Despite the remarkable contribution of smartphones in improving our lives, concerns have been raised about their uncontrolled usage, emphasizing its consequences on individual sleep and well-being. Therefore, we investigated the relationship between problematic smartphone use (PSU) and both positive and negative dimensions of subjective well-being (SWB) - subjective happiness and depressive symptoms, as well as the mediating role of sleep quality. A sample of 384 Bangladeshi youths (mean age = 18.99; 49.3 % female) were recruited through a convenience sampling technique and interviewed using a structured questionnaire that assessed PSU, sleep quality, subjective happiness, and depressive symptoms. The mediation analysis results indicated that sleep quality mediated the association between PSU and subjective happiness and depressive symptoms. The results also showed that subjective sleep quality, sleep disturbances, and daytime dysfunction were particularly responsible for the mediation effect. Thus, the findings highlight the necessity of designing sleep quality-enhancing interventions for youth to subside PSU's detrimental effects on subjective well-being.

Sleep problems are highly prevalent in autism and negatively impact the physical and mental health of children and their caregivers. Sleep education programs are often recommended as a first line-treatment to help parents implement healthy sleeping habits and a bedtime routine at home; however, the accompanying paper-based toolkits used in the bedtime routines have limitations related to engagement and adherence. To address these gaps, we iteratively developed and tested the usability of an augmented reality (AR) bedtime routine application. Our single participant design study (n = 7 child/parent dyads) found 86% compliance with the program and suggested good-excellent usability of the app with a trend toward increased willingness and faster completion of children's bedtime routines. This work supports the feasibility of using technology-based tools in sleep education programs and informs future clinical studies examining the effectiveness of these approaches for mitigating sleep difficulties.

Sleep duration (SD) is a critical determinant of health, with both short and long SD associated with increased risks of morbidity and mortality. However, distinct ages may exhibit unequal sleep needs. Few studies have addressed the modulation of age on SD associated all-cause mortality (AM). This study aimed to investigate age- and gender-specific associations between SD and AM.

Four national cohort studies were conducted: National Health and Nutrition Examination Survey (NHANES), Survey of Health, Ageing and Retirement in Europe (SHARE), Chinese Longitudinal Healthy Longevity Survey (CLHLS), and China Health and Retirement Longitudinal Study (CHARLS). Data pre-processing such as integration, weighting and interpolation was conducted following cohort-specific user manuals. Restricted cubic spline (RCS) was used to test the nonlinear relationship. Kaplan-Meier and Cox regression survival analysis were used to evaluate the association between SD and AM. The moderation of mortality by SD was subsequently investigated in adult, middle-age, elderly and longevity.

RCS analysis showed a nonlinear correlation between SD and AM in the four cohorts(P < 0.001). Survival analysis reveals 6-8 h to be the optimal SD. Subgroup analyses showed a higher risk in adults with ≤5 h than ≥9 h (HR: 2.95 [1.90-4.59] vs 1.83 [1.08-3.12]), and a similar risk in middle age (HR: 2.42 [1.76-3.32] vs 2.44 [1.64-3.61]). In contrast, four datasets suggest a higher risk of the elderly being affected by long SD. Adults (HR = 1.82 [1.14-2.92], P = 0.012) and middle age (NHANES: HR = 1.50 [1.04-2.16], P = 0.029; SHARE: HR = 3.04 [1.10-8.41], P = 0.032) significantly increased the risk of short sleep compared to elderly.

SD associated mortality risk varies with age. Young adults should avoid poor sleep, while elderly should avoid sleeping too much.

Insomnia is highly prevalent and poses significant personal and socio-economic challenges. While the National Institute for Health and Care Excellence (NICE) recommendations define possible medical approaches, over-the-counter products are commonly used to self-manage insomnia symptoms. This scoping review aims to determine the size and scope of the evidence-base regarding the effectiveness and safety of over-the-counter products for insomnia symptoms in adults.

The electronic databases of CENTRAL, MEDLINE, EMBASE, PsycINFO, and AMED were searched from inception to December 19th, 2022, for all randomised controlled trials evaluating over-the-counter products compared to placebo, in adults aged 18-65 with insomnia symptoms. Results were synthesised descriptively.

51 randomised controlled trials were included, evaluating herbal products (n = 34), dietary supplements (n = 15), herbal-dietary combinations (n = 4), and over-the-counter medicines (n = 2). Sample sizes ranged between 10 and 405 participants. Eleven studies were conducted in participants with co-morbidities. Interventions were most frequently given as monotherapy and compared against placebo. Most studies (n = 41) demonstrated interventions' positive effects on insomnia symptoms. Among the most studied products, valerian and melatonin have substantial evidence to demonstrate their effectiveness and safety. Promising products demonstrating benefits compared with prescription medication alone included: valerian; lemon balm and fennel; and valerian, hops, and passionflower. Intervention-related side effects were mostly mild and transient. No serious adverse events were reported across all studies.

Over-the-counter products show promising, but inconclusive findings in alleviating insomnia symptoms in adults. Future research should focus on investigating products currently used in real life, consider economic evaluations, and be evaluated in populations with co-morbidities and ethnic minorities, to better guide clinical advice.

Athletes often experience poor sleep quality and quantity which may hinder physical performance and cognitive function. Presleep nutritional strategies may be an alternative to pharmacological interventions to improve sleep. The aim of this study was to examine the effect of two different doses of a nutritional intervention (both containing high Glycemic Index carbohydrate, whey, tryptophan, theanine, and 5'AMP) versus placebo on objective and subjective sleep, next-morning physical performance, cognitive function, and postural sway. Seventeen healthy, trained adult males completed three double-blind trials in a randomized, counterbalanced, crossover design. Participants were allocated to conditions using a Latin Square design. A (a) low-dose, (b) high-dose, or (c) placebo drink was provided 90 min before sleep each night. Polysomnography was used to measure objective sleep parameters. Cognitive function, postural sway, and subjective sleep quality were assessed 30 min after waking. Physical performance was assessed using a 10-min maximal effort cycling time trial each morning. All data were analyzed using linear mixed effects models and effect sizes were calculated using Cohen's d. This study was registered prospectively as a clinical trial with Australian New Zealand Clinical Trials Registry (registration number: NCT05032729). No significant main effects or improvements were observed in objective or subjective sleep parameters, physical performance, cognitive function, or postural sway. The low-dose intervention appeared to reduce N3 sleep duration compared with placebo (-13.6 min). The high-dose intervention appeared to increase N1 sleep duration compared with placebo (+7.4 min). However, the magnitude of changes observed were not likely to cause meaningful reductions in sleep quality and quantity.

Chronic pain affects around 20% of the global population and is influenced by various factors, including sleep quality. Studies indicate that sleep disruption can enhance pain sensitivity; however, it is unclear how sex and baseline sleep quality impact these findings. This study examines how sex and baseline sleep quality impact the effects of three nights of sleep disruption on pain sensitivity in healthy individuals.

Fifty-nine participants (30 females) underwent two laboratory sessions, separated by three nights of sleep disruption. Pain sensitivity was measured using cuff and handheld algometry, and participants completed a battery of questionnaires on sleep quality, positive and negative affect, and pain catastrophising. Sleep patterns were collected through wrist actigraphy and self-reported sleep diaries.

