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Purpose: To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods: Sleep was assessed for a minimum of 25 nights (range = 25–31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results: There was a significant relationship between sleep duration and the day of the menstrual cycle (P =.042) and total symptoms reported that day (P <.001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P =.004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P =.950), wake after sleep onset (P =.217), and subjective sleep quality (P =.080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P =.220), subjective sleep quality (P =.502), or sleep latency (P =.740) but did significantly relate to wake after sleep onset (P <.001), with a significant day × symptom interaction (P <.001). Conclusions: Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics. [ABSTRACT FROM AUTHOR]

Purpose: Short sleep duration and poor sleep quality are common in swimmers. Sleep-hygiene strategies demonstrated beneficial effects on several sleep parameters. The present study assessed the impact of a multisession sleep-hygiene training course on sleep in elite swimmers. Methods: Twenty-eight elite swimmers (17 [2] y) participated. The sleep-hygiene strategy consisted of 3 interventions. Sleep was measured by actigraphy for 7 days before the beginning of the intervention (baseline), after the first collective intervention (postintervention), after the second collective intervention (postintervention 2), and, finally, after the individual intervention (postintervention 3). The Epworth Sleepiness Scale (ESS) was completed concurrently. Swimmers were classified into 2 groups: nonsomnolent (baseline ESS score ≤ 10, n = 13) and somnolent (baseline ESS score ≥ 11, n = 15). Results: All swimmers had a total sleep time of <8 hours per night. Sixty percent of swimmers were moderately morning type. Later bedtime, less time in bed, and total sleep time were observed in the somnolent group compared with the nonsomnolent group at baseline. An interaction between training course and group factors was observed for bedtime, with a significant advance in bedtime between baseline, postintervention 2, and postintervention 3 for the somnolent group. Conclusions: The present study confirms the importance of implementing sleep-hygiene strategies, particularly in athletes with an ESS score ≥11. A conjunction of individual and collective measures (eg, earlier bedtime, napping, and delaying morning training session) could favor the total sleep time achieved. [ABSTRACT FROM AUTHOR]

Purpose: This study examined posttravel perceptual responses of national-team footballers (soccer) following different flight paths, arrival/departure times, and trip contexts. Methods: Details of 396 flights from national-team players (N = 68) were obtained and verified via an online flight database. Each player provided ratings of perceptual fatigue, sleep, soreness, stress, and jet lag for 2 days before and after each trip. The flight path (continents of departure and arrival), travel context (into vs out of national team), and arrival and departure times were obtained for each trip. Linear mixed models compared the pretravel with posttravel change in perceptual responses based on flight path, context, and schedule. Results: Perceived jet-lag ratings were more responsive to travel variables (R2 =.48) than other perceptual ratings (R2 <.26). Travel from Asia to Europe (P <.05) and Europe to Australia (P <.001) had significantly higher jet-lag ratings than all other paths. Fatigue scores were worst following Asia to Europe (P <.05) and Europe to Australia (P <.05) travel, while sleep scores were worst following Europe to Australia travel (P <.01). Perceptual responses were poorer following travel from national team to club compared with all other travel contexts (P <.05). Arrival during the daytime (11 AM to 5 PM) resulted in better perceptual responses than early-morning or late-night arrivals (P <.05). Conclusions: Perceived jet-lag ratings are more responsive to travel demands than perceptual wellness scales in national-team football athletes. Poorer perceptual responses may be expected when travel is longer in nature, ends later in the day, or involves travel out of the national team back to club. [ABSTRACT FROM AUTHOR]

This systematic review aims to identify the sleep parameters of Olympic athletes and the instruments used to assess and monitor the sleep of these athletes. The search was conducted until February 2023 and was performed in PubMed, Web of Science, and Scopus databases. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), awakenings after sleep onset (WASO), quality of sleep, daytime sleepiness, and chronotype; the participants were Olympic athletes. The search returned a total of 280 studies. After screening based on exclusion and inclusion criteria, 11 studies were included. The main results demonstrate that Olympic athletes have TST of 06:10 h, SE of 84%, SOL of 28 min, and WASO of 49 min. The most predominant chronotype is indifferent; over half of the athletes have poor sleep quality and complaints. Furthermore, actigraphy was the most used method to assess sleep. It is concluded that Olympic athletes have TST, SE, and WASO poor than the recommended values. In addition, sleep complaints and poor sleep quality were also observed. Among the objective sleep assessment methods, actigraphy was the method most frequently used in this population. [ABSTRACT FROM AUTHOR]

Introduction and purpose Sleep apnea is a disturbance of sleep that affects about 10% of adult population and is not easily detected due to unspecific symptoms. The aim of this literature review is to present, respectively, obstructive sleep apnea and central sleep apnea symptoms and integrate the available data in the literature regarding the pathogenesis and treatment methods. Materials and methods A review of literature was performed using PubMed and Google Scholar database. The search criteria included keywords such as sleep apnea, obstructive sleep apnea treatment, central sleep apnea treatment. State of knowledge Sleep disturbances that involve breathing can be categorized as obstructive sleep apnea (OSA) and central sleep apnea. First one is associated with the obstruction of the upper airways and the second one -- with malfunctioning breathing generator in the pontomedullary breathing pacemaker. Symptoms are unspecific which makes diagnostic process difficult. However, the right diagnosis and treatment may prevent patients from developing many cardiovascular diseases. Treatment options for OSA include: CPAP, reducing body weight, changing sleep position, braces and surgeries; for CSA: CPAP and acetazolamide. Conclusions OSA and CSA need to be further investigated in order to find more precise ways of diagnosis and treatment, as these diseases remain underreported. It is worth noting, that these conditions predispose to serious diseases, e.g. stroke. Therefore, developing new treatment techniques would beneficial for the health of population. [ABSTRACT FROM AUTHOR]

