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Keita Kawai,1 Kunihiro Iwamoto,1 Seiko Miyata,1 Ippei Okada,1 Motoo Ando,1 Hiroshige Fujishiro,1 Akiko Noda,2 Norio Ozaki1 1Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; 2Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, Kasugai, JapanCorrespondence: Kunihiro Iwamoto, Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan, Tel +81-52-744-2282, Fax +81-52-744-2293, Email iwamoto@med.nagoya-u.ac.jpPurpose: Sleep state misperception, which is the discrepancy between subjective and objective sleep, is often observed in patients with depression. This phenomenon may delay the remission of depression. Previous studies have focused on the total sleep time (TST) misperception, with many of these studies using actigraphy. Thus, our study investigated depressed patients with the exploratory aim of clarifying factors associated with the sleep state misperception including the wake after sleep onset (WASO) misperception, with their objective sleep additionally evaluated by polysomnography (PSG).Patients and Methods: We conducted a cross-sectional study. Before undergoing overnight PSG monitoring, 40 patients with depression completed questionnaires that included the Beck Depression Inventory (BDI), Epworth sleepiness scale, Temperament and Character Inventory, and the Pittsburgh sleep quality index. Patients were also asked to estimate their subjective sleep duration after they woke up in the morning. Based on this data, we calculated the misperception using the following formula: subjective sleep duration minus objective sleep duration. We compared each factor between negative and positive misperception groups and the multiple regression analysis was performed for TST and WASO misperception, respectively.Results: Although sleep architectures, age, severity of depression and obstructive sleep apnea (OSA) exhibited differences in underestimating or overestimating the WASO, only sex differences were associated with underestimating or overestimating their total sleep time (TST). Moreover, BDI, the severity of OSA, sleep architectures (N1% and N2%), and benzodiazepine (BZD) use were significantly correlated with WASO misperception, whereas only OSA severity was significantly correlated with TST misperception. A subsequent multiple regression analysis demonstrated the BDI was independently correlated with the WASO misperception (β=0.341, p=0.049).Conclusion: In clinical practice, interventions especially for OSA, and the reduction of depressive symptoms are an important method for improving patient sleep perception. Moreover, current results suggest that BZD prescriptions should be avoided as well.Keywords: insomnia, personality, sleep architectures, discrepancy, sleep disorders

Patients with psychiatric disorders often complain of sleep disturbances and are frequently suspected of obstructive sleep apnea (OSA). However, data regarding sleep problems evaluated by attended polysomnography (PSG) remain limited in this population. We analyzed the results of attended PSG from psychiatric patients with sleep-related problems to determine the prevalence and features of sleep disorders among this population.We retrospectively investigated the attended PSG results of patients with psychiatric disorders: major depressive disorder, bipolar disorder, neurodevelopmental disorder, schizophrenia, neurocognitive disorder, anxiety disorder, somatic symptom disorder.Of 264 patients, 158 men (60%), mean age was 47 ± 19.9 years. More than half of the patients with major depressive disorder (62%), bipolar disorder (70%), schizophrenia (58%), neurocognitive disorders (55%), and somatic symptom disorder (56%) had OSA. Among the psychiatric patients with OSA, 62% of these patients had moderate to severe OSA. The risk factors for OSA were snoring, male, age, and body mass index. The presence of OSA was not associated with the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale score, or benzodiazepine, antipsychotic, or antidepressant use. Other sleep disorders were insomnia (19%), central disorders of hypersomnia (8%), restless legs syndrome/periodic limb movement of sleep (8%), rapid eye movement sleep behavior disorder (7%), and central sleep apnea syndrome (3%).PSG revealed that moderate to severe OSA was common in psychiatric patients with or without snoring. Subjective symptoms and psychotropics did not predict OSA. Therefore, PSG is needed to reveal sleep conditions in patients with psychiatric disorders.

