Insomnia can be caused by various factors including lack of sleep, stress, sadness, hormonal changes, excessive caffeine, anxiety, mental health disorders, and medications. Treatments include finding the cause, improving sleep patterns, using behavioral therapy, and taking sleeping pills in most cases. However, the drugs often cause worse side effects than insomnia. This study compared the efficacy of initial agomelatine and clonazepam doses with cognitive behavioral therapy for insomnia (CBT-i) in moderate to severe insomnia patients.

This quasi-experiment study involved 230 moderate to severe insomnia patients with group A as clonazepam 0.25 mg and B as agomelatine 25 mg. CBT-i was received by both of the groups and the Insomnia Severity Index (ISI), Subjective Units of Distress Scale (SUDS) score, medication adherence, and Adverse Drug Reactions (ADRs) were followed for up to 24 weeks.

In the comparative analysis between and within groups, group B exhibited a significant reduction in ISI (p = 0.001) and SUDS (p = 0.001) scores at week 24 compared to group A. Overall, both groups demonstrated improved adherence. However, 12 patients in group A and 10 in group B experienced ADR, which included drowsiness, hypersalivation, diarrhea, maculopapular rash, and myotoxicity. The clonazepam-treated group showed reduced efficacy from week 12 onwards in the ISI and from week 16 in the SUDS median score, which was not observed in the agomelatine group.

The initial dose of agomelatine with CBT-i has a better impact on improving moderate to severe insomnia than the initial dose of clonazepam with CBT-i.

Sleep deprivation is increasingly a problem in modern society. Therefore, understanding the restorative effects of short naps on cognitive function after sleep deprivation has considerable relevance. This study investigated changes in response inhibition function after 30 h of total sleep deprivation (TSD) and the impact of 1 h of recovery sleep (RS) on the recovery of this function.

Twenty-seven healthy male participants performed a visual Go/No-Go task while event-related potentials (ERP) were recorded. Response inhibition was assessed at three time points: at baseline (0 h of TSD), after 30 h of TSD, and after 1 h of RS.

The results from the behavioral indicators revealed a significant increase in reaction times to the Go stimuli (p = 0.013), a decrease in accuracy (p < 0.001), and a substantial rise in the error rate for the No-Go stimuli (p = 0.001) after 30 h of TSD compared with baseline. After 30 h of TSD, there was no significant improvement in task performance after 1 h of RS. ERP analysis showed a significant prolongation of the latencies of N2 (p = 0.012) and P3 (p = 0.010), a significant increase in P3 amplitude (p = 0.048), and no significant change in N2 amplitude after TSD compared with that at baseline. After 1 h of RS, N2 amplitude significantly increased (p = 0.010) and P3 latency remained prolonged (p = 0.008).

After thirty hours of sleep deprivation, the brain maintains task performance primarily through compensatory mechanisms. 1 h of RS partially ameliorates the impaired response inhibition caused by thirty hours of sleep deprivation, restoring this function closer to baseline levels.

To examine the abrupt effects of Ramadan onset on actigraphy-based time asleep in male youth Muslim football players.

We adopted a quasi-experimental, interrupted time-series research design and tracked objective time asleep over a minimum of 12 consecutive nights in the two weeks prior to and immediately after Ramadan onset, respectively. Twenty-two, male academy student-athletes (chronological age range: 12.6 to 16.2 years) participated in the study (464 individual observations). Segmented generalized mixed-effects modelling estimated the effects of Ramadan onset on time asleep during the first period of night sleep only.

Ramadan onset led to an immediate mean reduction of 89 min (95% confidence interval [CI], 54 to 123 min) in time asleep during the first period of night sleep compared to pre-Ramadan sleep patterns. Model-adjusted estimated marginal means for time asleep were ~ 5.7 h (95%CI, 5.1 to 6.2 h) before and ~ 4.2 h (95%CI, 3.6 to 4.7 h) after Ramadan onset. Night sleep interruptions resulting in two or more fragmented periods accounted for 8% (95%CI, 2 to 21%) to 19% (95%, 11 to 29%) of sleep observations before and after Ramadan onset, respectively.

The onset of Ramadan determined an abrupt reduction in time asleep of ~ 1 h 30 min in the first period of a night cycle and contributed to additional problems of heterogeneous sleep fragmentation that can impact optimal school learning and youth athlete performance development processes.

To investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males.

Repeated-measures, counter-balanced, crossover study design.

To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers (<5 on Pittsburgh Sleep Quality Index) completed either moderate-intensity cycling exercise for 40 min at 70 % HRmax at ~15:30 h or sedentary activities. Polysomnography was used to measure sleep during a 9-hour sleep opportunity (23:00 h to 08:00 h). Sleep was subjectively assessed using questionnaires 30 min after waking.

There were no statistically significant changes in objective or subjective sleep quality or quantity between conditions. The inter-quartile range for total sleep time (exercise: 51.5 min vs no exercise: 13.4 min) and sleep efficiency (exercise: 9.5 % vs no exercise: 2.5 %) suggests that there was more individual variability in subsequent sleep after afternoon exercise compared to no exercise. Exercise appeared to have a moderate effect on reducing total sleep time (mean ± SD; control 493.7 ± 12.6 min vs exercise: 471.5 ± 55.2 min; Cohen's d: -0.56), sleep efficiency (control 91.4 ± 2.3 % vs exercise: 87.3 ± 10.2 %; Cohen's d: -0.56), and delaying REM onset latency (control: 76.1 ± 45.1 min vs exercise: 102.8 ± 46.9 min; r: 0.33), although the results did not reach statistical significance (p > 0.05).

Healthy adult males can complete moderate-intensity exercise in the afternoon without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.

Insomnia is the most commonly reported sleep disturbance and significantly impacts mental health and quality of life. Traditional treatments for insomnia include pharmacological interventions or cognitive behavioral therapy for insomnia (CBT-I), but these options may not be accessible to everyone who needs treatment.

This study aims to assess the effectiveness of the app-based Headspace Sleep Program in adults with clinical insomnia on sleep disturbance and mental health outcomes, compared with a waitlist control group.

This randomized controlled trial included 132 adults with clinical insomnia who were assigned to either the Headspace Sleep Program (an 18-session self-guided, in-app program utilizing CBT-I techniques augmented by mindfulness) or a waitlist control group. Sleep disturbance outcomes were assessed by changes in insomnia symptoms (measured using the Insomnia Severity Index) and sleep efficiency (measured via sleep diary and actigraphy). Mental health outcomes included perceived stress (measured by the 10-item Perceived Stress Scale), depressive symptoms (measured by the 8-item Patient Health Questionnaire), sleep quality (measured by the Pittsburgh Sleep Quality Index), anxiety symptoms (measured by the 7-item Generalized Anxiety Disorder Scale), and mindfulness (measured by the Mindful Attention Awareness Scale). Changes from baseline to postintervention and follow-up were assessed for each outcome.

