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There has been a significant increase in mental health concerns among student-athletes in recent years. Several factors can contribute to this issue, such as inadequate sleep, social pressures, and the impact of social media. Among student-athletes, social media has become an integral part of their daily routine, particularly for those who aspire to pursue careers in sports after graduation. Self-promotion can be a great way for student-athletes to build their personal brand and connect with fans, but it can also increase the pressure and stress that student-athletes feel to maintain a positive image online. This study included 191 student athletes from various sports at one DII school in the US in one school semester. It emphasizes the importance of balancing self-promotion and social media use while being aware of potential negative effects and practicing proper sleep hygiene and time management. This study also touches on various other factors that positively or negatively impact the mental health of student-athletes, and the strongest significant negative relationships between self-promotion and mental health. [ABSTRACT FROM AUTHOR]

Purpose: To examine nocturnal sleep patterns, napping behaviors, and subjective wellness responses of elite water polo players within an in-season week and to identify whether sleeping patterns differ between men and women. Methods: Sleep characteristics of 10 male and 17 female professional water polo players were objectively assessed during 1 week of the in-season period, including 5 training days, 1 match day, and 1 day of rest. Internal load (rating of perceived exertion × duration of training or match) was assessed 30 minutes posttraining or postmatch, and the total quality of recovery was recorded every morning. A series of multilevel models were used to analyze the data. Results: Time in bed and wake-up time were earlier on both training (P <.001) and rest days (P <.001) than on the day of the match. Internal workload did not predict any of the players' sleeping patterns. Midday naps predicted less time in bed (P =.03) and likely less sleep time (P =.08). The total quality of recovery was predicted only by the total sleep time (P <.01). Women exhibited higher sleep efficiency (P <.001), less waking after sleep onset (P =.01), and a lower number of awakenings (P =.02) than men. Conclusions: The current results indicate that the nocturnal sleep patterns of elite water polo players are not associated with internal load and that women display better nocturnal sleep quality compared with men. As long naps interfere with nocturnal sleep, and total nocturnal sleep time predicts total quality of recovery, we suggest that athletes follow hygiene sleep strategies to facilitate adequate nocturnal sleep and next-day recovery. [ABSTRACT FROM AUTHOR]

Purpose: Few data are available on sleep characteristics of elite track-and-field athletes. Our study aimed to assess (1) differences in sleep between sexes and among different track-and-field disciplines, (2) the effect of individualized sleep-hygiene strategies on athletes' sleep parameters, and (3) daytime nap characteristics in track-and-field athletes. Methods: Sleep characteristics of 16 elite Olympic-level track-and-field athletes (male: n = 8; female: n = 8) were assessed during the preseason period, at baseline (T0), and during the in-season period, after the adoption of individualized sleep-hygiene strategies (T1). Sleep parameters were objectively monitored by actigraphy for a minimum of 10 days, for each athlete, at both T0 and T1. A total of 702 nights were analyzed (T0 = 425; T1 = 277). Results: Female athletes displayed better sleep efficiency (88.69 [87.69–89.68] vs 91.72 [90.99–92.45]; P =.003, effect size [ES]: 0.44), lower sleep latency (18.99 [15.97–22.00] vs 6.99 [5.65–8.32]; P <.001, ES: 0.65), higher total sleep time (07:03 [06:56–07:11] vs 07:18 [07:10–07:26]; P =.030, ES: 0.26), earlier bedtime (00:24 [00:16–00:32] vs 00:13 [00:04–00:22]; P =.027, ES: 0.18), and lower nap frequency (P <.001) than male athletes. Long-distance runners had earlier bedtime (00:10 [00:03–00:38] vs 00:36 [00:26–00:46]; P <.001, ES: 0.41) and wake-up time (07:41 [07:36–07:46] vs 08:18 [08:07–08:30]; P <.001, ES: 0.61), higher nap frequency, but lower sleep efficiency (88.79 [87.80–89.77] vs 91.67 [90.95–92.38]; P =.013, ES: 0.44), and longer sleep latency (18.89 [15.94–21.84] vs 6.69 [5.33–8.06]; P <.001, ES: 0.67) than athletes of short-term disciplines. Furthermore, sleep-hygiene strategies had a positive impact on athletes' total sleep time (429.2 [423.5–434.8] vs 451.4 [444.2–458.6]; P <.001, ES: 0.37) and sleep latency (14.33 [12.34–16.32] vs 10.67 [8.66–12.68]; P =.017, ES: 0.19). Conclusions: Sleep quality and quantity were suboptimal at baseline in Olympic-level track-and-field athletes. Large differences were observed in sleep characteristics between sexes and among different track-and-field disciplines. Given the positive effect of individualized sleep-hygiene strategies on athlete's sleep, coaches should implement sleep education sessions in the daily routine of top-level athletes. [ABSTRACT FROM AUTHOR]

