The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study

Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders

BACKGROUND

Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.

AIM

To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.

METHODS

A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.

RESULTS

The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.

CONCLUSION

Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.

Exploring the link between sleep and cognitive disengagement syndrome (CDS) in young adults: Integrating the role of ADHD

OBJECTIVE

This study aimed to: (1) compare sleep quality and sleep-related parameters in a Turkish adult population with and without CDS and ADHD symptoms; and (2) re-examine the relationship between CDS and sleep by exploring potential associations between sleep problems and CDS symptoms, while also examining the separate roles of sluggishness and daydreaming, as well as possible gender differences.

METHOD

The study included 274 participants (age:18-35, 70.4 % female). The Adult CDS Ratings Scale, the Adult ADHD Self-Report Scale (ASRS), and the Pittsburgh Sleep Quality Index were used. The data were analyzed using SPSS 22 and AMOS 23. Statistical analyses included ANOVA with post-hoc Tamhane's test, Mann-Whitney U test, Spearman Correlation Analysis, and structural equation modeling with path analysis. Linear regression analysis was conducted to identify factors influencing daydreaming.

RESULTS

The study yielded four key findings: CONCLUSIONS: This study is among the first to explore the relationship between CDS symptoms and sleep problems in young adults, accounting for ADHD. Our findings highlight the significant association of hyperactivity/impulsivity and daydreaming with sleep quality, as well as the relationship between poor sleep quality and increased daydreaming and sluggishness, though to a lesser extent than ADHD symptoms. Notably, gender differences emerged, with poor sleep quality affecting CDS symptoms primarily in women, while sluggishness decreased with age in men. These results underscore the importance of considering sleep issues in the context of CDS and ADHD, particularly with attention to gender-specific patterns.

Melatonin Mitigates Sleep Restriction-Induced Cognitive and Glymphatic Dysfunction Via Aquaporin-4 Polarization

Chronic sleep restriction (SR) impairs the glymphatic clearance of macromolecular toxic metabolites, which is associated with the loss of perivascular polarization of aquaporin-4 (AQP4). Melatonin (Mel) has been shown to maintain the circadian rhythm of AQP4 polarization. However, the role of AQP4 polarization in Mel's protective effects against SR-induced brain dysfunction remains unclear. In the present study, using a modified rotating rod SR mouse model, we demonstrated the time-dependent effect of SR on short-term memory deficits and AQP4 mislocalization in the hippocampus. Subsequent experiments characterized the dose-dependent pattern of Mel ameliorating SR-induced impairments of cognitive function and AQP4 polarity. Mel's treatment enhanced glymphatic transport in SR mice, as revealed by cerebrospinal tracer experiments, and reduced hippocampal amyloid-beta and phosphorylated tau levels. Additionally, Mel significantly decreased glial cell activation, pro-inflammatory cytokine production, and synaptic protein loss in the hippocampus of SR mice. However, in AQP4 knockout mice, Mel's protective effects against SR-induced pathophysiological alterations described above were largely abolished. Mechanistically, Mel activated the vitamin D receptor and then upregulated expression of DTNA (Dystrobrevin Alpha), a key component of the dystrophin-associated complex, which in turn restored AQP4 polarization during chronic SR conditions. This finding indicates that AQP4-mediated lymphatic clearance is necessary for Mel to combat chronic SR-induced brain impairment.

Association of sleep hygiene knowledge and physical activity with sleep quality in nursing and medical students: a cross-sectional study

Background

Sleep quality and physical activity are fundamental factors in the optimal functioning of the human organism and maintaining overall health. This study aimed to evaluate the relationship between knowledge of sleep hygiene and physical activity in relation to sleep quality among nursing and medical students.

Methods

In a cross-sectional online study, a suitable and convenient sample of 300 nursing and medical students from a private university located in Chiclayo, Peru, was collected. Data were collected using the following instruments: a questionnaire concerning sleep hygiene knowledge, the International Physical Activity Questionnaire (IPAQ), and the Pittsburgh Sleep Quality Index (PSQI). The data collection period spanned January and February 2024.

Results

Of the total sample, 59.3%, 51.7%, and 69.7% reported insufficient knowledge of sleep hygiene, low physical activity and poor sleep quality, respectively. Sleep hygiene knowledge and physical activity explained 17.9% of the variability in sleep quality (R 2 = 0.179, F = 32.31, p < 0.001). In addition, there is a positive and significant association between knowledge of sleep hygiene (β = 0.27; p < 0.001) and physical activity (β = 0.24; p < .001) with sleep quality.

Conclusion

The findings indicate that interventions designed to improve sleep hygiene knowledge and physical activity may be effective strategies for improving sleep duration among nursing and medical students.