Temporal summation of pain was significantly facilitated in males (p < 0.01), and pain during suprathreshold stimulation was increased for females (p < 0.01) after the experimental sleep disruption. No differences in any QST parameters were found when comparing participants with good or poor sleep at baseline, but those with good baseline sleep rated the suprathreshold stimulation as more painful (p < 0.05) after the experimental sleep disruption. Finally, having good or poor sleep quality at baseline was associated with a significant reduction in self-reported sleep quality and level of rest after the experimental sleep disruption (p < 0.05).

This study indicates that sleep disruption might impact sexes differently and indicates that prior sleep quality is less likely to impact this.

Sleep disruption protocols can mimic the sleep problems experienced by patients with chronic pain. The current study explains how different sexes respond to a 3-night sleep disruption protocol and explains how sleep quality at baseline might impact these results.

During crisis periods, understanding the impact of sleep quality on self-rated health becomes crucial. However, the role of anxiety and depression as potential mediators in this relationship remains insufficiently explored. Therefore, this study aimed to assess the association of sleep quality with self-rated health, and mediation by anxiety and depression. This cross-sectional, population-based study was conducted with 1762 adults from October to December 2020 in the Iron Quadrilateral region of Brazil. The exposure variable was poor sleep quality, as measured by the PSQI. The outcome was self-rated health. The mediators tested were anxiety and depression, which were evaluated using symptoms, medical diagnoses, and the use of drugs. To test the mediators' factors, the Karlson-Holm-Breen method was used. The direct acyclic graph was used to select a minimal set of adjustments in multivariate analysis. There were 22.6% of people who rated their health as poor, 52.5% were poor sleepers, 35.1% had symptoms of anxiety and 24.7% had symptoms of depression. According to the multivariate analysis, individuals with poor sleep quality were 2.82 times more likely to self-assess their health as poor. The presence of symptoms of anxiety and depression explained 16.57% and 5.99% of the association between poor sleep quality and poor self-rated health, respectively, in the mediation analysis. During the COVID-19 pandemic, individuals who had poor sleep quality had lower self-rated health. Furthermore, symptoms of anxiety and depression explained a portion of the association. Our study emphasizes the importance of evaluating individuals' sleep quality and mental health during a crisis.

Sleep is a complex behavior regulated by genetic and environmental factors impacting disease outcomes. However, the effect of multidimensional sleep encompassing several sleep dimensions on common diseases, specifically mental health disorders, has yet to be fully elucidated. Using the Mass General Brigham Biobank, we examined the association of multidimensional sleep with disease outcomes and investigated whether sleep behaviors modulate genetic predisposition to unfavorable sleep on mental health diseases.

We generated a Polygenic Sleep Health Score using previously identified single nucleotide polymorphisms and constructed a Sleep Lifestyle Index based on self-reported questions and electronic health records; tested their association; performed phenome-wide association analyses between these indexes and clinical phenotypes; and analyzed their interaction on prevalent mental health diseases. A total of 15,884 participants were included in the analysis (mean age 54.4; 58.6% female).

The Polygenic Sleep Health Score was associated with the Sleep Lifestyle Index (β=0.050, 95% CI=0.032, 0.068) and with 114 disease outcomes spanning 12 disease groups, including obesity, sleep, and substance use disease outcomes (p<3.3×10-5). The Sleep Lifestyle Index was associated with 458 disease outcomes spanning 17 groups, including sleep, mood, and anxiety disease outcomes (p<5.1×10-5). A total of 108 disease outcomes were associated with both indexes, spanning 12 disease groups. No interactions were found between the indexes on mental health diseases.

Favorable sleep behaviors and genetic predisposition to healthy sleep may independently protect against disease, underscoring the impact of multidimensional sleep on population health and the need for prevention strategies focused on healthy sleep habits.

Impaired sleep following trauma such as childhood maltreatment is both a prognostic factor for future mental illness and a feasible intervention point. Yet, associations between childhood maltreatment and objectively measured sleep components are rarely found. New approaches advance the use of multidimensional sleep health scores instead of individual sleep components. However, no such methodology has been used to study the consequences of maltreatment on sleep health in adolescent cohorts so far. We hypothesized that childhood maltreatment will be associated with poorer sleep health in adolescence.

A cross-sectional sample of 494 adolescents at high risk of emotional and behavioral problems (mean age 17.9) completed the Childhood Trauma Questionnaire-Short Form to assess five forms of maltreatment (emotional and physical abuse/neglect and sexual abuse) assessed as continuous sum scores. During nine nights of actigraphy and sleep diary measurements, data on sleep regularity, satisfaction, alertness, timing, efficiency, and duration were collected, which were combined into a sleep health composite score ranging from 0 to 6. Linear regression models were adjusted for age, sex, household income, ethnic origin, educational level, urbanization of living environment, and parental psychopathological problems.

Associations were found between all forms of maltreatment and poorer sleep health (p < .031), except for sexual abuse (p = .224). Partial r effect sizes ranged from -0.12 (95% CI = -0.22 to -0.01) for emotional neglect to -0.18 (-0.28 to -0.08) for total maltreatment.

Maltreatment was associated with impairment in everyday sleep health, reflected in both subjective and objective measurements of sleep.

Sleep disturbances are prevalent among elderly populations and are linked to various health complications. Understanding the underlying biological mechanisms contributing to sleep disorders is crucial for developing targeted interventions. In this study, we measured 355 plasma proteins in an elderly Japanese cohort (n=77) using a high-throughput proteomic platform. Additionally, we collected over 25,000 person-days of physical activity and sleep behavior data from wrist-worn wearable devices, focusing on total sleep time (TST) across 24 h and daytime sleep. Fragmented sleep was observed as one of the most prevalent sleep disturbances in this population. In protein expression analysis, we identified 9 protein biomarkers associated with increased secondary sleep TST, defined as additional sleep episodes outside of the main sleep episode within 24 h. These findings may suggest disruptions in circadian rhythms or underlying health conditions. Functional analysis revealed that biological processes related to inflammation play a significant role in regulating sleep behavior. Further analysis showed an association of 12 proteins with daytime sleep and 5 proteins with afternoon sleep. Overall, this study identified inflammatory biomarkers and biological processes associated with sleep behavior in the elderly, presenting promising opportunities for developing diagnostic tools and targeted clinical interventions.

Aging is influenced by genetic, environmental, and lifestyle factors, and chronological age alone may fail to capture one's true biological aging. Degenerative spinal disease (DSD) is associated with accelerated health decline, which could manifest as an increased Phenotypic Age (PhenoAge).

This study aimed to investigate the association between Phenotypic Age (PhenoAge) and degenerative spine disease (DSD) in a Japanese population using a cross-sectional analysis complemented by a follow-up analysis, while also exploring the impact of modifiable lifestyle factors on biological aging.

A cross-sectional design was employed using data from a large health examination program in Japan.

A total of 10,205 individuals who underwent health examinations formed the reference cohort. Separately, two distinct clinical cohorts were analyzed: an OA cohort of 306 patients with hip or knee osteoarthritis who underwent arthroplasty, and a DSD cohort of 397 patients with adult spinal deformity (ASD) or lumbar spinal stenosis (LSS) who also underwent surgery.

PhenoAge was calculated using clinical biomarkers, and the difference between PhenoAge and chronological age was expressed as PhenoAgeAccel. Additional inflammatory and metabolic markers (e.g., CRP, WBC) were evaluated alongside lifestyle factors such as smoking status, body mass index, and physical activity.