Purpose: Short sleep duration and poor sleep quality are common in swimmers. Sleep-hygiene strategies demonstrated beneficial effects on several sleep parameters. The present study assessed the impact of a multisession sleep-hygiene training course on sleep in elite swimmers. Methods: Twenty-eight elite swimmers (17 [2] y) participated. The sleep-hygiene strategy consisted of 3 interventions. Sleep was measured by actigraphy for 7 days before the beginning of the intervention (baseline), after the first collective intervention (postintervention), after the second collective intervention (postintervention 2), and, finally, after the individual intervention (postintervention 3). The Epworth Sleepiness Scale (ESS) was completed concurrently. Swimmers were classified into 2 groups: nonsomnolent (baseline ESS score ≤ 10, n = 13) and somnolent (baseline ESS score ≥ 11, n = 15). Results: All swimmers had a total sleep time of <8 hours per night. Sixty percent of swimmers were moderately morning type. Later bedtime, less time in bed, and total sleep time were observed in the somnolent group compared with the nonsomnolent group at baseline. An interaction between training course and group factors was observed for bedtime, with a significant advance in bedtime between baseline, postintervention 2, and postintervention 3 for the somnolent group. Conclusions: The present study confirms the importance of implementing sleep-hygiene strategies, particularly in athletes with an ESS score ≥11. A conjunction of individual and collective measures (eg, earlier bedtime, napping, and delaying morning training session) could favor the total sleep time achieved. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of a sleep hygiene strategy on parameters of sleep quality and quantity in youth elite rugby union players. Method: Eleven male players (age: 19.0 [1.4] y) undertook a sleep hygiene strategy composed of 2 theoretical sessions and 3 practical sessions over a 4-week period. Sleeping time, time in bed, total sleep time, sleep latency (SL), sleep efficiency (SE), wake after sleep onset, and wake bouts were recorded with an actigraphic device during the 4-week sleep hygiene strategy (baseline) and during 4 weeks after the last intervention (postintervention). Results: At baseline, the overall group reported poor sleep quantity (total sleep time = 6:27 [0:30] min), but sleep quality was considered acceptable (SL = 0:18 [0:08] min and SE = 77.8% [5.8%]). Postintervention, the overall group showed a small improvement in SL (d = −0.23 [−0.42 to −0.04], P =.003) and SE (d = 0.30 [0.03 to 0.57], P =.0004). For individual responses, sleeping time, time in bed, and total sleep time were positively influenced in only 4, 3, and 5 players, respectively. For parameters of sleep quality, SL and SE were positively influenced in a majority of players (n = 7 and 8, respectively). The magnitude of difference between baseline and postintervention was strongly associated with baseline values in SE (r = −.86; P =.0005) and wake after sleep onset (r = −.87; P =.0007). Conclusion: A sleep hygiene strategy is efficient to improve sleep quality but not sleep quantity in young rugby union players. The strategy was more efficient in players with lower initial sleep quality and should be implemented prior to a high cumulative fatigue period. [ABSTRACT FROM AUTHOR]

Bed-sharing can have a negative impact on infant sleep safety. In order to reduce the occurrence of bed-sharing with infants, it’s necessary to shift the research lens from newborn parents to the antenatal stage before infant birth. Our study aimed to assess the attitudes, subjective norms, perceived behavioral control, and intentions of pregnant women about bed-sharing based on the theory of planned behavior (TPB). This cross-sectional study was conducted with 512 pregnant women in the obstetrics clinic of a tertiary hospital in China using convenience sampling. Data were collected through self-reported questionnaires, consisting of demographic characteristics and a questionnaire for pregnant women on infant sleep safety based on TPB (12 items). Data were analyzed with SPSS 22.0 and AMOS 24.0. Structural equation modeling was carried out to verify the hypothetical model based on TPB. The results showed the average behavior intention score was 9.90 ± 5.14, indicating low intent for bed-sharing among pregnant women post-delivery. The Theory of Planned Behavior model explained 38.7% of the variance in bed-sharing intention, with attitude as the strongest predictor (β = 0.343, p < 0.001), followed by subjective norm (β = 0.232, p < 0.001) and perceived behavioral control (β = -0.210, p < 0.001). This study highlights the importance of antenatal health education and behavioral intervention early in pregnancy based on TPB theory to enhance infant sleep safety and encourage changes in bed-sharing behavior. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Maternal substance use during pregnancy heightens risk of sudden unexpected infant death (SUID), including through unsafe sleep practices. Families impacted by substance use frequently experience disproportionate social drivers of poor health and family vulnerability likely contributory to fatality risk. Characteristics of sleep-related SUID among infants born prenatally substance exposed versus nonexposed were compared to identify targeted prevention opportunities. METHODS: Using the Sudden Death in the Young Registry, we examined SUID with sleep-related death between 2015 and 2020 across infants prenatally exposed versus nonexposed. Distribution of sleep environment characteristics, social drivers of poor health, and family vulnerability factors were examined using descriptive statistics and χ². RESULTS: Of 2010 infants who experienced sleep-related deaths, 283 (14%) were prenatally exposed. More than half of deaths involved an adult bed (52%, n = 1045) or surface sharing with an adult (53%, n = 1074). Supervisors of prenatally exposed infants were disproportionately impaired at infant death versus nonexposed (34%, n = 97 vs 16%, n = 279). Statistically significant associations between prenatal exposure history and vulnerability factors (insurance, child welfare involvement, intimate partner violence, health care barriers) were identified (P < .05). CONCLUSIONS: Sleep-related SUID across infants prenatally exposed versus nonexposed differ in sleep environment characteristics and contributory social vulnerability. Disproportionate sleep environment hazards (surface sharing, supervisor impairment) are identified among prenatally exposed infants that should compel targeted prevention efforts, including safe sleep messaging, discouraging surface sharing, and engaging support persons during impairment periods. Addressing social needs and family vulnerability are also paramount to increase access to health care, safe sleep education, and material resource provision. [ABSTRACT FROM AUTHOR]

