Wake Time Research Articles

Enhancing Wireless Sensor Network in Structural Health Monitoring through TCP/IP Socket Programming-Based Mimic Broadcasting: Experimental Validation

This paper presents the implementation of a synchronous Structural Health Monitoring (SHM) framework utilizing wireless, low-cost, and off-the-shelf components. Vibration-based condition monitoring plays a crucial role in assessing the reliability of structural systems by detecting damage through changes in vibration parameters. The adoption of low-cost Micro-Electro-Mechanical Systems (MEMS) sensors in Wireless Sensor Networks (WSNs) has gained traction, emphasizing the need for precise time synchronization to schedule wake-up times of multiple sensor nodes for data collection. To address this challenge, our proposed method introduces a TCP/IP socket programming-based mimic broadcasting mechanism and a scalable sensing network controlled by a central gateway, leveraging the Raspberry Pi Python platform. The system operates using Internet of Things (IoT) concepts and adopts a star topology, where a packet is transmitted from the gateway to initiate measurements simultaneously on multiple sensor nodes. The sensor node comprises a MEMS accelerometer, a real time clock DS3231 module and Raspberry Pi Zero 2W (RPi0-2W), while the gateway employs a Raspberry Pi 4 (RPi4). To ensure accurate time synchronization, all Pi0-2W nodes were configured as Network Time Protocol (NTP) clients, synchronizing with an RPi4 server using chrony, the reliable implementation of the NTP. Through experimental evaluations, the system demonstrates its effectiveness and reliability in achieving initial time synchronization. This study addresses the challenge of achieving precise time alignment between sensor nodes through the utilization of the Dynamic Time Wrapping (DTW) method for Frequency Domain Decomposition (FDD) applications. The contribution of this research significantly enhances the field by improving the accuracy and reliability of time-aligned measurements, with a specific focus on utilizing low-cost sensors. By developing a practical and cost-effective SHM framework, this work advances the accessibility and scalability of structural health monitoring solutions, facilitating more widespread adoption and implementation in various engineering applications

Association between sleep traits and sarcopenia-related traits: A two-sample bidirectional Mendelian randomization study.

Despite limited evidence regarding the impact of sleep quality on sarcopenia, it is widely recognized as being associated with various diseases. This study aimed to explore the causal relationship between sleep traits and sarcopenia-related traits. This study utilized a two-sample bidirectional Mendelian randomization analysis. Genetic genome-wide summary data of sleep quality indicators, including chronotype, morning wake-up time, sleep duration, daytime napping, insomnia and daytime dozing, were used. Data on sarcopenia-related traits, such as appendicular lean mass, grip strength of both hands, walking pace and waist circumference, were collected from a large cohort study. The primary method used was the inverse-variance weighted analysis. A causal association was found between chronotype and appendicular lean mass (odds ratio [OR] 1.019, 95% confidence interval [CI] 1.016-1.211, P = 0.021). Napping during the day was connected with walking pace (OR 0.879, 95% CI 0.834-0.928, P = 2.289 × 10-6) and waist circumference (OR 1.234, 95% CI 1.081-1.408, P = 0.002). Insomnia was related to lower grip strength of the right hand (OR 0.844, 95% CI 0.747-0.954, P = 0.007), left hand (OR 0.836, 95% CI 0.742-0.943, P = 0.003), as well as walking pace (OR 0.871, 95% CI 0.798-0.951, P = 0.002). Furthermore, the reverse Mendelian randomization analysis showed associations between certain sarcopenia-related traits and poor sleep quality. Some sleep traits were associated with the occurrence of sarcopenia. These findings emphasized the significance of prioritizing sleep quality as a preventive measure against sarcopenia. Geriatr Gerontol Int 2024; 24: 537-545.

Quantifying Head Position Following Vitrectomy Using a 3-Dimensional Position Sensor Embedded in a Novel Ophthalmic Shield: A Pilot Study.

