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The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p =.01), nitric oxide (p =.01), and maximal oxygen uptake (VO2max; p =.002) increased, and glucose (p =.001), insulin (p =.001), insulin resistance (p =.01), systolic blood pressure (p =.01), and sleep disorders (p =.01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p =.01 and r = −.55) and glucose (p =.01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods: Sleep was assessed for a minimum of 25 nights (range = 25–31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results: There was a significant relationship between sleep duration and the day of the menstrual cycle (P =.042) and total symptoms reported that day (P <.001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P =.004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P =.950), wake after sleep onset (P =.217), and subjective sleep quality (P =.080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P =.220), subjective sleep quality (P =.502), or sleep latency (P =.740) but did significantly relate to wake after sleep onset (P <.001), with a significant day × symptom interaction (P <.001). Conclusions: Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics. [ABSTRACT FROM AUTHOR]

Background: Early stridor onset (≤ 3 years from disease onset) is a predictor of shorter survival in Multiple System Atrophy (MSA), but its role on disease progression is not yet established. In MSA, previous studies on trajectories of disease did not include stridor and REM sleep behavior disorder (RBD) as clinical variable. The aims of the study were: (1) to investigate disease progression in MSA patients with early stridor onset and with early stridor and/or RBD onset; (2) to assess cerebrospinal fluid (CSF) levels of neurofilament light chain protein (NfL) in MSA patients with early onset sleep disorders. Methods: This is a retrospective and prospective cohort study including 208 (120 males) MSA patients. Occurrence of symptoms/signs, milestones of disease progression, and their latency from disease onset were collected. RBD and stridor were video-polysomnography (VPSG)-confirmed. CSF NfL levels were analyzed. Survival data and predictors of mortality were calculated. Results: Out of 208 MSA patients (157 deceased), 91 were diagnosed with stridor and 160 with VPSG-confirmed RBD. Patients with early stridor onset (n = 41) and with early stridor and/or RBD onset (n = 132) showed an early autonomic involvement, developed a more progressive and severe disease and presented higher CSF NfL than those with late stridor and RBD onset. Early stridor and early RBD were independent risk factors on MSA survival. Conclusions: The evidence of a more rapid and severe disease progression and of high CSF NfL levels in patients who early developed sleep disorders could define a different MSA phenotype with a widespread impairment of central-brainstem circuits. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a common sleep disorder affecting approximately 10-20% of adults worldwide. Despite various available treatment modalities, significant gaps remain in improving sleep maintenance and reducing functional impairments. Objective: To systematically review and synthesize studies on the efficacy and safety of Dimdazenil for the treatment of insomnia. Methods: A comprehensive search of multiple databases and websites was conducted to identify published and unpublished trials from inception to July 19, 2024. Due to the limited number of studies available, quantitative data were synthesized narratively. Results: This synthesis included four randomized controlled trials. The primary efficacy endpoints of these studies met the predetermined criteria for superiority. Dimdazenil significantly improved certain objective and subjective sleep measures in patients with insomnia, including reduced sleep latency and longer total sleep duration. Importantly, these outcomes were achieved without causing significant excessive daytime drowsiness or impairing daytime functionality. Furthermore, Dimdazenil demonstrated a generally acceptable safety profile and was well tolerated. Most evaluation indicators related to withdrawal symptoms, drug residues, and rebound effects did not show significant statistical differences. Limitations: The number of included studies and sample sizes were small, and there is a lack of data on the long-term efficacy and safety of Dimdazenil. Conclusions: Dimdazenil offers significant benefits in improving sleep onset and maintenance in patients with insomnia. It presents a favorable safety and tolerability profile while preserving daytime functioning. Future studies should extend the duration and scale to assess the long-term efficacy and safety of Dimdazenil across diverse populations. [ABSTRACT FROM AUTHOR]

Device-based treatments exist in psychiatry for decades, but are usually operated by clinicians and require multiple office visits. Near-infrared transcranial photobiomodulation (tPBM) is a safe neurostimulation modality with potential antidepressant and hypnotic effects. We investigated the feasibility and efficacy of adjunctive tPBM treatment, self-administered by a wearable headband. We randomized 48 outpatients with major depressive disorder (MDD) into tPBM or sham with 1:1 ratio. All participants were advised to receive the device-based intervention for at least 20 min daily at their preferred time and place for 8 weeks. The compliance and adverse events were monitored throughout the trial. The Hamilton Depression Rating Scale (HAM D), Beck's Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the symptoms from baseline until week-12. Participants reported this self-administered intervention well-tolerated. Treatment compliance was equally good between various group-comparisons, and the adverse effects were minimal and transient. Post-treatment, the HAMD and BDI scores of patients in both tPBM group and sham group significantly decreased compared to baseline, with no between-group difference. However, a significant PSQI score reduction was only found in tPBM group from week-2 onward compared with baseline, with significant between-group difference lasting until week-12 (F 1,46 = 6.16, p = 0.017). Limitations. This smaller sample size and short treatment and follow-up durations. Self-administered wearable tPBM appears to be a feasible and well-tolerated in MDD patients. The low-level dosimetry appeared insufficient to produce an antidepressant effect but effective in improving sleep quality. Further studies should investigate different dosimetry and intervention time. NCT04619121. • Largest RCT testing the feasibility and efficacy of self-administered wearable tPBM • Good safety and compliance profiles in both the elderly and general adults. • A significant hypnotic effect but not antidepressant effect was found. [ABSTRACT FROM AUTHOR]