Short sleep duration is associated with heightened cardiometabolic disease risk and has reached epidemic proportions among children, adolescents and adults. Potential mechanisms underlying this association are complex and multifaceted, including disturbances in circadian timing, food intake and appetitive hormones, brain regions linked to control of hedonic eating, physical activity, an altered microbiome and impaired insulin sensitivity. Sleep extension, or increasing total sleep duration, is an emerging and ecologically relevant intervention with significant potential to advance our understanding of the mechanisms underlying the association between short sleep duration and the risk of cardiometabolic disease. If effective, sleep extension interventions have potential to improve cardiometabolic health across the lifespan. Existing data show that sleep extension is feasible and might have potential cardiometabolic health benefits, although there are limitations that the field must overcome. Notably, most existing studies are short term (2–8 weeks), use different sleep extension strategies, analyse a wide array of cardiometabolic health outcomes in different populations and, frequently, lack adequate statistical power, thus limiting robust scientific conclusions. Overcoming these limitations will require fully powered, randomized studies conducted in people with habitual short sleep duration and existing cardiometabolic risk factors. Additionally, randomized controlled trials comparing different sleep extension strategies are essential to determine the most effective interventions. Ongoing and future research should focus on elucidating the potential cardiometabolic health benefits of sleep extension. Such studies have high potential to generate crucial knowledge with potential to improve health and quality of life for those struggling with short sleep duration. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to investigate if major dietary patterns (DPs) interact with psychological disorders (PDs) in association with sleep quality and quantity among a large sample of Iranian adults living in Yazd, Iran. Methods: This cross-sectional investigation was conducted on the baseline data of a population-based Iranian cohort study (Yazd Health Study-Taghzieh Mardom-e-YaZd: YaHS-TAMYZ). All data regarding dietary intakes, PDs, and sleep status were collected via validated questionnaires. The interaction between major DPs and PDs in relation to sleep parameters was determined using multivariable adjusted binary logistic regression. Results: A total of 6048 adults participated in this study. Compared to subjects with the lowest adherence to each DP and without any severe PDs: a) individuals with the highest adherence to the "western" DP and with severe anxiety had higher risk of "short sleep duration" (P = 0.030) and "insufficient sleep" (P = 0.020); b) subjects in the "western" DP's top tertile and with severe depression had lower chance of having "short sleep duration" (P = 0.029) and "insufficient sleep" (P = 0.029); c) those with the highest adherence to the "high animal protein" DP and with severe anxiety had significantly greater odds of "long sleep duration" (P = 0.044); d) a lower chance of "low sleep quality" was observed in participants in the "high animal protein" DP's top tertile and with severe stress (P = 0.05). Conclusions: The "western" and "high animal protein" DPs might interact with PDs in association with the quality and duration of sleep. Further investigations are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Summary: Many patients with depression report insomnia symptoms that profoundly affect their health and well‐being. Non‐pharmacological treatments of insomnia may be preferable for some patients. In this randomised crossover trial, we investigated the efficacy of the Protac Ball Blanket® on insomnia among patients with depression. Included patients (n = 45) were diagnosed with unipolar depression, and with subjective insomnia and poor sleep quality (Pittsburgh Sleep Quality Index Score > 5). Each patient slept 2 weeks with a Protac Ball Blanket® and 2 weeks with a control duvet. Randomisation defined the order of the 2‐week sleep periods. Patients served as their own control in this design. The primary outcome was changes in total night‐time sleep. Secondary outcomes were sleep‐onset latency, number of awakenings, wake after sleep onset, daily use of pro necessitate sedatives and hypnotics, subjective sleep quality (Pittsburgh Sleep Quality Index), insomnia severity (Insomnia Severity Index), symptoms of depression (Hamilton Depression Rating Scale, Major Depression Inventory), symptoms of anxiety (Beck Anxiety Index), and patient‐reported outcomes concerning interpersonal sensitivity, neurasthenia, anxiety and depression (Self‐Reported Symptom State Scale). Paired two‐sided t‐tests were used to compare the means of the differences of the outcomes. Protac Ball Blanket® increased total night‐time sleep by 12.9 min (95% confidence interval: 1.21–24.63, p = 0.031). Among the secondary outcomes, Protac Ball Blanket® decreased Hamilton Depression Rating Scale by 2.78 (95% confidence interval: −5.44; −0.11, p = 0.042) and Insomnia Severity Index by 2.98 (95% confidence interval: −5.45; −0.50, p = 0.020). No changes were observed in sleep‐onset latency, number of awakenings, wake after sleep onset, Pittsburgh Sleep Quality Index, Major Depression Inventory, Beck Anxiety Index, Self‐Reported Symptom State Scale, and medication use. The results suggest that some patients may benefit from Protac Ball Blanket® as an add‐on non‐pharmacological treatment to improve sleep in depression. [ABSTRACT FROM AUTHOR]

Summary: This cross‐sectional study investigated the effect of maternal sleep quality in late pregnancy on prenatal, birth and early postnatal outcomes. The research was conducted in three parts with women at 28 or more weeks of gestation. In the first part, pregnant women admitted for delivery were evaluated in terms of eligibility criteria. Pregnant women in the latent phase of labour completed the Prenatal Questionnaire. In the second part, labour follow‐up was performed. The researchers completed the Birth Follow‐up Questionnaire based on observations and hospital birth records. In the third part, mothers were interviewed between the 12th and 24th hour of postnatal. Participants filled out the Postnatal Questionnaire, the Childbirth Experience Questionnaire, and the Pittsburgh Sleep Quality Index (n = 385). The data were analysed using the chi‐square independence test, Fisher test, independent samples t‐test, effect sizes, and binary logistic regression analysis. Participants had a mean maternal sleep quality score of 4.00 ± 1.38. They slept for 7.53 ± 0.92 hr on average. One‐third of the participants were poor sleepers (32.2%). Employed participants were 71.6% less likely to have poor maternal sleep quality than their non‐employed counterparts (odds ratio = 0.29, 95% confidence interval: 0.13–0.62; p = 0.002). The odds of poor maternal sleep quality increased by 13.7% when maternal weight gain during pregnancy increased by 1 kg (odds ratio = 1.14, 95% confidence interval: 1.03–1.26; p = 0.014). Increased maternal sleep quality positively affected the birth process (p < 0.05). Healthcare professionals should routinely screen the maternal sleep quality of pregnant women and increase their sleep hygiene. [ABSTRACT FROM AUTHOR]