Participants had a mean (SD) age of 37.2 (10.6) years, with 69 out of 132 (52.3%) identifying as female. Those randomized to the Headspace Sleep Program group experienced significantly greater improvements in insomnia symptoms from baseline to postintervention and follow-up compared with participants in the waitlist control group (P<.001, η²p=0.107). Improvements from baseline to postintervention and follow-up were also observed in the Headspace Sleep Program group for sleep efficiency, as measured by both sleep diary (P=.01, η²p=.03) and actigraphy outcomes (P=.01, η²p=.03). Participants in the Headspace Sleep Program group showed greater improvements in insomnia remission rates (8/66, 12%, at postintervention and 9/66, 14%, at follow-up) and treatment response (11/66, 17%, at postintervention and 15/66, 23%, at follow-up) compared with the control group (remission rate 2/66, 3%, at postintervention and 0/66, 0%, at follow-up; treatment response 3/66, 5%, at postintervention and 1/66, 2%, at follow-up). The results suggest significant improvements in depressive symptoms (P=.01, η²p=.04), anxiety symptoms (P=.02, η²p=.02), and mindfulness (P=.01, η²p=.03) in the Headspace Sleep Program group.

The Headspace Sleep Program is an effective intervention for improving sleep disturbances in adults with clinical insomnia.

ClinicalTrials.gov NCT05872672; https://clinicaltrials.gov/ct2/show/NCT05872672.

Effective regulation of energy metabolism is critical for survival. Metabolic control involves various nuclei within the hypothalamus, which receive information about the body's energy state and coordinate appropriate responses to maintain homeostasis, such as thermogenesis, pancreatic insulin secretion, and food-seeking behaviors. It has recently been found that the hippocampus, a brain region traditionally associated with memory and spatial navigation, is also involved in metabolic regulation. Specifically, hippocampal sharp wave-ripples (SWRs), which are high-frequency neural oscillations supporting memory consolidation and foraging decisions, have been shown to reduce peripheral glucose levels. However, whether SWRs are enhanced by recent feeding-when the need for glucose metabolism increases, and if so, whether feeding-dependent modulation of SWRs is communicated to other brain regions involved in metabolic regulation-remains unknown. To address these gaps, we recorded SWRs from the dorsal CA1 region of the hippocampus of mice during sleep sessions before and after consumption of meals of varying caloric values. We found that SWRs occurring during sleep are significantly enhanced following food intake, with the magnitude of enhancement being dependent on the caloric content of the meal. This pattern occurred under both food-deprived and ad libitum feeding conditions. Moreover, we demonstrate that GABAergic neurons in the lateral hypothalamus, which are known to regulate food intake, exhibit a robust SWR-triggered increase in activity. These findings identify the satiety state as a factor modulating SWRs and suggest that hippocampal-lateral hypothalamic communication is a potential mechanism by which SWRs could modulate peripheral metabolism and food intake.

To assess the association between physical activity (PA), sedentary time (ST), and sleep with body composition, and to explore the effects of reallocating ST to PA or sleep on body composition in individuals with prediabetes and overweight/obesity.

Baseline data from the PREDIPHONE trial, including 159 participants (mean age 59.6 years) with prediabetes (Fasting Plasma Glucose 100-125 mg/dl) and overweight/obesity (Body Mass Index 27-40 kg/m²), were analyzed. Body composition was assessed via bioelectrical impedance, while PA, ST, and sleep were measured with accelerometry. Linear regression and isotemporal substitution models evaluated associations. Increased ST was positively associated with body fat mass (kg) (β = 0.016; CI 95%: 0.003-0.030), body fat mass (%) (β = 0.009; 0.001-0.018), and visceral adipose tissue (β = 0.005; 0.001-0.010). Moderate-to-vigorous PA (MVPA) was negatively associated with body fat mass (kg) [β = -0.031; 0.055- (-0.008)], body fat mass (%) [β = -0.017; -0.032-(-0.003)], and Visceral adipose tissue [β = -0.009; -0.02-(-0.002)]. Replacing ST with MVPA was linked to lower Visceral adipose tissue [β = -0.012; -0.024-(-0.001)] and body fat mass (kg) [β = -0.039; -0.074-(-0.006)], but not with lean mass. No significant associations were found when substituting ST with light PA or sleep.

In individuals with prediabetes and overweight/obesity, replacing ST with MVPA could reduce body fat and VAT but not increases lean mass.

It is currently affirmed that sleep detracts from time for foraging, reproductive, and anti-predatory activities. In contrast, we show that the sleep-related reductions in food intake and reproductive activities may, in fact, be benefits. Furthermore, the present report shows that the optimal prey are the immature, weak, sick, and senescent animals and rarely the sleeping fit adults. Indeed, the reduced sleeping time observed in prey animals occurs, not because of an evolutionary antipredation pressure but because of the time-expensive foraging-related activities and the digestion of the high-cellulose content in the herbivores' diet, an activity that leaves reduced amounts of daily time for sleeping. We conclude that the need for sleep ranks lower than those of foraging, reproduction, and antipredation activities.

Breast cancer is a major public health concern, and modifiable health behaviors such as sleep quality and physical activity may influence risk. This study examined the associations between self-reported sleep trouble, sleep duration, and physical activity with breast cancer incidence in a prospective longitudinal cohort of 10,305 females from Nova Scotia. Breast cancer cases were identified through record linkage to the Nova Scotia Cancer Registry. Multivariable logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs), accounting for sociodemographic factors, reproductive history, comorbidities, and other health behaviors. Frequent sleep trouble ("all of the time") was significantly associated with increased odds of breast cancer (AOR = 2.41, 95% CI = 1.09-5.34, p = 0.03), while no significant associations were observed between sleep duration and breast cancer risk. High physical activity was significantly associated with a lower risk of breast cancer (AOR = 0.58, 95% CI = 0.39-0.86, p < 0.01). These findings suggest that frequent sleep disturbances may be associated with an increased risk of breast cancer, while high physical activity appears to be linked to a lower risk of breast cancer. Further research is needed to explore these relationships and their underlying mechanisms.

