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Artificial light at night (ALAN) changes animal behavior in multiple invertebrates and vertebrates and can result in decreased fitness. However, ALAN effects have not been studied in European honey bees (Apis mellifera), an important pollinator in which foragers show strong circadian rhythmicity. Colonies can be exposed to ALAN in swarm clusters, when bees cluster outside the nest on hot days and evenings, and, in limited cases, when they build nests in the open. We captured and maintained foragers in incubated cages and subjected them to constant light (LL), constant dark (DD), or 12 h light:12 h dark (LD) cycle, and observed them with infrared cameras. After 79 h, there was a significant interaction of treatment and time because LL bees slept less. In detail, the bees maintained a regular sleep pattern for three days but LL bees showed a shift on the fourth day. LL bees had the largest sleep differences from LD controls, with trends of lengthened periods and increased phase misalignment from both LD and DD bees. LL bees also experienced significantly more disturbances from their nestmates and preferred to sleep in the lower portion of the cages, which had significantly lower light intensity. These findings suggest that ALAN can disrupt the sleep of honey bee foragers, which has implications for their behavior and overall colony health.

COVID-related discrimination towards historically marginalized racial-ethnic groups in the United States has been well-documented; however, its impact on psychological distress and sleep (overall and within specific racial-ethnic groups) is largely unknown. We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, conducted from 12/2020-2/2021. Participants were asked how often they experienced discriminatory behaviors "because they think you might have COVID-19" (modified Everyday Discrimination Scale). Psychological distress was captured as having experienced anxiety-depression symptoms (Patient Health Questionairre-4, PHQ-4), perceived stress (modified Perceived Stress Scale), or loneliness-isolation ("How often have you felt lonely and isolated?"). Sleep disturbances were measured using the Patient-Reported Outcomes Information System Short Form Sleep Disturbance scale (PROMIS-SF 4a). Overall, 22.1% reported COVID-related discriminatory behaviors (sometimes/always: 9.7%; rarely: 12.4%). 48.4% of participants reported anxiety-depression symptoms (moderate/severe: 23.7% mild: 24.8%), 62.4% reported feeling stressed (moderate/severe: 34.3%; mild: 28,1%), 61.0% reported feeling lonely-isolated (fairly often/very often: 21.3%; almost never/sometimes: 39.7%), and 35.4% reported sleep disturbances (moderate/severe:19.8%; mild: 15.6%). Discrimination was only associated with increased psychological distress among racial-ethnic minorities. For example, COVID-related discrimination was strongly associated with anxiety-depression among Black/African American adults (mild: aOR=2.12, 95% CI=1.43-5.17; moderate/severe: aOR=5.19, 95% CI=3.35-8.05), but no association was observed among White or multiracial adults. Mitigating pandemic-related discrimination could help alleviate mental and sleep health disparities occurring among minoritized racial-ethnic groups.

The aim of this review was to evaluate the feasibility of treating sleep disorders using novel gut microbiota intervention strategies. Multiple factors can cause sleep disorders, including an imbalance in the gut microbiota. Studies of the microbiome-gut-brain axis have revealed bidirectional communication between the central nervous system and gut microbes, providing a more comprehensive understanding of mood and behavioral regulatory patterns. Changes in the gut microbiota and its metabolites can stimulate the endocrine, nervous, and immune systems, which regulate the release of neurotransmitters and alter the activity of the central nervous system, ultimately leading to sleep disorders. Here, we review the main factors affecting sleep, discuss possible pathways and molecular mechanisms of the interaction between sleep and the gut microbiota, and compare common gut microbiota intervention strategies aimed at improving sleep physiology. [ABSTRACT FROM AUTHOR]

Background: There is a high prevalence of sleep disturbances among people living with dementia (PLWD) in nursing homes. Reliable and valid measurements are needed to assess these disturbances. The aim of this systematic review was to identify, analyze and synthesize studies of sleep-related measurements to assess sleep disturbances in PLWD. Methods: The databases PubMed, CINAHL, and PsycINFO were systematically searched in 2019; the search was updated in March 2024. The inclusion criteria were as follows: participants with dementia or probable dementia in any care setting; and studies that reported at least one of the following aspects: (I) theoretical and conceptual frameworks, (II) user or patient involvement by type of users in measurement development, (III) feasibility and practicability of measurements, and (IV) results of psychometric analyses. The quality of the included studies was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria and the quality appraisal tool for studies of diagnostic reliability (QAREL) tool. Results: A total of 5169 studies were identified; ultimately, 15 studies describing three self-administered measurements, three proxy-administered measurements and two technological measurements were included. No sleep-related measurement showed acceptable psychometric properties in any of the COSMIN domains. Conclusions: No measurement without adaptation can be recommended for PLWD in nursing homes. If existing measurements are used in clinical practice, the self-perspective of PLWD should be taken into account. If this is no longer fully possible, proxy-rating perspectives in combination could be an option. Future research on sleep-related measurements should be strictly based on international consensus-based psychometric quality criteria. [ABSTRACT FROM AUTHOR]

Background/objective: Emotional dysregulation is bidirectionally associated with sleep disturbances, with potentially critical implications for emotional reactivity, in patients with borderline personality disorder (BPD). This study evaluated subjective and objective sleep quality, emotional regulation, and emotional reactivity in 20 patients with BPD compared to 20 non-clinical individuals. Methods: Subjective and objective sleep quality was assessed using the Pittsburgh Sleep Quality Index and a 3-day actigraphic measurement. Emotional regulation was evaluated using the Difficulties in Emotion Regulation Scale and the Berkeley Expressivity Questionnaire. Furthermore, each participant underwent an emotional reactivity task selected from the International Affective Picture System. Results: Compared to control subjects, individuals with BPD reported poor subjective sleep quality and objective sleep continuity disturbances, with more sleep fragmentation and decreased sleep efficiency. Moreover, BPD patients showed emotional dysregulation and altered subjective reactivity to emotional stimuli, particularly positively valenced stimuli. Conclusion: These results suggest the importance of further clarifying the specific direction of sleep-dependent emotional modulation in individuals with BPD, with significant clinical implications for patients with co-occurring sleep disturbances. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents' health and well-being are seriously threatened by suicidal behaviors, which have become a severe social issue worldwide. Suicide is one of the leading causes of mortality for adolescents in low and middle-income countries, with approximately 67,000 teenagers committing suicide yearly. Although an association between sleep disturbances (SDs) and suicidal behaviors has been suggested, data are still scattered and inconclusive. Therefore, to further investigate this association, we conducted a meta-analysis to verify if there is a link between SDs and suicidal behaviors in adolescents without diagnosed psychiatric disorders. Methods: PubMed, CENTRAL, EMBASE, and PsycINFO were searched from inception to August 30th, 2024. We included studies reporting the estimation of suicidal behaviors in adolescents from 12 to 21 years of age, with SDs and healthy controls. The meta-analysis was based on odds ratio (OR, with a 95% confidence interval ([CI]), estimates through inverse variance models with random-effects. Results: The final selection consisted of 19 eligible studies from 9 countries, corresponding to 628,525 adolescents with SDs and 567,746 controls. We found that adolescents with SDs are more likely to attempt suicide (OR: 3.10; [95% CI: 2.43; 3.95]) and experience suicidal ideation (OR: 2.28; [95% CI 1.76; 2.94]) than controls. Conclusion: This meta-analysis suggests that SDs are an important risk factor for suicidal ideation and suicide attempts in healthy adolescents. The findings highlight the importance of early identification of SDs to prevent suicidal behaviors in this population. Systematic review registration: PROSPERO, identifier CRD42023415526. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common autoimmune and chronic inflammatory dermatological disease that is mainly associated with aberrant immune response and oxidative stress (OS). OS, a crucial pathogenic factor in psoriasis, contributes to psoriasis-like inflammation mediated by the IL-23/IL-17 inflammatory axis. Sleep disturbances (SDs), highly prevalent in patients with psoriasis, exacerbate the condition by disrupting circadian rhythms and reducing melatonin levels, thus promoting OS and inflammation. Xiaoyin-Anshen formula (XYAS), a traditional Chinese medicine (TCM) formula, is composed of the Liangxue-Jiedu (LXJD) and Qingxin-Anshen (QXAS) TCM compounds and has been demonstrated to be effective in treating psoriasis complicated by SDs. However, its exact pharmacological mechanism remains uncertain. Thus, this study used animal experiments to verify whether XYAS can exert therapeutic effects on the disease by regulating melatonin (MLT) levels, protecting against OS, and inhibiting psoriasis-like skin inflammation. Methods: A mouse model for psoriasis combined with SDs was established by smearing 62.5 mg of 5% imiquimod (IMQ) cream for seven consecutive days, along with a daily injection of p-chlorophenyl alanine (PCPA) solution at a dosage of 300 mg/kg at days 6–7. The IMQ cream was continued to be used for maintaining the model at days 8–14. Mice were randomly divided into groups: control, model, MLT, XYAS, LXJD, QXAS. Each group was treated according to its designation at days 8–14, receiving either an oral gavage of XYAS/LXJD/QXAS solution at a dosage of 2 mL/100 g per day, or a daily injection of MLT solution at a concentration of 0.25 mg/mL, with a dosage of 5 mg/kg. Immunohistological analysis, pentobarbital-induced sleep test, Western blotting, and enzyme-linked immunosorbent assay (ELISA) were performed to assess and compare pathological features, sleep conditions, localization and/or levels of manganese-dependent superoxide dismutase (mnSOD), mitochondrial cytochrome c (Cyt-C), MLT, retinoid-related orphan nuclear receptor-α (RORα), and pro-inflammatory cytokines interleukin (IL)-6, IL-17A, and tumor necrosis factor-alpha (TNF-α) among groups. Results: MLT, XYAS, LXJD, and QXAS exhibited varying therapeutic effects on RORα regulation, OS inhibition, mitochondrial protection, and anti-inflammation. Compared to the model, the lesion severity/thickness and serum IL-6, IL-17A, and TNF-α levels were gradually reduced in the MLT, QXAS, LXJD, and XYAS. However, no statistical difference in TNF-α levels was identified between the MLT and the model groups. Additionally, skin MLT levels gradually increased in the MLT, QXAS, and XYAS groups, while RORα levels gradually increased in the MLT, QXAS, LXJD, and XYAS groups. All treatments increased mnSOD levels and reduced Cyt-C levels in skin lesions, with XYAS showing the most significant changes. Conclusion: XYAS may treat psoriasis complicated by SDs through two main mechanisms: (1) Improving melatonin-RORα axis in the skin can lead to an increase in mnSOD and a reduction in Cyt-C levels, which provide protection against oxidative stress, mitochondrial damage, and psoriatic inflammation. (2) Reducing IL-6, IL-17A, and TNF-α production to suppress IL-23/Th17 pro-inflammatory signaling axis and epidermal hyperplasia in psoriasis. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey. Methods: We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted. Results: Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points. Conclusion: Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis. [ABSTRACT FROM AUTHOR]