To assess head position following pars plana vitrectomy (PPV) using a novel low-energy, non-intrusive 3-D position sensor platform. In this prospective non-randomized interventional case series, a low-energy Bluetooth smart sensor housed within a novel eye shield recorded 3-D positional data every five minutes. The device was placed on the patient immediately after PPV and data was retrieved at the postoperative day 1 visit. Readings were processed by vector analysis into 4 groups, stratified by the angle of deviation away from a completely prone head position. The primary outcome was the angle between vectors. Ten patients were enrolled in this pilot study. The mean (SD) age was 57.5 (17.4). A total of 2318 readings with a mean (SD) of 231.8 (26.8) readings per patient were obtained. The mean (SD) number of readings were 132.9 (34.7) while awake and 98.9 (27.9) during sleep. Of total readings, only 11.7% fell into group 1 while a majority of readings fell in group 2 (52.4%), and group 3 (32.4%), and only 3.5% fell into group 4. Positional deviation increased during sleep hours, with about 46.8% of readings at a reclined angle (group 3) and 4.9% supine, which was 21.6% and 2.5% respectively during the wake time (p<0.001, p=0.002, respectively). In this pilot study, a non-intrusive wireless 3-D position sensor-shield platform was tolerated well and capable of capturing positional data. Adherence to face-down positioning was low and positional deviation increased significantly while sleeping.

Circadian misalignment proxies, BMI, and chronic conditions: the role for weekday to weekend sleep differences.

To evaluate whether social jet lag (SJL) and weekend catch-up sleep (CUS), proxies of circadian misalignment, were associated with BMI and chronic conditions. Participants (n = 2,050,18-65y) were part of a virtual cross-sectional and population-based research. We examined CUS and SJL as continuous and categorical (< 1h,1-2h, > 2h). Linear regression analyses were performed to assess the differences in BMI (outcome) associated with CUS and SJL. Restricted cubic splines were performed to explore the shape of the relationship between weekday-to-weekend variability in sleep duration, midpoint, wake time, and bedtime. Logistic regression models were used to estimate ORs(95%CIs) for chronic conditions and overweight related to CUS and SJL. Analyses were adjusted for sleep duration, biological and behavior-related variables. We found a positive association of SJL and CUS with BMI. The effects remained even after adjustment for weekly sleep duration and demonstrated a proportional increase with the magnitude of sleep variability. Among participants with SJL > 2h, BMI increased by 2.29kg/m2 (95%CI:0.84;3.74,p:0.002). They also had 129% higher odds of chronic conditions (95%CI:1.16;4.52, p:0.01) and 119% higher odds of overweight (95%CI: 1.20;3.98,p:0.01). Individuals with CUS > 2h presented 78% higher odds of overweight (95%CI:1.27;2.50,p:0.001) and an increase of 1.61kg/m2 in BMI (95%CI: 0.81; 2.40,p < 0.001). Our findings, which demonstrate that even a slight weekend sleep extension and variability of just 1h is associated with higher values of BMI, suggest incorporating measures for sleep consistency and regularity into clinical protocols and public health guidelines to prevent and treat obesity and related diseases.

Sleep and circadian rhythms in adolescents with attempted suicide

Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61–0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA.

Sleep duration and association with cardiometabolic health in adolescents and adults with type 1 diabetes: Results from the BCQR-T1D study.

Type 1 diabetes (T1D) increases the risk of morbidity and mortality from cardiovascular disease, and insufficient sleep is prevalent. Emerging evidence suggests a link between sleep and cardiometabolic health, but this has not been examined across the lifespan in individuals with T1D. We aimed to examine associations between sleep and cardiometabolic health in adolescents and adults with T1D in a secondary analysis of data from a 4-week double-blind, random-order, placebo-controlled crossover trial of bromocriptine quick release (BCQR) therapy with a 4-week washout in between conditions. Forty-two adults (19-60 years) and 42 adolescents (12-18 years) with T1D >9 months completed 1 week of home monitoring with wrist-worn actigraphy to estimate sleep duration and continuous glucose monitoring, anthropometrics, arterial stiffness, magnetic resonance imaging (adolescents only), and fasting laboratory testing at each treatment phase. Sixty-two per cent of adolescents and 74% of adults obtained <7 h of sleep per night at baseline. After adjustment for age, sex and diabetes duration, baseline sleep <7 h per night was associated with a higher body mass index, a higher waist circumference, a higher systolic blood pressure, worse arterial stiffness and a lower estimated insulin sensitivity (all p < .05). When examined by age group, associations between sleep duration and cardiometabolic health outcomes remained significant, predominantly for adolescents. In adolescents only, wake time was significantly later (p = .027) and time in bed was significantly longer with BCQR versus placebo (p = .049). Objectively measured sleep <7 h per night was prevalent in adolescents and adults with T1D and associated with poorer cardiometabolic health markers. Small changes in sleep were seen following BCQR treatment in adolescents only. Sleep may be an important and novel target for improving cardiometabolic health in individuals with T1D.

