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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]

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]

AbstractThe objectives of this prospective study were to explore the health-related lifestyle of police cadets and assess changes in their health behaviors following entry into the police force. To do so, 190 police cadets completed an online questionnaire assessing their physical activity level, sedentary behaviors, diet quality, sleep hygiene, alcohol consumption, cigarette smoking, and stress level. One year following their graduation from the police training program, participants were invited to, once again, complete the questionnaire. Our results suggest that police cadets generally display healthy lifestyles, with very few cadets being physically inactive, smokers, reporting insufficient sleep duration, and displaying obesity. Nevertheless, paired-sample comparisons highlighted significant decreases in physical activity, fruit and vegetable intake, sleep duration, and sleep quality at the follow-up. Likewise, significant increases in fast-food consumption and BMI were observed. [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.

Given the high prevalence of sleep problems and fine motor deficits that have been reported in persons with Down syndrome (DS), this study was to investigate the effect of sleep-related problems occurring during the day on fine motor function (i.e. manual dexterity and handgrip strength) in persons with DS. We also tested the moderating role of obstructive sleep apnoea (OSA) in the link between sleep-related problems occurring during the day and fine motor function. It was hypothesised that subtle sleep-related problems occurring during the day would significantly predict fine motor performance. Fifty-two persons with DS, aged 13–54, participated and caregivers completed a sleep questionnaire for their children with DS. Hierarchical multiple regression analyses indicated a greater frequency of sleep-related problems occurring during the day significantly predicted greater manual dexterity deficits. Results also suggested that OSA was the moderator for the association between sleep-related problems occurring during the day and manual dexterity. This study has highlighted the importance of exploring sleep problems that might impair fine motor performance for the DS population in their everyday lives. Additional studies are needed to develop effective interventions to promote sleep hygiene and fine motor development in this population. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) of digitally delivered Cognitive Behavioral Therapy for insomnia (CBT-I) have demonstrated reductions in insomnia severity, depression symptoms, anxiety symptoms, and suicidal ideation. The present study aimed to evaluate the effectiveness of self-guided, digital CBT-I to improve sleep-specific outcomes. An RCT of Australian adults with insomnia and depressive symptoms (N = 1149) compared SHUTi, a digital CBT-I intervention, with HealthWatch, an attention-matched control internet program, at baseline, posttest (9 weeks) and at 6-, 12-, and 18-month follow-ups. Online sleep diaries were used to derive measures of sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST). Participants in the SHUTi condition had greater improvements at posttest compared with control for: SOL, WASO, SE, number of awakenings, and sleep quality. These improvements were sustained at every follow-up (p <.02 for all outcomes except TST, in which statistically significant increases were observed only at 12- and 18-months). Digitally delivered CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and depressive symptoms. Findings provide further evidence of long-term improvements associated with a digital therapeutic for insomnia, compared to an attention-control condition. [ABSTRACT FROM AUTHOR]

Typically, LGBTQ + people sleep more poorly than their cisgender heterosexual (cishet) counterparts. However, there is a lack of literature investigating the impact of different lifestyle/psychosocial factors, outside of minority stress, on the negative relationship between being a sexual/gender identity minority and sleep quality. The current study aims to help fill critical gaps in the literature by looking at the effects generalized stress, COVID-19-related stress, social support, and sleep hygiene have on this relationship. Two hundred and seventy-three participants (74 LGBTQ+; 199 cishet), recruited online, completed a series of questionnaires assessing sleep quality, sleep hygiene, generalized stress, minority stress, COVID-19-related stress, and social support. Analyses showed that LGBTQ + participants reported worse sleep quality, higher levels of generalized stress and COVID-19 stress, and smaller social networks than their cishet peers. Generalized stress fully mediated the relationship between sexual/gender identity and sleep while sleep hygiene partially mediated the relationship between generalized stress and sleep quality. Social support and COVID-19-related stress did not moderate the relationship between generalized stress and sleep. Worse sleep quality in LGBTQ + than cishet adults is explained by differences in generalized stress and sleep hygiene. Stress management and sleep hygiene interventions may help prevent the negative associations between being LGBTQ + and poor sleep quality. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionThis population-based study aimed to evaluate the association of mental health and several sleep conditions with Social Frailty (SF) in a sample of Iranian middle-aged and older adults.This cross-sectional study was conducted using data from the Ardakan Cohort Study on Aging (ACSA). SF was assessed by five questions: inability to help others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to (HALFT). Based on the responses, the participants were divided into three groups: social robust (a score of 0), pre-SF (a score of 1-2), and SF (a score of ≥3). Mental health factors included depression and anxiety. Within the domain of sleep conditions, considerations included sleep duration, quality, subjective sleep health, and daytime sleepiness. The logistic regression models were employed to analyze the data.A total of 5782 subjects participated in the study, with females comprising 50.7% of the sample. This study revealed the total prevalence of pre-SF and SF were 76.4 and 9.3%, respectively. After adjusting for age, sex, marital status, education, number of comorbidities, and mental health, in the age group of 50-60 years, anxiety (borderline and abnormal compared to normal, OR = 1.49, 95% CI: 1.05–2.11 and OR = 1.98, 95% CI: 1.26–3.12, respectively) were associated with SF. Similarly, in the age group of 60 years and above, only depression was associated with SF (OR = 2.24, 95% CI: 1.45–3.44).These findings imply that mental health might contribute to SF in the middle-aged and older Iranian population. [ABSTRACT FROM AUTHOR]

Drawing on Levinasian concepts of sleep, insomnia, and the il y a, this paper examines the liminal states of insomnia and sleep within the Palestinian-Israeli conflict. Sleep and insomnia, being proximates of death as well as displacement and anonymous existence successively, are topics that have not, to the best of our knowledge, received any critical commentary within (post)colonial studies. This paper argues that the Israeli military occupation deprives Palestinians from sleep, casting them into the horror and anonymous existence of insomnia which, like the Israeli occupation, signifies impervious dialogue and is a catalyst for both psychic and physical displacement. As the Israeli occupation deprives Palestinians of place and sleep, two terms in the words of Levinas recognised as intertwined, it is the ethical responsibility of Palestinians and Palestinian leaders to arm themselves with wakefulness so as to secure their homeland (place) and to fortify themselves against displacement and the horror of the night. Sleep reveals an ethical dimension when examined closely within the Israeli-Palestinian conflict due to its subtle proximity to death. Hence, we contend that falling asleep on the part of Palestinians is unethical due to its direct adverse effects, namely, displacement and death. [ABSTRACT FROM AUTHOR]

