Search

Chia-Chao Wu,1,2 Pei-Lin Yang,3 Li-Ting Kao,4– 6 Yi-Chun Liu,7,8 Cai-Mei Zheng,9 Pauling Chu,1 Kuo‐Cheng Lu,10 Chi-Ming Chu,7,11– 13 Yu-Tien Chang7 1Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 2Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan; 3School of Nursing, National Defense Medical Center, Taipei City, Taiwan; 4School of Pharmacy, National Defense Medical Center, Taipei, Taiwan; 5Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; 6Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan; 7School of Public Health, National Defense Medical Center, Taipei City, Taiwan; 8Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan; 9Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 10Division of Nephrology, Fu-Jen Catholic Hospital, Fu-Jen Catholic University, Taipei, Taiwan; 11Department of Surgery, Songshan Branch of Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan; 12Division of Biostatistics and Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan; 13Department of Public Health, China Medical University, Taichung City, TaiwanCorrespondence: Yu-Tien Chang, School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Road, Neihu Dist, Taipei City, 11490, Taiwan, Tel +886-2-87923100#18454, Email greengarden720925@gmail.comObjective: Weekend sleep duration is linked to health issues, including mortality. However, how weekend sleep duration can impact chronic kidney disease (CKD) still needs to be understood. Therefore, we aimed to analyze how weekend sleep duration is associated with kidney function.Methods: This is a cross-sectiona

Rongcui Sui,1– 3 Jie Li,4 Yunhan Shi,1– 3 Shizhen Yuan,1– 3 Huijun Wang,1– 3 Jianhong Liao,1– 3 Xiang Gao,1– 3 Demin Han,1– 3 Yanru Li,1– 3 Xingjun Wang4 1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, People’s Republic of China; 3Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, People’s Republic of China; 4Department of Electronic Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, People’s Republic of ChinaCorrespondence: Demin Han; Yanru Li, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Dongcheng District, Beijing, People’s Republic of China, Email deminhan_ent@hotmail.com; liyanruru@aliyun.comPurpose: This study aimed to investigate the association between sleep spindle metrics and executive function in individuals with obstructive sleep apnea (OSA). Furthermore, we examined the association of age and education on executive function.Patients and Methods: A total of 230 (40.90 ± 8.83 years, F/M = 45/185) participants were enrolled. Overnight electroencephalogram (C3-M2) recording detected sleep spindles by a novel U-Net-type neural network that integrates temporal information with time-frequency images. Sleep spindle metrics, including frequency (Hz), overall density (events/min), fast density (events/min), slow density (events/min), duration (sec) and amplitude (μV), were measured. Executive function was assessed using standardized neuropsychological tests. Associations between sleep spindle metrics, executive function, and demographic factors were analyzed using multivariate linear regression.Results: In fully adjusted linear regression models, higher overall sleep spindl

Haonan Wang,1,2 Yinghong Dai,3 Xiaotian Li,2,4 Liang Yu1 1Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing, 100084, People’s Republic of China; 2Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China; 3Xiangya School of Medicine, Central South University, Changsha, 410008, People’s Republic of China; 4School of Sport Training, Wuhan Sports University, Wuhan, Hubei, 430079, People’s Republic of ChinaCorrespondence: Xiaotian Li, Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China, Tel +86 18975197870, Fax +86 731 88876141, Email xiaotianli@csu.edu.cn Liang Yu, Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing, 100084, People’s Republic of China, Tel/Fax +86 1062967640, Email yuliang@bsu.edu.cnIntroduction: Poor sleep negatively impacts cognitive and physical functioning and affects athletic and academic achievement. “Dual-career” athletes emphasize the pursuit of academic excellence along with athletic performance.Purpose: The study aimed to assess sleep characteristics and sleep quality in dual-career collegiate badminton athletes. Furthermore, the study explored associations between training and academic stress and sleep, providing a theoretical basis for better training and sleep programs for dual-career athletes.Participants and Methods: In this study, 15 dual-career collegiate badminton athletes were recruited, and 12 subjects (male n = 8, female n = 4, mean age 20.3 ± 1.7) completed the questionnaire. Repeated measurements were taken monthly in the spring semester from March to August 2021. The questionnaire assessed sleep quality and daytime sleepiness by the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Score (ESS). Moreover, we collected average training, study time per week, and monthly sports competitions and ac

Hilal Uygur,1 Oli Ahmed,2 Omer Faruk Uygur,3 Christopher B Miller,4,5 Onur Hursitoglu,6 Aynur Bahar,7 Dudu Demiroz,8 Christopher L Drake9,10 1Department of Psychiatry, Erzurum Training and Research Hospital, Erzurum, Turkey; 2Department of Psychology, University of Chittagong, Chattogram, Bangladesh; 3Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Turkey; 4Big Health Ltd, London, UK; 5Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK; 6Department of Psychiatry, Sular Academy Hospital, Kahramanmaras, Turkey; 7Department of Psychiatric Nursing, Gaziantep University Faculty of Health Sciences, Gaziantep, Turkey; 8Department of Psychiatry, Karamanoglu Mehmetbey University, Karaman, Turkey; 9Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI, USA; 10Department of Psychiatry and Behavioral Neurosciences, Wayne State College of Medicine, Detroit, MI, USACorrespondence: Hilal Uygur, Department of Psychiatry, Erzurum Training and Research Hospital, Erzurum, Turkey, Tel +90 (442) 4321000, Email atilahilal@yahoo.comPurpose: We aimed to adapt the Turkish Sleep Condition Indicator (SCI) version and examine its psychometric properties among the general population.Methods: This study was a cross-sectional study. The item-total correlation, standard error of measurement, Cronbach’s α, and McDonald’s ω were used for internal consistency. We ran confirmatory factor analysis (CFA) and network analysis to confirm the factor structure. Multigroup CFA was run to assess the measurement invariance across gender, whether clinical insomnia or not, and poor sleep quality. We correlated SCI scores with Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) scores to evaluate construct validity. A receiver operating characteristic (ROC) curve analysis was conducted to calculate the cut-off score of the SCI. The temporal stability was examined with the intraclass c

Maurice Junior Chery,1 Amrit Baral,1 LaShae D Rolle,1 Alireza Abdshah,1 Maritza J Bernard,2 Laxmi Poudel,3 Laura Francois,1 Deborah L Jones,4 Girardin Jean-Louis,4 Judite Blanc4 1Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA; 2Anne Bates Leach Eye Hospital at Bascom Palmer Eye Institute, the University of Miami Miller School of Medicine, Miami, FL, USA; 3South Florida Integrative Medicine, Miami, FL, USA; 4Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Judite Blanc, Department of Public Health Sciences, the University of Miami Miller School of Medicine, 1120 NW 14th St, Room 1448, Miami, FL, 33136, USA, Tel +1 954 471 0739, Email juditeblanc@miami.edu Maurice Junior Chery, Department of Public Health Sciences, the University of Miami Miller School of Medicine, 1120 NW 14th St, Room 1448, Miami, FL, 33136, USA, Tel +1 343 204 7128, Email mxc2759@miami.eduPurpose: The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic.Methods: We conducted a secondary analysis using self-reported data from the 2021 National Health Interview Survey (NHIS), focusing on adults aged 18 years and above (n=29,763). We utilized self-reported responses to questions about prescription medication and frequency of depressive feelings to determine participants’ depression status. Appropriate weights were applied to account for the sampling design of the surveys. Our analysis involved descriptive statistics and chi-squared tests to compare sociodemographic, clinical, behavioral, and sleep-related characteris

