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Purpose: Antarctic expeditions are exceptional physiological challenges. Sleep plays a critical role in athletic performance, recovery, and wellness, with sleep disturbances having a negative impact on health and performance. Methods: The authors investigated sleep, fatigue, and recovery profiles of the longest solo unsupported one-way polar ski journey across Antarctica. A 33-year-old woman covered 1484.53 km from Hercules Inlet to the South Pole, finishing at the Ross Ice Shelf, in 70 days and 16 hours. Questionnaires on sleep (Pittsburgh Insomnia Rating Scale and Karolinska Sleepiness Scale), fatigue (Subjective Assessment of Fatigue), recovery (Total Quality Recovery), and wellness were completed at different time points (before, during, and after the expedition). Results: Average daily sleep time was between 4 and 5 hours, increasing to 7 hours for the final part of the expedition. Satisfaction of sleep and lack of energy deteriorated as the expedition progressed, alongside signs of clinical insomnia. Fatigue and muscle soreness increased with increasing milage, with extreme levels and very poor recovery toward the end of the expedition. Despite this, the adventurer continued to perform on extremely high levels. Postexpedition scores returned to baseline, demonstrating the incredible adaptation and ability to recovery. The postexpedition interview showed that prior experience of an Antarctic expedition may have prepared the athlete and made her more resilient for this challenge. Conclusions: The data provide unique insights into Antarctic expeditions and may help us understand the limits of human performance when planning future expeditions of this nature. Female athletes are capable of extreme challenges, breaking established performance boundaries. [ABSTRACT FROM AUTHOR]

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

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

Purpose: This preliminary study examined the influence of estimated menstrual-cycle (MC) phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. Methods: Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20 W·kg−1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). Results: Sessional rating of perceived exertion responses to total distances ≥5 km were higher during the luteal phase (+0.6–1.0 au; P ≤.0178) versus menstruation (phase 1), but no other observable dose–response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (−0.73 au, P =.0275). Conclusions: Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose–response to soccer training and matches. [ABSTRACT FROM AUTHOR]

IntroductionWe investigated the association between sleep duration and neuropathologic changes 19 to 40 years later in oldest-old (age 90+) participants of The 90+ Study.MethodsParticipants self-reported sleep duration and underwent neuropathologic evaluation. We categorized sleep duration as  8 hours and dichotomized neuropathologic changes as present/absent. We estimated odds ratio (OR) and 95% confidence intervals (CI) using logistic regression.ResultsIn 264 participants, mean age at sleep self-report was 69 years, mean age at autopsy was 98 years, and mean interval between sleep self-report and autopsy was 29 years (range: 19-40). Those reporting > 8 hours of sleep had lower likelihood of limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) inclusions (OR = 0.18; CI = 0.04-0.82) and amyloid beta deposits (OR = 0.34; 95% CI = 0.12-0.94).DiscussionLong self-reported sleep is associated with lower odds of neurodegenerative neuropathologic changes 19 to 40 years later in the oldest-old, suggesting a potential role of sleep in accumulation of dementia-related neuropathologies.HighlightsAssociation of self-reported sleep with non-Alzheimer's disease neuropathologic changes has not been explored. Whether sleep duration is related to dementia neuropathologic changes decades later is unclear. Long self-reported sleep is associated with lower odds of Alzheimer's disease neuropathologic change 19 to 40 years later in the oldest-old. Long self-reported sleep is associated with lower odds of limbic-predominant age-related TDP-43 encephalopathy neuropathologic change 19 to 40 years later in the oldest-old.

Background: Little investigation of accelerometry assessed movement behaviors and physical inactivity was carried out in middle-aged and older adults in low-middle-income countries. Objective: Describe accelerometry-measured movement behaviors and prevalence of physical inactivity in middle-aged and older adults. Methods: We collected raw accelerometry data during the third visit (2017–2019) of ELSA-Brasil, a large-scale multicenter Brazilian cohort. Participants wore an ActiGraph wGT3X-BT on the waist for 24 hours for 7 days and documented sleep in a diary. Results: Nine thousand two hundred and seventy-nine participants had valid data (73.4% of the eligible cohort). Overall activity was higher for men (11.82mg; 95% confidence interval [CI], 11.7 to 11.93) than women (10.69mg; 95% CI, 10.6 to 10.77) and lower in older groups—women (−0.12mg/y; 95% CI, −0.13 to −0.11), men (−0.16mg/y; 95% CI, −0.17 to −0.14). Participants were more active from noon to midnight. Distribution of movement behaviors varied with sex and age, and sleep duration was longer in older individuals. Overall, 14.4% (95% CI, 13.7 to 15.1) were inactive, with inactivity being more frequent in women (16.4%; 95% CI, 15.4 to 17.4) than men (12.2%; 95% CI, 11 to 13). Higher rates were observed in the oldest. Retirement was associated with a higher prevalence of physical inactivity in both sexes. Conclusion: Women were less active than men. Older individuals showed a high prevalence of physical inactivity, probably related to transition into retirement. These findings strengthen evidence for public policies promoting physical activity by emphasizing the need to target women, older individuals, and those transitioning to retirement to improve and/or maintain physical activity levels throughout the course of their lives. [ABSTRACT FROM AUTHOR]

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

This study examined the prevalence and sociodemographic correlates of meeting individual behavior and 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. The sample comprised 273 older adults aged ≥60 years (80.2% women) with chronic diseases from Recife, Pernambuco, Brazil. Sociodemographic variables were self-reported, while 24-hr movement behaviors were assessed by accelerometry. Participants were classified as meeting (or not meeting) individual and integrated recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behavior, and sleep duration. No participant met the 24-hr movement behavior guidelines, while only 8.4% met integrated MVPA/sleep recommendations. The prevalence of meeting recommendations of MVPA, sedentary behavior, and sleep was 28.9%, 0.4%, and 32.6%, respectively. Discrepancies according to sociodemographic variables on meeting MVPA recommendations existed. The findings show the need for dissemination and implementation strategies to foster adoption of the 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. [ABSTRACT FROM AUTHOR]

Objectives: Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. Methods: This multicenter cross-sectional study included 3591 adolescents (aged 12–17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. Results: The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = −0.08; 95% confidence interval, −0.38 to −0.02) and anti- (adiponectin, β = −0.31; 95% confidence interval, −2.13 to −0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). Conclusion: Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators. [ABSTRACT FROM AUTHOR]

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

Purpose: To examine the effect of match schedule on self-reported wellness and sleep in rugby union referees during the 2019 Rugby World Cup. Methods: Following an observational design, 18 international-level male referees participating in the 2019 Rugby World Cup completed a daily questionnaire to quantify wellness status (sleep quality, mood, stress, fatigue, muscle soreness, and total wellness) and sleep characteristics (bedtime, wake-up time, and time in bed) from the previous night across the tournament. Linear mixed models and effect sizes (Hedges gav) assessed differences in wellness and sleep characteristics between prematch and postmatch days surrounding single-game and 2-game congested match schedules (prematch1, postmatch1, prematch2, and postmatch2 days). Results: During regular schedules, all self-reported wellness variables except stress were reduced (gav = 0.33–1.05, mean difference −0.32 to −1.21 arbitrary units [AU]) and referees went to bed later (1.08, 1:07 h:min) and spent less time in bed (−0.78, 00:55 h:min) postmatch compared with prematch days. During congested schedules, only wellness variables differed across days, with total wellness reduced on postmatch1 (−0.88, −3.56 AU) and postmatch2 (−0.67, −2.70 AU) days, as well as mood (−1.01, −0.56 AU) and fatigue (−0.90, −1.11 AU) reduced on postmatch1 days compared with prematch days. Conclusion: Referees were susceptible to acute reductions in wellness on days following matches regardless of schedule. However, only single-game regular match schedules negatively impacted the sleep characteristics of referees. Targeted strategies to maximize wellness status and sleep opportunities in referees considering the match schedule faced should be explored during future Rugby World Cup competitions. [ABSTRACT FROM AUTHOR]

