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Background To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work. Aims To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts. Methods A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N  = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days. Results A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work. Conclusions Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling. [ABSTRACT FROM AUTHOR]

This article discusses a case of a patient with anti-Ma encephalitis, a paraneoplastic neurological syndrome caused by the immune impact of cancer on the nervous system. The patient exhibited symptoms such as memory loss, narcolepsy, rapid eye movement behavior disorder, eye movement abnormalities, and parkinsonism. The case also highlights the presence of agrypnia excitata, a unique electroclinical syndrome that disrupts sleep structure. The article emphasizes the importance of investigating autoimmune origins in patients with sleep disorders and the emerging recognition of autoimmune disorders in rare electroclinical conditions. [Extracted from the article]

To explore sleep structure in participants with obstructive sleep apnea (OSA) and comorbid insomnia (COMISA) and participants with OSA without insomnia (OSA-only) using both single-night polysomnography and multi-night wrist-worn photoplethysmography/accelerometry. Multi-night 4-class sleep-staging was performed with a validated algorithm based on actigraphy and heart rate variability, in 67 COMISA (23 women, median age: 51 years) and 50 OSA-only (15 women, median age: 51) participants. Sleep statistics were compared using linear regression models and mixed-effects models. Multi-night variability was explored using a clustering approach and between- and within-participant analysis. Polysomnographic parameters showed no significant group differences. Multi-night measurements, during 13.4 ± 5.2 nights per subject, demonstrated a longer sleep onset latency and lower sleep efficiency for the COMISA group. Detailed analysis of wake parameters revealed longer mean durations of awakenings in COMISA, as well as higher numbers of awakenings lasting 5 min and longer (WKN ≥5min) and longer wake after sleep onset containing only awakenings of 5 min or longer. Within-participant variance was significantly larger in COMISA for sleep onset latency, sleep efficiency, mean duration of awakenings and WKN ≥5min. Unsupervised clustering uncovered three clusters; participants with consistently high values for at least one of the wake parameters, participants with consistently low values, and participants displaying higher variability. Patients with COMISA more often showed extended, and more variable periods of wakefulness. These observations were not discernible using single night polysomnography, highlighting the relevance of multi-night measurements to assess characteristics indicative for insomnia. • Single-night sleep measurements show limited value in the differentiation between OSA and COMISA. • COMISA patients more often show extended periods of wakefulness over multiple nights. • Combined photoplethysmography and actigraphy can adequately capture these differences. • Multi-night assessment is useful to objectively identify comorbid insomnia and prompt further investigation. [ABSTRACT FROM AUTHOR]

Parasomnia is potentially implicated in sleep pattern and sleep architecture, however, evidence is quite limited. This study aimed to investigate the association between parasomnia symptoms and sleep onset delay among children through a large epidemiological study. Two rounds of cross-sectional studies were conducted among 21,704 children aged 3–11; one taking place in Shanghai and the other in Sanya, Hainan province. Children's sleep characteristics were evaluated using the Children's Sleep Habits Questionnaire (CSHQ). Propensity score matching was adopted to balance the difference of covariates, and the logistic regression models were implemented to examine the associations between parasomnia symptoms and sleep onset delay. A total of 38.2 % of children had sleep onset delay. Parasomnias, especially non rapid eye movement (NREM) and rapid eye movement (REM) parasomnia symptoms, were associated with an increased risk of sleep onset delay (Sleep Walking: OR = 1.55; Sleep Terror: OR = 1.34; Nightmare: OR = 1.37, all p˂ 0.001). The similar findings were observed in stratified analyses according to sleep duration, and the association was pronounced in sleep sufficiency group (Sleep Walking: OR = 1.62; Sleep Terror: OR = 1.35; Nightmare: OR = 1.35, all p˂ 0.001). Moreover, a dose-dependent pattern was observed, in which cumulative parasomnia symptoms were associated with increasing risk of sleep onset delay (2 symptoms: OR = 1.19; ≥3 symptoms: OR = 1.40; by comparison with ≤1 symptom). All these findings were also similarly observed in the propensity score matching sample. Moreover, the associations were generally established in both Shanghai and Sanya children. Parasomnia symptoms were associated with a higher risk of sleep onset delay independently of sleep duration among children. More studies are needed to enrich the current evidence, thus further clarifying the association and interaction among different sleep parameters. • Associations exist between parasomnia symptoms, especially non-rapid eye movement (NREM) parasomnias, and sleep onset delay. • This association persisted across different sleep durations and exhibited a dose-dependent pattern. • Our results underscore the critical role of parasomnias in childhood sleep disturbances, prompting further research. [ABSTRACT FROM AUTHOR]

Summary: Sleep symptoms, including excessive sleepiness, are frequently reported by patients with functional motor disorders (FMD). We aimed to classify the comorbid sleep disorders in FMD, and to investigate the relationship between subjective sleepiness and objective measures of hypersomnia, comparing them with data from people with central hypersomnia. A total of 37 patients (mean [SD] age 46.4 [11.2] years) with clinically definite FMD, and 17 patients (mean [SD] age 41.1 [11.6] years) with central hypersomnia underwent structured medical and sleep history, neurological examination, polysomnography, multiple sleep latency test (MSLT), and questionnaires assessing sleepiness, fatigue, and depression. In all, 23 patients with FMD (62%) reported excessive daytime sleepiness. Evidence of specific sleep disorders was identified in our cohort, with 35% having restless legs syndrome; 49% obstructive sleep apnea; and 8% periodic limb movements in sleep; however, the presence of these disorders was not correlated with subjective sleepiness. Patients with FMD with self‐reported sleepiness reported higher fatigue (p = 0.002), depression (p = 0.002), and had longer sleep latencies in the MSLT (p < 0.001) compared to the patients with central hypersomnia. No correlation was found between subjective and objective sleepiness in either group. Fatigue positively correlated with self‐reported sleepiness in patients with FMD (p < 0.001). This study did not find objective correlates of increased sleepiness in patients with FMD. While sleep abnormalities were found to be common in FMD, they were not correlated with self‐reports of excessive sleepiness. Positive correlations between self‐reported sleepiness and fatigue support the current unified model of non‐motor symptoms in FMD. [ABSTRACT FROM AUTHOR]

Summary: A 1‐year systematic diary was kept by an anonymous diarist in Hamburg in the year 1755–1756. Sleep, activities, food intake, urine volume, and meteorological data were documented daily. The systematic recording of sleep and naps, with an accuracy of a quarter of an hour allowed analysis of the placement, duration, and consistency of sleep. The mean (range) night sleep duration was 6 (3–9) h. The distribution of sleep interruptions showed two peaks, short (≤30 min) and long (≥45 min) interruptions. The latter indicted nights with segmented sleep. Time in bed was subject to strong seasonal variations. Bedtime and rise time were earlier in summer than in winter and sleep latency was shorter in summer than in winter. However, sleep duration displayed a large spread in all seasons and did not differ substantially between summer and winter. Seasonal variations of sleep timing were related to the varying daylight hours during the year. Finally, the results of this individual case may prompt a more detailed investigation of the variability of sleep behaviour in the pre‐industrial period. [ABSTRACT FROM AUTHOR]