The Advanced Land Observing Satellite-2 (ALOS-2) was successfully launched on the 24th May 2014. The mission is equipped with a Phased Array type L-band Synthetic Aperture Radar called PALSAR-2, which is the state of the art of L-band SAR system. Successful completion of the initial checkout phase, ALOS-2 has been contributing to numerous applications with a special emphasize on emergency observations of natural disasters in Japan as well as regional and global space based disaster supporting systems. Furthermore, based on the Basic Observation Scenario (BOS) of ALOS-2, 10m global map data and other mode data are routinely collected and archived. This paper describes the status of ALOS-2 operation after completion of nominal operation period by May 2019.

Although performed inside a laboratory, attended polysomnography (PSG) has long been the gold standard for the diagnosis of sleep apnea. However, high costs and long wait times have led to the development of home-based portable monitoring devices. A bed sheet-shaped device called SD102 (Suzuken Co., Nagoya, Japan) has been developed, and its accuracy in evaluating sleep apnea is becoming evident. The purpose of this study was to confirm the accuracy of SD102 in evaluating sleep apnea and to investigate patient characteristics that may contribute to inaccurate test results in patients with suspected obstructive sleep apnea (OSA). One hundred and eighty-nine patients simultaneously underwent PSG and portable monitoring by using a home sleep apnea testing (HSAT) device. A blinded, experienced technologist using the American Academy of Sleep Medicine criteria versions 2.1 and 2.3 scored the PSG data and HSAT device data, respectively. The respiratory event index (REI) by HSAT significantly correlated with the apnea–hypopnea index (AHI) by PSG (r = 0.974, p < 0.001). HSAT sensitivity, specificity, and positive and negative predictive values of 0.99, 0.83, 0.95, and 0.97, respectively. Body mass index and arousal index were significantly associated with the difference between REI from SD102 HSAT and AHI from PSG. This study demonstrates the good agreement between REI and AHI in patients with suspected OSA and suggests that understanding the limitations of different testing methods may help in the accurate detection of OSA.

Objectives: Automobile accidents related to obstructive sleep apnea (OSA) represent an important public health concern. Frequent arousal response during sleep is responsible for the symptoms of daytime sleepiness and an increased risk of automobile accidents in patients with OSA. We therefore investigated the potential relationships between the intensity of arousal and occurrence of automobile accidents in OSA. Methods: We determined the incidence of automobile accidents in the past 5 years among 51 men with OSA (age, 58.5 ± 10.4 years) using a questionnaire. Daytime sleepiness was rated with the Epworth Sleepiness Scale (ESS). We calculated an automobile accident score, with two points per automobile accident causing damage and one point per near miss. Standard polysomnography was performed for all patients, and arousals were classified as electroencephalographic (EEG) arousal of an abrupt shift in EEG frequency alone and Movement arousal, which was defined as EEG arousal with increased electromyographic activity persisting for ≥3 s. The number of EEG or Movement arousals per hour (arousal index) was determined. Results: The Movement arousal index was significantly greater in the 27 patients who experienced at least one automobile accident causing damage than in the resting 24 patients who had no history of automobile accidents. Multiple regression analysis including age, body mass index, and sleep parameters revealed that the Movement arousal index was the most significant factor of risk for automobile accidents (β = 0.563, P = 0.017) as well as the ESS score (β = 0.417, P = 0.022). Conclusion: Movement arousal during sleep contributes to daytime sleepiness and the resulting frequent involvement of OSA patients in automobile accidents.

Sleep disturbances and cognitive decline are common in older adults. We aimed to investigate the effects of the total sleep time (TST) and sleep–wake rhythm on executive function and working memory in older adults. In 63 older participants, we measured the TST, wake after sleep onset (WASO), and sleep timing (midpoint between bedtime and wake-up time) using actigraphy. Executive function was evaluated with the trail making test B (TMT-B) and Wisconsin card sorting test (WCST). The number of back task (N-back task) was used to measure working memory. Participants with a TST ≥ 8 h had a significantly lower percentage of correct answers (% correct) on the 1-back task than those with a TST

