Sleep, recovery, and metaregulation: explaining the benefits of sleep

How different training sessions affect the sleep of professional soccer players

This study aimed to compare microcycle loading and sleep patterns concerning successive match days (MD) using objective measurements of sleep and external training load (eTL). Twenty professional female soccer players (mean age: 23.3 ± 3.5 years) were monitored using a multi-sensor sleep-tracker for sleep patterns and global positioning system devices for eTL. Sleep variables included total sleep time (TOTAL), awake time (AWAKE), REM sleep, deep sleep time (DEEP), light sleep time (LIGHT), percentage of sleep time spent moving (REST), and sleep onset latency (ONSET). eTL variables included total distance covered (TD), distance at various speed thresholds, accelerations (ACC3), and decelerations (DEC3). 1) eTL influenced sleep; 2) TOTAL and REM were reduced after high eTL sessions (MD-3); 3) MD-2 facilitated recovery and improved post-session sleep compared to MD-4 and MD-3; 4) post-session TOTAL and DEEP sleep times on MD-1 were shorter compared to pre-session times, but there was no difference in REM sleep. Additionally, DEEP had a negative correlation with eTL variables, while REST had a positive correlation with certain eTL variables. REM sleep was affected after high eTL sessions, indicating that fatigue negatively impacted sleep. However, sleep increased after lower eTL sessions. Players slept less with less DEEP sleep the day before a competition (MD-1 post-session sleep). Monitoring sleep during microcycle acquisition and loading phases could assess sleep changes. Strategies should be implemented to improve sleep during loading phases and the night before matches.

Relationship between physical activity and sleep habits with motor proficiency among school aged children in Iran

Despite the importance of basic motor skills in preschool and elementary school children for developing specialized skills in adulthood, the factors influencing motor proficiency have not yet been fully identified, and there are contradictory findings regarding the influencing factors. Therefore, the present study aims to investigate the relationship between physical activity and sleep habits with motor proficiency among school aged children in Iran. In this descriptive and analytical cross-sectional study, 403 school-aged children living in Bushehr were selected using cluster random sampling method. Data collection tools included demographic form, physical activity questionnaire for older children, children's sleep habits questionnaire, anthropometric measurements and short-form Bruininks-Oseretsky test of motor proficiency. The data were analyzed using SPSS 19.0, descriptive statistics and analytical tests (simple and multiple univariate regression). The significance level was considered less than 0.05 in all cases. The mean age of the children participating in the study was 9.65 ± 1.72 years. Approximately half of the children (46.5%) were classified as overweight and obese. The simple regression analysis showed a significant statistical correlation between motor proficiency and child's age, parent's age, number of siblings, BMI and physical activity (P < 0.05). The multiple regression analysis results indicated a significant correlation between motor proficiency and child's age (β = 0.462, P < 0.001), gender (β = 0.145, P = 0.001) and BMI (β = - 0.157, P < 0.001). Children with a higher BMI, younger age and female gender exhibited a lower level of motor proficiency. The obtained findings are of particular importance for raising awareness of school officials and health policymakers about various aspects of health such as growth and motor development, and developing necessary strategies to enhance girls' motor development and prevent obesity.

Simultaneous activation of different subtypes of dopamine receptors may lead to activation of homeostatic sleep regulatory mechanisms

Dopaminergic system gains importance in homeostatic sleep regulation, but the role of different dopamine receptors is not well-defined. 72 h rat electrocorticogram and sleep recordings were made after single application of dopaminergic drugs in clinical use or at least underwent clinical trials. The non-selective agonist apomorphine evoked short pharmacological sleep deprivation with intense wakefulness followed by pronounced sleep rebound. D2 agonist bromocriptine induced moderate and extended increase in wakefulness without a homeostatic sleep replacement but downregulated slow wave sleep need for 72 h. Selective D1 agonist SKF-38393 failed to induce enhanced waking sufficient for sleep replacement. High-dose D2 antagonism by sulpiride temporarily enhanced wakefulness. All drugs evoked extended (72 h) sleep changes after single application. Opposite sleep changes could be seen after the application of different doses in case of both bromocriptine and sulpiride. Theta, beta and gamma power reflected intensity differences in drug-induced wakefulness stages. Apomorphine- and high sulpiride dose-induced waking showed elevated power in all three frequency bands. Bromocriptine-induced wakefulness dominated by beta activity. Enhancement of more, than one type of electrocorticogram activities during wakefulness was a prerequisite for the activation of sleep homeostasis. According to present data, D1- or D2-like receptor agonism are not separately involved in the homeostatic regulation of slow wave sleep. Simultaneous and non-selective agonism on DA receptors is the most effective way to elicit intense W, which is followed by slow wave sleep rebound. REM sleep rebound could be evoked by D2 agonism. Rebound indicates the activation of homeostatic sleep regulation, but with unknown exact mechanisms.

Relationship Between Poor Sleep Quality and Body Mass Index Among University Students at Imam Mohammad Ibn Saud Islamic University

Introduction A chronic lack of sleep can lead to physical exhaustion, negatively affecting university students' academic performance. The relationship between insufficient sleep and increased body mass index (BMI) has garnered significant attention. Obesity, weight fluctuations, and cognitive conditions contribute to poor sleep quality. Aim The aim of this study was to investigate the correlation between poor sleep quality and BMI, which may negatively impact academic performance among university students at Imam Mohammad Ibn Saud Islamic University (IMSIU) in Riyadh, Saudi Arabia. The study also explores whether changes in weight and cognitive status are linked to poor sleep quality. Subject and methods This cross-sectional study was conducted among 1297 university students from IMSIU. A self-administered questionnaire was distributed among students using an online survey. The questionnaire included sociodemographic questions, sleep quality assessed through the Pittsburgh Sleep Quality Index (PSQI), and four subjective questions regarding weight and cognitive status changes over the last month. The study spanned from September 2021 to May 2023. The study utilized the chi-square test and a subsequent multivariate analysis to examine the correlation between poor sleep quality and high BMI, weight changes, and cognitive effects among students. Results The 1297 students were from various disciplines under science and humanities; 70.8% were females, and 48% were aged between 17 and 20 years old. Around 13.6% of students were obese, and 85.3% had sleep problems. In univariate analysis, the factors that influence poor sleep quality were high BMI, experiencing weight loss or weight gain, and experiencing cognitive effects like difficulty concentrating. In a multivariate regression model, experienced weight loss, weight gain, and cognitive effects were identified as the significant independent predictors of poor sleep. Conclusion The incidence of poor sleep among university students was high. The study identified increased BMI, weight loss, weight gain, and cognitive dysfunction due to lack of sleep as the influential factors in poor sleep quality. This study highlights the need for targeted interventions to improve sleep hygiene and promote physical well-being programs in this population.

The impact of COVID-19 pandemic on sleep duration and mental health among middle school students: a 3-year cross-sectional survey

Background

Since the outbreak of COVID-19 in late 2019, and until the Chinese government downgraded the pandemic control measures to Category B management in January 2023, various epidemic prevention measures were implemented across regions based on the local spread of the virus. Correspondingly, educational formats shifted between online and offline teaching according to the pandemic situation. Changes in daily life and teaching methods, along with the high initial mortality rate of COVID-19, have had varying degrees of negative impact on the mental health (MH) of adolescents.

Purposes

This study aimed to explore the impact of the COVID-19 pandemic status on the sleep duration (SD) and MH of adolescents, investigate the relationship between SD and MH in middle school students, and evaluate the protective effect of SD on MH.

Methods

Using a convenient sampling method, 6 junior high schools and 3 senior high schools in Guiyang City, China, were selected. Random samples from two classes per grade in each school were chosen for the survey. The study was conducted annually for three consecutive years using the Mental Health Inventory of Middle-school students (MMHI-60) scale and a self-designed questionnaire. Data were analyzed using IBM SPSS version 26.0 software, employing ANOVA, cross-tabulation, and generalized linear models to examine the relationship between SD and MH scores.

Results

The SD and MH scores of middle school students in 2021, 2022, and 2023 were 436.41 ± 71.21 min/day, 423.69 ± 61.71 min/day, and 445.26 ± 65.04 min/day (F = 41.44, p < 0.001), 1.72 ± 0.63, 1.87 ± 0.73, and 1.79 ± 0.67 (F = 18.31, p < 0.001). The SD compliance rates were 34.1%, 23.9%, and 33.2%, and the MH problem detection rates were 27.9%, 36.4%, and 33.4%, respectively; there is a significant correlation between SD and MH scores among middle school students (P < 0.001); the protective effects of SD compliance on MH were 1.859 times, 2.156 times, and 1.516 times higher than those of SD non-compliance (all p < 0.001).