Propensity score matching was used to compare PhenoAge between patients and controls. Linear regression examined the influence of lifestyle factors on PhenoAgeAccel. A subgroup analysis assessed differences between ASD and LSS, as well as between hip OA and knee OA. Individuals re-examined in 2023 were followed to evaluate the 3-year change in PhenoAgeAccel.

Japanese participants had a mean PhenoAgeAccel of -8.0 ± 4.0 years (p < 0.01, Cohen's d = 0.8). DSD patients showed a 4.2-year elevation in PhenoAge over controls, accompanied by higher CRP and WBC levels (both p < 0.01 Cohen's d = 0.65). Subgroup analyses revealed no significant differences in PhenoAge between ASD vs. LSS or hip OA vs. knee OA. Smoking (β = 0.6; p < 0.01) and obesity (β = 1.5; p < 0.01) raised PhenoAgeAccel, while physical activity lowered it (β = -0.2; p = 0.03). Non-risk individuals improved by -0.5 years, whereas risk individuals worsened by +0.5 years over three years.

These findings suggest that PhenoAge may serve as a more sensitive marker of biological aging in DSD patients, although the retrospective design and potential confounding variables warrant cautious interpretation.

To examine the association between intimate partner psychological violence (P-IPV) from before pregnancy to 2 years after the child's birth and child's sleep patterns, i.e. sleep onset difficulty (SOD), nighttime awakenings (NA), and nighttime sleep duration (NSD) between 2 and 5 years of child's age. Data come from the population-based French birth ELFE cohort launched in 2011. P-IPV was assessed before and during pregnancy, at 2 months and 2 years post-partum. Children's sleep patterns were measured at 2, 3, and 5 years of age. Group-based trajectory modelling was used to identify trajectories of P-IPV and each child's sleep patterns. Associations between P-IPV and children's sleep trajectories were assessed by weighted multivariate logistic regressions. Five P-IPV trajectories were identified: minimal (64%), prenatal (14%), decreasing (9%), increasing (8%), and persistent (5%). Two trajectories of SOD (few 65% and many 35%), three trajectories of NA (few 49%, decreasing 24%, and many 23%), and three trajectories of NSD (short 21%, medium 56%, and long 23%) were identified. About 9513, 9512, and 9499 children were included in comparative analyses, respectively, focused on SOD, NA, and NSD. Increasing and persistent P-IPV trajectories were both associated with the trajectory of many SODs [odds ratio (OR) = 1.53, 95% confident interval (CI) = 1.24-1.91; and OR = 1.71, 95% CI = 1.31-2.22, respectively] and the trajectory of many NA (OR = 1.66, 95% CI = 1.29-2.13); and (OR = 1.95, 95% CI = 1.42-2.69, respectively). Associations between persistent P-IPV and decreasing and many NA were significant among girls (OR = 1.76, 95% CI = 1.12-2.75 and OR = 2.27, 95% CI = 1.39-3.71, respectively), but not among boys. Family interventions in response to IPV should pay particular attention to sleep patterns of children exposed to IPV.

Sleep disturbances exacerbate chronic pain, increase psychological load, and increase inflammation. Delayed onset muscle soreness (DOMS) mimics aspects of chronic pain, predominantly affecting peripheral pain mechanisms, while experimental sleep provocations have been shown to impact central pain mechanisms. This study aimed to combine a DOMS model with total sleep deprivation (TSD) to create a novel model affecting both peripheral and central pain mechanisms. A total of 30 healthy participants attended two sessions (baseline and follow-up) separated by 24 h of TSD and a home rating after 48 h. Assessments of interleukin 6 (IL-6) levels, sleep quality, pain catastrophising, affect, and symptoms of depression and anxiety were included in the baseline and follow-up sessions. Additionally, pressure pain and tolerance thresholds, temporal summation, and conditioned pain modulation (CPM) were assessed using cuff-pressure algometry in the baseline and follow-up sessions. DOMS was induced with eccentric calf raises during the baseline session followed by 24 h of TSD. At follow-up pain tolerance (p = 0.012) was significantly reduced, and CPM (p = 0.036) was significantly impaired compared to baseline. Psychological changes included decreases in pain catastrophising (p = 0.027), positive affect (p < 0.001), negative affect (p = 0.003), and anxiety (p = 0.012). Explorative regression models predicted 58% and 68% of DOMS pain intensity after 24 and 48 h, respectively, based on baseline body mass index, pain thresholds, psychological measures, and IL-6 (p < 0.01). Combining DOMS with 1 night of TSD induced pain hypersensitivity, impaired CPM, and altered psychological states. A combination of baseline inflammation, psychological measures, and pain sensitivity significantly predicted DOMS pain intensity after 24 and 48 h.

Given its potential to impact physical and mental health, sleep quality is one of the most significant clinical outcomes among hemodialysis patients. Patients undergoing hemodialysis are required to adhere to an intricate treatment plan that consists of regular hemodialysis treatments, dietary and fluid restrictions, and a multi-drug regimen.

Investigate the relationship between adherence to a therapeutic regimen and sleep quality among chronic renal failure patients undergoing maintenance hemodialysis.

A descriptive correlational research design was followed. The study was conducted at the hemodialysis units in Hafr Albatin City, specifically at Hafr Albatin Central Hospital and King Khaled Hospital, Saudi Arabia. A convenience sample of 100 adult patients was selected for the study. The Hemodialysis Patients Adherence Questionnaire and Pittsburgh Sleep Quality Index were utilized to collect the data in 5 months from September 20, 2023 to February 15, 2024.

The study revealed that more than half of the studied patients adhered to the therapeutic regimen, while (46%) did not adhere to it. More than half of the patients had poor sleep quality and were nonadherent to diet and fluid restrictions. Overall adherence score is negatively correlated with the global sleep quality score (r = -0.368, p < 0.001), indicating that poorer sleep quality is associated with lower overall adherence to the therapeutic regimen.

While a significant proportion of the patients demonstrated adherence to overall therapeutic regimens, including dialysis sessions and medication intake, there was notable nonadherence to fluid and diet restrictions. Poor sleep quality, prevalent among two-thirds of the participants, correlates negatively with adherence to therapeutic regimens.

Metabolic Syndrome (MetSyn) and Sleep Apnea (SA) contribute to long-term cardiometabolic risks among adolescents and young adults (AYAs). Emerging research suggests that certain race and ethnic groups experience disproportionate burdens of MetSyn and SA. Therefore, this study investigated the association of SA symptoms and MetSyn among AYAs in the United States and reported on associated racial and ethnic disparities.

National Health and Nutrition Examination Survey data from 2015 to 2020 (N = 2539) were analyzed. Sleep disorders, medical conditions, and anthropometric data were collected via interviews and physical examinations. MetSyn was defined based on the International Diabetes Federation criteria. Bivariate associations were assessed by univariate logistic regression models and age-adjusted associations by multivariable logistic regression models. Stratified analyses examined race/ethnic group differences in the associations.