Background: Sleep disorders are one of the major public health problems, which can potentially induce inflammation and exacerbate disease activity, resulting in compromised sleep quality. This study aimed to investigate the prevalence and risk factors associated with sleep disorders among patients with inflammatory bowel disease (IBD). Methods: Between March 2023 and February 2024, the Pittsburgh Sleep Quality Index was employed to assess sleep quality in both IBD patients and healthy control subjects. Univariate and multivariate analysis were performed to identify the risk factors associated with SD in IBD patients. Results: Overall, 208 IBD patients [150 Crohn's disease (CD) and 58 ulcerative colitis (UC)] and 199 healthy individuals were included. Sleep disorders were observed in 59.6% of patients with IBD, with a higher prevalence among females (63.5%) compared to males (56.9%) (P = 0.476). The prevalence of sleep disorders in IBD patients was significantly higher than that found in healthy controls (37.7%) (all P < 0.01). The prevalence of sleep disorders among CD and UC patients was 58% and 63.8%, respectively (P = 0.291). The multivariate analysis revealed that older age (OR, 1.070; 95% CI: 1.035–1.105, P = 0.000), smoking (OR, 2.698; 95% CI: 1.089–6.685, P = 0.032), and depression (OR, 4.779; 95% CI: 1.915–11.928, P = 0.001) were risk factors for sleep disorders in IBD patients. However, higher body mass index (OR, 0.879; 95% CI: 0.790–0.977, P = 0.017) was identified as a protective factor. Conclusion: Sleep disorders are common among IBD patients regardless of activity levels. Smoking and depression are the major risk factors. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionAlthough cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for sleep disorders, little is known about the role of hyperarousal (especially trait arousal) in CBT-I interventions. Therefore, this study investigated the role of trait arousal in the maintenance of sleep problems using cross-sectional and longitudinal methods.Study 1, 1209 Chinese university students (63.9% female) completed the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), Pre-sleep Arousal Scale (PSAS), Arousal Predisposition Scale (APS), and Pittsburgh Sleep Quality Index (PSQI). The study calculated the moderating role of trait arousal in the relationship between dysfunctional beliefs about sleep and sleep quality. In study two, 89 participants completed the questionnaire used in Study 1 during pre-and post-treatment. A within-subjects mediation analysis examined the indirect effects of dysfunctional beliefs about sleep pre-sleep arousal (cognitive and somatic) on sleep quality. A within-subjects moderation analysis was used to investigate whether baseline trait arousal moderated sleep quality.Cross-sectional findings indicated that pre-sleep cognitive arousal mediated the effects of dysfunctional beliefs about sleep on sleep quality and that trait arousal moderated the first half of the mediating pathway described above; longitudinal analyses indicated that changes in dysfunctional beliefs about sleep and pre-sleep cognitive arousal mediated changes in sleep quality, and that, in addition, trait arousal moderated changes in sleep quality.Trait arousal correlates with the maintenance of sleep problems, and participants with higher trait arousal benefited less from CBT-I. Enhancement programs that incorporate mindfulness may be a direction for future research. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence has suggested that sleep disturbances and disorders are common in patients who undergo knee arthroplasty. Revision surgery represents one of the most catastrophic outcomes of knee arthroplasty. However, it remains unclear whether sleep traits are the causes or consequences of knee arthroplasty revision. This study aimed to genetically examine the relationships between sleep traits and knee arthroplasty revision. Methods: To determine the causal relationship between sleep traits and knee arthroplasty revision, we employed two-sample Mendelian randomization (MR) using summary statistics from the largest publicly available genome-wide association studies (GWASs). The MR design uses genetic variants as instrumental variables to help separate causal relationships from non-causal associations. The main analyses included an inverse variance weighted (IVW) meta-analysis to obtain primary effect estimates. Sensitivity analyses involving the weighted median approach and MR-Egger regression were also conducted to check for potential pleiotropic biases. Numerous complementary sensitivity analyses were also performed to identify statistically significant causal correlations when there were horizontal pleiotropy and heterogeneity across variants. Finally, a reverse MR analysis was performed to evaluate the possibility of reverse causation. Results: In the absence of heterogeneity and horizontal pleiotropy, the IVW method revealed that genetically-predicted short sleep duration short sleep duration (average sleep duration of 24 h is 6 h or less) was positively correlated with the risk of knee arthroplasty revision (odds ratio = 1.03, 95% confidence interval = 1.01–1.05, and P = 0.003), while the association between genetically-predicted long sleep duration and knee arthroplasty was negative. The reverse MR analysis did not yield evidence supporting reverse causality relation between knee arthroplasty revision and sleep phenotypes. Conclusion: This research indicated that, of the 10 sleep phenotypes we analyzed, only sleep duration was causally associated with knee arthroplasty revision. These discoveries added to the understanding of the role of sleep traits in the etiology of knee arthroplasty revision, which might further expand our insights into the prevention of knee arthroplasty revision. Highlights: 1. Genetically-predicted short sleep duration increases risk of knee arthroplasty revision. 2. Mendelian randomization used to analyze sleep traits and knee revision relationship. 3. Sleep duration causally linked to lower risk of knee arthroplasty revision. 4. No evidence found for reverse causality between knee revision and sleep traits. 5. Study enhances understanding of sleep's role in knee arthroplasty outcomes. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are common in early childhood and may be affected by parental adverse childhood experiences (ACEs). However, few studies have examined the longitudinal effect of parental ACEs on offspring sleep problems and the underlying mechanism. This study examined parents' psychological distress and harsh discipline (psychological aggression and corporal punishment) as mediators in the longitudinal pathway from parental ACEs to offspring sleep problems. Methods: The participants included 617 3-year-old children (mean age of 43.13 months, SD = 3.82) and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. The participants completed an online questionnaire on ACEs, psychological distress, and demographic characteristics in September 2022 (Time 1). Parents completed another online questionnaire in September 2023 (Time 2) on harsh discipline and offspring sleep problems. A path model was used to examine the associations. Results: Parental ACEs did not directly predict offspring sleep problems. Psychological distress (β = 0.041, 95% CI [0.005, 0.111]) and harsh discipline in the form of psychological aggression (β = 0.019, 95% CI [0.006, 0.056]) separately mediated the relationship between parental ACEs and offspring sleep problems. Psychological distress and psychological aggression also played a serial mediating role in the association of parental ACEs with offspring sleep problems (β = 0.014, 95% CI [0.007, 0.038]). Conclusions: Our findings showed the importance of psychological distress and psychological aggression in the intergenerational effect of trauma on offspring sleep problems. Specific interventions aimed at improving mental health and parenting practices should be provided for parents who were exposed to ACEs. [ABSTRACT FROM AUTHOR]

Isolated REM Sleep Behavior Disorder (iRBD) is considered a prodrome of Parkinson's disease (PD). We investigate whether the potentially disease-modifying compound acetyl-DL-leucine (ADLL; 5 g/d) has an effect on prodromal PD progression in 2 iRBD-patients. Outcome parameters are RBD-severity sum-score (RBD-SS-3), dopamine-transporter single-photon emission computerized tomography (DAT-SPECT) and metabolic "Parkinson-Disease-related-Pattern (PDRP)"-z-score in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). After 3 weeks ADLL-treatment, the RBD-SS-3 drops markedly in both patients and remains reduced for >18 months of ADLL-treatment. In patient 1 (female), the DAT-SPECT putaminal binding ratio (PBR) decreases in the 5 years pretreatment from normal (1.88) to pathological (1.22) and the patient's FDG-PET-PDRP-z-score rises from 1.72 to 3.28 (pathological). After 22 months of ADLL-treatment, the DAT-SPECT-PBR increases to 1.67 and the FDG-PET-PDRP-z-score stabilizes at 3.18. Similar results are seen in patient 2 (male): his DAT-SPECT-PBR rises from a pretreatment value of 1.42 to 1.72 (close to normal) and the FDG-PET-PDRP-z-score decreases from 1.02 to 0.30 after 18 months of ADLL-treatment. These results support exploration of whether ADLL may have disease-modifying properties in prodromal PD. Clinical trials with N-acetyl-L-leucine showed beneficial effects in lysosomal diseases. Here, the authors investigate a disease modifying effect of acetyl-DL-leucine in 2 patients with REM sleep behavior disorder, a prodrome of Parkinson's disease, and report improvements in neurological symptoms and imaging biomarkers. [ABSTRACT FROM AUTHOR]

Background: The aim of this research is to achieve the early detection of facial characteristics in patients diagnosed with neurodevelopmental deficits and obstructive sleep apnoea–hypopnea syndrome (OSAHS) through the analysis of the VERT index and Ricketts' cephalometry to minimise the neurocognitive morbidity associated with these disorders. Methods: This clinical study was conducted on 44 patients aged 4 to 15 years. Participants completed an initial questionnaire about sleep disturbances, followed by a polysomnography, a radiographic study, and an oral examination. Results: The maximum variability in the data was obtained in the mandibular plane angle, where we observed that the measurement was higher in patients diagnosed with OSAHS. The relative and normalised indices of facial depth and the mandibular plane showed variations between patients with a clinical picture compatible with OSAHS and the control group without pathology. Conclusions: Our findings indicate that Ricketts' VERT index by itself is unable to provide evidence of a diagnosis compatible with OSAHS in patients with early neurodevelopmental deficits, but, after analysing the results obtained, we observed that for the cephalometric measurements of the mandibular plane angle and facial depth relative to the patient's age, there are sufficiently strong variations for creating a solid method of differential diagnosis, thus preventing complications at the neurocognitive level. [ABSTRACT FROM AUTHOR]

There is a special relationship between major depressive disorder and excessive daytime sleepiness. However, given the negative impact of excessive daytime sleepiness on life quality and cardiovascular outcome in hypertensive patients, the objective of this study was to investigate the potential role played by major depressive disorder in the occurrence of this complaint for this particular subpopulation. Data from 1404 hypertensive patients recruited from the Sleep Unit's polysomnographic recordings database were analyzed. A score >10 on the Epworth Sleepiness Scale was used to define excessive daytime sleepiness in this study. Logistic regression analyses were performed to investigate the risk of excessive daytime sleepiness associated with major depressive disorder in hypertensive patients. Excessive daytime sleepiness was frequent (40.0%) in our sample of hypertensive patients. After adjustments for major confounding factors, multivariate logistic regression analyses demonstrated that unlike remitted major depressive disorder, only current major depressive disorder was associated with a higher risk of excessive daytime sleepiness in hypertensive patients. Given this potential implication of current major depressive disorder in the occurrence of excessive daytime sleepiness for hypertensive patients, it is therefore essential to achieve the complete remission of this psychiatric disorder to avoid negative consequences associated with this complaint in this particular subpopulation. [ABSTRACT FROM AUTHOR]