Background The modified Thomas test (MTT) is commonly used to assess the flexibility of hip musculature, including the iliopsoas, rectus femoris, and tensor fascia latae. This measurement is important to include in a comprehensive musculoskeletal examination. However, existing research shows conflicting results regarding its reliability, particularly due to variations in controlling pelvic tilt during testing, which may lead to inaccurate measurements of hip extension when quantifying the test outcomes. Purpose/Hypothesis This study aimed to evaluate the intra- and inter-rater reliability of the Modified Thomas Test (MTT) in assessing hip flexor length using a goniometer. It was hypothesized that controlling for pelvic tilt would enhance the reliability of these measurements. Study Design Intra- and inter-rater reliability study Methods Sixty-four healthy individuals were recruited to participate in this study. The MTT was performed twice on each leg by both an experienced and a student physical therapist. Blinded goniometric measurements for hip extension range of motion (ROM) in the MTT position were taken with neutral pelvic tilt being enforced via palpation. A double-blind protocol was used where both examiners were unaware of each other's measurements and the goniometer was covered to blind the measuring therapist to the values as well. ROM values were entered into a Microsoft Excel spreadsheet and quantified using SPSS software. Statistical analysis included calculating Intraclass Correlation Coefficients (ICCs) and Standard Errors of Measurement (SEMs) using SPSS software. Results The study included 64 participants (mean age = 23.7 ± 4.34 years). The MTT demonstrated high intra-rater reliability (ICC = 0.911) and inter-rater reliability (ICC = 0.851). The SEMs indicated minimal variability around the mean scores. The average hip extension ROM measured was 5.43± 9.73 degrees. Conclusion These results suggest that the MTT is a reliable tool for assessing hip flexor length in clinical practice, particularly when pelvic tilt is controlled. These results have important implications for accurately testing orthopedic limitations that can contribute to low back, hip, and knee pain. Level of Evidence 3 [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, epidemiological studies have shown that sleep patterns are risk factors for osteoarthritis, but the causal relationship between sleep characteristics and osteoarthritis remains unknown. OBJECTIVE: To investigate the causal relationship between seven sleep phenotypes and osteoarthritis, thereby providing a theoretical foundation for clinical prevention and intervention of osteoarthritis. METHODS: Seven sleep-related features, namely sleep duration, wake-up time, daytime napping, morning/evening preference, snoring, insomnia, and hypersomnia, were selected from published genome-wide association studies. Instrumental variables for these sleep-related features were extracted. Instrumental variables for knee osteoarthritis and hip osteoarthritis were obtained from publicly available genome-wide association studies. Causal relationships between sleep characteristics and outcome risks were evaluated using two-sample and multivariable Mendelian randomization analyses. The inverse variance weighted method was employed as the primary Mendelian randomization approach. Various methods, including weighted median, weighted mode, Mendelian randomization-Egger regression, Mendelian randomization pleiotropy-residual sum and outlier, were utilized to detect and correct for the presence of pleiotropy. RESULTS AND CONCLUSION: The results of the inverse variance-weighted method in the two-sample Mendelian randomization study revealed a detrimental causal association between the duration of sleep and the incidence risk of knee osteoarthritis [odds ratio (OR)=0.621, 95% confidence interval (CI): 0.470-0.822, P=0.001]. Concurrently, insomnia displayed a positive causal connection with hip osteoarthritis risk (OR=2.016, 95% CI: 1.249-3.254, P=0.005). Sensitivity analysis affirmed the robustness of these causal relationships, and Mendelian randomization-Egger intercept analysis found no evidence of potential horizontal pleiotropy (knee osteoarthritis: P=0.468, hip osteoarthritis: P=0.551). Moreover, the results from the multivariable Mendelian randomization analysis showed that the causal association between insomnia and hip osteoarthritis lacked statistical significance (P=0.715). In contrast, sleep duration exhibited a direct negative causal relationship with the incidence risk of knee osteoarthritis (OR=0.526, 95% CI: 0.336-0.824, P=0.005). Reverse Mendelian randomization analysis indicated that knee osteoarthritis did not influence sleep duration (P=0.757). These findings indicate a negative correlation between sleep duration and incidence risk of knee osteoarthritis, suggesting that correcting insufficient sleep might mitigate the incidence risk of knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Observational studies have shown that individual sleep traits habits are potential risk factors for major depression. However, it is not known whether there is a causal relationship between individual sleep traits habits such as continuous sleep duration, short sleep duration, short sleep duration, insomnia, nap during the day, snoring, and major depression. In this study, Mendelian randomization (MR) was used to predict major depressive disorder (MDD) in individuals sleep traits habits. Data were obtained from the genome-wide association study (GWAS). Nine MR analysis methods were used: Inverse Variance Weighted (IVW) [fixed effects/multiplicative random effects], simple mode, simple mode, weighted mode, simple median, weighted median, penalised weighted median, and MR-Egger, MR Egger (bootstrap). IVW was used as the main analysis method for the MR analysis of two samples, and the other methods were used as supplements. The results obtained through the IVW method supported a causal relationship between sleep duration and decreased risk of MDD (odds ratio, OR ivw : 0.998; 95 % CI: 0.996–0.999, P<0.001). Two-Sample MR, results showed that short sleep duration has a causal effect on the increased risk of MDD (odds ratio, OR ivw : 1.179; 95 % CI: 1.108–1.255, P<0.001). However, there were no sufficient evidence supported that long sleep duration has a causal effect on the decreased risk of MDD (odds ratio, OR ivw : 0.991; 95 % CI: 0.924–1.062, P = 0.793). A significant causal relationship between insomnia and increased risk of MDD was observed (OR: 1.233; 95 % CI: 1.214–1.253, P<0.001). Interestingly, our study also found that daytime napping has a causal effect on the increased risk of MDD (odds ratio, OR ivw : 1.519; 95 % CI: 1.376–1.678, P<0.001). The present results did not show a significant causal relationship between snoring and the risk of MDD (OR ivw : 1.000; 95 % CI: 0.998–1.002, P = 0.906). Obstructive sleep apnea (odds ratio, OR ivw : 1.021; 95 % CI: 0.972–1.072, P = 0.407) and morning person (odds ratio, OR ivw : 1.021; 95 % CI: 0.972–1.072, P = 0.407) have no causal effect on the increased risk of MDD. The study could not ascertain whether there were genetic differences among different ethnicities, nations, and regions, as it only included participants of European ancestry. In summary, our research provides genetic evidence for the relationship between individual sleep traits (short sleep duration, insomnia, daytime napping) and the increased risk of MDD. Interventions targeting lifestyle factors may reduce the risk of MDD. • This study explored the causality between lifestyle and major depressive disorder by Mendelian Randomization analysis. • This research provides genetic evidence supporting that sleep traits increase major depressive disorder risk. • The research primarily included European ancestry. The conclusions may not apply to other ethnic and regional groups. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the associations of retrospective reports of Recession hardships with 10-year changes in subjective and objective indicators of sleep, and whether these associations differ by race and gender. Methods: Five hundred and one adults (14.57% Black; 54.49% female) from the Midlife in the United States (MIDUS) study reported on the subjective Pittsburgh Sleep Quality Index (PSQI) across two waves (pre-Recession, collected 2004–2009; post-Recession, collected 2017–2022), as well as Recession hardships since 2008. A sub-sample of 201 adults (25.37% Black; 58.21% female) provided objective actigraphy-measured sleep data (total sleep time, sleep onset latency, and sleep efficiency) across the two waves. Results: Descriptive analyses revealed Black participants had higher average Recession hardships, poorer post-Recession PSQI scores, and poorer post-Recession actigraphy sleep quantity and quality compared to white participants. Females had higher average Recession hardships compared to males; and reported poorer post-Recession PSQI, but had better objective post-Recession sleep quantity and quality compared to males. Regression models showed Recession hardships (across overall events, and sub-domains of financial and housing hardships) were associated with poorer PSQI and actigraphy-measured sleep efficiency following the Recession, adjusting for sociodemographic covariates, corresponding pre-Recession sleep variables, and pre-Recession chronic conditions. There was no evidence for significant moderation by race on sleep outcomes. However, gender moderation indicated associations between housing hardships and poorer actigraphy-measured sleep efficiency were more apparent for females than for males. Conclusions: Findings indicate that Recession hardships (particularly in financial and housing domains) may be manifested in poor sleep. Racial and gender groups may have differential exposure and sleep-related reactivity to Recession hardships. [ABSTRACT FROM AUTHOR]