ANK3 encodes ankyrin‐G, a protein involved in neuronal development and signaling. Alternative splicing gives rise to three ankyrin‐G isoforms comprising different domains with distinct expression patterns. Mono‐ or biallelic ANK3 variants are associated with non‐specific syndromic intellectual disability in 14 individuals (seven with monoallelic and seven with biallelic variants). In this study, we describe the clinical features of 13 additional individuals and review the data on a total of 27 individuals (16 individuals with monoallelic and 11 with biallelic ANK3 variants) and demonstrate that the phenotype for biallelic variants is more severe. The phenotypic features include language delay (92%), autism spectrum disorder (76%), intellectual disability (78%), hypotonia (65%), motor delay (68%), attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) (57%), sleep disturbances (50%), aggressivity/self‐injury (37.5%), and epilepsy (35%). A notable phenotypic difference was presence of ataxia in three individuals with biallelic variants, but in none of the individuals with monoallelic variants. While the majority of the monoallelic variants are predicted to result in a truncated protein, biallelic variants are almost exclusively missense. Moreover, mono‐ and biallelic variants appear to be localized differently across the three different ankyrin‐G isoforms, suggesting isoform‐specific pathological mechanisms. [ABSTRACT FROM AUTHOR]

COVID-19 infection has resulted in a high prevalence of a post-infectious syndrome, known as post-acute sequelae of SARS-CoV-2 (PASC) or "Long COVID". PASC is a heterogeneous disease with a high prevalence of sleep disturbances, varying from an insomnia disorder to excessive daytime sleepiness. Patients seen in the Covid Survivorship Program at the Beth Israel Deaconess Medical Center Boston, USA, were screened for sleep disorders as part of a comprehensive multi-system evaluation. Those who screened positive were referred for a comprehensive sleep evaluation in a dedicated COVID-19-Sleep clinic, followed by diagnostic sleep testing and treatment. This report summarizes patients who completed an American Academy of Sleep Medicine (AASM) accredited facility-based diagnostic evaluation. International Classification of Sleep Disorders 3rd Edition-Revised criteria were met for all diagnoses. In 42 patients with PASC, five categories of sleep disorder syndromes were observed following a sleep clinic evaluation, including obstructive sleep apnea, chronic insomnia disorder, primary hypersomnia, REM behavior disorder (RBD), and new onset circadian phase delay. Seven patients met criteria for idiopathic hypersomnia, and two had narcolepsy type 2. RBD patients were infected in three different waves; circadian disturbance patients were all infected in the winter wave of 2020/21, and the primary hypersomnolence group occurred during all waves, predominantly the initial wave of 2020. A peculiar form of insomnia was a persistent loss of sleep regularity. Specific sleep symptoms/syndromes are reported in this select group of patients with PASC/Long Covid. As new onset sleep complaints are prevalent in PASC, we recommend a complete clinical and investigative sleep evaluation for persistent severe sleep symptoms following COVID-19 infection. • Sleep complaints in PASC are frequent, varying from insomnia to excessive daytime sleepiness. • Noted syndromes: sleep apnea, insomnia, primary hypersomnia, REM behavior disorder, and circadian phase delay. • All circadian disturbances patients were infected in the Winter 20/21 wave. • The response to therapy for hypersomnia and narcolepsy has so far been unremarkable. • Vaccination could have influenced the incidence of PACS patients and their sleep syndromes. [ABSTRACT FROM AUTHOR]

Angelman Syndrome (AS) is a neurodevelopmental disorder with severe symptoms and associated comorbidities. It is caused by the inactivity or lack of the UBE3a gene. Symptoms of the syndrome include intellectual disability and developmental delay. The current study investigated sleep disturbances (SD) in children and adolescents with AS, associations between SD and possible predictors of SD. Variables examined included age, gender, newborn and infancy history, challenging behavior, type of therapy received, genetic type of AS, and seizures. The sample included data from 109 participants with a mean age of 8.21, accessed via the Global Angelman Syndrome Registry. Chi-square tests were carried out to assess the associations between the variables and a logistical regression was carried out to assess the possible predictors of SD. Associations were found between SD and certain repetitive behaviors: slapping walls, focal hand movements, and agitation at new situations. From these associations, a regression formed a predictive model for sleep disturbances. The findings of this research demonstrated the importance of investigating the relationship between sleep disturbances and challenging behavior in children and adolescents with AS and the need for further research in this area. • The current study investigated sleep disturbances (SD) in children and adolescents with AS. • The sample included data from 109 participants accessed via the Global Angelman Syndrome Registry. • Associations between sleep disturbances and challenging behavior were examined. • Associations were found between SD and slapping walls, focal hand movements, and agitation at new situations. [ABSTRACT FROM AUTHOR]

Introduction: Little was known about the relationship between sleep disturbances and depressive and anxiety disorders, as well as the efficacy of treatment regimens. Methods: During 2021 to 2023, a total of 417 participants were screened by Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale (HAMA-14) for psychological status, and Pittsburgh sleep quality index (PSQI) assessment. 409 participants were finally enrolled, of which 188 (45.97%) were suffered from sleep disorders. All participants were received polysomnography (PSG) followed by six-week pharmacological treatment of escitalopram and zopiclone, and finally assessed by HAMD-17 and HAMA-14 for treatment efficacy. Result: PSG monitoring indicated that participants with depression experienced prolonged rapid eye movement sleep latency (REMSL) and increased wakefulness after sleep onset (WASO) (P=0.030 and P=0.002, respectively). Those with anxiety disorders demonstrated a significantly higher percentage of non-rapid eye movement sleep (NREM%) and reduced WASO (P=0.013 and P=0.001, respectively). After six-weeks pharmacological treatment, participants with or without sleep disorders exhibited with similar efficacy outcomes of depression and anxiety disorders (P>0.05). However, every point of PSQI increment at baseline would decrease 0.78 and 0.85 times of probability of effective pharmacological treatment of depression and anxiety disorders. Moreover, participants with both effective outcomes of depression and anxiety disorders were found significant shorter sleep onset latency (SOL) (P<0.001). Discussion: The insights gained underscore the necessity of considering sleep disturbances in enhancing the overall effectiveness of pharmacological treatments for depression and anxiety disorders. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common autoimmune and chronic inflammatory dermatological disease that is mainly associated with aberrant immune response and oxidative stress (OS). OS, a crucial pathogenic factor in psoriasis, contributes to psoriasis-like inflammation mediated by the IL-23/IL-17 inflammatory axis. Sleep disturbances (SDs), highly prevalent in patients with psoriasis, exacerbate the condition by disrupting circadian rhythms and reducing melatonin levels, thus promoting OS and inflammation. Xiaoyin-Anshen formula (XYAS), a traditional Chinese medicine (TCM) formula, is composed of the Liangxue-Jiedu (LXJD) and Qingxin-Anshen (QXAS) TCM compounds and has been demonstrated to be effective in treating psoriasis complicated by SDs. However, its exact pharmacological mechanism remains uncertain. Thus, this study used animal experiments to verify whether XYAS can exert therapeutic effects on the disease by regulating melatonin (MLT) levels, protecting against OS, and inhibiting psoriasis-like skin inflammation. Methods: A mouse model for psoriasis combined with SDs was established by smearing 62.5 mg of 5% imiquimod (IMQ) cream for seven consecutive days, along with a daily injection of p-chlorophenyl alanine (PCPA) solution at a dosage of 300 mg/kg at days 6-7. The IMQ cream was continued to be used for maintaining the model at days 8-14. Mice were randomly divided into groups: control, model, MLT, XYAS, LXJD, QXAS. Each group was treated according to its designation at days 8-14, receiving either an oral gavage of XYAS/LXJD/QXAS solution at a dosage of 2 mL/100 g per day, or a daily injection of MLT solution at a concentration of 0.25 mg/mL, with a dosage of 5 mg/kg. Immunohistological analysis, pentobarbital-induced sleep test, Western blotting, and enzyme-linked immunosorbent assay (ELISA) were performed to assess and compare pathological features, sleep conditions, localization and/or levels of manganese-dependent superoxide dismutase (mnSOD), mitochondrial cytochrome c (Cyt-C), MLT, retinoid-related orphan nuclear receptor-a (RORa), and pro-inflammatory cytokines interleukin (IL)-6, IL-17A, and tumor necrosis factor-alpha (TNF-a) among groups. Results: MLT, XYAS, LXJD, and QXAS exhibited varying therapeutic effects on RORa regulation, OS inhibition, mitochondrial protection, and anti-inflammation. Compared to the model, the lesion severity/thickness and serum IL-6, IL-17A, and TNF-a levels were gradually reduced in the MLT, QXAS, LXJD, and XYAS. However, no statistical difference in TNF-a levels was identified between the MLT and the model groups. Additionally, skin MLT levels gradually increased in the MLT, QXAS, and XYAS groups, while RORa levels gradually increased in the MLT, QXAS, LXJD, and XYAS groups. All treatments increased mnSOD levels and reduced Cyt-C levels in skin lesions, with XYAS showing the most significant changes. Conclusion: XYAS may treat psoriasis complicated by SDs through two main mechanisms: (1) Improving melatonin-RORa axis in the skin can lead to an increase in mnSOD and a reduction in Cyt-C levels, which provide protection against oxidative stress, mitochondrial damage, and psoriatic inflammation. (2) Reducing IL-6, IL-17A, and TNF-a production to suppress IL-23/Th17 proinflammatory signaling axis and epidermal hyperplasia in psoriasis. [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]