Effect of a nutraceutical combination on sleep quality among people with impaired sleep: a randomised, placebo-controlled trial

In this randomised, placebo-controlled trial, adults with impaired sleep (Pittsburgh Sleep Quality Index ≥ 5) were randomly assigned using a minimization algorithm to receive a formulation containing l-theanine plus lemon balm, valerian, and saffron extracts, or placebo, during 6 weeks. Objective sleep quality parameters were measured using an actigraphy device. We enrolled and randomised 64 individuals, 31 from the active group and 27 from the placebo group completed the 6 week follow-up. Mean sleep efficiency remained unmodified in the active group, and increased by 3% in the placebo group, the between-group difference in the change was not statistically significant (p = 0.49). Total sleep time also improved more with placebo (13.0 vs. 1.33 min, p = 0.66). Time wake after sleep onset (WASO) decreased more in the active group (4.6% vs. 2.4%), but the difference was not significant (p = 0.33). Mean PSQI decreased by 3.11 points (32.3%) in the active group, and by 3.86 points (39.5%) in the placebo group (p = 0.41). SF-36 increased more with placebo (+ 18.3 in active, + 32.1 in placebo, p = 0.68). Salivary cortisol remained unchanged in both groups. No serious adverse events were reported. Among adults with impaired sleep, a nutraceutical combination did not improve objective or subjective sleep parameters more than a placebo infusion.

Prevalence and factors of sleep problems among Japanese children: a population-based study.

High prevalence of sleep problems in not only children with neurodevelopmental disorders (NDS) but also non NDS has been established. However, there are few studies that have looked into population-based and age-specific prevalence of sleep problems of children. Moreover, there are even fewer studies that have investigated the correlation of demographic and lifestyle-related factors affecting sleep problems in children. Considering these, the purpose of this study is to assess the correlation of the prevalence of sleep problems and selected socio-demographic and lifestyle-related factors in 5-year-old Japanese children in population-based study. Study children (SC) were recruited from two cohorts of the Hirosaki City 5-Year-Old Child Developmental Health Checkup Study. The first cohort consisted of 281 (162 males, 119 females) children recruited from 2014 to 2015, and the second cohort consisted of 2055 (1,068 males, 987 females) children from 2018 to 2019. In total there were 2,336 SC participants (1,230 males and 1,106 females). To determine the prevalence of sleep problems the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) was utilized, and sleep problems are defined by a total score of ≥86. To determine socio-demographic and lifestyle-related factors affecting sleep, 10 factors (NDS diagnosis, birth month, childcare place, income, number of siblings, bedtime, waking time, sleeping hours, sleep onset delay, and screen time) were selected. Finally, to determine the correlation between prevalence of sleep problems and the selected demographic and lifestyle-related factors, data was analyzed using chi-square test. The prevalence rate of sleep problems in 5-year-olds was 18% (369/2,055). Further, the prevalence of sleep problems was high in participants with ASD (50.4%), ADHD (39.8%), <2 million yen of income (30.5%), no siblings (24.2%), >22:00 of bedtime (30.7%), >7:30 of waking time (30.7%), <9 h of sleeping hours (25.3%), >30 min of sleep onset delay (35.3%), and ≥2 h of screen time (21.1%). The findings report 18% prevalence rate of sleep problems in 5-year-old children. Further, the findings establish a significant correlation of sleep problems and NDS, specific socio-demographic, and lifestyle-related factors. In considering the identified modifiable lifestyle-related factors contributing to sleep problems among the participants (i.e., bed/waking times and screen times), sleep programs to address these concerns are suggested.

Sleep Behaviors and the Shape of Subcortical Brain Structures in Children with Overweight/Obesity: A Cross-Sectional Study.