Summary: Insufficient sleep syndrome possibly represents the worldwide leading cause of daytime sleepiness, but remains poorly recognised and studied. The aim of this case series is to comprehensively describe a cohort of patients with insufficient sleep syndrome. Eighty‐two patients were studied concerning demographic and socio‐economic features, medical, psychiatric and sleep comorbidities, substance use, sleep symptoms, actigraphy, video‐polysomnography, multiple sleep latency tests and treatment. The typical patient with insufficient sleep syndrome is a middle‐aged adult (with no difference of gender), employed, who has a family, often carrying psychiatric and neurological comorbidities, in particular headache, anxiety and depression. Other sleep disorders, especially mild sleep apnea and bruxism, were common as well. Actigraphy was a valuable tool in the characterisation of insufficient sleep syndrome, showing a sleep restriction during weekdays, associated with a recovery rebound of night sleep during weekends and a high amount of daytime sleep. An over‐ or underestimation of sleeping was common, concerning both the duration of night sleep and daytime napping. The average daily sleep considering both daytime and night‐time, weekdays and weekends corresponds to the recommended minimal normal duration, meaning that the burden of insufficient sleep syndrome could mainly depend on sleep fragmentation and low quality. Sleep efficiency was elevated both in actigraphy and video‐polysomnography. Multiple sleep latency tests evidenced a tendency toward sleep‐onset rapid eye movement periods. Our study offers a comprehensive characterisation of patients with insufficient sleep syndrome, and clarifies their sleeping pattern, opening avenues for management and treatment of the disorder. Current options seem not adapted, and in our opinion a cognitive‐behavioural psychotherapy protocol should be developed. [ABSTRACT FROM AUTHOR]

Summary: The Maintenance of Wakefulness Test is widely used to objectively assess sleepiness and make safety‐related decisions, but its interpretation is subjective and normative values remain debated. Our work aimed to determine normative thresholds in non‐subjectively sleepy patients with well‐treated obstructive sleep apnea, and to assess intra‐ and inter‐scorer variability. We included maintenance of wakefulness tests of 141 consecutive patients with treated obstructive sleep apnea (90% men, mean (SD) age 47.5 (9.2) years, mean (SD) pre‐treatment apnea–hypopnea index of 43.8 (20.3) events/h). Sleep onset latencies were independently scored by two experts. Discordant scorings were reviewed to reach a consensus and half of the cohort was double‐scored by each scorer. Intra‐ and inter‐scorer variability was assessed using Cohen's kappa for 40, 33, and 19 min mean sleep latency thresholds. Consensual mean sleep latencies were compared between four groups according to subjective sleepiness (Epworth Sleepiness Scale score < versus ≥11) and residual apnea–hypopnea index (< versus ≥15 events/h). In well‐treated non‐sleepy patients (n = 76), the consensual mean (SD) sleep latency was 38.4 (4.2) min (lower normal limit [mean – 2SD] = 30 min), and 80% of them did not fall asleep. Intra‐scorer agreement on mean sleep latency was high but inter‐scorer was only fair (Cohen's kappa 0.54 for 33‐min threshold, 0.27 for 19‐min threshold), resulting in changes in latency category in 4%–12% of patients. A higher sleepiness score but not the residual apnea–hypopnea index was significantly associated with a lower mean sleep latency. Our findings suggest a higher than usually accepted normative threshold (30 min) in this context and emphasise the need for more reproducible scoring approaches. [ABSTRACT FROM AUTHOR]

Background: Circadian preference refers to individual differences for mental and physical activity in the morning and evening. We hypothesized, that inadvertent use of electronic media can cause circadian misalignment that influences sleeping habits and sleep quality of young adults. Aims and Objectives: The aim of the study was to investigate the effect of circadian preferences on sleeping habits and the association of electronic media use with sleep quality and sleep disturbances. Materials and Methods: A total of 188 subjects were enrolled and divided into three groups: Evening, intermediate, and morning chronotype based on the Morningness-Eveningness score. Electronic media use at bedtime and duration of use were assessed subjectively. Sleep quality and subjective sleep disturbances, daytime sleepiness, and chronotype were assessed by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Morningness-Eveningness Questionnaire Self-assessment version, respectively. Results: The majority of subjects with the evening chronotypes suffered from poor sleep quality compared to other chronotypes and the difference was statistically significant. In evening-type subjects, electronic media use at bedtime, long sleep latency, short sleep duration, and daytime sleepiness were significantly associated with poor sleep quality with odds ratios of 2.34 (1.08-5.08), 11.42 (4.98-26.19), 8.54 (1.01-68.24), and 1.68 (1.03-2.73), respectively. Conclusion: The majority of evening-type subjects had poor sleep quality, altered sleeping habits, and electronic media use at bedtime is significantly associated with poor sleep quality. Hence, history regarding sleep habits and lifestyle, especially electronic media use, should be taken from young adults, who are coming to the outpatient department for other than sleep disorders, to prevent the development of health-related problems. [ABSTRACT FROM AUTHOR]

Appraise the evidence for daridorexant 50 mg and 25 mg versus placebo when treating chronic insomnia disorder in terms of number needed to treat (NNT), number needed to harm (NNH), and likelihood to be helped or harmed (LHH). NNT, NNH, and LHH were calculated from a 3-month pivotal Phase 3 study (N = 930; randomized 1:1:1 to daridorexant 50 mg, daridorexant 25 mg, or placebo once nightly). Wakefulness after sleep onset, latency to persistent sleep, self-reported total sleep time, Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ), and Insomnia Severity Index were used for the NNT efficacy analysis. NNH safety analysis was performed using rates of adverse events (AEs) occurring in >1% of the participants in any arm. LHH was assessed for all NNT estimates, contrasting them with NNH estimates for somnolence, headache, and fatigue AEs. NNT estimates for daridorexant 50 mg versus placebo were <10 for clinically meaningful thresholds across all outcomes. NNT estimates for daridorexant 25 mg versus placebo were not as robust as those observed for daridorexant 50 mg, with many values exceeding 10. NNH estimates for daridorexant 50 mg and 25 mg versus placebo did not show a statistically significant treatment difference except for falls, where NNH was negative for the daridorexant 50 mg group (−44 [95% CI −328; −21]; rate of falls was greater with placebo than for daridorexant 50 mg). All LHH ratios at Months 1 and 3 were >1 (except for daridorexant 25 mg for the IDSIQ alert/cognition domain), indicating that patients were more likely to respond to daridorexant 50 mg and 25 mg than to experience an AE of somnolence, headache, or fatigue. Daridorexant 50 mg and 25 mg have a favorable benefit–risk ratio over 3 months. Daridorexant 50 mg demonstrated more robust (lower) NNT estimates versus placebo than daridorexant 25 mg. Daridorexant, a dual orexin receptor antagonist, is a new treatment for chronic insomnia disorder. This analysis examined the effect and safety of daridorexant 50 and 25 mg, using data from a 3-month Phase 3 study (NCT03545191) to measure 'number needed to treat' (NNT) and 'number needed to harm' (NNH). NNT estimates how many patients need to be treated over a specific period to see one more beneficial response. Estimates versus placebo <10 indicate an effective treatment. Daridorexant 50 mg estimates were <10 for all objective and subjective measurements of insomnia assessed in this analysis, including evaluation of daytime functioning. NNT estimates for daridorexant 25 mg versus placebo were not as robust as daridorexant 50 mg, with values >10. NNH is calculated in the same way as NNT but estimates harmful outcomes rather than benefits. Estimates versus placebo >10 means the treatment is reasonably well tolerated. Using NNT and NNH, the 'likelihood to be helped or harmed' (LHH) ratio was calculated, determining how more likely a patient is to benefit versus experiencing harm from a treatment (LHH of >1 denotes a positive benefit–risk ratio). Both daridorexant doses had a favorable benefit–risk ratio over 3 months with LHH > 1. This analysis supports daridorexant 50 mg as the optimal dose to treat insomnia in adults, offering improved effectiveness compared with daridorexant 25 mg, with a similarly good safety profile. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación en Salud VIVE is the property of Revista de Investigacion en Salud VIVE 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 Journal of General Health Sciences (JGEHES) is the property of Journal of General Health Sciences (JGEHES) 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.)