Conclusion

Meeting the SD standard is a protective factor for adolescent MH. The COVID-19 pandemic and its control measures have had a severe and long-term negative impact on both SD and MH in middle school students, with differences observed between genders and academic levels. The greater the severity of the pandemic and the stricter the control measures, the more significant the negative impact on SD and MH etc.

[Sleep deprivation and the development of oxidative stress in animal models]

OBJECTIVE

To study the features and mechanisms of development of oxidative stress in animal models during sleep deprivation.

MATERIAL AND METHODS

The experiments were carried out on 6-month-old male rats (n=60), which were divided equally into 3 groups. Group 1 included intact animals, groups 2 and 3 were subjected to modeling of chronic sleep deprivation using the method of cyclic sleep restriction. Animals of group 3, in addition to the standard diet, received resveratrol (10 mg/kg, intragastric) daily. On days 0, 1, 3 and 5 of the experiment, the activity of antioxidant enzymes and the concentration of peroxidation products in the blood serum was assessed.

RESULTS

Sleep deprivation in animal models causes an intensification of oxidative processes (increased concentrations of malondialdehyde and diene conjugates) and a decrease in the activity of antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase, glutathione reductase).

CONCLUSION

Sleep deprivation contributes to the accumulation of highly toxic products of lipid peroxidation in the body tissues, which is reflected in metabolic disorders, and a decrease in adaptive capabilities. Additional administration of resveratrol helps to reduce the amplitude of fluctuations in redox balance, which can be considered as a possible way to correct oxidative stress and prevent disorders associated with sleep restriction and dysregulation of the sleep-wake cycle.

The Use of Principal Component Analysis for Reduction in Sleep Quality and Quantity Data in Female Professional Soccer

The main aim of the present study was to uncover multivariate relationships between sleep quantity and quality using principal component analysis (PCA) in professional female soccer players. A second aim was to examine the extent to which objective sleep quantity and quality variables can discriminate between perceived sleep. Ten objective sleep variables from the multisensory sleep-tracker were analyzed. PCA was conducted on the sleep variables, and meaningful principal components (PCs) were identified (eigenvalue > 2). Two sleep PCs were identified, representing the 'quantity of sleep' (quantity PC: eigenvalue = 4.1 and variance explained = 45.1%) and the 'quality of sleep' (quality PC: eigenvalue = 2.4 and variance explained = 24.1%). Cluster analysis grouped the players' sleep into three types: long and efficient, short and efficient, and long and inefficient; however, no association was found between the perceived sleep and the sleep clusters. In conclusion, a combination of both quantity and quality sleep metrics is recommended for sleep monitoring of professional female soccer players. Players should undergo a training process to improve self-assessment of sleep quality recorded from a subjective questionnaire, contrasting the perceived information with the sleep quality recorded objectively during a defined period in order to optimize the validity of their perceptions. The aim is to optimize the validity of their perceptions of sleep quality.

Translation and validation of sleep questionnaires in Jordanian and Qatari athletes

PURPOSE

To translate two prominent sleep questionnaires, the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10) and the Sleep Hygiene Index (SHI), into Arabic.

METHODS

The translations adhered to the established international criteria and underwent subsequent validation among 130 Arabic-speaking athletes from Jordan and Qatar. The validation process involved comparison against existing Arabic sleep questionnaires to ensure linguistic and cultural appropriateness.

RESULTS

Of the 130 participants, 70 completed the test-retest for FOSQ and 58 the test-retest for the SHI. The internal consistency reliability was excellent for the Arabic FOSQ-10 (0.824) and the Arabic SHI (0.892). The assessment of test-retest reliability of the total score for both measures showed that the Arabic FOSQ-10 had moderate reliability (ICC = 0.468, 95% CI = 0.263-0.633), whereas the Arabic SHI had excellent reliability (ICC = 0.952, 95% CI = 0.921-0.972). Both newly developed Arabic sleep measures had significant associations with almost all other established Arabic sleep questionnaires, indicating good validity. Exploratory factor analysis identified 5 factors for FOSQ and 3 factors for SHI, with significant loadings indicating distinct domains related to sleepiness, tiredness, discomfort, behavior, and sleep patterns. Confirmator factor analysuis confirmed these factors for both FOSQ and SHI, though the RMSEA values (0.132 for FOSQ and 0.171 for SHI).

CONCLUSIONS

the Arabic FOSQ-10 and the Arabic SHI were established and showed satisfactory reliability and validity in athletes. Further studies are needed to validate those measures in Arabic clinical populations.

Current Trends in Virtual Exercise Interventions Among People With Disabilities: A Scoping Review

Objective

To analyze existing literature on virtual exercise interventions delivered to people with disabilities to assess effectiveness, efficiency, usability, satisfaction, and feasibility, and describe current trends that aimed to improve health outcomes among people with disabilities.

Data Sources

CINAHL, MEDLINE, and PsycINFO were searched.

Study Selection

Articles were included if they were (1) incorporated a virtual exercise intervention including people with physical disabilities and mobility limitations aged 18 years and older and (2) published between the years of 2009-August 14, 2024 with free access to full-text, peer-reviewed papers; and (3) published in English. Exclusion criteria: (1) unrelated to disability; (2) non-peer-reviewed articles; (3) protocol or review papers; (4) study focused on virtual exercise through perspective other than that of the participant; (5) study's primary objectives were not related to physical functioning and/or rehabilitation; and (6) study used only qualitative methods.

Data Extraction

A single search was conducted from January 2023 and ceased on August 14, 2023. Duplicate records were pulled from the article search within each database; article abstracts were assessed; and finally, full-text articles were retained upon meeting inclusion criteria. The primary researcher conducted the initial search, while 2 independent reviewers, J.R. and J.W., assisted with and confirmed article extraction.

Data Synthesis

Thirty-seven articles were included. Trends were explained by recapitulating statistically significant results per study among each disability group and virtual exercise delivery mode, exercise type, and intervention synchronicity.

Conclusions

More facilitators, satisfaction, usability, and perceived benefits were reported when compared to reported barriers among people with physical disabilities and mobility limitations who participated in virtual exercise interventions.

Refining sleep staging accuracy: transfer learning coupled with scorability models

STUDY OBJECTIVES

This study aimed to (1) improve sleep staging accuracy through transfer learning (TL), to achieve or exceed human inter-expert agreement and (2) introduce a scorability model to assess the quality and trustworthiness of automated sleep staging.

METHODS

A deep neural network (base model) was trained on a large multi-site polysomnography (PSG) dataset from the United States. TL was used to calibrate the model to a reduced montage and limited samples from the Korean Genome and Epidemiology Study (KoGES) dataset. Model performance was compared to inter-expert reliability among three human experts. A scorability assessment was developed to predict the agreement between the model and human experts.

RESULTS

Initial sleep staging by the base model showed lower agreement with experts (κ = 0.55) compared to the inter-expert agreement (κ = 0.62). Calibration with 324 randomly sampled training cases matched expert agreement levels. Further targeted sampling improved performance, with models exceeding inter-expert agreement (κ = 0.70). The scorability assessment, combining biosignal quality and model confidence features, predicted model-expert agreement moderately well (R² = 0.42). Recordings with higher scorability scores demonstrated greater model-expert agreement than inter-expert agreement. Even with lower scorability scores, model performance was comparable to inter-expert agreement.

CONCLUSIONS

Fine-tuning a pretrained neural network through targeted TL significantly enhances sleep staging performance for an atypical montage, achieving and surpassing human expert agreement levels. The introduction of a scorability assessment provides a robust measure of reliability, ensuring quality control and enhancing the practical application of the system before deployment. This approach marks an important advancement in automated sleep analysis, demonstrating the potential for AI to exceed human performance in clinical settings.

Health promoting resources and lifestyle factors among higher education students in healthcare and social work programmes: a survey with a longitudinal multicentre design

BACKGROUND

It has been suggested that the university environment, to improve students' health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work.

METHODS

This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions.

RESULTS

The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems.

CONCLUSIONS

Students' report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality.

