changes in depressive symptoms. Conclusions: Our findings suggest the impact of depressive symptoms on insomnia is evident, but the reverse is not. Implications of this finding along with the need for research addressing depressive symptoms and insomnia as treatment targets are discussed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the relationship between women's menstrual hygiene product use and their level of concern around climate change as well as to identify the variables influencing this relationship. Methods: In all, 978 women between the ages of 18 and 49 who were of reproductive age participated in this descriptive cross‐sectional study. The CHERRIES criteria were followed in conducting the online survey. Data were gathered using the "personal information form" and the Climate Change Anxiety Scale for Women's Health The data were analyzed using descriptive analysis, multiple linear regression, and logistic regression. Results: Women were more prone to using throwaway goods than eco‐friendly, sanitary goods when their climate change worry level was lower. Age, education level, region of residence, and the intensity of menstrual bleeding have an impact on the hygiene products used during the menstrual cycle, whereas environmental pollution in the area of residence and a woman's allergy status have an impact on the level of climate change anxiety concerning a woman's health. Conclusion: Women who are worried about how climate change will affect their health prefer to purchase sustainable/eco‐friendly items. Starting in adolescence, women can receive advice about the use of sustainable products from health experts who are primarily responsible for women's health. Synopsis: Women who are concerned about the effects of climate change on women's health prefer eco‐friendly feminine hygiene products during their menstrual periods. [ABSTRACT FROM AUTHOR]

Background: Premature birth remains a public health problem worldwide, involving a broader context and a multidisciplinary team aimed at combating this phenomenon as much as possible. The consumption of addictive substances by women who are pregnant can occur in different social contexts and at different stages of their lives, which modulate its extent. Obstetricians and anesthetists should consider the anesthetic maternal risks that may arise due to these addictive behaviors. The maternal anesthetic risk is higher in women who are pregnant with a medium-level of education, imbalanced nutrition, stress associated with physical or mental activity, affected sleep hygiene, and failed marriages. Objectives: The objectives of the study refer to analyzing the impact of exogenous factors and the anesthetic risk on premature birth for women who were pregnant during the pandemic period and in women who were pregnant without COVID-19 infection. The authors studied a significant sample of 3588 women who were pregnant without COVID-19 infection, among whom 3291 gave birth at term and 297 gave birth prematurely. Methods: The methods analyzed consist of studying the specialized literature regarding the impact of exogenous factors and parturient's anesthetic risk on premature birth and identifying the regional risk profile of women who are pregnant in the southeast region of Romania compared to that identified in the specialized literature. In the analytical methods, we used a linear regression to study the incidence of exogenous risk factors on anesthetic risk in women who were pregnant with premature births compared to those with full-term births. Results: The results confirm the significant impact of exogenous factors on anesthetic risk and the significant impact of anesthetic risk on premature births. The novelty of the study lies in highlighting the modification of the regional exogenous risk profile during the pandemic period in southeast Romania due to unfavorable socio-economic causes and the translation of grade I and II prematurity events to higher frequencies with an increased level of maternal anesthetic risk. Conclusions: The study findings show that the anesthetic risk is maximized in parturients with a middle school education. Additionally, the anesthetic risk of patients who are pregnant increases with the intensification of smoking adherence and its maintenance throughout the pregnancy at the same intensity. Our study aims to provide a basis for the diversification and development of community intervention programs in the post-COVID-19 era, considering the reshaping of social models and the repositioning of social principles and values. Obstetricians and anesthetists must know and promote family values to harmonize the lives of family members and provide a better life for the mother and child. [ABSTRACT FROM AUTHOR]