Background: N-Ethylmaleimide (NEM), an agonist of the potassium chloride cotransporters 2 (KCC2) receptor, has been correlated with neurosuppressive outcomes, including decreased pain perception and the prevention of epileptic seizures. Nevertheless, its relationship with sleep-inducing effects remains unreported. Objective: The present study aimed to investigate the potential enhancement of NEM on the sleep-inducing properties of alprazolam (Alp). Methods: The test of the righting reflex was used to identify the appropriate concentrations of Alp and NEM for inducing sleep-promoting effects in mice. Total sleep duration and sleep quality were evaluated through EEG/EMG analysis. The neural mechanism underlying the sleep-promoting effect was examined through c-fos immunoreactivity in the brain using immunofluorescence. Furthermore, potential CNS-side effects of the combination Alp and NEM were assessed using LABORAS automated home-cage behavioral phenotyping. Results: Combination administration of Alp (1.84 mg/kg) and NEM (1.0 mg/kg) significantly decreased sleep latency and increased sleep duration in comparison to administering 1.84 mg/kg Alp alone. This effect was characterized by a notable increase in REM duration. The findings from c-fos immunoreactivity indicated that NEM significantly suppressed neuron activation in brain regions associated with wakefulness. Additionally, combination administration of Alp and NEM showed no effects on mouse neural behaviors during automated home cage monitoring. Conclusions: This study is the first to propose and demonstrate a combination therapy involving Alp and NEM that not only enhances the hypnotic effect but also mitigates potential CNS side effects, suggesting its potential application in treating insomnia. [ABSTRACT FROM AUTHOR]

Background: Perceived social support (PSS) plays a considerable role in mental health. The Multidimensional Scale of Perceived Social Support (MSPSS) is one of the most widely used scales, leading to much research evidence. The present study investigated its measurement model, equivalence across gender (male and female) and age groups (older patients= above 60 and non-older patients= below 60), and concurrent validity. Methods: A cross-sectional survey was conducted between March and October 2020, on patients hospitalized due to COVID-19 in Tehran, Iran. The scales were administered to 328 COVID-19 patients (54.6% male, aged 21 to 92) from two general hospitals; participants completed MSPSS (including friends, family, and significant others subscales), Pittsburgh Sleep Quality Index (PSQI, include sleep latency, subjective sleep quality, habitual sleep efficiency, sleep duration, use of sleep medication, daytime dysfunction, and sleep disturbances subscales), and the Perceived Stress Scale-10 (PSS-10, to assess patients' appraisal of stressful conditions). Results: The MSPSS three-factor structure was confirmed among COVID-19 patients by Confirmatory Factor Analysis (CFA). The results support the MSPSS internal consistency and configural, metric, and scalar invariance across gender and age groups. Nevertheless, small but significant differences were found across ages based on the latent factor mean of the MSPSS from friends, with a lower mean level in older patients. The coefficients of Cronbach's alpha (ranging from.92 to.96), the ordinal theta (ranging from.95 to.98), and Omega (ranging from.93 to.97) suggested high internal consistency of MSPSS. The concurrent validity of MSPSS was evidenced by its significant negative correlation with PSS-10 (Γb = -.13, p <.01) and also subjective sleep quality (Γb = -.22, p <.01), sleep disturbances (Γb = -.26, p <.001), and daytime dysfunction (Γb = -.26, p <.001). Conclusions: The MSPSS was valid and reliable for measuring individuals' perception of social support between males and females and older and non-older COVID-19 patients. [ABSTRACT FROM AUTHOR]

Copyright of RIIS: Revista de Investigação & Inovação em Saúde is the property of RIIS: Revista de Investigacao & Inovacao em Saude 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.)

Adolescent depression is a growing concern, and recent research has highlighted the links between poor sleep, the Dark Triad (DT) personality characteristics, and depressive symptoms. However, the intricate interrelationships between these variables remain largely unknown. To fill this research gap, we conducted an exploratory study with 302 adolescents aged 12 to 18. Participants completed online questionnaires, including the Dirty Dozen, the Consensus Sleep Diary (CSD), and the Beck Depression Inventory-II. Our findings indicate that adolescents who experience more problematic sleep patterns and higher levels of DT traits tended to exhibit greater depressive symptoms. Psychopathy and Machiavellianism, in particular, were strong predictors of depression in adolescents, while no significant relationship was found between narcissism and depressive symptoms. Furthermore, our study examined how sleep patterns moderated the link between DT traits and depression. We found that sleep latency and efficiency significantly moderated the association between psychopathy and depression. The findings suggest that specific sleep parameters can influence the link between DT and depression, providing important implications for the prevention and treatment of depression in adolescents. Overall, our study highlights the complex interrelationships between sleep, the Dark Triad, and adolescent depression and provides important insights for research and clinical work in the future. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is a complex phenomenon accompanied by biological, physiological and psychosocial changes for a mother. It is also regarded as a stressful life event where a woman's role, identity and interpersonal relationships are restructured. The present study from Pakistan explores the association of sleep quality and poor sleeping habits with prenatal stress using Pittsburgh Sleep quality Index. Results: There were a total of 516 women (mean age = 29.82 years), with more than half reporting poor sleep quality. Ethnically, a majority (395, 76.6%) were natives of the Punjab province while rest were non-natives. A high percentage of respondents reported poor subjective sleep quality (22.1%), sleep latency (44.1%), habitual sleep efficiency (27.5%), sleep disturbance (30.1%), use of medications (7.1%) and daytime dysfunction (29.5%). According to logistic regression analysis, respondents with poor sleep quality were 2.24 (95% CI = 1.55–3.22, P < 0.001) times more likely to have high stress levels (P < 0.001). [ABSTRACT FROM AUTHOR]

Insomnia is very common in psychiatric disorders, but the polysomnographic (PSG) characteristics of insomnia in various psychiatric disorders are still not agreed upon. This study aimed to investigate the characteristics of PSG and its relationship with metabolic indicators in insomnia patients with affective disorders and primary insomnia (PI) patients. A total of 38 patients with PI, 44 major depressive disorder patients with insomnia (DI), 49 generalized anxiety disorder patients with insomnia (GI), and 19 bipolar mania patients with insomnia (BI) were included. PSG was used to detect sleep problems in subjects, and biochemical indicators were also collected. The results of this study found that subjects with BI were lower on REM sleep latency (RL), awakenings number (AN), number of microarousals (NM), and apnea–hypopnea index (AHI) than those with DI and GI, and lower on RL and AN than those with PI. Subjects with PI had lower NM and AHI than those with DI and GI. Patients with DI had a higher RL than those with GI. All results passed Bonferroni correction (p < 0.00078). No differences in biochemical indices were found among the four groups of subjects. Also, AHI was found to be positively correlated with free triiodothyronine (FT3) and fasting blood glucose in subjects. This study suggests that various psychiatric disorders may have their characteristics in terms of PSG parameters, which prompted us to focus on the PSG characteristics of these disorders when assessing them, as well as to focus on their biochemical indicators. • The study aimed to investigate the PSG characteristics of insomnia in four psychiatric disorders. • Patients with BI had lower REM sleep latency, AN, NM, and AHI than those with other disorders studied. • Patients with PI had lower NM and AHI compared to patients with MI and GI. • Patients with MI had a higher REM sleep latency than those with GI. • FT3 and FBG correlated positively with AHI in all insomnia patients, indicating the importance of biochemical assessment. [ABSTRACT FROM AUTHOR]