The Mixed Role of Sleep and Time of Day in Working Memory Performance of Older Adults with Mild Cognitive Impairment

The importance of night sleep for maintaining good physical and cognitive health is well documented as well as its negative changes during aging. Since Mild Cognitive Impairment (MCI) patients bear additional disturbances in their sleep, this study aimed at examining whether there are potential mixed effects of sleep and afternoon time of day (ToD) on the storage, processing, and updating components of working memory (WM) capacity in older adults with MCI. In particular, the study compared patients' performance in the three working memory components, in two-time conditions: "early in the morning and after night sleep", and "in the afternoon and after many hours since night sleep". The Working Memory Capacity & Updating Task from the R4Alz battery was administered twice to 50 older adults diagnosed with MCI. The repeated measures analysis showed statistically significant higher performance in the morning condition for the working memory updating component (p < 0.001). Based on the findings, it seems that the afternoon ToD condition negatively affects tasks with high cognitive demands such as the WM updating task in MCI patients. These findings could determine the optimal timing for cognitive rehabilitation programs for MCI patients and the necessary sleep duration when they are engaged in cognitively demanding daily activities.

The impact of sleep quality on visual working memory varied with the duration of maintenance

Objective

Sleep quality can affect the performance of visual working memory. However, the effect of sleep quality on the maintenance stage, which is the key to maintain the quality and efficiency of visual working memory representation, remains unclear. This study is the first to explore the effect of sleep quality on the maintenance of visual working memory information.

Method

60 healthy college students completed the Pittsburgh Sleep Quality Index (PSQI) and color recall task of visual working memory. A mixed experimental design of sleep quality (high or low) and delay duration (1, 4, or 6 s) was used to assess the effect of sleep quality on the maintenance phase of visual working memory.

Results

The main effects of sleep quality were significant on visual working memory quantity, precision and offset indexes. Among the quantity index, the interaction between sleep quality and delay duration was also significant. This suggests that prolonging the delay time in the maintenance phase leads to difficulty in maintaining attention to the task for those with lower sleep quality, which results in poorer working memory quantitative representations.

Conclusion

Increases in the delay duration of the maintenance phase in visual working memory intensify the impact of sleep quality on task performance. Our study provides evidence to reveal the relationship between sleep quality and visual working memory and offers recommendations for improving sleep quality and cognitive functioning in individuals.

The Prevalence and Predictors of Sleep Disorders and Their Impact on Academic Performance Among Saudi University Students: A Cross-Sectional Study

BACKGROUND

University students encounter a variety of sleep problems that have an impact on their health and academic performance. Therefore, the aim of this study was to evaluate the prevalence of sleep disorders and their impact on academic performance among Saudi university students.

METHODS

This is an online cross-sectional study that involved university students and was conducted between November 2022 and February 2023 in Saudi Arabia. Sleep disorders were examined among undergraduate students through online screening surveys including the Epworth Sleepiness Scale (ESS) to assess excessive daytime sleepiness, the Insomnia Severity Index (ISI) to measure insomnia, and the Berlin questionnaire to examine obstructive sleep apnea (OSA). Restless leg syndrome (RLS) was measured using the RLS rating. SPSS version 29.0 (IBM Corp., Armonk, NY, USA) was used for all statistical analyses. Binary logistic regression analysis was used to identify predictors of having excessive daytime sleepiness, insomnia, sleep-disordered breathing, and RLS.

RESULTS

The sample included 449 participants. According to the ESS, 56.6% (n=254) of students reported excessive daytime sleepiness. Using the ISI, 78.4% (n=352) of students were found to have insomnia. The Berlin questionnaire indicated that 6.7% (n=30) of students had sleep-disordered breathing. Additionally, 13.6% (n=61) of students reported having RLS. Male students had higher odds of sleep-disordered breathing compared to females (p<0.01), while marital status showed that married students had higher odds of sleep-disordered breathing (p<0.05). Students who reported nighttime sleeping had lower odds of insomnia and restless leg syndrome (p<0.05). Having regular sleeping times was associated with higher odds of insomnia (p<0.05). Napping sometimes was associated with higher odds of excessive daytime sleepiness and sleep-disordered breathing (p<0.05). Students working day and night shifts had higher odds of sleep-disordered breathing (p<0.01). Interestingly, students with comorbidities had lower odds of RLS (p<0.01).

CONCLUSION

This study established that sleep disturbances among students significantly reduce grade point averages (GPAs), where the most affected were male students and those who were married. The government should implement sleep education programs, provide resources for the management of sleep, encourage consistent sleep schedules, and come up with targeted interventions for at-risk groups. More research is also recommended on effective sleep interventions.