The arousal state has been demonstrated to be involved in the fundamental pathophysiological mechanism of sleep disturbances. Tai chi (TC) and repetitive transcranial magnetic stimulation (rTMS) have been documented to alleviate sleep disturbances by interfering with different arousal components. It is reasonable to assume that combining TC and rTMS could induce synergistic and longer-lasting benefits for sleep disturbances. Thirty-eight older community-dwelling people were randomly assigned to one of three groups: TC plus rTMS (n = 12), TC alone (n = 13), and treat-as-usual (TAU) (n = 13). The interventions were conducted three times per week for 4 weeks for the two intervention groups. The primary outcome was the insomnia severity, while the secondary outcomes were the actigraphy-assessed sleep patterns, use of hypnotic medications, mood states, and quality of life. The mediator outcomes included self-reported somatic arousal and cognitive arousal as well as electroencephalogram (EEG)-assessed cortical arousal. The assessments were conducted at baseline (T0), post-intervention (T1), and 3-month follow-up (T2). Significant improvements in the insomnia severity were observed in the TC plus rTMS group compared with the TAU group at T1 (Cohen's d = 1.62, p = 0.003) and T2 (Cohen's d = 1.97, p < 0.001). In contrast, significant improvements in the TC alone group were found only at T2 (Cohen's d = 1.03, p = 0.010) when compared with the TAU group. Significant interaction effects were noted on the actigraphy-assessed sleep efficiency (p = 0.015) and total sleep time (p = 0.004), depression (p = 0.003) and stress scores (p = 0.002), and mental function in relation to quality of life (p = 0.042). However, none of the mediators elucidated how combining TC and rTMS could improve the insomnia severity. The research findings are expected to guide further clinical practice in the management of sleep disturbances among older adults using various interventions. Future studies are needed to unravel the underlying mechanism and optimize the protocol to maximize the therapeutic benefits. • Combining TC and rTMS was found to produce synergistic and longer-lasting effects on sleep disturbances among older adults. • The benefits of TC on sleep disturbances are consistent with previous evidence in comparison with usual treatment. • The pilot study provides preliminary evidence on pertinent mechanisms underlying such combination of intervention. • Integrating TC and rTMS is a safe approach with high treatment adherence for managing sleep disturbance in older adults. [ABSTRACT FROM AUTHOR]

Aim: The aim is to delineate the concept of sleep disturbances in health professional students during the COVID‐19 pandemic. Design: A concept analysis was conducted. Methods: A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used. Results: A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID‐19‐related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high‐quality care even during crises like the COVID‐19 pandemic. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Shaoxia Wang,1– 3 Xiang Zhang,1 Yanru Ding,1 Yanrong Wang,2,4 Chujun Wu,2,4 Shihao Lu,1,2 Jianqun Fang2,4 1School of First Clinical, Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China; 2Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China; 3Ningxia Civil Affairs Department Minkang Hospital, Yinchuan, Ningxia, 750001, People’s Republic of China; 4Mental Health Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of ChinaCorrespondence: Jianqun Fang, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China, Email fjq7887215@163.comObjective: Vitamin B12 is crucial for neurological functions and linked to various psychiatric disorders. Given its importance, this study explores the impact of vitamin B12 deficiency on sleep quality in Obsessive-Compulsive Disorder (OCD) patients, while also examining folate and homocysteine levels to explore their potential interactions with OCD symptoms and sleep quality.Methods: This cross-sectional study included 52 patients with OCD and 42 healthy controls. Serum levels of vitamin B12, homocysteine, and folate were measured. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the severity of OCD symptoms and the quality of sleep, respectively. Correlations and mediating effects between these variables were also assessed.Results: Vitamin B12 levels were significantly lower in OCD patients compared to healthy controls, and scores for sleep disturbances were significantly higher in the OCD group. No significant differences were observed in the levels of folate and homocysteine between the groups. Correlation analysis indicated that lower levels of vitamin B12 were significantly associated with more severe OCD symptoms and poorer sleep quality. Further mediation analysis suggested that low levels of vitamin B12 partially mediated the relationship between OCD symptoms and sleep disturbances.Conclusion: Lower levels of vitamin B12 not only affect sleep quality but also partially mediate the impact of OCD symptoms on sleep disturbances. Future clinical attention to vitamin B12 deficiency is crucial for further assessing the relationship between OCD symptoms and sleep disorders.Keywords: obsessive-compulsive disorder, sleep disturbances, vitamin b12, mediating effects

Abstract Artificial light at night (ALAN) changes animal behavior in multiple invertebrates and vertebrates and can result in decreased fitness. However, ALAN effects have not been studied in European honey bees (Apis mellifera), an important pollinator in which foragers show strong circadian rhythmicity. Colonies can be exposed to ALAN in swarm clusters, when bees cluster outside the nest on hot days and evenings, and, in limited cases, when they build nests in the open. We captured and maintained foragers in incubated cages and subjected them to constant light (LL), constant dark (DD), or 12 h light:12 h dark (LD) cycle, and observed them with infrared cameras. After 79 h, there was a significant interaction of treatment and time because LL bees slept less. In detail, the bees maintained a regular sleep pattern for three days but LL bees showed a shift on the fourth day. LL bees had the largest sleep differences from LD controls, with trends of lengthened periods and increased phase misalignment from both LD and DD bees. LL bees also experienced significantly more disturbances from their nestmates and preferred to sleep in the lower portion of the cages, which had significantly lower light intensity. These findings suggest that ALAN can disrupt the sleep of honey bee foragers, which has implications for their behavior and overall colony health.

