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Hypnagogia--the transitional state between wakefulness and sleep--is marked by "hypnagogic dreams," during which our brains tend to forge connections among concepts that are otherwise unrelated. This process of creating novel associations during hypnagogic dreams is said to contribute to enhancing creativity, learning, and memory. Recently, researchers have proposed that mind-wandering--a form of spontaneous thought that is freely moving and characterized by transitioning thought content--might be subserved by processes similar to those engaged during hypnagogia, and may serve similar creative functions. However, to date, the relationship between hypnagogia and mind-wandering remains poorly understood, which is likely due in part to the fact that research into hypnagogia requires time-consuming, cumbersome, and costly polysomnography. In light of this, the present study had two primary aims: first, to test a novel tool--called Dormio Light--for cueing and indexing hypnagogic dream content in a cost- and time-effective manner, with the ability for remote administration; second, to use this tool to examine any relations between hypnagogic dreams and mind-wandering (defined as "freely moving thought"). Participants (N = 80, with 34 females) completed a task in which our tool prompted them to engage in hypnagogia and, separately, mind-wandering, with instructions to think about a common everyday object (Tree or Fork) while experiencing these cognitive states. Following each state, participants reported thought content and completed phenomenological questionnaires. Providing an initial validation of our tool, we successfully cued hypnagogic and mind-wandering thought content that was specific to our cues (e.g., Tree), with our incubation-rate results comparable to those found in laboratory-based studies. Further, we found evidence for some phenomenological differences between hypnagogia and mind-wandering reports. Our study offers a novel, cost- and time-effective tool with which to remotely cue and index hypnagogia and mind-wandering, and sheds light on the relationship between hypnagogia and mind-wandering, thereby providing future directions for research into these two cognitive states. [ABSTRACT FROM AUTHOR]

The transition from wakefulness to sleep is neither an 'all-or-none' nor a linear phenomenon. It is a specific period characterized by fluctuations between various transient and local neural patterns with high inter- and intraindividual variability. During the SOP, there is an intricate interplay between the internal and external information sources that feed neurocognitive processing. Individuals can still respond to some external stimuli while having dream-like experiences. Drowsiness is often linked to negative cognitive effects (e.g., attention lapses). However, growing evidence indicates that the SOP may serve key cognitive functions (e.g., memory and creativity). About one-third of the population suffers from sleep-onset difficulties. A better understanding of the SOP could help to identify key markers for diagnosing and treating these disorders. Sleep is crucial for many vital functions and has been extensively studied. By contrast, the sleep-onset period (SOP), often portrayed as a mere prelude to sleep, has been largely overlooked and remains poorly characterized. Recent findings, however, have reignited interest in this transitional period and have shed light on its neural mechanisms, cognitive dynamics, and clinical implications. This review synthesizes the existing knowledge about the SOP in humans. We first examine the current definition of the SOP and its limits, and consider the dynamic and complex electrophysiological changes that accompany the descent to sleep. We then describe the interplay between internal and external processing during the wake-to-sleep transition. Finally, we discuss the putative cognitive benefits of the SOP and identify novel directions to better diagnose sleep-onset disorders. [ABSTRACT FROM AUTHOR]

Whether the Swiss psychiatrist Carl Jung (1875--1961) became psychotic after his mid-thirties is much debated. His recently published Black Books, a seven-volume journal, reveal new insights into this debate. Based on a phenomenological analysis of his self-reports in these books and in other writings, we here identify several types of anomalous perceptual experiences: hypnagogic-hypnopompic experiences, hyperphantasia, hallucinations, personifications, and sensed presence. We argue that these experiences were not indicative of a psychotic disorder, but rather stemmed from extremely vivid mental imagery, or hyperphantasia, a condition Jung's contemporaries and later biographers were unable to take into account because it had not yet been conceptualised. Recently, the degree of vividness of mental imagery and its potential to become indistinguishable from regular sense perception has been the subject of extensive studies. Unknowingly, Jung may have foreshadowed this line of research with his psychoanalytic concept of reality equivalence, i.e., the substitution of an external world for an inner mental reality that he encountered in individuals diagnosed with schizophrenia. There is a need for future research to investigate the possible role of hyperphantasia in psychotic experiences, but to Jung, psychosis was 'a failure to contain and comprehend' the content of one's experiences in the context of one's own life, whereas he himself did manage to put the content of his perceptual experiences into context, to find meaning in them, and to share them with others - to great acknowledgement and acclaim. [ABSTRACT FROM AUTHOR]

Hypnagogia—the transitional state between wakefulness and sleep—is marked by “hypnagogic dreams,” during which our brains tend to forge connections among concepts that are otherwise unrelated. This process of creating novel associations during hypnagogic dreams is said to contribute to enhancing creativity, learning, and memory. Recently, researchers have proposed that mind-wandering—a form of spontaneous thought that is freely moving and characterized by transitioning thought content—might be subserved by processes similar to those engaged during hypnagogia, and may serve similar creative functions. However, to date, the relationship between hypnagogia and mind-wandering remains poorly understood, which is likely due in part to the fact that research into hypnagogia requires time-consuming, cumbersome, and costly polysomnography. In light of this, the present study had two primary aims: first, to test a novel tool—called Dormio Light—for cueing and indexing hypnagogic dream content in a cost- and time-effective manner, with the ability for remote administration; second, to use this tool to examine any relations between hypnagogic dreams and mind-wandering (defined as “freely moving thought”). Participants (N = 80, with 34 females) completed a task in which our tool prompted them to engage in hypnagogia and, separately, mind-wandering, with instructions to think about a common everyday object (Tree or Fork) while experiencing these cognitive states. Following each state, participants reported thought content and completed phenomenological questionnaires. Providing an initial validation of our tool, we successfully cued hypnagogic and mind-wandering thought content that was specific to our cues (e.g., Tree), with our incubation-rate results comparable to those found in laboratory-based studies. Further, we found evidence for some phenomenological differences between hypnagogia and mind-wandering reports. Our study offers a novel, cost- and time-effective tool with which to remotely cue and index hypnagogia and mind-wandering, and sheds light on the relationship between hypnagogia and mind-wandering, thereby providing future directions for research into these two cognitive states.