Objective.Humans spend a significant portion of their lives in sleep (an essential driver of body metabolism). Moreover, as sleep deprivation could cause various health complications, it is crucial to develop an automatic sleep stage detection model to facilitate the tedious manual labeling process. Notably, recently proposed sleep staging algorithms lack model explainability and still require performance improvement.Approach.We implemented multiscale neurophysiology-mimicking kernels to capture sleep-related electroencephalogram (EEG) activities at varying frequencies and temporal lengths; the implemented model was named 'multiscale temporal convolutional neural network (MTCNN).' Further, we evaluated its performance using an open-source dataset (Sleep-EDF Database Expanded comprising 153 d of polysomnogram data).Main results.By investigating the learned kernel weights, we observed that MTCNN detected the EEG activities specific to each sleep stage, such as the frequencies, K-complexes, and sawtooth waves. Furthermore, regarding the characterization of these neurophysiologically significant features, MTCNN demonstrated an overall accuracy (OAcc) of 91.12% and a Cohen kappa coefficient of 0.86 in the cross-subject paradigm. Notably, it demonstrated an OAcc of 88.24% and a Cohen kappa coefficient of 0.80 in the leave-few-days-out analysis. Our MTCNN model also outperformed the existing deep learning models in sleep stage classification even when it was trained with only 16% of the total EEG data, achieving an OAcc of 85.62% and a Cohen kappa coefficient of 0.75 on the remaining 84% of testing data.Significance.The proposed MTCNN enables model explainability and it can be trained with lesser amount of data, which is beneficial to its application in the real-world because large amounts of training data are not often and readily available.

Inter-individual differences are necessary for selection to act, while plasticity (intra-individual variation) may buffer against selection. Sleep is a critical self-maintenance behaviour but, unlike most behaviours, the causes and consequences of its inter- and intra-individual variation in wild animals is poorly understood, particularly in neonates where sleep plays a key role in development. We have shown previously that free-ranging neonate fallow deer (Dama dama) differ in sleep during the first few weeks of life. Here, we test whether individual variability in sleep is organised systematically across the population, and whether these individual differences are associated with chronic stress measured using hair cortisol, or the timing of birth. Four dimensions of sleep behaviour (total sleep time, sleep fragmentation, sleep quality, and sleep distribution over 24-h) were quantified using state-of-the-art triaxial accelerometers. We then used a multivariate mixed-effects model in a Bayesian framework to evaluate covariation between multiple dimensions of sleep behaviour, and quantify the relative importance of chronic stress and the timing of birth, while accounting for the confounding effects of environmental conditions and age. We found that the timing of birth and chronic stress were not associated with changes in sleep between individuals. While both total sleep time and the number of bouts per day declined with age, their rate of development covaried, but no other sleep dimensions covaried. Our results represent an in-depth analysis of natural variation in sleep, and show that individual differences in four aspects of sleep architecture in free-living fallow deer fawns are strong but independent of one another and unrelated to chronic stress or the timing of birth. We suggest that covariation between sleep dimensions might emerge later in life and effects of cortisol and birth timing might be very short and transient.

Sleep, physical activity, and nutrition (SPAN) are critical behaviours for health, although they have traditionally been studied separately. We examined the combined associations of SPAN and the minimum between-individual variations associated with meaningfully lower all-cause mortality risk.

This prospective cohort analysis included 59,078 participants from the UK Biobank (median age: 64.0 years; 45.4% male) who wore trackers for 7 days and self-reported dietary data. Wearable-measured sleep (hours/day) and moderate to vigorous physical activity (MVPA; mins/day) were calculated using a machine learning based schema. A 10-item diet quality score (DQS) assessed the intake of vegetables, fruits, fish, dairy, whole grains, vegetable oils, refined grains, processed and unprocessed meats, and sugary beverages (0-100 for all components with higher values indicating higher quality). Cox proportional hazards models were used to estimate hazard ratios (HR) for all-cause mortality risk across 27 separate joint tertile combinations of SPAN behaviours with the lowest tertile for all three as the referent group. For more granular clinical interpretations, we examined combined incremental dose-response changes of the SPAN behaviours using the 5th percentile of each behaviour as the referent point.

Over the 8.1-year median follow-up time, 2,458 mortality events occurred. Compared to the referent group of combined SPAN exposure (lowest tertiles for all three), the optimal SPAN combination involving moderate sleep duration (7.2-8.0 h/day), high MVPA (42-103 min/day), and a DQS between 57.5 and 72.5 was associated with an HR of 0.36 (95% CI: 0.26-0.50). Relative to the 5th percentile of sleep (5.5 h/day), physical activity (7.3 min/day), and nutrition (36.9 DQS), a theoretical minimum combined increase of 15 min/day of sleep, 1.6 min/day MVPA, and 5 DQS points (corresponding to e.g., extra 1/2 serving of vegetables per day or 1 less serving of processed meat per week) was associated with 10% lower all-cause mortality risk (0.90; 0.88-0.93). Combined increases of 75 min/day of sleep, 12.5 min/day MVPA, and 25 DQS points were associated with 50% lower all-cause mortality risk (0.50; 0.44-0.58).

This study highlights the potential health value of subtle combined SPAN modification in relation to mortality risk and expands opportunities for more holistic recommendations.

Effective regulation of energy metabolism is critical for survival. Metabolic control involves various nuclei within the hypothalamus, which receive information about the body's energy state and coordinate appropriate responses to maintain homeostasis, such as thermogenesis, pancreatic insulin secretion, and food-seeking behaviors. It has recently been found that the hippocampus, a brain region traditionally associated with memory and spatial navigation, is also involved in metabolic regulation. Specifically, hippocampal sharp wave ripples (SWRs), which are high-frequency neural oscillations supporting memory consolidation and foraging decisions, have been shown to reduce peripheral glucose levels. However, whether SWRs are enhanced by recent feeding-when the need for glucose metabolism increases, and if so, whether feeding-dependent modulation of SWRs is communicated to other brain regions involved in metabolic regulation, remains unknown. To address these gaps, we recorded SWRs from the dorsal CA1 region of the hippocampus of mice during sleep sessions before and after consumption of meals of varying caloric values. We found that SWRs occurring during sleep are significantly enhanced following food intake, with the magnitude of enhancement being dependent on the caloric content of the meal. This pattern occurred under both food-deprived and ad libitum feeding conditions. Moreover, we demonstrate that GABAergic neurons in the lateral hypothalamus, which are known to regulate food intake, exhibit a robust SWR-triggered increase in activity. These findings identify the satiety state as a factor modulating SWRs and suggest that hippocampal-lateral hypothalamic communication is a potential mechanism by which SWRs could modulate peripheral metabolism and food intake.

The weight-adjusted-waist index (WWI) is a novel measure of central adiposity, potentially linked to various sleep disturbances. This study explores the relationship between WWI and sleep outcomes, such as trouble sleeping, sleep disorder, and sleep duration.

Data from the National Health and Nutrition Examination Survey 2007-2012 were analyzed, including 13,494 participants. The analysis focused on individuals aged 20 years and older who provided information on WWI and sleep. Sleep status was determined based on responses to the following questions: (1) "How many hours do you sleep?"; (2) if they reported trouble sleeping; and (3) if they had physician-diagnosed sleep disorders. Regression models assessed the association between WWI and sleep outcomes across the entire population and within subgroups. Restricted cubic spline (RCS) analysis was conducted to examine potential non-linear relationships between WWI and sleep outcomes.

