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

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

Existing research shows COVID-19 pandemic restrictions led to widespread disruptions in healthrelated behaviors, including physical activity (PA) and sleep patterns among university students, faculty and staff. The specific impact of pandemic restrictions and the lack of crisis preparedness at educational institutions are not well documented. This cross-sectional pilot study (n = 48) used a selfadministered questionnaire to investigate the impact of restrictions on PA and sleep to identify the health impact, possible modifiable behaviors, and policies to target for change in future crises to improve health, academic, and work outcomes, especially for institutions with natural green spaces. It was hypothesized the restrictions reduced adults' PA levels and negatively impacted sleep. Statistical analyses revealed significant differences (p < .05) in the time spent doing medium- and highintensity PA, walking, length of time to fall asleep, and hours slept before and during the pandemic. Concentration on infection prevention and spread rather than on health maintenance for those not acutely ill inadvertently discouraged using outdoor spaces for exercise while gym and sports facilities remained closed. These findings indicate the negative impact lockdown restrictions may have on general health, and how organizations can promote behaviors to maintain basic physical and sleep health. [ABSTRACT FROM AUTHOR]

Summary Sleepwalking and related parasomnias are thought to result from incomplete awakenings out of non‐rapid eye movement (non‐REM) sleep. Non‐REM parasomnia behaviours have been described as unconscious and automatic, or related to vivid, dream‐like conscious experiences. Similarly, some observations have suggested that patients are unresponsive during episodes, while others that they can interact with their surroundings. To better grasp and characterise the full spectrum of consciousness and environmental (dis)connection associated with behavioural episodes, 35 adult patients with non‐REM sleep parasomnias were interviewed in‐depth about their experiences. The level of consciousness during parasomnia episodes was reported to be variable both within and between individuals, ranging from minimal or absent consciousness and largely automatic behaviours (frequently/always present in 36% of patients) to preserved conscious experiences characterised by delusional thinking to varying degrees of specificity (65%), often about impending danger, variably formed, uni‐ or multisensory hallucinations (53%), impaired insight (77%), negative emotions (75%), and variable, but often pronounced, amnesia (30%). Patients described their experiences as a dream scene during which they felt awake (“awake dreaming”). The surroundings were either realistically perceived, misinterpreted (in the form of perceptual illusions or misidentifications of people), or entirely hallucinated as a function of the prevailing delusion. These observations suggest that the level of consciousness, amnesia and sensory disconnection during non‐REM parasomnia episodes is variable and graded. In their full‐fledged expression, non‐REM parasomnia experiences feature several core features of dreams. They therefore represent a valuable model for the study of consciousness, sleep‐related sensory disconnection and dreaming. [ABSTRACT FROM AUTHOR]

Self-direction skill (SDS) is an essential 21st-century skill that can help learners be independent and organized in their quest for knowledge acquisition. While some studies considered learners from higher education levels as the target audience, providing opportunities to start the SDS practice by K12 learners is still rare. Further, practicing such skills requires a concrete context and scaffolding during the skill acquisition. This article introduces the Goal Oriented Active Learner (GOAL) system that facilitates SDS acquisition in learners utilizing daily activities as context. The GOAL architecture integrates learning logs from online environments and physical activity logs from wearable trackers to provide a data-rich environment for the learners to acquire and practice their SDS. The GOAL users follow DAPER, a five-phase process model, to utilize the affordances in the system while practicing SDS. We implemented the GOAL system at a K12 public institution in Japan in 2019. Learners used the online environments for extensive reading and smartwatches for tracking walking and sleeping activities. This study analyzes detailed interaction patterns in GOAL while learners planned and monitored their self-directed actions. The results illustrate the strategies for DAPER behaviors that emerge in different activity contexts. We discuss the potentials and challenges of this technology ecosystem that connects learners' learning logs and physical activity logs, specifically in the K12 context in Japan and, more generally, from the learning analytics research perspective to provide a context to practice SDS. [ABSTRACT FROM AUTHOR]

Mia Couto is a Mozambican writer known for an aesthetics of the fantastic in his numerous works. In most of his writings, he blurs the distinctions between the human and the non-human, land and water, the natural and the supernatural. This is particularly evident in his 2006 novel Sleepwalking Land, set in the context of the Mozambican civil war. This paper argues that the elusive figure of the water spirit is an ideal lens by which to read Sleepwalking Land to capture the complexity of the horrendous civil war. Drawing on magical realism, I consider Couto's use of water-based indigenous beliefs to underscore ideas of flexibility and mobility in a land ravaged by war, while revising the myth of powerful water spirits in line with the raging civil war. The chaos of war is amplified in the novel through actions of spirits that encroach on the human world, influencing events and problematizing the laws of logic, time and space. Their intractability enables Couto to foreground ambiguity and hybridity with characters who assume different forms at different stages of the fragmented plot, mirroring the raging war. [ABSTRACT FROM AUTHOR]