Sociology, like most disciplines/institutions in racialized (and other oppressive) social systems, are steeped with policies and practices that are designed to maintain the status quo. Thus, they are partly responsible for the gatekeeping, careerism, racism, sexism, and other forms of discrimination that plague our scholarly communities. In this piece, an extension of my 2018 Presidential Address to the Association for Humanist Sociology, I challenge academics to push back and find better ways, through critical humanist sociology, to serve the public good. [ABSTRACT FROM AUTHOR]

The article offers an intellectual reconstruction of Otto Isakower's concept of the 'analyzing instrument', the vehicle by which the analyst's mind becomes joined to the patient's, each in a comparable state of regressed self-observation. This view of technique is shown to have grown out of Isakower's pre-war research (shaped by the work of Paul Schilder and Paul Federn) on a variety of pre-dormescent hallucination that still bears his name, 'the Isakower phenomenon'. Primarily, however, it is Isakower's amateur, apparently peripheral interest in the history and epistemology of science which was, the article argues, central to the evolution of his ideas. In particular, Isakower's study of the scientific practices of self-observation and self-experimentation used by the nineteenth-century sensory physiologist Johannes Müller is shown to have been a decisive relay point between his earlier clinical research on hypnagogic states and his later reflections on technique. In underscoring the significance of that study, the article suggests that something of the transitional character of Müller's scientific practices – his location on the threshold between Romantic and modern, positivist styles of investigating the senses – is retained in Isakower's fascinating model of the analytic situation. [ABSTRACT FROM AUTHOR]

Summary: The hypnagogic state refers to a transitional stage between wakefulness and sleep, in which sensory perceptions can be experienced. In this review, we compile and discuss the recent scientific literature on hypnagogia research regarding the future directions proposed by Schacter (1976; Psychological Bulletin, 83, 452). After a short introduction discussing the terminology used in hypnagogia research and the differentiation of hypnagogic states with other related phenomena, we review the reported prevalence of hypnagogic states. Then, we evaluate the six future directions suggested by Schacter and we propose three further future directions. First, a better understanding of the emotional quality of hypnagogic states is needed. Second, a better understanding of why hypnagogic states occur so frequently in the visual and kinaesthetic modalities is needed. Lastly, a better understanding of the purpose of hypnagogic states is needed. In conclusion, research has made great progress in recent years, and we are one step closer to demystifying the hypnagogic state. [ABSTRACT FROM AUTHOR]

Regarding Ebenezer Scrooge (Figure 2B), it appears that his dream content exhibits oscillatory changes throughout the night, from short reports to elaborate, vivid, emotional dreams with sensorimotor hallucinatory experiences that are common in REM-sleep dreams (Carr and Solomonova, [4]). Concerning lucid dreams, one is dreaming during sleep, with most dreams occurring during REM but also during non-REM sleep. This article aims to explore hypnagogia and dreams in two of Dickens' most famous characters, Oliver Twist in I Oliver Twist i (1837-1839) (Dickens, [8], [9],[10]) and Ebenezer Scrooge in I A Christmas Carol i (Dickens, [11]). Keywords: dream; lucid dream; REM sleep; hypnagogia; creativity EN dream lucid dream REM sleep hypnagogia creativity 1 6 6 07/29/21 20210727 NES 210727 Introduction Charles Dickens was a prolific and ingenious 19th-century English writer who died just over 150 years ago, in 1870. [Extracted from the article]

Peduncular hallucinosis is a rare syndrome that develops with upper brainstem and diencephalon lesions. Patients complain of vivid hallucinations that usually occur in hypnagogic states but maintain critical appraisal. Pathological disruption of the reticular activating systems partially explains this clinical phenomenon. We report the case of a 47-year-old man presenting with peduncular hallucinosis associated with central auditory disturbance consisting of bilateral hypoacusis and left-sided paradoxical hyperacusis, secondary to a pontine haemorrhage. [ABSTRACT FROM AUTHOR]

This article examines the question of sleeping (or not) during the course of ethnographic fieldwork. It is argued that the concept of what is termed here 'sleepwork' has yet to be fully addressed or adequately problematised in the fields of sociology and social anthropology, in particular. The first part of the article highlights the relative silence about sleeping and fieldwork in the literature on qualitative research methods, and reflects upon why this subject is largely absent from the ethnographic corpus. I then make a number of propositions about some potential methodological strategies for incorporating 'sleepwork' into fieldwork. The second part of the article suggests that data analysis should not be seen as an activity that only occurs in states of wakefulness, but rather as a 24/7 activity that is undertaken with varying intensity. [ABSTRACT FROM AUTHOR]

The diagnostic category of sleep-related hallucinations (SRH) replaces the previous category of Terrifying Hypnagogic Hallucinations in the 2001 edition of International Classification of Sleep Disorders-R. Hypnagogic and hypnopompic hallucinations (HHH) that occur in the absence of other symptoms or disorder and, within the limits of normal sleep, are most likely non-pathological. By contrast, complex nocturnal visual hallucinations (CNVH) may reflect a dimension of psychopathology reflecting different combinations of etiologic influences. The identification and conceptualization of CNVH is relatively new, and more research is needed to clarify whether CNVH share common mechanisms with HHH., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Sleep dysfunction is prevalent among patients with schizophrenia. Although sex differences have been identified in schizophrenia, sex differences in sleep patterns among patients with schizophrenia are not established. Therefore, the current study examined sex differences in subjective sleep quality patterns in people with schizophrenia utilizing a standardized inventory. Study sample consisted of 75 patients with schizophrenia and 82 healthy controls (HC). Participants completed the Pittsburgh Sleep Quality Index (PSQI). Compared to HC, patients with schizophrenia were more likely to report being poor sleepers (PSQI global score > 5), longer sleep duration, more sleep disturbances, longer sleep onset latency, increased daytime dysfunction due to poor sleep, and more frequent use of sleep medications. Regarding sex differences, female patients were more likely to report being poor sleepers and endorsed more sleep disturbances than female HC, while male patients reported longer sleep duration, more daytime dysfunction, and poorer overall sleep quality relative to male HC. Additionally, higher level of sleep dysfunction was linked to higher symptom severity in male patients only. Patients with schizophrenia endorsed a range of sleep difficulties, and male and female patients with schizophrenia differ compared to their HC counterparts. Implications for treatment of sleep complaints among patients with schizophrenia are discussed. [ABSTRACT FROM AUTHOR]

A growing body of work supports linear associations between sleep and socioemotional adjustment in adolescence. However, associations between sleep and adjustment are not necessarily linear and investigations of nonlinear effects are scarce. This study examined linear and nonlinear relations between several sleep-wake parameters and externalizing behavior and internalizing symptoms in adolescence, and assessed the role of adolescent sex as a moderator of effects. Participants were high school students (N = 180; M age = 17.49, SD =.62; 59% female; 68% White/European American, 32% Black/African American) from a wide range of socio-economic backgrounds living in semirural communities and small towns in Alabama. Sleep-wake parameters were indexed by actigraphy-derived sleep minutes and adolescents' reports on morningness-eveningness (circadian preference), sleep-wake problems (sleep quality), and sleepiness. Adolescents completed questionnaires on externalizing behaviors and internalizing symptoms. Controlling for sleep duration, a higher preference for eveningness and poor sleep quality were associated in a linear fashion with increased externalizing and internalizing symptoms. Nonlinear relations between sleepiness and internalizing symptoms emerged with pronounced sex-related effects, including somewhat delayed accelerating relations for males and rapidly accelerating associations that tended to plateau for females. Results illustrate the importance of examining multiple sleep-wake and adjustment variables as well as linear and nonlinear associations. [ABSTRACT FROM AUTHOR]