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

Summary: Sleep is fundamental to health. The aim of this study was to analyse and determine factors predicting sleep quality during and after national lockdowns due to severe acute respiratory syndrome coronavirus 2 (COVID‐19) in the UK. A longitudinal online survey‐based study (SleepQuest) involving UK adults was administered in Spring 2020, Winter 2020, and Winter 2022 including questionnaires probing sleep quality, depression, anxiety, beliefs about sleep, demographics, COVID‐19 status, and exercise. The primary outcome was sleep quality (Pittsburgh Sleep Quality Index). A linear mixed‐effects model evaluated factors associated with baseline and longitudinal sleep quality. Complete data were provided by 3306 participants in Spring 2020, 2196 participants in Winter 2020, and 1193 in Winter 2022. Participants were mostly female (73.8%), white (97.4%), and aged over 50 years (81.0%). On average, participants reported poor sleep quality in Spring 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.59 [3.6]) and Winter 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.44 [3.6]), with improved but still poor sleep quality in Winter 2022 (mean [SD] Pittsburgh Sleep Quality Index score = 6.17 [3.5]). Improved sleep quality was driven by better subjective sleep and reduced daytime dysfunction and sleep latency. Being female, older, having caring responsibilities, working nightshifts, and reporting higher levels of depression, anxiety, and unhelpful beliefs about sleep were associated with worse baseline PSQI scores. Better sleep quality was associated with more days exercising per week at baseline. Interventions focusing on improving mental health, exercise, and attitudes towards sleep, particularly in at‐risk groups, may improve sleep‐related outcomes in future pandemics. [ABSTRACT FROM AUTHOR]

Summary: Sleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane‐Library (n = 6745). Nineteen randomised and one non‐randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low‐risk, nine moderate‐risk, and one high‐risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta‐analysed (random‐effects model). We found moderate‐ to high‐quality evidence for the beneficial effects of exercise on self‐reported and objectively‐measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias. [ABSTRACT FROM AUTHOR]

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

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

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

Background: Recurrent episodes of upper airway collapse during sleep cause obstructive sleep apnoea (OSA). Patients with OSA, a serious clinical condition, frequently halt or reduce their breathing while they are asleep. This results in non-restful, fragmented sleep, which exacerbates symptoms such as morning headaches and drowsiness during the day. Aims and objectives: This review article focuses only on the current medical treatment of OSA. It will also catalyse further study and better awareness of the current medical treatment of OSA. Materials and methods: A search was conducted for recent research articles on current medical treatment for OSA. We searched the PubMed, Scopus, Medline and Google Scholar online databases. Results: Heart arrhythmias, depression, hypertension and coronary artery disease are among the medical disorders linked to OSA. Clinical symptoms that are predictive include obesity, enlarged neck circumferences, gasping when sleeping and loud snoring. Those who are obese, hypertensive, frequent snorers and hyper-somnolent should be suspected of having OSA. An essential test for accurately diagnosing OSA is overnight polysomnography. Conclusion: As OSA is a chronic illness, a long-term, interdisciplinary strategy is required. The first step in managing OSA is patient education. For treatment of OSA, lifestyle changes including losing weight, switching to a different sleeping position, abstaining from alcohol and using certain drugs are crucial. When treating OSA, positive airway pressure is a crucial choice. Since OSA affects both the person and society as a whole, further investigation is needed to find novel treatment approaches for this morbid clinical condition. [ABSTRACT FROM AUTHOR]

Purpose: To explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development. Methods: This 1:1 propensity-score matched study included 1,216 pregnant women divided into GDM and control groups based on diagnosis via the oral glucose tolerance test at 24–28 gestational weeks. Sleep conditions and hygiene behaviors were evaluated using structural questionnaires, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Sleep Hygiene Practice Scale. Univariate and multivariate logistic regression analyses and Spearman's correlation were conducted to identify the associations. Results: After adjusting for baseline clinical characteristics, women with GDM were more likely to have poor sleep quality (adjusted odds ratio [AOR] = 1.585, 95% confidence interval [CI]: 1.261–1.992) and higher scores for subjective sleep quality, latency, duration, efficiency, and sleep disturbances (all P < 0.01). Mild sleepiness (AOR = 1.311, 95% CI: 1.012–1.699) and worrying about not being able to fall asleep (AOR = 1.123, 95% CI: 1.005–1.255) were more likely to occur in the GDM group. Sleep quality and hygiene behaviors such as sleep-irrelevant activities, staying in bed after waking up, weekend catch-up sleep, and overeating before bedtime were significantly correlated with gestational diabetes variables. Conclusion: Poor sleep conditions and specific sleep hygiene behaviors in early pregnancy may be independent risk factors for GDM. This suggests that sleep assessment and behavior education can be used as new approaches for the early implementation of surveillance and prevention of GDM. [ABSTRACT FROM AUTHOR]