Japan Aerospace Exploration Agency (JAXA) launched its first L-band SAR mission - Japanese Earth Resources Satellite (JERS-1) in 1992. Though the design life of JERS-1 was 2 years, the satellite had obtained observational data for more than 6 years and ended the mission in 1998. Following to JERS-1, Advanced Land Observing Satellite (ALOS) was launched in 2006. ALOS was equipped with three sensors: the Phased Array type L-band SAR (PALSAR), the Panchromatic Remote-sensing Instrument for Stereo Mapping (PRISM), and the Advanced Visible and Near Infrared Radiometer type 2 (AVNIR-2). ALOS's observation data has been used in various areas including disaster mitigation through observing regions damaged by earthquakes, tsunami, or typhoons, as well as carrying out forest monitoring, natural environment maintenance, agriculture, and compiling a 1/25,000 topographical map. When the Great East Japan Earthquake hit Japan in 2011, ALOS took some 400 images over disaster-stricken areas to provide information to all parties concerned.Technologies acquired from the ALOS are succeeded to the second Advanced Land Observing Satellite “ALOS-2.”, which was successfully launched on 24th May 2014. The mission sensor of ALOS-2 is the Phased Array type L-band Synthetic Aperture Radar-2 called PALSAR-2 which is the state-of-the-art L-band SAR system. Until now after the successful completion of initial checkout after launching, ALOS-2 has been contributed to a lot of emergency observations for natural disasters, not only in Japan but also in the world. Furthermore, based on the Basic Observation Scenario (BOS) of ALOS-2, 10m global map data and other mode data are routinely collected and archived. This paper describes the results of ALOS-2 operation in nominal operation phase and outline of future ALOS series missions, especially ALOS-4 launched JFY2022.

Introduction: Sleep is essential for performing cognitive function in humans. We have hypothesized that sleep fragmentation compared to sleep efficiency may have a negative impact on the working memory. Material and Methods: Twenty-eight healthy adults (18 males and 10 females; mean age 27.8±15.5 years) were enrolled in this study. We measured the total sleep time (TST), sleep efficiency, %stage wakefulness (W), %stage rapid eye movement (REM), %stage N1, %stage N2, %stage N3, wake after sleep onset (WASO), and arousal index using polysomnography. Working memory, executive function, and sustained attention of three domains of cognitive function were evaluated with the number of back task (N-back task), Wisconsin card sorting test (WCST), and continuous performance test-identical pairs (CPT-IP), respectively. Results: The percentage of correct answers on the 2-back task was significantly correlated with %stage REM, %stage N1, and %stage N2 (%stage REM: r=0.505, p=0.006; %stage N1: r=-0.637, p

Key clinical symptoms observed among individuals with psychiatric disorders include difficulty falling asleep or maintaining sleep, poor sleep quality and nightmares. Those suffering from sleep disorders often present with symptoms of discontent with regard to sleep quality, timing and quantity, and these symptoms have an adverse impact on function and quality of life. A minimally invasive technique would be preferable in patients with psychiatric disorders, who tend to be sensitive to environmental change. Accordingly, we evaluated the performance of Zmachine Insight Plus, an ambulatory electroencephalography sleep monitor, in patients with psychiatric disorders. One hundred and three patients undergoing polysomnography were enrolled in this study. Zmachine Insight Plus was performed simultaneously with polysomnography. Total sleep time, sleep efficiency, wake after sleep onset, rapid eye movement (REM) sleep, light sleep (stages N1 and N2) and deep sleep (stage N3) were assessed. Total sleep time, sleep efficiency, wake after sleep onset, REM sleep duration and non-REM sleep duration of Zmachine Insight Plus showed a significant correlation with those of polysomnography. Lower sleep efficiency and increased frequency of waking after sleep onset, the arousal index and the apnea-hypopnea index on polysomnography were significantly associated with the difference in sleep parameters between the two methods. Among patients with psychiatric disorders who are sensitive to environmental change, Zmachine Insight Plus would be a useful technique to objectively evaluate sleep quality.

