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The current study focused on investigating the relationship between level and timing of physical activity and sleep quality and hygiene in healthy individuals. This cross-sectional study design recruited 175 participants (male: 98, 56%, female: 77, 44%, and BMI: 23.87 ± 3.92) aged between 18 and 65, 157 of whom were physically active and 18 of whom were physically inactive. The study recruited healthy participants from various sports facilities, fitness centers, and walking parks to ensure a diverse sample of physically active individuals in a metropolitan city. The study excluded people with sleep disorders, rheumatoid arthritis, heart or neurological problems, and those who had shift work. The study employed the Demographic Information Form, International Physical Activity Questionnaire (Short Form), Pittsburgh Sleep Quality Scale, and Sleep Hygiene Questionnaire. A one-way MANOVA was employed to compare sleep quality and hygiene in different physical activity levels. A second MANOVA compared sleep quality and hygiene in different physical activity timing, including only the minimally active and very active participants. One-way MANOVA showed a significant difference F (4, 171) = 7.532, Pillai's trace = 0.161, partial eta squared = 0.081 between sleep quality and hygiene scores among inactive, minimally active, and very active participants. A post hoc analysis showed sleep quality was significantly better in minimal active (6.42 ± 2.55, p = 0.002, Cohen's d = 0.867) and very active participants (5.99 ± 2.29, p < 0.001, Cohen's d = 1.092) than inactive (8.61 ± 2.50) participants. Also, sleep hygiene was significantly better in minimal active (28.50 ± 6.74, p = 0.001, Cohen's d = 0.867) and very active participants (29.52 ± 6.56, p < 0.001, Cohen's d = 0.992) than inactive (36.05 ± 8.39) participants. The one-way MANOVA revealed no statistically significant differences in sleep quality and hygiene scores based on physical activity time. Our study showed that physically active individuals had significantly better sleep quality and hygiene scores, while there was no difference based on the timing of physical activity. Healthy individuals may be encouraged to participate in physical activity in the morning, afternoon, or evening to improve sleep parameters. [ABSTRACT FROM AUTHOR]

Anxiety is being increasingly linked to circadian rhythms, including chronotype, in addition to its intricate links with sleep quality. Emotional competence is thought to be a strong predictor of wellbeing and mental health. This study aimed to examine whether a combination of chronotype, sleep quality, and intrapersonal emotional competence can predict anxiety in emerging adults (aged 18–29), who have the greatest prevalence of adult anxiety. One hundred and seventeen participants completed self-report measures of chronotype, sleep quality, emotional competence, and anxiety. A multiple linear regression, with anxiety as the criterion variable, showed that while all predictors were significant, sleep quality was the strongest predictor of anxiety. A later chronotype, poorer sleep quality and lower intrapersonal emotional competence were related to higher anxiety. Thus, integrating intrapersonal emotional competence and chronotype considerations into interventions may address the interplay between sleep quality and anxiety in emerging adults more effectively. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Due to the unclear etiology of recurrent aphthous stomatitis (RAS), a painful and distressing condition with a high prevalence, the researchers have hypothesized a connection between sleep quality and RAS.The cross‐sectional study enrolled 10,138 Fasa Cohort Study participants aged 35–70 years. Various sleep quality factors were calculated and categorized based on the Pittsburgh Sleep Questionnaire.Among 9030 subjects finally included with RAS prevalence of 20.2%, adjusted logistic regression showed significant odds ratios (ORs) in subjects who sleep < 5 h (OR = 1.44, 95%CI 1.25, 1.66), have sleep latencies of more than 60 min (OR = 1.37, 95%CI 1.11, 1.69), have sleep efficiencies of 65%–75% (OR = 1.55, 95%CI 1.21, 1.98), or regularly go to bed after 11 p.m. (OR = 1.23, 95%CI 1.11, 1.37). Subgroup analyses indicated no significant associations between RAS and various sleep factors in individuals who worked night shifts, and stronger associations were observed in men than women.The study found a significant positive association between RAS and sleep quality factors such as shorter duration, lower efficiency, longer latency, later bedtime, and regular sleeping pill use. Establishing early and sufficient sleep and addressing sleep onset disturbances by adhering to sleep hygiene principles should be prioritized in individuals with RAS. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine the relationship between sleep problems and executive functions in pre‐school children as reported by parents/caregivers. Methods: This cross‐sectional study of caregiver‐child dyads was conducted in a public kindergarten school in Northern Thailand. Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ), whereas executive functions were assessed using the Behavioural Rating Inventory of Executive Function – pre‐school version (BRIEF‐P). T‐scores greater than 65 of the BRIEF‐P were defined as deficits in executive functions. Multiple linear regressions were performed to assess the association between the executive function components and the total CSHQ scores. Results: Participants included 356 children, with a mean age of 5.04 (0.54) years. The total CSHQ scores of the executive dysfunction group were significantly higher than those of the group with executive functions below the cutoff (P < 0.001), which indicated more of sleep problems, including sleep‐onset delay, night waking and daytime sleepiness. However, the duration of night sleep, night awake, afternoon nap and total sleep time reported by parents did not differ between the two groups. Weak positive correlations between the total CSHQ and subscale scores and the Global Executive Composite score of the BRIEF‐P were noted. After adjusting for confounding variables, including child's age, gender, prematurity, maternal age and education, family income and media viewing time from the multiple linear regression analysis, the total CSHQ scores were significantly correlated with worse Global Executive Composite scores, which is the summary of five domains of executive functions (P < 0.001). Conclusions: This study highlights the association between sleep problems and deficits in executive functions in healthy pre‐school children. Health‐care providers are encouraged to consistently advocate for proper sleep hygiene and practices to enhance executive functions in pre‐schoolers. [ABSTRACT FROM AUTHOR]

Background: Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT‐I) reduced alcohol‐related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect. Specifically, we tested the change in negative emotionality as a mediator of the association between change in insomnia symptoms and alcohol‐related outcomes (craving, heavy drinking frequency, and alcohol‐related problems). Methods: Participants were 67 veterans in treatment for AUD who also met the criteria for insomnia disorder (91% male, 84% White, average age = 46.3 years). Participants were randomized to five sessions of CBT‐I or a single‐session sleep hygiene control. Assessments occurred at baseline, immediately posttreatment (~6 weeks after baseline), and at 6‐week follow‐up. Measures included the Insomnia Severity Index, Penn Alcohol Craving Scale, Timeline Followback, and Short Inventory of Problems. We created a latent negative emotionality indicator based on five validated and reliable measures of negative emotionality. Results: Contrary to hypotheses, CBT‐I did not improve negative emotionality relative to sleep hygiene control. However, across both treatment conditions, decreases in insomnia symptoms from baseline to posttreatment were associated with concurrent decreases in negative emotionality, which in turn predicted reductions in alcohol craving and heavy drinking. Conclusion: Negative emotionality may help explain links between insomnia symptoms and alcohol‐related outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To describe sudden unexpected infant deaths (SUIDs) occurring in safe sleep environments and explore differences in selected characteristics. METHODS: We examined SUID from 22 jurisdictions from 2011 to 2020 and classified them as unexplained, no unsafe sleep factors (U-NUSF). Data were derived from the Sudden Unexpected Infant Death and Sudden Death in the Young Case Registry, a population-based Centers for Disease Control and Prevention surveillance system built on the National Center for Fatality Review and Prevention's child death review program. SUID classified as U-NUSF included infants who were (1) awake, under supervision, and witnessed to become unresponsive or (2) found unresponsive in a safe sleep environment after sleep (unwitnessed). We calculated frequencies and percentages for demographics, birth and environmental characteristics, medical history, and death investigation findings. RESULTS: Most of the 117 U-NUSF SUID occurred before 4 months of age. Witnessed deaths most commonly occurred at <1 month of age (28%), whereas unwitnessed deaths most commonly occurred at ages 2 to 3 months (44%) Among all U-NUSF, 69% occurred in the infant's home (62% witnessed, 77% unwitnessed). All unwitnessed deaths occurred in a crib; most witnessed deaths occurred while being held (54%) or in a car seat traveling (18%). Most infants (84%) had no history of abuse or neglect. Abnormal autopsy findings were reported in 46% of deaths (49% witnessed, 42% unwitnessed). CONCLUSIONS: Characterizing these deaths is key to advancing our knowledge of SUID etiology. Our study revealed a heterogeneous group of infants, suggesting physiologic, genetic, or environmental etiologies. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to validate the Korean version of the sleep hygiene practice scale (SHPS-K) and determine its effectiveness in screening poor sleepers with insomnia. Methods: Online survey was conducted using translated SHPS in Korean, the Korean versions of the Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI-K), and Epworth Sleepiness Scale (KESS) in a non-clinical population. The internal consistency and test-retest reliability of the SHPS-K were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. Construct validity was evaluated using correlation analyses with other questionnaires and confirmatory factor analysis. We determined the cutoff values that could identify poor sleepers with insomnia symptoms (PSQI-K > 5 and ISI-K ≥ 15) using receiver operating characteristic analysis. Results: A total of 484 participants (242 women, mean age of 43.8 years) were enrolled. The average SHPS-K score was 71.2, with no significant sex differences. Women had poorer sleep scheduling and timing behaviors, and men had poorer eating and drinking behaviors. Good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.80) were observed. The SHPS-K was positively correlated with the PSQI-K (r = 0.55), ISI-K (r = 0.54), and KESS (r = 0.42). A cutoff value of 73 identified poor sleepers with insomnia (area under the curve = 0.828). Conclusions: The SHPS-K is a reliable instrument for evaluating sleep hygiene in non-clinical Korean populations. [ABSTRACT FROM AUTHOR]