Serum cotinine levels and adolescents' sleep health outcomes from NHANES 2005 to 2018

The association between tobacco smoke exposure and sleep has been widely discussed, but the correlation between serum cotinine levels and sleep health outcomes in adolescents has not been well described. This study aimed to further evaluate the association between serum cotinine levels and sleep health outcomes in adolescents using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. This cross-sectional study included participants aged 16-19 years from the NHANES 2005-2018. A weighted multivariate logistic regression model was used for the primary analysis. A restricted cubic spline (RCS) model was employed to investigate the non-linear association between serum cotinine levels and trouble sleeping. Subgroup analyses based on population characteristics were also conducted. In total, 2630 participants were included, which are representative of the 11.5 million US adolescents. Higher serum cotinine levels (≥ 3 ng/ml) were significantly associated with trouble sleeping in the fully adjusted model (odds ratio [OR] 1.817). The RCS model revealed a non-linear relationship between serum cotinine levels and trouble sleeping. Subgroup analyses indicated that this relationship was consistent and stable across various population characteristics. Serum cotinine levels are associated with sleep health outcomes in adolescents, with high serum cotinine levels being linked to increased trouble sleeping and longer or shorter sleep duration.

Predicting Sleep Quality through Biofeedback: A Machine Learning Approach Using Heart Rate Variability and Skin Temperature

Sleep quality (SQ) is a crucial aspect of overall health. Poor sleep quality may cause cognitive impairment, mood disturbances, and an increased risk of chronic diseases. Therefore, assessing sleep quality helps identify individuals at risk and develop effective interventions. SQ has been demonstrated to affect heart rate variability (HRV) and skin temperature even during wakefulness. In this perspective, using wearables and contactless technologies to continuously monitor HR and skin temperature is highly suited for assessing objective SQ. However, studies modeling the relationship linking HRV and skin temperature metrics evaluated during wakefulness to predict SQ are lacking. This study aims to develop machine learning models based on HRV and skin temperature that estimate SQ as assessed by the Pittsburgh Sleep Quality Index (PSQI). HRV was measured with a wearable sensor, and facial skin temperature was measured by infrared thermal imaging. Classification models based on unimodal and multimodal HRV and skin temperature were developed. A Support Vector Machine applied to multimodal HRV and skin temperature delivered the best classification accuracy, 83.4%. This study can pave the way for the employment of wearable and contactless technologies to monitor SQ for ergonomic applications. The proposed method significantly advances the field by achieving a higher classification accuracy than existing state-of-the-art methods. Our multimodal approach leverages the synergistic effects of HRV and skin temperature metrics, thus providing a more comprehensive assessment of SQ. Quantitative performance indicators, such as the 83.4% classification accuracy, underscore the robustness and potential of our method in accurately predicting sleep quality using non-intrusive measurements taken during wakefulness.

Revolutionizing Sleep Health: The Emergence and Impact of Personalized Sleep Medicine

Personalized sleep medicine represents a transformative shift in healthcare, emphasizing individualized approaches to optimizing sleep health, considering the bidirectional relationship between sleep and health. This field moves beyond conventional methods, tailoring care to the unique physiological and psychological needs of individuals to improve sleep quality and manage disorders. Key to this approach is the consideration of diverse factors like genetic predispositions, lifestyle habits, environmental factors, and underlying health conditions. This enables more accurate diagnoses, targeted treatments, and proactive management. Technological advancements play a pivotal role in this field: wearable devices, mobile health applications, and advanced diagnostic tools collect detailed sleep data for continuous monitoring and analysis. The integration of machine learning and artificial intelligence enhances data interpretation, offering personalized treatment plans based on individual sleep profiles. Moreover, research on circadian rhythms and sleep physiology is advancing our understanding of sleep's impact on overall health. The next generation of wearable technology will integrate more seamlessly with IoT and smart home systems, facilitating holistic sleep environment management. Telemedicine and virtual healthcare platforms will increase accessibility to specialized care, especially in remote areas. Advancements will also focus on integrating various data sources for comprehensive assessments and treatments. Genomic and molecular research could lead to breakthroughs in understanding individual sleep disorders, informing highly personalized treatment plans. Sophisticated methods for sleep stage estimation, including machine learning techniques, are improving diagnostic precision. Computational models, particularly for conditions like obstructive sleep apnea, are enabling patient-specific treatment strategies. The future of personalized sleep medicine will likely involve cross-disciplinary collaborations, integrating cognitive behavioral therapy and mental health interventions. Public awareness and education about personalized sleep approaches, alongside updated regulatory frameworks for data security and privacy, are essential. Longitudinal studies will provide insights into evolving sleep patterns, further refining treatment approaches. In conclusion, personalized sleep medicine is revolutionizing sleep disorder treatment, leveraging individual characteristics and advanced technologies for improved diagnosis, treatment, and management. This shift towards individualized care marks a significant advancement in healthcare, enhancing life quality for those with sleep disorders.

Exploring the Role of Circadian Rhythms in Sleep and Recovery: A Review Article

Sleep is essential for every living organism. Humans spend about one-third of their lives sleeping. Sleep has been studied extensively, and the role of sleep in psychological, mental, and physical well-being is established to be the best. The rhythm of the brain between wakefulness and sleep is called the circadian rhythm, which is mainly controlled by melatonin and the pineal gland. The imbalance of this rhythm can lead to devastating effects on health. Vigorous workouts close to bedtime can interfere with falling asleep. Meal timing and composition can significantly affect sleep quality. It is advised to avoid large meals, caffeine, and alcohol before bedtime. Heavy meals close to bedtime can lead to poor sleep and hormone disruption. By following these guidelines enumerated in the article, individuals can improve sleep quality and overall health. Sleep cycles, especially rapid eye movement sleep, have a profound influence on mental and physical health. Adhering to recommended sleep practices enhances bodily restoration, fortifies the immune system, and upholds metabolic equilibrium. Sleep hygiene aligned with circadian rhythms is crucial for disease prevention and well-being. Healthcare professionals should prioritize sleep optimization strategies for patient care and public health.

Assessment of Dietary and Lifestyle Quality among the Romanian Population in the Post-Pandemic Period

BACKGROUND

The pandemic caused by the SARS-CoV-2 virus demonstrated the importance of prevention through a healthy diet and lifestyle, the most vulnerable people being those with severe chronic conditions, those who are overweight, and those with an unbalanced immune system. This study aims to examine the nutritional status and lifestyle behaviors of the Romanian population.

METHODS

The evaluation of the eating habits and lifestyle of the Romanian population in the post-pandemic period was carried out based on a cross-sectional observational study with the help of a questionnaire.

RESULTS

A total of 4704 valid answers were registered (3136 female and 1568 male respondents). Among the respondents, most of them belong to the young population, 2892 between the ages of 18 and 40, i.e., 61.5%. Most male respondents are overweight (1400) and obese (780). Most respondents indicated a tendency to consume 1-2 meals per day irregularly (p = 0.617). Only 974 respondents adopted a healthy diet, and 578 a healthy lifestyle.

CONCLUSIONS

The present study reports low adherence to a healthy diet (20.7%) and healthy lifestyle (12.28%), especially among the young population (<30 years). In the current context, it reports a reduced tendency to consume vegetables and fruits among the population, below the daily average recommended by the nutrition guidelines, a tendency towards sedentary behavior, and even deficient hydration of some of the respondents; these negative aspects can create a long-term series of nutritional and psycho-emotional imbalances. Our results evidence that complex surveys among the population are regularly required to investigate nutritional or lifestyle deficiencies; moreover, it could be helpful in further educational measures in nutrition, food, and environmental safety.

Factors Influencing the Subjective Health and Physical Fitness Perceptions of Korean Adolescents

Background

Adolescence is an important period of growth and development. We aimed to analyz the factors affecting the subjective health and physical fitness perceptions of Korean adolescents.

Methods

This cross-sectional study used data from 2,599 Korean adolescents who participated in the Korea National Life and Sports Surveys during 2020-2022, along with secondary data analysis. The study included frequency analysis of the demographic variables and chi-square tests to examine the relationship between the variables and subjective health and fitness perceptions. Multivariate logistic regression was also used to explore the factors affecting adolescent subjective perceptions.

Results

The study revealed significant factors influencing health perceptions in Korean adolescents, including male gender, lack of regular physical activity, adequate rest, adherence to a consistent diet, and use of nutritional supplements (P<0.05).