Ghost encounters were found to be a key part of the trauma ontology among Cambodian refugees at a psychiatric clinic, a key idiom of distress. Fifty-four percent of patients had been bothered by ghost encounters in the last month. The severity of being bothered by ghosts in the last month was highly correlated to PTSD severity (r = .8), and among patients bothered by ghosts in the last month, 85.2% had PTSD, versus among those not so bothered, 15.4%, odds ratio of 31.8 (95% confidence level 11.3-89.3), Chi square = 55.0, p < .001. Ghost visitations occurred in multiple experiential modalities that could be classified into three states of consciousness: full sleep (viz., in dream), hypnagogia, that is, upon falling asleep or awakening (viz., in sleep paralysis [SP] and in non-SP hallucinations), and full waking (viz., in hallucinations, visual aura, somatic sensations [chills or goosebumps], and leg cramps). These ghost visitations gave rise to multiple concerns-for example, of being frightened to death or of having the soul called away-as part of an elaborate cosmology. Several heuristic models are presented including a biocultural model of the interaction of trauma and ghost visitation. An extended case illustrates the article's findings. [ABSTRACT FROM AUTHOR]

Sleep duration and sleep quality are often linked to increased risk of mortality and morbidity. However, national representative data on both sleep duration and sleep quality and their relationship with chronic health problems are rarely available from the same source. This current study aimed to examine the independent and combined associations of sleep duration and sleep quality with physical and mental disorders, using data from the Singapore Mental Health Study 2016. 6,126 residents aged ≥18years participated in this epidemiological, cross-sectional survey. Sleep measures were assessed using the Pittsburg Sleep Quality Index while lifetime or 12-month medical and psychiatric diagnoses were established using the Composite International Diagnostic Interview 3.0. Both short sleep (<6hrs compared to 7-8hrs) and poor sleep were found to be independently associated with chronic pain, obsessive compulsive disorder and any mental disorder while poor sleep was additionally associated with major depressive disorder, bipolar disorder, generalized anxiety disorder and any physical disorder, when adjusted for confounders. Poor sleep combined with short sleep (≤6hrs/day vs 7-8hrs/day) was associated with the highest number of comorbidities among other sleep combinations. Sleep duration and sleep quality, when adjusted for each other, remained independently associated with both physical and mental disorders. Affective disorders may be more closely related to poor sleep quality compared to abnormal sleep duration. Our findings suggest sleep quality to be a more important indicator for psychological and overall health compared to sleep duration. [ABSTRACT FROM AUTHOR]

Objectives: The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery. Methods: We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity. Results: Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared. Conclusions: Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients. [ABSTRACT FROM AUTHOR]

Rationale: The nuclear receptor retinoid X receptor (RXR) belongs to a nuclear receptor superfamily that modulates diverse functions via homodimerization with itself or several other nuclear receptors, including PPARα. While the activation of PPARα by natural or synthetic agonists regulates the sleep-wake cycle, the role of RXR in the sleep modulation is unknown. Objectives: We investigated the effects of bexarotene (Bexa, a RXR agonist) or UVI 3003 (UVI, a RXR antagonist) on sleep, sleep homeostasis, levels of neurochemical related to sleep modulation, and c-Fos and NeuN expression. Methods: The sleep-wake cycle and sleep homeostasis were analyzed after application of Bexa or UVI. Moreover, we also evaluated whether Bexa or UVI could induce effects on dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine contents, collected from either the nucleus accumbens or basal forebrain. In addition, c-Fos and NeuN expression in the hypothalamus was determined after Bexa or UVI treatments. Results: Systemic application of Bexa (1 mM, i.p.) attenuated slow-wave sleep and rapid eye movement sleep. In addition, Bexa increased the levels of dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine sampled from either the nucleus accumbens or basal forebrain. Moreover, Bexa blocked the sleep rebound period after total sleep deprivation, increased in the hypothalamus the expression of c-Fos, and decreased NeuN activity. Remarkably, UVI 3003 (1 mM, i.p.) induced opposite effects in sleep, sleep homeostasis, neurochemicals levels, and c-Fos and NeuN activity. Conclusions: The administration of RXR agonist or antagonist significantly impaired the sleep-wake cycle and exerted effects on the levels of neurochemicals related to sleep modulation. Moreover, Bexa or UVI administration significantly affected c-Fos and NeuN expression in the hypothalamus. Our findings highlight the neurobiological role of RXR on sleep modulation. [ABSTRACT FROM AUTHOR]

Objective: To assess the independent and combined effects of night sleep duration and sleep quality on depressive symptoms.Methods: A total of 28,202 participants (11,236 males and 16,966 females) aged 18-79 years from the Henan Rural Cohort were included in this study. Night sleep duration and sleep quality were defined by the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and restricted cubic splines were applied to evaluate the association of night sleep duration and sleep quality with depressive symptoms.Results: A U-shaped dose-response relationship between night sleep duration and depressive symptoms along with a J-shaped relationship between sleep quality and depressive symptoms were observed. Compared with reference group (7-<8 h), shorter sleep duration (<6 h) and longer sleep duration (≥10 h) were associated with increased risk of depressive symptoms in males (short sleep: Odds Ratio (OR) = 1.84, 95% confidence interval (CI), 1.34-2.52; long sleep: OR = 1.56, 95% CI, 1.01-2.42) and females (short sleep: OR = 2.19, 95% CI, 1.77-2.70; long sleep: OR = 1.51, 95% CI, 1.10-2.10). Compared with good sleepers, poor sleepers had 4.23-fold (95% CI:3.54-5.06) and 3.87-fold (95% CI: 3.41-4.40) increased odds of depressive symptoms in males and females. Furthermore, participants with longer night sleep duration (≥10 h) and poorer sleep quality had the strongest effect on depressive symptoms (males: OR = 6.64, 95% CI, 3.21-13.74; females: OR = 7.76, 95% CI, 5.00-12.02).Conclusions: Extreme night sleep duration and poor sleep quality were independently and combinedly related to elevated depressive symptoms, suggesting that keeping optimal night sleep duration and good sleep quality maybe benefit for maintaining mental health.Trial Registration: Chinese Clinical Trial Register. Registration number: ChiCTR-OOC-15006699. [ABSTRACT FROM AUTHOR]