Background Animal model studies show that reductive stress is involved in cardiomyopathy and myopathy, but the exact physiological relevance remains unknown. In addition, the microRNAs miR-143 and miR-145 have been shown to be upregulated in cardiac diseases, but the underlying mechanisms associated with these regulators have yet to be explored. Methods We developed transgenic mouse lines expressing exogenous miR-143 and miR-145 under the control of the alpha-myosin heavy chain (αMHC) promoter/enhancer. Results The two transgenic lines showed dilated cardiomyopathy-like characteristics and early lethality with markedly increased expression of miR-143. The expression of hexokinase 2 (HK2), a cardioprotective gene that is a target of miR-143, was strongly suppressed in the transgenic hearts, but the in vitro HK activity and adenosine triphosphate (ATP) content were comparable to those observed in wild-type mice. In addition, transgenic complementation of HK2 expression did not reduce mortality rates. Although HK2 is crucial for the pentose phosphate pathway (PPP) and glycolysis, the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG) was unexpectedly higher in the hearts of transgenic mice. The expression of gamma-glutamylcysteine synthetase heavy subunit (γ-GCSc) and the in vitro activity of glutathione reductase (GR) were also higher, suggesting that the recycling of GSH and its de novo biosynthesis were augmented in transgenic hearts. Furthermore, the expression levels of glucose-6-phosphate dehydrogenase (G6PD, a rate-limiting enzyme for the PPP) and p62/SQSTM1 (a potent inducer of glycolysis and glutathione production) were elevated, while p62/SQSTM1 was upregulated at the mRNA level rather than as a result of autophagy inhibition. Consistent with this observation, nuclear factor erythroid-2 related factor 2 (Nrf2), Jun N-terminal kinase (JNK) and inositol-requiring enzyme 1 alpha (IRE1α) were activated, all of which are known to induce p62/SQSTM1 expression. Conclusions Overexpression of miR-143 and miR-145 leads to a unique dilated cardiomyopathy phenotype with a reductive redox shift despite marked downregulation of HK2 expression. Reductive stress may be involved in a wider range of cardiomyopathies than previously thought.

Introduction: Olfactory dysfunction is recognized as an early sign of dementia. Hypertension is a risk factor for dementia in midlife, but it is less clear in old age. Materials and methods: Fifty-two consecutive volunteers aged ≥ 60 years (mean age, 71.0 ± 4.8 years) were enrolled in this study. We performed the Odor Stick Identification Test for the Japan (OSIT-J) as the olfactory test. Cognitive function was evaluated with the Revised Hasegawa’s Dementia Scale (HDS-R), Mini-Mental State Examination (MMSE), Trail Making Test B (TMT-B), and Touch Panel-type Dementia Assessment Scale (TDAS). The systolic blood pressure (SBP), diastolic BP (DBP), and heart rate (HR) were measured using plethysmography. Results: The TMT-B score was significantly correlated with the HR and OSIT-J score (HR: r = 0.306, p = 0.028; OSIT-J score: r = 0.279, p = 0.045), and HR and OSIT-J score were the significant factors of TMT-B score (HR: β = 0.295, p = 0.033; OSIT-J score: β = 0.281, p = 0.039). The TDAS score was significantly correlated with SBP and DBP (SBP: r = 0.293, p = 0.035; DBP: r = 0.302, p = 0.029). The SBP and DBP were higher in participants with TDAS scores ≥ 7 than those with TDAS scores < 7 (SBP: 155.6 ± 23.1 mmHg vs. 140.3 ± 16.1 mmHg, p = 0.017; DBP: 90.8 ± 10.3 mmHg vs. 80.9 ± 9.9 mmHg, p = 0.006). Conclusions: Decreased olfactory function, high BP, and increased HR were all associated with cognitive decline in older adults.