Despite exploring factors, little is known about sleep quality and room sharing in older adults. To examine differences in sleep quality among older adults as a function of bed/room sharing during the first wave of the COVID-19 pandemic. This cross-sectional study was conducted in Brazil and enrolled 1,123 older adults aged 60 years and older. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and sleep duration. Bed or room sharing was assessed using a single question ("do you have a bed partner or a roommate?" "no bed partner or roommate"; "partner/roommate in other room"; "partner in the same room, but not same bed"; "partner in same bed"). Between group comparisons were performed with ANCOVA adjusting for confounders. The group "partner in the same bed" reported significant lower global PSQI scores compared to the "no bed or roommate partner" group (6.00 ± 0.27 versus 7.22 ± 0.23, respectively; p = 0.029). Furthermore, the group "partner in same bed" reported superior (p < 0.001) sleep duration (7.42 ± 0.09 hours) compared with older adults in the "no bed or roommate partner" (6.82 ± 0.08 hours), "partner or roommate in another room" (6.77 ± 0.14 hours; p < 0.001), and "partner in the same room but not in same bed" (6.82 ± 0.11 hours; p < 0.001) groups. The findings suggest that sharing a bed with a partner seems to be associated with significant better quality and duration of sleep among older adults. [ABSTRACT FROM AUTHOR]

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver-specific disorder affecting pregnant women, with an Australian incidence of 0.6% pa and recurring in 70% of those affected. ICP causes mild to severe pruritus, often resulting in considerable skin excoriations, profound sleep disturbances, and severe anxiety, and yet the aetiology and optimal treatment or management of this condition remains unknown. In this review, we consider the role of viruses in causing or exacerbating ICP and discuss viruses that have been most closely implicated in the disease, including the role of Hepatitis B and Hepatitis C viruses in ICP. [ABSTRACT FROM AUTHOR]

Objective: Sleep bruxism (SB) is a repetitive rhythmic and nonrhythmic activity. It can be a comorbid condition for other disorders, such as sleep breathing disorders (SBD). However, a clear causal link between these factors is yet to be established. Moreover, this relationship is even more unknown in children. Thus, this systematic review aimed to determine the relationship between SB and SBD in children and teenagers and consolidate the current knowledge about the possible association between both phenomena at the pediatric age. Materials and Methods: Advanced searches were performed in five electronic databases with the last search updated on February 1, 2023. The methodological quality of the selected studies was analyzed using the quality assessment tool for experimental bruxism studies. Results: Twenty‐nine of 6378 articles were selected for detailed analyses. Most articles found a comorbid relationship between SB and SBD, though no study analyzed a temporary relationship. Due to the heterogeneity of the studies, a meta‐analysis could not be performed. Conclusion: Despite the limitations of this systematic review, it can be concluded that there is an association between SB and SBD in children. However, the level of evidence is low. [ABSTRACT FROM AUTHOR]

Prior research has observed reciprocal associations between sleep and mood. However, these findings are primarily based on the examination of one or two aspects of sleep behaviors (e.g., duration, quality), neglecting how multiple dimensions of sleep (particularly indicators pertinent to adolescence, e.g., sleep variability) are linked to adolescent mood both daily and longitudinally. Drawing on a multidimensional framework for sleep, this study addressed the knowledge gap by examining the directionality of and differential effects for associations between multiple dimensions of sleep and mood during early adolescence. Participants were 273 Chinese early adolescents (34.39% girls; Mage = 11.57, SD = 1.31), who filled out a pre-survey on demographics (T1) and 7-day diaries on sleep (i.e., duration, quality, disturbance, and latency) and mood (i.e., positive and negative mood). Adolescents completed another wave of diary reports 1 year later (T2). Findings revealed both bidirectional and unidirectional, within-person effects depending on specific sleep parameters, suggesting differential associations between multiple dimensions of sleep and mood. Specifically, on days when adolescents had longer sleep latency and greater disturbance than usual, they reported higher negative mood the next day, whereas higher negative mood was linked to poorer sleep quality the next day. The longitudinal investigation found that greater variability in sleep quality at T1 was associated with higher negative mood at T2. These findings underscore the importance of understanding the complex interplay between sleep and mood by examining the directionality of and differential effects for the daily and longer-term associations between multiple dimensions of sleep and mood among early adolescents. [ABSTRACT FROM AUTHOR]

Objective: Nocturnal symptoms are common in the asthmatic population, reflecting an exaggerated airway narrowing overnight due to several factors; it is questioned to what extent the awakenings documented in the clinical assessment of asthma control are due to the disease itself or to comorbidities. To answer this question, we aimed to evaluate to what proportion rhinitis, gastroesophageal reflux and the likelihood of being affected by OSAS were related to poor asthma control, by means of ACT evaluation. Methods: Asthmatics attending the outpatient clinic were enrolled and administered the following questionnaires: ACT, Total 5 Symptom Score, GERD Impact Scale, Pittsburgh Sleep Quality Index and the Sleep Disorders Questionnaire. Results: One-hundred consecutive patients (M/F: 42/58, mean age 52 ± 15 years) were recruited. According to the ACT findings, 14 asthmatics resulted as fully controlled (FC, ACT equal to 25), 55 partially controlled (PC, 25 < ACT >19) and 31 as uncontrolled (UC, ACT <19). GERD was not associated with the ACT score neither did rhinitic symptomatology. On the other hand, the PSQI scores appeared to significantly increase with the lack of symptom control: FC, 2.0 (1–4); PC, 3.5 (2–5); UC, 6.6 (4–8) (p = 0.002). The SA-SDQ questionnaire results significantly increased with the loss of asthma control: FC, 11.0 (9–12); PC, 12.5 (10–14); UC, 15.1 (14–16) (p = 0.005). Conclusions: These results confirm and extend previous findings showing that there is a higher likelihood that underlying unknown sleep disturbances worsen asthma control, suggesting that a more comprehensive assessment is necessary to clarify the cause of nocturnal symptoms in asthma. [ABSTRACT FROM AUTHOR]

Objective: To investigate the therapeutic utility of psychological nursing interventions for prostatic hyperplasia clients while they are receiving therapy. Methods: Clinical data of 110 patients with prostate group hyperplasia who underwent treatment in our hospital were collected and analysed retrospectively, and the selected period was from October 2021 to October 2023. The 110 cases of prostate group hyperplasia patients were divided into a research group and a control group according to the different methods of care, and each group had 55 cases each. The research group received psychological nursing intervention based on the conventional nursing care given to the control group. The total treatment compliance rate and contentment with nursing were contrasted between the research and control groups, and changes in the Self Rating Anxiety Scale (SAS) score, Self Rating Depression Scale (SDS) score, Health Survey Short Form score, and sleep problems were observed between the research group and the control group. Results: The research group's overall compliance rate was 94.55% (52/53), a substantial increase over the control group's rate, 69.09% (38/55), P < 0.01. Following nursing, the research group's SAS and SDS scores were considerably more reduced than those of the control group, and both groups' scores were substantially lower than they were prior to nursing (P < 0.05). Conclusion: This retrospective study found that psychological nursing intervention applied to patients with prostatic hyperplasia can effectively improve the patient's compliance with treatment, effectively reduce the occurrence of negative emotions, improve the patient's quality of life, and improve sleep problems. In addition, psychological nursing intervention can effectively alleviate the tension between nurses and patients, and is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Sleep disorders are prevalent and often neglected among breast cancer patients. This study aimed to identify the association among perceived stress, loneliness, resilience and sleep disorders and to further explore whether resilience could be a moderator in the association between them and sleep disorders. A cross-sectional study was conducted by 492 female breast cancer patients. Patients were asked in response to the questionnaires including the Pittsburgh Sleep Quality Index, Perceived Stress Scale-10, the Three-Item Loneliness Scale and Resilience Scale-14. The association among perceived stress, loneliness, resilience and perceived stress/loneliness × resilience interaction with sleep disorders were examined by hierarchical multiple regression analysis. The interaction was visualized by using simple slope analysis. 36.58% of the female breast cancer patients reported sleep disorders in our study. Perceived stress and loneliness were related to sleep disorders. Resilience could moderate the relationship between them and sleep disorders. When resilience was higher, perceived stress and loneliness had a weaker impact on sleep disorders. Medical staff should systematically evaluate the internal environmental factors related to patients' sleep quality and help patients relieve their emotional distress caused by the disease through positive psychological guidance. [ABSTRACT FROM AUTHOR]