Circadian rhythms refer to biological rhythms that have an endogenous period length of approximately 24 hr. However, not much is known about the variance in the development of the sleep–wake rhythm. The study objectives were (a) to describe the normative variation in the development of a sleep–wake rhythm in infancy, (b) to assess whether slower development is related to sleep quality and (c) to evaluate factors that are related to the slower development of a sleep–wake rhythm. The study is based on a representative birth cohort. Questionnaires at the ages of 3 (n = 1,427) and 8 months (n = 1,302) and actigraph measurement at 8 months (n = 372) were available. Infants with significant developmental delays (n = 11) were excluded. The results are based on statistical testing and multivariate modelling. We found that the average percentage of daytime sleep was 36.3% (standard deviation [SD], 8.5%) at 3 months and 25.6% (SD, 6.6%) at 8 months. At both time‐points, infants with slower sleep–wake rhythm development slept more hours per day, had a later sleep–wake rhythm, more difficulties in settling to sleep and longer sleep‐onset latency; they also spent a longer time awake during the night. According to actigraph registrations, we found that the infants with slow development of a sleep–wake rhythm slept less and had a later start and end to night‐time sleep than the other infants. Infants' sleep–wake rhythm development is highly variable and is related to parent‐reported and objectively measured sleep quality and quantity. Interventions to improve the sleep–wake rhythm might improve sleep quality in these infants. [ABSTRACT FROM AUTHOR]

Victor Erice's contemplative documentary 'Dream of Light' (1992) begins with a straightforward and unnarrated account of a realist painter, Antonio López, embarking upon a new painting of a quince tree growing outside his home in Madrid. Before long, however, the film digresses along various paths surrounding the painter, branching out from its core subject and exhaling into the lives and activities of others, extending all the way to remote urban environments without any apparent connection to the film's initial identity. What began as a vigilant documentary on the inner workings of painting from life becomes suddenly more exploratory, experimental, perhaps cinematic, upholding André Bazin's conviction that films about painting ought to emancipate themselves and expand cinema in some significant way or else risk the mere anecdotal. The decisive shift in mode from documentation to something like experimentation is a philosophically imaginative reply from the filmmaker, expressing itself as a 'reaching beyond the image' towards a more expansive and inclusive sense of reality which the painter's art, in turn, sacrifices for the sake of focusing on a single image and ultimately delving inside his dreams. The dare to digress exposes the film's own process of making and precarious path towards self-discovery. [ABSTRACT FROM AUTHOR]

Background: Sleep and physical activity are modifiable behaviors that play an important role in preventing overweight, obesity, and metabolic health problems. Studies of the association between concurrent objective measures of sleep, physical activity, and metabolic risk factors among adolescents are limited. Objective: The aim of the study was to examine the association between metabolic risk factors and objectively measured school day physical activity and sleep duration, quality, onset, and variability in adolescents. Materials and methods: We measured one school week of free-living sleep and physical activity with wrist actigraphy in 252 adolescents (146 girls), aged 15.8±0.3 years. Metabolic risk factors included body mass index, waist circumference, total body and trunk fat percentage, resting blood pressure, and fasting glucose and insulin levels. Multiple linear regression adjusted for sex, parental education, and day length was used to assess associations between metabolic risk factors and sleep and activity parameters. Results: On average, participants went to bed at 00:22±0.88 hours and slept 6.2±0.7 hours/night, with 0.83±0.36 hours of awakenings/night. However, night-to-night variability in sleep duration was considerable (mean ± interquartile range) 0.75±0.55 hours) and bedtime (0.64±0.53 hours) respectively. Neither average sleep duration nor mean bedtime was associated with any metabolic risk factors. However, greater night-to-night variability in sleep duration and bedtime was associated with higher total body and trunk fat percentage, and less physical activity was associated with higher trunk fat percentage and insulin levels. Conclusion: Greater nightly variation in sleep duration and in bedtime and less physical activity were associated with a less favorable metabolic profile in adolescents. These findings support the idea that, along with an adequate amount of physical activity, a regular sleep schedule is important for the metabolic health of adolescents. [ABSTRACT FROM AUTHOR]

Study Objectives: To analyze the association between sleep-related symptoms and sleep length in parents and their children in relation to other risk factors in both generations.Method: The participants were parents (n = 5,855, age 54.3 ± 6.5 years, 45.2% men) who participated in the community-based Respiratory Health in Northern Europe (RHINE) study and one random member of their adult offspring (n = 5,855, age 30.2 ± 7.7 years, 41.5% men) who participated in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) study. Both generations responded to identical questionnaires on sleep symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), snoring, nocturnal sweating, nocturnal gastroesophageal reflux (nGER), sleep time and excessive daytime sleepiness (EDS). Insomnia was defined as either, or both, DIS and DMS in combination with EDS.Results: All sleep variables except nocturnal sweating were more common in offspring whose parents had reported the same symptom. After adjusting for age, gender, BMI, smoking, physical activity, education, center and parents' total number of children, there were independent associations between sleep symptoms in parents and offspring for DIS (adj. OR, 95% CI: 1.52, 1.20-1.93), DMS (1.34, 1.15-1.56), snoring (1.45, 1.15,1.83), nGER (1.65, 1.15-2.37), insomnia (1.39, 1.13-1.73), short sleep time (<6 h/night) (2.51, 1.72-3.68) and EDS (1.48, 1.26,1.72). There were no independent relationships between symptoms in parents and offspring for EMA, nocturnal sweating or long sleep time (>9 h/night).Conclusion: The familiar aggregation of many sleep disturbances was not explained by investigated lifestyle and environmental factors. This supports a heritable factor in sleep problems. [ABSTRACT FROM AUTHOR]

Neuroticism, a broad trait measure of the tendency to experience negative emotions and vulnerability to stress, is consistently related to poor sleep quality. Less is known about potential pleiotropy in the genetic risk for high neuroticism and poor sleep. Therefore, the present study examined whether polygenic score (PGS) for neuroticism is related to sleep quality in two large samples of adults. In addition, depressive symptoms, anxiety and phenotypical neuroticism were tested as mediators in both samples. Participants were 8316 individuals aged from 50 to 101 years (mean age = 68.29, SD = 9.83) from the Health and Retirement Study, and 4973 individuals aged from 63 to 67 years (mean age = 64.30, SD = 0.68) from the Wisconsin Longitudinal Study. Participants from both samples were genotyped and answered questions on sleep quality. A higher PGS for neuroticism was related to lower sleep quality concurrently and over time in both samples. Anxiety, depressive symptoms and neuroticism mediated these relationships in the two samples. Although effect sizes were small, the present study provides replicable evidence that individuals with a higher genetic predisposition to experience negative emotions and distress are at risk of sleep difficulties. [ABSTRACT FROM AUTHOR]