Abstract 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

Sleep is essential for the cognitive, emotional, and physical development of children. Common sleep problems occur in 20–30% of children and are often resolved by improved sleep hygiene. Sleep disorders are more severe conditions, e.g., insomnia, obstructive sleep apnea, and circadian rhythm disturbances. If left untreated, these can have significant long-term consequences, including impaired cognitive function, increased risk of psychiatric conditions like anxiety and depression, and higher risk of obesity and cardiovascular diseases. To prevent these complications, timely recognition and management is essential. In this paper, we address the medical perspectives of common sleep disturbances in children, focusing on their diagnosis and treatment. Sleep hygiene education, behavioral interventions, and ambient adaptations are first-line interventions for managing all sleep disturbances in children. In cases where behavioral approaches are insufficient, other (non-)pharmacological options are discussed, with a focus on their efficacy and safety in children. Conclusions: Finally, potential long-term consequences and directions for future research are discussed that may improve sleep-related health and well-being. [ABSTRACT FROM AUTHOR]

Abstract Background Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep disturbances. Methods A cross-sectional analysis of the US nationally representative data of 21,414 adults (aged > = 18 years) from National Health and Nutrition Examination Survey (NHANES) (2005–2014) was performed. The data of sleep disturbances were assessed using NHANES questionnaire results, which included the question, “{Have you/has sp} ever been told by a doctor or other health professional that {you have/s/he has} a sleep disorder?”. All participants were stratified by quartiles of sedentary behavior distribution, which was the explanatory variable (sedentary time quartile cut points: Q1, 0

Firoj Al-Mamun,1– 3 Mohammed A Mamun,1– 3 Md Emran Hasan,1,4 Moneerah Mohammad ALmerab,5 David Gozal6 1CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh; 2Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh; 3Department of Public Health, University of South Asia, Dhaka, Bangladesh; 4Software College, Northeastern University, Shenyang, 110169, People’s Republic of China; 5Department of Psychology, College of Education and Human Development, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia; 6Department of Pediatrics and Office of the Dean, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, 25701, USACorrespondence: Mohammed A Mamun, CHINTA Research Bangladesh, Savar, Dhaka, 1342, Bangladesh, Email mamunphi46@gmail.com David Gozal, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, 25701, USA, Email gozal@marshall.eduBackground: Sleep disruptions among prospective university students are increasingly recognized for their potential ramifications on academic achievement and psychological well-being. But, information regarding sleep issues among students preparing for university entrance exams is unknown. Thus, this study aimed to investigate the prevalence and factors associated with sleep duration and insomnia among university entrance test-takers in Bangladesh, utilizing both traditional statistical analyses and advanced geographic information system and machine learning techniques for enhanced predictive capability.Methods: A cross-sectional study was conducted in June 2023 among 1496 entrance test-takers at Jahangirnagar University, Dhaka. Structured questionnaires collected data on demographics, academic information, and mental health assessments. Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS, while machine learning models were applied using Python and Google Colab.Results: Approximately 62.9% of participants reported abnormal sleep duration (< 7 hours/night or > 9 hours/night), with 25.5% experiencing insomnia. Females and those dissatisfied with mock tests were more likely to report abnormal sleep duration, while repeat test-takers, those with unsatisfactory mock test results, or anxiety symptoms had a higher risk of insomnia. Machine learning identified satisfaction with previous mock tests as the most significant predictor of sleep disturbances, while higher secondary school certificate GPA had the least influence. The CatBoost model achieved maximum accuracy rates of 61.27% and 73.46%, respectively, for predicting sleep duration and insomnia, with low log loss values indicating robust predictive performance. Geographic analysis revealed regional variations in sleep disturbances, with higher insomnia prevalence in some southern districts and abnormal sleep duration in northern and eastern districts.Conclusion: Sleep disturbances are prevalent among prospective university students and are associated with various factors including gender, test-taking status, mock test satisfaction, and anxiety. Targeted interventions, including sleep education and psychological support, hold promise in ameliorating sleep health and overall well-being among students, potentially enhancing entrance test performance.Keywords: sleep disturbances, abnormal sleep duration, insomnia, university entrance exams, mental health

Xuliang Shi,1,&ast; Miaomiao Hou,1,&ast; Xiaoyan Chen,2 Ya Zhu3 1College of Education, Hebei University, Baoding, Hebei Province, 071002, People’s Republic of China; 2Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong; 3Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, Guangdong Province, 523083, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xuliang Shi, Associate professor at the College of Education, Hebei University, Baoding, 071002, People’s Republic of China, Email shixl163@163.comObjective: This longitudinal study examined the reciprocal relationship between sleep disturbances with non-suicidal self-injury and whether self-compassion mediates these associations.Methods: A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students at the baseline. This study spanned six waves with a six-month interval between each wave. Data from the last four waves were used because self-compassion or non-suicidal self-injury was not measured in the first two waves. The cross-lagged panel models were used to examine the longitudinal dynamic relationships between sleep disturbances, self-compassion, and non-suicidal self-injury.Results: The results showed that all the auto-regressive paths were significant. For the cross-lagged paths, there was a reciprocal relation between sleep disturbances and self-compassion. Importantly, self-compassion played a longitudinal mediating role in the prediction from sleep disturbances to non-suicidal self-injury (indirect effect = 0.007 to 0.009, all p values < 0.001).Conclusion: Psychological interventions targeting improved sleep quality and self-compassion may hold great promise for reducing the incidence of non-suicidal self-injury.Keywords: sleep disturbances, self-compassion, NSSI, longitudinal design

Abstract Purpose Irritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients. Methods IBS patients ( $$n = 49$$ n = 49 ) and HCs ( $$n = 28$$ n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures. Results The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with $$K = 3$$ K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age. Conclusion The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.clinicaltrials.gov/ct2/show/NCT04296552 20/05/2019.

Abstract Background The coronavirus disease known as COVID-19 (2019) pandemic may increase the likelihood of psychological symptoms that can reach the level of psychiatric disorders. Aim We aimed to study psychiatric morbidity in patients with COVID-19 concerning gender differences and disease severity in the acute phase of infection and after 6 months. Methods This is a multicenter follow-up study registered in ClinicalTrials.gov (NCT04459403). Patients were recruited consecutively from three quarantine hospitals in Egypt. Data were collected through a questionnaire built using Google Forms including the Arabic versions of General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), and Taylor Manifest Anxiety Scale (TMAS). Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were assessed after 6 months. Results The study questionnaire was offered to 400 patients and 199 patients agreed to fill it. BDI and TAMS were higher in mild than moderate and severe COVID-19 (14, 8, 8, P-value = 0.009, 17, 13.5, 14, P-value = 0.04, respectively). Females showed a higher prevalence of depression, anxiety, sleep problems, and insomnia due to anxiety than males. Education level, marital status, previous psychiatric illness, and severity of COVID-19 independently affected depression. Marital status, family history of psychiatric illness, and chronic medical illness independently affected anxiety. On 6-month follow-up, BDI significantly decreased in males but not females. TMAS showed no significant changes, but the severity of anxiety was still higher in females. PTSD was more frequent in females (26 (37.1%) versus 4 (9.5%), respectively, P-value = 0.02). Conclusion The prevalence and severity of depression and anxiety were higher in females than male participants, suggesting that females are more affected by the COVID-19 pandemic.

Summary While sleep disturbances are prevalent in older people and are linked with poor health and cognitive outcomes, screening for the range of sleep disturbances is inefficient and therefore not ideal nor routine in memory and cognition clinic settings. We aimed to develop and validate a new brief self‐report questionnaire for easy use within memory and cognition clinics. The design for this study was cross‐sectional. Older adults (aged ≥50 in Sydney, Australia) were recruited from a memory and cognition research clinic. Participants (N = 402, mean age 67.3 years, range 50–86, 63.6% female) completed a comprehensive medical, neuropsychological, and mental health assessment, alongside self‐report instruments, including existing sleep questionnaires and a new 10‐item sleep questionnaire, the CogSleep Screener. We examined the factor structure, convergent validity, internal consistency, and discriminant validity of this novel questionnaire. Using exploratory principal component analysis, a 3‐factor solution was generated highlighting the factors of Insomnia, Rapid Eye Movement (REM) Symptoms and Daytime Sleepiness. Each factor was significantly correlated with currently used sleep questionnaires for each subdomain (all Spearman rho >0.3, all p < 0.001), suggesting good convergent validity. Internal consistency was also good (Cronbach's α = 0.73). Receiver operating characteristic curves showed good discriminative ability between participants with and without sleep disturbances (all area under curve >0.7, all p < 0.01). The CogSleep Screener has good psychometric properties in older to elderly adults attending a memory and cognition clinic. The instrument has the potential to be used in memory clinics and other clinical settings to provide quick and accurate screening of sleep disturbances. [ABSTRACT FROM AUTHOR]

Background: Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep disturbances. Methods: A cross-sectional analysis of the US nationally representative data of 21,414 adults (aged > = 18 years) from National Health and Nutrition Examination Survey (NHANES) (2005–2014) was performed. The data of sleep disturbances were assessed using NHANES questionnaire results, which included the question, "{Have you/has sp} ever been told by a doctor or other health professional that {you have/s/he has} a sleep disorder?". All participants were stratified by quartiles of sedentary behavior distribution, which was the explanatory variable (sedentary time quartile cut points: Q1, 0 < = Q1 < 3 h; Q2, 3 < = Q2 < 5 h; Q3, 5 < = Q3 < 8 h; Q4, 8 < = Q4 < 20 h). We used multivariable logistic regression and the restricted cubic splines (RCS) model to assess the relationship between sedentary time and sleep disturbances. Results: In the unadjusted multivariable logistic regression model (crude model), there was a demonstrated tendency for the odds of sleep disturbances to increase with the sedentary time (Q1 as reference, Q2: OR, 1.31 [95% CI 1.09–1.58] P = 0.005; Q3: OR, 1.62 [95% CI 1.39–1.88] P < 0.001; Q4: OR, 1.75 [95% CI 1.48–2.06] P < 0.001; P for trend < 0.001). In the adjusted model 4, adjustment for gender, age, marital type, education type, race, family poverty index ratio, waist circumference, recreational type, smoke status, drink status, diabetes mellitus status, cardiovascular disease status, sleep duration type, body mass index, the OR in Q2 subgroup didn't significantly increase (Q1 as reference. Q2: OR, 1.18 [95% CI 0.96–1.44] P = 0.1). However, the ORs in Q3 and Q4 (Q3: OR, 1.35 [95% CI 1.14–1.59] P < 0.001; Q4: OR, 1.45 [95% CI 1.21–1.75] P < 0.001) both revealed that the risk of sleep disturbances increased with increasing sedentary time, P for trend < 0.001. The unadjusted RCS model revealed that the risk of sleep disturbances increased non-linearly with increasing sedentary time for total participants (P for non-linearity < 0.001). After adjusting for all covariates, the RCS results revealed that the risk of sleep disturbances increased non-linearly with increasing sedentary time for total participants (P for non-linearity = 0.012). Conclusions: This study suggested that the longer sedentary time was strongly associated with the sleep disturbances. The protective effect of recreational activities on sleep disturbance, has not been significantly demonstrated. [ABSTRACT FROM AUTHOR]