Nearly 50% of the sample (mean age 20.6 years, 48.9% female, 55.3% non-Hispanic White) reported SA symptoms and 4.6% had MetSyn. After adjustment, central obesity was a consistent predictor of overall sleep apnea symptoms [aOR = 1.58; 95% CI: 1.29, 1.94], snoring [aOR = 2.10; 95% CI:1.70, 2.60], breath cessation [aOR = 2.59; 95% CI: 1.42, 4.73] and daytime sleepiness [aOR = 1.34; 95% CI: 1.06, 1.68]. Non-Hispanic Black individuals with MetSyn had significantly higher odds of sleep apnea symptoms [aOR = 4.19; 95% CI: 1.40, 12.51], snoring [aOR = 6.64; 95% CI: 2.10, 21.0], and breath cessation [aOR = 8.64; 95% CI: 3.12, 23.93] versus participants of other races and ethnicities without MetSyn.

This study highlights the significant relationships between parameters of MetSyn and SA symptoms, and the disproportionately higher odds of SA symptoms among certain race/ethnic groups with a heavy burden of metabolic disorders.

The autonomic nervous system regulates cardiovascular activity during sleep, likely impacting cardiovascular health. Aging, a primary cardiovascular risk factor, is associated with cardiac autonomic disbalance and diminished sleep slow waves. Therefore, slow waves may be linked to aging, autonomic activity and cardiovascular health. However, it is unclear how sleep and slow waves are linked to cardiac autonomic profiles across multiple nights in older adults. We conducted a randomized, crossover trial involving healthy adults aged 62-78 years. Across 2 weeks, we applied auditory stimulation to enhance slow waves and compared it with a SHAM period. We measured sleep parameters using polysomnography and derived heart rate, heart rate variability approximating parasympathetic activity, and blood pulse wave approximating sympathetic activity from a wearable. Here, we report the results of 14 out of 33 enrolled participants, and show that heart rate, heart rate variability and blood pulse wave within sleep stages differ between the first and second half of sleep. Furthermore, baseline slow-wave activity was related to cardiac autonomic activity profiles during sleep. Moreover, we found auditory stimulation to reduce heart rate variability, while heart rate and blood pulse wave remained unchanged. Lastly, within subjects, higher heart rate coincided with increased slow-wave activity, indicating enhanced autonomic activation when slow waves are pronounced. Our study shows the potential of cardiac autonomic markers to offer insights into participants' baseline slow-wave activity when recorded over multiple nights. Furthermore, we highlight that averaging cardiac autonomic parameters across a night may potentially mask dynamic effects of auditory stimulation, potentially playing a role in maintaining a healthy cardiovascular system.

Sleep irregularity is increasingly recognized as a modifiable factor for cardiovascular health. This study aims to investigate relationships between short- and long-term sleep irregularity with blood pressure (BP) dynamics among older adults.

We used data from a prospective cohort involving community-dwelling older adults based on a mobile health (mHealth) app from 2018 to 2022. Short-term exposure was defined as sleep irregularity for one week. Cumulative sleep irregularity, calculated as the area under the curve over 12 months, was regarded as long-term exposure. Outcomes included short-term deviations in BP, longitudinal changes in BP, and cumulative BP over one year. Linear mixed models and generalized additive mixed models were conducted to investigate the associations between sleep irregularity and BP.

A total of 1611 participants with a median age of 73.0 years were included. Short-term and long-term cumulative sleep irregularities were associated with increased SBP, DBP, and global BP Z-score. For instance, each SD increment in cumulative sleep onset timing SD was associated with a 0.42 mmHg increase in SBP (95 % CI, 0.25 to 0.60), a 0.31 mmHg increase in DBP (95 % CI, 0.17 to 0.45), respectively. Subgroup analyses indicated stronger associations among males and those with normotension. Strong linear dose-response relationships were further observed between cumulative sleep irregularity and cumulative BP.

Sleep irregularity, in both short-term and long-term exposure, is a risk factor for poor blood pressure control among older adults, highlighting the importance of implementing interventions promoting healthy sleep habits to mitigate cardiovascular risks.

The global ageing population is increasing. As their physical functions deteriorate, older adults face not only physical health challenges but also mental health issues. Enhancing the health status of older adults is imperative to improve their quality of life. However, research on the health status of older adults living in the community is limited, and the association between the built environment and daily activities remains largely unexplored.

This study aimed to utilize structural equation modeling to (1) explore the interrelationships between the community built environment, daily activities of older adults, and their health, and (2) examine the interrelationships among their correlates.

For data collection, this study administered structured questionnaires to 494 community-dwelling older adults across ten representative urban communities in Fuzhou, China. The questionnaire comprised four validated sections: demographic characteristics, perceived community built environment features, daily activity and health outcomes. Data analysis employed structural equation modeling (SEM) using AMOS 27.0, with SPSS 27.0 for preliminary analyses, to examine both direct effects of built environment on health outcomes and indirect effects mediated through daily activities.

Structural equation modeling revealed three pathways: Path 1 (community built environment →health of older adults), Path 2 (community built environment → daily exercise for older adults), and Path 3 (daily exercise for older adults →health of older adults). All three pathways were supported, indicating interaction among the factors.

The health status of older adults is influenced by their living environment and daily activities. An improved community built environment can enhance health status among older adults. Furthermore, daily activities serve as partial mediators between community built environments and health outcomes. Our methodology and findings offer valuable insights for optimizing community built environments to promote the health of older adults.

High-quality sleep is essential for both physical and mental well-being. Insufficient or poor-quality sleep is linked to numerous health issues, including cardiometabolic diseases, mental health disorders, and increased mortality. Snoring-a prevalent condition-can disrupt sleep and is associated with disease states, including coronary artery disease and obstructive sleep apnea.

The SleepWatch smartphone app (Bodymatter, Inc) aims to monitor and improve sleep quality and has snore detection capabilities that were built through a machine-learning process trained on over 60,000 acoustic events. This study evaluated the accuracy of the SleepWatch snore detection algorithm in a simulated real-world setting.

The snore detection algorithm was tested by using 36 simulated snoring audio files derived from 18 participants. Each file simulated a snoring index between 30 and 600 snores per hour. Additionally, 9 files with nonsnoring sounds were tested to evaluate the algorithm's capacity to avoid false positives. Sensitivity, specificity, and accuracy were calculated for each test, and results were compared by using Bland-Altman plots and Spearman correlation to assess the statistical association between detected and actual snores.

The SleepWatch algorithm showed an average sensitivity of 86.3% (SD 16.6%), an average specificity of 99.5% (SD 10.8%), and an average accuracy of 95.2% (SD 5.6%) across the snoring tests. The positive predictive value and negative predictive value were 98.9% (SD 2.6%) and 93.8% (SD 14.4%) respectively. The algorithm performed exceptionally well in avoiding false positives, with a specificity of 97.1% (SD 3.5%) for nonsnoring files. Inclusive of all snoring and nonsnore tests, the aggregated accuracy for all trials in this bench study was 95.6% (SD 5.3%). The Bland-Altman analysis indicated a mean bias of -29.8 (SD 41.7) snores per hour, and the Spearman correlation analysis revealed a strong positive correlation (rs=0.974; P<.001) between detected and actual snore rates.

The SleepWatch snore detection algorithm demonstrates high accuracy and compares favorably with other snore detection apps. Aside from its broader use in sleep monitoring, SleepWatch demonstrates potential as a tool for identifying individuals at risk for sleep-disordered breathing, including obstructive sleep apnea, on the basis of the snoring index.

To assess the quality of sleep and associated factors among medical interns at public universities in North Ethiopia.