Background: Excessive daytime sleepiness (EDS) is a cause of low quality of life among obstructive sleep apnoea (OSA) patients. Current methods of assessing and predicting EDS are limited due to time constraints or differences in subjective experience and scoring. Electroencephalogram (EEG) power spectral densities (PSDs) have shown differences between OSA and non-OSA patients, and fatigued and non-fatigued patients. Therefore, polysomnographic EEG PSDs may be useful to assess the extent of EDS among patients with OSA. Methods: Patients presenting to Israel Loewenstein hospital reporting daytime sleepiness who recorded mild OSA on polysomnography and undertook a multiple sleep latency test. Alpha, beta, and delta relative powers were assessed between patients categorized as non-sleepy (mean sleep latency (MSL) ≥10 min) and sleepy (MSL <10 min). Results: 139 patients (74% male) were included for analysis. 73 (53%) were categorized as sleepy (median MSL 6.5 min). There were no significant differences in demographics or polysomnographic parameters between sleepy and non- sleepy groups. In multivariate analysis, increasing relative delta frequency power was associated with increased odds of sleepiness (OR 1.025 (95% CI 1.024-1.026)), while relative alpha and beta powers were associated with decreased odds. The effect size of delta PSD on sleepiness was significantly greater than that of either alpha or beta frequencies. Conclusion: Delta PSD during polysomnography is significantly associated with a greater degree of objective daytime sleepiness among patients with mild OSA. Further research is needed to corroborate our findings and identify the direction of potential causal correlation between delta PSD and EDS. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine. [ABSTRACT FROM AUTHOR]

Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61–0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA. [ABSTRACT FROM AUTHOR]

Objective: Insomnia disorder stands out as one of the prevalent clinical sleep and psychiatric disorders. Prior research has unequivocally demonstrated variations in the diversity and abundance of gut microbiota among individuals with insomnia disorder. These alterations may play a direct or indirect role in the onset and progression of insomnia disorder by compromising the integrity of the intestinal barrier. This study aims to evaluate the impairment of the intestinal barrier in individuals with insomnia disorder by scrutinizing the serum functionality of this barrier. Materials and methods: 45 patients with chronic insomnia disorder and 30 matched healthy volunteers were meticulously selected based on inclusion criteria. ELISA technology was employed to measure serum levels of diamine oxidase (DAO), D-lactic acid (D-LA), intestinal fatty acid binding protein (I-FABP), and endothelin (ET). Spearman correlation analysis was used to explore the relationship between intestinal mucosal markers and clinical characteristics. Data were analyzed using SPSS 26.0. Results: Compared to the healthy control group, the insomnia disorder group exhibited significantly elevated scores on subjective mood and sleep scales (GAD-7, PHQ-9, HAMA, HAMD, PSQI, and ISI) (P < 0.05). Overnight PSG indicated a notable increase in bed time, total wake time, sleep onset latency, and wake after sleep onset in individuals with insomnia disorder. Additionally, there was a decrease in sleep efficiency and alterations in sleep structure (increased proportion of N1 and N3 stages, prolonged N1 stage) (P < 0.05). The chronic insomnia disorder group displayed significantly reduced concentrations of serum DAO, D-LA, I-FABP, and ET (P < 0.05). Furthermore, significant positive correlations were identified between intestinal epithelial barrier markers and sleep efficiency, while negative correlations were found with wake after sleep onset, total wake time, PSQI, HAMA, and HAMD. Additionally, D-LA levels were significantly positively correlated with ET concentrations. Conclusion: Individuals with chronic insomnia disorder manifest disruptions in sleep structure, heightened susceptibility to anxiety and depressive moods, and impaired intestinal barrier function. These findings suggest that the occurrence and development of insomnia disorder may be linked to the impairment of the intestinal barrier. [ABSTRACT FROM AUTHOR]

Objective: This pilot study assessed the effects of electronic noise-masking earbuds on subjective sleep perception and objective sleep parameters among healthcare workers (HCWs) reporting sleep difficulties during the COVID-19 pandemic. Methods: Using a pre-post design, 77 HCWs underwent 3 nights of baseline assessment followed by a 7-night intervention period. Participants wore an at-home sleep monitoring headband to assess objective sleep measures and completed subjective self-report assessments. The difference in mean sleep measures from baseline to intervention was estimated in linear mixed models. Results: Compared to baseline assessments, HCWs reported significant improvements in sleep quality as measured by the Insomnia Severity Index (ISI) (Cohen's d = 1.74, p < 0.001) and a significant reduction in perceived sleep onset latency (SOL) during the intervention (M = 17.2 minutes, SD = 7.7) compared to baseline (M = 24.7 minutes, SD = 16.1), (Cohen's d = -0.42, p = 0.001). There were no significant changes in objective SOL (p = 0.703). However, there was a significant interaction between baseline objective SOL (<20 minutes vs >20 minutes) and condition (baseline vs intervention) (p = 0.002), such that individuals with objective SOL >20 minutes experienced a significant decrease in objective SOL during the intervention period compared to baseline (p = 0.015). Conclusions: HCWs experienced a significant improvement in perceived SOL and ISI scores after using the electronic noise-masking earbuds. Our data provide preliminary evidence for a nonpharmacological intervention to improve the sleep quality of HCWs which should be confirmed by future controlled studies. [ABSTRACT FROM AUTHOR]

Sleep and light education (SLE) combined with relaxation is a potential method of addressing sleep and affective problems in older people. 47 participants took part in a four-week sleep education program. SLE was conducted once a week for 60–90 minutes. Participants were instructed on sleep and light hygiene, sleep processes, and practiced relaxation techniques. Participants were wearing actigraphs for 6 weeks, completed daily sleep diaries, and wore blue light-blocking glasses 120 minutes before bedtime. Measures included scores of the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI) and actigraphy measurements of sleep latency, sleep efficiency, and sleep fragmentation. Sleep quality increased after SLE based on the subjective assessment and in the objective measurement with actigraphy. PSQI scores were statistically reduced indicating better sleep. Scores after the intervention significantly decreased in ESS and ISS. Sleep latency significantly decreased, whereas sleep efficiency and fragmentation index (%), did not improve. Mood significantly improved after SLE, with lower scores on the BDI-II and STAI. SLE combined with relaxation proved to be an effective method to reduce sleep problems and the incidence of depressive and anxiety symptoms. [ABSTRACT FROM AUTHOR]

The article discusses the assessment and treatment of insomnia in older adults. Topics covered include the pathway of obtaining a thorough sleep history, assessing environmental factors, evaluating behavioral and social factors, assessing comorbid medical substance use disorders, evaluating medication effects on sleep, reviewing sleep diaries and sleep-insomnia indexes, and diagnosing insomnia. Also noted are the insomnia approved medications, and nonpharmacological treatments for insomnia.