Background: Among adolescents, symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are not only clinically significant but also continuingly increasing. During adolescence, individuals begin to establish distinct, self-determined lifestyle patterns. This study seeks to identify the associations between such lifestyle factors and the prevalence of GAD and SAD symptoms. Methods: The analyzable sample was based on a cross-sectional, nationally representative survey of Finnish 14–18 year old students from comprehensive schools, general upper secondary schools, and vocational institutions. The sample consisted of 60,252 boys and 71,118 girls, with the mean age of 16.05 years (standard deviation 1.06). Symptoms were identified using the GAD-7 (cutpoint of 10), the Mini-SPIN (cutpoint of 6), and the PHQ-2 (cutpoint of 3). Logistic regression models for both GAD and SAD symptoms were stratified by comorbidity group variables. Results: GAD symptoms were closely related to excessive internet use and decreased sleep duration among adolescents, regardless of comorbidity with depression or SAD. SAD symptoms were associated with excessive internet use and a lack of intense exercise, independent of comorbid depression or GAD. Conclusions: The findings underscore the importance of considering lifestyle factors when developing interventions to mitigate GAD and SAD symptoms in adolescents. Interventions and policy recommendations aiming at improving adolescents' health behaviour and mental health should take into account the intertwining of these factors. [ABSTRACT FROM AUTHOR]

Background: Studies have emphasised the adverse effects of poor sleep on human health, however, the correlation between sleep abnormalities and hypothyroidism remains unclear. This study evaluated whether sleep abnormalities may be related to increased prevalence of hypothyroidism in general US adults. Methods: In total, 9016 adults who participated in the National Health and Nutrition Examination Survey from 2007 to 2012 were analysed. A standardised questionnaire was used to collect data regarding sleep duration, self-reported trouble sleeping and sleep disorders. Values were assigned to the three aforementioned sleep factors, resulting in an overall sleep score of 0–3. The sleep patterns were divided into healthy sleep pattern (overall sleep score = 3), intermediate sleep pattern (overall sleep score = 2) and poor sleep pattern (overall sleep score = 0 or 1) according to a former study. Hypothyroidism was defined as thyroid-stimulating hormone (TSH) levels > 5.6 mIU/mL or the need to take thyroid hormones. Multivariable logistic regression analysis was performed to assess the relationship between sleep abnormalities and hypothyroidism. Results: The overall prevalence of hypothyroidism was 8.0% among the 9016 participants. Self-reported trouble sleeping (odds ratio [OR] = 1.38, 95% CI: 1.14–1.68, p = 0.001) and sleep disorders (OR = 1.40, 95% CI: 1.06–1.86, p = 0.0196) were associated with increased prevalence of hypothyroidism. Neither short sleep duration (OR = 0.99, 95% CI: 0.82–1.19) nor long sleep duration (OR = 0.98, 95% CI: 0.61–1.58) was significantly associated with hypothyroidism. Moreover, poor sleep pattern was significantly associated with increased prevalence of hypothyroidism (OR = 1.30, 95% CI: 1.03–1.66, p = 0.0301). Conclusions: Both trouble sleeping and sleep disorders were associated with increased prevalence of hypothyroidism. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionWe investigated the relationship between irregular sleep-wake patterns and other aspects of sleep and mental health among adolescents.Community-based sample of adolescents (n = 200, mean age 16.8; 61.7% female) completed baseline assessment (i.e. sleep quality, daytime sleepiness, depressive symptoms, social anhedonia, problematic alcohol use), and 7–8 consecutive days of wearing wrist actigraphy. Irregular sleep-wake patterns were assessed via two methods, both based on actigraphy, to capture day-to-day irregularity (intraindividual variability, IIV) and weekly irregularity (social jet lag, SJL). The Bayesian variability method was performed to calculate IIV in total sleep time (TST), sleep onset, and offset time. SJL was quantified as the actual difference in the sleep midpoint on school days versus non-school days.Greater IIV in TST was associated with poorer sleep quality (B = 1.66, 95% CI, 0.14, 3.31, p < .05), and greater depressive symptoms (B = 0.72, 95% CI, 0.17, 1.35, p < .05), while greater IIV in sleep offset time was associated greater depressive symptoms (B = 0.63, 95% CI, 0.03, 1.28, p < .05), and greater problematic alcohol use (B = 0.70, 95% CI, 0.12, 1.35, p < .05), all after adjusting for age, sex, family SES, alcohol drinks, and SJL. No significant association was found with sleep onset time. Greater SJL was associated with poorer sleep quality (B = 0.40, 95% CI, 0.27, 0.54, p < .001) and fewer problematic alcohol uses (B = −0.05, 95% CI, −0.09, −0.00, p < .05), when adjusting for age, sex, family SES, and alcohol drinks.Our findings add to a growing body of research on irregularity in sleep-wake patterns and clinical implications. [ABSTRACT FROM AUTHOR]

Background: As one of the key features of sleep, sleep duration (SD) has been confirmed to be associated with multiple health outcomes. However, the link between SD and cognitive function (CF) is still not well understood. Methods: We employed a combined approach utilizing data from the National Health and Nutrition Examination Survey (NHANES 2011–2014) and Mendelian Randomization (MR) methods to investigate the relationship between SD and CF. In the NHANES cross-sectional analysis, the association between these variables was primarily examined through multivariate linear regression to explore direct correlations and utilized smoothing curve fitting to assess potential nonlinear relationships. To ensure the robustness of our findings, subgroup analyses were also conducted. MR analysis was used to assess the causal relationship between SD and sleeplessness on CF. After excluding confounding factors, univariate and multivariate MR were performed using inverse variance weighting (IVW) as the main analysis method, and sensitivity analysis was performed. Results: The results of our cross-sectional study indicate a notable negative association between SD and CF, forming an inverted U-shaped curve with the inflection point occurring at SD = 6 h. This relationship remains consistent and robust across subgroup analyses differentiated by variables such as age, levels of physical activity, and frequency of alcohol intake. In MR analysis, IVW analysis showed no causal relationship between SD and sleeplessness on CF (Both P > 0.05). Conclusion: Cross-sectional studies suggest the existence of an inverted U-shaped correlation between SD and CF among the elderly. However, MR analysis did not reveal a causal relationship between SD and CF, which the lack of nonlinear MR analysis may limit. These findings provide evidence from a sleep perspective for optimizing cognitive strategies in older adults. [ABSTRACT FROM AUTHOR]