Introduction: Sleep is a fundamental necessity for the human body, particularly for ensuring optimal brain function, and health science students are predisposed to experiencing lower-quality sleep than the general population. Aim: To assess the knowledge, attitudes, and awareness of health science students regarding the influence of sleep quality on the brain. Materials and Methods: This descriptive cross-sectional study included male and female students from diverse Colleges at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia, encompassing the College of Science and Health Professions, College of Medicine, College of Applied Medical Sciences, and College of Nursing. The study spanned one year, commencing in September 2022 and concluding in September 2023. It included 361 participants who completed a self-administered validated questionnaire. Participants were chosen through non probability consecutive sampling, and the questionnaire covered demographic characteristics, attitudes towards sleep quality, awareness of its importance, and knowledge of its impact on the brain. Data analysis encompassed descriptive statistics and inferential tests, including the Independent t-test, and Chi-square test with a significance level of p-value <0.05. Results: Female students exhibited a higher likelihood of disagreeing (p-value=0.006) with the notion that sleep quality does not impact memory conversion compared to males. Additionally, a significant number of female students (p-value=0.009) acknowledged the correlation between anxiety and insomnia, which was not as prevalent among males. Among the participants, 66.8% were females, and 33.2% were males. Common presleep behaviours included avoiding tea/coffee (76.5%) and using smartphones before bedtime (90.6%). While awareness of sleep quality's influence on memory recall was high (72.0%), comprehension of its connection with seizures in epilepsy was relatively lower. Conclusion: This study underscores the significance of assessing attitudes, knowledge, and awareness regarding sleep quality among health science students. Notable gender variations were observed, with females demonstrating greater awareness of sleep's impacts on memory and insomnia related to anxiety. Consequently, sleep education initiatives and fostering healthy sleep habits among students in health science disciplines are essential. [ABSTRACT FROM AUTHOR]

Inadequate sleep has a negative impact on the psychological and physiological health of elite athletes. Studies have shown a correlation exists between sleep deprivation and a drop in performance. Despite rising interest in sleep science, current research focus is on outcome and the cause of sleep deprivation is a secondary consideration. This scoping review aims to identify themes in peer-reviewed studies that are related to the possible causation of sleep deprivation in competitive athletes. A scoping review was conducted using the PRISMA-ScR guideline. Three databases were used to research for the literature PubMed, Medline and EBSCO. After applying inclusion and exclusion criteria 16 peer-reviewed studies were identified. The studies were categorised into two sub-categories of short- and long-term causes of sleep deprivation. Five themes were identified: travel, night performance, prior, during and following competition and concussion. The findings of this scoping review identified a number a short and long-term causes of sleep deprivation. The causes of the short-term causes can be addressed by implementing some simple interventions such as napping, relaxation techniques and sleep hygiene could aid an athlete performance. However, the long-term causes were linked to concussion, any intervention would need to be studied in greater detail and is beyond the remit of this scoping review. [ABSTRACT FROM AUTHOR]

Within the context of sleep, attachment is hypothesized to play a central role in regulating bedtime affect and arousal. While previous studies have suggested a link between attachment and sleep quality, a meta-analysis specifically examining this association in adults has been lacking. To address this gap, we conducted a series of multilevel meta-analyses of 28 studies on this topic. Our results indicated a correlation between attachment anxiety and an individual's own sleep quality (r = −0.16, p < 0.001), as well as their partner's sleep quality (r = −0.10, p < 0.05). There was also a negative correlation between attachment avoidance and an individual's sleep quality (r = −0.15, p < 0.001) as well as their partner's sleep quality (r = −0.16, p < 0.01). Additionally, the relationships were moderated by several variables, including age, sleep measurement, and gender. Further analysis indicated that attachment anxiety was associated with poorer subjective sleep quality (PSQI) (r = −0.23, p < 0.001), longer sleep latency (r = −0.10, p < 0.05), increased wakefulness after sleep onset (r = −0.09, p < 0.05), and greater daytime sleepiness (r = −0.20, p < 0.01). Attachment avoidance was associated with poorer self-reported sleep quality (PSQI) (r = −0.16, p < 0.001), longer time to fall asleep (r = −0.15, p < 0.05), and increased daytime sleepiness (r = −0.15, p < 0.05). In summary, the findings of the current study supported the association between attachment insecurity and poorer sleep quality in both individuals and their partners. These findings hold important implications for future interventions aimed at improving sleep quality by addressing attachment-related concerns. • Meta-Analysis reveals attachment's impact on adult sleep quality. • Attachment anxiety correlates negatively with personal and partner sleep. • Attachment avoidance linked to poorer self and partner sleep quality. • Modulating factors include age and sleep measurement method. • Results inform future sleep interventions addressing attachment issues. [ABSTRACT FROM AUTHOR]