Yousef D Alqurashi,1 Abdullah S Alqarni,1 Faisal Maher Albukhamsin,1 Abdullah Abdulaziz Alfaris,1 Bader Ibrahim Alhassan,1 Waleed Khalid Ghazwani,1 Abdulaziz Abdulrahman Altammar,1 Mutlaq Eid Aleid,1 Hayfa Almutary,2 Abdulelah M Aldhahir,3 Saleh A Alessy,4 Rayyan Almusally,5 Abir Alsaid,5 Mahmoud Ibrahim Mahmoud,5 Hatem Othman Qutub,5 Tunny Sebastian,6 Suliman Alghnam,7 Michael I Polkey8 1Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Medical Surgical Nursing Department, King Abdulaziz University, Jeddah, Saudi Arabia; 3Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 4Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah, Saudi Arabia; 5Internal Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia; 6Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 7Population Health Section-King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; 8Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UKCorrespondence: Yousef D Alqurashi, Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, 34221, Saudi Arabia, Email ydalqurashi@iau.edu.saIntroduction: Sleepy driving is associated with Motor Vehicles Accidents (MVAs). In Saudi Arabia, previous studies have addressed this association among men only. Therefore, the aim of this study was to compare the prevalence of sleepy driving and associated factors between genders.Methods: In a cross-sectional study design, we offered a self-administered online questionnaire to 3272 participants from different regions of Saudi Arabia. The questionna

Nathalie Demaeyer,1 Marie Bruyneel1,2 1Department of Pneumology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium; 2Department of Pneumology, CHU Brugmann, Université Libre de Bruxelles, Brussels, BelgiumCorrespondence: Marie Bruyneel, Department of Pneumology, CHU Saint-Pierre, 322 rue haute, Brussels, 1000, Belgium, Tel +3225354219, Fax +3225353362, Email marie.bruyneel@stpierre-bru.beAbstract: The prevalence of obstructive sleep apnea (OSA) among the bariatric surgery population is estimated to be 45– 70%. However, weight loss obtained by bariatric surgery is not always associated with full remission of OSA, suggesting that other confounding factors are present. This article aims to review the current literature, focusing on factors that could predict the persistence of OSA after bariatric surgery. For this purpose, relevant studies of more than 50 patients that assessed pre- and post-operative presence and severity of OSA detected by poly(somno)graphy (PG/PSG) in bariatric populations were collected. Six retrospective and prospective studies were evaluated that included 1302 OSA patients, with a BMI range of 42.6 to 56 kg/m2, age range of 44.8 to 50.7 years, and percentage of women ranging from 45% to 91%. The studies were very heterogeneous regarding type of bariatric surgery, diagnostic criteria for OSA and OSA remission, and delay of OSA reassessment. OSA remission was observed in 26% to 76% of patients at 11– 12 months post-surgery. Loss to follow-up was high in all studies, leading to a potential underestimation of OSA remission. Based on this limited sample of bariatric patients, age, pre-operative OSA severity, proportion of weight loss, and type 2 diabetes (T2D) were identified as factors associated with OSA persistence but the results were inconsistent between studies regarding the impact of age and the magnitude of weight loss. Several other factors may potentially lead to OSA persistence in the bariatric surgery population, suc

Li Zeng,1 Yongqiang Shu,1,2 Wei Xie,3 Yaping Zeng,4 Kunyao Li,5 Ting Long,1 Ling Huang,1 Xiang Liu,1 Haijun Li,1,2 Dechang Peng1,2 1Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China; 2Department of PET, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China; 3Department of Radiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China; 4Department of Radiology, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China; 5Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Dechang Peng; Haijun Li, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwai Zheng Street, Donghu District, Nanchang, Jiangxi Province, 330006, People’s Republic of China, Tel +86 79186427565, Email pengdcdoctor@163.com; haijunli1990@163.comPurpose: Previous studies demonstrated that there was abnormal functional connectivity (FC) in the amygdala subregions in obstructive sleep apnea (OSA), which was associated with cognitive function. However, it is not clear whether these abnormalities can be improved after continuous positive airway pressure (CPAP) treatment. Therefore, the aim of this research was to investigate the changes in FC of amygdala subregions with other brain regions after 6 months of CPAP treatment (post-CPAP) in patients with OSA.Patients and Methods: Fifteen OSA patients underwent Magnetic Resonance Imaging prior to CPAP treatment (pre-CPAP) and following CPAP treatment. The amygdala was divided into six subregions, including bilateral dorsal amygdala (DA), medial amygdala (MA) and ventral amygdala (VA). The FC was calculated by using the amygdala subregions as seeds. A paired sample T-test was employed to assess alterations in

Abdulmajeed Abdullah Alghamdi,1 Abdulmalik Abdulrahman Abanumai,1 Meshal Fawaz Althobaiti,2 Meshari Salem Alzahrani,1 Salma Yasser Abu-Saleh,3 Achraf Ammar,4,5 Hadeel Ghazzawi,6 Khaled Trabelsi,7,8 Nicola Bragazzi,9 Ahmed S BaHammam,10,11 Haitham Jahrami,1,12 Maha M AlRasheed13 1Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 2Department of Medicine, College of Medicine, Taif University, Taif, Saudi Arabia; 3Department Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany; 5Interdisciplinary Laboratory in Neurosciences, Physiology, and Psychology: Physical Activity, Health, and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France; 6Nutrition and Food Science Department, Agriculture School, The University of Jordan, Amman, Jordan; 7High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia; 8Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia; 9Human Nutrition Unit (HNU) and Department of Food and Drugs, University of Parma, Medical School, Building C, Parma, Italy; 10The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, King Saud University, Riyadh, Saudi Arabia; 11King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 12Department of Psychiatry, Government Hospitals, Manama, Bahrain; 13Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Maha M AlRasheed, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, PO Box 2457, Riyadh, 11451, Saudi Arabia, Tel +966-114678707, Fax +966-114677480, Email mahalrasheed@ksu.edu.saBackground: Insomnia disorder is

Jun Zhang,1,* Xiaoyan Chen,2,* Yan Zhu,1,* Shanshan Wan,1 Shuqiong Hu,3 Yanning Yang1 1Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China; 3Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanning Yang, Department of Ophthalmology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, Hubei Province, People’s Republic of China, Tel/Fax +86-27-88041911, Email ophyyn@163.comBackground: Although previous studies of sleep-related behaviors in relation to primary open-angle glaucoma (POAG) have been noted, the causal relationship remains unclear. The purpose of our present study was to investigate the relationships of genetically predicted sleep traits with POAG using a two-sample bidirectional Mendelian randomization (MR) method.Methods: Summary-level data collected from publicly available genome-wide association studies (GWAS) of European decent were applied for the bidirectional MR analysis. After quality control steps, independent single-nucleotide polymorphisms for eight sleep behaviors and POAG were selected as the genetic instruments. The inverse-variance weighted (IVW) approach was adopted as the primary method, which was complemented by a series of sensitivity analyses to assess the robustness of the results by estimating heterogeneity and pleiotropy. Multivariable MR (MVMR) was used to assess the direct effect of sleep traits on POAG, after adjusting for several confounding factors.Results: Our investigation revealed a positive correlation between genetically predicted ease of getting up in the morning and sleep duration and POAG using the IVW method (