The purpose of reporting on selected cases is to increase the recognition and treatment of mechanical joint dysfunction (restrictions in movement at the joint level) in pediatric patients. The selected cases demonstrate a variety of clinical outcomes that are possible using manual therapy to improve mechanical joint dysfunction and chronic pain. The techniques used for these patents were performed by a physical therapist without formal manual therapy training to encourage more physical therapists to use manual therapy as an intervention to improve outcomes in pediatric patients. The hands-on treatment used to treat mechanical joint dysfunction improved participation and function in children of various ages with a variety of clinical issues. : Recognizing and treating mechanical joint restrictions that interfere with active movement in children may result in decreased pain and improved motor skills, balance, self-regulation, sleep hygiene, and social interactions. Clinicians should consider manual therapy as an intervention strategy for pediatric patients with mechanical joint restrictions. [ABSTRACT FROM AUTHOR]

Adolescent sleep disturbances and circadian delays pose significant challenges to mood and daytime functioning. In this narrative review, we explore the impact of light on sleep and highlight the importance of monitoring and managing light exposure in adolescents throughout the day and night. The benefits of daylight exposure in mitigating sleep and circadian disruptions are well-established; however, interventions targeting access to daylight in adolescents remain understudied and underutilized. The primary aim of this narrative review is to bring attention to this gap in the literature and propose the need for institutional-level interventions that promote access to daylight, especially considering adolescents' early school start times and substantial time spent indoors on weekdays. School-led interventions, such as active commuting to school and outdoor curriculums, have promising effects on sleep and circadian rhythms. Additionally, practical measures to optimize natural light in classrooms, including managing blinds and designing conducive environments, should also be considered. While future studies are necessary to facilitate the implementation of interventions, the potential for these school-level interventions to support adolescent sleep health is evident. Aiming for integration of individual-level regulation and institutional-level intervention of light exposure is necessary for optimal outcomes. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) and sleep disturbance are highly comorbid and repetitive negative thinking (RNT) is associated with both sleep disturbance and PTSD. However, few studies have examined the association between RNT and sleep disturbance in individuals exposed to trauma, with and without PTSD. Associations between trait-level and trauma-related RNT, insomnia, and sleep quality were investigated in a trauma-exposed MTurk (N = 342) sample. Additionally, PTSD symptom severity was tested as a moderator of the associations between RNT and insomnia and sleep quality. Trait-level RNT predicted poorer sleep quality and greater insomnia, regardless of PTSD severity. Trauma-related RNT was also associated with greater insomnia, though the effect was moderated by PTSD severity such that it was significant for participants with low and moderate, but not severe, PTSD. Both trait- and trauma-related RNT were associated with several specific aspects of sleep quality, including: sleep disturbances, daytime dysfunction, use of sleep medications, sleep onset latency, and subjective sleep quality. This study demonstrates significant associations linking RNT with insomnia and sleep disturbance in trauma-exposed individuals. Clinically, results suggest that it may be helpful to target both general and trauma-related RNT in sleep interventions for trauma-exposed individuals with insomnia. [ABSTRACT FROM AUTHOR]

The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event. The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12–17 (Mage = 15.44, SD = 1.51; 41.9% female). The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction. Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed. [ABSTRACT FROM AUTHOR]

Objectives: To develop the Parenting Behavior Checklist to Promote Preschoolers' sleep (PCPP), quantify sleep-promoting parenting behaviors for children, and examine the scale's reliability and validity. Methods: The PCPP was developed based on the recommendations of the ABCs of SLEEPING for children's sleep, which is strongly supported by research evidence. Its validity and reliability were evaluated using data from 140 participants. Structural validity was estimated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency was evaluated by Cronbach's a. Hypothesis testing was evaluated by analyzing the correlations between each factor of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) and the PCPP. Results: Regarding structural validity, EFA was conducted because CFA showed a poor model fit. The PCPP comprised one factor and six items. The JSQ-P subfactors of insomnia or circadian rhythm sleep-wake disorders, undesirable morning symptoms and behaviors, and insufficient sleep were moderately negatively correlated with the PCPP; the subfactor of undesirable daytime behaviors related to sleep problems was weakly negatively correlated with the PCPP. Thus, the sleep-promoting parenting behaviors listed in the PCPP were associated with better sleep in children. Conclusions: The PCPP showed sufficient reliability and validity. Future studies should use the scale to examine more effective interventions regarding sleep-promoting parental behaviors for children. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a scoping review to determine the nature, variety, and volume of empirical evidence on nonpharmacological interventions for sleep disturbances with potential implications for fatigue in adults sustaining a traumatic brain injury (TBI). A systematic literature search was conducted across four databases to identify primary studies testing a single non-pharmacological intervention or a combination of non-pharmacological interventions for sleep disturbances and fatigue in community-dwelling adults with TBI. Sixteen studies were reviewed addressing six non-pharmacological interventions for sleep disruptions and fatigue after TBI including light therapy, cognitive-behavioral therapy, warm footbath application, shiatsu, and sleep hygiene protocol. Non-pharmacological interventions involving light or cognitive-behavioral therapy were reported in 75% of the studies. Actigraphy-based estimation of total sleep time and subjective level of fatigue were frequent outcomes. While this scoping review has utility in describing existing non-pharmacological approaches to manage sleep and fatigue after TBI, the findings suggest that interventions are often developed without considering TBI individuals' source of motivation and the need for support in self-administration. Future studies may achieve greater sustainability by considering the evolving needs of TBI patients and their families and the drivers and barriers that might influence non-pharmacological intervention use at home. [ABSTRACT FROM AUTHOR]