Sleep-related dissociative disorder (SRDD) is a female-predominant psychiatric parasomnia that was first identified as a condition that mimics sleepwalking in 1989, and was included in the International Classification of Sleep Disorders, 2nd edition, in 2005, with a subsequent expanding literature of case series and case reports. The objective hallmark of SRDD, found in about half of the reported cases, is sustained electroencephalogram (EEG) wakefulness during dissociative episodes emerging during wake-sleep transitions or after awakenings from light non-rapid eye movement (NREM) sleep or rapid eye movement (REM) sleep. Herein are reported two additional cases of SRDD in two female patients aged 53 and 40 years with prominent histories of multimodal abuse (typical of SRDD), with childhood emotional and food deprivation abuse in Case 1, and childhood emotional, sexual, and physical abuse in Case 2. Both patients were affected by “sleep phobia” and had recurrent nocturnal eating episodes. Major findings from the cumulative literature on SRDD are reinforced by these cases, with additional findings being described, particularly nocturnal eating behaviors and priming/triggering factors.

Summary: Non‐rapid eye movement parasomnia disorders, also called disorders of arousal, are characterized by abnormal nocturnal behaviours, such as confusional arousals or sleep walking. Their pathophysiology is not yet fully understood, and objective diagnostic criteria are lacking. It is known, however, that behavioural episodes occur mostly in the beginning of the night, after an increase in slow‐wave activity during slow‐wave sleep. A better understanding of the prospect of such episodes may lead to new insights in the underlying mechanisms and eventually facilitate objective diagnosis. We investigated temporal dynamics of transitions from slow‐wave sleep of 52 patients and 79 controls. Within the patient group, behavioural and non‐behavioural N3 awakenings were distinguished. Patients showed a higher probability to wake up after an N3 bout ended than controls, and this probability increased with N3 bout duration. Bouts longer than 15 min resulted in an awakening in 73% and 34% of the time in patients and controls, respectively. Behavioural episodes reduced over sleep cycles due to a reduction in N3 sleep and a reducing ratio between behavioural and non‐behavioural awakenings. In the first two cycles, N3 bouts prior to non‐behavioural awakenings were significantly shorter than N3 bouts advancing behavioural awakenings in patients, and N3 awakenings in controls. Our findings provide insights in the timing and prospect of both behavioural and non‐behavioural awakenings from N3, which may result in prediction and potentially prevention of behavioural episodes. This work, moreover, leads to a more complete characterization of a prototypical hypnogram of parasomnias, which could facilitate diagnosis. [ABSTRACT FROM AUTHOR]

Summary: Dreams were a subject of interest to philosophers thinking about the connection between the mind and the body in the nineteenth century. Many scholars have pointed out that the mind and the body were intimately linked and affected each other. Although science was on its way to becoming more technical and numbers focused in its investigatory practices, medical students and other physician‐philosophers investigated the nature of sleep and dreams. Medical students and advanced researchers speculated on the nature of consciousness and mused on where the mind travels to during the sleep processes. Other romantic figures like Dr Polydori speculated on the nature of sleep walking in their medical dissertations. Dreams also had a powerful moral and motivational component, as dreams and activities in dreams, drove people like Benjamin Rush to embrace abolition. Other promoters of abolition used the nature of dreams to discusses the dreadfulness and suffering of slavery. [ABSTRACT FROM AUTHOR]

Introduction: Snakebite is an important public health concern, especially in tropical areas, but the true burden remains unclear due to sub-optimal reporting and over-reliance on health facility-based data. Methods: A community-based cross-sectional survey was conducted in Samburu County, Kenya from December 2019 to March 2020. Geospatial techniques were used to create a sampling frame of all households in Samburu County and a multistage cluster sampling strategy to select households and recruit study participants. Five year prevalence and mortality rates were estimated, the characteristics and circumstances of snakebite were described, and multilevel logistic regression models were built to identify independent risk factors for snakebite. Results: We recruited 3,610 individuals living in 875 households from 30 clusters. The 5-year prevalence of snakebite was 2.2% (95% CI 1.4%–3.4%), and the 5-year mortality rate was 138 (95% CI 44–322) deaths per 100,000 inhabitants, resulting in an estimated 1,406 snakebites and 88 deaths from snakebites per year in Samburu County. Snakebite incidents often occurred at night between 9pm and 6 am (44%, n = 36), and the participants were mostly walking/playing outdoors (51%, n = 41) or sleeping (32%, n = 27) when they were bitten. Lower household socioeconomic status and smaller numbers of people per house were significant independent risk factors. Conclusion: Samburu County has a high snakebite burden and the most victims are bitten while sleeping or walking outdoors at night. Snakebite prevention and health promotion programs in Samburu County, and other endemic regions, need to be contextualised and consider the geographic, seasonal, and temporal specificities found in our study. Our findings also have implications for health care delivery, especially identification of the need for night-time staffing with expertise in snakebite management and antivenom availability to better manage patients and thereby improve outcomes. Author summary: Contemporary reliable estimates of the number of cases and risk factors for snakebite are needed to inform interventions to reduce snakebite incidence, especially in countries with a high burden. We conducted a community-based study in Samburu County Kenya, using methods enabling the inclusion of mobile pastoralist communities that are hard-to-reach. Of the 3610 participants recruited into our study, 2.2% (95% CI 1.4%–3.4%) had experienced a snakebite in the past five years, and there were 138 (95% CI 44–322) deaths per 100,000 inhabitants. Snakebites were most common during the dry season and most victims were bitten when they were sleeping or walking/playing outdoors, usually at night. Living in a wealthier household or in a household with more inhabitants lowered the risk of a snakebite. Snakebite prevention interventions in Samburu County should consider the higher number of bites during the dry season and at night. Health facilities may need to ensure 24-hour availability of both antivenom treatment and of expertise in the management of snakebite. [ABSTRACT FROM AUTHOR]

