Circadian Rhythm Sleep Research Articles

A deleterious variant of INTS1 leads to disrupted sleep-wake cycles.

Sleep disturbances are common among children with neurodevelopmental disorders. Here, we report a syndrome characterized by prenatal microcephaly, intellectual disability and severe disruption of sleep-wake cycles in a consanguineous family. Exome sequencing revealed homozygous variants (c.5224G>A and c.6506G>T) leading to the missense mutations E1742K and G2169V in integrator complex subunit 1 (INTS1), the core subunit of the Integrator complex. Conservation and structural analyses suggest that G2169V has a minor impact on the structure and function of the complex, while E1742K significantly alters a negatively charged conserved patch on the surface of the protein. The severe sleep-wake cycles disruption in human carriers highlights a new aspect of Integrator complex impairment. To further study INTS1 pathogenicity, we generated Ints1-deficient zebrafish lines. Mutant zebrafish larvae displayed abnormal circadian rhythms of locomotor activity and sleep, as is the case with the affected humans. Furthermore, Ints1-deficent larvae exhibited elevated levels of dopamine β-hydroxylase (dbh) mRNA in the locus coeruleus, a wakefulness-inducing brainstem center. Altogether, these findings suggest a significant, likely indirect, effect of INTS1 and the Integrator complex on maintaining circadian rhythms of locomotor activity and sleep homeostasis across vertebrates.

Variability in sleep architecture and alterations in circadian rhythms in patients with acute cerebral infarction accompanied by sleep-disordered breathing.

To continuously and dynamically monitor the sleep status of patients in the acute phase of cerebral infarction, and to investigate the characteristics of acute cerebral infarction(ACI)associated with sleep-disordered breathing (SDB), variations in sleep structure, and changes in sleep circadian rhythms. Patients with ACI within 48h of onset who were admitted to the Department of Neurology at Kailuan General Hospital from November 2020 to December 2022 were selected. Detailed baseline information such as age, gender, smoking history, drinking history, were recorded for the selected participants. From the beginning of their hospitalization, the selected participants were monitored for their sleep status continuously for 5 days using the Intelligent Mattress-based Sleep Monitoring Platform System(IMSMPS). Based on the heart rate data obtained from the monitoring, the interdaily stability (IS) and intradaily variability (IV) of the sleep circadian rhythm were calculated. 1,367 patients with ACI were selected. Monitoring results over 5 days indicated 147 cases (10.75%) without SDB, and 1,220 cases (89.25%) with SDB. Among the group with SDB, there were 248 cases (18.14%) with continuous mild SDB, 395 cases (28.90%) with moderate SDB, 295 cases (21.58%) with severe SDB, and 282 cases (20.63%) that fluctuated between different severity levels. Within this fluctuating group, 152 cases (53.90%) fluctuated between two severity levels, 120 cases (42.55%) between three levels, and 10 cases (3.55%) among all four levels. There were statistically significant differences (P < 0.05) in the sleep latency, sleep efficiency, non-rapid eye movement stages 1-2, rapid eye movement, proportion of non-rapid eye movement, proportion of rapid eye movement, wake after sleep onset, time out of bed, number of awakenings, respiratory variability index, and heart rate variability index among patients with ACI monitored from day 1 to 5. However, other monitored sleep structure parameters did not show statistically significant differences (P > 0.05). The coefficient of variation for all sleep monitoring parameters ranged between 14.54 and 36.57%. The IV in the SDB group was higher than in the group without SDB (P < 0.05), and the IS was lower than in the group without SDB (P < 0.05). Patients in the acute phase of cerebral infarction have a high probability of accompanying SDB. The sleep structure of these patients shows significant variability based on the onset time of the stroke, and some patients experience fluctuations among different severity levels of SDB. ACI accompanied by SDB can further reduce the IS of a patient's sleep circadian rhythm and increase its IV.

Integrative Modeling of Accelerometry-Derived Sleep, Physical Activity, and Circadian Rhythm Domains With Current or Remitted Major Depression