Guangxin Zhou,1,2 Wei Zhao,2 Yi Zhang,2 Wenli Zhou,2 Haizhou Yan,2 Yongli Wei,1 Yuming Tang,1 Zijing Zeng,2 Hanrong Cheng1 1Department of Sleep Medicine, Institute of Respiratory Diseases, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 2OPPO Health, Guangdong OPPO Mobile Telecommunications Co. Ltd., Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Hanrong Cheng, Department of Sleep Medicine, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China, Email cheng.hanrong@szhospital.comObjective: To evaluate the clinical performance of the OPPO Watch (OW) Sleep Analyzer (OWSA) on OSA screening with polysomnography reference.Methods: We recruited 350 participants using OWSA and PSG simultaneously in a sleep laboratory. The respiratory event index (REI) derived from OWSA and the apnea-hypopnea index (AHI) provided by PSG were compared. SHapley Additive exPlanation (SHAP) values were calculated to explain the model of OWSA.Results: The OWSA-REI (26.5± 18.5 events/h) correlated well with PSG-AHI (33.2± 25.7 events/h; r = 0.91, p < 0.001), with an intraclass correlation coefficient (ICC) of 0.83. Using a threshold of AHI ≥ 15 events/h, the sensitivity, specificity, accuracy, and area under the curve (AUC) were 86.1%, 86.7%, 86.3%, and 0.94, respectively. Bland-Altman analysis showed that OWSA-REI and PSG-AHI were in good agreement (Mean Difference: − 6.7, 95% CI:16.0 to − 29.3 events/h). In addition, the effectiveness of the models in OWSA were also explained by visualizing SHAP values.Conclusion: The OWSA demonstrated a reasonable performance for OSA screening in the clinical setting. In light of this, it is possible for s

Myrto Koutsonida,1 Maria Psyhogiou,2 Eleni Aretouli,3,&ast; Konstantinos K Tsilidis1,4,&ast; 1Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece; 2Interdisciplinary Department 10B, General Hospital “Evaggelismos”, Athens, Greece; 3Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece; 4Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK&ast;These authors contributed equally to this workCorrespondence: Eleni Aretouli; Konstantinos K Tsilidis, Tel +30 2651005775 ; +44 20 7594 2623, Email earetouli@uoi.gr; k.tsilidis@imperial.ac.ukPurpose: Sleep is essential to all human body functions as well as brain functions. Inadequate sleep quantity and poor sleep quality have been shown to directly affect cognitive functioning and especially memory. The primary aim of the present study was to investigate the association of sleep quality with cognitive abilities cross-sectionally in a middle-aged Greek population and secondarily to examine this association prospectively in a smaller group of these participants.Patients and Methods: A total of 2112 healthy adults aged 25– 70 years (mean: 46.7± 11.5) from the Epirus Health Study cohort were included in the analysis and 312 of them participated in secondary prospective analysis. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) scale and cognition was assessed in primary cross-sectional analyses with three neuropsychological tests, namely the Verbal Fluency test, the Logical Memory test and the Trail Making test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, the Corsi block-tapping task and the Stroop task. Statistical analysis was performed using multivariable linear regression models adjusted for age, sex, education, body mass index and alcohol consumption.Results: Attention/process

Cristian Ricci,1,2 Madeleine Ordnung,1 Dietrich Rothenbacher,3 Jon Genuneit1,3 1Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany; 2Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa; 3Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, GermanyCorrespondence: Madeleine Ordnung, Liebigstraße 20a, Haus 6, Leipzig, 04103, Germany, Tel +49 341 - 97 24182, Fax +49 341 - 97 28210, Email madeleine.ordnung@medizin.uni-leipzig.dePurpose: Healthy sleep is essential for the physical, cognitive, and social development of children. Several studies have reported the increase in digital media use in preschool children and its association with impaired sleep. However, there is relatively little evidence on the effects of book reading as a potentially safe alternative. The objective of this study, therefore, was to investigate whether sleep in children could benefit from book reading, and whether the negative effects of media use on sleep can be mitigated by substituting book reading for screen time.Participants and Methods: We used longitudinal data from three consecutive waves of the SPATZ Health study, including children at the ages of 4 (n=581), 5 (n=508), and 6 (n=426) years. All data were collected by self-administered questionnaires. Parent-reported child sleep was assessed by the Children’s Sleep Habits Questionnaire.Results: Across the three waves, screen-based media use increased and was associated with lower sleep quality. In contrast, the time spent with book reading decreased; however, book reading appeared to be beneficial for children’s sleep. Substitution models revealed that the theoretical substitution of an equal amount of book reading for 50% of the time spent with screen-based media benefits several domains of preschoolers’ sleep health, including parasomnias, sleep anxiety, daytime sleepiness, and sleep onset delay.Conclusion

Fei Xu,1 XiuRong Zhang,2 YinRong Zhang,1 WenHui Chen,3 ZiCong Liao1 1General Surgery Department, Zhongshan Boai Hospital, Zhongshan, Guangdong, 528400, People’s Republic of China; 2Breast Surgery Department, Zhongshan Boai Hospital, Zhongshan, Guangdong, 528400, People’s Republic of China; 3Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, People’s Republic of ChinaCorrespondence: ZiCong Liao, General Surgery Department, Zhongshan Boai Hospital affiliated to Southern Medical University, No. 6 Chenggui Road, East Street, Zhongshan, Guangdong, 528400, People’s Republic of China, Tel +86 76088776658, Email dr_liaozc@163.com WenHui Chen, Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Avenue West, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel +86 13129349492, Fax +86 20 38688608, Email jnucwh2019@163.comBackground: Observational studies have yielded conflicting evidence concerning the relationships between obstructive sleep apnea (OSA) and bone mineral density (BMD). As the exact causal inferences remain inconclusive, we conducted a two-sample Mendelian randomization (MR) to identify the causal associations between OSA and BMD.Methods: Single-nucleotide polymorphisms associated with OSA were extracted from the FinnGen study. Summary statistics for 10 BMD measured at different age or skeletal sites were obtained from the publicly available IEU GWAS database. Inverse-variance weighted (IVW) method was chosen as the primary analysis, combined with several sensitivity analyses to evaluate the robustness of results. The study design included two-sample MR and network MR.Results: Our primary MR analysis revealed that genetically predicted OSA was positively linked to increased forearm BMD (β = 0.24, 95% confidence interval [CI]: 0.06– 0.41, p = 0.009) and heel BMD (β=0.10, 95% CI = 0.02– 0.18, p = 0.01

Wan Y, Lv M, Zhou K, et al. Nat Sci Sleep. 2023;15:511-522. The authors wish to advise that an unauthorized version of the Chinese MMSE was used by the study team without permission. The MMSE is a copyrighted instrument and may not be used or reproduced in whole or in part, in any form or language, or by any means without written permission of PAR (www.parinc.com). The issue was resolved between the authors and PAR. The authors confirm that no test items from the unauthorized version of the Chinese MMSE are included in the article.