Shift work is a common practice in many industries, but it can have negative effects on health, particularly an increased risk of type 2 diabetes. Insulin resistance, poor sleep quality, unhealthy eating patterns, and lack of physical activity are all factors that contribute to this risk. Diabetes educators can help shift workers by providing education and practical tips on improving sleep, nutrition, and exercise. For individuals with type 2 diabetes, managing blood glucose levels can be challenging, but lifestyle factors such as sleep, nutrition, exercise, and stress management can help. Online exercise videos and referrals to exercise professionals can be helpful, as well as stress reduction techniques and consistent medication intake. Diabetes educators can provide support and information to help shift workers manage their diabetes effectively despite irregular work hours. [Extracted from the article]

This article explores the impact of sleep on individuals with type 1 or type 2 diabetes. It emphasizes the importance of sleep in diabetes management and discusses the potential consequences of inadequate sleep, such as increased morbidity and mortality, reduced quality of life, and healthcare utilization. The article addresses the physiological and hormonal aspects of sleep, the role of the circadian system, and the relationship between sleep and glucose metabolism. It also provides recommendations for assessing and optimizing sleep in diabetes management, including screening for sleep disorders. The article concludes by emphasizing the need to integrate sleep health assessments and management strategies into routine diabetes care to improve outcomes. The document contains references to scientific studies related to sleep and its impact on health, specifically in relation to diabetes. [Extracted from the article]

Introduction: Approximately 3400 infants die suddenly and unexpectedly each year in the United States; many of these deaths include modifiable risk factors (such as a non‐supine position, sleeping on a soft surface, or loose bedding or items in the environment). Interventions have been successful at improving parental knowledge about recommendations to reduce risk of sleep‐related infant deaths, as well as improving intention to adopt recommendations. However, follow‐up studies have found a disconnect between knowledge/intentions to adhere to recommendations and actual practices. Exploring maternal decision‐making about infant sleep practices can better elucidate the disconnect between knowledge of infant sleep recommendations and the practice of it, and thus, inform more effective safe sleep interventions. The purpose of this study was to gain a more in‐depth understanding of decision‐making around infant sleep practices, and barriers and facilitators to adopting safe infant sleep recommendations. Methods: Semi‐structured in‐home interviews were conducted with 22 families (20 mothers and 2 mother–father dyads) of infants up to 6 months of age. Results: Thematic analysis of the transcripts revealed six themes: Plans changed when baby came, Trying things to figure out what works (infant preferences), Safety concerns, What's comfortable for me (maternal preferences), They say...(advice), and Trying to be careful. Conclusion: These results suggest that knowledge of infant sleep recommendations alone is not enough to ensure adherence and that decision‐making is a dynamic and ongoing process affected by multiple factors. Findings have implications for timing and content of risk reduction efforts, as well as for data collection in research studies. [ABSTRACT FROM AUTHOR]

The purpose of reporting on selected cases is to increase the recognition and treatment of mechanical joint dysfunction (restrictions in movement at the joint level) in pediatric patients. The selected cases demonstrate a variety of clinical outcomes that are possible using manual therapy to improve mechanical joint dysfunction and chronic pain. The techniques used for these patents were performed by a physical therapist without formal manual therapy training to encourage more physical therapists to use manual therapy as an intervention to improve outcomes in pediatric patients. The hands-on treatment used to treat mechanical joint dysfunction improved participation and function in children of various ages with a variety of clinical issues. : Recognizing and treating mechanical joint restrictions that interfere with active movement in children may result in decreased pain and improved motor skills, balance, self-regulation, sleep hygiene, and social interactions. Clinicians should consider manual therapy as an intervention strategy for pediatric patients with mechanical joint restrictions. [ABSTRACT FROM AUTHOR]