This study aimed to establish if a significant relationship exists between sleep and aggression in a large representative adolescent cohort and explores the impact of potential confounders. This cross-sectional secondary data analysis included 10,866 males and females aged 13–15 years, from the UK-based 2015 Millenium Cohort Study (sixth sweep). Independent variables included self-report measures of sleep duration and quality. The parent reported 'Strengths and Difficulties Questionnaire' conduct score measured aggression. Binary logistic regression examined independent associations between each sleep variable and aggression. Multiple regression models then adjusted for potential confounders: age, sex, socioeconomic status, arousal, and affect. Under 8 hours of sleep on average was significantly associated with aggression when age, sex and income were controlled (p =.008). This became insignificant following adjustment for both affect and arousal. Sleep quality remained significantly associated with aggression when all confounders were controlled: 'sleep onset latency >30 minutes' and 'wakening at least a good bit of the time' increased the odds of aggression by around 27.9% (p <.001) and 43.5% respectively (p <.001). A significant association exists between poor subjective sleep quality and heightened aggression in this cohort, when all our confounders are controlled, identifying sleep quality as a potential target in treating adolescent aggression. [ABSTRACT FROM AUTHOR]

Zizyphus spinosus Hu (ZS), as a "medicinal and food-homologous" plant, has been used for a long history. The study was to assess the sedative and hypnotic effects among various parts of ZS. The model, diazepam (DZP), ZS kernel (ZSS), ZS flesh (ZSF), and ZS husk (ZSKS) group occurred subsequent to the successful establishment of the para-chlorophenylalanine induced insomnia model via intraperitoneal injection. The latency and duration of sleep in mice in each group were recorded. The substance basis of various parts of ZS was analyzed by the UPLC-QTOF-MS technique. The results showed that relative to the model group, DZP, ZSS, ZSF, and ZSKS groups demonstrated shortened sleep latency (p < 0.05) and extended sleep duration (p < 0.01). The GABA, 5-HT, and BDNF levels were significantly upregulated in the brain tissues of the mice in the DZP, ZSF, and ZSS groups (p < 0.01). However, the improvement in ZSKS was non-significant. Additionally, the mRNA and protein expression levels of 5-HT1AR, GABAARα1, and BDNF in mice in the DZP, ZSS, and ZSF groups were significantly enhanced (p < 0.01). However, the improvement in the ZSKS group was insignificant (p < 0.05). The examination of the substance composition across different parts revealed that the shared chemical basis contributing to the sedative and hypnotic potency of different parts of ZS may involve the presence of compounds such as (1) magnoflorine, (8) betulinic acid, (9) ceanothic acid, and (10) alphitolic acid. It provides a basis for further elucidation of the substance basis responsible for the functional and medicinal effects of ZS. [ABSTRACT FROM AUTHOR]

Bedtime procrastination (BP) is prevalent and problematic, with no previous study conducted in Japan. This study developed the Japanese version of the Bedtime Procrastination Scale (BPS), assessed its validity, and investigated the relationship between BP, demographic features, and sleep outcomes. Participants were divided into two samples (N = 252 and N = 630). Sample 1 involved a longitudinal study to confirm test–retest reliability of the BPS. Sample 2 involved a cross-sectional study to assess confirmatory factor analysis, criterion-related validity, construct validity, and determine the internal consistency of the BPS. The relationship between BP and demographic features (gender, age, and employment status) and sleep outcomes (Athens Insomnia Scale, sleep hours, sleep onset latency, and sleep efficiency) was investigated using Sample 2. The BPS showed good internal consistency (Cronbach's α coefficients =.90–91), test–retest reliability (ICC =.86), and one factor model was valid; CFI =.95, TLI =.94, RMSEA =.10, and SRMR =.04. The BPS had a moderate positive association with general procrastination, moderate negative associations with self-control, sleep quality, and sleep duration on weekdays, and those who answered "yes" to the item "Do you have trouble with bedtime procrastination?" had higher BPS scores. BPS scores were moderately higher for younger participants (≤ 40 years), slightly higher for females, and non-significantly different between employment statuses. The BPS showed a significant positive correlation with insomnia symptoms, weak positive association with sleep efficiency on weekdays and holidays, and no significant association with sleep onset latencies on holidays and weekdays. This study provides new data on demographic predictors of BP in Japan. No clear effects of gender and employment status were found, but age was a strong predictor of BP, where younger age groups had a higher BP risk. [ABSTRACT FROM AUTHOR]

"The Orexinergic System: Neurobiology and Clinical Implications" is an article that provides an overview of the orexinergic system and its role in regulating sleep, energy balance, and arousal. It explains that orexins are neuropeptides produced in the hypothalamus and bind to specific receptors to exert their effects. The article discusses the neural connections of the orexinergic system and its involvement in sleep disorders, dementia, alcohol dependence, and eating disorders. It also highlights the potential therapeutic implications of targeting the orexin system, particularly in the treatment of insomnia and narcolepsy, but acknowledges the need for further research to fully understand the effectiveness and safety of these interventions for different patient populations. [Extracted from the article]

Introduction: Excessive smartphone usage among adolescents and young adults has been consistently linked to poor sleep. Moreover, smartphone overuse has been associated with daytime tiredness, longer sleeps latency, and reduced sleep duration. The significance of addressing poor sleep among adolescents and young adults is underscored by recent research linking it to adverse physical and psychological health outcomes, such as mood disturbances, impaired cognitive function, and increased risk incidence of hypertension and diabetes. Aim: To evaluate the effects of smartphone usage on sleep quality among individuals using Pittsburgh Sleep Quality Index (PSQI) and hypnogram data. Materials and Methods: In this cross-sectional observational study, sleep patterns were assessed using the PSQI questionnaire and Prime Nap sleep tracker app (version 1.1.4). The study was conducted by Deccan College of Medical Sciences, Hyderabad, Telangana, India. The data was collected in the form of a hypnogram and the study was conducted in the participants' homes (under domicile conditions) in the city of Hyderabad, Telangana, India from March 2020 to April 2020. A total of 60 participants (both male and female) in the age group of 15-25 years were recruited and divided into two groups: one comprising 30 individuals with regular prolonged exposure to smartphone screens at night, and the other consisting of 30 individuals who experienced minimal or no smartphone exposure once they prepared to sleep. Descriptive statistics were applied to the collected data using Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS) for Windows version 25.0. Results: Adding up the average scores of the seven factors gives a global PSQI score from 0 to 21, with 0-4 indicating good sleep and 5-21 indicating poor sleep. Among those who used smartphones regularly at night time, 20 participants (66.67%) had PSQI score >5 and poor sleep quality, 24 participants (80%) had prolonged sleep latency, 18 participants (60%) had poor sleep duration, 27 participants (90%) had sleep disturbances, and 22 participants (73.33%) had increased daytime dysfunction. Hypnogram abnormalities were seen in >15 participants (50%) of subjects. Conclusion: The prevalence of smartphone addiction is widely acknowledged in the medical literature, highlighting the need for its assessment, especially among adolescents and young adults. The study reveals that poor sleeping habits among participants were attributable either to a lack of awareness or neglect. By recognising the importance of adequate sleep, improvement in the quality of daily activities can be made by reducing daily screen time, consequently alleviating both physical and mental stress. Furthermore, the findings have implications for individuals whose work involves prolonged exposure to computer screens, especially during night time. [ABSTRACT FROM AUTHOR]