Purpose Hypertension is an important risk factor for death resulting from stroke, myocardial infarction, and end-stage renal failure. Hydrogen (H2) gas protects against many diseases, including ischemia-reperfusion injury and stroke. The effects of H2 on hypertension and its related left ventricular (LV) function have not been fully elucidated. The purpose of this study was to investigate the effects of H2 gas on hypertension and LV hypertrophy using echocardiography. Methods Dahl salt-sensitive (DS) rats were randomly divided into three groups: those fed an 8% NaCl diet until 12 weeks of age (8% NaCl group), those additionally treated with 2% H2 gas (8% NaCl + 2% H2 group), and control rats maintained on a diet containing 0.3% NaCl until 12 weeks of age (0.3% NaCl group). H2 gas was supplied through a gas flowmeter and delivered by room air (2% hydrogenated room air, flow rate of 10 L/min) into a cage surrounded by an acrylic chamber. We evaluated interventricular septal wall thickness (IVST), LV posterior wall thickness (LVPWT), and LV mass using echocardiography. Results IVST, LVPWT, and LV mass were significantly higher in the 8% NaCl group than the 0.3% NaCl group at 12 weeks of age, whereas they were significantly lower in the 8% NaCl + 2% H2 group than the 8% NaCl group. There was no significant difference in systolic blood pressure between the two groups. Conclusion Our findings suggest that chronic H2 gas inhalation may help prevent LV hypertrophy in hypertensive DS rats.

Insufficient sleep and irregular sleep/wake rhythm are common problems among university students. We investigated the effect of sleep/wake rhythm and excessive daytime sleepiness (EDS) on the corti...

Objective Nitric oxide (NO) plays a key role in the regulation of vascular tone and is known as one of the key markers of endothelial dysfunction. We investigated the relationship between NO and risk factors of lifestyle-related disease in factory workers. Methods Our study included 877 factory workers presenting hypertension, dyslipidemia and type 2 diabetes. Oxidated forms of NO, NO2-/NO3- (NOx) plasma concentrations were measured using a colorimetric method. Results NOx plasma levels in patients with lifestyle-related disease were significantly lower than those in the controls. The brachial-ankle pulse wave velocity (baPWV) measured in those patients was significantly greater than that of the controls. Multiple regression analysis revealed that LDL cholesterol was an independent risk factor for reducing NOx plasma concentrations. Interestingly, individuals with low NOx plasma concentrations were more likely to present type 2 diabetes compared to those with the highest plasma levels of NOx (odds ratio [OR] [95% confidence interval; CI]=3.65 [1.61–8.28], P=0.002, 2.67 [1.15–6.20], P=0.022, and 3.27 [1.43–7.48], P=0.005). Subjects with the lowest levels of plasma NOx were more likely to present dyslipidemia (OR [95% CI]=1.69 [1.13–2.53], P=0.01). Conclusion Endothelial function evaluated with plasma NOx may be indicative of lifestyle-related diseases independently from the vascular function assessed using baPWV.

Introduction The gold standard of sleep measurement has been laboratory polysomnography (PSG). However, electrodes and cables can cause discomfort, and exposure to an unfamiliar environment can cause the “first-night effect.” Difficulty falling asleep or maintaining sleep, poor sleep quality, and nightmares are some of the key clinical symptoms observed among individuals with psychiatric disorders. Those suffering from sleep disorders often present with symptoms of discontent with regard to sleep quality, timing, and quantity, and these symptoms have an adverse impact on function and quality of life. A minimally invasive technique would be preferable in patients with psychiatric disorders, who tend to be sensitive to environmental change. Accordingly, we evaluated the performance of a single-channel electroencephalography (EEG)-based sleep monitoring system in patients with psychiatric disorders. Methods Fifty-nine patients undergoing PSG were enrolled in this study. Single-channel EEG sleep monitoring was performed simultaneously with PSG. PSG and the EEG recordings were used to evaluate sleep parameters, such as total sleep time (TST), sleep efficiency, rapid eye movement (REM) sleep, light sleep (stages N1 and N2), and deep sleep (stage N3). Correlation analysis was used to evaluate the agreement on sleep parameters and attributing factors to the inaccuracies of the single-channel EEG recording. Results TST, sleep efficiency, REM sleep duration, and non-REM sleep duration of the single-channel EEG-based sleep monitoring showed a significant correlation with those of PSG. Lower sleep efficiency, a decrease in REM sleep, and increases in waking after sleep onset, arousal index, and apnea/hypopnea index were associated with the difference of sleep parameters between the two methods. Conclusion Among patients with psychiatric disorders who are sensitive to environmental change single-channel EEG sleep monitoring would be a useful technique to objectively evaluate sleep quality. Support Collaboration study with The KAITEKI Institute, Inc.