Yu Kawasaki,1 Takatoshi Kasai,2– 5 Yuko Sakurama,6 Fusae Kawana,2 Nanako Shiroshita,2 Natsue Koikawa6,7 1Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan; 2Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; 3Department of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine, Tokyo, Japan; 4Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; 5Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan; 6Japanese Center for Research on Women in Sport, Juntendo University, Tokyo, Japan; 7Graduate School of Health and Sports Science, Juntendo University, Chiba, JapanCorrespondence: Takatoshi Kasai, Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, Japan, Tel +81-33813-3111, Fax +81-5689-0627, Email kasai-t@mx6.nisiq.netPurpose: Female athletes with menstrual abnormalities have poor sleep quality. However, whether female athletes with poor sleep quality based on subjective assessment have distinctive changes in objective measures of sleep in association with menses remains unclear. This study aimed to compare changes in objective sleep measurements during and following menses between collegiate female athletes with and without poor subjective sleep quality.Patients and Methods: Female collegiate athletes (age range/mean ± standard deviation: 18– 22/ 22.2± 1.1) with regular menstrual cycles were recruited. The participants underwent home electroencephalogram monitoring during the first and second nights after the onset of menses and one night between the seventh and 10th nights after menses onset (mid-follicular phase). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the subjective sleep quality. Interactions between the presence of po

Lian Weng,1– 3,&ast; Xiongjunjie Luo,1– 3,&ast; Yuxi Luo,1– 3 Qian Zhang,1– 3 Kaitao Yao,1– 3 Junjie Tan,1– 3 Yiran Yin1– 3 1Department of orthopedics, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, 646000, People’s Republic of China; 2Sichuan Provincial Laboratory of Orthopedic Engineering, Luzhou, Sichuan Province, 646000, People’s Republic of China; 3Department of Clinical Medicine, Southwest Medical University, Luzhou, 646000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yiran Yin, Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, No. 25 Tai Ping Street, Jiang Yang District, Luzhou, Sichuan Province, 646000, People’s Republic of China, Tel +13982457750, Email yiranyin@swmu.edu.cnBackground: Sleep apnea syndrome(SAS) and osteoarthritis (OA) are two prevalent diseases that often coexist, but the causal relationship between them remains unclear. In light of this, our team utilizes Mendelian Randomization and bioinformatics analysis methods to investigate the potential association between the two diseases.Methods: In this study, we utilized GWAS data pertaining to SAS and OA to assess the causal relationship between the two diseases through Mendelian randomization (MR) analysis. We then employed transcriptomic data to perform differential gene identification, WGCNA, shared gene determination, functional enrichment analysis, and colocalization analysis, all designed to further elucidate the mechanisms underlying the association between the two diseases. In the end, we utilized Mendelian randomization (MR) analysis again to delve deeper into the relationship between the two diseases and immune cells.Results: Our research findings indicate that SAS is a risk factor for OA (p = 0.000004), knee OA (p = 0.0000001) and hip OA(p = 0.001). Furthermore, OA (p = 0.000195), knee OA (p = 0.001) are significant risk factors for S

Joaquin U Gonzales, Jacob R Dellinger Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USACorrespondence: Joaquin U Gonzales, Department of Kinesiology and Sport Management, Texas Tech University, Box 43011, Lubbock, TX, 79409-3011, USA, Tel +1 806-834-5944, Email joaquin.gonzales@ttu.eduPurpose: Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP measured during exercise after controlling for factors known to influence the exercise pressor reflex.Methods: Twenty-nine young adults (22± 4y; 19 men, 10 women) performed cycling exercise until volitional fatigue to assess peak oxygen uptake (VO2). Actigraphy was used to monitor sleep duration and daily physical activity for seven consecutive days after which participants completed two bouts of moderate-intensity cycling while BP and VO2 were measured using a Tango+ device and indirect calorimetry, respectively. Systolic BP was averaged from the two bouts of exercise and expressed as a change from seated rest (∆SBP). Sleep duration regularity was calculated as standard deviation (SD) and coefficient of variation (CV).Results: Systolic BP at seated rest, during exercise, and ∆SBP was 113± 13, 152± 21, and 38± 13 mmHg, respectively. Sleep duration SD (range 10– 146 min) and sleep duration CV (range 2– 54%) when excluding weekend nights were significantly correlated with ∆SBP (r = 0.58 and r = 0.62, respectively; both p< 0.01) after adjusting for age, sex, body mass index, peak VO2, physical activity, resting systolic BP, chronotype, and the VO2 response to exercise. Sleep duration regularity analyzed with weekend nights included (across all seven days) was also significantly correlated with ∆SBP (p≤ 0.01), but had weaker correlation coefficients.Conclusion: These results indicate that sleep regularity, especially when excluding weekend nights, is associate

Emily Kemp,1 Kate Sutherland,1– 3 Yu Sun Bin,2,3 Andrew SL Chan,1– 3 Hasthi Dissanayake,2,3 Brendon J Yee,2– 5 Kristina Kairaitis,2,3,6,7 John Robert Wheatley,2,3,6,7 Philip de Chazal,2,8 Amanda J Piper,2,4 Peter A Cistulli1– 3 On behalf of the Sydney Sleep Biobank Investigators1Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia; 2Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia; 3Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; 4Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 5Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Glebe, NSW, Australia; 6Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; 7Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia; 8School of Biomedical Engineering, The University of Sydney, Darlington, NSW, AustraliaCorrespondence: Peter A Cistulli, Department of Respiratory and Sleep Medicine, Level 8A, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia, Tel +61 29463 2934, Fax +61 2 9463 2099, Email peter.cistulli@sydney.edu.auAim: Recent data have identified specific symptom and polysomnographic profiles associated with cardiovascular disease (CVD) in patients with obstructive sleep apnoea (OSA). Our aim was to determine whether these profiles were present at diagnosis of OSA in patients with established CVD and in those with high cardiovascular risk. Participants in the Sydney Sleep Biobank (SSB) database, aged 30– 74 years, self-reported presence of CVD (coronary artery disease, cerebrovascular disease, or heart failure). In those without established CVD, the Framingham Risk Score (FRS) estimated 10-year absolute CVD risk, categorised as “low” (< 6%), “intermediate” (6– 20%), or “high” (> 20%)

Jiashu Zhu,1 Ye Li,1 Rui Wang,1 Jinfang Zhang,2 Can Liu,1 Hongyu Li,1 Deguang Yang,1 Shuqin Ma,2 Suzhen Guan1 1School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of China; 2Obstetric Clinic, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of ChinaCorrespondence: Suzhen Guan, School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13389511821, Email guansz_nx2017@sina.com Shuqin Ma, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13895493649, Email 3117957376@qq.comObjective: To examine the relationship between pregnancy-related anxiety, family functions, and sleep quality, and to determine whether family functions mediate the relationship between pregnancy-related anxiety and sleep quality.Methods: A cross-sectional survey was conducted on pregnant women between April to August in 2022 in the obstetrics outpatient clinic of a tertiary care hospital in the Ningxia Hui Autonomous Region of China. A total of 1014 pregnant women aged 18 years and older were surveyed. They completed questionnaires, including: general demographic characteristics, the Pregnancy-related anxiety scale (PAQ), the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Model 4 in PROCESS was used to analyze the relationships among pregnancy-related anxiety, family functions, and sleep quality, with family functions as a mediator.Results: Among the 1014 pregnant women, the pregnancy-related anxiety scale score was (21.84 ± 5.64). The total score of the family functions scale was (8.10± 2.26), and the overall sleep quality scale score was (7.89± 2.99). When participants were grouped according to different socio-demographic characteristics, the study showed that all variables differed from anxie