To examine the relationship between sleep and subcortical brain structures using a shape analysis approach. A total of 98 children with overweight/obesity (10.0 ± 1.1 y, 59 boys) were included in the cross-sectional analyses. Sleep behaviors (i.e., wake time, sleep onset time, total time in bed, total sleep time, sleep efficiency, and wakening after sleep onset) were estimated with wrist-worn accelerometers. The shape of the subcortical brain structures was acquired by magnetic resonance imaging. A partial correlation permutation approach was used to examine the relationship between sleep behaviors and brain shapes. Among all the sleep variables studied, only total time in bed was significantly related to pallidum and putamen structure, such that those children who spent more time in bed had greater expansions in the right and left pallidum (211-751 voxels, all p's <0.04) and right putamen (1783 voxels, p = 0.03). These findings suggest that more time in bed was related to expansions on two subcortical brain regions in children with overweight/obesity.

Safety and efficacy of remimazolam versus propofol during EUS: a multicenter randomized controlled study

Background and aimsPropofol, a widely used sedative in gastrointestinal endoscopic procedures, is associated with cardiorespiratory suppression. Remimazolam is a novel ultra-short-acting benzodiazepine sedative with rapid onset and minimal cardiorespiratory depression. This study aimed to compare the safety and efficacy of remimazolam and propofol during endoscopic ultrasound (EUS) procedures. MethodsA multicenter randomized controlled study was conducted between October 2022 and March 2023 in patients who underwent EUS procedures. Patients were randomly assigned to receive either remimazolam or propofol as a sedative agent. The primary endpoint was cardiorespiratory adverse events during the procedure, including desaturation, respiratory depression, hypotension, and tachycardia. Secondary endpoints included the time to achieve sedation, recovery time, quality of sedation, pain at the injection site, and satisfaction of both the endoscopists and patients. ResultsFour hundred patients enrolled in the study: 200 received remimazolam (10.8±7.7 mg) and 200 received propofol (88.0±49.1 mg). For cardiorespiratory adverse events, the remimazolam group experienced fewer occurrences than the propofol group (8.5% vs. 16%, p=0.022). There was a non-significant trend toward less oxygen desaturation (1.0% vs 3.5%, p= 0.09), respiratory depression (0.5% vs 1.5%, p= 0.62), hypotension (2.5% vs 5.5%, p=0.12) and tachycardia (4.5% vs 5.5%, p=0.68) with remimazolam than with propofol. Remimazolam showed a shorter induction time than propofol, while maintaining comparable awakening and recovery times. Injection site pain was significantly lower in the remimazolam group than in the propofol group. The remimazolam group demonstrated a significantly higher quality of sedation and satisfaction scores than the propofol group, as evaluated by both endoscopists and patients. ConclusionRemimazolam was superior to propofol in terms of safety and efficacy during EUS examinations.

Indices of Sleep Health Are Associated With Timing and Duration of Eating in Young Adults

BackgroundLimited data exist examining whether timing and/or duration of eating behaviors throughout the day affect sleep health. ObjectiveThe aim of this study was to identify the relationship between eating behaviors and sleep in young adults without chronic diseases or conditions. DesignThis was a cross-sectional study using 7 days of baseline data from a randomized crossover trial. Participants/settingParticipants included 52 young adults. The study took place in West Lafayette, Indiana, between April 2017 and May 2018. Main outcome measuresTiming and duration of eating were assessed via 3 nonconsecutive, 24-hour dietary recalls. Bedtime, wake time, total sleep time, sleep latency, sleep efficiency, and wake after sleep onset were measured over 7 days via wrist actigraphy and sleep diaries. Statistical analyses performedTwo-way analyses of variance were applied to assess group differences based on timing of consumption (early vs late eating) and duration of eating (long: >13 hours, short: <11 hours, or standard: 11-13 hours) with post-hoc pairwise comparisons. ResultsMain effects of timing of consumption, but not duration of eating, were detected for wake time, bedtime, and sleep efficiency (all, P < .05). Specifically, participants with later eating patterns that included breakfast skipping had later wake times and later bedtimes than those with earlier eating patterns. In addition, those who had later eating patterns that included breakfast skipping and nighttime eating experienced lower sleep efficiency (mean [SE], 77.0% [2.3%]) vs those who consumed breakfast and no nighttime eating (mean [SE], 84.6% [1.4%]; P < .001) and those who skipped breakfast but had no nighttime eating (mean [SE], 84.2% [2.5]; P < .05). Those who consumed breakfast but also had nighttime eating had a mean (SE) sleep efficiency of 82.4% (1.4%) (P = .09). ConclusionsThe timing of eating was associated with sleep–wake onset and sleep efficiency. This study provides the preliminary characterization of eating behaviors relative to sleep–wake cycles and highlights the need for experimental studies to understand whether manipulating the timing of eating occasions to better align with sleep–wake cycles could improve sleep health.