Objectives: Poor sleep is a common side effect of cancer. Cannabis is increasingly used to manage cancer treatment-related symptoms, including sleep. This study investigated factors related to cannabis use for sleep among Canadian cancer survivors. Method: Adult Canadian cancer survivors (N = 940) were recruited via the Angus Reid Institute and completed an online, cross-sectional survey. Univariate and multiple binomial logistic regression models identified factors associated with cannabis use for sleep. Results: Of the participants (Mage = 64.5 yrs; Women = 51.1%; White = 92.9%), 25.1% (n = 236) currently use cannabis for sleep. Participants were at greater odds of using cannabis for sleep if they identified as a gender other than man or woman (AOR = 11.132), were diagnosed with multiple medical conditions (2:AOR = 1.988; 3+:AOR = 1.902), two psychological conditions (AOR = 2.171), multiple sleep disorders (AOR = 2.338), insomnia (AOR = 1.942), bone (AOR = 6.535), gastrointestinal (AOR = 4.307), genitourinary (AOR = 2.586), hematological (AOR = 4.739), or an unlisted cancer (AOR = 3.470), received hormone therapy only (AOR = 3.054), drink heavily (AOR = 2.748), or had mild insomnia (AOR = 1.828). Older participants (AOR=.972) and those with sleep apnea were less likely to use cannabis for sleep (AOR=.560). Conclusion: Given its prevalence, research is needed to understand how factors associated with cannabis use as a sleep aid among Canadian cancer survivors may influence its use and effectiveness and whether these factors are barriers to accessing evidence-based treatments. [ABSTRACT FROM AUTHOR]

Study Objectives: To construct and evaluate the inter-rater reliability of the Structured Clinical Interview for DSM-5-TR Sleep Disorders – Kid (SCISD-Kid). Method: The SCISD-Kid was modeled on the adult SCISD-R and accounted for pediatric developmental and sociocultural factors. Fifty sleep-disturbed children (Mage = 11.9, SD = 2.9) and 50 caregivers responded to the final SCISD-Kid. Video recordings were double-scored to evaluate inter-rater reliability. Results: The final SCISD-Kid contained approximately 90 questions. Eight of the nine covered disorders had prevalence rates sufficient for analyses for both samples (i.e., k > 2). Inter-rater reliability was examined using Cohen kappa coefficients (κ); reliability estimates ranged from excellent to good. For youth, restless legs syndrome yielded the lowest reliability (.48), while nightmare disorder, narcolepsy, and NREM sleep arousal disorder – sleepwalking type showed the highest reliability (1.00). Across caregivers, NREM sleep arousal disorder – sleep terror type (.49) and hypersomnolence (.54) had the lowest reliability. In contrast, circadian rhythm – delayed sleep phase type, nightmare disorder, and NREM sleep arousal disorder – sleepwalking type showed the highest reliability (1.00). Conclusions: The SCISD-Kid is a promising tool for screening sleep disorders. It showed good to excellent reliability across both samples. Next steps for validation will be discussed. [ABSTRACT FROM AUTHOR]

Clinicians have limited options outside controlled substances to address sleep disturbance, which left untreated can negatively affect patient outcomes in cardiovascular health, mental health, immunologic function, and more. For some, genetic factors may influence sleep disturbances. L-methylfolate, the active form of folate, plays a critical role in regulation of monoamine neurotransmitters known to have significant impact on sleep regulation: dopamine, serotonin, norepinephrine. Single nucleotide polymorphisms of the enzyme methylene-tetrahydrofolate-reductase are common and can impact monoamine production. The goal of this study was to evaluate effects of L-methylfolate supplementation on sleep in a cohort with reduced methylene tetrahydrofolate reductase (MTHFR) activity. A retrospective cohort of patients being treated with L-methylfolate in a concierge medical clinic setting was studied. Patients presenting with sleep complaints were evaluated using the Patient-Reported Outcomes Measurement Information System at baseline. Patients with known MTHFR polymorphisms at either C667T and/or A1298C were recommended 5 mg of L-methylfolate daily and were reevaluated at 2 wks, at 4 wks, and at 8 wks of supplementation. Statistical comparisons were made utilizing ANOVA and T-test comparisons. Ten were included in the final cohort: six male and four female, average age 43 ± 16 years. Beginning at wk 2, average sleep disturbance improved significantly by −6.94 points (p = 0.005) and by 8 wks, all patients had improvement with a −14.34 change in disturbance from baseline (p = 0.001). Improvement in sleep disturbance was seen in both low and intermediate function phenotypes. L-methylfolate may be useful for improving sleep in patients with MTHFR polymorphism. [ABSTRACT FROM AUTHOR]

Restless legs syndrome (RLS) is a sensorimotor disorder of sleep/wake regulation characterized by an urge to move the legs accompanied by a wide range of sensory symptoms, mainly affecting the lower limbs. An increased incidence of RLS has been demonstrated in Parkinson's disease (PD) and has been associated with severe motor and non-motor manifestations. We aimed to provide a reliable estimate of RLS prevalence and the clinical features associated with its occurrence in PD (PD-RLS). We performed a systematic literature search up to January 2024 using PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with or without RLS, and these proportions were used to estimate the prevalence of PD-RLS. Clinical profile associated with PD-RLS was explored by comparing the clinical characteristics of PD patients with and without RLS. Forty-six studies were included in the meta-analysis. Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients and was associated with female sex, mixed motor phenotype, worse motor disturbances and functional disability, and a wide range of non-motor symptoms such as sleep disorders, cognitive and autonomic dysfunctions, and more severe neuropsychiatric manifestations. Sensitivity analyses indicated significant associations of PD-RLS with variables related to dopaminergic therapy. No association was found with serum ferritin, serum iron and hemoglobin levels. The prevalence of PD-RLS exceeds that reported in the general population, suggesting the existence of a relationship between the two disorders. Dopaminergic treatment seems to play an ambivalent role relieving, worsening or "mimicking" RLS manifestations. However, the clinical profile of PD-RLS patients, characterized by a greater severity of non-motor symptoms, also suggests that neurotransmitter systems other than the dopaminergic one are involved in PD-RLS etiology. • We aimed to provide prevalence and clinical aspects of RLS occurrence in PD. • Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients. • PD-RLS occurrence was associated with worse motor and non-motor manifestations. • Dopamine plays an ambivalent role worsening, relieving or "mimicking" RLS manifestations. • Non-dopaminergic pathways might be involved in PD-RLS etiology. [ABSTRACT FROM AUTHOR]