A higher WWI was significantly correlated with an increased likelihood of trouble sleeping (OR = 1.26, 95% CI: 1.16, 1.36; p < 0.001) and sleep disorder (OR = 1.71, 95% CI: 1.50, 1.95; p < 0.001) in the overall population. RCS analysis indicated a linear relationship between WWI and these sleep outcomes. Subgroup analysis identified that the connection between WWI and trouble sleeping was most pronounced among Non-Hispanic Blacks and individuals with lower educational levels. For sleep disorder, the association was stronger in males and Non-Hispanic Blacks. A slight negative association between WWI and sleep duration was found, especially among non-drinkers (β = - 0.13, 95% CI: - 0.24, - 0.02; p = 0.028).

The findings highlight a significant and linear relationship between elevated WWI and an increased likelihood of experiencing trouble sleeping and sleep disorder, with variations observed across different demographic and lifestyle subgroups. These results imply that central adiposity, as measured by WWI, plays an important role in sleep health.

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Idiopathic Intracranial Hypertension (IIH) is a disease of unknown etiology. Understanding the role of Retinol Binding Protein (RBP) in IIH pathogenesis could provide valuable perceptions into disease mechanisms and potentially identify new therapeutic targets.

The study conducted a comprehensive search of electronic databases following PRISMA guidelines. The inclusion criteria involved human studies published in English that reported RBP levels in IIH patients. The New Castle Ottawa scale was used for the quality assessment of the included studies. Analysis was done using the Random Effects Model with 95% Confidence Interval.

A total of 4 studies met the inclusion criteria for meta-analysis. The quality score for the included studies ranged from 5 to 6. The pooled analysis indicated significant association of RBP with risk of IIH, with higher serum RBP levels (SMD = 1.56, 95% CI: 0.13 to 2.98, I2 = 93.9) and lower CSF RBP levels (SMD = -0.67, 95% CI: -1.37 to 0.04, I2 = 65.4) as compared to controls. Significant heterogeneity was found in the studies, suggesting variability in study design and methods. Further subgroup analysis by investigation method also showed significant results (SMD = 1.56, 95% CI: 0.13 to 2.98, I2 = 93.9).

The findings of this study propose that an elevated level of RBP may contribute to the risk of IIH, potentially through its involvement in retinol transport and metabolism. The study has been registered in PROSPERO (CRD42023436827).

Objectives: This study investigated if unhealthy sleeping habits of university students can be explained by the Theory of Planned Behavior. Method: An online questionnaire was administered to 1006 undergraduate students at a Belgian university to measure their frequency of irregular sleeping times, daytime napping, and pre-bedtime alcohol or internet use, as well as the attitudes, perceived norms, perceived control and intentions for these behaviors. Results: Principal Component Analysis and internal consistency analysis confirmed the validity and reliability of the scales measuring the TPB dimensions. Expected outcomes, perceived norms and perceived control significantly explained intentions to avoid irregular sleeping times, daytime naps, pre-bedtime activity and pre-bedtime alcohol use. Intentions and perceived behavioral control explained self-reported irregular sleeping times, daytime napping, pre-bedtime activity, and pre-bedtime alcohol use. Significant differences in predictions were found for gender, study program, type of residence and age. Conclusions: The TPB provides a useful theoretical framework to explain students' sleeping behaviors.

Sleep deprivation (SD) significantly disrupts the homeostasis of the cardiac-brain axis, yet the neuromodulation effects of deep magnetic stimulation (DMS), a non-invasive and safe method, remain poorly understood.

Sixty healthy adult males were recruited for a 36-h SD study, they were assigned to the DMS group or the control group according to their individual willing. All individuals underwent heart sound measurements and functional magnetic resonance imaging scans at the experiment's onset and terminal points. During the recovery sleep phase, DMS was applied twice for 30 min before sleep onset and upon awakening to the individuals in the DMS group. Two-factor analysis was used to disclose the changes in two status and intervention effect in groups, along with Spearman rank correlation analysis to assess the correlation between brain activity and heart activity, the linear regression analysis was performed to explore the effect of DMS on brain regions to regulated the heart activity. Additionally, bootstrapping analysis was employed to verify the mediation effect.

The results indicated that the DMS group cardiac cycle duration was 0.81 ± 0.04 s, CON group was 0.80 ± 0.03 s, DMS presented a prolong effect (F = 0.32, p = 0.02), and all heart frequency and intensity indexes value were lower than CON group (p < 0.01). Two-factor analysis demonstrated the significant differences in the left insula and orbitofrontal inferior gyrus, which DC_Weight (0.25) value were lower 0.50 (p < 0.01), 0.42 (p < 0.01) after DMS. Furthermore, the correlation analysis confirmed that the negative association between the left orbital inferior frontal and left insula with the heart sound index (p < 0.05), such as Δ left orbital inferior frontal were negatively correlated with Δ Systolic_intensity (rho = -0.33, p < 0.05), Δ Diastolic_intensity (rho = -0.41, p < 0.05), Δ S1_intensity (rho = -0.36, p < 0.05), and Δ S2_intensity (rho = -0.43, p < 0.05). Δ Left insula was negatively correlated with Δ Diastolic_intensity (rho = -0.36, p < 0.05), Δ S1_intensity (rho = -0.33, p < 0.05), and Δ S2_intensity (rho = -0.36, p < 0.05). Mediated effect analysis showed that DMS affected S2_intensity by intervening in brain regions.

These findings suggest a causal effect on the cardiac-brain axis following 36 h of SD. The non-invasive intervention of DMS effectively regulates both brain and heart functions after SD, promoting homeostatic balance. The DMS can affect the cardiac-brain axis, offering a means to restore balance following extended periods of SD.

Climate warming and frequent incidents of extreme high temperatures are serious global concerns. Heat stress induced by high temperature has many adverse effects on animal physiology, especially in aquatic poikilotherms. Chinese mitten crab (Eriocheir sinensis) is sensitive to high temperatures, this study evaluated the harmful effects of heat stress on the neurotoxicity, intestinal health, microbial diversity, and metabolite profiles. The results showed that heat stress caused histopathological damages and altered the ultrastructure of lesions in the cranial ganglia. Heat stress significantly upregulated the mRNA expression of apoptosis-related genes, and significantly altered the expression of neurotransmitter receptors. In addition, heat stress induced significant intestinal damages that mainly manifested as a significant increase in the activity of diamine oxidase in the serum and contents of histamine in the intestine. The diversity and abundance of intestinal microbiota altered abnormally in E. sinensis exposed to heat stress, and the bacteria that exhibited significant variations in abundance were closely related to the production of neurotransmitters and neuromodulators. Heat stress caused significant changes in the intestinal metabolite profiles, which mainly involved the amino acid and lipid metabolism pathways. Analysis of the correlation showed that the abnormal changes in metabolites were closely related to differences in the abundance of intestinal microbiota. Therefore, this study showed that heat stress could cause neurophysiological toxic effects, which may be related to intestinal ecological imbalance.