Analysis of inducement of benign paroxysmal positional vertigo

Objective:To analyze the related factors that may affect the onset of benign paroxysmal positional vertigo（BPPV）. Methods:Fifty BPPV patients treated in Department of Otolaryngology Head and Neck Surgery, Shanxi Provincial People's Hospital from May to September 2023 were selected as the case group, and 50 healthy adults were selected as the control group. Relevant information was collected by means of questionnaire survey and medical history inquiry. The two groups were compared in terms of sleep time, night sleep duration, wake times, underlying diseases（hypertension, diabetes, coronary heart disease, etc.） and negative emotional impact. Results:The proportion of male and female in the case group was 16% and 84%, and that in the control group was 20% and 80%. The mean age of the case group was（54.66±13.39） years old, and the mean age of the control group was（54.42±12.55） years old, ranging from 27 to 80 years old. The sleeping time of the case group was significantly later than that of the healthy group, and the difference was statistically significant（P<0.05）. The night sleep duration of the case group was shorter than that of the healthy group, the difference was statistically significant（P<0.05）. There was no significant difference in awakening times between the case group and the healthy group（P>0.05）. There were more patients in the case group with underlying diseases（54%） and affected by negative emotions（70%） than in the healthy group, and the difference was statistically significant（P<0.05）. Conclusion:Late sleep time, short sleep duration at night, accompanied by underlying diseases and negative emotions can affect the onset of BPPV.

Sleep Patterns During Pre-Competition Training Phase: A Comparison Between Male and Female Collegiate Swimmers.

While there is a rising focus on sleep issues among athletes, a notable gap exists in the comparative analysis of sleep patterns between male and female athletes. This study aims to evaluate the sleep patterns of collegiate swimmers during a specific period (pre-competition training phase) based on the National Sleep Foundation's recommendations and compares sleep differences between males and females. 15 swimmers (6 males and 9 females) completed the Athlete Sleep Screening Questionnaire (ASSQ) and wore actigraphy devices for 8 consecutive nights to record objective sleep patterns including bedtime, wake time, sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency. The total sleep time of collegiate male (5.0±0.4 h, 4.6 to 5.4h) and female (6.0±0.7 h, 5.5 to 6.5h) swimmers was less than 7 hours per night, and male swimmers' sleep efficiency (76.7±8.9%, 67.4 to 86.0%) was lower than the 85% standard. Male swimmers had less objectively measured sleep duration (p=0.006, d=1.66, large effect), lower sleep efficiency (p=0.013, d=1.51, large effect), and longer wake after sleep onset (p=0.096, d=0.94, moderate effect). Female swimmers had higher sleep difficulty scores (p=0.06, d=1.08, moderate effect), and there was a significant difference in the distribution of sleep difficulty scores between male and female swimmers (p=0.033, V=0.045, small effect). Collegiate swimmers exhibited poor sleep patterns during pre-competition preparation, and the sleep fragmentation of male swimmers was more pronounced. There were sex differences in both subjective and objective measured sleep patterns, with male swimmers having less sleep and low efficiency, while female swimmers experienced more significant sleep disturbances.

Impact of an Internet-Delivered Sound Healing Intervention on Chronic Non-Malignant Pain and Sleep Disturbances in Community Settings