Conclusion

Key factors, such as rest, diet, and nutritional supplements should be considered while developing policies that support adolescent health. Unfortunately, there has been a decline in the physical activity of adolescents in Korea. Therefore, a variety of physical activity programs that consider the characteristics of each student need to be developed to address adolescent health issues.

Sleep: Giving it up to get it on

A new study presents evidence of sex-related sleep reduction in males of two marsupial mice species but not in females. The growing experimental data suggest that seasonal sleep reduction, linked to migrations and reproductive periods, is common among animals.

Obstructive sleep apnea treatment improves temporomandibular disorder pain

PURPOSE

The existence of a bidirectional relationship between poor sleep and pain intensity has been studied, and good sleep quality has been found to be a key factor underlying pain control. The purpose of this prospective cohort study was to observe if OSA treatment provides a reduction in temporo-mandibular disorder (TMD) pain and headache attributed to TMD in patients with obstructive sleep apnea (OSA) after 18 months of OSA treatment.

METHODS

A prospective cohort study was conducted on consecutive patients suffering from OSA. Patients underwent polysomnography and TMD examination according to the DC/TMD protocol at baseline and after 18 months. Intensity of TMD pain and headache attributed to TMD were analyzed.

RESULTS

Of 40 patients (31 men, mean age 51.3 ± 10.3 years), 33 underwent OSA treatment. At the follow-up examination after 18 months, significant improvements in the intensity of pain-related TMD and headache attributed to TMD were observed (p < 0.05). Seven patients did not start treatment for OSA or discontinued treatment. These patients did not show any significant difference in intensity of TMD-pain or headache attributed to TMD after 18 months (p > 0.05).

CONCLUSIONS

Significant reductions in intensity of pain-related TMD and headache attributed to TMD were observed in patients with OSA after 18 months of OSA treatment onset, while no difference was observed in subjects not undergoing or discontinuing OSA treatment.

TRIAL REGISTRATION

The protocol was registered on ClinicalTrials.gov database with number NCT04948541.

Beneficial Effects of Photoperiod Lengthening on Sleep Characteristics and Mechanical Hyperalgesia in Injured Rats

Sleep and muscle injury-related pain are in negative relationship, and sleep extension may be a favorable countermeasure. In response to muscle injury, an adaptive sleep response has been described in rats, characterized by an increase in total sleep time (TST) and nonrapid eye movement (NREM) sleep. This study examined the effects of photoperiod lengthening (a model of sleep prolongation in rats) on the sleep characteristics of muscle-injured rats and whether this lengthening could benefit injury-induced mechanical hyperalgesia using the Von Frey test. Switching from the conventional 12:12 light/dark (LD) photoperiod (light on: 08:00-20:00) to LD 16:8 (light extended to 24:00) gives rats an extra window of sleep. Our results show higher TST and NREM sleep times in LD 16:8 versus LD 12:12 injured rats during 4 h of light lengthening for 7 d postinjury, showing the efficiency of photoperiod lengthening to increase sleep time in injured rats. In addition, a cumulative effect with the adaptive sleep response to muscle injury occurred with higher TST and NREM sleep times in LD 16:8 injured versus noninjured rats during the dark period, reflecting the high need for sleep after the injury. Greater stability and higher relative delta power of NREM sleep during the extended light period were also observed in injured rats. Finally, the extended photoperiod limits the muscle injury-induced mechanical hyperalgesia for 13 d and allows faster recovery of the baseline mechanical threshold. This is associated with reduced pro-inflammatory cytokines levels in the hippocampus, a brain structure involved in pain processing.

Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers

Objective

This study examines factors predicting self-reported voice symptoms in call center workers.

Methods

Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed.

Results

Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment.

Limitations

This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis.

Value

This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders.

Conclusion

Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.

Sleep quality and comfort in fully automated vehicles: A comparison of two seat configurations

As autonomous driving technology advances, the possibility of using vehicles as sleeping environments becomes increasingly relevant. To investigate the feasibility of this concept, a sleep study was conducted with twelve participants who were given a 4-h opportunity window to sleep in both reclined and flat seat configurations. The evaluation involved both objective measures, including polysomnographic (PSG) data analysis, and subjective measures through questionnaires, assessing sleep quality and comfort. While the sleep quantity results were comparable between the two sleeping positions, the reclined position showed a slight advantage in sleep quantity (TST and WASO). Interestingly, a trend highlighting a possible difference was found between the seat positions regarding non-rapid eye movement stage 3 (NREM 3). NREM 3 tended to be in a higher proportion of total sleep time in the flat seat position. Sleep onset latency (SOL) also showed a trend of a shorter latency by participants in the flat position. Additionally, most participants reported a preference for the flat position over the reclined position. These findings suggest that a flat seat configuration could offer a more comfortable and restful sleep environment for passengers in autonomous vehicles.

Autogenous cerebral processes: an invitation to look at the brain from inside out

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualize autogenous cerebral processes (ACPs) as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus-response dynamics, are ACP-driven.

A wearable EEG system for closed-loop neuromodulation of sleep-related oscillations

Objective.Healthy sleep plays a critical role in general well-being. Enhancement of slow-wave sleep by targeting acoustic stimuli to particular phases of delta (0.5-2 Hz) waves has shown promise as a non-invasive approach to improve sleep quality. Closed-loop stimulation during other sleep phases targeting oscillations at higher frequencies such as theta (4-7 Hz) or alpha (8-12 Hz) could be another approach to realize additional health benefits. However, systems to track and deliver stimulation relative to the instantaneous phase of electroencephalogram (EEG) signals at these higher frequencies have yet to be demonstrated outside of controlled laboratory settings.Approach.Here we examine the feasibility of using an endpoint-corrected version of the Hilbert transform (ecHT) algorithm implemented on a headband wearable device to measure alpha phase and deliver phase-locked auditory stimulation during the transition from wakefulness to sleep, during which alpha power is greatest. First, the ecHT algorithm is implementedin silicoto evaluate the performance characteristics of this algorithm across a range of sleep-related oscillatory frequencies. Secondly, a pilot sleep study tests feasibility to use the wearable device by users in the home setting for measurement of EEG activity during sleep and delivery of real-time phase-locked stimulation.Main results.The ecHT is capable of computing the instantaneous phase of oscillating signals with high precision, allowing auditory stimulation to be delivered at the intended phases of neural oscillations with low phase error. The wearable system was capable of measuring sleep-related neural activity with sufficient fidelity for sleep stage scoring during the at-home study, and phase-tracking performance matched simulated results. Users were able to successfully operate the system independently using the companion smartphone app to collect data and administer stimulation, and presentation of auditory stimuli during sleep initiation did not negatively impact sleep onset.Significance.This study demonstrates the feasibility of closed-loop real-time tracking and neuromodulation of a range of sleep-related oscillations using a wearable EEG device. Preliminary results suggest that this approach could be used to deliver non-invasive neuromodulation across all phases of sleep.

Causal influence of sleeping phenotypes on the risk of coronary artery disease and sudden cardiac arrest: A Mendelian randomization analysis

OBJECTIVES

To assess the causal influence of sleep and circadian traits on coronary artery disease and sudden cardiac arrest with adjustment for obesity through a two-sample Mendelian randomization study.

METHODS

We used summary statistics of 5 sleep and circadian traits for genome-wide association studies, including chronotype, sleep duration, long sleep (≥9 h a day), short sleep (<7 h a day), and insomnia (sample size range: 237,622-651,295). Coronary artery disease genome-wide association studies with 60,801 cases and 123,504 controls, sudden cardiac arrest genome-wide association studies with 3939 cases and 25,989 controls, and obesity genome-wide association studies with 806,834 individuals were also used. Multivariable Mendelian randomization was performed to estimate the causality.

RESULTS

After adjusting for obesity, genetically predicted short sleep (odds ratio = 1.87 and p = .02), and genetically predicted insomnia (odds ratio = 1.17 and p = .001) were causally associated with increased odds of coronary artery disease. Genetically predicted long sleep (odds ratio = 0.06 and p = .02) and genetically predicted longer sleep duration (odds ratio = 0.36 for per-hour increase in sleep duration and p = .0006) were causally associated with decreased odds of sudden cardiac arrest.

CONCLUSIONS

The findings of this Mendelian randomization study indicate that insomnia and short sleep contribute to the development of coronary artery disease, whereas a longer sleep duration protects from sudden cardiac arrest, independent of the influence of obesity. The mechanisms underlying these associations warrant further investigation.