Grounding, a therapeutic technique involving direct contact with the earth, has been proposed by various studies to potentially have beneficial effects on pressure, sleep quality, stress, inflammation, and mood. However, the scientific evidence supporting its sedative effects remains incomplete. This study examined the sedative effectiveness of an earthing mat on sleep quality and investigated the underlying neural mechanisms using electroencephalography (EEG) analysis in rodents, focusing on orexin and superoxide dismutase (SOD) levels in the brain. Rats were randomly assigned to four groups: the naïve normal group (Nor), the group exposed to an earthing mat for 7 days (A-7D), the group exposed to an earthing mat for 21 days (A-21D), and the group exposed to an electronic blanket for 21 days (EM). EEG results revealed that the A-21D group exhibited significantly reduced wake time and increased rapid eye movement (REM), non-rapid eye movement (NREM), and total sleep time compared to the Nor group (p < 0.05). Moreover, the A-21D group demonstrated a significant increase in NREM sleep (p < 0.001), REM sleep (p < 0.01), and total sleep time (p < 0.001), along with a decrease in wake time compared to the EM group (p < 0.001). The orexin level in the A-21D group was significantly lower compared to the Nor group (p < 0.01), while SOD1 expression was markedly elevated in the A-21D group compared to the Nor group (p < 0.001). These results suggest that the earthing mat may represent a promising new method for promoting sleep quality and could serve as an effective therapeutic technique. [ABSTRACT FROM AUTHOR]

Introduction: Adequate sleep is important to children's overall health, as sleep disturbances can result in both cognitive and mental challenges. The global COVID-19 pandemic, with its significant lifestyle disruptions, potentially altered children's sleep patterns. This study investigates the prevalence of sleep problems in children and the factors associated with these issues during the pandemic. Materials and Methods: This cross-sectional analysis was conducted between March and April 2020 on 270 children aged 6-11 during the COVID-19 pandemic. Sleep behaviors were assessed using the Children's Sleep Habits Questionnaire (CSHQ), which was distributed online to the participants. The data were analyzed using SPSS 16, Chi-square test, and independent t-test. Results: Finally 262 were studied (131 boys and 131 girls). The mean age of participants was 8.56±1.97 years. The mean score of CSHQ was 51.99±7.85, with 95.8% (251 children) demonstrating sleep-related issues. Notably, children with highly educated parents exhibited significantly fewer sleep problems. Conclusion: The study reveals a high prevalence of sleep disturbances among children aged 6-11, particularly during the COVID-19 lockdown. The findings highlight the significant role of parental education in mitigating these sleep issues, emphasizing the need for further investigation into the effects of familial environments on children's sleep patterns during periods of stress and confinement. [ABSTRACT FROM AUTHOR]

Purpose: Patients with lung cancer endure the most sleep problems. Understanding the prevalence and risk factors of sleep disturbances in lung cancer populations is critical in reducing symptom burden and improving their quality of life. This systematic review aimed to determine the prevalence and risk factors of sleep disturbances in patients with lung cancer. Methods: Seven electronic databases were systematically screened for studies on the prevalence or risk factors of sleep disturbances in patients with lung cancer. Subgroup analyses were conducted to investigate significant heterogeneity (I2 > 50%) across studies. Results: Thirty-seven studies were found eligible. The pooled prevalence was 0.61 (95% CI = [0.54–0.67], I2 = 96%, p < 0.00001). Seven risk factors were subject to meta-analyses. Significant differences were found for old age (OR = 1.23; 95% CI = [1.09–1.39], p = 0.0006,I2 = 39%), a low education level (OR = 1.17; 95%CI = [1.20–2.66], p = 0.004, I2 = 42%), fatigue (OR = 1.98; 95%CI = [1.23–3.18], p = 0.005, I2 = 31%), pain (OR = 2.63; 95% CI = [1.35–5.14], p = 0.005, I2 = 91%), tumor stage of III or IV (OR = 2.05; 95%CI = [1.54–2.72], p < 0.00001, I 2 = 42%), anxiety (OR = 1.62; 95%CI = [1.22–2.14], p = 0.0008, I2 = 78%), and depression (OR = 4.02; 95% CI = [1.39–11.61], p = 0.01, I2 = 87%). After the included studies were withdrawn one after the other, pain (OR = 3.13; 95% CI = [2.06–4.75], p < 0.00001, I2 = 34%) and depression (OR = 5.47; 95% CI = [2.65–11.30], p < 0.00001) showed a substantial decrease of heterogeneity. Meanwhile, the heterogeneity of anxiety symptoms remained unchanged. Conclusion: Results showed that sleep disturbances were experienced in more than 60% of patients with lung cancer. The comparatively high prevalence of sleep disturbances in this population emphasizes the need to adopt measures to reduce them. Significant associations were found between sleep disturbances and various factors, including age, education level, fatigue, pain, cancer stage, anxiety, and depression. Among these factors, depression emerged as the most significant. Future research should concentrate on identifying high-risk individuals and tailored interdisciplinary interventions based on these risk factors. [ABSTRACT FROM AUTHOR]

Paradoxical sleep deprivation (PSD) presents different effects on metabolism and neurological functions. In addition, over long duration, sleep restriction (SR) can promote permanent changes. The prostate is an endocrine-dependent organ with homeostatic regulation directly related to hormone levels. Our study proposed to demonstrate the experimental prostatic effects of PSD (96 h), PSD with recovery (PSR – 96/96 h), and sleep restriction (SR – 30 PSD cycles/recovery). PSD and SR promoted decrease in serum testosterone and significant increase in serum and intraprostatic corticosterone. In agreement, androgen receptors (AR) were less expressed and glucocorticoid receptors (GR) were enhanced in PSR and SR. Thus, the prostate, especially under SR, demonstrates a castration-like effect due to loss of responsiveness and sensitization by androgens. SR triggered an important inflammatory response through enhancement of serum and intraprostatic pro- (IL-1α, IL-6, TNF-α) and anti-inflammatory (IL-10) cytokines. Furthermore, the respective receptors of anti-inflammatory cytokines (IL-1RI and TNF-R) were highly expressed in the prostatic epithelium and stroma. PSR can partially restore prostate homeostasis, as it restores testosterone and the prostate proliferation index, in addition to promoting balance in the inflammatory response that is considered protective. PSD and SR are key factors in the endocrine axis that coordinate prostatic homeostasis, and significant changes in these factors have consequences on prostate functionality. [ABSTRACT FROM AUTHOR]

Sleep apnea (SA) has been shown to negatively affect cognition, immunity, and bone mineralization. There is conflicting evidence for the contribution of SA to outcomes following total shoulder arthroplasty. However, the impact of SA on reverse shoulder arthroplasty (RSA) has not been elucidated. A substantial increase in utilization of RSA is projected through the 2030s. Our objective was to assess postoperative medical and implant-related complications and healthcare utilization in patients with SA undergoing RSA. A retrospective review of a private insurance claims database was conducted from 2010 to 2021. All cases of RSA and those with a prior diagnosis of SA were identified using their corresponding diagnosis and procedural codes. Patients undergoing RSA with a diagnosis of SA were matched to control patients 1:2 based on demographic and comorbidity profiles. A total of 18,229 SA patients were matched to 35,988 control patients. The SA cohort had significantly greater odds of all medical complications assessed compared to the control cohort. The SA cohort had greater odds of all implant-related complications including dislocation and mechanical loosening when compared to the control cohort. Mean length of stay was significantly greater in the SA group. The current data demonstrate that SA patients may have an increased risk of complications and healthcare burden following RSA compared to RSA patients without SA. These findings indicate potential value in preoperative screening for SA prior to RSA. [ABSTRACT FROM AUTHOR]