The prevalence of sleep-related issues among older adults is a significant concern, with half of the older population reporting these problems. Consequently, strategies to improve sleep are needed for this population. This study aims to assess the effects of a health educational program on sleep behaviour among pre-frail or frail older adults residing in the community and to explore possible associations with frailty. This randomised controlled trial (NCT05610605) included a total of 197 community-dwelling older adults with frailty/pre-frailty, divided into control (n = 88) and educational (n = 109) groups, were assessed at baseline, after the 6-month educational program (6 months), and 6 months after the intervention (12 months). The intervention comprised four group sessions and six follow-up phone calls, focusing on frailty, physical activity, dietary habits, and cognitive training. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and wrist-worn accelerometry. At 6 months, a significant time-by-group interaction was found for self-reported [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] and accelerometer-measured [β = 0.505, 95%CI (0.085, 0.926), p = 0.019] sleep efficiency, showing improved sleep efficiency in the intervention group vs. controls. A significant time-by-group interaction at 6 months was noted for sleep awakenings [β = −0.402, 95%CI (−0.825, −0.020), p = 0.047]. The educational program led to a significant decrease in awakenings, while the control group experienced an increase. The change in the number of awakenings (Rs = 0.183, p = 0.020) at 6 months was significantly associated with changes in frailty. Moreover, a significant time-by-group interaction was reported at the 12-month assessment [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] for self-reported sleep quality, indicating better results in the intervention group compared to controls. The educational program improved sleep quality and sleep efficiency while reducing the number of awakenings per night among community-dwelling frail older adults, offering a practical approach to addressing sleep-related challenges in this demographic. • A health educational program improved sleep quality among older adults with frailty. • Participants who adhered to their usual healthcare experienced a decrease in sleep quality. • Interventions for frailty, activity, diet, and cognition can boost sleep quality in frail adults. [ABSTRACT FROM AUTHOR]

Over the past few years, there has been a surge in interest regarding the connection between sleep duration and quality, sleep disorders, mainly Obstructive sleep apnoea (OSA) and Vitamin D. There is growing evidence to support a new role of Vitamin D in the maintenance and regulation of optimal sleep. Furthermore, a notable link has been identified between OSA and a decrease in serum Vitamin D levels, which appears to intensify as the severity of sleep apnea worsens. Vitamin D status could also potentially serve as a mediator or provide an explanation for the association between OSA and cardiometabolic morbidity, but the current state of research in this area is inadequate. Studies have indicated that the supplementation of Vitamin D can optimize sleep quality, presenting more proof of the connection between insufficient vitamin D levels and sleep disorders. However, it is unclear whether low serum Vitamin D levels are a contributing factor to OSA development or if OSA predisposes individuals to Vitamin D deficiency. As a result, various studies have endeavored to examine the complex relationship between OSA and Vitamin D deficiency. In children and adolescents, while data is limited, there seems also to be a link between sleep disorders and Vitamin D levels. Therefore, the objective of this review is to provide a comprehensive overview of the current evidence on the association between Vitamin D and sleep disorders in both adults and children. • Increasing evidence suggests a new role of vitamin D in the maintenance and regulation of optimal sleep. • OSA presence has been linked to lower serum Vitamin D levels, especially as the severity of OSA progresses. • In children and adolescents, despite the scarcity of data, an association between OSA and Vitamin D levels is also apparent. • Vitamin D status may potentially mediate or elucidate the association between OSA and cardiometabolic morbidity. • It remains uncertain whether vitamin D deficiency increases OSA risk, or if OSA itself predisposes to Vitamin D deficiency. [ABSTRACT FROM AUTHOR]

Although sleepwalking is one of the most prevalent and potentially injurious of the NREM parasomnias, it is still diagnosed primarily based on the patient's clinical history. Early pilot work suggested that sleep deprivation protocols could help obtain a polysomnographically-based (PSG) diagnosis of sleepwalking, but larger studies remain lacking. We compared baseline PSG recordings with those obtained after 25hrs of sleep deprivation in a cohort of 124 consecutively assessed adult sleepwalkers. When compared to baseline recordings, post-sleep deprivation PSG assessments resulted in nearly twice as many somnambulistic episodes being recorded in the laboratory and significantly increased the proportion of patients (from 48 % to 63 %) experiencing at least one lab-based episode. Moreover, while 17 % of patients experienced a sleepwalking event exclusively during recovery sleep, only 2 % of patients did so solely at baseline. Sleep deprivation had similar facilitating effects on patents' somnambulistic events regardless of age of onset and positive versus negative family history for sleepwalking. Younger age and higher home episode frequency both predicted a positive response to sleep deprivation. A separate group of 17 patients with comorbid sleep disorders showed a similar increase in their proportion experiencing at least one episode during recovery sleep. The results from this large series of sleepwalkers provide strong support for the use of sleep deprivation in facilitating the occurrence of somnambulistic events in the sleep laboratory. • Sleep deprivation increases sleepwalking episodes in the sleep laboratory. • Age and home episode frequency predict positive responses to sleep deprivation. • Sleep deprivation is also effective in sleepwalkers with comorbid sleep disorders. [ABSTRACT FROM AUTHOR]

Kleine-Levin syndrome (KLS) is a rare sleep disorder characterized by recurrent episodes of severe hypersomnolence in association with various degrees of cognitive impairment, perceptive abnormalities, apathy, behavioral disturbances. Some of these symptoms, hypersomnolence, compulsive eating and increased sexual drive may be replaced by their opposites or alternate with them. Remarkably enough, these « atypical symptoms » have never been enlighted nor compared in frequency with corresponding typical symptoms. Besides, KLS is more frequent in males than in females but no review has ever compared the frequency of precipitating factors and symptoms in males and females. To uncover these as yet uninvestigated aspects of KLS, a predesigned template was used to extract precipitating factors and symptoms, in 475 case reports of KLS, comprising 364 males and 111 females. Precipitating factors were more frequently recorded in males (67.31 %) than in females (49.55 %). Recurrent episodes of hypersomnolencee were present in 94.32 % of cases, recurrent insomnia in 1.05 % and alternation of hypersomnolence and insomnia in 4.63 %. Cognitive impairment was present in 67.37 % of cases and absent in 6.95 %. Derealization/altered perception was present in 38.32 % of cases and absent in 1.68 %. Severe apathy was present in 44.63 % of cases. Compulsive eating was present in 59.58 % of cases, absent in 13.26 %, replaced by anorexia in 9.05 %, alternation of compulsive eating and anorexia in 5.68 % and alternation of compulsive eating and no compulsive eating in 8.42 %. Increased sexual drive was present in 33.68 % of cases, absent in 22.74 %, replaced by decreased sexual drive in 1.47 %, alternation of increased sexual drive and no increased sexual drive in 2.95 %. Odd behaviors were present in 45.05 % of cases. Psychiatric features were present in 71.58 % of cases, absent in 2.95 %. Finally, the percentages of precipitating factors and of sleep disorder, apathy, sexual disorder, irritability/agressivity, were higher in males than in females. The frequency of the opposites of hypersomnolence, compulsive eating and increased sexual drive appears to be quite significant. In addition, a systematic comparison of precipitating factors and symptoms in males and females has shown limited differences between sexes. • Naming of Kleine-Levin symptoms must be standardized. • A review of KLS symptoms must include presence, absence and absence of data. • Hypersomnolence, hyperphagia, hypersexuality may be replaced by their opposite or alternate with it. • Comparison of precipitating factors and symptoms between sexes has shown minor differences. • Diagnostic criteria of Kleine-Levin syndrome should be updated. [ABSTRACT FROM AUTHOR]

Cannabis and its major constituents, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are being widely used to treat sleep disturbances. However, THC can cause acute cognitive and psychomotor impairment and there are concerns that driving and workplace safety might be compromised the day after evening use. Here, we examined possible 'next day' impairment following evening administration of a typical medicinal cannabis oil in adults with insomnia disorder, compared to matched placebo. This paper describes the secondary outcomes of a larger study investigating the effects of THC/CBD on insomnia disorder. Twenty adults [16 female; mean (SD) age, 46.1 (8.6) y] with physician-diagnosed insomnia who infrequently use cannabis completed two 24 h in-laboratory visits involving acute oral administration of combined 10 mg THC and 200 mg CBD ('THC/CBD') or placebo in a randomised, double-blind, crossover trial design. Outcome measures included 'next day' (≥9 h post-treatment) performance on cognitive and psychomotor function tasks, simulated driving performance, subjective drug effects, and mood. We found no differences in 'next day' performance on 27 out of 28 tests of cognitive and psychomotor function and simulated driving performance relative to placebo. THC/CBD produced a small decrease (-1.4%, p=.016, d=-0.6) in accuracy on the Stroop-Colour Task (easy/congruent) but not the Stroop-Word Task (hard/incongruent). THC/CBD also produced a small increase (+8.6, p=.042, d=0.3) in self-ratings of Sedated at 10 h post-treatment, but with no accompanying changes in subjective ratings of Alert or Sleepy (p's>0.05). In conclusion, we found a lack of notable 'next day' impairment to cognitive and psychomotor function and simulated driving performance following evening use of 10 mg oral THC, in combination with 200 mg CBD, in an insomnia population who infrequently use cannabis. [ABSTRACT FROM AUTHOR]