Study objectives: While zolpidem is considered as an example of a gender effect on drug response, there is insufficient evidence to reach a consensus. This study aimed to investigate gender differences in adverse events (AEs) of zolpidem. Methods: We estimated the difference between the reporting odds ratios (RORs) calculated in gender subgroups for the AEs signals detected in data mining using 2015–2019 Korea voluntary adverse drug events reporting system (KAERS) data. Different reporting risk by gender was evaluated by using the log RORs being significantly different by gender at the 5% significance level and the 95% confidence intervals of the gender ROR. Results: A total of 94 AE signals were detected. Among these, 35 signals showed significant disparities by gender at the 5% level or were detected only in one gender. When categorized by similarity of AEs, parasomnia including somnambulism and paroniria, and cardiovascular disorders including coronary thrombosis had higher reporting risks in women. Men were more likely to report cognitive disorders such as delirium, insomnia related disorders, and movement disorders. Among all AEs with gender differences in reporting risk, the difference in somnambulism was the most consistent and substantial. Conclusion: For several AEs associated with zolpidem, gender-based reporting disparities were evident. Notably, women exhibited a higher susbeptibility to somnambulism, potentially serious adverse effects of zolpidem. This underscores the need for further investigation into the underlying factors influencing these gender-specific reporting patterns. [ABSTRACT FROM AUTHOR]

Sleep, a specialized state of brain activity, has a lot of important physiological functions. This peculiar cyclical unconscious state influences various body systems and plays an important role in homeostasis. Researchers have studied the influence of sleep on different aspects like memory, mental health, cognitive function, athletic performance etc. Likewise, effect of sleep on sub-maximal exercise which encompasses much of the day to day activities may be a subject of research as concept in this issue may help in achieving knowledge about the role of sleep on daily activities and hence quality of life. Present study aims at finding the six minute walk distance and sleep quality in healthy young students of Gauhati Medical College, Guwahati Assam and to find if there is any association. 57 students of Gauhati Medical college (19 male and 38 female) participated in the study. Sleep quality was assessed by Pittsburgh sleep quality index and 6MWD was assessed as per American Thoracic Society standard.59.6 % of the students were found to have poor sleep quality (score=5) and 40.4 % students were found to have good sleep quality (score<5). Mean 6Minute Walk Distance was found to be 535±53 f for female and 583±37 m for male. In this study we could not find significant association between sleep quality and six minute walk distance (p value=0.965) which implies that sleep may not significantly influence regular day to day activities in healthy young adults. [ABSTRACT FROM AUTHOR]