Background: To ensure adequate treatment, individuals with delirium superimposed on dementia (DSD) need to be differentiated reliably from those with dementia only (DO). Therefore, we aimed to examine the clinical indicators of DSD by assessing motor subtypes, cognitive performance and neuropsychiatric symptoms in DSD and DO patients. Methods: Cross-sectional design with the Delirium-Motor-Subtyping Scale (DMSS), Mini-Mental-State-Examination (MMSE), Clock-Drawing-Test (CDT), DemTect, and Neuropsychiatric Inventory assessed after admission to an acute hospital. Results: 94 patients were included, 43 with DSD (78 ± 7 years, MMSE = 11 ± 9) and 51 with DO (79 ± 7 years, MMSE = 9 ± 8). DMSS "no subtype" was more common in the DO group (26% vs. 10%, p = .04). The DSD group showed lower CDT scores (DSD: M = 4 ± 3 vs. DO: M = 6 ± 1; p < .001) and higher anxiety (DSD: MED = 3 ± 8 vs. DO: MED = 3 ± 4; p = .01) and sleep/night-time behavior disturbances (DSD: MED = 0 ± 6 vs. DO: MED = 0 ± 0; p = .02). Conclusions: Sleep/night-time behavior disturbances appear to be a clinical indicator of DSD. Motor subtypes can identify cases at increased risk of developing delirium or unrecognized delirium. [ABSTRACT FROM AUTHOR]

This study aims to identify potential correlations of the severity of symptoms of children with autism spectrum disorder (ASD) with serum nutritional levels, body composition indicators, diet partiality, and sleep disturbances. The cohort of this cross-sectional study included 120 children with ASD and 110 typically developing (TD) children to assess symptoms of ASD, and to measure serum levels of vitamins and minerals and the body composition values. Diet partiality and sleep disturbances were assessed by administering questionnaires. The serum levels of folic acid, copper, and vitamin B were lower in children with ASD than in TD children, while magnesium and homocysteine were higher (p < 0.05). Children with ASD had greater chest circumference, abdominal skinfold thickness, and body mass index (BMI) than TD children (p < 0.05), and higher prevalences of diet partiality and sleep disturbances (p < 0.001). Lower vitamin A levels and higher vitamin D levels were related to social impairment in children with ASD. Moreover, there were significantly positive correlations of BMI, chest circumference, diet partiality, and sleep disturbances with severity of ASD symptoms (p < 0.05). Collectively, rational nutritional supplementation, dietary management, and behavioral interventions are essential for children with ASD. [ABSTRACT FROM AUTHOR]

Background: Infantile haemangiomas (IHs) sometimes require treatment with propranolol. Sleep disturbances are the most frequently reported side effects. Monitoring adverse drug events necessitates repeated hospital visits, which can be challenging during a pandemic. Objectives: To explore the effectiveness of a new electronic questionnaire in identifying sleep disturbances related to treatment with propranolol and potential confounding factors. To evaluate the response rate to the questionnaire. To report the proportion of patients on propranolol with sleep disturbances. Methods: In an observational, prospective cohort study, caregivers provided clinical information during ambulatory visits and via an electronic questionnaire after an 8-week treatment course with propranolol and at the time of treatment interruption. Adverse drug reaction reporting forms were assessed for causality. Results: The questionnaire response rate was 91%, and the completion rate was 100%. A total of 59% of patients experienced sleep disturbances during propranolol treatment, which were considered adverse reactions. Sleep disorders were frequent during sleep regression phases and in subjects who fell asleep during physical contact with caregivers or bed-sharing with parents. Conclusion: The application of this questionnaire allows for identifying adverse sleep events associated with propranolol in IHs and potential confounders. Counselling on sleep hygiene is recommended before treatment onset. [ABSTRACT FROM AUTHOR]

Purpose of Review: Sleep disturbances are amongst most frequent non-motor symptoms of Parkinson's Disease (PD), and they are similarly frequently reported in other alpha-syncleinopathies, such as Dementia with Lewy Bodies (DLB) and Multiple System Atrophy (MSA). More recently, the orexin system has been implicated in control of arousal based on salient environmental set points, and its dysregulation in sleep issues in alpha-synucleinopathies suggested by the findings from the translational animal models. However, its role in the patients with alpha-synucleinopathies remains unclear. We thus set to systematically review, and to critically assess, contemporary evidence on the association of the orexinergic system and sleep disturbances in alpha-synucleinopathies. In this systematic review, studies investigating orexin and sleep in alpha-synucleinopathies (Rapid Eye Movement (REM) Behaviour Disorder (RBD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) were identified using electronic database searches of PubMed, Web of Science and PsychINFO using MeSH terms, keywords, and title words such as "Alpha-synucleinopathies" AND "Orexin" AND "Sleep Disturbances". Recent findings: 17 studies were included in this systemic review, of which 2 studies on RBD, 10 on PD, 4 on DLB, and 1 on MSA patients. Taken together, RBD and PD studies suggest a potential adaptive increase in orexin levels in early stages of the neurodegenerative process, with reduced levels more often reported for later, more advanced stages of illness. To date, no differences in orexin levels were demonstrated between MSA patients and healthy controls. Summary: There is a dearth of studies on the role of orexin levels in alpha-synucleinopathies. Moreover, significant methodologic limitations in the current body of work, including use of non-standardised research protocols and lack of prospective, multi-centre studies, disallow for any finite conclusion in regards to underlying pathomechanisms. Nonetheless, a picture of a complex, multifaceted relationship between the dysregulation of the orexinergic pathway and sleep disturbances in alpha-synucleinopathies is emerging. Hence, future studies disentangling orexinergic pathomechanisms of alpha-syncleinopathies are urgently needed to obtain a more comprehensive account of the role of orexinergic pathway in alpha-synucleinopathies. Pharmacological manipulations of orexins may have multiple therapeutic applications in treatment strategies, disease diagnosis, and might be effective for treating both motor and non-motor symptoms. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance to Clinical Practice Demanding intensive care unit (ICU) work environments may lead to sleep disturbances in nurses, impacting their health and potentially patient safety. Yet, the prevalence remains unclear around the world.To quantify the prevalence of sleep disturbances in intensive care nurses.Systematic review and meta‐analysis. A database search was conducted in Embase, PubMed, Web of Science, Scopus and CINAHL from their inception to April 2024 for relevant studies. Data from observational studies (cross‐sectional or cohort) that reported the prevalence of sleep disturbances, assessed using the Pittsburgh Sleep Quality Index (PSQI > 5), pooled in random‐effects meta‐analyses. Subgroup analyses were used to investigate variations in the prevalence estimates in terms of available variables. A Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA)‐compliant protocol was registered in PROSPERO (CRD42023476428).In total, 24 articles were included in this study published from 1996 to 2023. Included studies were from 15 unique countries. Almost all of the studies were descriptive cross‐sectional studies (n = 22; 91.7%). The included studies encompassed a range of intensive care nurses, from 42 to 605, involving a total of 3499 intensive care nurses. The reported proportion of intensive care nurses with sleep disturbances ranged from 20.0% to 100.0%, with a median of 76.7% (interquartile range: 62.9–85.7). The pooled prevalence of sleep disturbances in intensive care nurses was 75.1% (95% confidence interval: 37.2–53.1; 95% prediction interval: 30.5–95.4).Sleep disturbance is a common issue in intensive care nurses. The study results highlight the importance of implementing effective interventions as early as possible to improve ICU sleep quality.High prevalence of sleep disturbances among intensive care nurses necessitates global interventions. Gender‐neutral approaches that acknowledge comparable risks and stable prevalence over time require long‐term strategies. Raising awareness through programmes is vital for implementing evidence‐based interventions to promote sleep health in intensive care nurses. [ABSTRACT FROM AUTHOR]

Introduction: Bariatric surgery is the mainstay of treatment of obesity, with a proven, long-lasting effect on body weight reduction and remission of co-morbidities. Sleep disorders, including insomnia, and deteriorated sleep quality and duration are associated with obesity, and a reduction in body weight can be associated with a reduction in prevalence of sleep disorders. The purpose of this study was to assess the influence of laparoscopic sleeve gastrectomy (LSG) on the prevalence and intensity of different sleep disturbances. Methods: This observational prospective study included 80 patients qualified for bariatric surgery who filled in a questionnaire with a set of structured questions about different sleep disturbances, such as difficulties in falling asleep, night awakenings, early morning awakenings, snoring, and nightmares, as well as eating at night and daytime dysfunction, supplemented with Athens Insomnia Scale (AIS), before and 6 months after bariatric surgery. Results: There was a statistically significant reduction in incidence of night awakenings, with 40.00% of participants reporting night awakenings before surgery and, respectively, 25.00% after surgery. A significant reduction was also observed in the rate of patients who reported snoring, with 60.00% before the surgery and 38.75% after the surgery (p < 0.05). There was a correlation present between estimated weight loss % (EWL%) and reduction in snoring (p < 0.05). The mean total AIS score before surgery was 7.21 and 5.99 after surgery, and the change was statistically significant (p < 0.05). A total AIS score of 8 or more, the cutoff score for insomnia diagnosis according to the Polish validation of the Athens Insomnia Scale, was present in 44.16% of cases before surgery and in 38.00% after surgery (p = 0.52). There was a significant difference in the incidence of awakening during the night score before and after surgery (p < 0.05; CI 0.022–0.341), sleep quality (p < 0.05; CI 0.0105–0.4311), well-being during the day (p < 0.05; CI 0.0273–0.4143), and sleepiness during the day (p < 0.05; CI 0.101–0.444). Conclusions: LSG is observed to have a positive effect on selected sleep disturbances and insomnia remission in patients with obesity, measured by a significant reduction in Athens Insomnia Scale scores in follow-up 6 months after surgery. Additionally, patients after bariatric surgery reported less night awakenings and there was a lower rate of snoring. Therefore, LSG can be considered an effective therapeutic tool for insomnia in patients with obesity. [ABSTRACT FROM AUTHOR]