Mihyeon Kim,1 Sarah Lyon-Caen,2 Sam Bayat,3 Claire Philippat,2 Sabine Plancoulaine1,4 1Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, F-75004, France; 2University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France; 3STROBE Inserm UA7 Laboratory & Grenoble University Hospital, Sept. of Pulmonology, Grenoble, France; 4Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, WAKING, Bron, F-69500, FranceCorrespondence: Sabine Plancoulaine, INSERM U1153, Team 6 EAROH, 16 Avenue Paul Vaillant Couturier, Villejuif Cedex, 94807, France, Email sabine.plancoulaine@inserm.frObjective: We investigated maternal and paternal sleep evolution from 3 to 36 months postpartum, their interrelations and predictors in the SEPAGES cohort.Methods: Sleep information (night sleep duration [NSD], weekend daytime sleep duration [DSD] and subjective sleep loss [SSL]) was collected by self-administered questionnaires at 3, 18, 24 and 36 months postpartum in the SEPAGES French cohort that included 484 mothers and 410 fathers. Group-based multi-trajectory modelling was used to identify maternal, paternal and couple sleep multi-trajectory groups among 188 couples reporting sleep data for at least 2 time points. Multinomial logistic regression was used to assess associations between parental sleep multi-trajectories and early characteristics such as sociodemographic, chronotypes, child sex, birth seasonality or breastfeeding duration.Results: We identified three maternal (M1-M3), paternal (F1-F3) and couple (C1-C3) sleep multi-trajectory groups with similar characteristics: a group with short NSD and high SSL prevalence (M1, F2, C2), a group with long NSD but medium SSL prevalence (M2, F3, C3) and a group with long NS

Diguo Zhai,1,2 Qingwei Chen,1,2 Ying Yao,3 Taotao Ru,1,2 Guofu Zhou1,2 1Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, 510006, People’s Republic of China; 2National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, People’s Republic of China; 3Anhui Provincial Library, Hefei, 230000, People’s Republic of ChinaCorrespondence: Taotao Ru; Qingwei Chen, Lab of Light and Physio-Psychological Health-National Center for International Research on Green Optoelectronics-South China Academy of Advanced Optoelectronics-South China Normal University, No. 55, West Zhongshan Road, Tianhe District, Guangzhou, 510631, People’s Republic of China, Tel +86 15603063417 ; +86 15521094813, Email taotao.ru@m.scnu.edu.cn; qingwei.chen@m.scnu.edu.cnPurpose: To explore whether sleep electroencephalogram (EEG) microarousals of different standard durations predict daytime mood and attention performance in healthy individuals after mild sleep restriction.Participants and Methods: Sixteen (nine female) healthy college students were recruited to examine the correlations between nocturnal EEG microarousals of different standard durations (≥ 3 s, ≥ 5 s, ≥ 7 s, ≥ 9 s) under mild sleep restriction (1.5 h) and the following morning’s subjective alertness, mood, sustained attention, and selective attention task performance.Results: Results revealed that mild sleep restriction significantly reduced subjective alertness and positive mood, while having no significant effect on negative mood, sustained attention and selective attention performance. The number of microarousals (≥ 5 s) was negatively associated with positive mood at 6:30. The number of microarousals was significantly and positively correlated with the response time difference value of disengagement

Qi Rui See,1,&ast; Kausar Raheel,1,&ast; Iain Duncan,1,&ast; Nazanin Biabani,1,&ast; Irene Di Giulio,2 Andrea Romigi,3 Veena Kumari,1,4 David O’Regan,1,2,5 Scott Cairney,6 Daniele Urso,7,8 K Ray Chaudhuri,8 Valentina Gnoni,1,7 Panagis Drakatos,1,2,5,&ast; Ivana Rosenzweig1,5,&ast; 1Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K; 2School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K; 3IRCCS Neuromed Istituto Neurologico Mediterraneo Pozzilli (IS), Pozzilli, Italy; 4Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, U.K; 5Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K; 6Department of Psychology, University of York and York Biomedical Research Institute, University of York, York, U.K; 7Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy; 8Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, U.K&ast;These authors contributed equally to this workCorrespondence: Ivana Rosenzweig, Sleep and Brain Plasticity Centre, Department of Neuroimaging, Box 089, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF, UK, Email ivana.1.rosenzweig@kcl.ac.ukBackground: Speech graph analysis (SGA) of dreams has recently shown promise as an objective and language-invariant diagnostic tool that can aid neuropsychiatric diagnosis. Whilst the notion that dreaming mentations reflect distinct physio

Ruichen Fang,1,2 Yihong Cheng,1,2 Fan Li,3 Yan Xu,1,2 Yuanhui Li,4 Xiang Liu,4 Simin Guo,4 Yuling Wang,1,2 Jinnong Jiang,1,2 Dan Zhou,1,2 Bin Zhang1,2 1Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, People’s Republic of China; 3School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian, 116024, People’s Republic of China; 4Adai Technology (Beijing) Co., Ltd, Beijing, People’s Republic of ChinaCorrespondence: Bin Zhang, Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, No. 1838 North, Guangzhou Avenue, Guangzhou, 510515, People’s Republic of China, Email zhang73bin@hotmail.comPurpose: In this study, we established the Chinese Clinical Sleep Database (CCSD), aiming to provide a safe, scalable, and user-friendly database that includes high-quality clinical data from Chinese population to facilitate sleep research.Material and Methods: We collect individual’s demographic data, scales, anthropometric measurements, clinical diagnosis, and polysomnography (PSG) recordings from the routine medical process of sleep medicine centers using standardized procedures. The distributed cluster storage technology are utilized to store these data. The structured data are stored in a high-performance MySQL database, while the unstructured data are stored in an object storage service. And we have developed an online data platform to share and manage our data.Results: The data collection has been conducted in three hospitals. In the preliminary stage of data collection (from October 18, 2022 to September 4, 2023), our database included a total of 1183 patients. Among them, 56.8% were male and their ages ranged from 3 to 88 years. These patients were diagnosed with various types of sleep disorders.Conclusion: Since the CCSD’s inception, it has demonstrated good st

Seiko Miyata,1,&ast; Kunihiro Iwamoto,1,&ast; Ippei Okada,1,&ast; Akihiro Fujimoto,2 Yuki Kogo,2 Daisuke Mori,1,3,4 Manabu Amano,5 Nao Matsuyama,5 Kazuki Nishida,5 Masahiko Ando,5 Toshiaki Taoka,6 Shinji Naganawa,7 Norio Ozaki1,4 1Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan; 2Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan; 3Brain and Mind Research Center, Nagoya University, Nagoya, Japan; 4Pathophysiology of Mental Disorders, Nagoya University, Graduate School of Medicine, Nagoya, Japan; 5Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan; 6Department of Innovative Biomedical Visualization (Ibmv), Nagoya University, Graduate School of Medicine, Nagoya, Japan; 7Department of Radiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan&ast;These authors contributed equally to this workCorrespondence: Seiko Miyata, Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan, Tel +81 52 744 2282, Fax +81 52 744 2293, Email miyata.seiko.v4@f.mail.nagoya-u.ac.jpPurpose: Both subjective and objective evaluations are essential for the treatment of insomnia. Lemborexant has been shown to be effective in the long-term based solely on a subjective basis, and no long-term objective measures have been evaluated under natural sleep conditions. Small, lightweight sleep electroencephalogram (EEG) monitor was used, instead of polysomnography, to objectively evaluate sleep at home 4 and 12 weeks after lemborexant treatment.Patients and Methods: Adults and elderly subjects with insomnia disorder, per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were enrolled in this open-label, single-arm, single-center trial. Objective and subjective measures of sleep were prospectively assessed. Sleep disturbance, excessive sleepiness, and depressive symptoms were assessed using questionnaires.Results: A tot