As urban populations grow, the problem of noise pollution becomes more significant. The limited number of epidemiological studies linking individual-level dynamic noise exposure to sleep highlights a gap in our understanding of how individual-level noise exposure impact sleep quality and duration. A cross-sectional survey was conducted in Hong Kong, and portable noise sensors were used to record participants' real-time noise exposure. The Pittsburgh Sleep Quality Index was used to assess their sleep quality. Logistic regression was used to examine the relationship of individual-level noise exposure with sleep quality and sleep duration. Among a total of 763 subjects included in the analysis, and a-weighted decibels [dB(A)] 24-h average exposure (L24) was 63.21 (58.85-67.85) dB(A) for workday and 63.52 (59.03-67.86) dB(A) for non-workday. A significant decrease in individual noise level was observed closer to bedtime (P < 0.05). Compared with the lowest noise exposure, exposure to the highest noise level was positively associated with the presence of poor sleep quality for L24, Ld and Ln, with an odds ratio (OR) and 95 % confidential interval (CI) of 1.53 (1.04-2.24), 1.65 (1.12-2.43), and 1.51 (1.03-2.21), respectively. Exposure to elevated noise level was associated with increased risk of shorter nocturnal sleep duration (< 7 h), the OR and 95 % CI was 1.87 (1.29-2.73) for L24, 1.58 (1.09-2.30) for Ld, 1.50 (1.03-2.18) for Le, and 1.60 (1.10-2.32) for Ln in the highest noise exposure group. Similar findings were observed both on workdays and non-workdays, respectively. Furthermore, the results showed that each 10 dB(A) increment in L24 and Ln was associated with a probable 29 % and 27 % increase in poor sleep quality and a 24 % and 24 % reduction in sleep duration. This study demonstrates that environmental noise exposure was associated with poor sleep quality and shorter sleep duration, posing a significant public health issue in Hong Kong.

In this review, we evaluate recent studies that employ neuromodulation, in the form of non-invasive brain stimulation, to improve sleep in both healthy participants, and patients with psychiatric disorders. We review studies using transcranial electrical stimulation, transcranial magnetic stimulation, and closed-loop auditory stimulation, and consider both subjective and objective measures of sleep improvement.

Neuromodulation can alter neuronal activity underlying sleep. However, few studies utilizing neuromodulation report improvements in objective measures of sleep. Enhancements in subjective measures of sleep quality are replicable, however, many studies conducted in this field suffer from methodological limitations, and the placebo effect is robust. Currently, evidence that neuromodulation can effectively enhance sleep is lacking. For the field to advance, methodological issues must be resolved, and the full range of objective measures of sleep architecture, alongside subjective measures of sleep quality, must be reported. Additionally, validation of effective modulation of neuronal activity should be done with neuroimaging.

Numerous studies have documented the effects of daytime napping, sleep duration, and depression on cardiovascular diseases (CVDs). However, the evidence has been gleaned from observational studies that might be riddled with confounding variables and the possibility of reverse causation bias. Therefore, the present study employed a Mendelian randomization (MR) methodology to meticulously explore the relationships between daytime napping, sleep duration, and depression, and the risk profiles of CVDs.

Genome-wide significant genetic variants associated with daytime napping, sleep duration, and depression were used as the instrumental variables (IVs). Data on the genetic correlations between these IVs and 15 CVDs were derived from the United Kingdom (UK) Biobank, Finnish Genome Studies, and other large-scale collaborations. We conducted both univariate and multivariate MR analyses to assess the overall effects and mediated relationships after adjusting for potential confounders, including body mass index (BMI), smoking status, and type 2 diabetes. The effect sizes were estimated using inverse variance-weighted (IVW) regression.

The MR analysis revealed that an increased risk of heart failure (HF) [odds ratio (OR): 1.366; 95% confidence interval (CI): 1.013-1.842; P=0.04], coronary atherosclerosis (OR: 1.918; 95% CI: 1.257-2.927; P=0.003), myocardial infarction (MI) (OR: 1.505; 95% CI: 1.025-2.211; P=0.04), and coronary artery disease (CAD) (OR: 1.519; 95% CI: 1.130-2.043; P=0.006) was significantly associated with genetically predicted daytime napping. Prolonged sleep duration was found to be related to a reduced risk of HF (OR: 0.995; 95% CI: 0.993-0.998; P=2.69E-04), peripheral vascular disease (PVD) (OR: 0.984; 95% CI: 0.971-0.997; P=0.02), and CAD (OR: 0.997; 95% CI: 0.994-0.999; P=0.006). Additionally, a statistically significant positive relationship was observed between depressive disorders and the occurrence of atrial fibrillation (AF) (OR: 1.298, 95% CI: 1.065-1.583, P=0.01), indicating a heightened susceptibility. The multivariable MR analyses substantiated the reliability of the observed associations between daytime napping and the incidence of HF and CAD, following adjustments for genetically predicted BMI and smoking. The sensitivity analysis did not reveal any evidence of horizontal pleiotropy or heterogeneity, thus supporting the validity of the study's results.

This MR investigation posits a potential causal nexus between daytime napping, sleep duration, and depression, and the genesis of CVDs, offering new perspectives on the prevention and management of CVDs.

This study explored the effects of partial sleep deprivation (PSD) on Sanda athletes' athletic performance, an area with limited research. Using a randomized crossover controlled trial with 18 male athletes, the PSD group had 4 h of sleep while the NSN group had 8 h. Results showed that after PSD intervention, the RAT time significantly increased compared to the NSN group (P = 0.0311). However, there was no significant change in CMJ (P = 0.2396) or YBT (left leg: P = 0.2767, right leg: P = 0.3225) between the PSD and NSN groups. In the Wingate test, the PSD group exhibited significant reductions in Pmax and Pave at 10s, 30s, and 60s (P＜0.0001), as well as a significant decrease in Prel at 60s (P＜0.0001), with no significant differences in Prel at 10s and 30s. These findings underscore the detrimental impact of limited sleep on anaerobic performance and agility in Sanda athletes, emphasizing the need for proper sleep management for optimal athletic outcomes.

This study aimed to prospectively investigate associations of working night shifts with weight gain in the Nightingale Study, a large cohort of female nurses.