Summary: Sleep disruption is common among intensive care unit patients, with potentially detrimental consequences. Environmental factors are thought to play a central role in ICU sleep disruption, and so it is unclear why environmental interventions have shown limited improvements in objectively assessed sleep. In critically ill patients, it is difficult to isolate the influence of environmental factors from the varying contributions of non‐environmental factors. We thus investigated the effects of the ICU environment on self‐reported and objective sleep quality in 10 healthy nurses and doctors with no history of sleep pathology or current or past ICU employment participated. Their sleep at home, in an unfamiliar environment ('Control'), and in an active ICU ('ICU') was evaluated using polysomnography and the Richard‐Campbell Sleep Questionnaire. Environmental sound, light and temperature exposure were measured continuously. We found that the control and ICU environment were noisier and warmer, but not darker than the home environment. Sleep on the ICU was perceived as qualitatively worse than in the home and control environment, despite relatively modest effects on polysomnography parameters compared with home sleep: mean total sleep times were reduced by 48 min, mean rapid eye movement sleep latency increased by 45 min, and the arousal index increased by 9. Arousability to an awake state by sound was similar. Our results suggest that the ICU environment plays a significant but partial role in objectively assessed ICU sleep impairment in patients, which may explain the limited improvement of objectively assessed sleep after environmental interventions. [ABSTRACT FROM AUTHOR]

Background: Hypokalemic periodic paralysis (HypoPP) is an autosomal dominant disease characterized by the episodic weakness of skeletal muscles and hypokalemia. More than half patients with HypoPP carry mutations in CACNA1S, encoding alpha‐1 subunit of calcium channel. Few reports have documented the non‐neuromuscular phenotypes of HypoPP. Methods: The proband is a Japanese woman who developed HypoPP at 6 years of age. An excessive insulin secretion with the oral glucose tolerance test rationalized that she had experienced frequent attacks of paralysis on high‐carbohydrate diets. Results: Voglibose and acetazolamide effectively controlled her paralytic episodes. Her 8‐year‐old son and 2‐year‐old daughter started showing the paralytic symptoms from 4 and 2 years of age, respectively. Laboratory tests revealed high concentrations of creatinine kinase in serum and elevated renin activities in plasma of these children. The targeted sequencing confirmed that these three patients had an identical heterozygous mutation (p.V876E) in CACNA1S. Conclusion: Our data indicate that the p.V876E mutation in CACNA1S contributes to the early onset of neuromuscular symptoms and unusual clinical phenotypes of HypoPP. [ABSTRACT FROM AUTHOR]

Zolpidem is a drug that is easily attached to the GABA receptors in the brain. This property makes it very effective for tranquilizing as well as hypnagogia. According to the advantages of electrochemical analysis like high selectivity, high sensitivity, low concentration of analyte, cost-effective, portable and easy-to-use setup, they gained high amount of attention among scientists for determination of different compounds. So in the work, an electrochemical sensor was prepared by the modification of a carbon paste with sulfur-tin@tin oxide nanocomposite (SnS@SnO2NP/CPE) and was investigated for the determination of zolpidem in an aqueous solution. For this reason the electrochemical characteristic of SnS@SnO2NP/CPE including cyclic voltammetry and electrochemical impedance techniques were used. Cyclic voltammetry studies indicated that the process was irreversible. Determination of zolpidem was performed using differential pulse differential technique at the modified electrode surface and linear relationship of oxidation peak current with concentration of this drug show a LOD of 0.66 μM was in the range of 2-80 μM. [ABSTRACT FROM AUTHOR]

Focusing on lucid dreaming, this paper examined relationships between dissociated experiences related to rapid eye movement (REM) sleep (lucid dreaming, nightmares, and sleep paralysis), reality testing, and paranormal experiences/beliefs. The study comprised a UK-based online sample of 455 respondents (110 males, 345 females, Mean age = 34.46 years, SD = 15.70), who had all previously experienced lucid dreaming. Respondents completed established self-report measures assessing control within lucid dreaming, experience and frequency of nightmares, incidence of sleep paralysis, proneness to reality testing deficits (Inventory of Personality Organization subscale, IPO-RT), subjective experience of receptive psi and life after death (paranormal experience), and paranormal belief. Analysis comprised tests of correlational and predictive relationships between sleep-related outcomes, IPO-RT scores, and paranormal measures. Significant positive correlations between sleep and paranormal measures were weak. Paranormal measures related differentially to sleep indices. Paranormal experience correlated with lucid dreaming, nightmares, and sleep paralysis, whereas paranormal belief related only to nightmares and sleep paralysis. IPO-RT correlated positively with all paranormal and sleep-related measures. Within the IPO-RT, the Auditory and Visual Hallucinations sub-factor demonstrated the strongest positive associations with sleep measures. Structural equation modeling indicated that Auditory and Visual Hallucinations significantly positively predicted dissociated experiences related to REM sleep, while paranormal experience did not. However, paranormal experience was a significant predictor when analysis controlled for Auditory and Visual Hallucinations. The moderate positive association between these variables explained this effect. Findings indicated that self-generated, productive cognitive-processes (as encompassed by Auditory and Visual Hallucinations) played a significant role in conscious control and awareness of lucid dreaming, and related dissociative sleep states (sleep paralysis and nightmares). [ABSTRACT FROM AUTHOR]