Sleep pattern (sleep duration, trouble sleeping, sleep disorder) is associated with both energy density dietary inflammatory index (EDII) and depression. However, whether depression mediates the EDII-sleep pattern relationship is unclear. 14,305 participants from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014 were included in this study. Weighted multivariable logistic regression and mediated effect analysis were conducted to analyze the associations between EDII, depression and sleep pattern. In the regression model with full confounding variables adjusted, the OR (95 % CI) for the association between EDII and sleep pattern was 2.11 (1.44, 3.08). Similarly, comparing the highest to the lowest EDII scores, the association with depression yielded an identical OR of 2.62 (1.89, 3.64). Mediation models showed depressive symptoms mediated 24.06 % of the EDII-sleep pattern link. Analysis by sleep pattern subtypes found depressive symptoms mediated 18.22 % for sleep duration, 30.53 % for sleep disorder (both with substantial direct EDII effects), and 93.73 % for trouble sleeping, where EDII's direct impact was not considerable. Positive association of EDII with unhealthy sleep pattern is partly mediated by depression, and anti-inflammatory diet could be beneficial. • EDII scores were positively associated with unhealthy sleep patterns, including sleep duration trouble sleeping and sleep disorder. • Depressive symptoms mediated 24.06 % of the EDII-sleep pattern relationship, including 93.73 % of the EDII-trouble sleeping association. • The associations were consistent across demographic and lifestyle subgroups, suggesting that anti-inflammatory diets may broadly improve sleep. [ABSTRACT FROM AUTHOR]

Narcolepsy is a chronic disorder that requires lifelong management; however, few studies have evaluated disease burden of narcolepsy. We estimated the healthcare burden of narcolepsy in Japan using data from the Japan Medical Data Center health insurance claims database. This was a retrospective analysis of clinical burden, healthcare resource utilization, and costs among incident narcolepsy cases and matched controls identified between January 1, 2014 and December 31, 2019. Of the 1317 incident cases; 889 (with 1778 controls) were analyzed for healthcare burden, 626 (with 1252 controls) for clinical journey, and 439 (no controls) for treatment patterns. The most common baseline comorbidity was non-narcolepsy sleep disorder (41.6 % cases vs 3.0 % controls), including insomnia (28.5 % vs 2.6 %) and sleep apnea (10.8 % vs 0.3 %; both p < 0.001). The most common nonsleep disorder comorbidities were depression (35.0 % vs 2.6 %), anxiety (30.4 % vs 2.7 %), and headache/migraine (18.1 % vs 5.5 %; all p < 0.001). Compared to controls, narcolepsy cases had more prescription claims in the year following index date (82.8 % vs 9.5 %; p < 0.001), higher rates of outpatient (2291.8 vs 674.9 visits/100 person-years; p < 0.001) and inpatient claims (56.8 vs 5.1/100 person-years; p < 0.001), and longer hospital stays (mean 2.9 vs 0.5 days; p < 0.001). Similarly, median HCRU costs were higher in cases than controls (total annual healthcare costs, $2531 vs $266; community pharmacy claims, $826 vs $47 per person; and outpatient claim costs, $1053 vs $188 per person year). Narcolepsy carries a substantial comorbidity burden, a high rate of medication prescribing, and high healthcare resource use in Japan. [Display omitted] • This study provides much-needed information on the burden of narcolepsy in Japan. • Narcolepsy has a substantial burden of sleep and non-sleep-related comorbidities. • Medication prescribing rates were high for people with narcolepsy. • Healthcare resource utilization and medical costs were high compared with controls. [ABSTRACT FROM AUTHOR]