Sleep Deprivation-Induced Oxidative Stress in Rat Models: A Scoping Systematic Review

Sleep deprivation is highly prevalent in the modern world, possibly reaching epidemic proportions. While multiple theories regarding the roles of sleep exist (inactivity, energy conservation, restoration, brain plasticity and antioxidant), multiple unknowns still remain regarding the proposed antioxidant roles of sleep. The existing experimental evidence is often contradicting, with studies pointing both toward and against the presence of oxidative stress after sleep deprivation. The main goals of this review were to analyze the existing experimental data regarding the relationship between sleep deprivation and oxidative stress, to attempt to further clarify multiple aspects surrounding this relationship and to identify current knowledge gaps. Systematic searches were conducted in three major online databases for experimental studies performed on rat models with oxidative stress measurements, published between 2015 and 2022. A total of 54 studies were included in the review. Most results seem to point to changes in oxidative stress parameters after sleep deprivation, further suggesting an antioxidant role of sleep. Alterations in these parameters were observed in both paradoxical and total sleep deprivation protocols and in multiple rat strains. Furthermore, the effects of sleep deprivation seem to extend beyond the central nervous system, affecting multiple other body sites in the periphery. Sleep recovery seems to be characterized by an increased variability, with the presence of both normalizations in some parameters and long-lasting changes after sleep deprivation. Surprisingly, most studies revealed the presence of a stress response following sleep deprivation. However, the origin and the impact of the stress response during sleep deprivation remain somewhat unclear. While a definitive exclusion of the influence of the sleep deprivation protocol on the stress response is not possible, the available data seem to suggest that the observed stress response may be determined by sleep deprivation itself as opposed to the experimental conditions. Due to this fact, the observed oxidative changes could be attributed directly to sleep deprivation.

Psychological torture: definitions, clinical sequelae and treatment principles

Psychological torture, in its broadest sense, is the intentional infliction of suffering without resorting to direct physical violence, in what is known as 'no-touch' torture. While several other definitions of psychological torture have been suggested, there is no one precise definition. Given the rapidly evolving current global political climate and the intensification of conflict, war and asylum seeking, the need for better recognition of psychological torture among clinicians, followed by the provision of appropriate treatment support for victims, has become increasingly pertinent. This article raises awareness of the concept of psychological torture among clinicians, through an overview of its debated definitions, the modalities which constitute this form of torture, and its clinical sequelae and treatment approach.

Attenuation of homeostatic sleep response and rest-activity circadian rhythm in vitamin D deficient mice

The link between vitamin D deficiency (VDD) and sleep disturbances has long been suggested. However, the direct causality between VDD, sleep disturbances, and circadian rhythm remains unclear. We aimed to characterize sleep-wake behavior and circadian rhythms in an animal model of VDD. VDD was induced by feeding vitamin D-deficient chow, and we analyzed sleep and circadian rhythm parameters. During light period, VDD mice exhibited reduced wake with more frequent wake bouts and increased NREM sleep time. However, during dark period, the wake EEG power spectrum peaked at theta band frequency, and slow-wave energy was suppressed in mice with VDD. Rest-activity analyses revealed increased circadian period, lower wheel counts, and more frequent and short activity bouts during VDD. Combining sleep and circadian data, we found significantly suppressed activities during the hours with a wake duration shorter than 30 minutes. Moreover, mice in VDD state exhibited a negative correlation between wake theta power and hourly wheel-running counts during dark period. Our data point to a direct link between VDD and disturbances in sleep and rest-activity circadian rhythm, featuring frequent wake bouts during the sleeping phase, reduced sleep pressure build-up in dark period, and reduced activity levels due to increased susceptibility to sleepiness.

The Correlation of Sleep Disturbance and Location of Glioma Tumors: A Narrative Review

Sleep disturbance can occur when sleep centers of the brain, regions that are responsible for coordinating and generating healthy amounts of sleep, are disrupted by glioma growth or surgical resection. Several disorders cause disruptions to the average duration, quality, or patterns of sleep, resulting in sleep disturbance. It is unknown whether specific sleep disorders can be reliably correlated with glioma growth, but there are sufficient numbers of case reports to suggest that a connection is possible. In this manuscript, these case reports and retrospective chart reviews are considered in the context of the current primary literature on sleep disturbance and glioma diagnosis to identify a new and useful connection which warrants further systematic and scientific examination in preclinical animal models. Confirmation of the relationship between disruption of the sleep centers in the brain and glioma location could have significant implications for diagnostics, treatment, monitoring of metastasis/recurrence, and end-of-life considerations.

Sleep Deprivation in Middle Age May Increase Dementia Risk: A Review

Neurodegenerative diseases present increasing interest in clinical practice for the aging population and involve dysregulation of sleep-wake behaviors. Approximately 5.8 million adults aged 65 and older were living with Alzheimer's disease (AD) in the United States in 2020 with increased mortality compared to the declining cardiovascular and cancer death rates. We conducted an extensive literature review to evaluate and synthesize evidence regarding the association between short sleep duration or sleep deprivation and the risk of developing all-cause dementia and Alzheimer's disease. There are multiple mechanisms describing brain damage, such as brain hypoxia, oxidative stress, or blood-brain barrier (BBB) impairment, induced by chronic sleep restriction (CSR) and the potential correlation with future cognitive decline and dementia. More studies are necessary to identify the specific factors involved in the sleep loss-cognitive decline association that could be taken into consideration while elaborating recommendations for dementia prevention measures.

The Effects of Recovery Sleep on Experimental Pain

Recent research suggests that recovery sleep (RS) has the potential to restore pain sensitivity and modulation after hyperalgesia due to preceding sleep deprivation. However, it has not yet been systematically examined whether the restoration of these pain parameters is driven by sleep characteristics of RS. Thus, the present study assessed changes in experimental pain during RS after total sleep deprivation (TSD) to test whether RS parameters predicted the restoration of the pain system. Thirty healthy participants completed one night of habitual sleep, one night of TSD and a subsequent recovery night. At-home sleep during baseline and recovery was assessed using portable polysomnography and a questionnaire. Before and after each night pressure pain thresholds (PPTs), temporal pain summation (TSP) and conditioned pain modulation (CPM) were assessed. PPTs decreased after TSD and increased following RS, indicating a restoration of pain sensitivity after hyperalgesia. RS characteristics did not predict this restoration, suggesting other mechanisms (eg, changes in serotonergic activity) underlying the observed pain changes. TSP indicated a lack of effect of experimental sleep manipulations on excitatory processes whereas CPM lacked sufficient reliability to investigate inhibitory processes. Thus, results indicate moderate effects of sleep manipulations on pain sensitivity, but not on pain modulation. PERSPECTIVE: This article highlights the potential of recovery sleep to let pain thresholds return to normal following their decrease after a night of total sleep deprivation. In contrast, endogenous pain modulation (temporal pain summation, conditioned pain modulation) was not affected by sleep deprivation and recovery sleep.

A novel automated robust dual-channel EEG-based sleep scoring system using optimal half-band pair linear-phase biorthogonal wavelet filter bank

Nowadays, the hectic work life of people has led to sleep deprivation. This may further result in sleep-related disorders and adverse physiological conditions. Therefore, sleep study has become an active research area. Sleep scoring is crucial for detecting sleep-related disorders like sleep apnea, insomnia, narcolepsy, periodic leg movement (PLM), and restless leg syndrome (RLS). Sleep is conventionally monitored in a sleep laboratory using polysomnography (PSG) which is the recording of various physiological signals. The traditional sleep stage scoring (SSG) done by professional sleep scorers is a tedious, strenuous, and time-consuming process as it is manual. Hence, developing a machine-learning model for automatic SSG is essential. In this study, we propose an automated SSG approach based on the biorthogonal wavelet filter bank's (BWFB) novel least squares (LS) design. We have utilized a huge Wisconsin sleep cohort (WSC) database in this study. The proposed study is a pioneering work on automatic sleep stage classification using the WSC database, which includes good sleepers and patients suffering from various sleep-related disorders, including apnea, insomnia, hypertension, diabetes, and asthma. To investigate the generalization of the proposed system, we evaluated the proposed model with the following publicly available databases: cyclic alternating pattern (CAP), sleep EDF, ISRUC, MIT-BIH, and the sleep apnea database from St. Vincent's University. This study uses only two unipolar EEG channels, namely O1-M2 and C3-M2, for the scoring. The Hjorth parameters (HP) are extracted from the wavelet subbands (SBS) that are obtained from the optimal BWFB. To classify sleep stages, the HP features are fed to several supervised machine learning classifiers. 12 different datasets have been created to develop a robust model. A total of 12 classification tasks (CT) have been conducted employing various classification algorithms. Our developed model achieved the best accuracy of 83.2% and Cohen's Kappa of 0.7345 to reliably distinguish five sleep stages, using an ensemble bagged tree classifier with 10-fold cross-validation using WSC data. We also observed that our system is either better or competitive with existing state-of-art systems when we tested with the above-mentioned five databases other than WSC. This method yielded promising results using only two EEG channels using a huge WSC database. Our approach is simple and hence, the developed model can be installed in home-based clinical systems and wearable devices for sleep scoring.