Obtaining good quality sleep is crucial to mental health. Social work students might be particularly vulnerable to mental health challenges and insufficient sleep, which can have important implications for self-care education. Examining social work students' sleep characteristics (i.e. sleep duration and sleep quality) and health knowledge gaps can provide an important context for promoting healthy sleep among social work students. Nonetheless, the empirical literature lacks such data. The purpose of this study was to employ a sample of undergraduate and graduate social work students to: 1. assess sleep duration and sleep quality; 2. quantitatively and qualitatively examine knowledge about sleep and healthy sleep behaviors; and 3. identify sleep health knowledge gaps. Twenty-five social work students completed validated assessments and participated in a semi-structured focus group. Quantitative and qualitative data highlight poor sleep duration, poor sleep quality, and sleep health knowledge gaps among this population. Data also reveal that while students recognize the importance of sleep, they have difficulty obtaining adequate sleep due to various contextual constraints. These data support the importance of including sleep health in self-care education among social work students and highlight sleep health knowledge gaps that could be integrated into self-care education. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the frequency of sleep and eating problems in children with autism spectrum disorder (ASD), the factors associated with these problems, and the relationship with the risk of developing depression and anxiety in their parents. In the study, 156 children with ASD and their parents were included. The Brief Autism Mealtime Behavior Inventory (BAMBI), the Children's Sleep Habits Questionnaire (CSHQ), the Hospital Anxiety Depression Scale (HADS) were completed by the parents. The Childhood Autism Rating Scale (CARS) was administered by the researchers to evaluate the severity of ASD in children. The mean age of children was 8.08 ± 2.84, and 87.2% of the children were male. The mean score of CARS was 41.25 ± 6.16, the mean score of BAMBI was 45.67 ± 11.87, and the mean score of CSHQ was 51.67 ± 10.17. According to the CSHQ, 83.3% of the children had sleep problems. The response rate above the cut-off point in the HAD-A subscale was 59.6%, whereas it was 67.3% in the HAD-D subscale. There was a positive correlation between CARS and BAMBI, CSHQ, HAD-A, and HAD-D subscales. There was a positive correlation between BAMBI and CHSQ, HAD-A, and HAD-D subscales. There was a positive correlation between the CSHQ, HAD-A, and HAD-D subscales. There was a negative correlation between the age of the child with ASD, food refusal, and resistance to bedtime. As sleeping and eating problems affect a large portion of children diagnosed with ASD and their caregivers, large population-based studies evaluating both these problems must be designed and carried out to understand factors affecting the prevalence, development, and persistence of sleeping and eating problems and to determine interventions to reduce these issues. [ABSTRACT FROM AUTHOR]

Sleep and light education (SLE) combined with relaxation is a potential method of addressing sleep and affective problems in older people. 47 participants took part in a four-week sleep education program. SLE was conducted once a week for 60–90 minutes. Participants were instructed on sleep and light hygiene, sleep processes, and practiced relaxation techniques. Participants were wearing actigraphs for 6 weeks, completed daily sleep diaries, and wore blue light-blocking glasses 120 minutes before bedtime. Measures included scores of the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI) and actigraphy measurements of sleep latency, sleep efficiency, and sleep fragmentation. Sleep quality increased after SLE based on the subjective assessment and in the objective measurement with actigraphy. PSQI scores were statistically reduced indicating better sleep. Scores after the intervention significantly decreased in ESS and ISS. Sleep latency significantly decreased, whereas sleep efficiency and fragmentation index (%), did not improve. Mood significantly improved after SLE, with lower scores on the BDI-II and STAI. SLE combined with relaxation proved to be an effective method to reduce sleep problems and the incidence of depressive and anxiety symptoms. [ABSTRACT FROM AUTHOR]

The novel coronavirus caused a global pandemic with negative implications on stress and a significant impact on dance education. The aim of this study was to investigate mental well-being and sleep hygiene in undergraduate dance students during this global pandemic. Fourteen undergraduate dance students completed the DASS-21, PSQI, and questions relating to motivation to participate in online and in-studio classes in week 2 and week 26 of the 2020–2021 academic year. Although no significant differences were found between these time points for depression, anxiety, stress, or sleep quality, levels of anxiety and stress were classified as severe and extremely severe consistently. Sleep quality, efficiency, and duration were good; however, sleep timings may impact mental well-being. It is recommended that due to chronic levels of stress amongst dancers, which may have also been accentuated by the global pandemic, that mindfulness, somatic practice, and aerobic fitness training be incorporated into dance programs. [ABSTRACT FROM AUTHOR]

Among the public health recommendations for supporting mental health during the COVID-19 pandemic, many strategies had an impact on biological rhythms, like sleep hygiene, physical exercise and healthy eating habits. Considering the known relationship between circadian organization and mental health, our aim was to test the association between behavioral regularity and mental health, and its interaction with chronotype, in a large sample surveyed in Brazil. We collected longitudinal data using online questionnaires that assessed sociodemographic characteristics, behavioral routines, mental health (PHQ-9, GAD-7, WHO-5 scales), and chronotype estimation based on midpoint of sleep on free days – MSF (μMCTQ), in a sample of 1390 participants (81% females). We computed a Routine Regularity Score (RRS) that reflects regularity across four behaviors: sleep, eating, working, exercising. There was a strong negative association between RRS and the severity of anxiety and depressive symptoms (GAD-7 and PHQ-9 scores), which was weaker among participants with late MSF, and a strong positive association with well-being (WHO-5 scores). RRS was a mediator of the MSF-mental health association and a predictor of mental health states. This study provides empirical evidence that maintaining behavioral routines during times of hardship may serve as tools to alleviate the negative impact on mental health. [ABSTRACT FROM AUTHOR]

Identifying those who are most (and least) likely to benefit from a stepped-care approach to cognitive behavioral therapy for insomnia (CBT-I) increases access to insomnia therapies while minimizing resource consumption. The present study investigates non-targeted factors in a single-session of CBT-I that may act as barriers to early response and remission. Participants (N = 303) received four sessions of CBT-I and completed measures of subjective insomnia severity, fatigue, sleep-related beliefs, treatment expectations, and sleep diaries. Subjective insomnia severity and sleep diaries were completed between each treatment session. Early response was defined as a 50% reduction in Insomnia Severity Index (ISI) scores and early remission was defined by < 10 on the ISI after the first session. A single-session of CBT-I significantly reduced subjective insomnia severity scores and diary total wake time. Logistic regression models indicated that lower baseline fatigue was associated with increased odds of early remission (B = −.05, p =.02), and lower subjective insomnia severity (B = −.13, p =.049). Only fatigue was a significant predictor of early treatment response (B = −.06, p =.003) Fatigue appeared to be an important construct that dictates early changes in perceived insomnia severity. Beliefs about the relationship between sleep and daytime performance may hinder perceived improvements in insomnia symptoms. Incorporating fatigue management strategies and psychoeducation about the relationship between sleep and fatigue may target non-early responders. Future research would benefit from further profiling potential early insomnia responders/remitters. [ABSTRACT FROM AUTHOR]

Examine how changes in sleep duration, objectively measured by activity trackers, impact weight gain in incoming college freshman. Participants: Incoming college freshmen, age ≥ 18. Methods: We measured weight and daily sleep duration before college entry and through the 1st college quarter. Additionally, we examined changes in sleep variability, activity levels and smartphone screen time use as possible predictors of weight gain. Results: 75 participants completed the study. Total sleep duration decreased from 437.9 ± SD 57.3 minutes at baseline to 416.5 ± SD 68.6 minutes by the end of the first quarter (p = 6.6 × 10−3). (BMI) did not change significantly in this cohort. Higher sleep variability at baseline and an increase in sleep variability were associated with increases in BMI. Smartphone screen use was note to be high (235.2 ± SD 110.3 minutes/day) at the end of the first quarter. Conclusions: College weight gain may be affected by factors other than sleep duration, including sleep variability. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2032720 [ABSTRACT FROM AUTHOR]