Lydia B Munns,1,2,&ast; Harriet Demnitz-King,1,&ast; Claire André,3 Stéphane Rehel,3 Valentin Ourry,3 Vincent de La Sayette,4 Denis Vivien,3,5 Gaël Chételat,3 Géraldine Rauchs,3,&ast; Natalie L Marchant1,&ast; On behalf of the Medit-Ageing Research Group1Division of Psychiatry, University College London, London, UK; 2Department of Psychology, York University, York, UK; 3Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France; 4Service de Neurologie, CHU de Caen-Normandie, Caen, France; 5Département de Recherche Clinique, CHU Caen-Normandie, Caen, France&ast;These authors contributed equally to this workCorrespondence: Natalie L Marchant, Division of Psychiatry, University College London, London, UK, Email n.marchant@ucl.ac.uk Lydia B Munns, Department of Psychology, York University, York, United Kingdom, Email lydbmunns@gmail.comObjective: Poor sleep and high levels of repetitive negative thinking (RNT), including future-directed (ie, worry) and past-directed (ie, brooding) negative thoughts, have been associated with markers of dementia risk. The relationship between RNT and sleep health in older adults is unknown. This study aimed to investigate this association and its specificities including multiple dimensions of objective and subjective sleep.Methods: This study used a cross sectional quantitative design with baseline data from 127 cognitively healthy older adults (mean age 69.4 ± 3.8 years; 63% female) who took part in the Age-Well clinical trial, France. RNT (ie, worry and brooding) levels were measured using the Penn State Worry Questionnaire and the Rumination Response Scale (brooding subscale). Polysomnography was used to assess sleep objectively, and the Pittsburgh Sleep Quality Index and the St. Mary’s Hospital Sleep Questionnaire were used to measure sleep subjectively. In primary analyses the associations between RNT and sleep (ie

Qian Yang,1 Lingfeng Liu,1 Jing Wang,2 Ying Zhang,2 Nan Jiang,3 Meiyun Zhang2 1Tianjin Union Medical Center, Tianjin Medical University, Tianjin, 300070, People’s Republic of China; 2Department of Neurology, Tianjin Union Medical Center, Tianjin, 300121, People’s Republic of China; 3School of Mechanical Engineering, Tianjin University, Tianjin, 300354, People’s Republic of ChinaCorrespondence: Meiyun Zhang, Email zmy22202@aliyun.comObjective: To investigate the changes in the wavelet entropy during wake and different sleep stages in patients with insomnia disorder.Methods: Sixteen patients with insomnia disorder and sixteen normal controls were enrolled. They underwent scale assessment and two consecutive nights of polysomnography (PSG). Wavelet entropy analysis of electroencephalogram (EEG) signals recorded from all participants in the two groups was performed. The changes in the integral wavelet entropy (En) and individual-scale wavelet entropy (En(a)) during wake and different sleep stages in the two groups were observed, and the differences between the two groups were compared.Results: The insomnia disorder group exhibited lower En during the wake stage, and higher En during the N3 stage compared with the normal control group (all P < 0.001). In terms of En(a), patients with insomnia disorder exhibited lower En(a) in the β and α frequency bands during the wake stage compared with normal controls (β band, P < 0.01; α band, P < 0.001), whereas they showed higher En(a) in the β and α frequency bands during the N3 stage than normal controls (β band, P < 0.001; α band, P < 0.001).Conclusion: Wavelet entropy can reflect the changes in the complexity of EEG signals during wake and different sleep stages in patients with insomnia disorder, which provides a new method and insights about understanding of pathophysiological mechanisms of insomnia disorder. Wavelet entropy provides an objective indicator for assessing sleep quality.Keywords: ins

Donghao Wang,1,&ast; Yating Chen,1,&ast; Yutong Ding,1,&ast; Yongkang Tang,1,&ast; Xiaofen Su,1,&ast; Shiwei Li,1 Haojie Zhang,1,2 Yanyan Zhou,1 Zhiyang Zhuang,1 Qiming Gan,1 Jingcun Wang,1 Yuting Zhang,1 Dongxing Zhao,1 Nuofu Zhang1 1State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China; 2The Clinical Medicine Department, Henan University, Zhengzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Nuofu Zhang, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China, Tel +86-13600460056, Email nfzhanggird@163.comBackground: Obstructive sleep apnea (OSA) is a common chronic disease with various comorbidities. The cardiometabolic index (CMI) reflects visceral fat tissue distribution and function, assessing the risk of obesity-related conditions such as metabolic syndrome (MetS) and stroke, which are strongly connected to OSA. The relationship between CMI with OSA and OSA combined with MetS (OMS) remains unclear. This study aims to evaluate the screening value of CMI for OSA and OMS, compared to the lipid accumulation product (LAP).Methods: A total of 280 participants who underwent polysomnography were finally included, with the measurements of metabolic-related laboratory test results such as total cholesterol and triglyceride. Receiver operating curve (ROC) analysis and calculation of the area under the curve (AUC) were conducted to assess the screen

Ziyu Ren,1 Jiangchuan Long,1 Wenzhen Deng,1 Yuanyuan Jing,1 Jingwen Qiu,1 Wei Ren,2 Dongfang Liu1 1Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Endocrinology and Metabolism, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Wei Ren, Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No. 1. You-Yi Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +86-23-89012755, Email renwei67@sina.com Dongfang Liu, Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, No. 74, Linjiang Road, Yuzhong District, Chongqing, 400010, People’s Republic of China, Tel +86-23-63832133, Email 300306@hospital.cqmu.edu.cn; ldf023023@qq.comBackground: In recent years, multiple observational studies have confirmed the association between sleep traits and various human physiopathological states. However, the causal relationship between sleep traits and hypothalamic-pituitary-target gland axis (HPTGA) function remains unknown.Methods: We obtained summary statistics on sleep traits (insomnia, chronotype, and sleep duration (long and short)) from the UK Biobank database. Data related to the HPTGA functions were obtained from the publicly available database. Subsequently, a two-sample Mendelian randomization (MR) analysis was performed to investigate the causal relationship between different sleep traits and the HPTGA function. Reverse MR analysis was conducted to examine the direction of causality.Results: The MR analysis results suggested that chronotype is associated with decreased levels of six hormones in HPTGA. Sleep duration was causally associated with decreased levels of free thyroxine and progesterone. Both long and short sleep durations are detrimental to the secretion of prolactin-releasing peptide