Background: The 24-hour movement guidelines (24-HMG) include screen time (ST), sleep duration, and physical activity. Previous studies have explored the associations of adherence to the 24-HMG with depression and anxiety symptoms among adolescents, ignoring changes in behaviors. This study aimed to examine whether changes in adherence to the 24-HMG were associated with depression and anxiety symptoms among adolescents. Methods: We recruited adolescents from Shenzhen, China in 2021 and followed them up 1 year later. Changes in adherence to the individual 24-HMG were categorized into four groups: persistent non-adherence, adherence to non-adherence, non-adherence to adherence, and persistent adherence. Changes in the numbers of adherence to the overall 24-HMG were obtained by subtracting the number of guidelines adhered to in wave 2 from that in wave 1. Results: We included 12,570 participants aged 9–18 years with 52.2% boys. Compared with persistent non-adherence for the ST/sleep duration guideline, non-adherence to adherence and persistent adherence were associated with lower depression and anxiety symptoms, but adherence to non-adherence was not. Changes in adherence to the physical activity guideline were not related to outcomes. The β coefficients (95% CIs) for each point increase in changes in the numbers of adherence to guidelines were − 0.58 (− 0.69, − 0.47) and − 0.43 (− 0.53, − 0.33) for depression and anxiety symptoms, respectively. The association of persistently adhering to sleep guideline with anxiety symptoms and the associations of changes in the numbers of adherence to the 24-HMG had sex differences. Conclusions: Maintaining and strengthening healthy movement behaviors to meet more guidelines of the 24-HMG, especially sleep and ST, may be beneficial for preventing depression and anxiety symptoms in adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations of screen time, homework and reading duration, sleep duration, social jetlag with mental health in children and adolescents, as well as its gender differences. Methods: From December 2023 to April 2024, a total of 62 395 children and adolescents were selected from 51 schools in 17 cities of China by stratified cluster sampling. Screen time, homework and reading duration, sleep duration, and social jetlag were calculated by answering the questions about watching TV time, playing smartphones time, doing homework time, reading extracurricular books time, bedtime, wake-up time, and nap time during weekdays and weekends. Mental health was assessed by the Revised Mental Health Inventory-5 (MHI-5). The generalized linear model was used to determine the association between screen time, homework and reading duration, sleep duration, social jetlag, and mental health in children and adolescents. Results: The generalized linear model results showed that longer watching TV time, longer playing smartphones time, longer homework time, and greater social jetlag were correlated with poorer mental health in children and adolescents, while longer nighttime sleep duration, and longer daytime nap duration were correlated with better mental health. Moreover, in primary school and junior high school, we found that this association was stronger during the weekdays. However, in senior high school, this association was stronger during the weekends. After according to gender stratified, we found that the strength of this association was different in boys and girls at different study phases. Furthermore, our findings also revealed a significant quadratic relationship, indicating the association of better mental health with an optimal amount of sleep duration. Conclusions: There was a significant association between screen time, homework and reading duration, sleep duration, social jetlag, and mental health in children and adolescents. This study has the potential to offer useful insights for the prevention and control of mental health issues in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: the independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time. Methods: This cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model. Conclusion: Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents. [ABSTRACT FROM AUTHOR]

Recent research suggests that microbial molecules translocated from the intestinal lumen into the host's internal environment may play a role in various physiological functions, including sleep. Previously, we identified that butyrate, a short-chain fatty acid produced by intestinal bacteria, and lipoteichoic acid, a cell wall component of gram-positive bacteria, induce sleep when their naturally occurring translocation is mimicked by direct delivery into the portal vein. Building upon these findings, we aimed to explore the sleep signaling potential of intraportally administered lipopolysaccharide (LPS), a primary component of gram-negative bacterial cell walls, in rats. Low dose of LPS (1 μg/kg) increased sleep duration and prolonged fever, without affecting systemic LPS levels. Interestingly, administering LPS systemically outside the portal region at a dose 20 times higher did not affect sleep, indicating a localized sensitivity within the hepatoportal region for the sleep and febrile effects of LPS. Furthermore, both the sleep- and fever-inducing effects of LPS were inhibited by indomethacin, a prostaglandin synthesis inhibitor, and replicated by intraportal administration of prostaglandin E2 or arachidonic acid, suggesting the involvement of the prostaglandin system in mediating these actions. [ABSTRACT FROM AUTHOR]

Summary Both rapid eye movement and non‐rapid eye movement sleep are important for cognitive function and well‐being, yet few studies have examined whether human sleep architecture is affected by long‐duration spaceflight. We recorded 256 nights of sleep from five crew members before (n = 112 nights), during (n = 83 nights) and after (n = 61 nights) ~6‐month missions aboard the Mir space station, using the Nightcap sleep monitor. We compared sleep outcomes (including total sleep time, efficiency, latency, rapid eye movement and non‐rapid eye movement) during spaceflight with those on Earth. We also evaluated longitudinal changes over time in space. We found that wakefulness increased by 1 hr in space compared with on Earth. Over time in space, rapid eye movement was initially reduced and then recovered to near preflight levels at the expense of non‐rapid eye movement sleep. Upon return to Earth, sleep architecture returned to preflight distribution. Our findings suggest that spaceflight may alter sleep architecture and should be explored further. [ABSTRACT FROM AUTHOR]

Sleep is crucial for children’s health and eating habits. The decline in family meals has raised concerns about its impact on children. Previous research indicated associations between family meals and psychological health and dietary habits, but their relationship with sleep behavior is less understood. This study examined the association between family meals (breakfast and dinner), sleep patterns, and quality of life among Japanese preschoolers and elementary school students (1st to 3rd grade). The cross-sectional study involved 6,177 children aged 3–8 years in Japan. Mothers completed an online survey on family meal habits, sleep patterns, and the KINDL-R questionnaire to assess quality of life. Results showed that family meals were associated with sleep behaviors and KINDL scores. Multiple regression analysis indicated that family breakfast was associated with earlier bedtime and wake-up time, shorter weekend sleep duration, reduced social jet lag, and a morning chronotype, as detected by the Munich ChronoType Questionnaire. Family dinners were linked to later sleep and wake-up times and an evening chronotype. Family breakfast and dinner were associated with higher KINDL scores, with dinner having a stronger positive impact. These findings underscore the significance of family meals in associating sleep patterns and quality of life among Japanese children. [ABSTRACT FROM AUTHOR]

The bidirectional relationship between sleep duration and pain during the COVID-19 pandemic remains poorly understood. This study explores these interactions and the mediating roles of depression and chronic diseases using data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. A cross-sectional analysis was conducted on 15,979 participants aged 45 and older. Sleep duration was self-reported, and pain was assessed using validated anatomical charts. Depression symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and chronic diseases were self-reported. Personal activity during the pandemic was measured using the Personal Activity Score during COVID-19 (PAS-COVID-19). The results showed a significant association between deviations from optimal sleep duration and increased pain frequency. Participants with both shorter and longer sleep durations reported higher pain levels, with depression and chronic diseases acting as significant mediators. However, personal activity did not significantly mediate the association between sleep duration and pain. These findings underscore the complex interplay among sleep duration, pain, depression, and chronic diseases during the COVID-19 pandemic, emphasizing the importance of integrated interventions to manage these interconnected health issues. [ABSTRACT FROM AUTHOR]