Non-rapid eye movement (NREM) parasomnias are often benign and transient, requiring no formal treatment. However, parasomnias can also be chronic, disrupt sleep quality, and pose a significant risk of harm to the patient or others. Numerous behavioral strategies have been described for the management of NREM parasomnias, but there have been no published comprehensive reviews. This systematic review was conducted to summarize the range of behavioral and psychological interventions and their efficacy. We conducted a systematic search of the literature to identify all reports of behavioral and psychological treatments for NREM parasomnias (confusional arousals, sexsomnia, sleepwalking, sleep terrors, sleep-related eating disorder, parasomnia overlap disorder). This review was conducted in line with PRISMA guidelines. The protocol was registered with PROSPERO (CRD42021230360). The search was conducted in the following databases (initially on March 10, 2021 and updated February 24, 2023): Ovid (MEDLINE), Cochrane Library databases (Wiley), CINAHL (EBSCO), PsycINFO (EBSCO), and Web of Science (Clarivate). Given a lack of standardized quantitative outcome measures, a narrative synthesis approach was used. Risk of bias assessment used tools from Joanna Briggs Institute. A total of 72 publications in four languages were included, most of which were case reports (68%) or case series (21%). Children were included in 32 publications and adults in 44. The most common treatment was hypnosis (33 publications) followed by various types of psychotherapy (31), sleep hygiene (19), education/reassurance (15), relaxation (10), scheduled awakenings (9), sleep extension/scheduled naps (9), and mindfulness (5). Study designs and inconsistent outcome measures limited the evidence for specific treatments, but some evidence supports multicomponent CBT , sleep hygiene, scheduled awakenings, and hypnosis. This review highlights the wide breadth of behavioral and psychological interventions for managing NREM parasomnias. Evidence for the efficacy of these treatments is limited by the retrospective and uncontrolled nature of most research as well as the infrequent use of validated quantitative outcome measures. Behavioral and psychological treatments have been studied alone and in various combinations, and recent publications suggest a trend toward preference for multicomponent cognitive behavioral therapies designed to specifically target priming and precipitating factors of NREM parasomnias. [Display omitted] • 72 publications reported behavioral and psychological treatments for NREM parasomnias (1909–2023). • Most have been case reports (68%) or case series (21%). • Hypnosis and psychotherapies were the most common treatments reported. • Evidence for specific treatments is limited by study designs and measurement methods. • Multicomponent cognitive behavioral therapy is emerging as a favored approach. [ABSTRACT FROM AUTHOR]

Anxious-withdrawal is a well-established individual risk factor for psychosocial difficulties during adolescence. It is unknown, however, whether it also places youth at increased risk for physical health problems, such as sleep difficulties. This study examines the concurrent and prospective associations between anxious-withdrawal and six types of sleep difficulties (i.e., sleeping too much, sleeping too little, talking/walking in sleep, being overtired, nightmares, and general trouble sleeping). We further evaluate whether these associations differ for adolescents who are high versus low in exclusion and victimization. The participants were 395 adolescents (Mage = 13.61 years; 35% ethnic minority) who completed peer nominations of anxious-withdrawal, exclusion, and victimization at Time 1 (T1). Their mothers completed reports of sleep difficulties at T1 and at Time 2 (T2). Path analyses revealed unique associations between anxious-withdrawal and several types of sleep difficulties (e.g., sleeping too much) at T1. Analyses also revealed a significant interaction effect between T1 anxious-withdrawal and exclusion/victimization such that anxious-withdrawal was prospectively associated with trouble sleeping only for those young adolescents who are highly excluded/victimized. Our findings are the first to link anxious-withdrawal to a physical health outcome in adolescence and point to the need for future research to not only examine anxious-withdrawal and physical health but also to include assessments of peer difficulties. [ABSTRACT FROM AUTHOR]

REM sleep behavior disorder (RBD) is a parasomnia in which the customary generalized skeletal muscle atonia of REM sleep, "REM-atonia", is compromised, allowing for the injurious actingout of dreams. RBD can be idiopathic/isolated (iRBD) or symptomatic of neurological disorders, and can be triggered by most antidepressants. RBD mainly affects middle-aged and older adults, and is strongly linked with alpha-synucleinopathies, mainly Parkinson's disease (PD) and dementia with Lewy bodies (DLB). iRBD is now known to be the earliest and strongest predictor of future PD/DLB, which has stimulated a major international clinical and basic science research effort to enroll iRBD patients for upcoming neuroprotective/disease-modifying trials and to identify the most promising interventions to test in these cohorts. This review will provide the latest pertinent information on the rapidly expanding field of RBD. The methods included a PubMed literature search that included PubCrawlers, which utilizes the NCBI (National Center for Biotechnology Information) E-utils tools for publication retrieval, using the keywords "REM sleep behavior disorder" and "RBD". The results yielded the latest updates on iRBD as prodromal PD/DLB, with the most promising biomarkers for phenoconversion provided, along with a presentation of three clinical research consortiums that are systematically gathering patients in preparation for enrollment in upcoming clinical trials: (i) The International RBD Study Group; (ii) The North American Prodromal Synucleinopathy (NAPS and NAPS2) Consortium; and (iii) The FARPRESTO Italian multicenter RBD research consortium. In addition, updates on the Parasomnia Overlap Disorder (RBD + NREM parasomnia) and on narcolepsy-RBD are provided, along with new epidemiologic data, the latest RBD management guidelines, and updates on animal models of RBD. Emerging areas of critical RBD research are also highlighted. In conclusion, RBD is a notable example of clinical and translational neuroscience research. [ABSTRACT FROM AUTHOR]

Introduction The clinical diagnosis of disorders of arousal (DOA) is based primarily on a clinical history including amnesia for episodes. The presence of amnesia means the patient cannot provide direct evidence. In a forensic setting, when the defendant has been charged criminally with violent actions or sexual related assaults allegedly during sleep, a sleepwalking defense may be presented. As opposed to clinical history, the prosecution generally focuses on the single episode of alleged DOA that resulted in the criminal charges against the defendant. The prosecution will argue that this episode of complex behavior was not consistent with a DOA. A past history of purported episodes is not proof that a recent single episode must be a DOA. However, most sleepwalking defenses rely heavily on standard clinical evaluations despite the fact they have no direct connection with the current criminally charged episode.