Centenarians represent a phenomenon of successful aging. This systematic review aimed to understand lifestyles and health practices, focusing on diet and medication use for healthy longevity in community-based adults 95 years or over. Medline, CINAHL, Scopus, and gray literature were searched from 1 January 2000 to 10 December 2022. Study quality was assessed using the Modified Newcastle-Ottawa Scale (mNOS). Pooled prevalence [%; 95% confidence interval] for categorical variables and pooled mean for continuous variables were estimated for demographics, weight status, lifestyle factors, medications, and health conditions. Of 3392 records screened, 34 studies were included in the review, and 71% (24/34) met the 6/8 criteria in mNOS. Centenarians/near-centenarians' ages ranged from 95 to 118 years, with 75% (71–78%) female and 78% (68–88%) living in rural areas. They had an overall healthy lifestyle: current smoking (7%; 5–9%), drinking (23%; 17–30%), normal weight (52%; 42–61%), overweight (14%; 8–20%), physical activity (23%; 20–26%), and sleep satisfaction (68%; 65–72%). Diet averaged 59.6% carbohydrate, 18.5% protein, and 29.3% fat; over 60% consumed a diverse diet, and < 20% preferred salty food, contributing to lower mortality risks and functional decline. About half used antihypertensives (49%; 14–84%) or other cardiovascular drugs (48%; 24–71%), with an average of 4.6 medications. Common health issues included impaired basic activities of daily living (54%; 33–74%), hypertension (43%; 21–65%), and dementia (41%; 23–59%). The findings of this systemic review underscore the pivotal role of dietary practice and weight management in healthcare strategies to promote healthy ageing. It also recognises rural living styles and sleep hygiene as potential factors contributing to healthy longevity. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is the most common complication of pregnancy, affecting an estimated 16.7% of live births worldwide, which translates to approximately 21 million cases annually. Although poor sleep quality is a prevalent concern in this population, most existing studies predominantly focus on the impact of sleep disorders on GDM, rather than directly assessing sleep quality in women diagnosed with GDM. This study aimed to investigate sleep quality and its associated factors specifically among women with GDM. Methods: We originally aimed to include 287 women with GDM; ultimately, 618 were invited, of whom 393 participated in the survey through a convenience sampling method at the obstetric clinics of four general tertiary hospitals in Chongqing, China, from June to August 2022. Data were collected utilizing sociodemographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Scale, and the Pregnancy-related Anxiety Scale (PrAS). We employed linear regression analysis to identify factors associated with sleep quality. Results: The PSQI score of participants was (5.83 ± 3.41). Notably, 43.77% of participants reported an actual sleep duration of less than 8 h per night, whereas 45.55% experienced poor sleep quality. Worrying during the day about your inability to fall asleep (β = 0.204, P < 0.01), body image concern (β = 0.159, P < 0.01), going to bed thirsty (β = 0.160, P < 0.01), educational attainment (β=-0.150, P < 0.01), avoidance (β = 0.124, P < 0.01), sleep disturbed by bed partner's sleep (β = 0.126, P < 0.01), and worrying as you prepare for bed about your inability to fall asleep (β = 0.137, P < 0.05) significantly affected the sleep quality of participants. Conclusions: The study revealed a high prevalence of insufficient sleep duration and poor sleep quality among women with GDM, which was significantly influenced by inadequate sleep hygiene habits and pregnancy-related anxiety. These findings enhance our understanding of the factors affecting sleep quality in this population and underscore the necessity for healthcare professionals to timely identify sleep disorders. Implementing appropriate interventions, such as the development of educational programs focused on sleep hygiene and body image acceptance through cognitive behavioral therapy, could enhance the quality of care for women with GDM. [ABSTRACT FROM AUTHOR]

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

Background: Insomnia is a prevalent sleep disorder affecting cognitive functions critical to academic performance. University students, particularly in high-stress academic settings, are highly vulnerable. Despite its significant impact on students' health and education, there is limited research on the prevalence of insomnia among university students in Saudi Arabia. This systematic review and meta-analysis aim to assess the prevalence of insomnia among university students in Saudi Arabia, focusing on demographic variations and academic settings, to provide evidence for targeted interventions. Methods: A comprehensive literature search was conducted across databases including PubMed, Scopus, and Web of Science, with additional manual searches. Inclusion criteria were cross-sectional studies addressing insomnia prevalence among Saudi university students, using standard diagnostic criteria. A total of 11 studies met the inclusion criteria, comprising data from diverse faculties, including medical and non-medical disciplines. Quality assessment was conducted using the Newcastle-Ottawa Scale. Statistical analyses were performed using a random-effects model to account for heterogeneity. Results: Eleven studies, involving a total of 8297 university students, were included in the analysis. Insomnia prevalence varied widely, ranging from 19.3% to 98.7%, with a pooled prevalence of 43.3% (95% CI 28.9–58.2%). Subgroup analyses showed a prevalence of 38.6% among medical students and 38.7% among female students. The analysis revealed high heterogeneity (I2 = 99.17%), indicating significant variability in study designs, populations, and diagnostic methods. Conclusions: Insomnia is highly prevalent among university students in Saudi Arabia, with significant variations across demographics and academic contexts. The findings underscore the urgent need for targeted interventions, including stress management, improved sleep hygiene education, and support systems to mitigate the impact of insomnia on academic performance and overall health. Future research should explore the longitudinal impacts of insomnia and the efficacy of tailored interventions in this population. [ABSTRACT FROM AUTHOR]

Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population. Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature. Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months. Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P -value of.021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p -value of.005. Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients. Plain language summary: The Effects of HbA1c Reduction on Alleviating Nonspecific Back Pain Pre-diabetes is a condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes. People with pre-diabetes are at risk of developing diabetes and other health problems, including low back pain, a type of low back pain without a clear cause. Researchers believe this link might be due to problems with metabolism, inflammation, or nerve function. Changes in diet, especially focusing on lowering blood sugar levels and reducing inflammation, along with managing weight, may help people with pre-diabetes who have low back pain without a clear cause feel better. In this study, 82 people with both pre-diabetes and low back pain without a clear cause that lasted for more than 3 months took part in a clinical trial at a clinic in Baghdad. The trial lasted from January to September and was designed to see if lowering blood sugar (measured by HbA1c levels) would reduce low back pain. The participants received personalized care, which included making changes to their diet, improving their sleep, and correcting any vitamin or mineral deficiencies they had. They were followed closely for six months, with monthly check-ups. The results showed that after 12 weeks, many people who managed to lower their blood sugar levels experienced less severe low back pain. The improvement was even more noticeable after 24 weeks, as fewer people reported ongoing low back pain, and this improvement was strongly linked to lower blood sugar levels. In conclusion, the study found that reducing blood sugar levels in people with pre-diabetes who are not obese can significantly improve symptoms of low back pain. This suggests that managing blood sugar could be an important way to relieve low back pain without a clear cause. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint dysfunction (TMD) is a multifactorial and complex problem. The underlying causes of the symptoms and related factors of TMD should be specifically identified. This study aimed to examine factors in the relationship between TMD severity and compare cases regarding TMD severity in university students. Methods: The participants were evaluated with the Visual Analog Scale (VAS) for jaw and neck pain severity. TMD severity was assessed with the Fonseca Anamnestic Index (FAI), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), oral habits with the Oral Behavior Checklist (OBC), and depression and anxiety status with the Hospital Anxiety and Depression Scale (HADS). In addition, mandibular movements were also evaluated. Results: A total of 51 individuals (39 female, 12 male; mean age: 21.9 ± 3.8) were included in the study. There was a positive moderate correlation between FAI and OBC (r = 0.560, p < 0.01). PSQI (r = 0,373), VAS-jaw pain (r = 0,374, p < 0.05), VAS-neck pain (r = 0,437, p < 0.05) and HADS-D (r = 0,392, p < 0.05) were moderately associated with FAI. There was also a low correlation between FAI and HADS-A (r = 0.346, p < 0.05). A statistically significant predictive correlation was found between VAS-Neck pain and OBC with FAI (p < 0.05). Conclusions: This study's results show that jaw and neck pain, sleep habits, oral habits, and anxiety-depression levels are associated with TMD severity. This association highlights the need to consider these factors in assessing and treating TMD. [ABSTRACT FROM AUTHOR]