Background and purpose: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted people's lifestyles, changing sleep patterns. This study investigated changes in sleep patterns and disturbances in South Koreans over the past decade, including during the pandemic. Methods: We compared data from the Korean Sleep Headache Society Phase I survey (n = 2484; conducted in 2010) and the National Sleep Survey of South Korea 2022 (n = 3729; conducted in 2022), involving participants aged 20–69 years. Changes in sleep schedule, sleep duration, social jet lag, insomnia, and daytime sleepiness were explored. Results: Workday bedtimes were advanced and free-day bedtimes and workday and free-day waking times were delayed during the pandemic. Increased circadian preference for eveningness and social jet lag were noted. A significant decrease in sleep duration and sleep efficiency, along with an increased prevalence of insomnia and daytime sleepiness, was noted with age- and sex-specific variations. Conclusions: Over the past decade, including during the COVID-19 pandemic, sleep habits have changed significantly and sleep problems worsened. This study emphasize the need for more comprehensive public health strategies and research to facilitate sleep recovery in the post-pandemic period within a society known for its high prevalence of sleep deprivation. [ABSTRACT FROM AUTHOR]

Background: Resting heart rate (HR) and HR variability (HRV) are widely used parameters to assess cardiac autonomic nervous system function noninvasively. While resting assessments can be performed during sleep or after awakening, it would be relevant to know how interchangeable the results of these measurements are. This study aimed at examining the alignment between nocturnal and morning assessments during regular endurance training and in response to intensive training. A total of 24 recreational runners performed a 3-week baseline period (BL) and a 2-week overload (OL) period (Lucia's training impulse + 80%). Their running performance was assessed with a 3000-m running test after the BL and OL. The participants recorded daily their nocturnal HR and HRV (the natural logarithm of the root mean square of successive differences; LnRMSSD) with a photoplethysmography-based wrist device and performed an orthostatic test (2-min supine, 2-min standing) every morning with a chest-strap HR sensor. The HR and LnRMSSD segments that were analyzed from the nocturnal recordings included start value (SleepStart), end value (SleepEnd), first 4-h segment 30 min after detected sleep onset (Sleep4h), and full sleep time (SleepFull). The morning segments consisted of the last-minute average in both body positions. All segments were compared at BL and in response to the 3000-m test and OL. Results: All nocturnal HR and LnRMSSD segments correlated with supine and standing segments at BL (r = 0.42 to 0.91, p < 0.05). After the 3000-m test, the HR increased and LnRMSSD decreased only in the SleepStart, Sleep4h, and SleepFull segments (p < 0.05). In response to the OL, the standing HR decreased (p < 0.01), while the LnRMSSD increased (p < 0.05) in all segments except for SleepStart. The Pearson correlations between relative changes in nocturnal and morning segments were − 0.11 to 0.72 (3000-m) and − 0.25 to 0.79 (OL). The OL response in Sleep4h HR and LnRMSSD correlated with the relative change in 3000-m time (r = 0.63, p = 0.001 and r=-0.50, p = 0.013, respectively). Conclusions: Nocturnal and morning HR and LnRMSSD correlated moderately or highly in the majority of cases during the BL, but their responses to intensive training were not similarly aligned, especially in LnRMSSD. The nocturnal segments seemed to be sensitive to physical loading, and their responses were associated with the performance-related training responses. Key Points: • Moderate-to-high correlations were found between nocturnal and morning assessments of HR and HRV during regular endurance training in recreational runners. • In their responses to maximum exercise, nocturnal and morning HR and HRV were not necessarily aligned, as nocturnal segments seemed more responsive to such a stimulus. • While lower HR and higher HRV were associated with better endurance performance in all recording segments, changes in these parameters after the overload period correlated only in nocturnal segments. [ABSTRACT FROM AUTHOR]

Sleep disorders are becoming more and more common, leading to many health problems. However, most of current available medications to treat sleep disorders are addictive and even impair cognitive abilities. Therefore, it is important to find a natural and safe alternative to treat sleep disorders. In this study, twenty-four 8-week-old male ICR mice (25 ± 2 g) were equally divided into three groups: the control group (gavage of 0.9% saline), the eucalyptus essential oil (EEO) group (10 mg/kg B.W.), and the diazepam group (1 mg/kg B.W.). Firstly, open field test and sleep induction test were used to determine the sedative-hypnotic effect of EEO. Secondly, the effect of EEO on neurotransmitters in the mice brain was determined. Finally, based on the gut microbiota-brain axis (GMBA), the effect of EEO on the intestinal flora of mice was explored. It was found that EEO significantly reduce the activity and prolong the sleep duration of mice, exhibiting a good sedative-hypnotic effect. In the brain, EEO could increase the levels of sleep-promoting neurotransmitters, such as glutamine, Gamma-aminobutyric acid (GABA), glycine, tryptophan, N-acetylserotonin, and 5-hydroxyindoleacetic acid (5-HIAA). In the intestine, EEO was found to increase the diversity of gut microbes, the abundance of short chain fatty acid (SCFA) producing flora, and the abundance of functional flora synthesizing GABA and glycine neurotransmitters. These studies suggested that EEO exerted a sedative-hypnotic effect by acting on gut microbes and neurotransmitters in the brain. EEO has the potential to become a natural and safe alternative to traditional hypnotic sedative drugs. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the sleep status of middle-aged and elderly adults in Bengbu City, Anhui Province, China, to identify the major dietary patterns, and to analyze the association of different sleep duration and dietary patterns with metabolic syndrome (MetS) and its related influencing factors, as well as to explore the predictive value of sleep duration and dietary patterns. A cross-sectional analysis was performed utilizing data collected from the Community-based Cardiovascular and Health Promotion Study 2019 (COCHPS 2019) conducted in Bengbu. The definition of MetS adhered to the criteria of Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults (2016 Revision). Dietary information was obtained using the Food Frequency Questionnaire (FFQ) to assess dietary intake over the past year. Principal component analysis (PCA) was performed to identify dominant dietary patterns. A logistic regression model was developed to analyze the associations among sleep duration, dietary patterns, and MetS, and a decision tree (DT) model was developed to compare factors affecting MetS and screen people at high risk for MetS. The prevalence of MetS was 13.4% among the 9132 middle-aged and elderly residents over 45 years of age included in COCHPS 2019. Participants were divided into short (< 6 h/d), normal (6–8 h/d), and long (> 8 h/d) groups based on their daily sleep duration. Three dietary patterns were identified by PCA, the fruit-milk pattern, the tubers-meat pattern, and the vegetable-cereal pattern. After adjusting for covariables, logistic regression analysis showed that long sleep duration was significantly negatively associated with MetS. The fruit-milk and vegetable-cereal patterns were negatively associated with MetS, whereas the tubers-meat pattern was positively correlated with MetS. The results of the DT model analysis showed that the vegetable-cereal pattern is the most important factor impacting MetS, followed by marital status, the tubers-meat pattern, the fruit-milk pattern, exercise, sleep duration, and gender. The DT model also screened out five types of MetS high-risk groups. The results of our study indicate that normal sleep duration and consumption of either a fruit-milk or vegetable-cereal diet may lower the likelihood of developing MetS in middle-aged and elderly adults. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Implications Conclusions We aimed to characterize relationships between delayed high school start time policy, which is known to lengthen school night sleep duration, and patterns in activity outcomes: physical activity, non‐school electronic screen time (non‐schoolwork), and sports and extracurricular activity among adolescents.We used data from the START study, a multi‐site evaluation of a natural experiment, assessing the effects of a school start time policy change in high schools in the Minneapolis, Minnesota metropolitan area. The study follows students in 2 schools that shifted to a later start time (8:20 or 8:50 am) after baseline year and 3 schools that maintained a consistent, early start time (7:30 am) over the 3‐year study period. Activity was measured by participant self‐report on an in‐school survey. The analysis used a difference‐in‐differences estimator, in which the changes in each outcome observed in the comparison schools estimate the changes in each outcome that would have been observed in the late‐start adopting schools had they not delayed their start times after baseline.Over 2 years of follow‐up, no changes emerged to suggest that later school start times either interfered with, or promoted, any activity‐related outcome that was measured.Communities interested in promoting sleep by delaying start times may do so knowing that there are unlikely to be adverse effects on adolescent physical activity, electronic screen time, or organized sports and activity participation.A shift to later school start times does not appear to enhance or detract from the healthfulness of students' activity level. [ABSTRACT FROM AUTHOR]