The prevalence of Parkinson's disease (PD) is increasing rapidly worldwide, but there are notable inequalities in its distribution and in the availability of healthcare resources across different world regions. Low- and middle-income countries (LMICs), including Thailand, bear the highest burden of PD so there is an urgent need to develop effective solutions that can overcome the many regional challenges associated with delivering high-quality, and equitable care to a diverse population with limited resources. This article describes the evolution of healthcare delivery for PD in Thailand, as a case example of a LMIC. The discussions reflect the author's presentation at the Yoshikuni Mizuno Lectureship Award given during the 8th Asian and Oceanian Parkinson's Disease and Movement Disorders Congress in March 2023 for which he was the 2023 recipient. The specific challenges faced in Thailand are reviewed along with new solutions that have been implemented to improve the knowledge and skills of healthcare professionals nationally, the delivery of care, and the outcomes for PD patients. Technology and innovation have played an important role in this process with many new tools and devices being implemented in clinical practice. Without any realistic prospect of a curative therapy in the near future that could halt the current PD pandemic, it will be necessary to focus on preventative lifestyle strategies that can help reduce the risk of developing PD such as good nutrition (EAT), exercise (MOVE), good sleep hygiene (SLEEP), and minimizing environmental risks (PROTECT), which should be initiated and continued (REPEAT) as early as possible. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

"Black Health: The Social, Political, and Cultural Determinants of Black People's Health" by Professor Keisha Ray is a comprehensive exploration of the factors contributing to health inequities among Black Americans. The book examines the role of medical professionals in perpetuating prejudice and the connection between bioethics, medicine, race, and racism. It addresses issues such as racism in maternity care, inadequate pain management, and the impact of housing and environmental factors on Black health. The author emphasizes that race is a social construct and highlights shared experiences of racism and social inequities. The book also examines the historical roots of Black maternal mortality and the complex issue of pain influenced by cultural beliefs and bias. It provides valuable insights for understanding health disparities and promoting health equity for marginalized groups. [Extracted from the article]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives This study examined how mental health symptoms (i.e. depression, anxiety, stress) and baseline sleep characteristics (i.e. sleep quality and levels of daytime sleepiness) predicted adherence to and initial success of a brief sleep extension research protocol in emerging adults. Methods 184 emerging adults (ages 18–25; M  = 20.96, SD  = 2.04) were asked to extend their nightly sleep opportunity to 8 hr for 1 week and to anchor bedtime and waketime. Sleep outcomes (adherence and initial protocol success) were tracked using actigraphy. Baseline sleep quality, daytime sleepiness, depression, anxiety, and stress were assessed using self-report questionnaires. Results Poorer baseline sleep quality predicted better adherence to the protocol (p = .002). Other baseline sleep characteristics and mental health were not predictive of adherence (p s>.50). Lower levels of baseline daytime sleepiness approached significance in predicting greater initial protocol success following the protocol (p   =  .05). Baseline sleep quality and mental health did not predict initial protocol success (p s > 0.34). Conclusions Mental health symptoms did not significantly predict adherence to or the success of a sleep extension protocol. Surprisingly, individuals with poor baseline sleep quality were more likely to adhere to the extension protocol, perhaps suggesting heightened motivation for change or increased risk for sleep problems. This research provides valuable insight into factors that predict adherence to sleep extension protocols in emerging adults. [ABSTRACT FROM AUTHOR]

Background Adolescence is a stage of significant transition as children develop into young adults. Optimal sleep is crucial during this period to ensure physical, emotional and mental wellbeing. However, it is well recognised that insufficient quality and quantity of sleep is common among adolescents worldwide. Objective This article aims to provide general practitioners with an overview of the key issues encountered in adolescent patients relating to sleep and summarises approaches to assessment and evidencebased management of sleep problems in this population. Discussion This review highlights the physiological changes that affect sleep during adolescence and how other factors, including unhealthy sleep behaviours, influence these. It discusses the importance of healthy sleep and the consequences of sleep disturbance in adolescents. Management strategies are outlined, focusing on the key common issues that affect sleep in the teenage years, and guidance on when to consider co-management with specialist care is provided. [ABSTRACT FROM AUTHOR]