Background/Objectives: Depression, anxiety, and stress are common mental health issues that affect individuals worldwide. This systematic review and meta-analysis examined the effectiveness of various lifestyle interventions including physical activity, dietary changes, and sleep hygiene in reducing the symptoms of depression, anxiety, and stress. Using stress as an outcome and conducting detailed subgroup analyses, this study provides novel insights into the differential effects of lifestyle interventions across diverse populations. Methods: Five databases were systematically searched: PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar, for gray literature searches. Keywords were used to search each database. The search period was from the conception of the databases until August 2023 and was conducted in English. For each analysis, Hedges' g was reported with a 95% confidence interval (CI) based on the random-effects method. Subgroups were analyzed and heterogeneity and publication bias were examined. Results: Ninety-six randomized clinical trial studies were included in this meta-analysis. Lifestyle interventions reduced depression (Hedges g −0.21, 95% confidence interval −0.26, −0.15; p < 0.001; I2 = 56.57), anxiety (Hedges g −0.24, 95% confidence interval −0.32, −0.15; p < 0.001; I2 = 59.25), and stress (−0.34, −0.11; p < 0.001; I2 = 61.40). Conclusions: Lifestyle interventions offer a more accessible and cost-effective alternative to traditional treatments and provide targeted benefits for different psychological symptoms. [ABSTRACT FROM AUTHOR]

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

Background: Sleep and mental health problems are very common in university students. The objective of this study was to assess the effectiveness of a multi-component sleep-mood intervention on improving sleep and mental health in university students with clinically significant insomnia symptoms, and to investigate possible mediators. Methods: Thirty-five participants were randomized to the Sleep Mood Intervention: Live Effectively (SMILE) intervention (n = 23), or wait-list group (n = 12). SMILE is a multi-component group therapy and includes elements of cognitive behavioral therapy for insomnia (CBT-I), mindfulness, and lifestyle modifications, in four weekly two-hour sessions. The primary outcome was insomnia severity. Secondary outcomes were severity of depression and anxiety, and quality of life (QoL). Dysfunctional beliefs and attitudes about sleep and pre-sleep arousal were assessed as mediators. Results: Intention-to-treat analysis showed significant time x treatment interaction on insomnia symptoms p =.02, partial η²= 0.15, d = 0.84 [95% CI: 0.63 to 1.14], with significantly lower insomnia severity for SMILE compared to waitlist at post-test. No significant effects were found on depression d = 0.02 [95% CI: -0.35 to 0.37], anxiety d = 0.15 [95% CI: -0.16 to 0.53], and QoL d = 0.09 [95% CI: -0.25 to 0.42]. Dysfunctional beliefs mediated the effect on insomnia severity, but pre-sleep arousal did not. Conclusions: This integrated group intervention is associated with reductions in insomnia symptoms in university students. Since no significant effects were detected on mood and QoL, future studies with larger sample size may explore the effects of this intervention on these outcomes. Trial registration: Registry: Overzicht van Medisch-wetenschappelijk Onderzoek. Registration number: NL-OMON46359. Date of registration: September 18th, 2018. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

Our study examined the longitudinal relationship between parenting stress and screen time, outdoor play, and sleep routines in toddler to preschool-aged children. We conducted a descriptive quantitative analysis of a prospective observational cohort study of 300 families with an 18-month-old toddler who were followed for 2 years. Parenting stress was measured using a subscale of the Parenting Stress Index-4 Short Form at child age 18 months. Screen time, outdoor play, and sleep routines were parent-reported at child age 36 months. Multivariable regression estimated associations between parenting stress and screen time behaviors, outdoor play, and sleep routines. Data from 280 children (42.1% female) showed that 39.6% did not have rules around screen time and 82% of families reported frequently having the television on without anyone watching. In adjusted models, a 1-standard deviation increase in parenting stress at 18 months was associated with increased odds of having a television on without anyone watching (OR 1.26, 95% CI: 1.01, 1.57) and decreased odds of not having rules about the amount of screen time at 36 months (OR 0.75, 95% CI: 0.58, 0.96). Increased parenting stress in early childhood was associated with some suboptimal screen time behaviors and sleep routines when children were preschool-aged. [ABSTRACT FROM AUTHOR]

Introduction and purpose: The impact of electronic devices on our daily lives is becoming increasingly significant. The contemporary generation of young people is growing up in a world where smartphones, tablets, computers, and other electronic devices are widely available and utilized. Scientists are contemplating the challenges posed by excessive exploitation of electronics on the health of young individuals. The aim of the article is to present the harmful effects of using electronic devices before sleep in young people, considering medical aspects such as sleep disorders and their influence on overall psychophysical health. Summary: Electronic devices negatively affect the sleep of young people by reducing sleep time and delaying the sleep onset phase. The main problem is the use of electronic devices without time limits. In the era of technology, it is significantly important to raise awareness among young people about the importance of sleep hygiene and how blue light emitted by electronic devices affects its quality. Materials and Evidence: A literature review was conducted in the PubMed database using [ABSTRACT FROM AUTHOR]