This study included 36 273 registered nurses, who completed questionnaires in 2011 and 2017. Cumulative number of nights, mean number of nights/month and consecutive number of nights/month in 2007-2011 were assessed. We used Poisson regression to estimate multivariable-adjusted incidence rate ratios (IRR) of >5% weight gain from 2011 to 2017 among all participants and assess risk of development of overweight/obesity (BMI≥25 kg/m2) among women with healthy baseline body mass index. The reference group consisted of women who never worked nights.

Overall, working night shifts in 2007-2011 was associated with >5% weight gain [IRR 1.07, 95% confidence interval (CI) 1.01-1.13]. Associations differed by menopausal status in 2011, with an increased risk of gaining >5% weight limited to postmenopausal women who worked nights (IRR 1.23, 95% CI 1.10-1.38). Postmenopausal women had an increased risk of >5% weight gain when they worked on average ≥4 nights/month (4-5: IRR 1.29, 95% CI 1.09-1.52, ≥6: IRR 1.27, 95% CI 1.11-1.47) or ≥4 consecutive nights/month (IRR 1.37, 95% CI 1.19-1.58), compared to postmenopausal women who never worked nights. For postmenopausal women with healthy weight at baseline, night shift work was associated with an increased risk of overweight/obesity at follow-up (IRR 1.24, 95% CI 1.03-1.50).

Working night shifts was associated with a slightly increased risk of weight gain and overweight/obesity development among women who were postmenopausal at study inclusion. Our findings emphasize the importance of health promotion to maintain a healthy weight among (postmenopausal) night workers.

Infusions of home parenteral nutrition (HPN) are often cycled at night coinciding with sleep episodes. Adult consumers of HPN are known to experience poor sleep attributed to frequent awakenings and long durations of wakefulness after falling asleep. Consequently, most consumers do not meet recommendations for sleep duration and quality or daytime napping. The primary underlying pathophysiology resulting in sleep problems is nocturia; however, other factors also exist, including disruptions caused by medical equipment (ie, pump alarms), comorbid conditions, dysglycemia, and medication use. Early guidance on sleep is imperative because of the central role of sleep in physical health and wellbeing, including mitigating complications, such as infection risk, gastrointestinal problems, pain sensitivity, and fatigue. Clinicians should routinely inquire about the sleep of their patients and address factors known to perturb sleep. Nonpharmacologic opportunities to mitigate sleep problems include education on healthy sleep practices (ie, sleep hygiene); changes in infusion schedules, volumes, rates, and equipment; and, possibly, behavioral interventions, which have yet to be examined in this population. Addressing comorbid conditions, such as mood disorders, and nutrition deficiencies may also help. Pharmacologic interventions and technological advancement in HPN delivery are also needed. Research on sleep in this population is considered a priority, yet it remains limited at this time.

To investigate how short sleep duration (SSD) during pregnancy is related to neurodevelopmental delays in offspring, we aimed to inform pregnancy sleep guidelines and promote maternal health and child development.

To identify the associations between SSD during pregnancy and offspring neurodevelopmental delay and to determine whether fetal glucose metabolism plays a role in SSD and neurodevelopmental delays.

This cohort study followed 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index at weeks 24 to 28 and 32 to 36. Neurodevelopmental outcomes from 6 to 36 months postpartum were assessed via the Denver Developmental Screening Test-II and the Gesell Development Diagnosis Scale. Cox proportional hazard regression was used to analyze the link between maternal SSD and neurodevelopmental delay risk. Mediation analysis was used to evaluate the role of cord blood serum C-peptide levels. Three hospitals and children's health centers in Hefei were involved.

The stratified analysis revealed a significant association between mothers with SSD during midpregnancy and neurodevelopmental delay in boys (adjusted HR 2.05, 95% CI 1.29, 3.25). Cord blood marker analysis revealed a positive relationship between cord blood serum C-peptide levels and neurodevelopmental delay in offspring (RR 0.04, 95% CI 0.00, 0.08). The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%.

Maternal SSD during pregnancy was continuously associated with an increased incidence of neurodevelopmental delay with sex differences among offspring. This association may be mediated in part by increased higher levels of cord C-peptide.

Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression.

In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT.

Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m2). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity.

Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.

Objective  To evaluate which condition of sleep debt has a greater negative impact on insulin resistance: sleep deprivation for 24 hours or 4 hours of sleep restriction for 4 nights. Materials and Methods  In total, 28 healthy male subjects aged 18 to 40 years were recruited and randomly allocated to two groups: sleep deprivation (SD) and sleep restriction (SR). Each group underwent two conditions: regular sleep (11 pm to 7 am ) and total sleep deprivation for 24 hours (SD); regular sleep (11 pm to 7 am ) and 4 nights of sleep restriction (SR) (1 am to 5 am ). The oral glucose tolerance test (OGTT) was performed, and baseline glucose, insulin, free fatty acids (FFAs), and cortisol were measured. In addition, the area under the curve (AUC) for glucose and insulin, the homeostasis model assessment of insulin resistance (HOMA-IR), and the Matsuda Index (Insulin Sensitivity Index, ISI) were calculated. Results  Glucose and insulin had a similar pattern between groups, except at the baseline, when insulin was higher in the sleep debt condition of the SR when compared with the SD ( p  < 0.01). In the comparison between regular sleep and sleep debt, the SD had a higher insulin AUC ( p  < 0.01) and FFAs ( p  = 0.03) after sleep deprivation, and insulin and the insulin AUC increased ( p  < 0.01 for both), while the ISI decreased ( p  = 0.02) after sleep restriction in the SR. In baseline parameters covariate by the condition of regular sleep, insulin ( p  = 0.02) and the HOMA-IR ( p  < 0.01) were higher, and cortisol ( p  = 0.04) was lower after sleep restriction when compared with sleep deprivation. Conclusion  Sleep restriction for 4 consecutive nights is more detrimental to energy metabolism because of the higher insulin values and insulin resistance compared with an acute period of sleep deprivation of 24 hours.

Poor sleep quality is a widespread concern. While the influence of particle exposure on sleep disturbances has received considerable attention, research exploring other dimensions of sleep quality and the chemical components of the particles remains limited. We employed a marginal structural model to explore the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality. The odds ratio (95 % CI) for poor sleep quality was 1.335 (1.292-1.378), 1.097 (1.080-1.113), 1.137 (1.100-1.174), 1.197 (1.156-1.240), and 1.124 (1.107-1.140) per IQR increase in the concentration of PM2.5, SO42-, NO3-, NH4+, and BC, respectively. The score (and 95 % CI) of sleep latency, use of sleep medication, habitual sleep efficiency, subjective sleep quality, and daytime dysfunction were affected by PM2.5, with an increase of 0.059 (0.050-0.069), 0.054 (0.049-0.059), 0.011 (0.008-0.014), 0.011 (0.005-0.018), and 0.026 (0.018-0.034) per IQR increase in PM2.5 concentrations, respectively. This study supports the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality.