Shift work, particularly in the auto industry, presents significant health challenges, notably in how it impacts cardiovascular health due to irregular work schedules and associated sleep disruptions. This prospective study evaluated 4683 workers from a single Romanian automotive enterprise to investigate the relationship between fixed shift work schedules and cardiovascular health outcomes. Our analysis focused on fixed-shift workers, excluding those on rotating shifts to reduce variability and enhance the clarity of the findings. The findings reveal that night shift workers are at a heightened risk of cardiovascular diseases (CVDs) compared to their day shift counterparts. Night shift workers demonstrated a higher CVD incidence (4.3%) compared to day shift workers (2.6%), with an odds ratio (OR) of 1.68 (95% CI: 1.08 to 2.62, p = 0.021). This association remained significant after adjusting for potential confounders, with an adjusted OR of 1.74 (95% CI: 1.09 to 2.75, p = 0.019). Male night shift workers exhibited a significantly higher CVD incidence (4.5%) compared to male day shift workers (3.0%), with an OR of 1.75 (95% CI: 1.07 to 2.89, p = 0.026). Female night shift workers also showed a higher CVD incidence (3.4%) compared to female day shift workers (1.3%), although this was not statistically significant. These findings underscore the urgent need for targeted interventions and effective strategies to mitigate these risks and promote the cardiovascular health and overall well-being of shift workers in the auto industry. This research contributes to a deeper understanding of how non-traditional work schedules affect health and provides a basis for implementing protective measures in occupational settings. [ABSTRACT FROM AUTHOR]

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]

The comfort of a smartwatch is recognized as a pivotal determinant affecting users' engagement with the device. This study delved into the intricate interplay between smartwatch comfort, users' behavioral intention, and their actual usage behavior within the specific context of sleep. Through the lens of a structural equation model, we find that the appearance and movement dimensions of comfort significantly influence users' intention to wear the smartwatch during sleep, while other dimensions like pressure, harm, attachment, and perceived change do not show significant effects. Furthermore, this intention significantly translated into smartwatch usage behavior. Building on these insights, we subsequently embarked on an exploration of how personality traits interplay with comfort and intention to impact smartwatch usage during sleep. The moderated mediation models revealed that the personality trait of openness acts as a moderator, amplifying the relationship between smartwatch comfort and behavioral intention. Individuals with higher levels of openness exhibit increased inclination to adopt the smartwatch during sleep, even when comfort is compromised. These insights contribute to a nuanced understanding of smartwatch usage behavior and offer guidance for personalized design strategies, especially within the sleep context. [ABSTRACT FROM AUTHOR]

Introduction: Delivering cognitive behavioral therapy for insomnia over the internet bears the advantage of accessibility and uptake to many patients suffering from chronic insomnia. In the current study, we aimed to investigate the effectiveness of internet-based cognitive behavioral therapy for insomnia (iCBT-I) in routine care. Materials and methods: We conducted a two-arm non-blinded randomized controlled trial with care as usual (CAU) as a control condition. Participants were recruited in a specialized outpatient sleep medicine department. Both arms had access to other healthcare resources, and the intervention group had access to the iCBT-I program for 2 months. The primary outcome was insomnia severity, measured by the Insomnia Severity Index (ISI). Secondary outcomes were fatigue severity, daytime sleepiness, affective symptoms, dysfunctional beliefs and attitudes about sleep, sleep locus of control, sleep hygiene, sleep efficiency (SE), sleep onset latency, wake time after sleep onset (WASO), and total sleep time (TST). Linear mixed models for repeated measures were used to analyze the longitudinal data at baseline, post-treatment, and after 3 months of follow-up. The trial was registered at www.clinicaltrials.gov (NCT04300218 21.04.2020). Results: The results showed a significant time*group interaction effect (p = 0.001) at post-treatment with between-group effect size (d = 0.51), indicating that the ISI decreased by a score of 3.8-fold in the iCBT-I group than in the CAU group. There was no significant difference in ISI between groups at follow-up. Regarding secondary outcomes, dysfunctional beliefs about sleep, SE, and WASO decreased significantly during treatment in the intervention group with betweengroup effect sizes d = 0.35, d = -0.51, and d = 0.47, respectively. At the follow-up, between-group effects on DBAS and SE remained significant: d = 0.36 and d = -0.63, respectively. For TST, we observed a significant time*group effect of d = -0.38 only after follow-up. Conclusion: Our findings suggest that iCBT-I has a significant effect on insomnia severity at post-treatment compared to CAU. iCBT-I further improved dysfunctional beliefs about sleep and improved subjective sleep characteristics, such as SE, WASO, and TST during 3 months after treatment. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia (SCZ) is linked to a heightened risk of impulsive aggression and disturbances in sleep patterns. Cognitive and social cognitive impairments have been connected to aggression, with social cognitive deficits appearing to play a more immediate role. In this investigation, we conducted a retrospective analysis of the impact of cognitive training and sleep interventions on aggressive behavior and the quality of sleep among individuals with SCZ who were hospitalized. Methods: This study divided 80 hospitalized patients into two groups according to medical advice, namely the normal group and the study group. The control group received routine drug treatment and education; The research group implemented cognitive training and sleep intervention based on the normal group. Collect basic clinical data, aggressive behavior indicators, and sleep quality indicators. Results: There is no difference in the basic information statistics between the two groups. Both groups can reduce aggressive behavior and improve sleep quality. In the study group, there was a notable decrease in aggressive behavior compared to the control group. Furthermore, the sleep quality in the study group exhibited significant improvement when compared to the control group. Conclusion: Cognitive training and sleep intervention have been proven to be effective nonpharmacological treatments, effectively reducing aggressive behavior and improving sleep quality. [ABSTRACT FROM AUTHOR]