IntroductionChronic pain patients often contend with insomnia symptoms, creating a reciprocal relationship that adds complexity to their condition. Evaluating interventions targeting insomnia in this population becomes paramount, given the intertwined nature of pain and sleep disturbances.ObjectivesThis retrospective pretest design aimed to assess the efficacy of an Internet-delivered sound healing intervention in reducing insomnia severity and addressing sleep- and pain-related parameters among individuals with chronic pain.MethodsConducted as a community-based project, Tuning for Health provided support to individuals grappling with long-term illnesses. The intervention involved the virtual delivery of a specially crafted sound track using tuning forks over a 6-week period, supervised by an experienced therapist and administered weekly for an hour. Participants were instructed to play the track daily at a time convenient for them. A total of 68 participants (mean age 59.3 years) completed the intervention. Outcome measures, including the Insomnia Severity Index (ISI), a sleep diary, and assessments for anxiety, depression, and pain-related parameters, were collected at the end of the 6-week intervention and repeated after a 6-month follow-up. Negative effects were monitored and reported.ResultsSignificant immediate interaction effects (time by treatment) were observed for the pain severity, ISI and various sleep parameters, such as sleep efficiency, sleep onset latency, early morning awakenings, and wake time after sleep onset. A time effect for anxiety and depression was noted at the 6-month follow-up. The group exhibited highly significant improvements in pain-related parameters. At the 6-month follow-up, sustained enhancements in sleep parameters and mental health were reported, with no reported side effects.ConclusionsThese unique results suggest the potential efficacy of sound healing in alleviating chronic pain and associated insomnia. Further research with a larger sample size is warranted to validate these findings. Combining sound healing with other treatments may offer enhanced outcomes for individuals dealing with both chronic pain and comorbid insomnia. This study lays the groundwork for future investigations into the promising intersection of sound healing, chronic pain management, and sleep improvement.Disclosure of InterestNone Declared

Insomnia and Its Association with Successful Aging in the Older Indian Population: A Large Population-Based Study Based on LASI, Wave 1

IntroductionEvidence regarding the link between insomnia and successful aging (SA) in the older generation remains scarce.ObjectivesThe purpose of this study is to explore the relationship of insomnia with SA within a substantial sample of the community-dwelling Indian population.MethodsData were drawn from the Longitudinal Ageing Study in India (LASI), Wave 1, conducted during 2017-2018. Older participants aged 60 years and above who completed both the insomnia and SA surveys were included. Insomnia was determined by the presence of at least one of three symptoms: 1) difficulty in initiating sleep; 2) difficulty in maintaining sleep; or 3) early morning awakening, occurring 5 or more times per week. SA was assessed by five components: 1) absence of chronic diseases; 2) low probability of disability; 3) high cognitive functionality; 4) low probability of depression; and 5) active social engagement. The association between insomnia and SA was examined through survey-weighted multivariable logistic regression, with adjustments made for potential covariates. Subgroup analyses were carried out to evaluate interactions with age, sex, alcohol use, and smoking status.Results A total of 31362 participants met the eligibility criteria. The overall weighted prevalence was 9.91% for insomnia and 23.94% for SA. In fully adjusted models, insomnia exhibited a negative association with SA (OR 0.70; 95% CI 0.63-0.78, see Table 1) and with each of SA’s components, except for the absence of chronic diseases (OR 0.94; 95% CI 0.85-1.04, see Table 1). Subgroup analyses, stratified by age, sex, alcohol use, or smoking status, did not reveal any significant interactions between insomnia and SA (p for interaction = 0.098, 0.873, 0.704, 0.095, respectively).Table 1.Relationship between insomnia and successful aging.InsomniaORs (95% CIs)Unadjusted modelModel 1Model 2NoReferenceReferenceReferenceYesSuccessful aging0.50 (0.45, 0.55)0.54 (0.49, 0.60)0.70 (0.63, 0.78)Absence of chronic diseases0.66 (0.61, 0.71)0.65 (0.60, 0.70)0.94 (0.85, 1.04) †Low probability of disability0.43 (0.40, 0.46)0.45 (0.42, 0.49)0.51 (0.47, 0.55)High cognitive functionality0.66 (0.61, 0.72)0.75 (0.68, 0.83)0.78 (0.71, 0.87)Low probability of depression0.33 (0.30, 0.36)0.34 (0.31, 0.38)0.38 (0.34, 0.42)Active social engagement0.79 (0.73, 0.86)0.87 (0.80, 0.95)0.86 (0.78, 0.94)† p &gt; 0.05; ORs, odds ratios; 95% CIs, 95% Confidence intervals.Model 1 adjusted for: age, sex, level of education, work status, marital status, place of residence, economic status, caste; Model 2 adjusted for: model 1 plus body mass index (BMI), alcohol use, smoking status.ConclusionsInsomnia was negatively linked with SA within the older Indian population. Future prospective studies are warranted to validate these relationships, investigate underlying mechanisms, and enhance the understanding and promotion of SA.Disclosure of InterestNone Declared