Prevalence of Comorbid Depression and Insomnia Among Veterans Hospitalized for Heart Failure with Alzheimer Disease and Related Disorders

OBJECTIVE

To examine prevalence of Alzheimer Disease and related dementias (ADRD) and patient characteristics as a function of comorbid insomnia and/or depression among heart failure (HF) patients discharged from hospitals.

DESIGN

Retrospective cohort descriptive epidemiology study.

SETTING

VA Hospitals.

PARTICIPANTS

N = 373,897 Veterans hospitalized with heart failure from October 1, 2011 until September 30, 2020.

MEASUREMENTS

We examined VA and Center for Medicare & Medicaid Services (CMS) coding in the year prior to admission using published ICD-9/10 codes for dementia, insomnia, and depression. The primary outcome was the prevalence of ADRD and the secondary outcomes were 30-day and 365-day mortality.

RESULTS

The cohort were predominantly older adults (mean age = 72 years, SD = 11), male (97%), and White (73%). Dementia prevalence in participants without insomnia or depression was 12%. In those with both insomnia and depression, dementia prevalence was 34%. For insomnia alone and depression alone, dementia prevalence was 21% and 24%, respectively. Mortality followed a similar pattern with highest 30-day and 365-day mortality higher in those with both insomnia and depression.

CONCLUSIONS

These results suggest that persons with both insomnia and depression are at an increased risk of ADRD and mortality compared to persons with one or neither condition. Screening for both insomnia and depression, especially in patients with other ADRD risk factors, could lead to earlier identification of ADRD. Understanding comorbid conditions which may represent earlier signs of ADRD may be critical in the identification of ADRD risk.

Impact of chronic sleep deprivation and sleep recovery on hippocampal oligodendrocytes, anxiety-like behavior, spatial learning and memory of rats

Sleep and its quality play an important role in memory, cognition, and quality of life. Sleep deprivation-induced changes in hippocampal neurons and behavior have been studied widely, in contrast, the extent of damage to oligodendrocytes have not been fully understood. The present study aims to investigate chronic sleep deprivation (CSD) and sleep recovery-induced changes in oligodendrocytes of the hippocampus, cognition, and behavior of rats. Male Sprague-Dawley rats (n = 48) were grouped as control, sham control (SC), CSD, and CSD+sleep recovery (CSD+SR) (n = 12/group). CSD and CSD+SR group rats were sleep deprived for 21-days. After CSD, the CSD+SR group rats sleep recovered for 21-days. Oxidative markers, CNPase+ve oligodendrocytes, CNPase intensity, and CNPase gene expression were measured in the hippocampus, and the anxiety-like behavior, spatial learning, and memory were assessed. The 21-days of CSD significantly (p < 0.001) increased oxidative stress and significantly (p < 0.001) reduced the number of CNPase+ve oligodendrocytes, CNPase intensity, and CNPase gene expression when compared to controls. The increased oxidative stress was correlated with reduced CNPase+ve oligodendrocytes, CNPase intensity, and CNPase gene expression (r = -0.9). In-line with cellular changes, an increased (p < 0.01) anxiety-like behavior and impaired spatial memory were observed in the CSD group compared to controls. The 21-days of sleep recovery significantly (p < 0.01) reduced oxidative stress and anxiety-like behavior, improved spatial memory, increased CNPase intensity and CNPase gene expression, and non-significant (p > 0.05) increase in CNPase+ve oligodendrocytes compared to CSD. Overall, the 21-days of CSD reduced the number of CNPase+ve oligodendrocytes in the hippocampus, increased anxiety, and impaired spatial memory in rats. Though the 21-day sleep recovery showed an improvement in all parameters, it was not sufficient to completely reverse the CSD-induced changes to the control level.

Shorter sleep time relates to lower human defensin 5 secretion and compositional disturbance of the intestinal microbiota accompanied by decreased short-chain fatty acid production

Sleep is essential for our health. Short sleep is known to increase disease risks via imbalance of intestinal microbiota, dysbiosis. However, mechanisms by which short sleep induces dysbiosis remain unknown. Small intestinal Paneth cell regulates the intestinal microbiota by secreting antimicrobial peptides including α-defensin, human defensin 5 (HD5). Disruption of circadian rhythm mediating sleep-wake cycle induces Paneth cell failure. We aim to clarify effects of short sleep on HD5 secretion and the intestinal microbiota. Fecal samples and self-reported sleep time were obtained from 35 healthy middle-aged Japanese (41 to 60-year-old). Shorter sleep time was associated with lower fecal HD5 concentration (r = 0.354, p = 0.037), lower centered log ratio (CLR)-transformed abundance of short-chain fatty acid (SCFA) producers in the intestinal microbiota such as [Ruminococcus] gnavus group (r = 0.504, p = 0.002) and Butyricicoccus (r = 0.484, p = 0.003), and lower fecal SCFA concentration. Furthermore, fecal HD5 positively correlated with the abundance of these genera and SCFA concentration. These findings suggest that short sleep relates to disturbance of the intestinal microbiota via decreased HD5 secretion.

Sleep During the COVID-19 Pandemic

PURPOSE OF REVIEW

We reviewed current evidence on the impact of coronavirus disease 2019 (COVID-19) pandemic on sleep of different populations.

RECENT FINDINGS

Several studies demonstrated that sleep deprivation may cause immune system dysregulation, which deteriorates the course of COVID-19. The increased prevalence of sleep disorders among COVID-19 patients has been associated with more severe disease and worse clinical outcomes. Healthcare workers who were subjected to atypical workload and more nightshifts developed sleep disorders which associated with work-related errors and COVID-19 infection susceptibility. In general population, circadian misalignment and excessive stressors impaired sleep quality. Sleep dysfunction has been recorded due to the pandemic. It is essential to implement interventions in order to alleviate pandemic-related sleep disorders. Telemedicine, cognitive behavioral therapy, and sleep hygiene practices appear to be helpful. Psychotropic medication should be cautiously administered, while other pharmacological agents, such as melatonin, have shown promising results.

Polysomnographic features of idiopathic restless legs syndrome: a systematic review and meta-analysis of 13 sleep parameters and 23 leg movement parameters

STUDY OBJECTIVES

This study aims to explore the polysomnographically measured sleep and leg movement differences between idiopathic restless legs syndrome (RLS) patients and healthy controls.

METHODS

An electronic literature search was conducted in EMBASE, MEDLINE, all EBM databases, CINAHL, and PsycINFO. Only observational case-control studies were included in the meta-analysis. The differences in 13 sleep parameters and 23 leg movement parameters between RLS patients and healthy controls were explored.

RESULTS

Thirty-eight studies were identified for systematic review, 31 of which were used for meta-analysis. Meta-analyses revealed significant reductions in total sleep time, sleep efficiency, stage N2 and rapid eye movement (REM) sleep percentages, and increases in wake time after sleep onset, stage shifts per hour, stage N1 percentage, REM latency, arousal index, and apnea-hypopnea index. Some leg movement parameters, such as periodic limb movement during sleep (PLMS) index, PLMS sequence duration, number of PLMS sequence, and periodicity index, were higher in RLS patients compared with healthy controls. Further, our meta-analysis revealed a higher PLMS index during non-REM sleep compared with that during REM sleep.

CONCLUSIONS

RLS patients manifest a lightening of sleep, increased sleep fragmentation, and greater sleep-related breathing disruption and limb movements during sleep relative to healthy normal individuals. The distributions of PLMS during a night's sleep may provide more information to clarify the specific characteristics of leg movements in RLS. PLMS in RLS are concentrated in non-REM sleep. The periodicity index may be a more sensitive and specific marker of RLS than the PLMS index.