Purpose: Irritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients. Methods: IBS patients ( n = 49 ) and HCs ( n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures. Results: The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age. Conclusion: The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.clinicaltrials.gov/ct2/show/NCT04296552 20/05/2019. [ABSTRACT FROM AUTHOR]

Objective: Cerebral palsy (CP) is a chronic condition that can have a significant impact on the quality of life (QoL) of patients and their families. A child's sleep disturbances and maternal anxiety are common issues in CP; however, their impact on family QoL is not fully understood. This study aimed to investigate the relationship among child's sleep disturbances, maternal anxiety levels, and family QoL in children CP. Methods: This study included 58 children with CP and 63 typically developing (TD) peers matched for age and sex, along with their mothers. We used the Sleep Disturbance Scale for Children, Beck Anxiety Inventory, and Beach Center Family Quality of Life Scale to assess children's sleep problems, maternal anxiety, and family QoL, respectively. Regression analysis was conducted to identify other factors that could affect the family QoL. Results: Children with CP had more sleep disturbances, lower family QoL, and higher levels of maternal anxiety compared to their TD peers. Moreover, maternal anxiety was significantly related to family QoL and child's sleep disturbances in children with CP. Regression analysis revealed that other factors such as age, sex, motor function, having a diagnosis of epilepsy, and cognitive level did not affect family QoL in children with CP. Conclusion: Addressing children's sleep disturbances and mother's anxiety can be important for the family QoL of children with CP. Interventions focused on these issues can help this population, but further research is needed to develop effective strategies for enhancing the well-being of children with CP. [ABSTRACT FROM AUTHOR]

This study aimed to examine the associations between specific sleep parameters and specific aspects of cognitive functioning in individuals diagnosed with mild cognitive impairment (MCI), compared with healthy controls (HCs) by using cognitive, subjective, and objective sleep measures. A total of 179 participants were enrolled, all aged ≥ 65 years (mean age = 70.23; SD = 4.74) and with a minimum of six years of education (mean = 12.35; SD = 3.22). The sample included 46 HCs (36 females), 75 individuals with amnestic MCI (aMCI) (51 females), and 58 individuals with non-amnestic MCI (naMCI) (39 females). Inhibition, cognitive flexibility as a combined application of inhibitory control and set shifting or task/rule switching, and planning were examined. The following D-KEFS subtests were administered for their evaluation: Verbal Fluency Test, Color–Word Interference Test, and Tower Test. Self-reported sleep questionnaires (Athens Insomnia Scale, Stop-Bang questionnaire, and Pittsburg Sleep Quality Index) were used for subjective sleep assessments. Actigraphy was used for objective sleep measurements. Mixed-measures ANOVA, MANOVA, and one-way ANOVA, as well as the Scheffe post hoc test, were applied to the data. The results showed that the three groups exhibited statistically significant differences in the Tower Test (total achievement score, total number of administered problems, and total rule violations). As regards objective sleep measurements, the total sleep time (TST) was measured using actigraphy, and indicated that there are significant differences, with the HC group having a significantly higher mean TST compared to the naMCI group. The relationships evaluated in the TST Tower Test were found to be statistically significant. The findings are discussed in the context of potential parameters that can support the connection between sleep duration, measured as TST, and cognitive planning, as measured using the Tower Test. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has induced significant impairments, including sleep disturbances. The present study aimed to explore the impact of fear in relation to stress on sleep disorders among Italian adults and older participants in the second phase of the EPICOVID19 web‐based survey (January‐February 2021). Sleep disturbances during the pandemic were evaluated using the Jenkins Sleep Scale, perceived stress through the 10‐item Perceived Stress Scale and fear of contagion and about economic and job situation with four ad hoc items. The strength of the pathways between stress, sleep disturbances and fear was explored using structural equation modelling, hypothesising that stress was related to sleep disturbances and that fear was associated with both stress and sleep problems. Out of 41,473 participants (74.7% women; mean age 49.7 ± 13.1 years), 8.1% reported sleep disturbances and were more frequently women, employed in a work category at risk of infection or unemployed, and showed higher deprivation scores. Considering an a priori hypotheses model defining sleep and stress scores as endogenous variables and fear as an exogenous variable, we found that fear was associated with sleep problems and stress, and stress was associated with sleep problems; almost half of the total impact of fear on sleep quality was mediated by stress. The impact of stress on sleep quality was more evident in the younger age group, among individuals with a lower socioeconomic status and healthcare workers. Fear related to COVID‐19 seem to be associated with sleep disturbances directly and indirectly through stress. [ABSTRACT FROM AUTHOR]

Background: Exposure to adversity early in life (ELA) has been associated with elevated risk for depression during adolescence, particularly for females; the mechanisms underlying this association, however, are poorly understood. One potential mechanism linking ELA and sex differences in depressive symptoms is sleep disturbances, which increase during adolescence and are more common in females. Here, we examined whether sleep disturbances mediate the association between ELA and increases in depressive symptoms during adolescence and whether this mediation differs by sex. Methods: 224 (N = 132 females) youth were recruited at age 9–13 years and assessed every 2 years across three timepoints. At the first timepoint, we conducted extensive interviews about stressful events participants experienced; participants provided subjective severity ratings of events and we objectively scored the severity of each event. Self‐reported sleep disturbances and depressive symptoms were assessed at all timepoints. We conducted linear mixed models to estimate both initial levels and changes in sleep disturbances and depressive symptoms, and moderated mediation analyses to test whether initial levels and/or changes in sleep disturbances mediated the association of ELA (objective and subjective) with increases in depressive symptoms across adolescence and whether the mediations differed by sex. Results: While higher initial levels and increases in sleep problems were uniquely associated with increases in depressive symptoms for males and females, they were related to ELA differently by sex. For females, greater ELA (both objectively and subjectively rated) was associated with higher initial levels of sleep problems, which in turn were associated with increases in depressive symptoms from early to late adolescence. In contrast, for males, ELA exposure was not associated with either initial levels of, or increases in, sleep problems. Conclusions: These findings highlight the role of sleep disturbances during the transition to adolescence in mediating sex differences in the effects of ELA on depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: One of the challenges in bipolar disorder (BD) lies in early detection of the illness and its recurrences, to improve prognosis. Sleep disturbances (SD) have been proposed as reliable predictive markers of conversion. While preliminary studies have explored the relationship between SD and the onset of mood episodes, the results remain heterogeneous and a few have specifically examined patients' perception of prodromal symptoms and their progression until the episode occurs. Identifying prodromes represents a crucial clinical challenge, as it enables early intervention, thereby reducing the severity of BD. Therefore, the objective of this study is to better characterize and evaluate the progressive nature of SD as prodromal symptoms of mood episodes, and patients' perception of it. Methods: Patients diagnosed with BD, either hospitalized or seeking treatment for a (hypo)manic or depressive episode benefited from standardized questionnaires, structured interviews, and self‐report questionnaires to evaluate SD prior to the current episode, as well as sociodemographic and clinical information. Results: Out of the 41 patients included, 59% spontaneously reported SD prior to the episode, appearing 90 days before depression and 35 days before mania (pre‐indexed/spontaneous reports: 51.22% insomnia complaints, 4.88% hypersomnolence complaints, 7.32% parasomnias, 2.44% sleep movements). After inquiry about specific SD, the percentage of patients reporting prodromal SD increased significantly to 83%, appearing 210 days before depression and 112.5 days before mania (post‐indexed reports: 75.61% presented with insomnia complaints appearing 150 days before depression and 20 days before mania, 46.34% had hypersomnolence complaints appearing 60 days before depression, 43.9% had parasomnias appearing 210 days before depression and 22.5 days before mania, 36.59% had sleep movements appearing 120 days before depression and 150 days before mania). Of note, bruxism appeared in 35% of patients before mania, and restless legs syndrome in 20% of patients before depression. Conclusion: This study highlights the very high prevalence of SD prior to a mood episode in patients with BD with differences between depressive and manic episodes. The more systematic screening of sleep alterations of the prodromal phase improved the recognition and characterization of different symptoms onset by patients. This underscores the need for precise questioning regarding sleep patterns in patients, to better identify the moment of transition toward a mood episode, referred to as "Chronos syndrome". The study emphasizes the importance of educating patients about the disorder and its sleep prodromal symptoms to facilitate early intervention and prevent recurrences. [ABSTRACT FROM AUTHOR]