The Effect of Rocking Bed on Mood and Attention

Objective: The current study aims to explore the effects of sleep in the rocking bed on mood and attention.Methods: Thirty-nine young adults (14 with insomnia and 25 without insomnia) slept in the Sway Bed under three different conditions; 1) motionless condition, 2) continuously rocking condition, and 3) before-sleep rocking condition. In the motionless condition, participants slept without rocking for all night. In the continuously rocking condition, rocking started when lights out and stopped at wake-up time. In the before-sleep rocking condition, rocking started when lights out, but stopped after sleep onset. The Profile of Mood States and the computerized Comprehensive Attention Test were conducted before and after experimental sleep.Results: Under continuously rocking, depression, tension, anger, fatigue, confusion, and standard deviation of reaction time in divided attention were reduced. Under after-sleep bed condition, depression, tension, fatigue, confusion and omission errors in divided attention were reduced. There were no significant differences in after-sleep mood or attention changes between bed conditions. However, within those with insomnia, after-sleep improvement of depression and divided reduction were larger under continuously rocking conditions than under motionless conditions.Conclusion: Sleeping in the rocking bed improved negative affects and divided attention. The effects of rocking bed on depression and divided attention were prominent especially in those with insomnia. The current findings suggest that the sleep in the rocking bed may improve the depressive mood and the impaired attention of insomnia patients.

Sleep Disturbance During Post-Traumatic Amnesia and Early Recovery After Traumatic Brain Injury.

After moderate to severe traumatic brain injury (TBI), sleep disturbance commonly emerges during the confused post-traumatic amnesia (PTA) recovery stage. However, the evaluation of early sleep disturbance during PTA, its recovery trajectory, and influencing factors is limited. This study aimed to evaluate sleep outcomes in patients experiencing PTA using ambulatory gold-standard polysomnography (PSG) overnight and salivary endogenous melatonin (a hormone that influences the sleep-wake cycle) assessment at two time-points. The relationships between PSG-derived sleep-wake parameters and PTA symptoms (i.e., agitation and cognitive disturbance) were also evaluated. In a patient subset, PSG was repeated after PTA had resolved to assess the trajectory of sleep disturbance. Participants with PTA were recruited from Epworth HealthCare's inpatient TBI Rehabilitation Unit. Trained nurses administered overnight PSG at the patient bedside using the Compumedics Somté portable PSG device (Compumedics, Ltd., Australia). Two weeks after PTA had resolved, PSG was repeated. On a separate evening, two saliva specimens were collected (at 24:00 and 06:00) for melatonin testing. Results of routine daily hospital measures (i.e., Agitated Behavior Scale and Westmead PTA Scale) were also collected. Twenty-nine patients were monitored with PSG (mean: 41.6 days post-TBI; standard deviation [SD]: 28.3). Patients' mean sleep duration was reduced (5.6 h, SD: 1.2), and was fragmented with frequent awakenings (mean: 27.7, SD: 15.0). Deep, slow-wave restorative sleep was reduced, or completely absent (37.9% of patients). The use of PSG did not appear to exacerbate patient agitation or cognitive disturbance. Mean melatonin levels at both time-points were commonly outside of normal reference ranges. After PTA resolved, patients (n = 11) displayed significantly longer mean sleep time (5.3 h [PTA]; 6.5 h [out of PTA], difference between means: 1.2, p = 0.005). However, disturbances to other sleep-wake parameters (e.g., increased awakenings, wake time, and sleep latency) persisted after PTA resolved. This is the first study to evaluate sleep disturbance in a cohort of patients as they progressed through the early TBI recovery phases. There is a clear need for tailored assessment of sleep disturbance during PTA, which currently does not form part of routine hospital assessment, to suggest new treatment paradigms, enhance patient recovery, and reduce its long-term impacts.

Identifying predictive factors for mood recurrence in early-onset major mood disorders: A 4-year, multicenter, prospective cohort study

We investigate the predictive factors of the mood recurrence in patients with early-onset major mood disorders from a prospective observational cohort study from July 2015 to December 2019. A total of 495 patients were classified into three groups according to recurrence during the cohort observation period: recurrence group with (hypo)manic or mixed features (MMR), recurrence group with only depressive features (ODR), and no recurrence group (NR). As a result, the baseline diagnosis of bipolar disorder type 1 (BDI) and bipolar disorder type 2 (BDII), along with a familial history of BD, are strong predictors of the MMR. The discrepancies in wake-up times between weekdays and weekends, along with disrupted circadian rhythms, are identified as a notable predictor of ODR. Our findings confirm that we need to be aware of different predictors for each form of mood recurrences in patients with early-onset mood disorders. In clinical practice, we expect that information obtained from the initial assessment of patients with mood disorders, such as mood disorder type, family history of BD, regularity of wake-up time, and disruption of circadian rhythms, can help predict the risk of recurrence for each patient, allowing for early detection and timely intervention.