• Endometriosis has been associated with sleep disorders. • Hyperarousal is involved in pathogenesis of sleep disorder. • Hyperarousal is involved in pathogenesis of endometriosis. • Investigating hyperarousal in Endometriosis patients is useful. • CBT is effective in improving hyperarousal and sleep disorders. Endometriosis has been associated with sleep disorders, and hyperarousal appears to be involved in their pathogenesis; however, the presence of hyperarousal in the endometriosis population was never investigated. We conducted a case-control survey study by sending a questionnaire to all endometriosis patients followed up at our Centers. Controls were recruited among the general population. The questionnaire included demographic information, symptoms and history of endometriosis, the Hyperarousal Scale (H-Scale), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). A total of 847 women completed the questionnaires: 430 (50.8 %) had endometriosis, and 417 (49.2 %) were controls. Endometriosis was associated with higher H-scale score (OR 2.9, 95 % CI 2.4–3.8, p = 0.000), higher PSQI score (OR 4.3, 95 % CI 3.2–5.7, p = 0.000), and higher ISI score (OR 4.6, 95 % CI 3.5–6.1, p = 0.000) in multivariable ordinal logistic regressions analysis. With path analysis, hyperarousal (H-Scale) reported a partial mediating role in the association between endometriosis and sleep disorders. The mediation effect represented 22.3–27.8 % of the entire association between endometriosis and sleep disturbances. Endometriosis patients complaining sleep disorders may benefit by investigating the presence of hyperarousal given cognitive behavioral therapy was reported effective in improving hyperarousal and associated sleep disorders. [ABSTRACT FROM AUTHOR]

Introduction: Sjögren's syndrome (SS) is a chronic autoimmune disease characterized by lymphocytic infiltrates in the exocrine glands. Carpal tunnel syndrome (CTS) is suggested to be more frequent among SS patients than in the general population. The aim of this study was to seek associations between the CTS and the laboratory and clinical findings of SS patients. Methods: Fifty patients diagnosed with primary SS (pSS) were examined. Clinical evaluation by a rheumatologist and electrophysiological studies were conducted. Data on laboratory tests results was collected. Control group consisted of 50 sex and age-matched individuals with osteoarthritis (OA). Results: Out of 50 patients in the study group 27 (54%) were diagnosed with CTS. The prevalence of CTS among 50 individuals in the control group was 8%. Among pSS patients with CTS the joint involvement was not more common than in those from the non-CTS group [15 vs. 13 (p = 0.945)]. There was an expected difference in sleep disorders [18 vs. 9 (p = 0.012)] and paresthesia [23 vs. 13 (p = 0.024)]. The major finding was a significant difference in elevated beta2-microglobulin (B2MG) [23 vs. 13 (p = 0.024)]. Other studied factors, suggested in the literature as significant in the pSS-related neuropathy, were not statistically different between the groups. Conclusion: Our study confirms that CTS is more prevalent among pSS patients than in the general population and suggests that a new approach is required towards the pathogenesis of this phenomenon. We hypothesize that CTS is more associated with an overall disease activity than joint involvement as such. [ABSTRACT FROM AUTHOR]

Poor sleep and chronic pain are commonly related in adolescents. Only 5% of adolescents meet recommendations for physical activity and screen time, both of which impact the experience of sleep and pain disturbances. Research is needed to better understand the sleep-pain relationship in adolescents and to identify potential protective factors, such as activity-related health behaviors. This study examined sleep, behaviors that influence activity (i.e., physical activity, screen time), and their interaction as predictors of pain in a sleep-disordered sample of 105 adolescents aged 12–18 presenting for polysomnography. A hierarchical multiple linear regression was conducted to examine these relationships. Consistent with hypotheses, worse insomnia predicted worse pain. However, other activity-related health behaviors did not influence this relationship, ps >.05. Findings suggest that sleep should be the focus of treatment for adolescents with primary sleep disorders to prevent the onset or exacerbation of pain. [ABSTRACT FROM AUTHOR]

Background: Autogenic training (AT) is a structured meditative‐style practice, consisting of a sequence of simple mental exercises intended to induce a relaxed state in patients. There is some emerging evidence to suggest that AT can be effective in treating certain chronic conditions, however, further evidence is required. A service evaluation of AT services at the Royal London Hospital for Integrated Medicine was conducted to evaluate the impact of AT on patients with chronic conditions. Methods: The service evaluation consisted of the completion of validated quantitative outcome measures pre and posttreatment to explore the impact of AT. AT patients were asked to complete the Measure Yourself Medical Outcomes Profile (MYMOP) and Perceived Stress Scale (PSS) at their first hospital appointment (baseline) and then again 8 weeks later following completion of their AT sessions. Pre‐ and posttreatment scores for each outcome measure were analysed in SPSS using the Wilcoxon signed‐rank test. Results: One hundred ninety‐nine patients completed both initial and follow‐up MYMOP forms and were included in the evaluation. The most common presenting complaints for MYMOP symptom 1 were prolonged anxiety/stress and depression (n = 70, 35.2%), chronic pain and migraine headache (n = 44, 22.1%), chronic insomnia and sleep problems (n = 42, 21.1%) and, long‐term exhaustion and fatigue (n = 18, 9%). The change in median score pre‐ and posttreatment for all MYMOP categories (symptoms, activity and well‐being) were statistically highly significant p < 0.001. Anxiety, stress, depression, pain and insomnia were the symptoms that had the largest statistically significant difference between the median score pre‐ and posttreatment. Fifty‐five patients completed the PSS questionnaire at two time points (pre‐ and posttreatment). It showed a highly statistically significant change in PSS median score in patients experiencing stress (p < 0.001). Discussion: The findings of the evaluation indicate that 8 weeks of AT appears to be effective in improving symptoms of concern to patients and enhancing patients' overall well‐being. In particular, AT was found to be beneficial for patients with symptoms of anxiety, stress, depression, pain and insomnia. [ABSTRACT FROM AUTHOR]

Background: The effect of dietary patterns on sleep disorders and mental illness has previously been investigated. However, these studies have reported contradictory findings, and thus, the present study aimed to assess the association of the MIND diet on the sleep pattern and mental health in obese women. Methods: This is a cross-sectional study in which 282 women, aged 18–56 years with BMI ≥ 25 kg/m2.with no underlying diseases and malignancies, and participated. We used a semi-quantitative food frequency questionnaire (FFQ) to collect participant's dietary intake. The Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scales (DASS) were used to measure the status of sleep disturbance and psychological disorders, including depression, anxiety, and stress respectively. Results: A decreasing trend for psychological stress was observed in the highest quartiles of MIND diet score vs. the lowest quartiles (OR = 0.6 CI: 0.23–1.5 vs. 1.16 CI: 0.55–2.47). No significant difference was observed between severity of depression (OR = 0.87 95%, CI: 0.7–1.09, P = 0.23), anxiety (OR = 1.02, 95% CI: 0.81–1.27, P = 0.86), stress (OR = 0.99 95%, CI: 0.79–1.23, P = 0.92), and MIND diet adherence in the crude and adjusted models. Conclusion: The main finding from this study was that there is no significant association between adherence to the MIND diet and studied psychological disorders. [ABSTRACT FROM AUTHOR]