We conducted a cross-sectional study among 259 medical interns using a structured, interviewer-administered questionnaire. We employed the Pittsburgh Sleep Quality Index (PSQI) to determine the quality of sleep.

Of the subjects, 72.6% were screened as having poor sleep quality. Anxiety [adjusted odds ratio (AOR) = 4.5, 95% CI: 1.93, 11.50; p < 0.001], poor sleep hygiene (AOR = 4.5, 95% CI: 1.4, 11.65; p < 0.001), current alcohol use (AOR = 3.85, 95% CI: 2.16, 6.89; p < 0.001), and current tobacco use (AOR = 2.4, 95% CI: 2.3, 25; p = 0.001) were significantly associated with poor quality of sleep.

Poor quality of sleep is prevalent among medical interns. Addressing anxiety, and alcohol and tobacco use and enhancing the practice of sleep hygiene among medical interns requires significant attention.

Previous studies have linked ADHD with self-harm, but the processes underlying this association are not fully understood. This research aims to investigate the role of sleep disturbances as a potential pathway between ADHD diagnosis and self-harm behaviors.

The study included 90 youth aged between 11 and 18 years, divided into two groups: a case group of 45 youth diagnosed with ADHD and a control group of 45 youth without ADHD. Both groups completed the Inventory of Statements About Self-Injury to evaluate self-harm behaviors and the Sleep Disturbance Scale for Children to assess sleep disturbances. A path analysis was conducted to examine whether a significant proportion of the association between ADHD and self-harm was shared with sleep disturbances, while controlling for gender, youth education, family income, maternal education, and overall anxiety and depression scores.

An ADHD diagnosis was significantly associated with sleep disturbances (β = .62, p < .001) and self-harm behaviors (β = .35, p = .03). Additionally, sleep disturbances were significantly linked to self-harm (β = .51, p = .002) and played a significant role in the association between ADHD and self-harm (indirect effect β = .32, p = .001).

These findings suggest that sleep disturbances account for a substantial proportion of the shared variance in the association between ADHD and self-harm. While the cross-sectional design limits causal interpretations, these results highlight the importance of addressing sleep issues in clinical care for ADHD to potentially reduce self-harm risks and improve outcomes for at-risk youth.

The COVID-19 pandemic has had a profound global impact, leading to a range of persistent sequelae referred to as post-COVID-19 condition or "long COVID" that continue to affect patients worldwide. Among these sequelae, post-COVID-19 insomnia (PCI) has emerged as a significant issue. Conventional treatments, including cognitive behavioral therapy and pharmacological interventions, face limitations such as variable efficacy, potential side effects, and substantial costs. Recently, acupuncture has gained traction due to its efficacy, cost-effectiveness, and safety profile.

This study aims to conduct a meta-analysis and systematic review evaluating the efficacy and safety of acupuncture for the treatment of PCI to delineate the optimal modality, intervention frequency, and duration for achieving the most beneficial outcomes, thereby providing a comprehensive understanding of acupuncture's role in managing PCI, contributing to evidence-based clinical practice, and informing clinical decision-making.

Electronic searches will be performed in 12 databases from inception to October 2024 without language restrictions. This includes both English databases (PubMed, Cochrane Library, Web of Science, Embase, OVID and Scopus), as well as Chinese databases (China National Knowledge Infrastructure, Wan-Fang Data, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Duxiu Database and the Chinese Clinical Trial Registry Center). Randomized controlled trials on acupuncture for PCI will be included. Primary outcomes will include the response rate and insomnia severity; secondary outcomes will include the Traditional Chinese Medicine Symptom Scale (TCMSS) and adverse event rates. Data synthesis will use risk ratios for dichotomous data and mean differences for continuous data. Study selection, data extraction, and quality assessment will be conducted independently by 2 reviewers. Methodological quality of eligible studies will be evaluated following the Cochrane Handbook for Systematic Reviews of Interventions (version 6.3). Meta-analysis will be performed with RevMan 5.3.

Based on the data on response rate, insomnia severity, TCMSS score, and adverse event rates, this study will provide an evidence-based review of the efficacy and safety of acupuncture for PCI treatment.

This systematic review will present the current evidence for acupuncture for PCI, aiming to inform clinical practices and decision-making and to enhance the understanding of acupuncture's role in managing PCI. Furthermore, it will identify research gaps and suggest potential areas for future investigation.

PROSPERO CRD42024499284; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=499284.

DERR1-10.2196/69417.

Sleep is crucial for physical and psychological health, and disturbances are closely linked to psychiatric disorders, making their management essential for improving treatment outcomes and preventing relapse. Although sleep disturbances are implicated in psychopathology of eating disorders, its role in anorexia nervosa (AN) remains unclear. This review aimed to characterise sleep in AN.

A systematic search was conducted in four scientific databases, including papers from inception to 25 May 2024. A machine learning algorithm (ASReview) was utilised to screen titles and abstracts for eligibility. Sleep quantity, architecture, and quality were investigated. Meta-analyses were conducted to investigate the difference between patients with AN and healthy controls (HC) in total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency, Sleep Stage 1, 2, slow wave sleep, rapid eye movement (REM) sleep and REM latency. Certainty of evidence was assessed using the GRADE approach.

Out of 67 potentially eligible papers, 31 were included in this review, with 15 in the meta-analyses. Statistically significant average mean differences were found for TST (-32.1 min [95% CI: -50.9, -13.4]), WASO (19.0 min [95% CI: -2.4, 40.3]), and sleep efficiency (-4.4% [95% CI: -7.9, -0.9]). Additionally, Sleep stage 1 was significantly increased (2.4% [95%-CI: 0.05, 4.7]), while REM sleep was reduced (-2.1% [95%-CI: -4.2, -0.02]). Subgroup analysis showed that TST and WASO did not improve significantly after weight restoration.

Sleep in patients with AN is impaired, with lower TST and sleep efficiency, higher WASO, more time in stage 1 sleep, and less in REM. Weight restoration alone may not improve sleep. While more research is needed, substantial accompanying sleep disturbances in AN justifies addressing these in current treatment practice, also because of the chronic character of AN and importance of sleep for long term (mental) health.

To evaluate the association between sleep quality and ovarian reserve among women of reproductive age.

Cross-sectional study.

A total of 1,070 female participants aged 20-40 years enrolled from February 2023 to January 2024.

Not applicable.

A questionnaire was administered to the participants to collect baseline information related to reproductive and lifestyle factors. Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The assessment was conducted on ovarian reserve, including total antral follicle count (AFC), antimüllerian hormone (AMH) level, and basal sex hormone level.

The study sample of 1,070 women had a mean age of 31.67 ± 4.41 years. A total of 314 participants (29.35%) were classified under the poor sleep group (PSQI score >5). Significant differences were observed in the follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, testosterone, AFC, and AMH between the two groups. The poor sleep group exhibited significantly lower levels of AMH and AFC. The FSH levels in the poor sleep group were higher. After the adjustment for confounding factors, multivariate regression analysis results indicated that the per unit increase in PSQI score was associated with increased odds of diminished ovarian reserve (adjusted odds ratio [AOR] of 1.28 for AMH <1.1 ng/mL; 95% confidence interval [CI], 1.20-1.37; AFC <7; AOR, 1.34; 95% CI, 1.25-1.43; FSH ≥10 mIU/mL; AOR, 1.16; 95% CI, 1.08-1.25; AMH <1.1 ng/mL or AFC <7 or FSH ≥10 mIU/mL; AOR, 1.29; 95% CI, 1.22-1.37). Compared with the PSQI ≤5 group, subjects with PSQI >5 had increased odds of diminished ovarian reserve (odds ratio, 3.80; 95% CI, 2.82-5.13; AOR, 4.43; 95% CI, 3.22-6.14). After stratification by age and body mass index, compared with the PSQI ≤5 group, all subgroups of the PSQI >5 group had increased odds of diminished ovarian reserve, especially <35-year-old and body mass index ≤18.4 kg/m2 subgroups.