Aim Short sleep duration is a risk factor for cardiovascular diseases. Cerebral blood flow and its regulation are affected by pathological conditions commonly observed in the elderly population, such as dementia, atherosclerosis, diabetes mellitus (DM), stroke, and hypertension. The purpose of this study was to examine the influence of sleep duration on cortical oxygenated hemoglobin (OxyHb) using near-infrared spectroscopy (NIRS). Methods Seventy-three individuals (age, 70.1 ± 3.9 years, 51 men and 22 women) participated in this study. Cortical OxyHb levels were measured with NIRS. We evaluated age, body mass index (BMI), smoking status, alcohol intake, sleep duration, hypertension, DM, and hyperlipidemia using a questionnaire. Blood pressure was measured using plethysmography. Results Peak OxyHb and area under the NIRS curve significantly decreased in participants with sleep duration

The Advanced Land Observing Satellite-2 (ALOS-2) was successfully launched on 24th May 2014. The mission sensor of ALOS-2 is the Phased Array type L-band Synthetic Aperture Radar-2 called PALSAR-2 which is the state of the art L-band SAR system. Until now after the successful completion of initial checkout after launching, ALOS-2 has been contributed to a lot of emergency observations for natural disasters, not only in Japan but also in the world. Furthermore, based on the Basic Observation Scenario (BOS) of ALOS-2, 10m global map data and other mode data are routinely collected and archived. This paper describes the results of ALOS-2 operation in nominal operation phase and outline of future ALOS series missions.

Purpose Myocardial contractile reserve is associated with clinical prognosis in patients with dilated cardiomyopathy (DCM). We assessed myocardial contractile reserve using tissue Doppler strain rate imaging with dobutamine stress echocardiography in DCM patients. Methods Simultaneous echocardiography and left ventricular (LV) catheterization during dobutamine stress were performed in 20 patients with DCM, and echocardiography was performed in 31 control subjects. Dobutamine was infused at a starting dose of 5 μg/kg/min for 5 minutes and then at 10 μg/kg/min. Peak endomyocardial radial strain (ɛ) and systolic strain rate (SRsys) measured with echocardiography and the maximum first derivative of LV pressure (LV dP/dtmax) derived from catheterization were used as indices of contractility. Their percentage change from baseline to the dose of 10 μg/kg/min was calculated. Results The ɛ and SRsys were significantly smaller in DCM patients than in controls. The LV dP/dtmax, ɛ, and SRsys were significantly higher at the dose of 10 μg/kg/min than at baseline. The percentage change in SRsys was significantly correlated with the percentage change in LV dP/dtmax. Conclusions Strain rate imaging during dobutamine stress in DCM might prove noninvasively informative for the evaluation of myocardial contractile reserve and provide insight into LV systolic dysfunction. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:555–560, 2016