Background: Delirium is a state of altered level of consciousness often leading to confusion, inattention, and changes to levels of cognition. Delirium increases average length of stay in the hospital and costs the US health care system approximately $148 billion each year in associated medical costs. Sleep hygiene is an important factor in delirium prevention for all hospitalized patients. Objectives: This quality improvement project was designed to increase implementation of an evidence-based sleep hygiene bundle in the neurocritical care population in order to decrease rates of hospital-acquired delirium. Methods: This project followed the Plan, Do, Study, Act (PDSA) framework to facilitate a continuous quality improvement intervention at amid-Atlantic academicmedical center in the neurocritical care population. The continuous quality improvement included the incorporation of "sleep" as a topic into the daily rounding checklist, thus optimizing the ability to improve adherence to a multicomponent sleep hygiene bundle. The intervention includes the preintervention-postintervention occurrences of delirium and use of the daily rounding checklist. Results: Nursing adherence to documentation of delirium assessments was high at approximately 99%. Following the intervention, there was a 41% decrease in the number of patients who screened positive for hospital-acquired delirium. Discussion: The improvement in cases of hospital-acquired delirium may be attributed to the project intervention. Recommendations for future interventions include analysis of training on sleep plans, focus on nursing education regarding delirium assessment tools, or a measure of staff and/or patient satisfaction related to the intervention. [ABSTRACT FROM AUTHOR]

AbstractObjective: This study investigates the effects of a sleep education program, “Sleep 101”, on sleep hygiene practices, sleep quality, and weekday and weekend sleep behaviors among college students. Participants: A total of 338 college students from a midsized public university in the US participated, with 25 completing both the baseline and post-intervention questionnaire. Methods: The Sleep Hygiene Index (SHI) and self-reported questions were used to assess sleep behaviors and subjective sleep quality. Results: Participants who completed the study experienced a significant increase in weekday sleep duration and were less likely to engage in activities unbeneficial for sleep before bedtime. Additionally, 40% of the completers reported improvements in their sleep quality. Conclusions: These findings suggest that a brief online program like “Sleep 101” can effectively improve sleep behaviors among college students and might be a scalable approach to addressing current sleep issues and preventing future sleep problems in this population. [ABSTRACT FROM AUTHOR]

Background: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. Methods: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. Results: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). Conclusion: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents. [ABSTRACT FROM AUTHOR]

Summary Several studies have demonstrated the relevance of cognitive factors in the development of insomnia complaints, but very few have investigated how these factors influence the development of insomnia complaints over time. In this study we set out to investigate key factors associated with present insomnia severity and the development of insomnia complaints over time. We employed a two‐wave longitudinal design where we measured insomnia severity, pre‐sleep arousal, dysfunctional beliefs about sleep, sleep‐related worry and safety‐behaviours in a sample of students at baseline and 1 year later. At baseline, 353 respondents filled in the questionnaires and 79 completed these a year later. In the cross‐sectional analyses, pre‐sleep arousal and sleep‐related worry were unique contributors to insomnia severity. Using baseline data to predict insomnia severity 1 year later, only sleep‐related safety emerged as a predictor. These findings suggest that sleep‐related worry and pre‐sleep arousal are the primary factors influencing current severity. In terms of development and/or persistence, sleep safety may constitute a potentially underestimated factor. [ABSTRACT FROM AUTHOR]

Background: Emotional eating is a prevalent maladaptive coping mechanism among college students, which is associated with mental health and sleep concerns. Though previous studies have established a link between sleep quality, depression and emotional eating, most of these have been in Western populations. In addition, few existing studies have taken physical activities into account, and the underlying mechanisms between these four variables remain to be further studied. Therefore, our study investigated the mediating role of depression and the moderating role of physical activity levels in the relationship between sleep quality and emotional eating among Chinese college students. Our study can help to understand the characteristics of this population and provide guidance on the intervention pathways for emotional eating. Methods: A convenience sampling method was employed to select eligible participants for investigation. The General Information Questionnaire, the Pittsburgh Sleep Quality Index Scale, the Patient Health Questionnaire, the Dutch Eating Behavior Scale, and the International Physical Activity Questionnaire were employed to measure the general condition, sleep quality, depression, emotional eating, and physical activity. A total of 813 college students (Mage = 19.14, SD = 1.12, range = 17 ~ 25 years old, 71.1% females) completed the survey. The moderated mediation analysis was carried out using the SPSS PROCESS macro. Results: After controlling for sex, age, and body mass index (BMI), sleep quality positively predicted emotional eating. Depression primarily mediated the association between them. Besides, physical activity levels moderated the relationship between sleep quality and emotional eating via depression. Depression significantly predicted emotional eating among students with low levels of physical activity; however, it was not significant among students with moderate or high levels of physical activity. Conclusions: The role of depression mediates the link between sleep quality and emotional eating. Regular exercise can ease the symptoms of emotional eating through depression. This implies the importance of offering more sleep hygiene education and physical activity in university settings. Plain English summary: College students often experience poor sleep quality and negative emotions due to different kinds of pressure, which can lead to emotional eating. But the mediating or moderating mechanism is not fully understood between them. Our research looked at how depression might explain this connection and whether physical activity can help. We surveyed 813 college students about their sleep quality, depression, emotional eating, and physical activity levels. The results showed that students with poor sleep were more likely to eat emotionally, which was totally mediated by depression. However, students who were physically active were less affected by this pattern. This means that regular exercise can weaken the impact of poor sleep and depression on emotional eating. Our findings suggest that encouraging good sleep habits and physical activity in colleges can help prevent emotional eating. [ABSTRACT FROM AUTHOR]

Background: The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x'common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators. Methods: Forty-four overweight/obese T2DM women with insomnia, aged 30–65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed. Discussion: The use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions. Trial registration: IRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772 [ABSTRACT FROM AUTHOR]