CITATION

Zhang H, Zhang Y, Ren R, et al. Polysomnographic features of idiopathic restless legs syndrome: a systematic review and meta-analysis of 13 sleep parameters and 23 leg movement parameters. J Clin Sleep Med. 2022;18(11):2561-2575.

Early onset of sleep/wake disturbances in a progressive macaque model of Parkinson's disease

Parkinsonian patients often experience sleep/wake disturbances, which may appear at an early stage of the disease; however, these disturbances have not been fully described. To better understand the evolution of these disturbances with respect to disease progression, we aimed to characterize these clinical signs in a progressive nonhuman primate model of Parkinson's disease. Three adult macaques (Macaca fascicularis) were equipped with a polysomnographic telemetry system allowing the characterization of sleep/wake behavior via long-term neurophysiological recordings and underwent a modified multiple sleep latency test. Experiments were first performed in a healthy state and then during the progressive induction of a parkinsonian syndrome by intramuscular injections of low doses of MPTP. We observed an early onset of significant sleep/wake disturbances (i.e., before the appearance of motor symptoms). These disturbances resulted in (i) a disorganization of nighttime sleep with reduced deep sleep quality and (ii) an excessive daytime sleepiness characterized by sleep episodes occurring more rapidly in the morning and spreading through the middle of the day. The present study suggests that nighttime and daytime sleep/wake disturbances may appear early in the disease and should be considered in the development of biomarkers in further studies.

Investigation of the Effectiveness of Traditional Breathing Therapy on Pulmonary Function in College Students with Obstructive Sleep Apnea

Background

Obstructive sleep apnea (OSA) is a problem that involves many body systems, but its impact on the respiratory system deserves special attention. While there are many studies investigating the use of continuous positive airway pressure (CPAP) to treat lung function in patients with sleep apnea, the lack of studies in the literature on the effects of traditional breathing therapy on lung function in patients with OSA prompted us to conduct such a study.

Objective

The present randomized trial aims to assess the effect of traditional breathing therapy on daytime sleepiness and pulmonary function in college students with OSA.

Methods

Forty college students (male) with OSA were randomly divided into two groups: the control group (CG) and the traditional breathing therapy group (TG). Daytime sleepiness symptoms in OSA are measured primarily by the Epworth Sleepiness Scale (ESS). Pulmonary function measurements included FVC, FEV1, PEE, and MEF50%. The changes in morning blood pressure (BP), including diastolic BP and systolic BP, were also recorded. Data were recorded before and after the experiment.

Results

A decrease in ESS at 12 weeks after intervention had statistical significance compared with values recorded before intervention (P < 0.05). A decrease in systolic and diastolic BP at 12 weeks after intervention had statistical significance compared with values recorded before intervention (P < 0.05). Comparisons made in terms of pulmonary functions demonstrated a statistically significant increase in 12-week postintervention values of FVC, FEV1, PEF, and MEF50% (P < 0.05).

Conclusion

Our study shows the positive effects of traditional breathing therapy on pulmonary function parameters. This suggests that traditional breathing therapy treatment in OSA patients is as effective as CPAP on pulmonary function, while there is an improvement in daytime sleepiness and a modest decline in the mean daytime systolic and diastolic BP.

Perceived sleep quality: a comparison between hospital nurses and student nurses

BACKGROUND

The prevalence of poor sleep quality is high among nurses, and affects them physically and psychologically as well as organisational functioning. However, evidence on equipping student nurses with good sleep practices that could mitigate poor sleep as they transition into the nursing workforce is lacking.

AIM

This study compared the prevalence and quality of good sleep among hospital nurses and student nurses.

METHODS

A descriptive cross-sectional study of 130 hospital nurses and 130 student nurses in Brunei was carried out. Sleep quality was assessed using the Pittsburgh Sleep Quality index. Multiple logistic regression was applied.

RESULTS

Hospital nurses were 4.29 times more likely to experience poor sleep than student nurses. Those who were overweight were 2.35 times more likely to have poor sleep quality than those with a healthy weight. Although students had significantly good sleep latency, needing less time to fall asleep, they experienced significantly more sleep disturbances, shorter sleep duration and less sleep efficiency.

CONCLUSION

The prevalence of poor sleep quality among nurses in Brunei is higher than global estimates. Stakeholders such as nursing leaders, nursing educators and healthcare policymakers should prepare student nurses and help existing nurses by formulating strategies to promote working schedules and rosters that minimise circadian disruption.

Sleep Restriction in Elite Soccer Players: Effects on Explosive Power, Wellbeing, and Cognitive Function

Purpose: To investigate the cognitive, physical, and perceptual effects of sleep restriction (SR) in soccer players following a night match. Methods: In a crossover design, nine male soccer players from the English Premier League 2 (age, 21 ± 5 years; height, 1.80 ± 0.75 m; body mass, 74.2 ± 6.8 kg) recorded their sleep quality and quantity with sleep logs and a subjective survey after two night matches (19:00); one where sleep duration was not altered (CON) and one where sleep was restricted by a later bed-time (SR). Countermovement jump height (CMJ), subjective wellbeing (1-5 likert scale for mood, stress, fatigue, sleep, and soreness), and cognitive function were measured at baseline and the morning following the match (+12 h; M + 1). Results: Bed-time was later in SR than CON (02:36 ± 0.17 vs. 22:43 ± 29; P = .0001; ηp² = 0.999) and sleep duration was shorter in SR than CON (5.37 ± 0.16 vs. 8.59 h ± 0.36; P = .0001; ηp² = 0.926). CMJ decreased by ~8% after the match in both SR and CON (P = .0001; ηp² = 0.915) but there were no differences between the conditions (P > .05; ηp² = 0.041-0.139). Wellbeing was rated worse after both matches (P = .0001; ηp² = 0.949) but there were no differences between the trials (P > .05; ηp² = 0.172-257). SR did not influence cognitive function (P > .05; interaction effects, ηp² = 0.172-257). Conclusion: SR following a nighttime soccer match does not impair CMJ performance, subjective wellbeing, or cognitive function the following morning.

Comparison of sleep quality deterioration by subgroup of painful temporomandibular disorder based on diagnostic criteria for temporomandibular disorders

Chronic pain conditions, including temporomandibular disorders, are closely related to poor sleep quality. This study investigated whether sleep deterioration in patients with painful temporomandibular disorder differed depending on the origin of pain, and also analyzed which clinical disease characteristics and whether psychological distress affected sleep quality. A total of 337 consecutive patients (215 women; mean age, 33.01 ± 13.01 years) with painful temporomandibular disorder (myalgia [n=120], temporomandibular joint arthralgia [n=62], mixed joint–muscle temporomandibular disorder pain [n=155]), who were assessed and classified based on the diagnostic criteria for temporomandibular disorder (DC/TMD), were enrolled. They completed a battery of standardized reports on clinical sign and symptoms, and answered questions on sleep quality, excessive daytime sleepiness, and patients’ psychological status. The mean global Pittsburgh Sleep Quality Index scores were significantly higher in the mixed temporomandibular disorder pain group (6.97 ± 3.38) and myalgia group (6.40 ± 3.22) than in the arthralgia group (5.16 ± 2.94) (p=0.001). Poor sleepers were significantly more prevalent in the mixed temporomandibular disorder pain group (76.8%) and myalgia group (71.7%) than in the arthralgia group (54.8%) (p=0.006). The presence of psychological distress in the myalgia group (β=1.236, p=0.022), global severity index of the Symptom Checklist-90-Revised in the arthralgia group (β=1.668, p=0.008), and presence of headache (β=1.631, p=0.002) and self-reported sleep problems (β=2.849, p<0.001) in the mixed temporomandibular disorder pain group were associated with an increase in the Pittsburgh Sleep Quality Index score. Ultimately, as the source of pain in painful temporomandibular disorder can affect and determine sleep quality and contributing factors, and as the complex interplay between sleep and pain can vary, a comprehensive treatment approach is necessary because good sleep is required by patients.