Objective: To assess sleep-related difficulties (e.g., trouble staying asleep, oversleeping, falling asleep while on duty, disturbing dreams, sleep paralysis) and behavioral patterns of active-duty service members (ADSMs) performing security duties. Participants: The participants were 1,169 ADSMs (20–44 years of age). Methods: ADSMs completed an online survey (67.3% response rate) with items assessing demographics, the occupational environment, sleep-related attributes, habits, or difficulties, factors affecting sleep, aids and techniques used to improve sleep, and the use of sleep-related products. Results: ADSMs reported sleeping ~6.5 hr/day (~56% reported sleeping < 6 hr). Sleep-related difficulties were reported by ~72% of the ADSMs (i.e., 55.1% had problems staying asleep, 33.1% reported experiencing sleep paralysis, 25.6% reported oversleeping, 21.6% had disturbing dreams, and 4.79% reported falling asleep while on duty). Daily sleep duration and quality, occupational factors (shift work, operational commitments, collateral duties, habitability, taking antimalarial medication, years deployed), and personal factors or behaviors (history of sleep problems, problems in personal life, late exercise times, altering sleep schedule to talk or text with family or friends) were associated with sleep-related difficulties. Some ADSMs reported using alcohol (~14%) or exercising prior to bedtime (~34%) in an attempt to fall sleep faster. Conclusions: We identified a high prevalence of sleep-related difficulties in our military sample. Even though most ADSMs used sleep hygiene practices to improve their sleep, some ADSMs used methods not recommended. Improving ADSMs' daily schedule (to include periods for exercising, and protected sleep periods), and further emphasis on sleep hygiene practices may be viable methods to reinforce behaviors promoting healthy sleep and improve performance. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the sleep quality characteristics and factors related to either good or poor sleep quality in acromegaly patients before surgery and to explore sleep quality changes after transsphenoidal surgery and the factors related to these changes.Methods: We prospectively enrolled 39 acromegaly patients and 78 patients with nonfunctioning pituitary adenomas. Scales for anxiety, depression, disease stigma and nasal condition were evaluated. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was administered before surgery as well as one month and three months after surgery.Results: A higher percentage of acromegaly patients had poor sleep quality compared to controls (35.9% vs. 5.1%, p < 0.001). In addition, acromegaly patients experienced worse subjective sleep quality, extended sleep latency, increased sleep disturbance and decreased daytime functioning. Higher scores for anxiety, disease stigma and sinonasal outcomes were correlated with worse sleep quality in acromegaly patients. At one month after transsphenoidal surgery, we found worse subjective sleep quality, extended sleep latency, shortened sleep duration, impaired sleep efficiency and increased sleep disturbance in acromegaly patients. At three months postoperatively, most impaired PSQI domains in acromegaly patients recovered to preoperative levels. The use of soluble gauze was related to decreased sleep quality at one month after surgery and severe anxiety and depression were related to improved sleep quality at three months after surgery.Conclusions: Sleep quality was reduced in acromegaly patients. Moreover, sleep quality initially worsened after surgery but later recovered. Emotional problems and the use of soluble gauze were related factors.Clinical Trial Registration: None. [ABSTRACT FROM AUTHOR]

Objective: In forensic psychiatric patients, sleep problems as well as impulsivity and aggression are highly prevalent, yet studies on their association over time are lacking. This study investigates the association between sleep quality and changes in impulsivity and aggression in forensic psychiatric patients over one year.Methods: Data were drawn from an ongoing prospective observational study in adult forensic psychiatric patients admitted to a forensic treatment facility between October 2006 and January 2018. Validated self-reports and observational instruments were used to assess sleep quality, impulsivity and aggression upon admission to the hospital and after one year. Linear regression analyses were performed to examine the association between sleep quality, impulsivity and aggression. All models were adjusted for baseline values of outcome measures, demographic features and general psychopathology.Results: Data from 83 men (age 37.7 ± 11.7 years) with completed consecutive measurements were analyzed. Poor sleep quality was associated with increased self-reported aggression (β = 1.08; 95% CI, 0.38-1.78). This association was positively confounded by general psychopathology, indicating that sleep quality is specifically related to self-reported aggression instead of being part of general psychopathology (adjusted β = 1.18; 95% CI, 0.39-1.97). Poor sleep quality was not associated with changes in self-reported impulsivity, clinician-rated impulsivity or clinician-rated hostility in this population.Conclusion: Poor sleep quality was associated with an increase in self-reported aggression over one year in male forensic psychiatric patients. Early evaluation and treatment of sleep problems in (forensic) psychiatric patients may play an important role in reducing the risk of aggressive behavior. [ABSTRACT FROM AUTHOR]

Study Objectives: Sleep disorders are significant problems in patients with rheumatoid arthritis (RA) and are associated with poor quality of life. Irisin is myokine which may have anti-inflammatory and energy regulatory roles. This study assessed the association of serum irisin levels with the quality of sleep and disease activity in RA patients.Methods: In sum, 58 RA patients and 30 matched healthy controls were included. Disease activity score in 28 joints (DAS28-ESR) and the patients' global score were calculated. RA patients were grouped according to the Pittsburgh Sleep Quality Index score (PSQI) into good-sleepers (group 1) defined as a PQSI score≤5 and poor sleepers (group 2) with a PSQI > 5. Serum irisin levels were measured for both patients and controls by commercially available enzyme-linked immunosorbent assay kits.Results: Poor sleep quality was found in 26 (45%) of the RA patients. Irisin levels were significantly lower in RA patients with poor sleep compared to those with good sleep and healthy controls (p < 0.001). Serum irisin levels correlated inversely with disease duration, morning stiffness duration, DAS28-ESR, global score, and total PSQI score (r = -0.722 to -0.263 & p values≤0.001-0.04) indicating a possible anti-inflammatory role of irisin in RA patients. The analysis employed Student's t-test, ANOVA, and Pearson correlation.Conclusions: Irisin levels were decreased in RA patients with poor sleep quality compared to RA patients with good sleep quality and healthy controls, indicating a possible association of decreased serum irisin with sleep impairment in RA patients. [ABSTRACT FROM AUTHOR]

Recent neuroscientific theories have proposed that emotions experienced in dreams contribute to the resolution of emotional distress and preparation for future affective reactions. We addressed one emerging prediction, namely that experiencing fear in dreams is associated with more adapted responses to threatening signals during wakefulness. Using a stepwise approach across two studies, we identified brain regions activated when experiencing fear in dreams and showed that frightening dreams modulated the response of these same regions to threatening stimuli during wakefulness. Specifically, in Study 1, we performed serial awakenings in 18 participants recorded throughout the night with high‐density electroencephalography (EEG) and asked them whether they experienced any fear in their dreams. Insula and midcingulate cortex activity increased for dreams containing fear. In Study 2, we tested 89 participants and found that those reporting higher incidence of fear in their dreams showed reduced emotional arousal and fMRI response to fear‐eliciting stimuli in the insula, amygdala and midcingulate cortex, while awake. Consistent with better emotion regulation processes, the same participants displayed increased medial prefrontal cortex activity. These findings support that emotions in dreams and wakefulness engage similar neural substrates, and substantiate a link between emotional processes occurring during sleep and emotional brain functions during wakefulness. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the neural mechanisms of brain-wave music on sleep quality. Background: Sleep disorders are a common health problem in our society and may result in fatigue, depression, and problems in daytime functioning. Previous studies have shown that brain-wave music generated from electroencephalography (EEG) signals could emotionally affect our nervous system and have positive effects on sleep. However, the neural mechanisms of brain-wave music on the quality of sleep need to be clarified. Methods: A total of 33 young participants were recruited and randomly divided into three groups. The participants listened to rapid eye movement (REM) brain-wave music (Group 1: 13 subjects), slow-wave sleep (SWS) brain-wave music (Group 2: 11 subjects), or white noise (WN) (Control Group: 9 subjects) for 20 min before bedtime for 6 days. EEG and other physiological signals were recorded by polysomnography. Results: We found that the sleep efficiency increased in the SWS group but decreased in REM and WN groups. The sleep efficiency in the SWS group was ameliorated [ t (10) = −1.943, p = 0.076]. In the EEG power spectral density analysis, the delta power spectral density in the REM group and in the control group increased, while that in the SWS group decreased [ F (2,31) = 7.909, p = 0.005]. In the network analysis, the functional connectivity (FC), assessed with Pearson correlation coefficients, showed that the connectivity strength decreased [ t (10) = 1.969, p = 0.073] between the left frontal lobe (F3) and left parietal lobe (C3) in the SWS group. In addition, there was a negative correlation between the FC of the left frontal lobe and the left parietal lobe and sleep latency in the SWS group (r = −0.527, p = 0.064). Conclusion: Slow-wave sleep brain-wave music may have a positive effect on sleep quality, while REM brain-wave music or WN may not have a positive effect. Furthermore, better sleep quality might be caused by a decrease in the power spectral density of the delta band of EEG and an increase in the FC between the left frontal lobe and the left parietal lobe. SWS brain-wave music could be a safe and inexpensive method for clinical use if confirmed by more data. [ABSTRACT FROM AUTHOR]