Introduction: Overuse musculoskeletal injuries (MSKI) remain a significant medical challenge in military personnel undergoing military training courses; further understanding of the biological process leading to overuse MSKI development and biological signatures for injury risk are warranted. The purpose of this study was to determine the association between overuse MSKI occurrence and physiological characteristics of allostatic load characterized as maladaptive biological responses to chronic stress measured by wearable devices in USMarine Corps officer candidates during a 10-wk training course. Methods: Devices recorded energy expenditure (EE), daytime heart rate (HR), sleeping HR, and sleep architecture (time and percentage of deep, light, rapid eye movement sleep, awake time, total sleep). Flux was calculated as the raw or absolute difference in the average value for that day or night and the day or night beforehand. Linear mixed-effect model analysis accounting for cardiorespiratory fitness assessed the association between overuse MSKI occurrence and device metrics (a = 0.05). Results: Sixty-nine participants (23 females) were included. Twenty-one participants (eight females) sustained overuse MSKI. Overuse MSKI occurrence in male participants was positively associated with daytime HR (ß = 5.316, P = 0.008), sleeping HR (ß = 2.708, P = 0.032), relative EE (ß = 8.968, P = 0.001), absolute flux in relative EE (ß = 2.994, P = 0.002), absolute EE (ß = 626.830, P = 0.001), and absolute flux in absolute EE (ß = 204.062, P = 0.004). Overuse MSKI occurrence in female participants was positively associated with relative EE (ß = 5.955, P = 0.026), deep sleep time (ß = 0.664, P < 0.001), and percent deep sleep (ß = 12.564, P < 0.001) and negatively associated with absolute flux in sleeping HR (ß = -0.660, P = 0.009). Conclusions: Overuse MSKI occurrences were associated with physiological characteristics of allostatic load, including chronically elevated HR and EE and greater time in restorative sleep stages, whichmay serve as biological signatures for overuse MSKI risk. [ABSTRACT FROM AUTHOR]

Background: Insomnia is common in patients with psychiatric disorders. However, patients' awareness of sleep has seldom been examined in detail. In this study, we investigated sleep awareness in outpatients at the psychiatry department of a university hospital. Methods: The participants (n = 241) were recruited at the psychiatry department of Ehime University Hospital between 11 October and 5 November 2021. The following questionnaires were used: Clinical Global Impression Scale of Severity (CGI-S), Global Assessment of Functioning (GAF), General Health Questionnaire (GHQ-30), Athens Insomnia Scale (AIS), and Epworth Sleepiness Scale (ESS). Psychiatric disorders were diagnosed by certified psychiatrists using the International Statistical Classification of Diseases and Related Health Problems 10. Participants with an AIS score of ≥6 were allocated to the insomnia group for statistical analysis. A logistic regression analysis was conducted to identify which items of sleep hygiene the patients with insomnia practiced using the Sleep Guidelines for Health Promotion. Results: Of 241 participants, 133 (55.2%) were allocated to the insomnia group. The mean scores for the CGI were significantly higher and the GAF scores were significantly lower in the insomnia group than in the healthy sleep group (p < 0.01). Of the 12 sleep guidelines proposed by the Japanese Government, "Do not go to bed until you are sleepful, do not delay getting up", was the item that maximally influenced insomnia. Conclusions: The insomnia group had worse scores on various medical assessment scales compared to the healthy sleep group. Based on a survey of outpatients at the psychiatry department of the university hospital, appropriate stimulus control techniques may help clinicians to treat outpatients with insomnia. [ABSTRACT FROM AUTHOR]

Background: Exogenous melatonin, a nutraceutical for maintaining a healthy sleep–wake cycle and managing sleep disorders, requires large, repeated doses due to its low bioavailability and short half-life. This necessitates the development of a sustained-release formulation with a longer half-life and sustained plasma concentration. Therefore, exogenous novel 5 mg sustained-release melatonin capsules (Melatonin-SR, test product) were formulated. Methods: This open-label cross-over study compared the pharmacokinetics (maximum concentration [Cmax], time to reach Cmax [Tmax], area under the curve [AUC], and elimination half-life [t1/2]) and the safety of Melatonin-SR with 5 mg immediate-release melatonin capsules (Melatonin-IR, reference product) after single-dose oral administration in healthy fasting adults. Results: Sixteen participants (aged 18–45 years) were randomized (1:1) to receive either Melatonin-SR or Melatonin-IR in two periods with a 7-day washout period. Melatonin-SR reported a lower Cmax (11,446.87 pg/mL) compared to Melatonin-IR (22,786.30 pg/mL). The mean Tmax of Melatonin-SR and Melatonin-IR was 1.26 h and 0.87 h, respectively. The mean t1/2 of Melatonin-SR (5.10 h) was prolonged by five-fold compared to Melatonin-IR (1.01 h). One adverse event (vomiting) was reported following the administration of the Melatonin-IR. Conclusions: Melatonin-SR resulted in higher and sustained plasma melatonin concentrations for an extended period and was well-tolerated. Hence, Melatonin-SR may be a promising nutraceutical for maintaining healthy sleep. [ABSTRACT FROM AUTHOR]

Summary: This review examines the temporal association between nocturnal gastro‐oesophageal reflux and sleep‐arousal cycles. Most nocturnal gastro‐oesophageal reflux events occur during the awake cycle, and arousals precede most nocturnal gastro‐oesophageal reflux events, indicating that arousal from sleep predisposes to nocturnal gastro‐oesophageal reflux. This sheds light on the complex relationship between nocturnal gastro‐oesophageal reflux and sleep, and has implications for managing nocturnal gastro‐oesophageal reflux symptoms. The appearance of symptoms and the pathophysiology of nocturnal gastro‐oesophageal reflux are influenced by sleep hygiene, sleep disturbances and the misalignment of circadian rhythms. Nocturnal gastro‐oesophageal reflux and its related sleep disorders are prevalent and negatively impact the quality of life. There is conflicting evidence on whether nocturnal gastro‐oesophageal reflux and sleep disturbances are causally linked, and whether sleep disturbances drive nocturnal gastro‐oesophageal reflux. Poor sleep quality increases oesophageal hypersensitivity and overall acid exposure. The nocturnal gastro‐oesophageal reflux is linked to the more severe forms of gastro‐oesophageal reflux disease, especially with atypical/extra‐oesophageal manifestations and complications of mucosal damage such as oesophagitis and stricture, Barret's oesophagus, and oesophageal adenocarcinoma. This review highlights the role of sleep problems in presenting nocturnal gastro‐oesophageal reflux, and the potential benefits of treating sleep disturbances in enhancing patient care and quality of life. [ABSTRACT FROM AUTHOR]

Summary: Insomnia and pain disorders are among the most common conditions affecting United States adults and veterans, and their comorbidity can cause detrimental effects to quality of life among other factors. Cognitive behavioural therapy for insomnia and related behavioural therapies are recommended treatments for insomnia, but chronic pain may hinder treatment benefit. Prior research has not addressed how pain impacts the effects of behavioural insomnia treatment in United States women veterans. Using data from a comparative effectiveness clinical trial of two insomnia behavioural treatments (both including sleep restriction, stimulus control, and sleep hygiene education), we examined the impact of pain severity and pain interference on sleep improvements from baseline to post‐treatment and 3‐month follow‐up. We found no significant moderation effects of pain severity or interference in the relationship between treatment phase and sleep outcomes. Findings highlight opportunities for using behavioural sleep interventions in patients, particularly women veterans, with comorbid pain and insomnia, and highlight areas for future research. [ABSTRACT FROM AUTHOR]