Markers of intestinal barrier damage in patients with chronic insomnia disorder.

Insomnia disorder stands out as one of the prevalent clinical sleep and psychiatric disorders. Prior research has unequivocally demonstrated variations in the diversity and abundance of gut microbiota among individuals with insomnia disorder. These alterations may play a direct or indirect role in the onset and progression of insomnia disorder by compromising the integrity of the intestinal barrier. This study aims to evaluate the impairment of the intestinal barrier in individuals with insomnia disorder by scrutinizing the serum functionality of this barrier. 45 patients with chronic insomnia disorder and 30 matched healthy volunteers were meticulously selected based on inclusion criteria. ELISA technology was employed to measure serum levels of diamine oxidase (DAO), D-lactic acid (D-LA), intestinal fatty acid binding protein (I-FABP), and endothelin (ET). Spearman correlation analysis was used to explore the relationship between intestinal mucosal markers and clinical characteristics. Data were analyzed using SPSS 26.0. Compared to the healthy control group, the insomnia disorder group exhibited significantly elevated scores on subjective mood and sleep scales (GAD-7, PHQ-9, HAMA, HAMD, PSQI, and ISI) (P < 0.05). Overnight PSG indicated a notable increase in bed time, total wake time, sleep onset latency, and wake after sleep onset in individuals with insomnia disorder. Additionally, there was a decrease in sleep efficiency and alterations in sleep structure (increased proportion of N1 and N3 stages, prolonged N1 stage) (P < 0.05). The chronic insomnia disorder group displayed significantly reduced concentrations of serum DAO, D-LA, I-FABP, and ET (P < 0.05). Furthermore, significant positive correlations were identified between intestinal epithelial barrier markers and sleep efficiency, while negative correlations were found with wake after sleep onset, total wake time, PSQI, HAMA, and HAMD. Additionally, D-LA levels were significantly positively correlated with ET concentrations. Individuals with chronic insomnia disorder manifest disruptions in sleep structure, heightened susceptibility to anxiety and depressive moods, and impaired intestinal barrier function. These findings suggest that the occurrence and development of insomnia disorder may be linked to the impairment of the intestinal barrier.

Longer sleep duration and neuroinflammation in at-risk elderly with a parental history of Alzheimer's disease.

Although short sleep could promote neurodegeneration, long sleep may be a marker of ongoing neurodegeneration, potentially as a result of neuroinflammation. The objective was to evaluate sleep patterns with age of expected Alzheimer's disease (AD) onset and neuroinflammation. We tested 203 dementia-free participants (68.5 ± 5.4 years old, 78M). The PREVENT-AD cohort includes older persons with a parental history of AD whose age was nearing their expected AD onset. We estimated expected years to AD onset by subtracting the participants' age from their parent's at AD dementia onset. We extracted actigraphy sleep variables of interest (times of sleep onset and morning awakening, time in bed, sleep efficiency, and sleep duration) and general profiles (sleep fragmentation, phase delay, and hypersomnia). Cerebrospinal fluid (CSF) inflammatory biomarkers were assessed with OLINK multiplex technology. Proximity to, or exceeding, expected age of onset was associated with a sleep profile suggestive of hypersomnia (longer sleep and later morning awakening time). This hypersomnia sleep profile was associated with higher CSF neuroinflammatory biomarkers (IL-6, MCP-1, and global score). Interaction analyses revealed that some of these sleep-neuroinflammation associations were present mostly in those closer/exceeding the age of expected AD onset, APOE4 carriers, and those with better memory performance. Proximity to, or exceeding, parental AD dementia onset was associated with a longer sleep pattern, which was related to elevated proinflammatory CSF biomarkers. We speculate that longer sleep may serve a compensatory purpose potentially triggered by neuroinflammation as individuals are approaching AD onset. Further studies should investigate whether neuroinflammatory-triggered long sleep duration could mitigate cognitive deficits.