Poor sleep quality is associated with diminished ovarian reserve in women of reproductive age.

Background: New treatment options for patients with locally advanced pancreatic cancer (LAPC) have proven to be safe but, in addition, may have an effect on the patient's quality of life. Objectives: To evaluate the effect of stereotactic body radiotherapy (SBRT) combined with intradermal heat-killed mycobacterium obuense (IMM-101) vaccination on health-related quality of life (HRQoL), pain, and sleep, in patients with LAPC. Design: Prospective cohort study. Setting/Participants: In total, 42 Dutch patients with LAPC were included after completion of at least four cycles of (m) leucovorin calcium (folinic acid), fluorouracil, irinotecan hydrochloride, and oxaliplatin (FOLFIRINOX). Measurements: Quality of life was assessed with the EORTC QLQ-C30. Patients completed the Richard Campbell Sleep Questionnaire (RCSQ) for five consecutive nights and wore simultaneously a GENEActiv tri-axial accelerometer, which registered sleep duration and sleep efficiency. The Numeric Rating Scale was used to assess pain intensity during treatment. Data were collected at the baseline visit [i.e., at inclusion in the study after (m)FOLFIRINOX treatment] and at week 8 (i.e., 6 weeks after start date of SBRT and after four IMM-101 vaccinations). Results: Univariable linear mixed model analysis revealed significant improvement for EORTC QLQ-C30 items "cognitive functioning" and "emotional functioning." Outcomes on RCSQ subscales and "RCSQ total score" did not significantly change. In the multivariable model, with "Global HRQoL scale" and "RCSQ total score" as outcomes, we did not find a significant change during treatment. Conclusion: In this prospective cohort study, we found that SBRT combined with IMM-101, in patients with LAPC, is well tolerated and does not negatively affect HRQoL, sleep quality, and pain.

This study investigates the potential health risks associated with exposure to extremely low-frequency magnetic fields (ELF-MFs), focusing on the impact on sleep quality. The hypothesis is that increasing ELF-MF exposure will correlate with elevated blood pressure (BP), altered heart rate (HR) dynamics and poorer sleep quality among occupational workers in Korea.

The study involved 85 participants. Assessment of ELF-MF exposure was carried out continuously for 24 h in the two groups. Measurements of BP parameters, HR and sleep quality were conducted accordingly.

The study found significant ELF-MF exposure levels in both working and sleeping times for industrial factory workers (0.19 ± 0.38 and 0.17 ± 0.23 µT, p < 0.05). Long-term exposure among industrial workers may contribute to a significant difference in systolic blood pressure (SBP) (125.61 ± 9.60 mm Hg, p < 0.05). Additionally, a significant difference in deep sleep analysis was observed between the high-exposure and low-exposure groups (67.13 ± 31.15 min, p < 0.05).

The hypothesis was confirmed, indicating possible effects of high ELF-MF exposure on SBP and deep sleep. However, further research on long-term exposure and its association with sleep quality disturbances is needed for validation.

Cancer is a major cause of death worldwide and laughter therapy is used as a complementary therapy for cancer treatment. This study aimed to investigate the effects of laughter therapy on psychological symptoms (stress, anxiety, and depression) and physical symptoms (pain, fatigue, and sleep quality) among cancer patients.

Eight databases were searched, with the search period was limited to April 2024. Quality assessment of the included randomized controlled trials was performed according to the criteria for evaluating randomized controlled trials in the Cochrane Handbook for Systematic Reviews of Interventions. The RevMan 5.4 software was used for the data analysis.

Nine randomized controlled trials were included in this systematic review and meta-analysis. The quality of the included studies was relatively high. The results showed that laughter therapy can effectively improve cancer patients' stress, anxiety, depression, pain, and fatigue, but has no effect on sleep quality.

Laughter therapy is a low-cost, easy-to-implement intervention that may have potential benefits in improving psychological symptoms (stress, anxiety, and depression) and physical symptoms (pain and fatigue) among cancer patients. Laughter therapy has the characteristics of high safety, strong interaction, and strong feasibility. It may promote communication between patients and between patients and medical healthcare, enhance the trust relationship between medical staff, and potentially improve the quality of life for cancer patients. Healthcare professionals should consider laughter therapy as a potential adjunctive therapy, but its implementation should be tailored to individual patient needs and supported by robust evidence.

Sleep problems are common in palliative care patients. In addition, psychological problems can affect sleep quality. The aim of this study was to investigate sleep quality, anxiety, and depression in palliative care patients.

The study was conducted between May 1, 2023 and October 31, 2023 in Turkey. The patient information form, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The data were analyzed using the Pearson correlation and multiple linear regression test.

A total of 59.3% of patients were male, 76.7% were married, 89.3% had poor sleep quality, 61.3% had anxiety, and 86.7% were at risk of depression. A positive moderate correlation was found between HADS-anxiety, HADS-depression, and HADS total with subjective sleep quality. A positive moderate correlation was found between HADS-anxiety, HADS depression, and HADS total with the PSQI total. Sleep latency, sleep duration, sleep disturbances, use of sleep medication, and daytime dysfunction showed a weak positive correlation with HADS-depression and HADS total. In the regression analysis, anxiety proved to be a statistically significant predictor of sleep quality, while depression was not a significant predictor. These variables were found to explain 22% of the total variance in sleep quality.

The patients' sleep quality was poor. Anxiety and the risk of depression were high. A positive moderate correlation was found between the total score of sleep quality and anxiety and depression. Anxiety was found to be a statistically significant predictor of sleep quality.

As adequate sleep is an indicator of healthy aging, it is of concern that in India, the prevalence of sleep disorders is significant among older women. Using a qualitative approach, we aimed to understand how older Indian women perceive, engage in, and experience sleep and the factors influencing their sleep. Eight urban-residing older women from a southern Indian district were interviewed. Three main themes emerged: perceptions about sleep and sleep disturbances, causes and consequences of disturbed sleep, and sleep practices. Results may guide contextually relevant occupational assessments and interventions to support good sleep and healthy aging of this vulnerable population.

The aim of this study was to determine the effects of a personalized smartphone application on subjective sleep quality, wellbeing and stress in participants with subclinical sleep problems. Healthy participants with subclinical threshold sleep issues that did not meet diagnostic criteria for insomnia were randomly assigned to use the app or be on a waiting list for app usage (control group). Subjective data on sleep quality (sleep quality component of Sleep Questionnaire B [primary endpoint] and the Pittsburgh Sleep Quality Index), feeling refreshed after the sleep component of Sleep Questionnaire B, Short Form-12 physical and mental components, and stress (Perceived Stress Scale) were compared between the app and control groups at baseline and after 6 and 12 weeks. Depending on their usage, app users were defined as "frequent", "occasional" or "rare/never" users. Two-hundred and six and 205 app users and 286 and 285 control participants completed the 6- and 12-week assessments, respectively. Sleep Questionnaire B scores improved in frequent (effect size 0.595; F = 13.7) and occasional users (0.653; F = 9.4) after 6 weeks; effects persisted at 12 weeks, and were similar for the Pittsburgh Sleep Quality Index. Feeling refreshed after the sleep component of Sleep Questionnaire B improved over time in all groups, with no significant difference between app users and controls. There were no changes in Short Form-12 physical component, Short Form-12 mental component, and Perceived Stress Scale scores. A personalized app positively affected subjective sleep quality in a population of users with subclinical threshold sleep issues, and could serve as a low-burden digital intervention to potentially prevent the exacerbation of sleep pathologies.