There is growing evidence that essential tremor (ET) patients are at high risk of cognitive impairment. Predictors of cognitive impairment have not been studied extensively. There is evidence from cross-sectional studies that sleep dysregulation is associated with cognitive dysfunction in ET, but longitudinal studies of the impact of sleep disruption on cognitive change have not been conducted. We investigated the extent to which sleep problems predict cognitive change in patients with ET. ET cases enrolled in a prospective, longitudinal study of cognitive performance. Sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI). Cognitive abilities across five domains (memory, executive function, attention, language, and visuospatial ability), and a global cognitive score (mean of the domains) were extracted from an extensive neuropsychological assessment. Generalized estimated equations were used to examine the association between baseline sleep problems and cognitive changes over three follow-up assessments each spaced 18 months apart. The 188 non-demented ET cases had a mean age of 77.7 ± 9.5 years. Longer sleep latency was associated with longitudinal decline in executive function (p = 0.038), and marginally with longitudinal decline in global cognitive performance (p = 0.075). After excluding 29 cases with mild cognitive impairment, results were similar. Cognitively healthy people with ET who have longer sleep latency had greater declines in executive function during prospective follow-up. Early detection of, and possibly intervention for, abnormal sleep latency may protect against certain aspects of cognitive decline in ET patients. • Sleep dysfunction is one of the major non-motor symptoms of ET. • Cognitive deficits seem to also appear significantly in patients with ET. • Longer sleep latency is associated with decline in executive function. • Results were significant in cognitively healthy older adults. [ABSTRACT FROM AUTHOR]

Huntington's disease (HD) is a rare neurodegenerative disorder with a distinct phenotype, including involuntary movements, cognitive decline, and behavioral disturbances. Sleep disorder include insomnia, increased sleep onset latency, decrease in total sleep time with frequent nocturnal awakenings and excessive daytime sleepiness. Increased sleep motor activities and abnormal nocturnal agitation have been increasingly recognized as an important component affecting negatively the sleep quality. Here, we report a case of an intensification of diurnal choreic movement during the night, notably during REM-sleep in a patient with manifest HD. This case highlights the diversity of nocturnal sleep motor disorders encountered in HD. [ABSTRACT FROM AUTHOR]

Summary: This study investigated how changing or maintaining parent‐set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self‐reported their sleep patterns, and whether they had parent‐set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent‐set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent‐set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re‐introducing a parent‐set bedtime may be possible and beneficial for adolescents' sleep. [ABSTRACT FROM AUTHOR]

Summary: Two out of three adults seeking treatment for alcohol or other substance use disorders report co‐occurring symptoms of insomnia. This study compared the feasibility, acceptability, and preliminary efficacy of cognitive behavioural therapy for insomnia (CBT‐I) among adults seeking and not seeking treatment for substance use. Adults with alcohol or other substance use disorders (n = 22, 32% female, 82% White; Mage = 39.5) completed assessments at baseline, post‐treatment, and at 6 week follow‐up. Of those, 11 were and 11 were not enrolled in substance use treatment. All received CBT‐I. Multiple imputation was used for missing data. Data were analysed using repeated measures analyses of variance. In the substance use treatment group, 6/11 completed post and 5/11 completed follow‐up. In the non‐treatment group, 9/11 completed post and 7/11 completed follow‐up. Participants in both groups reported improvements in insomnia severity, sleep onset latency, and dysfunctional beliefs about sleep, with most effects evident at post and follow‐up. There was a marginal group‐by‐time interaction in the change in frequency of substance use, with only participants not in substance use treatment reporting decreases at follow‐up. Participants in substance use treatment reported significant reductions in substance‐related problems and symptoms of post‐traumatic stress disorder over time; however, they also reported more symptoms at baseline. CBT‐I produces similar reductions in insomnia but is relatively less feasible among individuals in (versus not in) treatment for substance use disorder. This may be due to the more complex logistics of accessing CBT‐I among those in treatment. We speculate that integrating CBT‐I into treatment for addictions may improve feasibility in this population. clinicaltrials.gov NCT04198311. [ABSTRACT FROM AUTHOR]

Introduction: The characteristics of patients across different sleep clinics may vary because they selectively visit specific specialists on the basis of their primary symptoms. This study aimed to compare the clinical and polysomnography (PSG) features of patients with suspected obstructive sleep apnea (OSA) at three sleep specialty clinics (otolaryngology [ENT], neurology [NR], and psychiatry [PSY]). Methods: We retrospectively analyzed the medical records and PSG reports of adult patients who underwent full-night PSG between January 2022 and June 2023 at a tertiary medical center. The demographic, questionnaire, and PSG variables were compared. Results: Of the 407 patients, 83.0% exhibited sleep-disordered breathing (apnea–hypopnea index ≥ 5) with varying severity among the specialty pathways. Patients in the ENT group (n = 231) were the youngest and had the shortest sleep latency and most severe OSA markers with the highest positive airway pressure (PAP) acceptance, while those in the NR group (n = 79) had similar OSA-related PSG parameters to those in the ENT group but were older and had more OSA-related comorbidities, although their PAP acceptance was relatively low. The PSY group (n = 97) included a significant proportion of patients with normal or mild OSA, a female majority, high levels of depression, and subjective sleep distress. Conclusion: Our results highlight the multidisciplinary aspects of sleep medicine and diverse patients, and specialist needs for diagnosing sleep disorders and PAP acceptance. Exploring the potential differences in prognosis and treatment responses across various sleep specialty clinics would facilitate the development of personalized strategies. [ABSTRACT FROM AUTHOR]