The article "A call for transdiagnostic attention to insomnia and its treatment in mental healthcare" published in the Journal of Sleep Research highlights the prevalence of insomnia across various psychiatric disorders, emphasizing its impact on emotional distress and the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in treating conditions like major depressive disorder and PTSD. The study, conducted with participants recruited through the Netherlands Sleep Registry, reveals high rates of co-occurring insomnia in individuals with mental health issues, underscoring the need for a transdiagnostic approach to addressing insomnia in mental healthcare. Network analysis suggests direct links between insomnia severity and symptoms of MDD, GAD, and BPD, while indirect associations are observed with SAD, PD, and PTSD. The findings stress the importance of systematically addressing insomnia in patients with affective and emotion regulation disorders, advocating for the inclusion of CBT-I as a potential dual treatment strategy for psychiatric conditions. [Extracted from the article]

The article "Rxercise: Maintaining Exercise Throughout Residency" explores the difficulties faced by medical residents, such as stress, lack of sleep, and long work hours, which can negatively impact their well-being and lead to burnout. The authors propose the concept of "Rxercise," which presents exercise as a solution to these challenges. Research suggests that exercise can reduce burnout rates, improve quality of life, and enhance patient counseling on exercise benefits. The article provides a framework for promoting exercise in residency, including personalized and program-based interventions, while emphasizing the importance of consulting healthcare professionals and practicing safe exercise. It acknowledges the obstacles to incorporating exercise into residency training but emphasizes the need for individual and institutional efforts to encourage exercise among residents. The article also calls for further research on effective strategies for implementing exercise into residents' routines. [Extracted from the article]

Aims: To consolidate adolescents' perspectives regarding various aspects of sleep and offer insights to promote healthier sleep habits during their critical developmental years. Methods/Data Sources: Six electronic databases (PubMed, CINAHL, Embase, Scopus, PsycINFO and Web of Science) were searched from their inception dates to June 2023. Data were extracted and meta‐summarised using Sandelowski and Barroso's approach and synthesised using Thomas and Harden's thematic analysis framework. Results: Meta‐synthesis from 11 peer‐reviewed published studies identified four main themes: (1) Awareness and understanding of sleep's significance, (2) The shadows and radiance of slumber, (3) Traversing the sleepscape: trouble bubbles and (4) Illuminating the path: Guiding lights to enhanced sleep. Conclusion/Implications: Our review findings suggest a lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Identified barriers to adequate sleep encompass various factors, including overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. Strategies to improve adolescents' sleep health involve multiple sleep strategies, including sleep education, workshops/seminars, parental involvement, incorporating digital well‐being practices, the promotion of relaxation techniques and the provision of essential resources. Prioritising sleep health and implementing targeted interventions are key steps to empower adolescents, create supportive environments and shape a healthier future generation. Future research endeavours should focus on evaluating the effectiveness of interventions and exploring the influence of cultural factors. Impact: There exists a notable lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents.Barriers to achieving adequate sleep among adolescents include overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities.The collaboration between healthcare institutions, professionals and educational institutions is crucial to facilitate (1) the implementation of sleep education workshops/seminars targeting adolescents, (2) increased parental involvement and role‐modelling to instil good sleep practices among adolescents and (3) enhanced integration of digital well‐being practices, the promotion of relaxation techniques and accessibility to essential sleep hygiene resources. Reporting Method: Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Patient or Public Contribution: No patient or public contribution. Trial and Protocol Registration: This review was registered on the Prospective Register of Systematic Reviews (CRD42023403775). [ABSTRACT FROM AUTHOR]

Sleep is a vital but overlooked and undervalued part of our overall health and well-being. Striving to optimize productivity and meet numerous daily demands often means that sleep is not prioritized. As sleep stewardship's importance gains wider recognition, clinical and ethical management of sleep resources and practices will likely be key features of health professionalism. This article considers how sleep stewardship should be advanced as a clinical, ethical, and cultural priority. [ABSTRACT FROM AUTHOR]

Primary care clinicians are well-equipped to screen for sleep concerns, help some patients, and refer patients whose sleep troubles are more complex to specialists. Poor sleep affects nearly every organ system and influences many morbidity and mortality causes, so screening for sleep sufficiency and quality should be prioritized in primary care settings. This commentary on a case suggests strategies for more fully supporting primary care clinicians' compensation and capacity for conducting effective conversations with patients experiencing sleep trouble. [ABSTRACT FROM AUTHOR]

Background: Sleep hygiene behaviours are a suggested set of behaviours people can engage in to improve sleep. However, there are numerous issues relating to the measurement of sleep hygiene, primarily, the lack of consensus as to which behaviours impact sleep and should therefore be included in scales. Method: Cross-sectional correlational methods were used to assess the association between sleep quality, a highly inclusive range of sleep hygiene behaviours, and individual perceptions of those behaviours in a non-clinical sample of 300 participants. Results: Of the 35 sleep hygiene behaviours assessed, 18 were independently associated with sleep quality. Post-hoc factor analysis revealed that behaviours clustered together across four factors. A 'routine' factor included behaviours such as going to bed and waking up at the same time each night, and were important predictors of sleep quality, as were behaviours belonging to the 'perseverative cognition' and 'negative emotionality' factor. Other behaviours related to physiological processes like exposure to sunlight during the day and going to bed hungry were also significantly associated with sleep. Negative perceptions moderated the relationship between daytime exposure to sunlight and sleep. Conclusions: Although certain behaviours were significantly related to sleep, almost half were not, supporting the need to examine the association between sleep and behaviours used for sleep hygiene recommendations more critically. Reframing sleep hygiene recommendations into a condensed set of shared underlying mechanisms may be of benefit for the development of sleep hygiene scales and interventions in non-clinical populations. [ABSTRACT FROM AUTHOR]

Objective: Sleep disorders are widespread and constitute a major public health risk. The present study thus aims to investigate the effect of a facial cosmetic self‐massage daily routine on women's sleep and well‐being. Methods: The present pilot study was conducted on 62 middle‐aged women declaring daily tiredness and sleep troubles. We examined the effect of a regular facial cosmetic self‐massage routine on sleep patterns, daytime sleepiness, and well‐being over the course of 2 months. Results: After 1 and 2 months, our results show improved sleep quality (Pittsburgh Sleep Quality Index, PSQI – −20.2% after 2 months), reduced daytime sleepiness (Epworth Sleepiness Scale, ESS, −31.2% after 2 months), and increased well‐being measures. The number of participants with abnormal sleep (PSQI >5) decreased over the course of the experiment as well, from 71.9% to 49.2% at the end of the 2 months [odds ratio 95% CI for decrease: 0.38 (0.18–0.81)]. Similarly, the number of participants with excessive daytime sleepiness (>10 on the ESS) decreased over the course of the study from 44.3% to 21% after 1 month [95% CI: 0.33 (0.15–0.73)] and to 16.1% after 2 months [95% CI: 0.24 (0.10–0.56)]. Conclusions: These results suggest that a facial cosmetic self‐massage routine may improve sleep patterns and is likely to be a useful addition to a standard sleep hygiene routine. [ABSTRACT FROM AUTHOR]