Individual differences in sleep duration have been reported, and genetic components of sleep duration have been identified showing various heritability. To identify genetic variants that contribute to sleep duration, we conducted a human genome-wide identification on sleep duration and performed confirmatory experiments using a Drosophila model. Genome-wide association study in human was analyzed to determine the association of the genetic variants with self-aware sleep duration from two community-based cohort, Ansan (cohort 1, n = 4635) and Ansung (cohort 2, n = 4205), recruited from the Korean Genome and Epidemiology Study. Individual single nucleotide variants (rs16948804 and rs4887991) in the WW domain containing oxidoreductase (WWOX) gene were associated with self-aware sleep duration in human (p-values, 1.11 × 10- 7 and 2.05 × 10- 7, retrospectively). To examine the functional relevance of the WWOX gene identified in the genome-wide association study, we analyzed the sleep duration of Drosophila loss-of-function mutants. The deletion of Wwox in flies reduced sleep duration and quality with average bout length during daytime and increased night-time sleep duration (all of p-values < 0.01). Our findings suggested that WWOX expression is associated with sleep duration in both humans and Drosophila and genetic factors play a role in inter-individual variability in sleep characteristics.

Sleep disorders are highly prevalent in the general population and are considered a major public health issue. Insomnia constitutes the most frequent sleep disorder in healthy individuals and has been shown to be even more frequent in patients with physical illnesses including cardiovascular diseases. Inadequate sleep quality and short sleep duration, independent of underlying causes, have been linked to the development and progression of cardiometabolic disorders. Additionally, insomnia has been found to be associated with adverse outcome measures, including daytime sleepiness, fatigue, decreased self-reported physical functioning, lower exercise capacity, poor health related quality of life, depressive symptoms, higher rates of hospitalization and increased mortality in patients with cardiovascular diseases. Against this background, comparatively little information is available in the literature regarding the treatment of chronic insomnia in cardiac patient populations. While guidelines for the general population suggest cognitive behavioral therapy for insomnia as a first-line treatment option and preliminary evidence suggests this treatment to be beneficial in cardiac patients with insomnia symptoms, it is often limited by availability and possibly the clinician's poor understanding of sleep issues in cardiac patients. Therefore, pharmacologic treatment remains an important option indicated by the high number of hypnotic drug prescriptions in the general population and in patients with cardiovascular disorders. In this narrative review of the literature, we summarize treatment options for chronic insomnia based on clinical guidelines for the general population and highlight necessary considerations for the treatment of patients with cardiovascular diseases.

The outpatient palliative care system is a central component of the palliative care structure in Germany, with family caregivers playing a vital role in ensuring and maintaining its success. However, crisis situations can destabilise and harm outpatient care. Previous studies have analysed hospitalisations and emergency admissions during palliative care. However, little is known about the factors that contribute to the emergence of crises in palliative outpatient care. The aim of this study was to identify factors contributing to the emergence of crisis in palliative outpatient care including the identification of protective strategies.

A qualitative study using semi-structured interviews with family caregivers recently involved in outpatient palliative care was performed. The analysis was conducted using thematic coding.

A total of 15 family caregivers (13 female and 2 male) were recruited for the study. Crisis situations emerged through a cumulation of factors. Four categories of factors were identified: (1) structural factors, including limited access to health care professionals and a lack of necessary information, (2) illness related factors such as sudden progression in the illness trajectory and symptoms, (3) the intensity of care involvement and (4) emotional and psychological burden of family caregivers. A diverse range of protective strategies were employed by family caregivers, encompassing the involvement of the social network, the pursuit of information and the identification of a sense of purpose.

The findings of this study confirm the importance of providing continuous, competent, and empathetic care to both family caregivers and patients in palliative outpatient care. The study highlights the importance of expanding the palliative care infrastructure, as well as ensuring unrestricted access to palliative care professionals, developing tailored information tools for family caregivers, and reducing bureaucracy. Further studies are needed to identify additional influencing factors and evaluate effective measures.

Understanding the impacts of daily movement behaviours on the well-being of children is crucial for developing effective health promotion strategies. This study examined the relationship between movement behaviours and life satisfaction (LS) using longitudinal data from a sample of primary school students. This one-year follow-up study included 683 students (8.91 ± 1.31 years old) from Shanghai, China. Information on days of moderate- to vigorous-physical activity (MVPA), days of muscle-strengthening exercise (MSE), screen time (ST), and sleep duration was measured via a self-reported questionnaire. Cross-lagged models were used to assess the relationships between movement behaviours at baseline and LS at follow-up. Path analysis showed baseline sleep duration was a significant predictor of subsequent LS. Sex-specific models indicated baseline LS and sleep duration were predictors in males, and baseline MVPA, MSE, and sleep duration in females. Grade-specific models revealed positive relationships of baseline MSE and sleep duration with LS in Level 1 (grade 1 and 2), and baseline MVPA and MSE in Level 2 (grade 3 and 4). This study shows a complex interplay between 24-hour movement behaviours and LS among children. While baseline sleep duration emerged as a consistent predictor of LS at follow-up across the overall sample, the influence of MVPA, MSE, and ST varied by sex and grade level. These results highlight the importance of considering a range of lifestyle factors, including sleep and physical activity, in understanding and potentially enhancing life satisfaction in childhood.

Obstructive sleep apnoea syndrome (OSAS) is a relatively common condition. It has a range of negative health and quality of life implications, but there are established tests to detect it, and recommended treatment pathways which have been well tested. OSAS is prevalent in people with severe mental illness (SMI), and research suggests it is under-detected in this group. This study aimed to examine and explore barriers and facilitators to the detection and treatment of OSAS in people with severe mental illnesses. Staff and patients with a range of relevant experiences were interviewed, and a large scale survey of potential OSAS referrers was conducted. Interviews were analysed thematically, survey responses were summarised descriptively, and results are presented together for comparison and enhanced interpretation. The results highlight a lack of awareness of OSAS outside of specialist sleep services, resulting in poor detection and treatment of OSAS in people with SMI. Comorbidities, symptoms and circumstances of this group may make the presence of OSAS less obvious, and can make diagnosis and adapting to treatment more difficult, but also emphasise the benefits of successful continuous positive airway pressure (CPAP) treatment in this group. The challenges of adapting to CPAP were described and acknowledged, but the impact of successful CPAP was for some life changing. The harm of delayed diagnosis was perceived as unjust. We recommend increased screening for OSAS in people with SMI, supported by increased education and training about OSAS in staff who work with people with severe mental illnesses, and increased awareness in service users and carers.