Modern societies grapple with an escalating prevalence of sleep problems and addiction. This nexus warrants exploration, particularly concerning preventive strategies. Hence, this study endeavors to elucidate the interplay between sleep problems, social jet lag, chronotype, and addiction susceptibility. The present research, applying a cross-sectional correlational design, employed 180 Iranian adults through internet invitations. Research data were collected using the Iranian Addiction Potential Scale (IAPS), MCTQ, ESS, and rMEQ. The findings highlight the predictive role of ESS, weekly sleep duration, social jet lag, and rMEQ in addiction potential. It is worth mentioning that there was no significant association between MSFsc and morning/evening chronotype and addiction potential. The results indicate the importance of identifying and supporting individuals predisposed to addiction. According to the results, it seems that sleep problems, sleep duration, and social jet lag are more important variables in preventing addiction, so sleep hygiene programs are suggested. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the sleep-wake cycle pattern, mood, perceived stress and some behaviors, such as physical exercise and exposure to natural light of college students during the COVID-19 pandemic. This is a cross-sectional study conducted between June and August 2020 using an electronic form provided by Google. The sample consisted of undergraduate students aged between 18 and 30 years old and residents of the northeast region of Brazil. The students generally had sleepiness and poor sleep quality, high levels of anxiety, mild to moderate depressive symptoms and moderate perceived stress. Some of these aspects were worse in women. The college students showed three sleep patterns: one group had good sleep quality without excessive daytime sleepiness; another group had poor sleep quality, but no excessive daytime sleepiness; and a third group had high daytime sleepiness, and less expressive sleep quality impairment. Greater exposure to sunlight and practicing physical exercise predominated in individuals with better sleep quality, suggesting that they are protective factors. In addition, excessive daytime sleepiness and poor sleep quality were separately associated with higher anxiety, depression and stress perception levels, proving to be important aspects for care in order to favor mental health during the pandemic. In conclusion, it is suggested that the COVID-19 pandemic affected the sleep of college students in a heterogeneous way. The differentiated sleep patterns are associated with exposure to natural light and exercising. [ABSTRACT FROM AUTHOR]

This pilot randomized controlled study evaluates the feasibility and preliminary efficacy of a 7-week remote intervention combining well-being therapy and sleep hygiene to improve sleep and psychological outcomes among adults reporting poor sleep and distress. Thirty-one participants (81% women, 40.2 ± 13.0 y, 48% racial/ethnic minority) were recruited from the community during the COVID-19 pandemic through online and local advertisement, and randomized to well-being therapy+sleep hygiene or sleep hygiene-only. Study outcomes were evaluated by self-reported questionnaires administered at baseline and post-intervention and a daily sleep diary. Compared to sleep hygiene-only, well-being therapy+sleep hygiene led to greater improvements in wake after sleep onset (time-by-group interaction: 3.6 ± 1.5 min, p =.017), personal growth (β −3.0, 95%CI −5.2, −0.8, p =.01), and purpose in life (β −3.5, 95%CI −6.1, −0.9, p =.009). Anxiety, perceived stress, sleep quality, and insomnia symptoms improved similarly in both groups (between-group differences, p >.05). Improvements in sleep quality, insomnia, and sleep duration were associated with reductions in multiple measures of psychological distress (all p <.05). These findings suggest that, in a non-clinical setting of individuals suffering from combined poor sleep and psychological distress, the addition of well-being therapy to sleep hygiene may provide additional benefits for sleep by promoting sleep continuity and well-being. [ABSTRACT FROM AUTHOR]

1) Systematically review meta-analyses and systematic reviews that (a) explored health/lifestyle factors affecting sleep, and/or (b) investigated behavioral/psychological sleep interventions in young people (10–25-years); 2) Evaluate the quality of published literature, and, if an intervention; 3) Examine method and effectiveness of mode of delivery, to inform current clinical practice and research direction. A systematic search of Embase (n = 45), MEDLINE (n = 67), Web of Science (n = 375), Google Scholar (n = 138), and hand-searching was conducted. After full review, 12 papers were selected, 2 systematic reviews without, and 10 with, meta-analyses. Six examined associations between sleep and lifestyle/health, and six examined cognitive-behavioral (n = 4), or school education (n = 2), programs. Electronic media use, type of day (week/end), sex, age, culture/geographical location, substance use, family environment, and evening light exposure were negatively associated with sleep, in young people. Only cognitive and/or behavioral interventions of at least 2 × 1-hr sessions improved sleep. This paper informs sleep recommendations for young people and advises that ≥ 2 × 1-hr sessions of cognitive behavioral or behavioral therapy is the minimum to improve sleep in young people. School-based sleep interventions do not produce long-term change. [ABSTRACT FROM AUTHOR]

To investigate self-reported sleep duration, sleep timing, sleep status and influencing factors in the Chinese population. This web-based cross-sectional survey was conducted in 2022, covering 31 provinces (91%) in China. 11,000 questionnaires were collected, of which 8970 were valid for analysis. Self-reported sleep habits, problems and quality were investigated. Good or fair sleep ratings, enough duration, regular, with no sleep disturbances and <30 min sleep latency was defined as a composite variable: 'Good sleep'. Factors influencing sleep patterns and 'Good sleep' were analyzed by multivariate logistic regression. Most participants sleep less than 7 h per night (55.13%), usually go to bed at 10–12 pm (47.99%), wake up at 6–8 am (49.86%), and take less than 30 min to fall asleep (66.30%) with regular sleep schedule (76.01%). Only 12.36% have 'Good sleep'. In the past 3 months, 46.80% of the participants reported symptoms of insomnia, and 21.54% had snoring problems. Among the adults, the young, males, college students, freelancers, and those who resided in urban areas and pandemic-free areas slept later, and the northerners woke up earlier. The adults with low-moderate and moderate income and the minors at elementary and middle school slept earlier and woke up earlier. Mid-aged adults who often napped at noon were more likely to have 'Good sleep' than any other age group, and urban dwellers with the same habit were more likely to have 'Good sleep' than people dwelled in other regions. While people who slept late, woke up too early or too late, slept too little or too much, resided at GMT 7–8 area or pandemic area, had high income, or took up some occupations (entrepreneurs/individuals, professionals, manual and non-manual workers, housewives) were less likely to get a 'Good sleep'. The national survey provided a sleep profile of the Chinese population. Both socio-economic status and personal sleep hygiene habits had an impact on 'Good sleep'. [ABSTRACT FROM AUTHOR]