Since then, asthma research findings and management recommendations[31] have shown that this practice is no longer fit for purpose, indeed it is antiquated and harmful.[[30], [32]] There are few diseases that are still treated as they were 30 years ago, yet that is what is happening for many patients with asthma. Importantly, there are several non-pharmacological interventions that can help reduce the burden of asthma (and conditions treated as asthma) for many patients. Keywords: Asthma; Primary care; Community care; Chronic disease EN Asthma Primary care Community care Chronic disease 49 52 4 07/18/23 20230717 NES 230717 The burden of asthma for patients and doctors can be reduced through simple evidence-based approaches to care and self-management Asthma continues to be a major but avoidable burden on the Australian health care system.[1] It is a treatable and responsive disease, and much has been achieved in the years since asthma was declared a National Health Priority. [Extracted from the article]

Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness—wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep—can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases. [ABSTRACT FROM AUTHOR]

Background: Sleep disorders refer to physiological and psychological states that cause adverse consequences due to the inability to fall asleep or poor sleep quality. The prevalence of sleep disorders varies greatly in different countries and regions due to different causes. This study aimed to investigate the prevalence and influencing factors of sleep disorders among preschool children in Urumqi city, China. Methods: A cross-sectional study was conducted with stratified random cluster sampling. Children aged 3–6 years old in one kindergarten randomly selected from each of the 8 districts of Urumqi from March to July 2022, and their parents were surveyed with a sleep quality questionnaire. Results: The prevalence of sleep disorders among preschool children in Urumqi was 14.29% (191/1336), and the prevalence of different symptoms was 42.81% for limb movements, 19.61% for snoring, 18.11% for bruxism, 16.39% for sleep talking, 12.57% for sweating, 11.60% for nocturnal awakening, 8.46% for nightmares, 6.89% for bed wetting, 3.74% for apnea, and 3.29% for sleepwalking. The prevalence of body movements, snoring, sweating, night-wake, nightmares, bed-wetting, apnea, and sleepwalking among different ethnicities were significantly different (P < 0.05). Multivariate analysis revealed that the major risk factors of sleep disorders were difficulty adapting to new environments, unwillingness to express emotions, inconsistent attitudes of the family toward children's education, running before bedtime, strict family education methods, etc. Conclusion: The prevalence of sleep disorders in preschool children in Urumqi is lower than the average level reported in other studies. Many factors affect the prevalence of sleep disorders in preschool children, but it is necessary to focus on the ability to adapt to new environments, psychological problems, and the impact of family education on sleep disorders. Further studies on the prevention and treatment of sleep disorders are needed for different ethnicities. [ABSTRACT FROM AUTHOR]

Promising technologies such as sensors, networking, and edge have led to many smart healthcare solutions to monitor and track patient health status. The health sector is now experiencing a significant transformation from conventional patient care to a smart healthcare environment. Smart health care allows medical professionals to monitor patients remotely and visualize the disease prognosis effectively. The Internet of medical things connect patients, doctors, and medical equipment via wireless networking technologies to process the data with Artificial Intelligence models. One of the domains of automated health care systems is to alert the caregivers and hospital on emergency conditions. This research study is a novel work that aims to help the caregivers of somnambulism patients attend to them in case of emergency. Sleep quality improves the health and work efficiency of any person. The caregivers of sleepwalking patients suffer from lack of sleep as the patient gets active during the night hours. The model is based on fall detection and sleep detection from wearable sensor data. The fall detection model includes feature selection by LASSO and classification by ensemble classifier. The proposed methodology shows improved performance for the fall detection model for all ensemble machine learning classifiers. [ABSTRACT FROM AUTHOR]

Non-rapid eye movement (NREM) sleep parasomnias are recurrent abnormal behaviors emerging as incomplete arousals out of NREM sleep. Mounting evidence on NREM sleep parasomnias calls for an update of clinical and therapeutical strategies. In the current review, we summarize the state of the art and provide the necessary background to stimulate a critical revision of diagnostic criteria of disorders of arousal (DoA), the most common NREM sleep parasomnia. In particular, we highlight the poor sensitivity of the diagnostic items related to amnesia and absence of conscious experiences during DoA episodes, encourage the role of video-polysomnography and home-video recordings in the diagnostic and treatment work-up, and suggest three levels of diagnostic certainty based on clinical and objective findings. Furthermore, we highlight current gaps of knowledge that prevent the definition of standard guidelines and future research avenues. [ABSTRACT FROM AUTHOR]