Wound healing is a complex process accompanying numerous health conditions, and millions of people across the world experience deleterious impacts caused by wounds. There are many non-biological factors that can directly or indirectly affect the health outcomes of patients with wounds. The purpose of this review was to investigate the effects of psychological, behavioural and other relevant factors on wound healing. In addition, as the possible associations among these factors have, in the authors' view, not been addressed appropriately, we also aimed to examine if there were specific relationships among these factors and between these factors and health outcomes. Finally, we reviewed the role of various interventions in buffering negative impacts during health procedures.

Symptoms of psychological distress such as depression and anxiety as well as gender are known to be associated with sleep quality in middle-aged and older adults. However, little is known about the effect on sleep quality of interactions among these factors.

This study was developed to investigate the moderating effect of gender on the relationship between psychological distress and sleep quality in middle-aged and older adults.

A cross-sectional design, secondary data analysis of data on 5,590 individuals aged ≥ 45 years from the Taiwan Biobank database (2009-2018) was used. In this database, psychological distress was assessed using the Patient Health Questionnaire-4, and sleep quality was assessed using a self-report, one-question scale. Demographic data and health-related variables were evaluated as potential confounding factors. A hierarchical regression was conducted to examine the moderating effect of gender on the relationship between psychological distress and sleep quality after adjusting for potential confounders.

The participants with severe psychological distress were found to have a lower mean quality of sleep than those without ( p < .01), and males returned a better mean quality of sleep score than females ( p < .01). Moreover, a significant interaction effect between psychological distress and gender on sleep quality score was found ( b = 0.123, SE = 0.022, p = .03). In terms of participants with severe psychological distress, males reported significantly poorer sleep quality than females.

The findings provide evidence that gender moderates the relationship between sleep quality and psychological distress. Also, in terms of individuals with severe psychological distress, males reported worse sleep quality than women, indicating psychological distress impacts sleep quality in men more than women. Nurses should be aware of these findings when working with clinical professionals to tailor gender-specific education interventions to improve sleep quality and psychological health.

While animals across species typically experience suppressed consciousness and an increased arousal threshold during sleep, the responsiveness to specific sensory inputs persists. Previous studies have demonstrated that rhythmic and continuous vibration can enhance sleep in both animals and humans. However, the neural circuits underlying vibration-induced sleep (VIS) and its potential therapeutic benefits on neuropathological processes in disease models remain unclear. Here, it is shown that intermittent vibration, such as cycles of 30 s on followed by 30 s off, is more effective in inducing sleep compared to continuous vibration. A clear evidence is further provided that allatostatin A (AstA)-GABA signaling mediates short-term intermittent vibration-induced sleep (iVIS) by inhibiting octopaminergic arousal neurons through activating GABAA receptors. The existence of iVIS in mice is corroborated, implicating the GABAergic system in this process. Finally, intermittent vibration not only enhances sleep but also reduces amyloid-β (Aβ) deposition and reverses memory defects in Alzheimer's disease models. In conclusion, the study defines a central neural circuit involved in mediating short-term iVIS and the potential implications of vibration in treating sleep-related brain disorders.

To provide a comprehensive review of sleep disturbances in hospitalized patients, focusing on a case-based approach to illustrate the multifaceted nature of this clinical challenge.

An extensive review of related literature was conducted to determine the common causes of sleep disturbances in hospitalized patients, such as environmental, medical, psychological, and physiological factors. The case of Mrs. Z was used to illustrate how these factors interact in a clinical setting.

The study revealed a high prevalence of sleep disturbances in hospitalized patients, which can lead to significant adverse outcomes. A multidisciplinary approach involving physicians, nurses, pharmacists, and other healthcare professionals is essential to effectively manage sleep disorders due to the interplay of various factors. Nonpharmacological interventions are fundamental to a comprehensive sleep management plan. Pharmacotherapy may sometimes be necessary to improve sleep quality and duration.

Health professionals can significantly enhance the sleep quality of hospitalized piatients by understanding the value of sleep and providing evidence-based strategies for improvement. In return, this improves patient outcomes, reduces healthcare costs, and advances general patient satisfaction.

Sleep quality is fundamental to physical and mental health. Recent research shows that the COVID-19 pandemic has affected individuals' sleep quality. This study aims to investigate whether the containment and health policies (Oxford Coronavirus Government Response Tracker indexes) adopted by European countries and Israel during the pandemic are related to sleep problems in people aged 50 and over. A cross-sectional study was conducted using a logistic regression analysis based on data from the Survey of Health, Ageing and Retirement in Europe, collected in 27 European countries and Israel, in 2021. The results show that containment and health policies affect older adults' sleep, once we neutralise the influence of the sociodemographic, economic, and health characteristics of the individuals and close contact with COVID-19. In fact, the more containment and health policies, the fewer chances of sleep problems. A possible explanation for this is that these policies give people over 50 a sense of safety and security in relation to COVID-19, which may reduce sleep problems.

Objective: To investigate COVID-19's impact on sleep, specifically insomnia, in college students. Participants: Students from a private university were eligible if they registered for Refresh, an online sleep-health program. Methods: A pre-intervention survey was distributed and assessed insomnia and COVID-19 factors using the Insomnia Severity Index (ISI) and a COVID-19 questionnaire. Baseline ISI scores from students enrolled in 2020-2021 were compared to scores from students enrolled in 2018-2019 using a two-sample t-test. Associations between insomnia and the COVID-19 factors were determined using chi-square tests. Results: There was no significant difference in baseline ISI scores when comparing 2018-2019 scores to those collected during the pandemic, p = 0.274. There was a statistically significant association between having insomnia and a student's learning location, p = 0.006, as well as disturbances in sleep caused by the pandemic, p = 0.026. Conclusion: Our results indicate that the COVID-19 pandemic did not worsen baseline insomnia.

To examine the developmental association of the odds ratio product (ORP), an electroencephalographic measure of sleep depth, during non-rapid eye movement (NREM) sleep with 24-hour heart rate variability (HRV), an electrocardiographic measure of cardiac autonomic modulation (CAM), in the transition to adolescence.

Leveraging data from the Penn State Child Cohort, we performed longitudinal analyses on 313 children (median [Md] age 9 years) followed-up after Md=7.4y and cross-sectional analyses on 344 adolescents (Md=16y). We extracted ORP during NREM sleep and in the 9 seconds following cortical arousals (ORP-9) from 9-hour, in-lab polysomnography, and frequency- and time-domain HRV indices from 24-h Holter ECG monitoring. Longitudinal and cross-sectional, multivariable-adjusted, regression models examined the association between ORP and ORP-9 with adolescent 24-h HRV indices.

Longitudinally, a greater increase in ORP-9 since childhood was associated with lower daytime Log-LF, SDNN, RMSSD and higher HR in adolescence (p<0.05). A greater increase in ORP since childhood was associated with lower nighttime Log-LF and SDNN (p<0.05). Cross-sectionally, higher ORP and ORP-9 were associated with lower daytime and nighttime Log-LF, SDNN or RMSSD and higher HR within adolescence (p<0.05).

A greater increase in cortical arousability since childhood is a strong developmental predictor of daytime cardiac autonomic imbalance in adolescence. Shallower sleep depth additionally arises as a proximal determinant of both daytime and nighttime cardiac autonomic imbalance within adolescence. These data suggest a coupling between fine-grained spectral measures of the sleeping brain and those of CAM, which may inform sleep-related cardiovascular risk early in life.