Given the high prevalence of sleep disorders (e.g. insomnia) among long-COVID-19 patients (LC19Ps), approaches to tackle these disorders should not only depend on sleep specialists, but they should also involve general practitioners (GPs). Indeed, according to the World Health Organization, GPs should be on the front line in the management of LC19Ps. However, in real practice, little data with regard to the management of LC19Ps are available for GPs, which represents an embarrassing situation. Thus, the main aim of this correspondence was to provide GPs with some advice related to the management of sleep disorders in LC19Ps. The pieces advice presented in this correspondence are related to: i) Early and accurate recognition of sleep disorders, ii) General recommendations to manage sleep disorders in LC19Ps (e.g. encouraging vaccination against the virus); and iii) Specific recommendations, such as improving sleep hygiene (patients' behavior and diet), psychological or behavioral therapies (stimulus control therapy, relaxation, sleep restriction), promising tools (heart coherence, neurofeedback), and pharmacological treatment. The authors of this correspondence deeply believe that given the undesirable side effects associated with the use of hypnotics, the pharmacological approach must only be a "last resort". The authors believe that an important percentage of pharmacological prescriptions could be avoided if more focus is put on educating GPs to provide LC19Ps with more tools to deal with sleep disorders. The pieces advice presented in this correspondence are indispensable to resume the normal life of LC19Ps and to promote their mental health recovery. [ABSTRACT FROM AUTHOR]

Attempts to improve evening sleep hygiene have overlooked that sleep preparation behaviours are often undertaken automatically with little awareness; that is, habitually. This mixed-methods study assessed aspects of the feasibility and acceptability of a novel behavioural intervention procedure ('script elicitation'), which encourages reflection on and reorganisation of the content and sequencing of habitual evening pre-sleep routines. The study was advertised via social media, and circular lists at a UK university. Twenty-four UK-based adults, reporting <6 h/night sleep, were recruited. At baseline, they completed sleep hygiene and quality measures, then participated in an online, one-to-one script elicitation interview. This involved the interviewer working with the participant to generate a fine-grained description of the content, organisation and variability of their typical pre-sleep routine, and plan a more sleep-conducive alternative routine to follow over the next week. One week later, participants completed sleep quality and hygiene measures, and a semi-structured interview about the intervention. Feasibility was assessed using quantitative data on response rates and attrition, and acceptability via sleep hygiene and quality scores, and qualitative data on intervention experiences. All criteria were met. The target response rate was exceeded, none of the 24 participants dropped out, and sleep hygiene and quality scores either improved or remained stable. In interviews, all participants reported finding script elicitation useful. Script elicitation raised participants' awareness of habitual sleep hygiene routines, which gave many a newfound sense of autonomy over changing their sleep hygiene habits. While the habitual nature of existing routines obstructed change for some participants, most reported successfully changing aspects of their routine, and achieving behaviour, sleep and wellbeing improvements. Script elicitation is a promising and acceptable method for tackling poor evening sleep hygiene habits. A more rigorous trial is warranted. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) and Autism Spectrum Disorder (ASD) are often accompanied by sleep problems influencing social, emotional and cognitive functioning in everyday activities. Aim: The aim of this study was to investigate whether the use of a weighted blanket has a positive impact on sleep and everyday activities in individuals with ADHD and/or ASD. Material and methods: The study included 85 individuals diagnosed with ADHD and/or ASD, 48 children aged <17 (57%) and 37 adults >18 years (44%), who were prescribed with a weighted blanket. The participants responded via a telephone interview. Results: Findings demonstrated that a weighted blanket improved abilities related to falling asleep, sleeping the whole night, and relaxing during the day. Using a weighted blanket improved morning/evening daily routine, including preparing/going to sleep and waking up in the morning. Conclusions: Weighted blankets showed positive impact on falling asleep, sleeping the whole night, and relaxing during the day, and they were used frequently by children and adults with ADHD and/or ASD. Findings indicate that a weighted blanket improved morning/evening routine, however this research area needs further investigation using both subjective and objective parameters. [ABSTRACT FROM AUTHOR]

Objective: To examine sleep health within a self-determination framework across a diverse college sample. Participants: A nonclinical sample of undergraduate students (n = 399) from a large, urban, public university in the Mid-Atlantic United States in Spring 2020. Methods: Participants were recruited via an online research participation portal and received extra credit for participation. All measures were administered via an online survey. Results: Basic psychological need satisfaction was associated with sleep health. This association was partially mediated by sleep hygiene but not by regulatory style. There were no racial/ethnic differences in sleep health, sleep hygiene, basic need satisfaction, or regulatory style. Men reported more maladaptive motivational styles for sleep health, and non-binary/transgender students reported worse sleep hygiene. Conclusion: Basic psychological need satisfaction and sleep hygiene are critical targets for intervention across diverse college student populations. Motivation may be less critical for nonclinical interventions. [ABSTRACT FROM AUTHOR]

Despite the clear influence of poor sleep on mental health, sleep education has been neglected in psychology training programs. Here, we develop a novel behavioral sleep medicine (BSM) education workshop, the Sleep Psychology Workshop, designed for integration within graduate psychology programs. We also examined the potential efficacy and acceptability of the workshop to upskill trainee psychologists in sleep and insomnia management. The Sleep Psychology Workshop was developed using a modified Delphi Method. Eleven trainee psychologists completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the workshop, delivered as three, two-hour lectures (total of six hours). Sleep knowledge, attitudes, and practice assessments were completed pre-and post-intervention using the GradPsyKAPS Questionnaire. A focus group and 6-month follow-up survey captured feedback and qualitative data. Trainees' sleep knowledge quiz scores (% correct) increased from 60% to 79% pre- to post-workshop (p =.002). Trainees' self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep disturbances increased, along with their confidence to manage insomnia (all p <.02). Participant feedback was positive, with 91% of trainees rating the workshop as "excellent" and qualitative data highlighting trainees developing practical skills in BSM. Six months post-intervention, 100% of trainees endorsed routinely asking their clients about sleep, with 82% reporting improvements in their own sleep. The Sleep Psychology Workshop is a potentially effective and acceptable introductory BSM education program for trainee psychologists, ready for integration within the graduate psychology curriculum. [ABSTRACT FROM AUTHOR]