Disorders of arousal (DOA) are parasomnias that emerge from incomplete arousal out of Non-Rem Sleep (NREM) and lead to a broad variety of emotional and motor behaviours. Increasing evidence supports the hypothesis that specific psychopathological traits contribute to the multifactorial origin of these phenomena. The aim of the current multicenter study was to compare the personality profile of children and adolescents with and without DOA using the Junior Temperament and Character Inventory (JTCI). We enrolled 36 patients with a diagnosis of DOA (mean age of 11 ± 3 years, 64% males), and 36 healthy age and gender matched control subjects (mean age of 11.2 ± 3.6, years, 67% males). Their parents completed the Paris Arousal Disorder Severity Scale (PADSS), the Sleep Disturbance Scale for Children (SDSC) and the JTCI. Patients with DOA reached significantly higher levels compared to their control group in total PADSS (p < 0.0001) and in total SDSC (p < 0.0001). They also displayed higher scores in novelty seeking (p = 0.005), harm avoidance (p = 0.01), self-transcendence (p = 0.006) JTCI subscales, and lower scores on the self-directedness subscale (p = 0.004). Our pediatric sample with DOA exhibited specific psychobiological personality traits compared to age and gender matched subjects without DOA. These results shed light on new possible etiopathogenetic mechanisms, as TCI traits have been linked to specific genetic variants and brain circuits, like the reward system. Prospective studies are required to assess the effect of targeted psychological/psychiatric treatment on DOA symptomatology. [ABSTRACT FROM AUTHOR]

Disorders of arousal (DoA) are NREM parasomnias characterized by motor and emotional behaviors emerging from incomplete arousals from deep sleep. DoA are largely present in pediatric populations, a period during which they are labeled as self-limited manifestations. However, an extensive literature has shown that DoA can persist in adulthood, with different characteristics from childhood DoA. Adult DoA patients usually report excessive daily sleepiness, sleep-related violence during DoA episodes or potentially harmful behaviors, which are rare in childhood. The semeiological features of DoA episodes in adulthood may complicate differential diagnoses with other motor manifestations during sleep, in particular sleep-related hypermotor epilepsy. However, it cannot be excluded that adults with DoA attending sleep centers constitute a more severe phenotype, thus not being representative of adult DoA in the general population. Video-polysomnographic studies of DoA document a spectrum of motor patterns of different complexities, the simplest of which may often go unnoticed. Despite the different complexities of the episodes, neurophysiologic studies showed the co-existence of deep sleep and wakefulness during DoA episodes or even before their onset. These aspects make DoA an ideal model to investigate the mechanisms regulating local sleep, sleep arousal and cognitive functions including spatial and temporal orientation, attention or memory. [ABSTRACT FROM AUTHOR]

Objective: The current study describes the prevalence of sleep disorders in enuretic children, playing as influencing factors in the response to treatment and risk of relapse. Materials and methods: Data were collected from September 2020 to February 2021 in 114 children aged between 5 and 14 years, with a diagnosis of nocturnal enuresis and concomitant sleep disorders, referred to the Pediatric Unit, Campus Bio-Medico University, Rome. Enuretic children were subjected to an anamnestic and clinical assessment. Sleep disorders investigated were sleep apnea, sleep talking, snoring, bruxism, restless sleep, and somnambulism. Each patient was subjected both to pharmacological and to non-pharmacological treatments and monitored for 3 months to identify the presence of relapse. Patients were divided into 2 groups according to therapy response, and statistical analysis was performed to evaluate possible variables involved in enuresis relapse. Results: A high prevalence of sleep disorders was documented: 8/114 children (7%) had sleep apnea, 47/114 (41.2%) had bruxism, 66/114 (57.8%) had snoring, 54/114 (47.3%) had sleep talking, 18/114 (15.7%) had restless sleep. Forty-three of 114 children (37.7%) had relapses: 21/43 (49%) relapses occurred in children with only 1 sleep disorder, while 22/43 (51%) relapses occurred in children with 2 or more sleep disorders. Lower risk of relapses was reported in children subjected to dual therapy. Conclusion: Sleep disorders were widely associated with nocturnal enuresis, acting as comorbidities in the clinical course of nocturnal enuresis. Combined therapy seems to be associated with a lower rate of relapse of enuresis in a 3-month follow-up. A multi-disciplinary approach is required to improve patients' management. [ABSTRACT FROM AUTHOR]

The article discusses the rising issue of obesity in the UK and the need for effective public health campaigns to address it. The author suggests that barbers in the community, such as Nick and Tris in Saxmundham, have the potential to be influential in spreading vital health messages and promoting weight loss. The author argues that these barbers, who have personal experience and spend more time with people than doctors, can establish rapport and impart their knowledge and experience effectively. The article emphasizes the importance of involving key community influencers in public health initiatives to have a significant impact. [Extracted from the article]