Importance: Sleep disorders are associated with a range of health conditions, with poor sleep often further exacerbating individuals' health, well-being, and ability to participate in daily occupations. Weighted blankets offer a potentially simple nonpharmacological sleep intervention option. Objective: To summarize available literature on instrumentation and outcomes associated with overnight use of weighted blankets for therapeutic purpose. Evidence Review: A scoping review following the PRISMA review guidelines was conducted. Sources included MEDLINE, Cochrane Library, CINAHL, PsycINFO, Scopus, Embase, and Google. Included studies reported on overnight use of weighted blankets. Critical appraisal of studies was conducted with standardized tools. Findings: Eighteen studies met the inclusion criteria. Positive outcomes were reported for adults, including improved sleep, reduction in medication use, and improved mood. Sleep outcomes were mixed for children and adolescents but included improved occupational performance. Methodological quality of included studies regarding effectiveness was variable. Ten studies included details of the intervention, whereas only one study reported on implementation. No specific guidelines for use were included. Conclusions and Relevance: Weighted blankets are used as a sleep intervention for individuals across the life span experiencing a range of health conditions. Currently, there is more evidence of effectiveness with adults, although parents are favorable regarding weighted blanket use for children. Implementation and recommendation of weighted blankets are typically led by occupational therapists, with knowledge of the intervention facilitating use. This review provides information to inform occupational therapists' clinical decision-making and continued implementation of weighted blankets for individuals with sleep problems. Plain-Language Summary: This scoping review summarizes what is known about the use of weighted blankets as a sleep intervention for people of all ages. There is more evidence for overnight use of weighted blankets for adults, with improvements reported in sleep, mood, medication use, and pain. Although there is little evidence of improvement in sleep for children, some children show improvement in everyday functioning, and parents report positive outcomes from overnight use of weighted blankets. These findings suggest that occupational therapists should consider offering or recommending weighted blankets as a sleep intervention option for people of all ages, alongside consideration of individuals' preferences. Development of practice guidelines that incorporate current research findings is urgently needed to support occupational therapists' use of weighted blankets. The findings of this scoping review suggest that occupational therapists should consider recommending weighted blankets as a sleep intervention option for people of all ages. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To assess self‐reported parasomnias in patients with sleep disorders and explore relationships with psychiatric illness, comorbidities, subjective sleep assessments, and polysomnographic study results.Results from intake questionnaires and polysomnographic assessments, collected from 240 sleep centers across 30 US states between 2004 and 2019, were analyzed retrospectively. Of 540,000 total patients, 371,889 who answered parasomnia‐specific questions were included. Patients responding “often” or “always” to parasomnia‐specific questions were considered “symptom‐positive,” whereas a “few times” or “never” were considered “symptom‐negative” (controls).The study sample was 54.5% male with mean age 54 years (range, 2–107 years). Frequencies for the different parasomnias were 16.0% for any parasomnia, 8.8% for somniloquy, 6.0% for hypnagogic hallucinations, 4.8% for sleep‐related eating disorder, 2.1% for sleep paralysis, and 1.7% for somnambulism. Frequent parasomnias were highly associated with diagnosed depression (odds ratio = 2.72). All parasomnias were associated with being younger and female and with symptoms of depression, anxiety, insomnia, restless legs, pain, medical conditions, fatigue, and sleepiness. Associations with objective sleep metrics showed characteristics of consolidated sleep and differentiated weakly between nonrapid eye movement sleep and rapid eye movement sleep parasomnias. Machine learning accurately classified patients with parasomnia versus controls (balanced accuracies between 71% and 79%). Benzodiazepines, antipsychotics, and opioids increased the odds of experiencing parasomnias, while antihistamines and melatonin reduced the odds. Z‐drugs were found to increase the likelihood of a sleep‐related eating disorder.Our findings suggest that parasomnias may be clinically relevant, yet understudied, symptoms of depression and anxiety. Further investigation is needed to quantify the nature of multimorbidity, including causality and implications for diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Introduction: Despite significant advancements in understanding the biochemical, anatomical, and functional impacts of vestibular lesions, developing standardized and effective rehabilitation strategies for patients unresponsive to conventional therapies remains a challenge. Chronic vestibular disorders, characterized by permanent or recurrent imbalances and blurred vision or oscillopsia, present significant complexity in non-pharmacological management. The complex interaction between peripheral vestibular damage and its impact on the central nervous system (CNS) raises questions about neuroplasticity and vestibular compensation capacity. Although fundamental research has examined the consequences of lesions on the vestibular system, the effect of a chronic peripheral vestibular error signal (VES) on the CNS remains underexplored. The VES refers to the discrepancy between sensory expectations and perceptions of the vestibular system has been clarified through recent engineering studies. This deeper understanding of VES is crucial not only for vestibular physiology and pathology but also for designing effective measures and methods of vestibular rehabilitation, shedding light on the importance of compensation mechanisms and sensory integration. Methods: This retrospective study, targeting patients with chronic unilateral peripheral vestibulopathy unresponsive to standard treatments, sought to exclude any interference from pre-existing conditions. Participants were evaluated before and after a integrative vestibular exploratory and rehabilitation program through questionnaires, posturographic tests, and videonystagmography. Results: The results indicate significant improvements in postural stability and quality of life, demonstrating positive modulation of the CNS and an improvement of vestibular compensation. Discussion: Successful vestibular rehabilitation likely requires a multifaceted approach that incorporates the latest insights into neuroplasticity and sensory integration, tailored to the specific needs and clinical progression of each patient. Focusing on compensating for the VES and enhancing sensory-perceptual-motor integration, this approach aims not just to tailor interventions but also to reinforce coherence among the vestibular, visual, and neurological systems, thereby improving the quality of life for individuals with chronic vestibular disorders. [ABSTRACT FROM AUTHOR]

Background/Objective: Pain is one of the most common chronic conditions in the US, estimated to affect 20.9% of the population (51.6 million people). We evaluated the Partners Aligned in Transformative Healing (PATH) program at University Medical Center's Comprehensive Pain Program clinic. Feasibility, initial clinical and financial results were assessed to inform payers' support for PATH, an integrative transdisciplinary program within a bundled payment format. Methods: Participants completed a multi-week program including integrative therapies, with empirically validated assessment surveys administered at the beginning and end of the program. Insurance claims data were analyzed 12 months pre- and post-program. Statistical significance of pre-post differences was assessed by paired T-tests with P < 0.05. Results: Between June 2019 and August 2022, 170 individuals enrolled in PATH, 151 (88.8%) completed the program, and 121 participants completed outcome surveys. Participants were predominately White, non-Hispanic (98%), female (76%), with an average age of 49.8. All participant-reported clinical outcomes (PROs) showed statistically significant improvement from baseline to final assessment, and some but not all were clinically significant. PEG subscale of average pain interference, enjoyment of life, and interference with general activity each decreased. The T-scores for the following domains of PROMIS-29 decreased: Pain interference; fatigue; sleep disturbance; anxiety, and depression. The PROMIS-29 domains of overall physical function and social roles and activities mean T-scores increased. Per Member Per Month (PMPM) total cost of care decreased by $462 (18%). Emergency room utilization for all diagnoses decreased by 457 visits/1000 patients (65%), and for pain-related diagnoses by 194 visits/1000 patients (67%) during the observation period. Conclusions: Results suggest that the PATH Program is a feasible and acceptable model that shows initial effectiveness relative to short-term patient-reported clinical outcomes and shows signs of durability in both utilization and financial outcomes at 1 year. The results support continued study including a multi-site RCT. [ABSTRACT FROM AUTHOR]