Background Sleep–wake disturbances are common and disabling in primary brain tumor (PBT) patients but studies exploring longitudinal data are limited. This study investigates the feasibility and relationship between longitudinal patient-reported outcomes (PROs) and physiologic data collected via smart wearables. Methods Fifty-four PBT patients ≥ 18 years wore Fitbit smart-wearable devices for 4 weeks, which captured physiologic sleep measures (eg, total sleep time, wake after sleep onset [WASO]). They completed PROs (sleep hygiene index, PROMIS sleep-related impairment [SRI] and Sleep Disturbance [SD], Morningness-Eveningness Questionnaire [MEQ]) at baseline and 4 weeks. Smart wearable use feasibility (enrollment/attrition, data missingness), clinical characteristics, test consistency, PROs severity, and relationships between PROs and physiologic sleep measures were assessed. Results The majority (72%) wore their Fitbit for the entire study duration with 89% missing < 3 days, no participant withdrawals, and 100% PRO completion. PROMIS SRI/SD and MEQ were all consistent/reliable (Cronbach's alpha 0.74–0.92). Chronotype breakdown showed 39% morning, 56% intermediate, and only 6% evening types. Moderate-severe SD and SRI were reported in 13% and 17% at baseline, and with significant improvement in SD at 4 weeks (P  = .014). Fitbit-recorded measures showed a correlation at week 4 between WASO and SD (r  = 0.35, P  = .009) but not with SRI (r  = 0.24, P  = .08). Conclusions Collecting sleep data with Fitbits is feasible, PROs are consistent/reliable, > 10% of participants had SD and SRI that improved with smart wearable use, and SD was associated with WASO. The skewed chronotype distribution, risk and impact of sleep fragmentation mechanisms warrant further investigation. Trial Registration NCT04 669 574 [ABSTRACT FROM AUTHOR]

There is growing enthusiasm towards the role of smartphone app-based interventions in the management of insomnia and related sleep problems. A considerable number of apps designed to address insomnia have been developed in recent years, and randomized controlled trials (RCTs) have begun to explore their efficacy. We conducted a meta-analysis investigating the effectiveness of apps for insomnia and sleep disturbances. From 19 RCTs, we identified significant pooled effect sizes for the primary outcomes of self-reported insomnia (g = 0.60; 05 % CI = 0.44, 0.76; NNT = 4.8) and sleep disturbances (g = 0.70; 95 % CI = 0.58, 0.83; NNT = 4.1) in favour of apps over control conditions. These effects remained robust when restricting the analyses to trials that delivered a placebo control, received a lower risk of bias rating, and had a larger sample size. Significant pooled effects in favour of apps were also observed for secondary outcomes of night time awakenings (g = 0.56), total sleep time (g = 0.33), and sleep onset latency (g = 0.32), but non-significant effects emerged for daytime sleepiness, dysfunctional beliefs about sleep, sleep efficiency, sleep hygiene, and wake after sleep onset. The pooled dropout rate from app conditions was 13.1 % (95 % CI = 8.3, 20.0), which was significantly higher than control conditions (OR = 1.78, 95 % CI = 1.39, 2.28). Findings suggest that stand-alone app-based interventions can effectively address insomnia and sleep disturbances, and may play an important role in the management of these symptoms. • Conducted a meta-analysis of 19 randomized trials of app-based interventions for insomnia. • Apps produced medium-large effects over controls on insomnia and sleep disturbances. • Apps may play an important role in the management of sleep disturbances. [ABSTRACT FROM AUTHOR]

Summary A randomised, placebo‐controlled, parallel‐group study was conducted to examine the effect of periocular skin warming before bedtime on sleep and anxiety in female workers with mild sleep difficulty. A total of 64 participants were included in the study, which consisted of a 1‐week baseline period and a 4‐week intervention period. They were randomly assigned to either the Warm group (N = 32) or the Sham group (N = 32) and were instructed to wear eye masks (warming or sham) before their habitual bedtime during the intervention period. The study found that the Athens Insomnia Scale score after the intervention was significantly lower in the Warm group compared to the Sham group. Additionally, participants in the warm condition showed a decrease in subjective sleep onset latency, better restorative sleep, and improved subjective anxiety before bedtime. A significant reduction in wake after sleep onset was observed in the Warm group at 4 weeks, and this decrease was significantly associated with the degree of improvement in subjective anxiety before bedtime. Furthermore, regular periocular skin warming before bedtime decreased sleep reactivity and improved well‐being. In conclusion, the study suggests that periocular skin warming may be an effective approach for female workers with sleep problems, as it can easily be incorporated into daily life. [ABSTRACT FROM AUTHOR]

Summary Utilizing a randomized control design, 42 healthy adults (22.5 ± 2.8 years) participated in alternate‐day modified fasting over a 12‐day treatment period. Assessments of sleep included sleep time, efficiency, latency and wake after sleep onset, and assessments of physical activity included steps, energy expenditure, sedentary time, time spent in light physical activity and time spent in moderate‐to‐vigorous activity. Additional measurements included body composition and mood. The alternate‐day modified fasting group consumed 25.8% ± 0.3% fewer calories compared with the control group (p = 0.03). There were no differences between groups for change in body mass index (p = 0.87), total fat mass (p = 0.91) or total lean mass (p = 0.88). Daily energy expenditure did not differ between groups (p = 0.11). On fast days, participants spent 34.5 ± 12.7 more minutes sedentary (p = 0.01), took 1100 ± 362 fewer steps (p < 0.01), and engaged in 27.2 ± 8.4 fewer minutes of moderate‐to‐vigorous physical activity (p = 0.00) compared with non‐fasting days. Sleep duration, efficiency, latency or wake after sleep onset were not different between conditions (p = 0.92, p = 0.10, p = 0.09 and p = 0.66, respectively). We conclude that alternate‐day modified fasting does not alter sleep time, efficiency, latency or wake after sleep onset in people reporting poor sleep quality, and does not alter overall physical activity. Although average daily physical activity is not altered, fasting in this manner does tend to result in more sedentary time and less physical activity with compensation on non‐fasting days. [ABSTRACT FROM AUTHOR]

Background: Due to work commitments, shiftworkers often obtain inadequate sleep, consequently experiencing negative health, wellbeing, and safety outcomes. Given shiftworkers may have limited control over their work commitments, lifestyle and environmental factors within their control may present an intervention opportunity. However, such interventions require tailoring to ensure applicability for this sleep-vulnerable population. Methods: A randomised waitlist control pilot trial investigated the effectiveness of mobile health application Sleepfit, which delivered a tailored sleep health intervention aimed at improving sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. Outcome measures of self-reported sleep health (sleep need, duration, and quality, fatigue, Insomnia Severity Index, Fatigue Severity Scale, and Epworth Sleepiness Scale scores) and sleep hygiene (Sleep Hygiene Index score) were collected at baseline, post-intervention, and 3-month follow-up. Results: Fifty-eight paramedics (aged 33.4 ± 8.0 years; 50% male) were recruited, and trialed Sleepfit for a 14-day intervention period between August 2021–January 2022. For all participants, there was a significant reduction in Insomnia Severity Index and Sleep Hygiene index scores after intervention engagement. Regression models demonstrated no significant intervention effect on sleep health or sleep hygiene outcomes (intervention versus waitlist control group). A high study drop-out rate (91.4%) prevented assessment of outcomes at 3-month follow-up. Conclusions: Pilot trial findings demonstrate that Sleepfit may elicit improvements in sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. However, low enrolment and retention means that findings should be interpreted with caution, further highlighting potential engagement challenges, especially among paramedics who are particularly in need of support for improved sleep. Trial registration: Prospectively registered with the Australian New Zealand Clinical Trial Registry 24/01/2020 (reference no. ACTRN12620000059965). [ABSTRACT FROM AUTHOR]