Sleep walking disorder or somnambulism is a parasomnia that occurs in non-rapid eye movement sleep (NREM) characterized by an individual arising from bed and ambulating without fully awakening. It is known to be associated with multiple medications and has been reported with atypical antipsychotics. Here, we report a case of sleep walking induced by clozapine; before this, there have only been two reported cases of clozapine induced somnambulism. [ABSTRACT FROM AUTHOR]

This paper argues that Brown's sleepwalkers in Edgar Huntly offer us an early figuration for the problems inherent in the phenomenon we now refer to as "populism." Both populism and sleepwalking function through paradoxical and incongruent forms of expression that appear incoherent. The most prominent explanations that account for this paradoxical form of expression rely on an analysis of the breakdown of discourse. However, this paper argues that the incongruous form of expression is rooted in the reconfiguration of the social arrangements that enable Clithero and Edgar to advance socially but also places them in proximity to social crises. The contradictions of this position of social mobility are the source of the contradictions of the expression of sleepwalking. In depicting a world that makes social identity precarious, Brown offers us an explanation for how such paradoxical modes of expression are rooted in unstable resolutions of post-revolutionary society. [ABSTRACT FROM AUTHOR]

Thoroughly saturated by ordinary crisis, routinized emergency and the normalization of apocalypticism, late-modern society is nevertheless depicted as sleep-walking into crisis; a further, overlapping crisis of the 'real.' This paper explores the potential of prepper awakening narratives – the moment preppers 'wake up' to the reality of crisis – to contribute to explorations of detachment and denial in the Anthropocene. These narratives, part of the wider repertoire of prepper story-crafting, provide justification for the prepper's transition to an anticipatory subjectivity, emotionally and sensually attuned to crisis and motivated to prepare. Extending existing conceptualizations of awakening, I argue that prepper awakenings are defined by the uncanny realization of distance from an ideal state of security. To illustrate, I consider narratives of bodily vulnerability, insecurity at home and abandonment in public places, which express shock at the failure of relationality implicit to the safety fictions of these spaces. In this reckoning with the 'autonomous' modern self the agential and aware prepper emerges, but this does not in itself lead to a renewed moment of politics or production of revolutionary consciousness. Instead, the horrifying real' is recrafted as a vital space of self-reliance and resourcefulness, a place to reflect on endurance beyond this world-ending. [ABSTRACT FROM AUTHOR]

Confusional arousal is the milder expression of a family of disorders known as Disorders of Arousal (DOA) from non-REM sleep. These disorders are characterized by recurrent abnormal behaviors that occur in a state of reduced awareness for the external environment. Despite frequent amnesia for the nocturnal events, when actively probed, patients are able to report vivid hallucinatory/dream-like mental imagery. Traditional (low-density) scalp and stereo-electroencephalographic (EEG) recordings previously showed a pathological admixture of slow oscillations typical of NREM sleep and wake-like fast-mixed frequencies during these phenomena. However, our knowledge about the specific neural EEG dynamics over the entire brain is limited. We collected 2 consecutive in-laboratory sleep recordings using high-density (hd)-EEG (256 vertex-referenced geodesic system) coupled with standard video-polysomnography (v-PSG) from a 12-year-old drug-naïve and otherwise healthy child with a long-lasting history of sleepwalking. Source power topography and functional connectivity were computed during 20 selected confusional arousal episodes (from -6 to +18 sec after motor onset), and during baseline slow wave sleep preceding each episode (from - 3 to -2 min before onset). We found a widespread increase in slow wave activity (SWA) theta, alpha, beta, gamma power, associated with a parallel decrease in the sigma range during behavioral episodes compared to baseline sleep. Bilateral Broadman area 7 and right Broadman areas 39 and 40 were relatively spared by the massive increase in SWA power. Functional SWA connectivity analysis revealed a drastic increase in the number and complexity of connections from baseline sleep to full-blown episodes, that mainly involved an increased out-flow from bilateral fronto-medial prefrontal cortex and left temporal lobe to other cortical regions. These effects could be appreciated in the 6 sec window preceding behavioral onset. Overall, our results support the idea that DOA are the expression of peculiar brain states, compatible with a partial re-emergence of consciousness. [ABSTRACT FROM AUTHOR]

This article is the fruit of exceptional circumstances that brought together two scholars working on late medieval notarial documents from opposite sides of the Mediterranean, one looking at the role of women in the Greek island of Chios, the other at the Jewish community of Barcelona. Discussing some curious records involving a Jew operating in Chios in 1404 led to the discovery that the name was also present in notarial records of Barcelona from 1387 to 1392. The coincidence and unusual nature of the documents prompted the unravelling of the intriguing circumstances in the life of Benedictus de Ologar presented in the following pages. [ABSTRACT FROM AUTHOR]