Transition to motherhood is a period full of challenges and demands. In this review, we focused on the associations of sleep and circadian activity patterns during and after pregnancy with postpartum mental health factors. A systematic review and meta-analysis were conducted (PROSPERO reference 316,505). A search for articles was performed using PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, DARE, hand search, and citation tracking. The search was meant to identify peer-reviewed, experimental and observational studies reporting on women over 18 years old that assessed sleep and circadian activity patterns during pregnancy or postpartum using actigraphy, and investigated postpartum mental health factors. Nineteen relevant publications were selected. Postpartum total sleep at night was the indicator that was most closely related to the psychological functioning of women after childbirth. The results of the systematic review indicated that postpartum total sleep at night was related to postpartum fatigue, and the results of the meta-analysis suggested that total sleep at night was most strongly linked with postpartum depression. More studies are needed to estimate the associations of sleep-wake rhythm during pregnancy and in the postpartum period with postpartum mental health factors.

The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons.

This study was conducted on a representative sample of 3452 Iranian older people (≥ 60 years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL.

More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7 h) and long sleepers (equal or more than 9 h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001).

The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.

As a chronic skin disease, psoriasis often affects the physical, psychological and social status of the patient, which in turn impacts on their experience of illness and needs. However, there is no review of qualitative research that integrates and analyses the experiences and needs of these three influences from a holistic perspective.

This review follows the ENTREQ guidelines. Six English databases (JBI, Cochrane Library, PubMed, PsyINFO, CINAHL and Embase) and three Chinese databases (CNKI, VIP and Wanfang) were searched from January 2012 to October 2022. Literature was included if it was relevant to the experience of illness and caring needs of patients with psoriasis. The JBI-QARI was used to rate the quality of included studies.

Eleven studies were included in the meta-synthesis. Four analytical themes were identified for analysis: physical challenges, psychological discomfort, social phenomena and caring needs.

The combined physical, psychological and social effects of psoriasis and the consequent caring needs should be emphasised. Health professionals, including doctors and nurses, should be aware of the multiple changes in patients and their coping strategies, provide information about psoriasis, monitor and follow-up regularly over time and obtain feedback to inform further treatment and care so as to develop high-quality therapeutic interventions to help and guide patients with their coping strategies.

These findings describe the physical, psychological and social experiences of illness and caring needs of patients with psoriasis. Healthcare professionals should be more aware of patients' easily overlooked psychological and social distress, providing prompt attention and recognition of patients' experiences and needs, offering relevant assistance and support and enhancing daily, regular follow-up to help them improve their understanding of and ability to manage their illness.

This is a meta-synthesis without direct patient involvement.

We aimed to assess the associations between sleep duration and Visceral Adiposity Index (VAI).

Cross-sectional study.

The National Health and Nutrition Examination Survey (2007-2018).

A total 11 252 eligible participants who have complete information for sleep duration and VAI.

The VAI index, which is sex-specific and takes into consideration factors such as waist circumference, body mass index, high-density lipoprotein cholesterol and triglycerides, was calculated in accordance with prior research. Multiple linear regressions and subgroup analyses were employed to evaluate the connection between the duration of sleep and the VAI.

The mean sleep duration and VAI of included participants were 7.05 hours/day and 2.03, respectively. After adjusting for the sociodemographic, lifestyle and other covariates, short sleep was significantly linked to increased VAI (β=0.15, 95% CI 0.01 to 0.28) in relation to middle sleep duration, whereas no significant association was found between long sleep duration and VAI. An L-shaped relationship was observed between sleep duration and VAI. When sleep duration was less than 7.5 hours/day, a negative association between sleep duration and VAI was obvious. However, when sleep duration was >7.5 hours/day, VAI was increased with a longer sleep duration, although it was not significant.

An L-shaped relationship was observed between sleep duration and VAI, with insufficient sleep, being independently linked to a higher VAI. This implies that sleep deprivation might be associated with visceral adipose distribution and disfunction.

Sleep deprivation is a potential risk factor for metabolic diseases, including obesity and type 2 diabetes. We evaluated the impacts of moderate chronic sleep deprivation on glucose and lipid homeostasis in adult rats.

Wistar rats (both sexes) were sleep-perturbed daily for 2 hours at the early (06:00-08:00) and the late light cycle (16:00-18:00) five days a week (except weekends) for 4 weeks.

Sleep perturbation (SP) resulted in reduced body weight gain in both sexes, associated with altered food intake and reduced adiposity. SP did not alter the short- or long-term memories or cause anxiogenic behavior. No major changes were observed in the plasma insulin, leptin, triacylglycerol, non-esterified fatty acids, and blood glucose upon SP. After SP, females exhibited a transitory glucose intolerance, while males became glucose intolerant at the end of the experimental period. Male rats also developed higher insulin sensitivity at the end of the SP protocol. Morphometric analyses revealed no changes in hepatic glycogen deposition, pancreatic islet mass, islet-cell distribution, or adrenal cortex thickness in SP rats from both sexes, except for lower adipocyte size compared with controls. We did not find homogeneous changes in the relative expression of circadian and metabolic genes in muscle or hepatic tissues from the SP rats.

Moderate chronic SP reduces visceral adiposity and causes glucose intolerance with a more pronounced impact on male rats, reinforcing the metabolic risks of exposure to sleep disturbances.

To pilot a novel approach investigating the interplay of social and institutional determinants influencing university undergraduate student sleep patterns.

A two-part, three-phase mixed-methods approach.

A mid-size US university conducted in spring and fall 2020.

191 undergraduate students (69 first-years, 43 second-years, 48 third-years, 31 fourth-years).

For Part A, participants texted their activities and emotions in real time, producing a data-rich, weeklong diary of comprehensive activity logs, emoticons, multimedia submissions, and juxtapositions of ideal vs real schedules. Semi-structured contextual interviews were also conducted. For Part B, a one-time survey examined Part A insights across all class years. These diverse datasets were triangulated using thematic, comparative, and content analyses through MAXQDA software and visual mapping methods.

Three preliminary themes were identified as encouraging an irregular sleep schedule: a prevailing academic ethos emphasizing busyness, time management challenges, and the rhythm of institutional schedules and deadlines. An overarching theme suggests that perceptions of peer sleep habits and academic prioritization above all else could be influential across factors.

This pilot study indicates that sleep regularity among undergraduates is potentially shaped by individual choices combined with broader institutional paradigms. While it is limited by its exploratory nature, timing, and small sample size, the results highlight the promise of this methodology for more extensive studies and suggest that future interventions should emphasize systemic changes that prioritize sleep.