To quantify school-age children's sleep and parent-associated factors on weekdays and weekends in Singapore, and investigate school-related and parent-related factors associated with short sleep. In an online survey, 251 parents with a child aged 7–12 y in Singapore reported their child's sleep duration and school start time. Parent-related factors including sleep hygiene (e.g., parent-set bedtime), sleep priority (the amount of sleep respondents allowed their children to trade for other activities), and both parents' sleep durations, were also reported. The prevalence of short sleep among the children was 64.5% on weekdays and 19.5% on weekends. Children's sleep duration increased from 8.42 h on weekdays to 9.45 h on weekends (p <.001). Relative to weekdays, on weekends, parents showed similar increases in sleep durations (p <.001), imposed poorer sleep hygiene on their children (reduced likelihood of setting bedtimes and increased pre-bedtime electronic device use; p <.001), and allowed their children to trade more sleep for interacting with family and friends, social media, gaming, and TV / videos (p <.001). Shorter sleep duration in children was significantly associated with earlier school start time (B = 0.80, p =.02) and poorer sleep hygiene on weekdays (B = 0.16, p <.001), but lower sleep priority (B = 0.05, p =.002) and shorter parental sleep duration on weekends (maternal: B = 0.18, p <.001, paternal: B = 0.17, p =.002). Delaying school start times may be effective in increasing school-age children's sleep duration on weekdays, while family-based interventions designed to enhance sleep hygiene, priority of sleep over other activities, and parents' sleep durations can benefit children's sleep duration on both weekdays and weekends. [ABSTRACT FROM AUTHOR]

There is little research in the field of problematic smartphone use, which directly enquired with users about what they find disturbing about smartphone usage behaviour. This qualitative study addressed sub-critical issues which may be a precursor to more severe problems such as problematic smartphone usage. Ninety-nine participants completed an online questionnaire with open questions regarding disturbing smartphone usage behaviour. Using the method of 'thematic analysis', we identified eight themes that we clustered into two overarching themes: reasons for use and consequences of use. Five themes related to reasons for use, including inevitability, habitual use, avoiding unpleasant circumstances, need satisfaction and fulfilling social expectations. Three themes referred to consequences of smartphone usage (i.e. life management, social life, and online life). Across all themes it appeared that the different aspects of disturbing smartphone usage were triggered and sustained by contextual factors and complex social dynamics, suggesting that participants lack control over their actual usage. Therefore, this research provides a holistic view of the sub-critical issues disturbing participants as well as identifies several mechanisms perpetuating these problems. The listing and description of such sub-critical issues and the different mechanisms are of high importance for prevention and the design of interventions. [ABSTRACT FROM AUTHOR]

This study examined the association between Night Eating Syndrome (NES) problems, sleep disturbances, and the expression of anxiety, depression, and stress in adolescents, taking gender into account. It also investigated whether sleep problems mediate the relationship between NES and anxiety, depression, and stress. This cross-sectional web-based study included 167 adolescents aged 12 to 18 (55.0% girls). Participants completed the self-report Night Eating Questionnaire (NEQ), Scales for Outcomes in Parkinson's disease (SCOPA) Sleep Scale, and Depression, Anxiety, and Stress Scale–21 items (DASS-21). Increased stress, worsening of depressive symptoms, difficulty falling asleep, and daytime sleepiness were all found to have a significant relationship with NES (p <.05). While higher DASS scores for stress and depression were associated with NEQ > 25 in adolescent girls, higher DASS scores for depression and SCOPA were related in adolescent boys (p <.05). Having trouble falling asleep and feeling sleepy during the day are directly linked to experiencing Night Eating Syndrome (NES). This is mediated both directly and indirectly through symptoms of depression and stress, with statistical significance (p < 0.05). Sleep problems, directly and indirectly, influenced the NES through depression and stress. Reducing depression and stress and addressing sleep problems may help treat NES in adolescents. [ABSTRACT FROM AUTHOR]

To evaluate the relationship between sleep habits and sleep bruxism (SB) in schoolaged children. Survey data were collected from the parents of 500 children (267 males and 233 females; age range 6–12 years). The American Academy of Sleep Medicine diagnostic criteria were used to evaluate SB. A Children's Sleep Habits Questionnaire was conducted to determine sleep habits. The chi-square test was used for statistical evaluation. SB was observed in 160 children (32%). SB awareness was 5.4%. The presence of SB in other family members, mothers' education ≤8 years, and income below minimum wage were found as family risk factors. The presence of sleep disorders was 61.4% and observed to be statistically higher in those with SB. SB is a prevalent disorder that might be associated with sleep disorders. The parents of children with SB had inadequate knowledge and awareness pertaining to SB. [ABSTRACT FROM AUTHOR]

Bedtime digital media use (BDM) is linked to poor sleep and fatigue in many populations. Pediatric cancer patients have been observed to engage in BDM in clinical settings, but it is unknown whether BDM rates are higher in this population or how this impacts their sleep and fatigue during treatment and into survivorship. The goal of this study was to evaluate patterns of BDM and its relationship with sleep and fatigue in a sample of pediatric cancer survivors and to compare these patterns with children from their own family (i.e. siblings) and children from unaffected families (i.e. healthy matched controls and siblings of controls). Ninety-nine children (4 groups: 24 acute lymphoblastic leukemia survivors, 13 survivor siblings, 33 controls, 29 control siblings) ages 8-18 were recruited from a long-term survivor clinic at a large children's hospital and via community advertisements. Survivors were 2-7 years post-treatment (M = 4.80 years). Children's BDM was parent-reported. Children completed 7 consecutive days of sleep actigraphy and the PedsQL Multidimensional Fatigue Scale. Most survivors (66.67%) engaged in BDM; smartphones were the most common medium. BDM patterns were equivalent across survivors, their siblings, controls, and control siblings. Statistical trends suggested that BDM was associated with fewer minutes of sleep and greater fatigue for all children; these relationships were equivalent across groups. BDM was common among survivors, but usage was not different from their own siblings or compared to healthy control children and sibling pairs. This study underscores the importance of assessing bedtime digital media use in childhood cancer survivors, although other factors impacting sleep should be explored. Clinicians should emphasize established recommendations for healthy media use and sleep habits in pediatric oncology settings. [ABSTRACT FROM AUTHOR]