• Routine EEGs were abnormal in 73.33 % and sleep EEGs were abnormal in 100 % of juvenile myoclonic epilepsy cases. • Individuals with JME tend to experience a substantial portion of their NREM sleep in the CAP phase, and this pattern persists even in those using VPA, except for the N3 sleep stage. • The average cyclic alternating pattern rate was significantly higher JME as compared to healthy controls. • Epileptic discharges can increase sleep instability, resulting in more epileptic discharges and leading to more seizures. • After all, we can assume that juvenile myoclonic epilepsy patients have a subjective evening chronotype, but it needs to be improved also with objective tests. Sleep disturbances significantly impact the lives of individuals with Juvenile Myoclonic Epilepsy (JME). This study aimed to investigate sleep studies, disturbances, and the impact of anti-seizure drugs on sleep in JME patients. Relevant studies were retrieved from the National Library of Medicine (Pubmed) database and the Cochrane Library utilizing the search terms "Juvenile Myoclonic Epilepsy" and "sleep". A total of 160 papers' review, data extraction, and resolution of discrepancies were performed independently by two reviewers according to the PRISMA protocol and were registered in PROSPERO (CRD42023472439). A systematic review of 31 studies was conducted, encompassing various methodologies, including sleep questionnaires (Pittsburgh Sleep Quality Index (n = 13), Epworth Sleepiness Scale (n = 10)), polysomnography (n = 8), EEG (n = 9), actigraphy (n = 1), and transcranial magnetic stimulation (n = 1). Most studies were hospital-based (n = 31), cross-sectional (n = 11), and prospective (n = 25). Patients with JME exhibit a higher prevalence of sleep disturbances, worse quality of sleep (n = 4), daytime sleepiness (n = 2), sleep efficiency (n = 7), and increased sleep latency (n = 1) compared to controls. These disruptions are characterized by increased wakefulness (n = 3), frequent arousals (n = 3), decreased REM sleep (n = 2), and conflicting NREM sleep findings (n = 3). Additional sleep-related issues observed in JME patients include insomnia (n = 1) and increased prevalence of parasomnias such as nightmares and sleep talking. Periodic limb movement and obstructive sleep apnea are similar or less frequent (3/28). REM behavioral disorders and sleepwalking were not seen. Valproate showed conflicting effects on sleep (n = 7), while levetiracetam did not impact sleep (n = 1). These findings underlined the need for more sufficient evidence of sleep studies in JME. Future research should prioritize understanding the nature of sleep in JME and its impact on management. [ABSTRACT FROM AUTHOR]

Background: Mental well-being is important for medical students to perform effectively. The COVID-19 pandemic posed different stressors to medical students increasing their vulnerability to distress and impaired well-being. Aim: To assess the effect of the COVID-19 pandemic on the well-being of medical students and its relation with COVID-related psychological distress and fear as well as sleep quality. Materials and Methods: We planned a cross-sectional study on medical students with the help of an online Google Form including sociodemographic data, medical students well-being index (MSWBI), Psychological Distress Scale, fear of COVID-19 Scale (FCV-19S), and Pittsburgh Sleep Quality Index (PSQI). Results: 48.13% of students reported higher distress and impaired mental well-being. Impaired well-being is correlated with COVID-related psychological distress, fear of COVID-19, and disturbed sleep quality. Regression analysis showed that joint family and sleep disturbances significantly predicted distress or poor well-being in medical students. Conclusion: Almost half of the medical students revealed impaired mental well-being underlining the role of COVID-related stressors in worsening the psychological health of students. In this situation, it is important to take prompt measures to identify vulnerable students and help them. [ABSTRACT FROM AUTHOR]

Background: Among the most demanding careers that many Indians choose is teaching. Teachers are under a lot of stress because of all the extra responsibilities and duties they have from the school, education boards, and institutions. This can be a fertile ground for psychological problems among teachers. Aim: To assess depression, anxiety, stress, and sleep disturbances among school teachers and to find out their correlates. Materials and Methods: A cross-sectional observational study was planned in 100 teachers working in the government schools of the rural catchment of Nandyal district, Andhra Pradesh. Teachers were assessed through a semistructured proforma containing sociodemographic information, information about job-related factors, and DASS 21 to assess depression, anxiety, and stress and Insomnia Severity Index to assess sleep disturbances. Results: The overall prevalence of depression, anxiety, and stress symptoms among teachers was found to be 28%, 61%, and 24%, respectively, and sleep disturbances were 38%. Depression was found to be independently associated with marital status (married > single, P < 0.001), position at workplace (secondary grade > primary grade, P < 0.001), mode of transport (public transport > personal, P = 0.001), source of income (single > family, P = 0.013), higher level of income ( P < 0.001), stress ( P < 0.001), and anxiety ( P < 0.001). Anxiety was associated with migration for the job ( P < 0.001), stress ( P < 0.001), and depression ( P < 0.001), while insomnia was associated with the type of family (nuclear > joint, P = 0.015), source of income (single > family, P = 0.039), no interaction with a colleague ( P = 0.007), being dissatisfied with job ( P = 0.002), and stress ( P = 0.005). Conclusion: The significantly moderate proportion of depression, anxiety, stress, and insomnia among government schoolteachers is suggestive of the need for the necessary psychological aid and counseling for such teachers. Therefore, appropriate methods must be introduced to address the concerns of teachers, thereby reducing anxiety and stress among them. [ABSTRACT FROM AUTHOR]

Background and Aims: Medical staff have experienced anxiety, sleep disturbances, and suicide due to the COVID‐19 epidemic. Thus, this study examined the relationship between corona disease anxiety, sleep problems, and suicidal ideation in medical staff and how resiliency and cognitive flexibility mediate it. Methods: This descriptive‐analytical cross‐sectional study examined medical staff. In 2022, participants were affiliated with Hamadan University of Medical Sciences, Iran educational and treatment centers. Sampling was done at primary COVID‐19 treatment centers. Data was collected using validated instruments. Ethics were observed during data collecting. Results: Path analysis was employed to test hypotheses. Analysis showed significant positive relationships between Corona disease anxiety and sleep disturbances (p = 0.001, β = 0.438) and suicidal ideation (p = 0.001, β = 0.310). Conversely, negative and significant associations were identified between resiliency and cognitive flexibility with sleep disturbances and suicidal ideation. Conclusions: The study illustrates how medical staff's psychological health is linked to COVID‐19. High Corona disease anxiety causes sleep disturbances and suicidal thoughts. Resilience and cognitive flexibility modulated Corona disease anxiety, sleep problems, and suicidal thoughts. The comprehensive study focuses on medical staff mental health issues, suggesting targeted solutions. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has probably contributed to sleep disturbance among nurses, especially those working at emergency departments (EDs). Sleep disorders in nurse managers can negatively impact their health and impair work performance and decision-making. This study aimed to explore the quality of sleep among nurses working in EDs and its influencing factors during the COVID-19 pandemic. Method: In this study, a cross-sectional design was employed to assess the sleep quality of nurses working in EDs during the COVID-19 pandemic. The research recruited a convenience sample of emergency nurses, who were selectively sourced from four hospitals in Hail City. This recruitment occurred over the period from April to July 2022. Descriptive data analysis was conducted using SPSS, with the significance level set at 0.05. Results: Among the 216 participants in the study, the majority (55.6%) were aged between 30 and 39 years, and 73.6% were female. Additionally, 64.4% were married, while 69.4% had a bachelor's degree, 20% held a diploma, and the remaining had a master's degree. Notably, a significant 81.5% of the nurses reported poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), with an overall mean score of 10.55 indicating poor sleep. The study highlighted that poor sleep quality among nurses was linked to being female, being married, and not exercising regularly. Better sleep was associated with nurses who manage fewer patients per shift and have adequate monthly income. Conclusion: The prevalence of poor sleep quality among Emergency nurses during the COVID-19 pandemic is high. There is a pressing need for targeted interventions to enhance sleep quality among ED nurses. Improving sleep quality is not only essential for the wellbeing of these nurses but is also likely to contribute to better patient care. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease known as COVID-19 (2019) pandemic may increase the likelihood of psychological symptoms that can reach the level of psychiatric disorders. Aim: We aimed to study psychiatric morbidity in patients with COVID-19 concerning gender differences and disease severity in the acute phase of infection and after 6 months. Methods: This is a multicenter follow-up study registered in ClinicalTrials.gov (NCT04459403). Patients were recruited consecutively from three quarantine hospitals in Egypt. Data were collected through a questionnaire built using Google Forms including the Arabic versions of General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), and Taylor Manifest Anxiety Scale (TMAS). Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were assessed after 6 months. Results: The study questionnaire was offered to 400 patients and 199 patients agreed to fill it. BDI and TAMS were higher in mild than moderate and severe COVID-19 (14, 8, 8, P-value = 0.009, 17, 13.5, 14, P-value = 0.04, respectively). Females showed a higher prevalence of depression, anxiety, sleep problems, and insomnia due to anxiety than males. Education level, marital status, previous psychiatric illness, and severity of COVID-19 independently affected depression. Marital status, family history of psychiatric illness, and chronic medical illness independently affected anxiety. On 6-month follow-up, BDI significantly decreased in males but not females. TMAS showed no significant changes, but the severity of anxiety was still higher in females. PTSD was more frequent in females (26 (37.1%) versus 4 (9.5%), respectively, P-value = 0.02). Conclusion: The prevalence and severity of depression and anxiety were higher in females than male participants, suggesting that females are more affected by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]