Objective: Driving during young adulthood is a time of increased crash risk. Many factors (e.g., driving experience, aggression) contribute to the increased risk, but factors associated with daytime sleepiness and sleep health may also contribute. The current study examined the relationships between experiences of sleepiness, sleep timing and stability, sleep-impaired emotional regulation, and sleep-impaired cognition among younger persons engaging in 2 risky sleepy driving behaviors: Continuing to drive while sleepy and having experienced a sleep-related close call.Method: The study was advertised in the Queensland University of Technology's online environment and 137 young adults (58.39% women) aged 18 to 25 years completed an anonymous online questionnaire assessing aspects related to daytime sleepiness, sleep timing and stability, sleep-impaired emotional regulation, and sleep-impaired cognition.Results: In total, 15.38% of the participants reported that they had experienced a sleep-related close call. The main outcomes were that both age and the sleep-impaired emotional regulation variable were associated with the outcome variables. The study variables accounted for 18.94% of the variance in continuing to drive while sleepy, and the same variables accounted for 42.69% of the variance (Nagelkerke's R2 statistic) in having had a sleep-related close call. Shorter sleep durations and greater levels of sleep-impaired cognition were significantly associated with having a sleep-related close call.Conclusion: Different variables were associated with the 2 risky driving behaviors, suggesting different underlying factors. Sleep-impaired emotional regulation and/or sleep-impaired cognition could be used to signal drivers that they are impaired by sleepiness. [ABSTRACT FROM AUTHOR]

Eveningness and sleep disturbances are considered as markers of Bipolar Disorder (BD) and influence mood and emotional or behavioral states. This study investigates the associations between circadian markers and sleep quality on residual depressive symptoms and inhibition/activation dimensions during the euthymic phase. A sample of 89 euthymic adult individuals with BD was assessed for circadian preference and typology using the Composite Scale of Morningness (CSM) and the Circadian Type Inventory (CTI) and for sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The Montgomery and Asberg Depression Rating Scale (MADRS) and the Multidimensional Assessment of Thymic States (MAThyS) were used to measure residual depressive symptoms and the inhibition/activation dimensions. We examined any associations between these parameters using correlations and path analyses. We identified significant associations between eveningness and poorer sleep quality that correlated to higher depressive residual symptoms and a global inhibition. The use of path analyses led us to conclude that poor sleep quality mediated the relationship between eveningness and either residual mood symptoms or behavioral inhibition (motivation, sensory perception, interpersonal interaction, and cognition). These factors should be considered in the clinical evaluation of individuals with BD, with a specific attention during the euthymic phase, in order to achieve the best functional outcome possible. [ABSTRACT FROM AUTHOR]

Background/objective: Sleep problems are commonly reported by individuals with Autism Spectrum Disorder (ASD). However, to date, no quantitative evidence synthesis of available studies has been performed to quantify sleep alterations in adults with ASD. We performed a systematic review and meta-analysis of objective (ie, based on actigraphy or polysomnography [PSG]) and subjective (ie, based on sleep diaries/questionnaires) studies comparing sleep parameters in adults with ASD and in a typically developing (TD) control group.Methods: PubMed, OVID databases and Web of Knowledge were systematically searched up to February 2019 with no language restrictions. Original studies including adults with a diagnosis of ASD according to DSM, ICD, or based on standard diagnostic tools (eg, ADOS), and a TD control group were included. Random-effects models were used. Study quality was evaluated with the Newcastle Ottawa Scale (NOS). Analyses were conducted using Comprehensive Meta-Analysis.Results: From initial pool of 1948 references, 14 publications including 8 datasets, (194 ASD and 277 controls) met the inclusion criteria. Compared to controls, individuals with ASD were significantly more impaired in six out of 11 subjective parameters, including lower sleep efficiency (SE, SMD = -0.87, CI = -1.14 - 0.60) and in 10 out of 17 objective outcomes, including longer sleep onset latency (PSG) (SMD = 0.86, CI = 0.29-1.07) and wake after sleep onset (WASO, actigraphy) (SMD = 0.57, CI = 0.28-0.87). The mean NOS score was 4.88/6.Conclusions: Individuals with ASD demonstrated impaired sleep compared to controls in most subjective and objective measures. [ABSTRACT FROM AUTHOR]

Background: Sleep is related to various kinds of health outcomes. Many studies traditionally collect data on sleep using questionnaires or sleep diaries. An increasing popular alternative is a wrist-worn device. The accuracy of these devices is uncertain, and assessment of this accuracy is important. Introduction: The purpose of this study is to compare consensus sleep diary (CSD) and an actigraphy-based wrist-worn device (Fitbit Alta™ [Fitbit, San Francisco, CA]) measurements of total sleep time (TST), sleep onset latency, wake time after sleep onset, number of awakenings, and sleep efficiency. Materials and Methods: Ten healthy young adults (50% female, 100% Asian) in the age range between 20 to 24 years old wore a Fitbit Alta around their nondominated hand during seven consecutive nights. The participants also filled in a CSD every day. Results: On average, the wrist-worn device (Fitbit Alta) recorded a TST per night of 437.15 min, which is 5.46 min shorter on average than the CSD recorded (442.61 min). Bland–Altman plots indicate that there is large variance in the sleep recorded between Fitbit™ (Fitbit, San Francisco, CA) and CSD. For example, Fitbit recorded 2.15 more awakenings per night than CSD, which is equal to 13.09 min on average longer wake time after sleep onset. Conclusion: Fitbit and CSD show significant differences in recording sleep. We find that for most sleep metrics, the level of disagreement is small enough for the devices to be interchangeably used except for recording wakes during the night. [ABSTRACT FROM AUTHOR]