Community-delivered sleep education interventions have been demonstrated to be effective in improving sleep outcomes, but whether these benefits persist once the program ends is not well characterized. This study sought to determine whether the previously reported positive effects attributed to the SLeep Education for Elders Program (SLEEP) were maintained six months after program completion. Nineteen participants were surveyed three times: at baseline, program completion (six weeks), and the six-month post-program timepoint. Sleep outcomes for quality, duration, insomnia symptoms, sleep hygiene behaviors, and excessive daytime sleepiness were assessed using validated surveys, including the Pittsburgh Sleep Quality Index (from which duration was also extracted), the Insomnia Severity Index, the Sleep Hygiene Index, and the Epworth Sleepiness Scale. Longitudinal models adjusted for baseline sleep problems revealed the benefits achieved immediately after the program were retained at six months for sleep quality (estimate: −2.0 (95%CI: −2.7, −1.3)), sleep duration (estimate: 0.9 (95%CI: 0.6, 1.2)), insomnia symptoms (estimate: −3.5 95%CI: (−4.6, −2.3)), and sleep hygiene behaviors (estimate: −2.6 (−4.3, −0.9)). These results suggest that a community-delivered sleep education intervention can produce sustained benefits for participants and should be considered as a tool to address uncomplicated sleep issues. [ABSTRACT FROM AUTHOR]

Delayed sleep-wake phase disorder (DSWPD) is common and easily misdiagnosed in young people, and to date, there is no evidence-based treatment. A nonblinded randomized controlled study evaluated the effect of agomelatine therapy (AT) and cognitive behavior therapy (CBT) on DSWPD in young adults. Sixty adolescents and young adults (range = 19–24 years, mean = 22 years, 52% female) diagnosed with DSWPD were randomized to receive 4 weeks of agomelatine therapy with or without cognitive behavior therapy. Sleep diaries, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and World Health Organization wellbeing questionnaire (WHO-5) were measured pre-treatment and post-treatment. Agomelatine therapy for 4 weeks shifted the sleep-wake rhythm (p <.001) forward in both groups at the week 4 assessment. There were no significant differences in sleep onset (p =.099) and sleep offset (p =.959) between the CBT group and the no treatment (NT) group at the follow-up visits. However, significant differences were found in sleep duration (p =.002), sleep quality (p=0.005), sleep difficulties (p <.001), daytime sleepiness (p =.001), and wellbeing (p =.007) between groups. The improvements were received largely through the sleep-promoting effects of agomelatine therapy, and combining with cognitive behavior therapy on maintenance of altered sleep rhythms might be feasible. [ABSTRACT FROM AUTHOR]

Humanitarian and health crisis have drastic effects on the physical and mental well-being of people. The COVID-19 pandemic forced many countries to impose containment measures on its population to halt the spread of the new coronavirus (SARS-CoV-2). This aim of this study was to explore self-reported sleep quality and insomnia symptoms in a sample of the Brazilian population before and during the COVID-19 quarantine period. Our data was collected through online questionnaires, including the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Sleep Hygiene Index. The final sample comprised 1,109 volunteers. Generalized estimating equations (GEE) revealed that during the initial months of the COVID-19 pandemic, alterations in self-reported sleep parameters were observed in the participants. Sleep efficiency and sleep duration increased, but there was a worsening in sleep quality and an increase in symptoms related to insomnia. [ABSTRACT FROM AUTHOR]

Keys to Embracing Aging (KTEA) is a community-based educational program that introduces and reinforces health behaviors that promote healthy aging. Data from 12 distinct KTEA lessons delivered by 42 Cooperative Extension educators to 764 unique participants across one year were examined to determine the program's impact on attitude, diet, physical activity, brain health, belonging, staying up-to-date, safety, health, stress, finances, sleep, and self-care. The most frequent immediate behavior changes occurred in practicing self-care, developing a positive attitude, and making safe choices. And longer-term behavior change was reported in the areas of maintaining a positive attitude, brain health, and healthy eating. Participants discussed challenges related to time, commitment, and maintaining a habitual routine of healthy behaviors. KTEA outcomes indicated a promising community-based educational program and supported continued investigation and development in health promotion within Cooperative Extension. Future research is needed to examine the versatility and long-term effects of the KTEA intervention. [ABSTRACT FROM AUTHOR]

Early school leaving (ESL) is considered a significant societal issue globally due to the negative effect on young people's health, affect, and quality of life. Continued absenteeism is a risk factor for ESL. This study aimed to explore Irish children's health and wellbeing experiences during school closures due to the COVID-19 pandemic. These children were all considered at risk of ESL by their schools. Semi-structured interviews, adopting a "write, draw or tell" method, were conducted with ten children ages 9 − 13 years old. The study used an Interpretative Phenomenological Analysis (IPA) methodology. The loss of routine, social ties, and sense of success and belonging experienced in schools had a detrimental impact on the health and wellbeing of the children. They experienced adverse mental health effects, including anxiety, depression, anger, and loneliness. Their physical health and wellbeing were impacted by changes to sleep behavior, physical activity levels, boredom, and gaming usage. Children remain very vulnerable to the impact of school closures, contact restrictions, and living with the pandemic. Recommendations include improving online resources for young people and developing in-school programs to improve sleep hygiene. [ABSTRACT FROM AUTHOR]

We aim to investigate factors which might affect the sleep of medical students, and how they currently manage their sleep. An online survey was sent to medical students at the University of Otago. After adjusting for gender, ethnicity and age, depressive symptoms (Mild: odds ratio (OR) = 6.3; Moderate: OR = 18.1; Severe: OR = 15.6), and sleep hygiene (OR = 1.07) were associated with insomnia symptoms. Commonly endorsed strategies for sleep management by students were undertaking regular exercise (80.1%), having consistent sleep-wake time (71.3%), and limiting caffeine intake (70.3%). Few were willing to see a clinician (23.4%) or take medication (22.3%). Participants with insomnia symptoms were more likely to prefer limiting their alcohol intake (OR = 1.8), limiting daytime naps (OR = 1.5), seeing clinicians (OR = 1.9), and taking sleep medication (OR = 4.0), but less likely to prefer avoiding intense work (OR =.71) or minimizing using electronics (OR =.60) close to bedtime than those without insomnia symptoms. High sleep self-efficacy was associated with lower odds for having insomnia symptoms (OR =.74 (.70,.77)). Increased awareness and greater resources are needed to support the sleep health of medical students. [ABSTRACT FROM AUTHOR]