Background: Sleep disorders have a significant impact on asthma. The aim of this study was to explore the association between nocturnal bedtime and asthma among adults in the United States. Methods: This study was a cross-sectional analysis involving 11,475 participants from the National Health and Nutrition Examination Survey (NHANES) during the period of 2015–2018. Nocturnal bedtime was categorized into three distinct groups: 2100 h or earlier, between 2100 h and 2300 h, and 2300 h or later. The association between night bedtime and asthma was detected using multivariable logistic regression analyses. Additionally, subgroup analyses were conducted to assess the impact of subgroups. Results: After adjustment for confounders, a positive association was revealed between later bedtime (after 2300 h) and the prevalence of asthma (OR = 1.20, 95%CI: 1.01–1.43). In the subgroup analysis, the following factors were associated with increased risk: 18–39 years (OR = 1.23, 95%CI: 1.02–1.48); female sex (OR = 1.30, 95%CI: 1.01–1.68); Hispanic patients (OR = 1.66, 95%CI: 1.17–2.37); heavy drinkers (OR = 1.52, 95%CI: 1.17–1.96); Body Mass Index (BMI) (< 25 kg/m2) (OR = 1.45, 95%CI: 1.13–1.87); vigorous physical activity (OR = 1.32, 95%CI: 1.05–1.65);Significant interactions were found between nocturnal bedtime and asthma based on age, sex, eosinophils (EOS) percent and depression (P Interaction < 0.05). Conclusion: Our results confirmed a moderately increased risk of asthma attributed to later bedtime, especially in 18–39 years, women and patients of Hispanic ethnicity. Future studies should investigate the underlying mechanisms of this association and explore the clinical implications for asthma management. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or experiencing poor-quality sleep. People with this problem often have trouble falling asleep at night, wake up frequently during the night, and may wake up too early in the morning and feel tired and not refreshed. This can lead to daytime fatigue, irritability, difficulty concentrating, and impaired functioning in their day-to-day activities. Study is scarce in resource-limited countries such as Ethiopia, particularly concerning the study setting. As a result, this study aimed to assess the prevalence of insomnia and its associated factors among undergraduate students at Hawassa University. Methods: An institution-based cross-sectional study design was used. A stratified simple random sampling method was used among 398 study participants. The data were collected using a structured self-administered questionnaire. The outcome variable was assessed by the insomnia severity index (ISI). The data were then gathered by using the Kobo toolbox online and then exported into the Statistical Package for Social Sciences version 27 to analyze the data. Data cleaning and screening were conducted exclusively by the investigators. Descriptive statistics like frequency, percentages, and mean were used. Bivariate and multivariate binary regression were performed. In multivariate binary logistic regression, a p-value of<0.05 was identified as a significantly associated factor with the dependent variable. Results: Among 398 students who participated in the study, 81 (20.4%) experienced insomnia. Being female [adjusted odds ratio (AOR) = 2.98; 95% confidence interval (CI) 1.56--5.69], age (AOR = 3.06; 95% CI 1.11--8.45), mild anxiety symptom (AOR = 4.89; 95% CI 1.56--15.37), and mobile device use ≥30 min just before going to sleep (AOR = 7.81; 95% CI 2.34--26.12) were significantly associated with insomnia. Conclusion: In this study, the prevalence of insomnia was one-fifth among university students, which is high when compared to another study at the national level. There were significant associations between being female, age, anxiety symptoms, and mobile device use before going to sleep with insomnia. This indicates that there is a need to treat and prevent insomnia in college students, emphasizing the necessity for mental healthcare and ethical technology use. [ABSTRACT FROM AUTHOR]

Background: Contactin-associated protein-2(CASPR2) antibody-associated autoimmune encephalitis(AE) is rare in children. This study aimed to report the clinical characteristics and long-term outcome of CASPR2 autoimmunity in children to expand the disease spectrum. Methods: Children who were hospitalized in our hospital with clinically suspected AE from May 2015 to April 2022 and underwent neuronal surface antibodies detections were retrospectively analyzed. Clinical data of patients with CASPR2 autoimmunity were collected. Results: Patients who were positive for NMDAR-IgG, CASPR2-IgG, LGI1-IgG and IgLON5-IgG occupied 95.2%(119/125),3.2%(4/125),0.8%(1/125) and 0.8%(1/125), respectively.The median onset age of the 4 patients with CASPR2-IgG was 5.6 years. The most common symptoms were psychiatric symptoms/abnormal behavior(3/4) and sleep dysfunction(3/4). One patient developed a phenotype of Rasmussen encephalitis(RE). Tumor was absent in our patients. Two patients showed abnormal findings on initial brain magnetic resonance imaging(MRI) scans. All the patients showed favorable response to immunotherapy except the patient with RE experienced recurrent symptoms who finally achieved remission after surgery. All the patients had a favorable long-term outcome at the last follow-up(33-58months). Conclusions: CASPR2 autoimmunity may be the second most common anti-neuronal surface antibodies associated neurological disease in children. Psychiatric symptoms/abnormal behavior and sleep disorder were common in children with CASPR2-associated AE. Tumor was rare in those patients. Most pediatric patients had a favorable long-term outcome. [ABSTRACT FROM AUTHOR]

Background: Individuals may experience a range of symptoms after the clearance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This condition is termed long COVID (LC) or Post-COVID-19 condition (PCC). Despite the appreciable number of symptoms documented to date, one key challenge remains in the robust characterization of LC outcomes. This review aimed to assess the properties, identify gaps, and provide recommendations for relevant descriptive and evaluative Patient-Reported Outcome Measurement (PROM) instruments that can be used to comprehensively characterize LC. Methods: To achieve this objective, we identified and reviewed descriptive and evaluative PROM instruments that have been developed and validated to date with people living with LC. Our review assessed their properties, identified gaps, and recommended PROMs suitable for characterizing LC. To ensure a comprehensive and robust characterization of LC, we next identified, reviewed, and selected (with the input of patient partners) PROMs associated with the most frequently reported LC symptoms. The evaluation criteria included psychometric evidence, mode of delivery, cost, and administration time. Results: Traditional matrix mapping revealed Post-COVID Functional Status Scale (PCFS) as a choice instrument for capturing LC outcomes largely because of the comprehensive domains it covered, and the number of psychometric evidence reported in literatures. This instrument can be effectively paired with the Fatigue Severity Scale (FSS), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ-9), Headache Impact Test (HIT), Pittsburgh Sleep Quality Index (PSQI), and DePaul Symptom Questionnaire (DSQ-PEM) to characterize fatigue, cognitive impairment, depression/anxiety, headache, sleeplessness, and post-exertional malaise respectively. Conclusion: Our paper identified appropriate PROM instruments that can effectively capture the diverse impacts of LC. By utilizing these validated instruments, we can better understand and manage LC. Plain language summary: Some individuals who once contracted the virus responsible for COVID-19 may continue to experience a range of symptoms persisting for more than 3 months. These symptoms include fatigue, difficulty sleeping, anxiety and difficulty breathing amongst others. This condition is known by many as Long COVID (LC). To understand the health outcomes of patients faced with this condition, standardized Patient Reported Outcome Measurement instruments (PROMs) are pivotal. PROMs are standardized questionnaires completed by patients to measure their symptoms, perceptions of health status, and/or functional well-being. In this paper, we have examined standardized instruments suitable for measuring LC outcomes. We conducted a comprehensive strength and weakness analysis of each instrument reviewed, guided by specific criteria. Based on our strength and weakness analyses, we identified several potential instruments that can be used to reports patients' outcomes concerning LC. The data collected from PROMs provides valuable insights for healthcare practitioners and policy makers, enabling the enhancement of patient-centric care and serving as an instrument for systemic transformation. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion Automated sleep detection in movement disorders may allow monitoring sleep, potentially guiding adaptive deep brain stimulation (DBS).The aims were to compare wake‐versus‐sleep status (WSS) local field potentials (LFP) in a home environment and develop biomarkers of WSS in Parkinson's disease (PD), essential tremor (ET), and Tourette's syndrome (TS) patients.Five PD, 2 ET, and 1 TS patient were implanted with Medtronic Percept (3 STN [subthalamic nucleus], 3 GPi [globus pallidus interna], and 2 ventral intermediate nucleus). Over five to seven nights, β‐band (12.5–30 Hz) and/or α‐band (7–12 Hz) LFP power spectral densities were recorded. Wearable actigraphs tracked sleep.From sleep to wake, PD LFP β‐power increased in STN and decreased in GPi, and α‐power increased in both. Machine learning classifiers were trained. For PD, the highest WSS accuracy was 93% (F1 = 0.93), 86% across all patients (F1 = 0.86). The maximum accuracy was 86% for ET and 89% for TS.Chronic intracranial narrowband recordings can accurately identify sleep in various movement disorders and targets in this proof‐of‐concept study. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]