Purpose: Elite swimmers often schedule altitude training camps ahead of major events in an attempt to maximize performance. However, the relationships between altitude-induced hematological changes, markers of training adaptation, and performance changes in such context are unclear. This study assessed hematological status, markers of daily adaptation, and swimming performance in elite middle-distance and distance swimmers during a 22-day altitude training camp at 2,320 m, 2 weeks prior to World Championship qualification competition. Methods: Venous blood was obtained and total hemoglobin mass (tHbmass) measured (CO rebreathing) in 7 elite swimmers (4 females, 3 males) 8 days before and on day 22 of the altitude camp. Resting heart rate, peripheral oxygen saturation, urinary specific gravity, body mass, fatigue and self-reported sleep duration and quality were monitored daily during the altitude camp. Swimming performance was assessed through a standardized set (6 sets of 4 maximal repetitions of 100 m front crawl) on days 3, 10 and 17 of the camp, and at sea level competitions (200 m–1,500 m) immediately after the camp, and 2 weeks later. Results: tHbmass (+5.6 ± 3.3%; range: 2.1%–11.0%; p < 0.05), red blood cell count, hemoglobin concentration, hematocrit increased at the end of the training camp (p < 0.05). Performance at altitude improved throughout the camp (+1.4 ± 0.4%; range: 0.7%–2.5%; p < 0.05). No significant relationship was noted between hematological changes, the change in altitude performance and any of the monitored daily markers of adaptation during the camp. Compared to the swimmers' previous personal best, competition performances did not improve immediately (2.5% ± 1.9% slower times) and 2 weeks after altitude (1.2% ± 1.4% slower times). Conclusion: The 22-day altitude training camp at 2,320 m was beneficial for elite swimmers' tHbmass, hematological status and performance at altitude, but these benefits did not clearly translate into enhanced sea level performance immediately after or 2 weeks later. The present study confirms the large inter-individual variability in hematological responses to altitude training, and that the improvement in performance at altitude and sea level may depend on factors other than the increase in tHbmass alone. [ABSTRACT FROM AUTHOR]

We evaluated the relationships of daily sleep duration and inconsistency with soft tennis competitive performance among 15 healthy collegiate soft tennis players (13 male, 2 female, mean age = 19.7 ± 0.8 years, height = 170.8 ± 7.3 cm, weight = 60.3 ± 5.6 kg, soft tennis experience = 8.7 ± 2.0 years). Sleep duration and inconsistency were determined by a 50-day sleep diary, which recorded sleep and wake times of sleep. Soft tennis athletic performance was evaluated by a service and baseline stroke accuracy test and the spider run test. Mean sleep duration was 7.4 ± 1.7 h. No correlation was found between long-term mean sleep duration and athletic performance. But inconsistency in sleep duration (SD of sleep duration) was inversely correlated with service score after controlling for soft tennis experience and sex (r = −0.56, p = 0.046). There was no significant relationship between sleep inconsistency and other athletic performance. This result indicates that reducing the instability of sleep duration (i.e., sleep regular hours) in the long-term may have a positive effect on soft tennis players' service performance. Although participants' current mean sleep duration (7.4 h) was not as sufficient as the recommendation in sleep extension experiments (9–10 h), it revealed the importance for athletes to maintain regular sleep in daily life. [ABSTRACT FROM AUTHOR]

Objective: Although sleep duration and sleep quality are considered to be significant factors associated with epilepsy and seizure risk, findings are inconsistent, and their joint association remains uncertain. This study aimed to determine independent and joint associations of these two modifiable sleep features with seizure recurrence risk in newly treated patients with epilepsy (PWE). Methods: This is a prospective cohort study of newly treated PWE at a comprehensive epilepsy center in northeast China between June 2020 and December 2023. Self‐reported sleep duration and sleep quality were collected at baseline. All patients were followed for 12 months for recurrent seizures. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of seizure recurrence. Models fitted with restricted cubic spline were conducted to test for linear and nonlinear shapes of each association. Results: A total of 209 patients were included, and 103 experienced seizure recurrence during follow‐up. Baseline short sleep was significantly associated with greater risk of seizure recurrence (adjusted HR = 2.282, 95% confidence interval [CI] = 1.436–3.628, p <.001). Sleep duration (h/day) and recurrent seizure risk showed a significant nonlinear U‐shaped association, with a nadir at 8 h/day. Baseline poor sleep quality was significantly associated with greater risk of seizure recurrence (adjusted HR = 1.985, 95% CI = 1.321–2.984, p <.001). Pittsburgh Sleep Quality Index score and seizure recurrence risk exhibited a positive linear association. Participants with a combination of poor quality–short sleep showed the highest risk of seizure recurrence (adjusted HR = 3.13, 95% CI = 1.779–5.507, p <.001) compared to the referent good quality–intermediate sleep group. Significance: Baseline sleep duration and sleep quality were independently and jointly associated with risk of seizure recurrence in newly treated PWE. Our results point to an important potential role of baseline sleep duration and sleep quality in shaping seizure risk. [ABSTRACT FROM AUTHOR]

Objective: To describe the changes in sleep health domains and examine the associations between the repeated measures and intraindividual variability (IIV) of these domains and perceived stress. Participants: A diverse racial and ethnic group of first-year college students (N = 23, 78.3% female, aged 17–18) attending in-person classes during the COVID-19 pandemic. Methods: Sleep health domains were determined using 7-day wrist actigraph and daily sleep diaries, and perceived stress scale was completed at 1-month intervals across 3 months. Results: Sleep timing, regularity, and alertness during daytime demonstrated statistically significant changes between three timepoints. Greater stress was associated with more irregularity (B = 2.25 [.87–3.62], p <.001), more dissatisfaction in sleep (B =.04 [.02–.19], p <.01), alertness during daytime (B =.18 [.05–.31], p <.001), and greater IIV (ie, fluctuations) in sleep satisfaction (B =.083 [.02,.15], p <.01). Conclusion: These findings offer insights for future researchers to facilitate intervention development to promote mental and sleep health among college students. [ABSTRACT FROM AUTHOR]