Introduction Rotating shiftwork schedules are known to disrupt sleep in a manner that can negatively impact safety. Consumer sleep technologies (CSTs) may be a useful tool for sleep tracking, but the standard feedback provided by CSTs may not be salient to shift-working populations. SleepTank is an app that uses the total sleep time data scored by a CST to compute a percentage that equates hours of sleep to the fuel in a car and warns the user to sleep when the "tank" is low. Royal Australian Navy aircraft maintenance workers operating on a novel rotational shift schedule were given Fitbit Versa 2s to assess sleep timing, duration, and efficiency across a 10-week period. Half of the participants had access to just the Fitbit app while the other half had access to Fitbit and the SleepTank app. The goal of this study was to evaluate differences in sleep behavior between shifts using an off-the-shelf CST and to investigate the potential of the SleepTank app to increase sleep duration during the 10-week rotational shift work schedule. Materials and Methods Royal Australian Navy volunteers agreed to wear a Fitbit Versa 2 with the SleepTank app (SleepTank condition), or without the SleepTank app (Controls), for up to 10 weeks from May to July 2023 during the trial of a novel shift rotation schedule. Participants from across 6 units worked a combination of early (6:00 AM to 2:00 PM), day (7:30 AM to 4:30 PM), late (4:00 PM to 12:00 AM), and night shifts (12:00 AM to 6:00 AM) or stable day shifts (6:00 AM to 4:00 PM). Differences in sleep behavior (time in bed, total sleep time, bedtime, wake time, sleep efficiency [SE]) between conditions and shift types were tested using Analysis of Variance. This study was approved by the Australian Departments of Defence and Veterans' Affairs Human Research Ethics Committee. Results Thirty-four participants completed the full study (n  = 17 Controls; n  = 17 SleepTank). There was a significant effect of shift type on 24-hour time in bed (TIB24; F(4,9) = 8.15, P  < .001, η2 = 0.15) and total sleep time (TST24; F(4,9) = 8.54, P  < .001, η2 = 0.18); both were shorter in early shifts and night shifts compared to other shift types. TIB24 and TST24 were not significantly different between conditions, but there was a trend for greater SE in the SleepTank condition relative to Controls (F(1,9) = 2.99, P  = .08, η2 = 0.11). Conclusions Sleep data collected by Fitbit Versa 2s indicated shorter sleep duration (TIB24, TST24) for Royal Australian Navy workers during early and late shifts relative to stable day shifts. Access to the SleepTank app did not greatly influence measures of sleep duration but may be protective against fatigue by affecting SE. Further research is needed to evaluate the utility of the SleepTank app as a means of improving sleep hygiene in real-world, shift-working environments. [ABSTRACT FROM AUTHOR]

Dentistry can be considered a challenging field, with dental students often experiencing high levels of stress and poor mental health. Hence, maintaining mental well-being is important so that dental students can cope with their stressors effectively. Lifestyle factors like physical activity, sleep problems, and addictions impact the levels of mental well-being. This article aimed to identify the association between dental students' lifestyle factors and mental well-being. This cross-sectional descriptive study was conducted among all the undergraduate dental students at a university in Malaysia. Data were collected by using a self-administered questionnaire [which included questions on demographic background, lifestyle factors, and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS)] and analysed using SPSS (version 26.0). Out of the surveyed students, 83.2% responded. The mean WEMWBS score for this study population was 46.09 ± 7.93. The results showed that engagement in physical activity positively affected mental well-being scores, while the presence of sleep-related problems was associated with lower mental well-being scores. Encouraging the adoption of healthier lifestyle factors, such as regular physical activity and practising good sleep hygiene along with the intervention of sleep-related problems, could improve mental well-being levels among dental students significantly. [ABSTRACT FROM AUTHOR]

The article from the Australian Diabetes Educator discusses how short sleep duration is linked to an increased risk of developing type 2 diabetes and glucose dysregulation. Researchers analyzed data from the UK Biobank and found that healthy eating alone may not be enough to counteract the negative effects of chronic sleep loss on diabetes risk. Strategies to mitigate this risk include engaging in physical activity, improving dietary intake, and addressing coexisting conditions like obstructive sleep apnea. The study highlights the importance of sleep hygiene and adequate sleep duration in promoting metabolic well-being and reducing the risk of type 2 diabetes. [Extracted from the article]

Objective: Sleep disturbance is common among individuals with eating disorders (EDs), with approximately 50% of patients with EDs reporting sleep disturbance. Sleep problems may promote, exacerbate, or maintain ED symptoms through a variety of hypothesized mechanisms, such as impaired executive function, increased negative affect, and disruptions to appetitive rhythms. Although research investigating the role of sleep in EDs is growing, the current literature suffers from methodological limitations and inconsistencies, which reduce our ability to translate findings to improve clinical practice. The purpose of this forum is to propose a coordinated approach to more seamlessly integrate sleep research into ED research with particular emphasis on best practices in the definition and assessment of sleep characteristics. Methods: In this article, we will describe the current status of sleep‐related research and relevant gaps within ED research practices, define key sleep characteristics, and review common assessment strategies for these sleep characteristics. Throughout the forum, we also discuss study design considerations and recommendations for future research aiming to integrate sleep research into ED research. Results/Discussion: Given the potential role of sleep in ED maintenance and treatment, it is important to build upon preliminary findings using a rigorous and systematic approach. Moving forward as a field necessitates a common lens through which future research on sleep and EDs may be conducted, communicated, and evaluated. [ABSTRACT FROM AUTHOR]

Sleep disorders increase with age and are known risk factors for several mental and physical diseases. They also significantly contribute to a lower quality of life. Nonpharmaceutical approaches, such as cognitive behavioral therapy for insomnia, sleep hygiene advice, relaxation exercises, and physical activity programs, can be delivered directly to patients via mHealth technologies, thereby increasing the accessibility of such interventions and reducing health care-related costs. This scoping review aims to evaluate the effectiveness of mHealth interventions for improving sleep quality among older adults. Published studies in the last 10 years (2013–2023) were identified by searching electronic medical databases (PubMed, PsycINFO, CINAHL, and Scopus) in July 2023 and were independently reviewed by two different authors. The analysis of the data was performed in 2023. The research retrieved 693 records; after duplicates were removed, 524 articles were screened based on their title and abstract, and 28 of them were assessed in full text. A total of 23 studies were excluded because they did not meet the inclusion criteria in terms of population age (60 years or over) or type of intervention (mHealth-based) or because they addressed secondary insomnia. A total of five studies were included in this review, and all of them reported improvements in subjective sleep quality after the application of the mHealth interventions. Two studies also conducted objective assessments of sleep outcomes using actigraphy, reporting improvements only in some of the variables considered. Despite the limited number of available studies, these results are promising and encourage further research. [ABSTRACT FROM AUTHOR]

College students often experience sleep–wake alterations. Different factors can contribute to insomnia symptoms in this population. The present study aims at investigating pre-sleep behaviours and strategies used to aid sleep onset in young college students and their association with insomnia symptoms. A total of 548 Italian college students (mean age = 23.48 years, range = 19–30 years, 80.5% female) completed a web-based survey on pre-sleep behaviours and sleep-onset facilitators, insomnia symptoms and sleep hygiene, anxiety and depression, and coping strategies. The use of electronic devices at bedtime and as a sleep-onset facilitator was predominant. Students using specific behaviours as sleep-onset facilitators were characterised by more psychological difficulties and poorer sleep. In multivariable linear regression analysis, the frequency of using medications and melatonin, regardless of motivations, was associated with higher insomnia symptoms. The use of specific sleep-onset facilitators positively correlated with the severity of insomnia symptoms. Many students engage in behaviours that are considered sleep-interfering and that are often employed in an attempt to facilitate sleep onset without benefits. Overall, the motivational factors behind pre-sleep behaviours need to be addressed in preventive programs targeting young college students. [ABSTRACT FROM AUTHOR]