Key Points: Question: What is the association of each component and delivery format of cognitive behavioral therapy for chronic insomnia with outcomes? Findings: This systematic review and component network meta-analysis including 241 trials found that cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person format may be beneficial. Cognitive restructuring, third-wave components and in-person delivery were mainly associated with improved subjective sleep quality, while sleep restriction and stimulus control were associated both with improved sleep quality and self-reported sleep continuity. Meaning: The findings suggest that beneficial cognitive behavioral therapy for insomnia may include cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person format. This systematic review and component network meta-analysis evaluates associations between different components and delivery formats of cognitive behavior therapy for insomnia. Importance: Chronic insomnia disorder is highly prevalent, disabling, and costly. Cognitive behavioral therapy for insomnia (CBT-I), comprising various educational, cognitive, and behavioral strategies delivered in various formats, is the recommended first-line treatment, but the effect of each component and delivery method remains unclear. Objective: To examine the association of each component and delivery format of CBT-I with outcomes. Data Sources: PubMed, Cochrane Central Register of Controlled Trials, PsycInfo, and International Clinical Trials Registry Platform from database inception to July 21, 2023. Study Selection: Published randomized clinical trials comparing any form of CBT-I against another or a control condition for chronic insomnia disorder in adults aged 18 years and older. Insomnia both with and without comorbidities was included. Concomitant treatments were allowed if equally distributed among arms. Data Extraction and Synthesis: Two independent reviewers identified components, extracted data, and assessed trial quality. Random-effects component network meta-analyses were performed. Main Outcomes and Measures: The primary outcome was treatment efficacy (remission defined as reaching a satisfactory state) posttreatment. Secondary outcomes included all-cause dropout, self-reported sleep continuity, and long-term remission. Results: A total of 241 trials were identified including 31 452 participants (mean [SD] age, 45.4 [16.6] years; 21 048 of 31 452 [67%] women). Results suggested that critical components of CBT-I are cognitive restructuring (remission incremental odds ratio [iOR], 1.68; 95% CI, 1.28-2.20) third-wave components (iOR, 1.49; 95% CI, 1.10-2.03), sleep restriction (iOR, 1.49; 95% CI, 1.04-2.13), and stimulus control (iOR, 1.43; 95% CI, 1.00-2.05). Sleep hygiene education was not essential (iOR, 1.01; 95% CI, 0.77-1.32), and relaxation procedures were found to be potentially counterproductive(iOR, 0.81; 95% CI, 0.64-1.02). In-person therapist-led programs were most beneficial (iOR, 1.83; 95% CI, 1.19-2.81). Cognitive restructuring, third-wave components, and in-person delivery were mainly associated with improved subjective sleep quality. Sleep restriction was associated with improved subjective sleep quality, sleep efficiency, and wake after sleep onset, and stimulus control with improved subjective sleep quality, sleep efficiency, and sleep latency. The most efficacious combination—consisting of cognitive restructuring, third wave, sleep restriction, and stimulus control in the in-person format—compared with in-person psychoeducation, was associated with an increase in the remission rate by a risk difference of 0.33 (95% CI, 0.23-0.43) and a number needed to treat of 3.0 (95% CI, 2.3-4.3), given the median observed control event rate of 0.14. Conclusions and Relevance: The findings suggest that beneficial CBT-I packages may include cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person delivery but not relaxation. However, potential undetected interactions could undermine the conclusions. Further large-scale, well-designed trials are warranted to confirm the contribution of different treatment components in CBT-I. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article is to systematically review the association between dry eye and sleep quality. Methods: PubMed, EMBASE, Cochrane, Web of Science, and grey literature databases were searched for observational studies published before April 2023. Meta-analysis was performed using STAT15 software. Results: A total of 21 studies with 419,218 participants were included. The results showed that the dry eye subjects had a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep. The Pittsburgh Sleep Quality Index (PSQI) scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 1.78, 95%CI: 1.06, 2.50, P < 0.001). The dry eye subjects scored higher than the control subjects in sleep quality, sleep latency, and sleep disturbance in PSQI; there was no difference between the dry eye individuals and control subjects in sleep duration, sleep efficiency, daytime dysfunction, and sleep medication scores. The risk of sleep disorders in the dry eye subjects was significantly higher than that in the non-dry eye subjects (RR = 2.20, 95%CI: 1.78, 2.72, P < 0.001); the risk of insufficient sleep in the dry eye subjects was higher than that in the control subjects (RR = 3.76, 95%CI: 3.15, 4.48, P < 0.001), and the prevalence of excessive sleepiness in dry eye subjects was higher than that in the control subjects (RR = 5.53, 95%CI: 3.83, 7.18, P < 0.001). The ESS scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 3.02, 95%CI: 2.43, 3.60, P < 0.01). Conclusion: Our meta-analysis suggests that individuals with dry eye have a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleepiness. [ABSTRACT FROM AUTHOR]

Background: The traditional plant Decalepis hamiltonii, indigenous to southern India, is a key component in the well-known herbal beverage nannari. It has also been utilised as a general vitalizer and paediatric rejuvenator in siddha, ayurveda, and folk medicine. However, it has been demonstrated that this plant's phytoconstituents can modulate CYP450 enzymes, which are crucial for determining the fate of xenobiotics within the body. It has not yet been observed that this plant's modulatory property would result in herb-drug interactions when used in conjunction with xenobiotics. Materials and Methods: The goal of the current investigation was to determine how Decalepis hamiltonii affected the pharmacokinetics of the CYP3A substrate lopinavir and the pharmacodynamics of another CYP3A substrate midazolam, in rats. An in vivo pharmacokinetic study of oral lopinavir (35.50 mg/kg), and the effects of Aqueous Root Extract of Decalepis hamiltonii (AREDH) pretreatment on the pharmacokinetic parameters were evaluated. Further the acute and chronic pretreatment of AREDH on pharmacodynamics of midazolam was assessed through measuring hypnotic responses produced in rats. Results: The findings showed that, in comparison to the control, AREDH pretreatment significantly decreased the area under the concentration-time curve (AUC), while a small but not statistically significant change was seen in the half-life of lopinavir (T1/2 k10), the amount of time needed to reach the peak plasma concentration (Tmax), and the elimination rate constant (k10). In addition, AREDH pretreated groups had significantly less sleep duration than the control group irrespective of the pretreatment duration. However, there was no discernible difference in sleep latency. Conclusion: Conclusively, it suggests that Decalepis hamiltonii caused CYP3A-mediated increased metabolism via inducing the enzyme, which significantly decreased the oral bioavailability of lopinavir. Clinical investigations are necessary to assess this interaction's therapeutic importance in more detail. [ABSTRACT FROM AUTHOR]

The static lighting condition (SLC) in confined spaces may pose great challenges to the health of long-stay workers, inducing sleep disorders, cognitive decline, and negative emotions such as depression or anxiety. To explore human responses to the SLC (300 lx and 6000 K), 20 young subjects (22.6 ± 1.88 years old) were recruited in the underground confined lab for a week by measuring melatonin, core body temperature (CBT), subjective alertness (KSS score), sleep quality (Pittsburgh Sleep Quality Index, PSQI), Psychomotor Vigilance Task (PVT), Hamilton Depression Scale (HAMD) and Self-rating Anxiety Scale (SAS). The results showed a posterior shift in circadian rhythm after 1 week of confinement, with 0.62 h delay of dim light melatonin onset (DLMO), higher melatonin concentrations in the evening, lower melatonin concentrations at midnight, a day-by-day increase in KSS and CBT at bedtime, but this decreased daily when waking up, with cumulative effects. There was a progressive increase in sleep latency, PSQI scores, response time and scores of subjective emotion scales, meaning worse sleep, performance and emotional state. Due to limited exposure to high-lighting stimuli during the daytime, the initial concentrations of melatonin increased in the evening and decreased before sleep. In confined spaces, active health interventions by dynamic lighting patterns were proposed to safeguard human health and performance. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization (WHO) defines probiotics as "live microorganisms that, when administered in adequate amounts, confer health benefits to the host." A number of scientific reports show that their effects extend beyond the immune and gastrointestinal systems, and that poor sleep quality and insomnia are an increasingly important social problem. Studies indicate that 30-50% of adults experience sleep problems. Sleep deficiencies are associated with higher rates of obesity, hypertension, type 2 diabetes, cardiovascular diseases, mental health disorders and increased risk of death. One promising way to help treat sleep problems is through the use of probiotics. Interaction through the gut-brain axis suggests that altering the gut microbiota may become a useful tool for improving sleep quality. Aim of the study The purpose of this study was to investigate the potential effectiveness of probiotics in improving sleep quality and treating insomnia. Materials and Methodology PubMed and Google Scholar databases were analyzed. Articles were searched in English using the following keywords: probiotics; sleep quality. Results Probiotics resulted in a favorable cumulative effect on sleep quality as measured by the PSQI global questionnaire and a statistically significant positive effect on at least one of the components characterizing sleep quality (i.e., sleep latency, sleep length, sleep disturbance, daytime sleepiness). They allow to maintain a high percentage of slow-wave sleep, despite stressors, and indirectly affect sleep quality in athletes by reducing muscle soreness. Conclusion The results of studies to date indicate that probiotics are an effective, safe and clinically sound adjunctive method for improving sleep quality and treating insomnia. However, these studies are at an early stage and require further efforts using larger research groups. [ABSTRACT FROM AUTHOR]