With few treatment options available for non-ambulatory children with cerebral palsy (CP), a robotic lower extremity gait trainer may provide a non-invasive addition to conventional treatment options. This case study investigates the usage and impact of robotic lower extremity gait trainer use in a participant with CP over the initial 3 months of use. This prospective case study involves a 7-year old female (GMFCS V) with CP (registered clinical trial: NCT04251390). The participant used a Trexo Home robotic gait trainer (Trexo) in the community with assessments occurring in the home and school. Trexo usage and bowel movements (BMs) were tracked daily. Postural control and lower extremity range of motion (ROM) and spasticity were evaluated prior to Trexo use and weekly to biweekly thereafter. The participant used the device an average of 46 min/week, over 3.3 d/week. BM frequency increased from 0.4/d at baseline, to 1.2 (±0.5)/d during Trexo use. There were no diffuse systematic changes in postural stability, ROM or muscle spasticity, but specifically head control and spasticity in the knee flexors had improvements. Data and anecdotal reports suggest that regular use of the Trexo Home robotic gait trainer has positive outcomes on frequency and quality of BMs, and may improve head control, and knee flexor spasticity. Larger controlled studies are needed to evaluate the impacts of Trexo use in children with CP. Non-ambulatory children with CP can use and may experience benefits from using a robot-assisted gait trainer (RAGT). Constipation, aspects of balance and focal spasticity may improve. [ABSTRACT FROM AUTHOR]

We examined the direct and indirect effects of sleep hygiene practices on restful sleep and mental health with a sample of 270 NCAA Division I student athletes. Bootstrapping mediation analysis with 95% confidence intervals indicated that sleep hygiene had a direct and indirect effect, via days of restful sleep in the past week, on psychological distress and psychological well-being. Better sleep hygiene was associated with more days of restful sleep, improved well-being, and decreased distress. [ABSTRACT FROM AUTHOR]

Pandemics are amongst the most destructive disasters to have afflicted humankind through history. These disasters entail a disproportionate effect on refugee populations, who are already in a state of high vulnerability. This study aims to assess the perception of risk of COVID-19 in the refugee populations in Turkey, in addition to evaluating anxiety levels during the pandemic. The participants of this study were refugees enrolled in a local nonprofit organization in Istanbul. They were asked to complete questionnaires which asked about COVID-19 and any self-protection measures. The questionnaire also incorporated the General Anxiety Disorder-7 screening test. In this young, male and mostly unemployed population, knowing someone who experienced COVID-19 was associated with a greater likelihood of compliance with hygiene and physical distancing measures. Anxiety levels were above 29%, and the highest scores were in the age group between 25 and 55 years. We argue that comprehensive public health measures against COVID-19 should include focused interventions for refugee populations that take the extra vulnerability (health, financial, and other) into account. [ABSTRACT FROM AUTHOR]

As a necessary part of physiological and emotional well-being, sleep is often overlooked or undervalued in Western society, in spite of the role restorative sleep plays in growth, healing and recovery, immune response, and emotional regulation. The effect of psychoactive drugs on sleep, including pharmacological substances meant to assist in sleep, is notable and profound, especially in their disruption of REM sleep, the stage of sleep associated with dreaming. This article provides an overview of sleep stages, the brain and sleep, sleep disorders, and the effect of various psychoactive drugs on sleep architecture and hygiene. Future research that treats substance use and sleep as bi-directional in nature and longitudinally explores sleep-related interventions in treatment and longer-term recovery that are sustainable and person-centered is merited. [ABSTRACT FROM AUTHOR]

Sleep is inexorably linked to both physiological and psychological wellbeing. Restrictions imposed to control the COVID-19 pandemic likely impacted upon daily and weekly routines, which can have a negative impact on a range of factors including sleep quality, and/or quantity and general wellbeing. The aim of this study was to investigate the effect of COVID-19 related restrictions on sleep patterns and psychological wellbeing of healthcare students. A survey was delivered to healthcare students across three faculties at a single institution. Participants completed questionnaires on the effect of COVID-19 restrictions on course delivery and clinical placements, its effect on sleep-wake times, sleep quality, sleep hygiene, psychological wellbeing, their current sleep knowledge and sleep education in their current course. Using the Pittsburgh Sleep Quality Index (PSQI), over 75% of participants were found to have poor sleep quality. Changes in sleep habits and sleep behaviours during COVID-19 restrictions were associated with poorer sleep quality, and this poor sleep quality was associated with poor psychological wellbeing, particularly, motivation, stress and fatigue. Increases in negative sleep hygiene behaviours were associated with a statistically significant increase in PSQI global score. Positive emotions were positively correlated with PSQI (r = 0.22–0.24, p <.001), negative emotions were negatively correlated with PSQI (r = −0.22 - −0.31, p <.001). Also, a self-perceived lack of sleep education was identified. This study illustrates the negative association between self-reported poor sleep behaviour and poor sleep quality during COVID-19 restrictions on university student mental health and wellbeing. Additionally, there is a self-perceived lack of sleep education with little to no time spent educating students in their current degree. Hence, appropriate sleep education may improve sleep behaviours and subsequent sleep quality, which may prove to be a protective factor against poor mental health in the face of unexpected changes to routines. [ABSTRACT FROM AUTHOR]

Disrupted sleep is associated with non-suicidal self-injury (NSSI) in young adults, but many specific features of sleep continuity and timing have yet to be examined. Additionally, the psychological mechanisms linking sleep to NSSI are unclear. The present study evaluated 14 sleep variables as classifiers of lifetime or recent NSSI and examined potential confounding and mediating factors. A sample of 885 college students provided measures of sleep continuity (e.g., duration, timing, fragmentation), nightmares, insomnia, and perceived sleep control. Lifetime and past 3-month NSSI were measured using a self-report version of the Columbia Suicide Severity Ratings Scale. Bidirectional stepwise regression identified significant sleep classifiers and subsequent models examined their associations with NSSI after adjusting for covariates and through potential psychological mediators. Only absolute social jetlag was associated with recent NSSI, even after adjusting for covariates, such that each additional hour difference between weekday and weekend sleep schedules was associated with a 17% greater risk of recent NSSI. Nightmares, weekend sleep efficiency, and perceived sleep control were associated with lifetime NSSI, although only weekend sleep efficiency remained associated after adjusting for covariates. Bootstrap mediations identified negative urgency as a partial mediator for recent and lifetime NSSI, and lack of premeditation and perceived burdensomeness as partial mediators for lifetime NSSI. The timing and consistency of young adults' sleep schedules may be of greater importance to NSSI among college students than insomnia or insufficient sleep. Future studies of sleep and NSSI should include these measures as potential risk factors. Differences between weekday/weekend sleep timing are linked to recent NSSI. Negative urgency partially mediates poor sleep on recent and lifetime NSSI. Sleep shares a multifaceted relationship with NSSI risk in college students. [ABSTRACT FROM AUTHOR]