Purpose: Previous research has established that food intake is a biological regulator of the human sleep–wake cycle. As such, the timing of eating relative to sleep may influence the quality of sleep, including daytime naps. Here, we examine whether the timing of lunch (1 h vs. 2 h interval between lunch and a napping opportunity) impacts the quality of an afternoon nap. Methods: Using a randomized within-subject design over two separate experimental sessions (7 days apart), participants (n = 40, mean age = 25.8 years) consumed lunch 1 h and 2 h prior to an afternoon nap opportunity. Polysomnography and subjective self-reports were used to assess sleep architecture, sleepiness levels, and nap quality. Results: Results revealed no significant differences in subjective ratings of sleep quality and sleepiness, or in sleep architecture (total sleep time, sleep efficiency, sleep onset latency, sleep stages) between the 1 h and 2-h lunch conditions. Conclusions: All sleep measures were similar when napping followed eating by either 1 h or 2 h, suggesting that eating closer to nap onset may not negatively impact sleep architecture and quality. Future research should continue to identify conditions that improve nap quality, given the well-documented benefits of naps to reduce sleep pressure and improve human performance. [ABSTRACT FROM AUTHOR]

Being overweight or obese can have severe negative psychological impacts and reduce health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight or obesity, it is important to design and implement effective interventions. The aim of this study was to evaluate the effects of a 6-month family-based lifestyle intervention on HRQoL and sleep habits in Norwegian children with overweight or obesity in a primary-care setting. This 6-month, non-randomised, cluster-controlled trial included Norwegian children aged 5–13 years with overweight or obesity and their parents. A questionnaire was filled out by the parents. A total of 33 and 52 children in the control group and 41 and 78 children in the intervention group answered the HRQoL and sleep habits questions, respectively, and were included. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. The Children's Sleep Habits Questionnaire (CSHQ) and Kidscreen-10 index were used to assess sleep habits and HRQoL. At baseline, the mean average scores for HRQoL were 50.0 [standard deviation (SD) 8.1] for the intervention group and 49.0 (SD 10.1) for the control group. For sleep habits at baseline, the mean average scores were 45.2 (SD 11.8) for the intervention group and 46.0 (SD 11.9) for the control group. No significant changes in HRQoL and sleep habits after the intervention were revealed. Overall, the family-based lifestyle intervention targeting overweight and obese children in a primary-care setting showed no significant effect on HRQoL or sleep quality. [ABSTRACT FROM AUTHOR]

The article focuses on a case study of a 15-year-old girl exhibiting chronic throat-squeezing behavior as a form of nonsuicidal self-injury (NSSI) following trauma. Topics include the prevalence and implications of NSSI among adolescents, the psychological impact of negative childhood experiences on such behaviors, and the effectiveness of sertraline treatment in reducing both depressive symptoms and the frequency of throat-squeezing behavior.

Combat sports is a term applied to various competitive contact sports involving 2 competitors engaging in a bout or contest under a specific ruleset. Little is known about combat sports athletes' sleep and nutritional knowledge. This study aimed to assess (a) sleep behaviors, (b) alcohol and shiftwork disorders, and (c) the nutritional knowledge of combat sports athletes. Subjects completed various demographic questions and estimations of their weight management practices and validated surveys, including the Athlete Sleep Behavior Questionnaire, Shiftwork Disorder (SWD) Screening Questionnaire, Alcohol Use Disorders Identification Test, and the Abridged Nutrition for Sports Knowledge Questionnaire. A total of 844 combat sports athletes completed the survey, 79% male, height of 177 ± 10 (cm), and body mass of 79 ± 15 (kg). Subjects were categorized into their specific combat sport type (e.g., boxing or Brazilian jiu-jitsu [BJJ]) and by their level (professional or amateur). Sleep quality was average for all combat sport types and risk prevalence of shiftwork disorder at 11%. Mann-Whitney U tests revealed that amateurs, compared with professional strikers (p = 0.046, CLES = 0.80), boxers (p = 0.01, CLES = 0.78), and BJJ (p = 0.046, CLES = 0.61) athletes, consumed significantly more alcohol. A Friedman test showed significant (p < 0.001, W = 0.51) differences in weight between time points, with most combat sports athletes reducing weight for competition. An overall nutritional knowledge average of 55% was reported. This study highlights a critical gap in the knowledge and practices of combat sports athletes in relation to sleep behaviors and disorders, alcohol consumption, and nutritional knowledge, emphasizing the need for targeted educational interventions. [ABSTRACT FROM AUTHOR]

Racial and ethnic minority adolescents living in urban settings experience sleep disparities. Few interventions have been developed to address these disparities. Guided by principles of participatory design and inclusion, our team developed a novel intervention that combined sleep hygiene education with mind-body integrative health (MBIH) practices to improve sleep quality among adolescents in New York City. The goal of this article is to describe our iterative development and design process, the final product, and future directions. Our participatory approach incorporated information from formative work with adolescents having lived experience, practitioners, and syntheses of published literature. The final intervention—Sleeping Healthy, Living Healthy—consists of six, 40-minute group sessions and one 20-minute individual session designed for high school students. Each session has a set of learning objectives, combining instruction, group activities, and discussions on sleep hygiene and MBIH topics. Our manualized intervention includes handouts created by a graphic design team that served as a review and reminder for home practice. We describe intervention implementation to two unique cohorts and detail our methods used to fine-tune the intervention between cohorts. Our partnership with and insights from both adolescents and practitioners serve as a guide for researchers aiming to use participatory methods to develop interventions to decrease health disparities in specific populations. [ABSTRACT FROM AUTHOR]

Shorter sleep duration can negatively impact children's daytime functioning and health. Latino children living near urban areas in the Mainland U.S. and Island Puerto Rico (PR) can be exposed to urban poverty and sociocultural stressors that challenge optimal sleep outcomes. Interventions to improve urban Latino children's sleep health should consider families' cultural background and environmental context to enhance acceptability and feasibility. This work describes our stepwise, multimethod approach to adapting a culturally and contextually tailored "School Intervention to Enhance Latino Students' Time Asleep (SIESTA)" for sixth- to eighth-grade Latino children residing in Greater Providence and San Juan and findings from a pilot randomized control trial (RCT) demonstrating SIESTA's efficacy. Results indicated high acceptability and greater improvement of sleep duration and behaviors in SIESTA versus control participants. The SIESTA shows potential to improve sleep outcomes in urban Latino middle schoolers. Results will inform a large-scale RCT to evaluate SIESTA's effectiveness and barriers to implementation. [ABSTRACT FROM AUTHOR]

Sleep is essential for the cognitive, emotional, and physical development of children. Common sleep problems occur in 20–30% of children and are often resolved by improved sleep hygiene. Sleep disorders are more severe conditions, e.g., insomnia, obstructive sleep apnea, and circadian rhythm disturbances. If left untreated, these can have significant long-term consequences, including impaired cognitive function, increased risk of psychiatric conditions like anxiety and depression, and higher risk of obesity and cardiovascular diseases. To prevent these complications, timely recognition and management is essential. In this paper, we address the medical perspectives of common sleep disturbances in children, focusing on their diagnosis and treatment. Sleep hygiene education, behavioral interventions, and ambient adaptations are first-line interventions for managing all sleep disturbances in children. In cases where behavioral approaches are insufficient, other (non-)pharmacological options are discussed, with a focus on their efficacy and safety in children. Conclusions: Finally, potential long-term consequences and directions for future research are discussed that may improve sleep-related health and well-being. [ABSTRACT FROM AUTHOR]