Sleep is broadly conserved across the animal kingdom but can vary widely between species. It is currently unclear which selective pressures and regulatory mechanisms influence differences in sleep between species. The fruit fly Drosophila melanogaster has become a successful model system for examining sleep regulation and function, but little is known about the sleep patterns in many related fly species. Here, we find that fly species with adaptations to extreme desert environments, including D. mojavensis, exhibit strong increases in baseline sleep compared with D. melanogaster. Long-sleeping D. mojavensis show intact homeostasis, indicating that desert flies carry an elevated drive for sleep. In addition, D. mojavensis exhibit altered abundance or distribution of several sleep/wake-related neuromodulators and neuropeptides that are consistent with their reduced locomotor activity and increased sleep. Finally, we find that in a nutrient-deprived environment, the sleep patterns of individual D. mojavensis are strongly correlated with their survival time and that disrupting sleep via constant light stimulation renders D. mojavensis more sensitive to starvation. Our results demonstrate that D. mojavensis is a novel model for studying organisms with high sleep drive and for exploring sleep strategies that provide resilience in extreme environments.

As the number of total hip and knee arthroplasties (TJA) performed increases, there is heightened interest in perioperative optimization to improve outcomes. Sleep is perhaps one of the least understood perioperative factors that affects TJA outcomes. The purpose of this article is to review the current body of knowledge regarding sleep and TJA and the tools available to optimize sleep perioperatively.

A manual search was performed using PubMed for articles with information about sleep in the perioperative period. Articles were selected that examined: sleep and pain in the perioperative period; the effect of surgery on sleep postoperatively; the relationship between sleep and TJA outcomes; risk factors for perioperative sleep disturbance; the effect of anesthesia on sleep; and the efficacy of interventions to optimize sleep perioperatively.

Sleep and pain are intimately associated; poor sleep is associated with increased pain sensitivity. Enhanced sleep is associated with improved surgical outcomes, although transient sleep disturbances are normal postoperatively. Risk factors for perioperative sleep disturbance include increasing age, pre-existing sleep disorders, medical comorbidities, and type of anesthesia used. Interventions to improve sleep include optimizing medical comorbidities preoperatively, increasing sleep time perioperatively, appropriating sleep hygiene, using cognitive behavioral therapy, utilizing meditation and mindfulness interventions, and using pharmacologic sleep aids.

Sleep is one of many factors that affect TJA. As we better understand the interplay between sleep, risk factors for suboptimal sleep, and interventions that can be used to optimize sleep, we will be able to provide better care and improved outcomes for patients.

Sleep is increasingly recognized as a multidimensional construct that occurs within the 24-hour day. Despite advances in our understanding, studies continue to consider the relationship between sleep, sedentary time and physical activity separately, and not as part of the 24-hour day.

To determine the association between the 24-hour activity composition and dimensions of healthy sleep.

This study examined data on 1168 children (mean age 12years; 49% female) and 1360 adults (mean age 44years; 87% female) collected as part of the Child Health CheckPoint study. Participants were asked to wear a GENEActiv monitor (Activinsights, Cambs, UK) on their nondominant wrist for eight consecutive days to measure 24-hour time-use. Compositional data analysis was used to examine the association between time use (actigraphy-derived sleep duration, sedentary time, light physical activity and moderate-vigorous physical activity) and dimensions of healthy sleep. Healthy sleep was conceptualized in terms of continuity/efficiency, timing, alertness/sleepiness, satisfaction/quality, and regularity. Time allocations were also examined.

The 24-hour activity composition was significantly associated with all objectively measured and self-report dimensions of healthy sleep in both children and adults. Allocating more time to sleep was associated with earlier sleep onsets, later sleep offsets, less efficient and more consistent sleep patterns for both children and adults.

This study highlights the integral relationship between daily activities and dimensions of sleep. Considering sleep within the 24-hour day activity composition framework may help inform lifestyle decisions to improve sleep health.

We aimed to systematically review and synthesize the available evidence regarding the link between dietary patterns and insomnia symptoms among the general population using observational studies. We reviewed 16,455 references, of which 37 studies met inclusion criteria with a total sample size of 591,223. There was a significant association of the Mediterranean diet (OR: 0.86; 95 % CI, 0.79, 0.93; P < 0.001; I2 = 32.68 %), a high-quality diet (OR: 0.66; 95 % CI, 0.48, 0.90; P = 0.010; I2 = 84.62 %), and an empirically-derived healthy dietary pattern (OR: 0.91; 95 % CI, 0.85, 0.98; P = 0.010; I2 = 57.14 %) with a decreased risk of insomnia symptoms. Moreover, the dietary glycemic index (OR: 1.16; 95 % CI, 1.08, 1.25; P < 0.001; I2 = 0.0 %), the dietary glycemic load (OR: 1.10; 95 % CI, 1.01, 1.20; P = 0.032; I2 = 74.36 %), and an empirically-derived unhealthy dietary pattern (OR: 1.20; 95 % CI, 1.01, 1.42; P = 0.040; I2 = 68.38 %) were linked with a higher risk of insomnia symptoms. Most individual studies were of good quality (NOS) but provided very low certainty of evidence (GRADE). Consistent data reveals that following healthy diets is associated with decreased insomnia symptoms prevalence, while adherence to an unhealthy pattern is associated with an increased prevalence of insomnia symptoms.

The most common symptom and reason patients seek treatment for carpal tunnel syndrome is lack of sleep. Our purpose was to determine how much sleep-related symptoms of carpal tunnel syndrome improve after carpal tunnel release using validated patient-reported outcome measures (PROMs) and objective sleep data as primary measures of interest.

A PRISMA-guided literature search was conducted using Ovid MEDLINE, PubMed, Cochrane, and ClinicalTrials.gov. Only interventional clinical trials that examined primary outcome measures of interest were included. Patient-reported outcome measures underwent meta-analysis to determine how much scores improved following carpal tunnel release.

The Pittsburgh Sleep Quality Index improved significantly after carpal tunnel release, by 4.43 points and 6.02 points at 1-3 and 6-12 months postoperatively, respectively, and continued to improve up to 2 years. Improvement on the Insomnia Severity Index after carpal tunnel release was also significant, with improvement up to 1 year postoperatively, by 8.54 points and 9.05 points at 1-3 and 6-12 months, respectively. Insomnia Severity Index scores improved significantly after splinting as well.

The present meta-analysis determined to what extent patients can expect their sleep to improve after operative and non-operative intervention, as measured by various patient-reported outcome measures that assess sleep. The Pittsburgh Sleep Quality Index and Insomnia Severity Index correlated very well between studies and across hundreds of patients with carpal tunnel syndrome. Data are lacking to define the minimal clinically important difference and assess whether patients achieve a minimal clinically important difference for sleep questionnaires; more information on this topic is needed.

III.