The Interplay of Sleep Quality, Mental Health, and Sociodemographic and Clinical Factors among Italian College Freshmen

Background/Objectives: Sleep and mental health are closely linked, with sleep deprivation increasing the risk of mental health problems in college students. This study aimed to analyze the role of sleep in the mental health status of a sample of Italian freshmen, considering various mental health outcomes and potential interactions between sleep and other relevant factors, such as sociodemographic characteristics, academic experiences, and mental health history. Methods: All freshmen from a medium-sized Italian university were invited to participate in a multidimensional online survey (n = 3756). Sleep quality was assessed through questions on average hours of sleep per night and on satisfaction of perceived sleep quality. Mental health outcomes included psychophysical well-being, psychological distress, substance use, and problematic internet use. Statistical analysis involved multivariate analysis of variance, followed by pairwise comparisons. Results: The sample (n = 721) exhibited low levels of well-being and a high prevalence of psychological distress (52.1%). Approximately one-third of students (n = 258) were dissatisfied with their sleep quality, and one-fourth (n = 186) reported inadequate sleep (less than 7 h per night). More specifically, 24.4% of students slept on average six hours per night, and 1.4% slept five hours or less. Satisfaction with perceived sleep quality significantly influenced well-being, psychological distress, and cannabis use (ηp2 = 0.02). Interaction effects were observed between satisfaction with sleep quality and drop-out intentions (ηp2 = 0.01), as well as between satisfaction with sleep quality and history of mental health diagnosis (ηp2 = 0.02), both of which were significant for psychological distress and cannabis use. Conclusions: This study highlights the influence of perceived sleep quality on academic distress among college freshmen, particularly those with higher intentions of leaving university and with a history of mental health diagnosis.

Research on the impact of the socio-educational environment on the academic performance of college students: the mediating role of study motivation

Background

Enhancing the academic performance (AP) of college students can contribute to the overall scientific literacy among this population, thereby fostering societal progress.

Objective

The study investigates the correlation between college students' AP and the socio-educational environment (SEE, including family, roommates, and teachers), study motivation (SM, including self-efficacy and study behaviors). Based on the research findings, recommendations are offered to students, educators, and school administrators.

Settings

Utilizing a stratified sampling approach, data was collected by selecting a sample of 330 first-year computer science students from a specific local university in Hebei Province, China.

Methods

Data will be collected through a hierarchical sampling method. Using correlation analysis, difference analysis, and structural equation modeling (SEM) as data analysis methods. The data passed reliability and validity analysis (Cronbach's Alpha = 0.88, KMO = 0.88, χ2/df = 1.49RMSEA = 0.04).

Results

The independent sample T-test results showed that female students had higher academic performance than male students (p < 0.001), and there was no significant difference in academic performance between students from single parent or orphan families and students from normal families (p = 0.14), from non urban areas and from urban areas (p = 0.67). The results of the mediating effect analysis indicate that SM exerts complete mediation in the association between SEE and AP, with a mediating effect value of 0.18.

Conclusion

The educational disparity between urban and rural areas in China is gradually narrowing. Support policies for students from impoverished families in higher education institutions are showing initial effectiveness. The conducive learning environment and educational atmosphere for students can indirectly influence their psychological state, thus impacting their academic performance during their university years.

Impact of the COVID-19 pandemic on the sleep quality of students: A meta-analysis and meta-regression

OBJECTIVE

The present systematic review aims to assess the impact of the COVID19 pandemic on the sleep quality of students.

METHODS

An electronic search was performed in the databases and in gray literature for articles published up to January 2022. The results included observational studies that assessed sleep quality through validated questionnaires, comparing moments pre and postCOVID19 pandemic. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. The Grading of Assessment, Development and Evaluation (GRADE) was used to assess the certainty of scientific evidence. Estimates of interest were calculated using random effects meta-analyses and possible confounding factors were meta-regressed.

RESULTS

Eighteen studies were considered for qualitative synthesis and thirteen were considered for meta-analysis. Considering the comparison of means obtained by the Pittsburgh Sleep Quality Index, there was an increase in the scores obtained during the pandemic period [MD = -0.39; 95% CI = -0.72 - -0.07; I2 = 88.31%], thus evidencing a slight worsening in the sleep quality of these individuals. Risk of bias was considered low in nine studies, moderate in eight studies, and high in one study. The unemployment rate (%) in the country of origin of each included study partially explained the heterogeneity of analysis. GRADE analysis showed a very low certainty of scientific evidence.

CONCLUSION

The COVID-19 pandemic may have a slight negative impact on the sleep quality of high school and college students, but the evidence is still uncertain. The socioeconomic reality must be considered when evaluating this outcome.