Background: Adolescent overweight and obesity are a public health problem with an epidemic trend. There is growing evidence that sleep quality correlates to body weight. The aim of this study was to investigate, sleep quality in adolescents with obesity/overweight. Methods: A total of 100 adolescents with overweight/obesity aged 12–18 years were enrolled. Anthropometric parameters were recorded and a laboratory investigation in the fasting state [glucose, insulin, cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides, uric acid and glycated hemoglobin (HbA1c)] was performed. Insulin resistance was calculated by the Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR). Sleep quality was assessed with the Adolescent Sleep Hygiene Scale (ASHS) questionnaire. Results: According to ASHS, 93% of the participants were classified as "Good Sleepers" (GSs) (score > 3.8) and 7% as "Poor Sleepers" (PSs) (score < 3.8). PSs had a statistically higher body mass index (BMI) compared to GSs (p = 0.026). Increased body mass index (BMI) (r = −0.306, p = 0.002), fast insulin (r = −0.224, p = 0.027), and HOMA-IR (r = −0.260, p = 0.010) exerted a negative effect on sleep quality. Controlling for lipids and uric acid, only TC levels appeared to have a statistically significant and specifically positive correlation with the ASHS score (r = 0.202, p = 0.045). HbA1c values and waist circumference tended to be negatively correlated, but not significant to adolescent sleep quality [(r = −0.101, p = 0.330), (r = −0.095, p = 0.359), respectively]. The influence of central obesity on the ASHS score was also explored, but no correlation was found (p = 0.566). Conclusions: Sleep quality, as reflected by the ASHS score, was associated negatively with BMI, fasting insulin levels, and insulin resistance. Furthermore, a gender difference was observed, as adolescent males were found to achieve a higher overall ASHS score compared to females. [ABSTRACT FROM AUTHOR]

Blue Zones are regions of the world that have a higher number of individuals who live longer than the expected average. The current paper revisits principles previously identified to be common in Blue Zones and to be contributing to longevity (move naturally, eat wisely, improve resilience to stress, get adequate sleep, keep strong family ties, stimulate strong community support, respect for the planet and having a purpose in life'), compares these to the 6 pillars of Lifestyle Medicine (healthy eating, exercising, avoidance of smoking and other risky substances, stress management, restorative sleep, and forming and maintaining relationships) and reviews new studies investigating the association between behavioral factors and longevity. In addition to the role of behavior, the review also discusses the important role of genetics and emphasizes the importance of conducting further research to understand how behavioral and genetic factors may affect molecular pathways with consequent effects on wellbeing and longevity. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers often encounter inadequate sleep conditions. However, limited research has examined the underlying sleep patterns among healthcare workers. This study aimed to identify sleep patterns in healthcare workers, explore predictors associated with various sleep patterns, and investigate the relationship between sleep patterns and psychiatric symptoms. Methods: This cross-sectional study was conducted in Shenzhen, China, from April 2023 to June 2023. In total, data from 1,292 participants were included using a convenience sampling method. A latent profile analysis was conducted to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Multinomial logistic regression analysis was conducted to investigate the influence of socio-demographic variables on each profile. A one-way ANOVA test was employed to examine the relationships between sleep patterns and psychiatric symptoms. Results: Three distinct profiles were identified: good sleepers (63.9%), inefficient sleepers (30.3%), and poor sleepers (5.7%). Multinomial logistic regression analysis indicated that gender and marital status were predictors of various sleep patterns. The ANOVA revealed significant differences in psychiatric symptoms scores among the three sleep patterns; poor sleepers exhibited the highest levels of mental distress. Conclusion: This study identified three distinct sleep patterns in healthcare workers and their significant associations with psychiatric symptoms. These findings contribute to the development of targeted intervention strategies aimed at improving sleep and reducing psychiatric symptoms among healthcare workers. [ABSTRACT FROM AUTHOR]

Background: Digital therapeutics (DTx) in the form of mobile health (mHealth) self-management programs have demonstrated effectiveness in reducing disease activity across various diseases, including fibromyalgia and arthritis. However, the content of online self-management programs varies widely, making them difficult to compare. Aim: This study aims to employ generative artificial intelligence (AI)-based knowledge graphs and network analysis to categorize and structure mHealth content at the example of a fibromyalgia self-management program. Methods: A multimodal mHealth online self-management program targeting fibromyalgia and post-viral fibromyalgia-like syndromes was developed. In addition to general content, the program was customized to address specific features and digital personas identified through hierarchical agglomerative clustering applied to a cohort of 202 patients with chronic musculoskeletal pain syndromes undergoing multimodal assessment. Text files consisting of 22,150 words divided into 24 modules were used as the input data. Two generative AI web applications, ChatGPT-4 (OpenAI) and Infranodus (Nodus Labs), were used to create knowledge graphs and perform text network analysis, including 3D visualization. A sentiment analysis of 129 patient feedback entries was performed. Results: The ChatGPT-generated knowledge graph model provided a simple visual overview with five primary edges: "Mental health challenges", "Stress and its impact", "Immune system function", "Long COVID and fibromyalgia" and "Pain management and therapeutic approaches". The 3D visualization provided a more complex knowledge graph, with the term "pain" appearing as the central edge, closely connecting with "sleep", "body", and "stress". Topical cluster analysis identified categories such as "chronic pain management", "sleep hygiene", "immune system function", "cognitive therapy", "healthy eating", "emotional development", "fibromyalgia causes", and "deep relaxation". Gap analysis highlighted missing links, such as between "negative behavior" and "systemic inflammation". Retro-engineering of the self-management program showed significant conceptual similarities between the knowledge graph and the original text analysis. Sentiment analysis of free text patient comments revealed that most relevant topics were addressed by the online program, with the exception of social contacts. Conclusion: Generative AI tools for text network analysis can effectively structure and illustrate DTx content. Knowledge graphs are valuable for increasing the transparency of self-management programs, developing new conceptual frameworks, and incorporating feedback loops. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