Background: The usage of smart-devices has increased considerably both globally and specifically in Middle Eastern countries. Recently, it has been shown that 65% of United Arab Emirates (UAE) residents lack proper sleep. Several health aspects of the relationship between over usage of smart-devices and poor sleep quality have not been thoroughly investigated. This study aims to determine the correlation between smart-device overuse and sleep quality among UAE residents.Methods: This is a cross-sectional, self-administered questionnaire-based study. Our sample comprised 494 participants, from the three major cities in the UAE. Statistical and regression analyses were conducted using SPSS.Results: Overall, 47.5% of the population were considered heavy users of smart-devices, of which 81% were poor sleepers. Furthermore, the physical proximity of the smart-device at night affected sleep quality; as the distance decreased, the sleep quality worsened, reaching a value of 86.8%. It was also found that 74.5% of the participants used their smart-device at bedtime.Conclusion: Poor sleep is strongly correlated with smart-device overuse. Specifically, poor sleepers were five times more likely to be overusers. The intensity and duration of smart-device usage during the whole day impacted sleep quality more drastically than just before bedtime usage. With the increasing dependence and inappropriate use of smart-devices, future studies are needed to further understand the short and long term impact of this trend on the health and wellbeing of younger individuals as well as the whole community. [ABSTRACT FROM AUTHOR]

A post-hoc analysis comparing morning and evening persons with insomnia on sleep and mental health characteristics was conducted in order to investigate whether an Internet-based cognitive behavioral therapy for insomnia (ICBTi) was effective both for morning and evening persons. Adult patients (N = 178, mean age = 44.8, 67% females) with insomnia were randomized to either ICBTi (N = 92; morning persons = 41; evening persons = 51) or a web-based patient education condition (N = 86; morning persons = 44; evening persons = 42). All patients were assessed with sleep diaries, the Insomnia Severity Index (ISI), the Bergen Insomnia Scale (BIS), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), the Hospital Anxiety and Depression Scale (HADS) and the Chalder Fatigue Scale (CFQ). Patients were characterized as morning or evening persons based on a median split on the Horne-Östberg Morningness Eveningness Questionnaire. Short and long-term effects of treatment were examined with mixed-model repeated-measures analyses. Morning and evening persons did not differ in terms of age, gender or educational status. At baseline, morning persons had more wake time after sleep onset (d= 0.54, p <.001) and more early morning awakening (d= 0.38, p <.05) compared to evening persons, while evening persons reported longer sleep onset latency (d= 0.60, p <.001), more time in bed (d= 0.56, p <.001), longer total sleep time (d= 0.45, p <.01), more fatigue (d= 0.31, p <.05) and more dysfunctional beliefs and attitudes about sleep (d= 0.47, p <.01). Despite these differences at baseline, both morning and evening persons receiving ICBTi benefitted more across most measures compared to morning and evening persons who received patient education. For morning persons in the ICBTi group, ISI scores were reduced from 17.3 at baseline to 8.8 (dpre-post = 2.48, p <.001) at post-assessment, and to 10.0 at 18-month follow up (dpre-post18m = 2.13, p <.001). Comparable results were found for evening persons in the ICBTi group, with a reduction in ISI scores from 17.4 at baseline to 8.6 (dpre-post = 2.24, p <.001) at post-assessment, and to 8.7 at 18-month follow up (dpre-post18m = 2.19, p <.001). Similar results were found on the BIS, DBAS, HADS, CFQ and sleep diary data. Despite different insomnia symptomatology between the two groups, the current study suggests that ICBTi is effective across scores on the morningness-eveningness dimension. The study was pre-registered at: ClinicalTrials.gov Identifier: NCT02261272. [ABSTRACT FROM AUTHOR]

Aim: There have been no previous reports on the efficacy and safety of suvorexant for insomnia in people with psychiatric disorders. Methods: This one‐week, prospective, single‐arm, clinical trial of fixed dose of suvorexant (20 mg if ages 18–64 or 15 mg if age ≥ 65 years) for insomnia included 57 patients with psychiatric disorders who had experienced any of the following insomnia symptoms for four or more nights during the week prior to the start of the study: total sleep time (TST) <6 hours, time to sleep onset (TSO) ≥30 minutes, or two or more episodes of wake after sleep onset. Results: The mean age of the patients was 49.4 ± 17.3 years; 54.4% were women, 49.1% had a major depressive disorder, and 77.2% completed the trial. Compared with the baseline scores (the mean scores for the two days before the start of the study), taking suvorexant was associated with significant improvements in TST, TSO, wake time after sleep onset, and the patients' sleep satisfaction level at week 1. Adverse events included at least one adverse event (43.9%), sleepiness (28.8%), fatigue (11.5%), nightmares (5.8%), headache (3.8%), dizziness (3.8%), and vomiting (1.9%). Conclusion: Suvorexant was beneficial for the treatment of insomnia in people with psychiatric disorders. However, this study was of short duration and included only a relatively small number of patients. A larger, long‐term study is needed to investigate the efficacy and safety of suvorexant for insomnia in people with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to establish the determinants of perceived sleep quality over a longer period of time, taking into account the separate contributions of actigraphy-based sleep measures and self-reported sleep indices. Methods: Fifty participants (52 ± 6.6 years; 27 females) completed two consecutive weeks of home monitoring, during which they kept a sleep–wake diary while their sleep was monitored using a wrist-worn actigraph. The diary included questions on perceived sleep quality, sleep–wake information, and additional factors such as well-being and stress. The data were analyzed using multilevel models to compare a model that included only actigraphy-based sleep measures (model Acti) to a model that included only self-reported sleep measures to explain perceived sleep quality (model Self). In addition, a model based on the self-reported sleep measures and extended with nonsleep-related factors was analyzed to find the most significant determinants of perceived sleep quality (model Extended). Results: Self-reported sleep measures (model Self) explained 61% of the total variance, while actigraphy-based sleep measures (model Acti) only accounted for 41% of the perceived sleep quality. The main predictors in the self-reported model were number of awakenings during the night, sleep onset latency, and wake time after sleep onset. In the extended model, the number of awakenings during the night and total sleep time of the previous night were the strongest determinants of perceived sleep quality, with 64% of the variance explained. Conclusion: In our cohort, perceived sleep quality was mainly determined by self-reported sleep measures and less by actigraphy-based sleep indices. These data further stress the importance of taking multiple nights into account when trying to understand perceived sleep quality. [ABSTRACT FROM AUTHOR]