Sleep disturbances are common in individuals with autism spectrum disorder (ASD) or bipolar disorder (BD). However, to the best of our knowledge, there has been no study investigating prevalence and features of sleep disorders in youth with ASD with and without comorbid BD. The aim of this case-controlled study was to investigate sleep disturbances in autistic youth with and without comorbid BD. The study included 43 individuals with both ASD and BD as the case group, and 43 age and gender-matched participants with ASD but no mood disorders as the control group. Both groups were assessed using the Sleep Disturbance Scale for Children (SDSC), the Childhood Autism Rating Scale (CARS), and the Aberrant Behavior Checklist (ABC). The case group exhibited significantly higher levels of sleep breathing disorders, disorders of arousal, disorders of excessive somnolence, and sleep hyperhidrosis on the SDSC compared to the control group (p < 0.05). Partial correlation analysis revealed a significant association between total SDSC scores and total ABC scores in the case and control groups (r = 0.424, p = 0.005; r = 0.629, p < 0.001, respectively) Sleep disturbances are common in youth with ASD with further increased rates in the presence of comorbid BD. Sleep disturbances are also associated with more behavioral problems among youth with ASD regardless of comorbid BD diagnosis. Clinicians working with youth with ASD should routinely assess sleep habits and related problems and should give particular attention in the presence of comorbid mood disorders. This study highlights the importance of recognizing and managing sleep disturbances in this unique population. • Sleep disorders may be more frequent in the presence of BD comorbidity in youth with ASD. • Sleep disturbances were associated with more behavioral problems in youth with ASD and BD. • Sleep breathing disorder symptoms were more frequently associated with ASD + BD. [ABSTRACT FROM AUTHOR]

REM sleep behaviour disorder (RBD) is a known predictor of the subsequent development of neurodegenerative diseases, particularly Parkinson's disease and other alpha synucleinopathies. RBD has also been found to be common among children with other psychiatric disorders such as anxiety, depression, and ADHD. This retrospective study aims to analyze the prevalence of early-onset psychiatric disorders among patients referred for RBD to our sleep laboratory. Our hypothesis is that early-onset psychiatric disorders are more common in patients with polysomnographically confirmed RBD. A retrospective chart review was performed through the Kingston Health Sciences Centre (KHSC) Sleep Laboratory. Data collection involved gathering information regarding the patient's sleep study, psychiatric diagnoses and/or symptoms, mental health medication history and any neurodegenerative conditions noted in hospital clinical notes. Patients referred for and polysomnographically confirmed RBD were more likely to have presented with symptoms, or received a clinical diagnosis, of an early-onset psychiatric disorder at 32 % compared to the obstructive sleep apnea (OSA) control group at 3 %. Conclusions : History of early-onset psychiatric disorders is more common among patients referred as RBD compared to a control group of patients with OSA. Future studies are required to confirm the validity and replicability of this finding. • Patients with RBD more likely to have psychiatric disorders when young, compared to matched OSA patients. • Potential time relationship between early-onset psychiatric disorders, RBD, and neurodegenerative conditions observed. • History of mental health medications use commoner in RBD cohort than among OSA patients. [ABSTRACT FROM AUTHOR]

It is unknown whether loudness of snoring or hypoxic burden are related to higher hyperactivity scores in habitually snoring children and whether this effect is impacted by the severity of sleep-disordered breathing (SDB). This study investigates the prevalence of hyperactivity in children with habitual snoring and the independent effects of loudness of snoring, as reported by the parents, hypoxic burden and obstructive sleep apnea syndrome's severity (OSAS) on hyperactivity, as measured by the Conners' Parent Rating Scale-Hyperactivity Index (CPRS-HI). Children with habitual snoring aged 3–18 years were recruited for an overnight polysomnography reporting apnea-hypopnea index (AHI) and hypoxic burden, acoustic rhinometry, clinical examination and parental questionnaires assessing snoring loudness and CPRS-HI. The study analysis included 512 children (median (25th; 75th percentile) age, 10.6 (7.6; 13.4) years; 295 (58 %) males), of whom 358 (70 %) were overweight or obese and 179 (35 %) had an obstructive AHI >3/h. Findings revealed that 36 % [95 % CI: 32%–41 %] of children exhibited increased hyperactivity/impulsivity, and 25 % [21%–29 %] showed emotional lability. Snoring loudness was significantly correlated with higher hyperactivity scores, particularly for hyperactivity/impulsivity, while hypoxic burden showed no significant association (rho s = −0.09; p = 0.082). Multivariate analysis showed that the presence of very loud as compared to mildly quiet snoring was an independent predictor of hyperactivity symptoms, while an obstructive AHI >3/h was associated with decreased hyperactivity scores. These results suggest that the loudness of snoring, independent of OSAS severity, contributes to hyperactivity in children. [Display omitted] • The independent effect of loud snoring on hyperactivity in children is unkown. • We included 512 habitual snoring children, of whom one third had an OAHI >3/h. • The prevalence of increased hyperactivity scores was 36 %. • Hyperactivity increased with loud snoring, while OSAS had the opposite effect. • Hypoxic burden was not associated with hyperactivity behavior. [ABSTRACT FROM AUTHOR]