COVID-19 and health in children and adolescents in the US: A narrative systematic review

In the United States, the Coronavirus Disease 2019 (COVID-19) pandemic necessitated nationwide closures of kindergarten through twelfth grade (K-12) schools. Stay-at-home orders and social distancing mandates were also implemented to mitigate the spread of COVID-19. The purpose of this systematic review was to synthesize the existing literature on how COVID-19 impacted K-12 students' eating patterns, physical activity, and sleep in the United States. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted between October and December 2021. Inclusion criteria were studies focused on COVID-19 and eating patterns, physical activity, and sleep in students enrolled in K-12 schools since March 2020. International studies were excluded. Mixed findings were observed for eating patterns whereby the consumption of unhealthful savory and sweet items and healthful snacks (e.g., fruit and vegetables) increased. Reductions in physical activity and disrupted sleep routines were also observed. Heterogeneity in methodological procedures may limit the generalizability of these findings. In the United States, preliminary data suggest that select health-promoting behaviors were negatively impacted by the COVID-19 pandemic. Given that prolonged unhealthful eating patterns, physical inactivity, and poor sleep contribute to chronic disease risk, initiatives that increase health-promoting behaviors are warranted.

The Effects of Light and the Circadian System on Rhythmic Brain Function

Life on earth has evolved under the influence of regularly recurring changes in the environment, such as the 24 h light/dark cycle. Consequently, organisms have developed endogenous clocks, generating 24 h (circadian) rhythms that serve to anticipate these rhythmic changes. In addition to these circadian rhythms, which persist in constant conditions and can be entrained to environmental rhythms, light drives rhythmic behavior and brain function, especially in nocturnal laboratory rodents. In recent decades, research has made great advances in the elucidation of the molecular circadian clockwork and circadian light perception. This review summarizes the role of light and the circadian clock in rhythmic brain function, with a focus on the complex interaction between the different components of the mammalian circadian system. Furthermore, chronodisruption as a consequence of light at night, genetic manipulation, and neurodegenerative diseases is briefly discussed.

Ecological and social pressures interfere with homeostatic sleep regulation in the wild

Sleep is fundamental to the health and fitness of all animals. The physiological importance of sleep is underscored by the central role of homeostasis in determining sleep investment – following periods of sleep deprivation, individuals experience longer and more intense sleep bouts. Yet, most sleep research has been conducted in highly controlled settings, removed from evolutionarily relevant contexts that may hinder the maintenance of sleep homeostasis. Using triaxial accelerometry and GPS to track the sleep patterns of a group of wild baboons (Papio anubis), we found that ecological and social pressures indeed interfere with homeostatic sleep regulation. Baboons sacrificed time spent sleeping when in less familiar locations and when sleeping in proximity to more group-mates, regardless of how long they had slept the prior night or how much they had physically exerted themselves the preceding day. Further, they did not appear to compensate for lost sleep via more intense sleep bouts. We found that the collective dynamics characteristic of social animal groups persist into the sleep period, as baboons exhibited synchronized patterns of waking throughout the night, particularly with nearby group-mates. Thus, for animals whose fitness depends critically on avoiding predation and developing social relationships, maintaining sleep homeostasis may be only secondary to remaining vigilant when sleeping in risky habitats and interacting with group-mates during the night. Our results highlight the importance of studying sleep in ecologically relevant contexts, where the adaptive function of sleep patterns directly reflects the complex trade-offs that have guided its evolution.

The cyclic interaction between daytime behavior and the sleep behavior of laboratory dogs

Sleep deprivation has been found to negatively affect an individual´s physical and psychological health. Sleep loss affects activity patterns, increases anxiety-like behaviors, decreases cognitive performance and is associated with depressive states. The activity/rest cycle of dogs has been investigated before, but little is known about the effects of sleep loss on the behavior of the species. Dogs are polyphasic sleepers, meaning the behavior is most observed at night, but bouts are also present during the day. However, sleep can vary with ecological and biological factors, such as age, sex, fitness, and even human presence. In this study, kennelled laboratory adult dogs' sleep and diurnal behavior were recorded during 24-h, five-day assessment periods to investigate sleep quality and its effect on daily behavior. In total, 1560 h of data were analyzed, and sleep metrics and diurnal behavior were quantified. The relationship between sleeping patterns and behavior and the effect of age and sex were evaluated using non-parametric statistical tests and GLMM modelling. Dogs in our study slept substantially less than previously reported and presented a modified sleep architecture with fewer awakenings during the night and almost no sleep during the day. Sleep loss increased inactivity, decreased play and alert behaviors, while increased time spent eating during the day. Males appeared to be more affected by sleep fragmentation than females. Different age groups also experienced different effects of sleep loss. Overall, dogs appear to compensate for the lack of sleep during the night by remaining inactive during the day. With further investigations, the relationship between sleep loss and behavior has the potential to be used as a measure of animal welfare.

Associations of Sleep Quality, Anxiety, and Depression with Cognitive and Executive Functions among Community-Dwelling Women Aged ≥ 65 Years: A Cross-Sectional Study

(1) Background: The objective of this study was to evaluate the associations of sleep quality, anxiety, and depression with cognitive performance, executive functions, and verbal fluency among women aged ≥ 65 years; (2) Methods: A cross-sectional study was conducted on 241 women (72.52 ± 3.93 years). Cognitive performance (Mini-Mental State Examination) and impairment (Montreal Cognitive Assessment), verbal fluency (Isaacs test) and executive function (Trail Making Test), Sleep quality (Pittsburgh Sleep quality Index) and anxiety and depression (Hospital Anxiety and Depression Scale) were determined; (3) Results: The linear regression analysis indicated that anxiety, depression and age, were related to lower Mini-Mental State Examination score (adjusted R2 = 0.306), and age, anxiety and daytime dysfunction were linked to reduced Montreal Cognitive Assessment score (adjusted R2 = 0.248). Age and daytime dysfunction were associated with worse verbal fluency (adjusted R2 = 0.094). Finally, sleep latency, sleep disturbances, the Pittsburgh Sleep quality Index total score were associated with longer times in TMT-A (adjusted R2 = 0.758) and TMT-B (adjusted R2 = 0.508); (4) Conclusions: Sleep quality was associated with cognitive performance, verbal fluency and executive functions. Besides, both anxiety and depression were related with cognitive performance, while only anxiety was linked to executive functions. As for confounders, age was associated with cognitive performance and verbal fluency.

Sleep and Physical Performance: A Case Study of Collegiate Women's Division 1 Basketball Players

In this work, we present a case study to evaluate the connections between sleep, training load, and the perceptions of physical/emotional state of a collegiate, division 1 Women's basketball team. The study took place during the off- (3 weeks) and pre-season (6 weeks) while sleep was tracked using WHOOP wearable straps. Training load was recorded by the strength coach and athletes. Short Recovery and Short Stress (SRSS) questionnaire was used to evaluate the perceptions of athletes on their own emotional and physical states. Our results showed that heart rate measurements are associated with stress levels and recovery perception. We also discovered that the training load was not linked to the sleep variables without the considerations of athletic performance. However, training load may alter perceived stress and recovery which requires further exploration.

High sleep quality can increase the performance of CrossFit® athletes in highly technical- and cognitive-demanding categories

BACKGROUND

In current sports science, the important role of sleep quality for health and peak performance is well acknowledged. More precisely, it is evident that the negative combination of stressful factors, low resources, and bad sleep habits causes short-term performance losses as well as long-term health consequences. As the maximization of human performance consisting of multiple fixed workloads is the main motivation in CrossFit® (CF), the aim of the present study was to investigate the influence of high sleep quality on performance in CrossFit® athletes (CFA) and the different training categories that are addressed in CF.

METHODS

In total, 149 CFA (81 females, 68 males; 32.01 ± 7.49 years old, 2.56 ± 1.77 active years in CF) filled in the online survey comprising the Pittsburgh Sleep Quality Index (PSQI) and CF performance-specific questions.

RESULTS

It was found that CFA with high sleep quality reported higher values in all performance-related outcomes. Especially in Hero-/Girl-Workouts (χ2 = (1, n = 83) = 9.92, p = .002, φ = 0.37) and Gymnastics (χ2 = (1, n = 129) = 8.74, p = .003, φ = 0.28), performance differed significantly between good and poor sleeping CFA. Since those CF categories are highly technical- and cognitive-demanding high sleep quality seems to play a fundamental role in complex motor skill learning and performance development.

CONCLUSIONS

These results reveal for the first time the positive effects of high sleep quality for performance in CFA and could be used as basis for future studies. Future research should also develop and empirically test suitable interventions to foster high sleep quality in CFA.

TRIAL REGISTRATION

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (06/04/2018).