OBJECTIVE Rapid eye movement (REM) sleep behavior disorder (RBD) is commonly associated with Lewy body disease, narcolepsy, or depression. In contrast, the relationship between REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, and clinical characteristics remains unclear. The purpose of this study is to investigate the clinical features of psychiatric patients exhibiting RWA and its relevance to Lewy body disease. METHODS Of 55 consecutive patients who underwent polysomnography at the psychiatric ward, 25 patients with sleep apnea syndrome were excluded, and 12 patients exhibiting RWA were identified. The clinical profiles were compared between the groups with and without RWA. RESULTS The mean age and the frequency of neurocognitive disorders were significantly higher in 12 patients with RWA than in 18 without. Only five of the 12 patients exhibiting RWA had episodes of dream-enactment behavior, and fulfilled the clinical criteria for RBD. Two young patients were diagnosed with narcolepsy, while the other middle-aged and older patients fulfilled the clinical criteria for Parkinson's disease (n = 1), dementia with Lewy bodies (n = 4), idiopathic RBD (n = 2), and major depressive disorder (MDD) (n = 3). The patients with MDD exhibited constipation and/or olfactory dysfunction. Moreover, neuroimaging examinations in the patients with MDD revealed isolated occipital hypoperfusion in three patients and mild dopamine transporter deficit in one patient. CONCLUSIONS Rapid eye movement sleep without atonia itself may be associated with specific clinical profiles, even when dream-enactment behavior is absent. Continued follow-up of the patients with MDD exhibiting RWA is warranted to determine if they represent the prodromal Parkinson's disease/dementia with Lewy bodies. Copyright © 2016 John Wiley & Sons, Ltd.

BackgroundInsomnia is common. However, no systematic reviews have examined the effect of exercise on patients with primary and secondary insomnia, defined as both sleep disruption and daytime impairment. This systematic review and meta-analysis aimed to examine the effectiveness/efficacy of exercise in patients with insomnia.MethodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov to identify all randomized controlled trials that examined the effects of exercise on various sleep parameters in patients with insomnia. All participants were diagnosed with insomnia, using standard diagnostic criteria or predetermined criteria and standard measures. Data on outcome measures were subjected to meta-analyses using random-effects models. The Cochrane Risk of Bias Tool and Grading of Recommendations, Assessment, Development, and Evaluation approach were used to assess the quality of the individual studies and the body of evidence, respectively.ResultsWe included nine studies with a total of 557 participants. According to the Pittsburgh Sleep Quality Index (mean difference [MD], 2.87 points lower in the intervention group; 95% confidence interval [CI], 3.95 points lower to 1.79 points lower; low-quality evidence) and the Insomnia Severity Index (MD, 3.22 points lower in the intervention group; 95% CI, 5.36 points lower to 1.07 points lower; very low-quality evidence), exercise was beneficial. However, exercise interventions were not associated with improved sleep efficiency (MD, 0.56% lower in the intervention group; 95% CI, 3.42% lower to 2.31% higher; moderate-quality evidence). Only four studies noted adverse effects. Most studies had a high or unclear risk of selection bias.DiscussionOur findings suggest that exercise can improve sleep quality without notable adverse effects. Most trials had a high risk of selection bias. Higher quality research is needed.

Objective To assess the effects of hypnotics on prefrontal cortex activity in healthy subjects using near-infrared spectroscopy (NIRS) in a double-blind, placebo-controlled crossover trial. Methods Eighteen healthy males received acute doses of ramelteon (8 mg), triazolam (0.125 mg), or placebo in a predetermined randomization schedule, with a washout period of more than 1 week. All subjects performed a verbal fluency task during NIRS assessments at baseline and at 1 and 4 hr post-dose. The number of words correctly generated during the task (behavioral performance) and scores on the Stanford Sleepiness Scale (SSS) were also recorded at each test time. Results Compared with the placebo, triazolam (0.125 mg) significantly decreased oxyhemoglobin (oxy-Hb) concentration change in NIRS during the posttask period and significantly increased behavioral performance, whereas triazolam (0.125 mg) and ramelteon (8 mg) significantly increased SSS scores. Conclusions The differential effects of two types of hypnotics on oxy-Hb change measured by NIRS were observed in acute dosing, suggesting that when assessing brain activity of patients with psychiatric disorders, researchers should consider how certain types of hypnotics can influence brain function. This would also provide useful information to clinicians when prescribing hypnotics suitable for their patients' conditions.

Chronic sleep restriction adversely effects cognitive performance and mood, resulting in accidents and economic loss. We examined the effects of three nights of sleep restriction on cortical oxygenation, cognitive performance and mood. We studied 14 young adults. All subjects spent ≥8 h/night in bed prior to the study day (sufficient sleep), followed by