Yue Liu, Shi Qi Xie, Xia Yang, Jing Lan Chen, Jian Rong Zhou School of Nursing, Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jian Rong Zhou; Shi Qi Xie, School of Nursing, Chongqing Medical University, 1 Medical College Road, Yu Zhong District, Chongqing, 400016, People’s Republic of China, Tel +86-135 0830 0955 ; +86-156 0833 2043, Fax +86-23-63555767, Email 202028@cqmu.edu.cn; xie47@cqmu.edu.cnPurpose: The clinical presentation of Obstructive Sleep Apnea (OSA) in children is insidious and harmful. Early identification of children with OSA, particularly those at a higher risk for severe symptoms, is essential for making informed clinical decisions and improving long-term outcomes. Therefore, we developed and validated a risk prediction model for severity in Chinese children with OSA to effectively identify children with moderate-to-severe OSA in a clinical setting.Patients and Methods: From June 2023 to September 2023, we retrospectively analyzed the medical records of 367 Children diagnosed with OSA through portable bedside polysomnography (PSG). Predictor variables were screened using the least absolute shrinkage and selection operator (LASSO) and logistic regression techniques to construct nomogram to predict the severity of OSA. Receiver operating characteristic curve (ROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were used to determine the discrimination, calibration, and clinical usefulness of the nomogram.Results: A total of 367 children with a median age of 84 months were included in this study. Neck circumference, ANB, gender, learning problem, and level of obstruction were identified as independent risk factors for moderate-severe OSA. The consistency indices of the nomogram in the training and validation cohorts were 0.841 and 0.75, respectively. The nomogram demonstrated a strong concordance between the predicted probabilities and the observed probabilities for children

Renzhe Tang,1,&ast; Chong Li,2,&ast; Dongmei Di,1 Lin Zhou,2 Yongxiang Qian,1 Chaohua Qiang,3 Chao Ma,1 Rui Zhou,1 Bin Wang,1 Min Wang1 1Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213003, People’s Republic of China; 2Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213003, People’s Republic of China; 3Department of Echocardiography, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213003, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Min Wang; Bin Wang, Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, No. 185 of Juqian Street, Changzhou, Jiangsu Province, 213003, People’s Republic of China, Email wangmin80808@163.com; wangbin1987@suda.edu.cnObjective: Obstructive sleep apnea (OSA) is a disorder characterized by disruption in breathing and hypoventilation. In parallel, metabolic syndrome (MetS) mainly co-occur with OSA, however, their association has not been fully elucidated. Therefore, this study aimed to reveal the relationship between OSA and MetS using data from the National Health And Nutrition Examination Survey (NHANES) database and pooled data from Genome-Wide Association Studies (GWAS).Material and Methods: Data from the National Health and Nutrition Examination Survey and pooled data from genome-wide association analysis (GWAS) were used univariate and multivariate logistic regression analyses were carried out to evaluate the correlation between OSA and MetS, and multivariate logistic regression models were utilized for adjusting for potential confounders. Two-sample Mendelian randomization (MR) was used to assess the causal relationship between OSA and MetS. The variance-weighted inverse method was employed as the main method of analysis.Results: A positive relationship of

Gengyao Hu,1,&ast; Yuanhang Pan,1,&ast; Na Yuan,1,&ast; Zhixian Yang,2 Xiuyu Shi,3 Sha Ma,4 Shan Li,4 Xiaohua Hou,5 Fei Liu,5 Dongmei Li,6 Junxiang Bao,7 Yonghong Liu1 1Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China; 2Department of Pediatrics, Peking University First Hospital, Beijing, People’s Republic of China; 3Department of Pediatrics, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China; 4Department of Neurology, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China; 5Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China; 6Department of Dentistry for Special Services, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China; 7Department of Aerospace Hygiene, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yonghong Liu, Email liuyhong@fmmu.edu.cnBackground: Sleep-related facial mandibular myoclonus (SRFMM) remains rare in clinical practice. The aim of this study was to provide a comprehensive understanding of the electroclinical manner, therapeutic regimen, and prognosis of SRFMM.Methods: Twenty-three patients who were diagnosed with SRFMM by clinical manifestation, video-electroencephalography (EEG) and electromyography over bilateral masseter and temporalis muscles were enrolled. Clinical and electrophysiological evaluation as well as follow-up information were recorded and analyzed.Results: The cohort involved 4 infants and 19 adults with a mean onset age of 43.5 years for SRFMM, among whom 19 were male. Twenty-one patients complained of tongue injuries and d

Qin Yang,1,2 Xiao Huang,2 Yanhong Lin,1 Ke Chen,1 Qinghua Lu,1 Weinan Lin,1 Xing Wang,2 Yishu Teng,3 Peng Jiang,3 Sandip Patil,3 Yuejie Zheng1 1Department of Respiratory Medicine, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, People’s Republic of China; 2Department of Sleep Centre, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, People’s Republic of China; 3Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, People’s Republic of ChinaCorrespondence: Sandip Patil, Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, People’s Republic of China, Tel +85-755-82008283, Email sandippatil1309@yahoo.com Yuejie Zheng, Department of Respiratory Medicine, Shenzhen Children’s Hospital, Shenzhen, Guangdong Province, People’s Republic of China, Email shine1990@sina.comBackground: Pediatric obstructive sleep apnea (OSA) is a multifaceted disorder marked by recurrent upper airway obstruction during sleep, often coexisting with various medical conditions. This study, aimed to comprehensively analyze the Multifaceted Landscape of Pediatric Insights into Prevalence, Severity, and Coexisting Conditions. With a sample of 1928 participants, our study sought to determine the prevalence, severity, and associations between OSA and diverse conditions.Methods: Conducted retrospectively from February 2019 to April 2023, the study included pediatric patients. Data were collected through electronic health records, involving clinical assessments, medical histories, and diagnostic tests to establish OSA and coexisting condition diagnoses. Relationships between sleep parameters, apnea types, and severity indices were evaluated.Results: High OSA prevalence was evident across age groups, with severity peaking between 3 to 12 years. Among the participants, coexisting conditions included allergic rhinitis (59.6%), tonsillar hypertrophy (49.7%), adenoid hypertrophy

Ahmed Salem BaHammam1,2 1Department of Medicine, University Sleep Disorders Center and Pulmonary Service, King Saud University, Riyadh, Saudi Arabia; 2King Saud University Medical City, Riyadh, Saudi ArabiaCorrespondence: Ahmed Salem BaHammam, University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia, Tel +966-11-467-9495, Fax +966-11-467-9179, Email ashammam2@gmail.com

Jia Chen,1– 4,&ast; Xiaoyu Deng,1– 4,&ast; Ting Lin,1– 4 Jiefeng Huang,1– 4 Yisong Yang,1– 4 Ningfang Lian1– 4 1Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Fujian Provincial Sleep-Disordered Breathing Clinic Center, Fuzhou, Fujian, People’s Republic of China; 3Institute of Respiratory Disease, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China&ast;These two authors contributed equally to this workCorrespondence: Ningfang Lian, Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, Fujian Province, 350005, People’s Republic of China, Tel +86-591-87981698, Email 1533532863@qq.comPurpose: Chronic intermittent hypoxia (CIH) related arterial endothelium injury is a common cause of cardiovascular system injury. However, the mechanism still needs to be clarified. In this study, we aimed to clarify the role and mechanism of ferrostatin-1 (Fer-1) in CIH-related rat arterial endothelial cells (ROAEC) ferroptosis.Methods: ROAEC was divided into control group, CIH group, and CIH+ Fer-1 group. Cell viability was detected by cell counting kit 8 kits (CCK8). The apoptotic rate, reactive oxygen species (ROS) levels, Fe2+ levels, and lipid ROS levels were detected by flow cytometry. Malondialdehyde (MDA) levels and nicotinamide adenine dinucleotide (NAD+)/NADH ratio were detected via Elisa kits. The mRNA and protein levels of cystine/glutamate antiporter solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) were detected by qRT-PCR and Western blot. Mitochondrial structure and func