Hyperpolarization-activated cyclic nucleotide-gated (HCN) ion channels generate electrical rhythmicity in various tissues although primarily heart, retina and brain. The HCN channel blocker compound, Ivabradine (Corlanor), is approved by the US Food and Drug Administration (FDA) as a medication to lower heart rate by blocking hyperpolarization activated inward current in the sinoatrial node. In addition, a growing body of evidence suggests a role for HCN channels in regulation of sleep/wake behavior. Zebrafish larvae are ideal model organisms for high throughput drug screening, drug repurposing and behavioral phenotyping studies. We leveraged this model system to investigate effects of three HCN channel blockers (Ivabradine, Zatebradine Hydrochloride and ZD7288) at multiple doses on sleep/wake behavior in wild type zebrafish. Results of interest included shorter latency to daytime sleep at 0.1 μM dose of Ivabradine (ANOVA, p: 0.02), moderate reduction in average activity at 30 μM dose of Zatebradine Hydrochloride (ANOVA, p: 0.024) in daytime, and increased nighttime sleep at 4.5 μM dose of ZD7288 (ANOVA, p: 0.036). Taken together, shorter latency to daytime sleep, decrease in daytime activity and increased nighttime sleep indicate that different HCN channel antagonists affected different parameters of sleep and activity. [ABSTRACT FROM AUTHOR]

This article explores the relationship between sleep, immunity, and asthma. Asthma is a chronic respiratory disorder characterized by airway inflammation and narrowing. Sleep has emerged as a crucial factor influencing asthma's progression and management. Poor sleep quality can lead to increased systemic and bronchial inflammation, which can affect an individual's vulnerability to asthma. The article discusses the role of sleep in modulating cytokines and T-cell responses, as well as the potential for sleep-based interventions in asthma management. However, there are still many aspects of this relationship that remain unexplored, and further research is needed to fully understand and develop effective strategies for asthma management. [Extracted from the article]

Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards‐Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t‐tests and chi‐square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post‐surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio‐cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well‐being in neurosurgical settings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effects of foot reflexology on fatigue and sleep quality in school‑aged children receiving hemodialysis. Methods: A quasi‑experimental pretest–posttest design was utilized. Thirty children of ages 6–12 undergoing in‑center hemodialysis were recruited. The Pittsburgh Sleep Quality Index (PSQI) and Inventory of Fatigue Symptom(IFS) scales were administered at baseline. Participants then received 30 min of foot reflexology massage before hemodialysis sessions 3 days per week for 12 weeks. Posttest administration of the sleep and fatigue scales occurred after the intervention period. Results: Reflexology massage led to significant improvements in sleep quality components, including duration (0%–30% normal sleepers), efficiency (0%–50% >85%), latency (50%–0% >60 min), disturbances, and daytime dysfunction. The mean PSQI score decreased from 18.2 to 9.7 (P < 0.05). Fatigue severity substantially decreased, with the mean IFS score improving from 105.7 to 64.1 (P < 0.05). Conclusion: Foot reflexology is an effective nursing intervention for reducing fatigue and improving sleep quality in children on hemodialysis, warranting integration into routine care. [ABSTRACT FROM AUTHOR]

ObjectivesSleep is an indispensable part of human health, which can help us to restore physical strength, enhance immunity and maintain nervous system stability. The relationship between sleep quality and cognitive dysfunction is unclear, especially at the community population level. This study aims to explore the association between sleep quality and cognitive dysfunction.MethodsA total of 5,224 community residents were enrolled in this cross-sectional study. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). Sleep quality was assessed by the multidimensional sleep questionnaire. Multivariate logistic regression was used to analyze the association between sleep quality and cognitive dysfunction. The adjusted models took into account relevant demographic, clinical, and sleep variables.ResultsA total of 3,106 participants were enrolled in this study, of whom 463 (15%) had cognitive dysfunction. Total sleep duration, staying up, sleep latency, number of awakenings, and history of sleep medications were associated with cognitive dysfunction in unadjusted models, and these effects were consistent after adjustment. First, those who slept 6–7.9 h per day (OR = 0.57, 95% CI 0.40 to 0.80, p = 0.001) had a lower risk for cognitive dysfunction compared to those who slept less than 6 h per day. Second, participants who stayed up more than 10 times over the 3 months (OR = 1.90, 95% CI 1.20 to 3.00, p = 0.006) were more likely to suffer cognitive dysfunction than those who never stayed up. Third, we also found that participants with sleep latencies of 16–30 min were less likely to experience cognitive dysfunction than those with sleep latencies of less than 16 min after adjusting confounders (OR = 0.33, 95% CI 0.23 to 0.47, p

This article explores the advancements in seizure forecasting tools, biomarkers, and devices. It discusses the use of data collection methods and computational algorithms to identify seizure patterns and likelihood. Challenges such as false alarms and individual variability in seizure patterns are acknowledged. The article emphasizes the importance of identifying biomarkers that capture the complex nature of physiological signals. It also highlights the need for standardized datasets and the potential of wearable devices for more accurate seizure forecasting. The authors declare no financial support or conflicts of interest, and provide references for further reading. [Extracted from the article]

This article discusses a case report of a 33-year-old female patient who presented with treatment-resistant migraines and multiple somatic complaints. The patient had a history of poor sleep quality and was diagnosed with obstructive sleep apnea (OSA) in addition to chronic migraine with aura. The patient underwent level 1 polysomnography (PSG) and was subsequently treated with positive airway pressure (PAP) therapy. Following PAP therapy, the patient reported significant improvement in her migraines and daily use of PAP. The article highlights the importance of recognizing and addressing sleep disturbances in patients with migraines, particularly those with OSA. [Extracted from the article]

Purpose: Most athletes sleep poorly around competition. The aim of this study was to examine sleep before/after games during an entire season in elite Australian Rules footballers (N = 37) from the same team. Methods: Sleep was monitored using activity monitors for 4 consecutive nights (beginning 2 nights before games) during 19 rounds of a season. Differences in sleep on the nights before/after games, and differences in sleep before/after games as a function of game time (day vs evening), location (local vs interstate), and outcome (win vs loss), were examined using linear mixed effects models. Results: Players fell asleep earlier (+1.9 h; P <.001), and woke up later (+1 h; P <.001) on the night before games compared with the night of games. Players obtained less sleep on the night of games than on the night before games (5.2 h vs 7.7 h; P <.001), and this reduction was exacerbated when games were played in the evening—after evening games, players obtained approximately 40 minutes less sleep than after day games (P <.001). Sleep duration on the nights before and after games was not affected by game location or game outcome, but players had later sleep onset (P <.001) and offset times (P <.001) on most nights when sleeping away from home. Conclusions: Elite footballers obtain good sleep on the night before games but obtain approximately 30% less sleep on the night of games. Given the role of sleep in recovery, it will be important to determine whether a reduction in sleep duration of this magnitude impairs recovery on the days following games. [ABSTRACT FROM AUTHOR]