Summary: Despite emerging public concern regarding the sleep health of military personnel over the past two decades, there remains a dearth of research examining sleep health among naval personnel assigned to sea duty. This study examined sleep metrics (e.g. fatigue, short sleep duration) and mental (e.g. posttraumatic stress disorder, depression) and physical health (e.g. type 2 diabetes, bodily pain) outcomes among naval personnel with recent sea duty (i.e. afloat) compared with naval personnel with recent shore duty (i.e. ashore). Prevalence ratios and mean differences for all outcomes were estimated and adjusted for demographic and military variables, and subsequently stratified by obesity. Sleep metrics were similar between afloat and ashore sailors except for short sleep duration, while sailors with recent shore duty had poorer physical health compared with those with recent sea duty. Stratified analyses suggested naval personnel with obesity had a higher proportion of nearly all adverse sleep‐related health outcomes than those without obesity. Among participants without obesity, afloat personnel were more likely to report very short sleep (≤ 5 hours) and fewer hours of average nightly sleep, but were less likely to report physical health outcomes compared with ashore personnel. These findings suggest potential differences in sleep metrics and sleep‐related health outcomes between afloat and ashore naval personnel. Additional research examining sleep outcomes using more objective measures is required to further investigate these findings, which may inform strategies to foster consolidated sleep despite environmental and occupational challenges in order to maintain high‐performing naval personnel. [ABSTRACT FROM AUTHOR]

On February 6, 2023, two major earthquakes with magnitudes of 7,7 and 7,6 struck the Kahramanmaraş region in Turkey. Over 50.000 people lost their lives and more than half a million buildings were damaged as a result of these earthquakes. Earthquake survivors may develop post-traumatic stress disorder and sleep hygiene problems. This study aims to evaluate the correlation between post-traumatic stress and sleep hygiene among surviving adults six months after the February 6th Kahramanmaraş Earthquakes in Turkey. This study was conducted with 1004 earthquake survivors in 11 provinces influenced by the February 6th Kahramanmaraş earthquakes in Turkey. The data was collected with Personal Information Form, Impact of Events Scale-Revised, and the Sleep Hygiene Index. It has been determined that 54.1% of earthquake survivors scored ≥ 33 on the Impact of Events Scale-Revised. The level of post-traumatic stress disorder was high and their sleep hygiene index level was above average among earthquake survivors. A strongly significant positive correlation was observed between the Impact of Events Scale-Revised and the Sleep Hygiene Index. It is recommended to plan and implement community-based psychological interventions to reduce post-traumatic stress disorder and improve sleep hygiene among survivors after earthquakes. [ABSTRACT FROM AUTHOR]

The Child Sleep Hygiene Questionnaire (CSHQ) and its adapted version for autistic children, known as CSHQ-Autism, have gained recognition as essential tools for studying pediatric sleep patterns. 67 autistic children were evaluated using these questionnaires. 52 children screened positive on the CSHQ while 18 were screened positive on the CSHQ-Autism. Notably, both tools showed elevated ratings in the domains of sleep anxiety and co-sleeping, which may hinder their ability to accurately distinguish sleep disturbances. However, the prevalence of sleep anxiety/co-sleeping in Indian culture was found to be linked to more severe sleep disorders, while also serving as a protective factor against separation anxiety and sudden infant death syndrome (SIDS). Therefore, while the CSHQ and CSHQ-Autism serve as valuable assessment tools, their scores may be inflated by ingrained cultural norms in the Indian context. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate the feasibility, acceptability, and preliminary efficacy of mindfulness-based therapy for insomnia (MBT-I) among Black women. The MBT-I group received weekly sessions that included mindfulness meditation and behavioral sleep strategies. The time and attention control group received lifestyle health education (HE) that included healthy eating, physical activity, and sleep hygiene. The primary outcome was post-intervention changes in insomnia severity score by the Insomnia Severity Index (ISI) at week 10. Other measures included: Pittsburgh Sleep Quality Index, Sleep Hygiene Practice, Spielberger State-Trait Anxiety Inventory (STAI), and Patient Health Questionnaire-9 (PHQ-9). Objective sleep was measured by Actiwatch™ at baseline and week 10. Thirty Black women completed the interventions with no attrition. About 97% of all participants attended 6–8 out of 8 sessions. The ISI scores were reduced at week 10 (MBT-I vs. HE: -7.67 vs. -7.22, p <.05). Anxiety and depression symptoms were significantly improved only in the MBT-I group. This is the first MBT-I for Black women with insomnia. Online MBT-I may be feasible and acceptable for Black women. The MBT-I and HE showed a clinically significant improvement in insomnia symptoms (ISI reduction > 7). MBT-I may be more effective in improving anxiety and depression symptoms than HE. Our findings encourage further study efforts with a longer follow-up and larger sample size to address sleep health disparities among Black women. [ABSTRACT FROM AUTHOR]

The American Heart Association (AHA) recently redefined cardiovascular health (CVH) with the introduction of Life's Essential 8 (LE8), which encompasses eight areas (diet, physical activity, nicotine exposure, sleep duration body mass index, non-HDL cholesterol, blood glucose, and blood pressure). This study aimed to explore the relationships between both the aggregate and individual CVH metrics, as defined by Life's Essential 8, and cognitive function in older adults in the United States. This cross-sectional, population-based study analyzed data from the National Health and Nutrition Examination Survey conducted between 2011 and 2014, focusing on individuals aged 60 years and older. CVH was categorized as low (0–49), moderate (50–79), or high (80–100). Cognitive function was assessed through the CERAD tests, Animal Fluency test, and Digit Symbol Substitution test. Multivariable logistic models and restricted cubic spline models were employed to investigate these associations. This study included a total of 2279 older adults in the United States. Only 11% of adults achieved a high total CVH score, while 12% had a low score. After further adjustment for potential confounding factors, higher LE8 scores were significantly associated with higher scores on CERAD: delayed recall score (0.02[0.01, 0.03]; P < 0.001), CERAD: total score (3 recall trials) (0.04[0.02, 0.06]; P < 0.001), animal fluency: total score (0.09[0.05, 0.12]; P < 0.001), and digit symbol: score (0.29[0.18, 0.41]; P < 0.001), demonstrating a linear dose–response relationship. Similar patterns were also observed in the associations between health behavior and health factor scores with cognitive function tests. LE8 scores exhibited positive linear associations with cognitive function. Maintaining better levels of CVH may be associated with higher levels of cognitive function in older Americans, but further research is needed to confirm the causal and temporal relationships between LE8 and cognitive function. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disrupted the daily life and routines of Americans across the United States (U.S.), including those of our active-duty service members (ADSMs). Limited movement orders enacted during this time to promote social distancing prohibited access to fitness and dining facilities for ADSMs. This study aims to expand on previous work identifying changes in body mass index (BMI) among U.S. Army service members by identifying changes in body mass index (BMI) among active-duty service members from both the Navy and Marine Corps during the same time period. Methods: We conducted a retrospective cohort study of active-duty service members from the Navy and Marine Corps using data from the Military Health System Data Repository. BMI was calculated and categorized according to CDC guidelines both before (February 2019 - January 2020) and during the pandemic (September 2020 - June 2021). Women who were pregnant or delivered during and one year prior to the study periods were excluded. Statistical analyses included paired t-tests evaluating mean BMI, percent change, and the Stuart-Maxwell test for marginal homogeneity. Results: We identified 98,330 active-duty Sailors and 55,298 active-duty Marines for inclusion in this study. During the pandemic period the percentage of Sailors with Underweight decreased by 11%, Healthy weight decreased by 11.1%, Overweight increased by 2.1%, and the percentage of Sailors with Obesity increased by 16.5%. During this same time period, Marines with Underweight decreased by 1%, Healthy weight decreased by 16%, Overweight increased by 3.0%, and Marines with Obesity increased by 51%. The largest increases in service members with overweight and obesity observed among both cohorts were among female service members, service members under age 20, and service members with a Junior Enlisted rank. Conclusions: Significant increases in obesity were observed amongst active-duty United States Navy and Marine Corps service members during DoD pandemic mitigation efforts. Increased rates of obesity likely effected fitness and force readiness. Future interventions should be targeted at younger, Junior-Enlisted Marines and Sailors to promote healthy lifestyles and provide education on nutrition, appropriate exercise, sleep hygiene, and stress management. [ABSTRACT FROM AUTHOR]