Background: Poor sleep is common in the context of cannabis use, but experimental and daily‐life studies provide mixed evidence for whether cannabis use helps or disturbs same‐night sleep. Despite a high prevalence of co‐use of alcohol and cannabis, most studies of cannabis use and sleep do not consider alcohol use. We sought to add to this literature by examining associations between cannabis and sleep in the context of alcohol co‐use and to examine these associations bidirectionally using ecological momentary assessment. Methods: Participants were 88 adults reporting cannabis use at least 3×/week and simultaneous alcohol and cannabis use at least 2×/week. For 14 days, participants completed morning surveys assessing hours slept and perceived sleep quality from the night before. In morning surveys, random surveys, and substance‐specific surveys, participants also reported on alcohol and cannabis craving, use, and amounts. Results: Primary results from multilevel models demonstrated that cannabis use was not independently associated with sleep (duration or quality). However, cannabis use attenuated alcohol's negative effects on sleep quality. Conclusions: Results question the utility of cannabis use to improve sleep but highlight the attenuated negative effects of alcohol as a potential reinforcer of alcohol‐cannabis co‐use. Future work should continue to consider polysubstance use and integrate additional self‐report and objective measures of sleep health to further clarify how cannabis use affects sleep. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study evaluated the impact of continuous positive airway pressure (C-PAP) therapy combined with a rigorous diet regimen on obese patients with obstructive sleep apnea syndrome (OSAS). Methods: Sixty obese patients (BMI ≥ 30) diagnosed with severe OSAS were recruited in order to establish the evaluation of CPAP therapy with different extents of adherence to a rigorous diet regimen. After one year, significant improvements were observed. Results: BMI reduced by 12.32%, apnea–hypopnea index (AHI) by 22.04%, oxygen desaturation index (ODI) by 15.87%, total sleep time with oxygen saturation below 90% (TST90%) by 25.2%, and Epworth Sleepiness Scale (ESS) scores by 21.74%. Patients were, then, divided into three groups, based on adherence to the restricted diet, as well as to the correct use of the nocturnal C-PAP, showing different reductions in BMI, AHI, ODI, TST90%, and ESS, according to their adherence, based on the sum of % reduction in BMI + AHI into three groups. Conclusions: These findings underscore the effectiveness of combining C-PAP therapy with a strict diet in improving OSAS symptoms and overall health in obese patients. Future studies with larger cohorts and longer follow-up periods are needed to confirm these results and explore the long-term benefits of this integrated approach. [ABSTRACT FROM AUTHOR]

The benefits of sufficient and high-quality sleep for people are well documented. Insufficient sleep increases the risk of accidents, injuries, and negative health implications for people. This is especially relevant for farmers because they work with large animals and machinery. Dairy farming often requires early start times and long days, particularly over the high-workload calving period in block-calving, pasture-based systems. However, there is little published data quantifying the sleep quantity and quality of farmers over this period. In this study, the sleep patterns of workers (n = 33) on 10 New Zealand dairy farms were measured for 90 d over the spring calving period using a sleep measuring device (Oura ring, Oura Health Ltd., Oulu, Finland). Total sleep time (TST) averaged 6 h 15 min, lower than the required 7 to 9 h for optimal wellbeing and cognitive functioning. The TST decreased over the calving period and was significantly correlated with both sleep start and wake times. Factors such as work start time, farm location, and role on farm influenced sleep quantity and quality. Further research is required to better understand sleep and its effect on dairy farmers, over both the calving period and the remaining months of the year. The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. [ABSTRACT FROM AUTHOR]

This study characterized the sleep activity, sleep mechanism, and active peptides of whey protein hydrolysates selected through behavioral analysis of fruit flies (Drosophila melanogaster). Sleep-inducing whey protein (WP) hydrolysate was selected through fruit fly behavior analysis, and sleep activity was measured using a pentobarbital model and electroencephalographic analysis. The mechanism of action was confirmed using a γ-aminobutyric acid (GABA) receptor antagonist, and the active peptide was identified using liquid chromatography-mass spectrometry. Whey protein hydrolysate, prepared using Alcalase and Prozyme (WP-AP), increased sleep time in a dose-dependent manner. The WP-AP significantly increased not only sleep time but also slow-wave sleep and showed an insomnia-alleviating effect in a caffeine-induced insomnia mouse model. In addition, the gene and protein expression levels of GABA subtype A receptors increased in the brains of mice orally administered with WP-AP. Through peptide analysis, the mixture of DIQK, VPPF peptide, and GABA contained in WP-AP was estimated to exhibit sleep activity, and due to its high content, DIQK was speculated to be the main sleep-inducing ingredient. These results indicate that WP-AP has the potential to be used as a new ingredient to improve sleep quality. The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. [ABSTRACT FROM AUTHOR]

Objectives: Parents' healthy behaviors are important for both their health and role models for their children. The purpose of this study was to evaluate adherence to the three recommendations associated with health in the Canadian 24‐h movement or Japanese physical activity (PA) guidelines and their relationship with weight status (underweight or obesity) in Japanese parents. Methods: This cross‐sectional study included 425 mothers and 237 fathers. Meeting the 24‐h movement guidelines was defined as: ≥150 min/week of moderate‐to‐vigorous PA (MVPA) (Canada) or at least 60 min/day of MVPA (Japan), ≤8 h/day of sedentary time which includes ≤3 h of recreational screen time, and 7 to 9 h/night of sleep. MVPA and sedentary time were accelerometer‐determined while screen time and sleep duration were self‐reported. Results: The prevalence of mothers meeting all three recommendations was 30.6% using Canadian PA guidelines and 20.7% using Japanese PA guidelines, while that of fathers was 10.6% and 8.0%, respectively. Mothers not meeting the sedentary behavior recommendation had a lower odds ratio and those not meeting Japanese PA recommendations had a higher odds ratio for underweight compared to mothers meeting the recommendations, adjusted for age and area socioeconomic status. Conclusions: The screen time recommendation and Japanese PA recommendation were associated with underweight in mothers. None of the recommendations was associated with weight status in fathers. Further research is needed to understand the relationships among movement behaviors and weight status, particularly among Japanese women, whose routine behaviors, such as household activities, may be misclassified by a questionnaire. [ABSTRACT FROM AUTHOR]

Purpose: Dexmedetomidine increases sleep and reduces delirium in postoperative patients, but it is expensive and requires a monitored environment. Clonidine, another α 2-agonist, is cheaper and is used safely for other purposes in wards. We assessed whether clonidine would improve sleep in postoperative high-dependency unit (HDU) patients. Methods: The Clonidine at Low dosage postoperatively to Nocturnally Enhance Sleep (CLONES) study was a double-blind, placebo-controlled, parallel-group pilot effectiveness randomised trial involving adult elective surgery HDU patients in a single academic hospital. Patients received clonidine 0.3 μg/kg/h or saline placebo on the night of surgery. The primary outcome was total sleep time measured using a consumer actigraphy/photoplethysmography device. Results: Of the 83 randomised patients, three had no data available, leaving 80 (39 clonidine, 41 placebo) in the intention-to-treat analysis, modified for missing data. Median patient ages of the groups were similar (61 and 59 years), as were other baseline characteristics. Clonidine patients had a mean of 100.8 (95% confidence interval [CI] 38.2–163.4) minutes (p = 0.002) longer total sleep time (mean 497.2 vs. 396.4 min) and reported better sleep overall. Delirium was only observed in one patient prior to study drug infusion, and none at the end of the study. Safety outcomes were not different. Four clonidine patients had their medication ceased due to bradycardia and hypotension that required no additional treatment. Conclusion: Among postoperative elective surgical patients admitted to HDU, low-dose non-titrated clonidine, compared to placebo, was associated with longer and subjectively better-quality sleep. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is a leading cause of death worldwide among adults. Traditionally, the disease has been considered as a condition affecting older adults. However, its risk factors (e.g., poor diet, sedentary behavior, inadequate sleep, and obesity) are increasingly being identified in younger populations. There is a need to increase the evidence of CVD risk factors in this population to further support preventive programs in this demographic. Objective(s): This study investigates the prevalence of CVD risk factors in young adult, college students. Design: Data was used from the American College Health Association's National College Health Assessment (ACHA‐NCHA) II‐C. Sample: The sample included data from 426,259 students, ages 18–25. Measurements: Data was reviewed on race, nutrition, physical activity, tobacco use, sleep, weight, and history of chronic disease. Descriptive statistics were utilized to examine the prevalence of CVD risk factors. Results: There was a notable prevalence of CVD risk factors, such as insufficient nutrition, obesity, insufficient physical activity, and inadequate sleep, among college students. Conclusions: CVD‐related risk factors are on the rise within this demographic. There is a pressing need for the expansion of public health initiatives aimed at enhancing CVD awareness and prevention among college students. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the comparative efficacy and acceptability of cognitive behavioral therapy for insomnia (CBT‐I), pharmacotherapy, and their combination in the long and short terms among adults with chronic insomnia disorder. Methods: We searched multiple databases to December 27, 2023. We included trials in hypnotic‐free adults with chronic insomnia comparing at least two of CBT‐I, pharmacotherapy, or their combination. We assessed the confidence in evidence using CINeMA. The primary outcome was long‐term remission. Secondary outcomes included all‐cause dropout and self‐reported sleep continuity measures in the long term, and the same outcomes in the short term. We performed frequentist random‐effects network meta‐analyses (CRD42024505519). Findings: We identified 13 trials including 823 randomized participants (mean age, 47.8 years; 60% women). CBT‐I was more beneficial than pharmacotherapy in the long term (median duration, 24 weeks [range, 12 to 48 weeks]; remission odds ratio, 1.82 [95% confidence interval (CI), 1.15–2.87]; [certainty of evidence: high]), while there was weaker evidence of benefit of combination against pharmacotherapy (1.71 [95% CI, 0.88–3.30: moderate]) and no clear difference of CBT‐I against combination (1.07 [95% CI, 0.63–1.80: moderate]). CBT‐I was associated with fewer dropouts than pharmacotherapy. Short‐term outcomes favored CBT‐I over pharmacotherapy except total sleep time. Given the average long‐term remission rate in the pharmacotherapy‐initiating arms of 28%, CBT‐I resulted in a long‐term remission rate of 41% (95% CI, 31%–53%) and combination 40% (95% CI, 25%–56%). Interpretation: The current study found that starting with CBT‐I for chronic insomnia leads to better outcomes than pharmacotherapy. Combination may be better than pharmacotherapy alone, but unlikely to be worth the additional burden over CBT‐I alone. [ABSTRACT FROM AUTHOR]