Sleep problems are common in children with attention deficit hyperactivity disorder (ADHD). Children's sleep problem may influence, and be influenced by, parents' sleep problems as well as parents' ADHD symptoms. In the current study we examined the associations of parent-rated sleep quality and sleep timing of pre-adolescent children with parental insomnia symptoms, parental ADHD symptoms and dysfunctional attitudes and beliefs about sleep in a convenience sample recruited by advertisement (N = 120). Childhood sleep problems were common in the sample, with 82% of children exceeding the threshold for the presence of a paediatric sleep disorder. Children's sleep quality showed minimal association with their sleep timing and chronotype. Parental insomnia symptoms, ADHD symptoms and dysfunctional beliefs and attitudes about sleep all associated with their children's sleep quality, and with the sleep subdomains of sleep anxiety and parasomnias. In multiple regression analysis only parental insomnia score was a significant predictor of children's sleep quality. Children's bedtimes, wake times, sleep duration, chronotype or social jetlag did not associate with parents' ADHD or insomnia symptoms. Sleep quality was significantly poorer in children whose parents scored as both consistent for adult ADHD and probable for insomnia disorder compared to parents who scored as either ADHD consistent or insomnia probable, or those who parents scored as neither. We discuss the putative nature of the relationships between sleep quality of children with ADHD and parental ADHD and insomnia symptoms, and suggest that clinicians consider parental sleep when attending to children with ADHD. [ABSTRACT FROM AUTHOR]

Summary Despite emerging public concern regarding the sleep health of military personnel over the past two decades, there remains a dearth of research examining sleep health among naval personnel assigned to sea duty. This study examined sleep metrics (e.g. fatigue, short sleep duration) and mental (e.g. posttraumatic stress disorder, depression) and physical health (e.g. type 2 diabetes, bodily pain) outcomes among naval personnel with recent sea duty (i.e. afloat) compared with naval personnel with recent shore duty (i.e. ashore). Prevalence ratios and mean differences for all outcomes were estimated and adjusted for demographic and military variables, and subsequently stratified by obesity. Sleep metrics were similar between afloat and ashore sailors except for short sleep duration, while sailors with recent shore duty had poorer physical health compared with those with recent sea duty. Stratified analyses suggested naval personnel with obesity had a higher proportion of nearly all adverse sleep‐related health outcomes than those without obesity. Among participants without obesity, afloat personnel were more likely to report very short sleep (≤ 5 hours) and fewer hours of average nightly sleep, but were less likely to report physical health outcomes compared with ashore personnel. These findings suggest potential differences in sleep metrics and sleep‐related health outcomes between afloat and ashore naval personnel. Additional research examining sleep outcomes using more objective measures is required to further investigate these findings, which may inform strategies to foster consolidated sleep despite environmental and occupational challenges in order to maintain high‐performing naval personnel. [ABSTRACT FROM AUTHOR]