Disorders of Arousal (DOA) are non-rapid eye movement (NREM) parasomnias traditionally regarded as unconscious states. However, recent research challenges this assumption. This narrative review aims to explore the presence and qualitative features of conscious experiences in patients with DOA during their episodes. The literature indicates a higher recall of conscious experiences during DOA episodes than previously believed, estimated at about 50-60 % in adults (immediately post-episode). Data on children are limited but suggest a lower recall rate (<30 % when interviewed retrospectively). Patient reports range from brief scenic fragments to elaborate scenarios with plot development, often fraught with negative emotions and misfortunes and with considerable correspondence between subjective experiences and observed behaviors. In many of the described cases, patients appear to enact their dreams, entering a hallucinatory state where internally generated images overlay external percepts. The potential implications for clinical management, research endeavors, and legal considerations regarding nocturnal violence, along with existing limitations and controversial points, are discussed., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Confusional arousal, classified under parasomnias, is a condition in which patients exhibit wakeful behaviors while still apparently asleep. It may be associated with shouting or sleepwalking and usually lasts for a few minutes to several hours. Patients tend to have no memory of the occurrence of such episodes. We report two cases of confusional arousals, the first, a 15-year-old boy suffering from autism spectrum disorder, and the second, a 10-year-old boy, with no other significant history. [ABSTRACT FROM AUTHOR]

Summary: Disorders of arousal (DOA) is an umbrella term initially covering classical sleepwalking, sleep terrors, and confusional arousals, and now including a wider spectrum of specialised forms of non rapid eye movement (non REM) parasomnias such as sexsomnia, sleep‐related eating disorder, and sleep‐related choking syndrome. Growing evidence has shown that DOA are not restricted to children but are also prevalent in adults (2%–4% of the adult population). While DOA run in family, genetics studies remain scarce and inconclusive. In addition to the risk of injury on themselves and others (including sexual assaults in sexsomnia), adults with DOA frequently suffer from excessive daytime sleepiness, pain, and altered quality of life. The widespread view of DOA as automatic and amnesiac behaviours has now been challenged by subjective (dream reports) and objective (dream‐enacting behaviours documented on video‐polysomnography) observations, suggesting that sleepwalkers are 'dream walking' during their episodes. Behavioural, experiential, cognitive, and brain (scalp electroencephalography [EEG], stereo‐EEG, high density‐EEG, functional brain imaging) data converge in showing a dissociated pattern during the episodes. This dissociated pattern resembles the new concept of local arousal with a wake‐like activation in motor and limbic regions and a preserved (or even increased) sleep intensity over a frontoparietal network. EEG and behavioural criteria supporting the DOA diagnosis with high sensitivity and specificity are now available. However, treatment is still based on controlling priming and precipitating factors, as well as on clinicians' personal experience with sedative drugs. Placebo‐controlled trials are needed to improve patients' treatment. DOA deserve more attention from sleep researchers and clinicians. [ABSTRACT FROM AUTHOR]

Summary: Sleepwalking is a common non‐rapid eye movement (NREM) parasomnia and a significant cause of sleep‐related injuries. While evidence suggest that the occurrence of this condition is partly determined by genetic factors, its pattern of inheritance remains unclear, and few molecular studies have been conducted. One promising candidate is the adenosine deaminase (ADA) gene. Adenosine and the ADA enzyme play an important role in the homeostatic regulation of NREM sleep. In a single sleepwalking family, genome‐wide analysis identified a locus on chromosome 20, where ADA lies. In this study, we examined if variants in the ADA gene were associated with sleepwalking. In total, 251 sleepwalking patients were clinically assessed, and DNA samples were compared to those from 94 unaffected controls. Next‐generation sequencing of the whole ADA gene was performed. Bio‐informatic analysis enabled the identification of variants and assessed variants enrichment in our cohort compared to controls. We detected 25 different coding and non‐coding variants, of which 22 were found among sleepwalkers. None were enriched in the sleepwalking population. However, many missense variants were predicted as likely pathogenic by at least two in silico prediction algorithms. This study involves the largest sleepwalking cohort in which the role of a susceptibility gene was investigated. Our results did not reveal an association between ADA gene and sleepwalking, thus ruling out the possibility of ADA as a major genetic factor for this condition. Future work is needed to identify susceptibility genes. [ABSTRACT FROM AUTHOR]

With the increasing presence of 'datafied' educational settings across Australia, critical components of teachers' educational practice and work have been quantified. Digital data collected through teachers' labour in and around the classroom links to educational practice and the commercial datafication of teachers' online persona. Often described as 'sleepwalking' towards surveillance, this paper argues that corporate marketing strategies induce teachers in a state of 'commercial and computational comatose'. It challenges the concept of 'sleepwalking' by introducing an emergent way of thinking, through the metaphor eMorpheus, to stress broader tensions concerning teachers' working conditions, rights, and employment. Drawing on in-depth interview data generated via the Apps in Australian Classrooms Project, the findings highlight how the new forms of leadership are emerging in educational settings in response through consideration of the eMorpheus metaphor. [ABSTRACT FROM AUTHOR]