Purpose: To examine the dose‒response relationships of sedentary behavior (SB) and physical activities (PAs) with depression, and to explore the effects of replacing SB with PAs on depression risk. Methods: The study used data from UK Biobank aged 37 to 73 years. Light physical activity (LPA), moderate-to-vigorous activity (MVPA), sleep duration, and total sedentary behavior (TSB) were measured by accelerometers. Self-reported SB was also adopted when daily screen-sedentary behavior time (SSB) and leisure-sedentary behavior time (LSB) were the focus. Incident depression was obtained from the part of mental and behavioral disorders in the "first occurrence fields" of UK Biobank. A Cox proportional hazard model and isotemporal substitution model were performed to explore the associations of LPA, MVPA, TSB, LSB, SSB, and sleep on depression and the effects of replacing SB time with equal PA time. Results: Highest levels of MVPA (HR = 0.58, 95%CI: 0.50-0.68) were associated with decreased depression risk compared with the lowest level (Q1). Longer SSB time (HR = 1.18, 95%CI: 1.06-1.32), LSB time (HR = 1.19, 95%CI: 1.07-1.32), and TSB time (HR = 1.17, 95%CI: 1.00-1.38) could increase depression risk significantly. Replacing 1h/day TSB, SSB, and LSB with MVPA brought the greatest risk reductions [31% (HR = 0.69, 95%CI: 0.62-0.77), 30% (HR = 0.70, 95%CI: 0.65-0.77), and 29% (HR = 0.71, 95%CI: 0.65-0.77)]. Under the same conditions, the effects of LPA replacement were also significant, but weaker than those of MVPA. Subgroup analyses showed that replacing 1h/d TSB with LPA could significantly decrease the depression risk for the females, but not for the males. Conclusion: Large benefits for reducing the risk of incident depression could be attained by replacing a period of TSB, SSB, or LSB with equal PA time, especially for MVPA. Regular PA and less SB were recommended for improving mental health. [ABSTRACT FROM AUTHOR]

Purpose: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores. Methods: This study utilized self-reported survey data from 56,008 Canadian students (grades 7–12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10). Results: RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score. Conclusion: This study highlights RF's utility in identifying important correlates of adolescent depressive symptoms. RF's natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression. [ABSTRACT FROM AUTHOR]

Purpose: Delaying high school start times prolongs weekday sleep. However, it is not clear if longer sleep reduces depression symptoms and if the impact of such policy change is the same across groups of adolescents. Methods: We examined how gains in weekday sleep impact depression symptoms in 2,134 high school students (mean age 15.16 ± 0.35 years) from the Minneapolis metropolitan area. Leveraging a natural experiment design, we used the policy change to delay school start times as an instrument to estimate the effect of a sustained gain in weekday sleep on repeatedly measured Kandel-Davies depression symptoms. We also evaluated whether allocating the policy change to subgroups with expected benefit could improve the impact of the policy. Results: Over 2 years, a sustained half-hour gain in weekday sleep expected as a result of the policy change to delay start times decreased depression symptoms by 0.78 points, 95%CI (-1.32,-0.28), or 15.6% of a standard deviation. The benefit was driven by a decrease in fatigue and sleep-related symptoms. While symptoms of low mood, hopelessness, and worry were not affected by the policy on average, older students with greater daily screen use and higher BMI experienced greater improvements in mood symptoms than would be expected on average, signaling heterogeneity. Nevertheless, universal implementation outperformed prescriptive strategies. Conclusion: High school start time delays are likely to universally decrease fatigue and overall depression symptoms in adolescents. Students who benefit most with respect to mood are older, spend more time on screens and have higher BMI. [ABSTRACT FROM AUTHOR]

Acute mountain sickness (AMS) is a well‐studied illness defined by clinical features (e.g., headache and nausea), as assessed by the Lake Louise score (LLS). Although obvious in its severe form, early stages of AMS are poorly defined and easily confused with common travel‐related conditions. Measurement of hypoxaemia, the cause of AMS, should be helpful, yet to date its utility for identifying AMS susceptibility remains unclear. This study quantified altitude‐induced hypoxaemia in individuals during an ascent to 4800 m to determine the utility of nocturnal pulse oximetry measurements for prediction of AMS. Eighteen individuals (36 ± 16 years of age) ascended to 4800 m over 12 days. Symptomology of AMS was assessed each morning via LLS criteria, with participants categorized as either AMS‐positive (LLS ≥ 3 with headache) or AMS‐negative. Overnight peripheral oxygen saturations (ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$) were recorded continuously (1 Hz) using portable oximeters. Derivatives of these recordings were compared between AMS‐positive and ‐negative subjects (Mann–Whitney U‐test). Exploratory analyses (Pearson's) were conducted to investigate relationships between overnight parameters and AMS severity. Overnight derivatives, including ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, heart rate/ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, variance, oxygen desaturation index, hypoxic burden and total sleep time at <80% SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, all differed significantly between AMS‐positive and ‐negative subjects (all P < 0.01), with cumulative/relative frequency plots highlighting these differences visually. Exploratory analysis revealed that ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$ from 3850 m was correlated with peak LLS at 4800 m (r = 0.58–0.61). The findings highlight the potential for overnight oximetry to predict AMS susceptibility during ascent to high altitude. Further investigation is required to develop, evaluate and optimize predictive models to improve AMS management and prevention. What is the central question of this study?Early stages of acute mountain sickness are poorly defined, with existing assessment methods for the illness being highly ineffective. Can overnight pulse oximetry be used as a detection and prediction tool for deterioration in acute mountain sickness?What is the main finding and its importance?Overnight oximetry measurements from 3850 m were significantly correlated with acute mountain sickness severity at 4800 m (3 days later), whereas Lake Louise scores from the same time points were unrelated. These findings highlight the potential for pulse oximetry recorded from lower camps to be predictive of acute mountain sickness severity at higher altitude. [ABSTRACT FROM AUTHOR]