Background: Maintaining a consistent sleep and wake time is often reported as a key component of circadian rhythmicity and quality sleep. However, the impact of sleep onset and offset time variability on overall sleep outcomes are underreported in elite athlete populations. This study investigated the relationship between sleep onset and offset time variability using the sleep regularity index (SRI) and measures of sleep and well-being in professional rugby union athletes. Twenty-three professional male rugby union athletes (mean ± SD, age: 23 ± 3 y) underwent sleep monitoring via wrist actigraphy for three weeks during a pre-season phase of training and completed a daily wellness questionnaire. Median SRI was calculated and used to stratify the trainees into two quantile groups: >76.4 SRI (Regular, n = 11) and < 76.4 SRI (Irregular, n = 12). Results: The regular sleep group showed significantly longer total sleep duration (p = 0.02, d = 0.97) compared to the irregular group (7:42 ± 0:29 vs. 7:18 ± 0:20 h: min per night, respectively). Furthermore, while not statistically significant, the regular sleep group showed greater sleep efficiency and less wake episodes compared to irregular sleepers, as demonstrated by moderate effect sizes (d = 0.71 and 0.69, respectively). Conclusions: The results from this study indicate that minimizing variability in sleep onset and offset time is beneficial for increasing sleep duration and may improve sleep efficiency during pre-season training in elite male rugby union athletes. This study provides evidence for the importance of including sleep-wake routines as a key component of sleep education interventions. Key Points: •When compared to irregular sleepers, regular sleepers demonstrated significantly longer total sleep duration (∼ 24 min per night) over a three-week period (> 9 h more of total sleep). •Regular sleepers experienced fewer wake episode during the night, and had moderately higher sleep efficiency than irregular sleepers. •The median sleep regularity index in this male, professional rugby cohort was 76.4, considerably lower than that reported in previous reports of elite team sport athletes. •This study provides further support for the inclusion of promoting regular sleep-wake routines as a key component of sleep hygiene education. [ABSTRACT FROM AUTHOR]

Background: Adolescent insufficient sleep is an endemic issue that may result in compromised functioning throughout the course of the day and is associated with increased risk for a variety of adverse outcomes. Early school start time (SST) has been consistently found to be detrimental to adolescents' sleep achievement on school nights. However, there are logistical barriers to changing SST. Evidence supports daily engagement in moderate-to-vigorous intensity physical activity (MVPA) to enhance adolescents' nightly sleep achievement. However, the role of MVPA in the association between SST and sleep duration is unknown. This study examines the potential moderating effect of MVPA in the association between SST and sleep duration on a typical school day among adolescents. Methods: This study examined data (collected in April and October 2014) from a national sample of 1132 adolescents (mage = 14.5 years) living in the United States from the Family Life, Activity, Sun, Health, and Eating study, a cross-sectional, internet-based survey. First, three linear regressions were computed to examine bivariate associations between SST, MVPA, and sleep duration while controlling for participant sex, race and ethnicity, household income, school level, and the presence of a TV in the bedroom. Next, a three-step multiple regression was computed with sleep duration as the dependent variable, and the final step included an interaction term between SST and MVPA. Results: Later SST (b1 = 0.41, p < 0.001) and increased MVPA (b1 = 0.39, p < 0.001) were both associated with increased sleep duration, while SST and MVPA were not significantly associated. In the final multiple regression model, which included the interaction term, school day MVPA moderated the positive association between SST and school night sleep duration (b1 = − 3.7, p < 0.05), such that the greater the MVPA on a typical school day, the weaker the positive association between early SST and sleep duration. In post-hoc analysis, the interaction effect was only significant for females and not males. Conclusions: The significant buffering effect of MVPA on the association between SST and sleep duration suggests that in the absence of SST changes, promoting MVPA among adolescents may be a promising strategy to mitigate insufficient sleep among US adolescents. [ABSTRACT FROM AUTHOR]