Yanan Zhang,1 Qianqian Chen,1 Qingqing Sun,1 Mingyang Tang,1 Yi Yang,1,2 Zhen-Ni Guo,1,2 Zan Wang1,2 1Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China; 2Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of ChinaCorrespondence: Zhen-Ni Guo, Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1&num;, Chang Chun, 130021, People’s Republic of China, Tel +86-431-88782378, Email zhen1ni2@jlu.edu.cn Zan Wang, Sleep Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1&num;, Chang Chun, 130021, People’s Republic of China, Tel +86-431-88782378, Email wangzan@jlu.edu.cnBackground: Restless legs syndrome (RLS) is a prevalent sensorimotor nervous system disorder in patients accompanied with insomnia, blood pressure fluctuation, and sympathetic dysfunction. These symptoms may disrupt cerebral hemodynamics. Dynamic cerebral autoregulation (dCA) describes the temporary response of cerebrovascular system to abrupt fluctuations in blood pressure, which keep cerebral blood flow stable and serve as a marker of cerebrovascular system ability.Objective: This research aimed to assess dCA in RLS patients.Methods: In this study, RLS patients were recruited and subsequently classified into four groups (mild, moderate, severe, and very severe) based on the International RLS Rating Scale (IRLS). Healthy controls matched for age and sex were enrolled. All participants were evaluated dCA by assessing phase difference (PD). A portion of patients with RLS was reassessed for dCA after one month of medication therapy (pramipexole [0.125 mg/day] and gabapentin [300 mg/day]).Results: There were altogether 120 patients with RLS and 30 controls completed the polysomnography and dCA assessment. PD was lower in the moderate, severe, and very severe RLS groups than that in the controls a

Hao Guo,1,&ast; Li-Heng Li,2,&ast; Xiao-Hong Lv,1,&ast; Feng-Zhi Su,1,&ast; Jie Chen,1,&ast; Fei Xiao,1,3 Min Shi,1 Yu-Bo Xie1,3 1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Anesthesiology, The Guilin Municipal Hospital of Traditional Chinese Medicine, Guangxi, People’s Republic of China; 3Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu-Bo Xie, Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530000, People’s Republic of China, Tel +86 13977121557, Email xybdoctor@163.comPurpose: Postoperative sleep disturbance, characterized by diminished postoperative sleep quality, is a risk factor for postoperative delirium (POD); however, the association between pre-existing sleep disturbance and POD remains unclear. This study aimed to evaluate the association between preoperative sleep disturbance and POD in elderly patients after non-cardiac surgery.Patients and methods: This retrospective cohort study was conducted at a single center and enrolled 489 elderly patients who underwent surgery between May 1, 2020, and March 31, 2021. Patients were divided into the sleep disorder (SD) and non-sleep disorder (NSD) groups according to the occurrence of one or more symptoms of insomnia within one month or sleep- Numerical Rating Scale (NRS)≥ 6 before surgery. The primary outcome was the incidence of POD. Propensity score matching analysis was performed between the two groups. Multiple logistic regression analysis was performed to identify the risk factors for POD.Results: In both the unmatched cohort (16.0% vs 6.7%, P=0.003) and the matched cohort (17.0% vs 6.2%, P=0.023), the

Anran Xu,1 Xiaotian Li1,2 1Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China; 2School of Sports Training, Wuhan Institute of Physical Education, Wuhan, 430079, People’s Republic of ChinaCorrespondence: Xiaotian Li, Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China, Email xiaotianli@csu.edu.cnPurpose: While there is a rising focus on sleep issues among athletes, a notable gap exists in the comparative analysis of sleep patterns between male and female athletes. This study aims to evaluate the sleep patterns of collegiate swimmers during a specific period (pre-competition training phase) based on the National Sleep Foundation’s recommendations and compares sleep differences between males and females.Patients and Methods: 15 swimmers (6 males and 9 females) completed the Athlete Sleep Screening Questionnaire (ASSQ) and wore actigraphy devices for 8 consecutive nights to record objective sleep patterns including bedtime, wake time, sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency.Results: The total sleep time of collegiate male (5.0± 0.4 h, 4.6 to 5.4h) and female (6.0± 0.7 h, 5.5 to 6.5h) swimmers was less than 7 hours per night, and male swimmers’ sleep efficiency (76.7± 8.9%, 67.4 to 86.0%) was lower than the 85% standard. Male swimmers had less objectively measured sleep duration (p=0.006, d=1.66, large effect), lower sleep efficiency (p=0.013, d=1.51, large effect), and longer wake after sleep onset (p=0.096, d=0.94, moderate effect). Female swimmers had higher sleep difficulty scores (p=0.06, d=1.08, moderate effect), and there was a significant difference in the distribution of sleep difficulty scores between male and female swimmers (p=0.033, V=0.045, small effect).Conclusion: Collegiate swimmers exhibited poor sleep patterns during pre-competition preparation, and the sleep fragme

Heru Santoso Wahito Nugroho,1 Rafif Naufi Waskitha Hapsari,2 Rozan Asyrofi Rakyan Risang Aji3 1Center of Excellence of Community Empowerment in Health, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia; 2Department of Health, Knowledge Dynamics, Ponorogo, Indonesia; 3Faculty of Medicine, Universitas Surabaya, Surabaya, IndonesiaCorrespondence: Heru Santoso Wahito Nugroho, Center of Excellence of Community Empowerment in Health, Poltekkes Kemenkes Surabaya, Jl. Pucang Jajar Tengah 56, Surabaya, Indonesia, Email heruswn@poltekkesdepkes-sby.ac.id

Jiewei Huang,1,2 Jiajing Zhuang,2,3 Huaxian Zheng,4 Ling Yao,5,6 Qingquan Chen,7,8 Jiaqi Wang,1,2 Chunmei Fan1 1The Clinical Laboratory Center of the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, 362018, People’s Republic of China; 2The Graduate School of Fujian Medical University, Fuzhou, Fujian Province, 350108, People’s Republic of China; 3Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, 350001, People’s Republic of China; 4The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian Province, 350108, People’s Republic of China; 5Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, People’s Republic of China; 6Department of Nephrology, Rheumatology and Immunology, Fujian Children’s Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, People’s Republic of China; 7The Sleep Disorder Medicine Center of the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, 362018, People’s Republic of China; 8The School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, 350108, People’s Republic of ChinaCorrespondence: Chunmei Fan, The Clinical Laboratory Center of the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, 362018, People’s Republic of China, Tel +86 15906069575, Email fanchunmei9575@163.comObjective: Obstructive sleep apnea (OSA) is a common and potentially fatal sleep disorder. The purpose of this study was to construct an objective and easy-to-promote model based on common clinical biochemical indicators and demographic data for OSA screening.Methods: The study collected the clinical data of patients who were referred to the Sleep Medicine Center of the Second Affiliated Hospital of Fuj