Background: Sleep distrurbances involves daytime preoccupation about sleep, which plays a critical role in perpetuating sleep disturbances. Recent cognitive models highlight the importance of daytime processes, like processing sleep-related information and interpretations during waking hours, in influencing sleep quality and quantity. The Sleep Preoccupation Scale (SPS) quantifies this daytime cognitive activity related to sleep. This study aimed to translate and validate an Arabic version of the SPS for assessing sleep preoccupation among Arabic speakers. Methods: 523 Arabic speakers (mean age 23.6 years, 75% female) from four countries completed the Arabic SPS alongside the Athens Insomnia Scale, Generalized Anxiety Disorder-7 Scale, and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ). The sample repeated the SPS after two weeks for test-retest reliability. Confirmatory factor analysis evaluated the SPS's two-factor structure. Internal consistency, item response theory, and convergent validity with the other scales were examined. Results: Confirmatory factor analysis supported the two-factor model's fit. Measurement invariance results suggest that the SPS exhibits a similar basic factor structure across both insomnia and non-insomnia groups. The Arabic SPS demonstrated good internal consistency (Cronbach's α = 0.92, McDonald's ω = 0.92) and two-way mixed effects, consistency, single rater/measurement intraclass correlation coefficient (ICC) test-retest reliability (ICC = 0.95). Most items exhibited satisfactory item response theory fit statistics and discrimination. The SPS total score showed strong positive correlations with insomnia severity (r = 0.48, p < 0.001), generalized anxiety (r = 0.57, p < 0.001), and sleep-related anxiety/preoccupation (r = 0.79, p < 0.001), demonstrating convergent validity. Conclusion: The Arabic version of the SPS demonstrated good psychometric properties and validity, supporting its use for assessing sleep preoccupation among Arabic speakers. This culturally-adapted version enhances sleep assessment capabilities for improving insomnia understanding and treatment within Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity represents a major public health issue worldwide. Evidence showed the need to implement prevention strategies mainly focused on lifestyle habits. Sleep hygiene is a variable of great interest and this review systematically examined the effects of sleep duration in increasing childhood obesity risk Methods: A systematic literature review was conducted from December 2023 to February 2024. Study selection and data extraction procedures were performed in accordance with Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines and Statement, and risk of publication bias was assessed by the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results: Original works in English were eligible for review and eleven studies that met the inclusion criteria were included. Studies collected were heterogeneous in terms of duration, sample characteristics, hours of sleep manipulation, anthropometric and hematological parameters collected, therefore it was not possible to perform a meta-analysis. A narrative synthesis of the reported evidence highlighted the impact of sleep duration above all on food intake, eating habits and hormone levels and consequently on the risk of childhood obesity development. Conclusion: This finding suggests the need to consider sleep hygiene as a modifiable lifestyle habit like diet and physical activity, in order to early prevent childhood obesity. Poor sleep hygiene can significantly contribute to weight gain and exacerbation of metabolic disorders linked to childhood obesity. Although more rigorous studies are needed, clinicians need to be aware of the role of sleep hygiene in reducing childhood obesity risk. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Insomnia affects both quality of life and productivity at work, and it raises the risk of other diseases, such as depression, that coexist with insomnia. Nowadays, it is highly advised to treat insomnia with behavioral and psychological therapeutic methods to ensure the quality of your sleep. Aim: This study aimed to find the efficacy of sleep hygiene techniques in improving sleep quality and mental ability among insomnia clients. Methods: Self-structured questionnaires used to evaluate sleep quality and the McQuaig Mental Ability Test to test mental ability were used to collect data during the study's six-week duration, which involved the recruitment of 50 participants using a purposive sample technique. A paired sample t -test and Pearson correlation were used for the statistical analysis. Results: Data analysis shows that sleep quality (t = 33.35) (P = 0.0000) and mental ability (t = 35.33) (P = 0.0001) are both highly significant at P =0.0001. Correlation regression data of sleep hygiene elements such as schedule, avoiding caffeine and beverages, relaxation routine, and sleep-stimulating environment shows that there is a positive correlation with the quality of sleep at r = 0.9, 0.89, 0.75, and 0.68, whereas P = 0.000, 0.01, and 0.023, respectively. Similar to this, there is a positive association between mental ability and good sleep habits such as a relaxing routine, a sleep-promoting environment, and a schedule with r = 0.91, 0.88, and 0.92, respectively, with P values of 0.0001, 0.001, and 0.001. Conclusion: The results of the study provide compelling evidence that good sleep hygiene can help enhance insomniacs' mental ability and sleep quality. Furthermore, those with moderate levels of sleep quality, those between the ages of 18 and 38, and those with higher education benefited more than others. [ABSTRACT FROM AUTHOR]

Insomnia is commonplace in the general population. Poor sleep quality leads to various health dysfunctions and compromises the well-being of the affected individuals. Non-pharmacologic approaches should be considered the first-line treatment as suggested by various guidelines. Among others (e.g., sleep hygiene, cognitive-behavioral therapy, light therapy), appropriate physical activity seems to be promising in treating and preventing sleep disturbance development. We found that improvement in a particular objective and subjective sleep quality parameters may be attributed to appropriate physical activity. When further analyzing the activity, lightintensity aerobic exercises and resistance training reduced insomnia symptoms. High-intensity interval training also showed a positive effect on the improvement in depressive symptoms. Regarding mind-body practices, current evidence is insufficient to conclude. However, it was documented that stress, depression, and anxiety reduction, can improve well-being. [ABSTRACT FROM AUTHOR]

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

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