Accelerometry has been increasingly used as an objective index of sleep, physical activity, and circadian rhythms in people with mood disorders. However, most prior research has focused on sleep or physical activity alone without consideration of the strong within- and cross-domain intercorrelations; and few studies have distinguished between trait and state profiles of accelerometry domains in major depressive disorder (MDD). To identify joint and individual components of the domains derived from accelerometry, including sleep, physical activity, and circadian rhythmicity using the Joint and Individual Variation Explained method (JIVE), a novel multimodal integrative dimension-reduction technique; and to examine associations between joint and individual components with current and remitted MDD. This cross-sectional study examined data from the second wave of a population cohort study from Lausanne, Switzerland. Participants included 2317 adults (1164 without MDD, 185 with current MDD, and 968 with remitted MDD) with accelerometry for at least 7 days. Statistical analysis was conducted from January 2021 to June 2023. Features derived from accelerometry for 14 days; current and remitted MDD. Logistic regression adjusted for age, sex, body mass index, and anxiety and substance use disorders. Among 2317 adults included in the study, 1261 (54.42%) were female, and mean (SD) age was 61.79 (9.97) years. JIVE reduced 28 accelerometry features to 3 joint and 6 individual components (1 sleep, 2 physical activity, 3 circadian rhythms). Joint components explained 58.5%, 79.5%, 54.5% of the total variation in sleep, physical activity, and circadian rhythm domains, respectively. Both current and remitted depression were associated with the first 2 joint components that were distinguished by the salience of high-intensity physical activity and amplitude of circadian rhythm and timing of both sleep and physical activity, respectively. MDD had significantly weaker circadian rhythmicity. Application of a novel multimodal dimension-reduction technique demonstrates the importance of joint influences of physical activity, circadian rhythms, and timing of both sleep and physical activity with MDD; dampened circadian rhythmicity may constitute a trait marker for MDD. This work illustrates the value of accelerometry as a potential biomarker for subtypes of depression and highlights the importance of consideration of the full 24-hour sleep-wake cycle in future studies.

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 ismainly 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.

Dampened circadian amplitude of EEG power in women after menopause.

Postmenopausal women are at high risk of developing sleep-wake disturbances. We previously reported dampened circadian rhythms of melatonin, alertness and sleep in postmenopausal compared with young women. The present study aims to further explore electroencephalography power spectral changes in the sleep of postmenopausal women. Eight healthy postmenopausal women were compared with 12 healthy, naturally ovulating, young women in their mid-follicular phase. Participants followed a regular 8-hr sleep schedule for ≥ 2 weeks prior to laboratory entry. The laboratory visit included an 8-hr baseline sleep period followed by an ultradian sleep-wake cycle procedure, consisting of alternating 1-hr wake periods and nap opportunities. Electroencephalography power spectral analysis was performed on non-rapid eye movement sleep obtained over a 48-hr period. The baseline nocturnal sleep of postmenopausal women comprised lower power within delta and sigma, and higher power within alpha bands compared with that of younger women. During nighttime naps of the ultradian sleep-wake cycle procedure, lower power within delta and sigma, and higher power within beta bands were observed in postmenopausal women. During the ultradian sleep-wake cycle procedure, postmenopausal women presented lower power of delta, theta and sigma (14-15 Hz), undetectable rhythms of delta and theta, and a dampened or undetectable rhythm of sigma (12-15 Hz) power compared with younger women. Our results support the hypothesis of a dampened circadian variation of sleep microstructure in healthy-sleeping postmenopausal women. Circadian changes with aging are potential mechanisms for increased susceptibility to develop sleep disturbances; however, further research is needed to clarify their clinical implications and contribution to insomnia.

Research on healthy human sleep circadian rhythms

The exhaustion of humans during the day is the primary motivation for this paper. Circadian Rhythm is a necessary system, which is the 24-hour cycle that is part of humans inner clock that controls and organizes the essential functions and processes in our body. A significant example of circadian rhythms is the cycle of sleep-wake. Sleep is an inalienable part of human life (humans will die for sure if they stay awake for 10 years). However, the length of sleep will decrease based on humans age. The older human is, the less sleep they will require. However, circadian rhythm can greatly impact dietary intake and physical activities and is fundamentally impacted by brightness and sleep-inducing substances. And this paper will introduce how to scientifically set up the circadian rhythm, and how to maintain a healthy circadian rhythm by utilizing those 4 main factors. So that reduces the exhaustion for humans dyscalculia from the circadian rhythms; and implies a healthy, positive, and efficient society. And the goal for this paper is that advising human maintain a consistently daily life which can greatly reduce exhaustion.

Curcumin mitigates the sleep-deprivation impacts on rat hypothalamic paraventricular nucleus

IntroductionThe paraventricular nucleus of the hypothalamus (PVH) is an important efferent system that relays the circadian rhythm of sleep and stress information to the periphery. Chronic REM sleep deprivation (CSD) is thought to damage this system. We evaluated the effects of CSD after 21 days on the spatial arrangement of PVH in male rats and the anti-apoptotic effects of curcumin on cell loss in sleep-deprived rats. MethodsThe rats received 1 mL of 100 mg/kg/day of curcumin in 3 groups: the CSD (through a modified multiple platform apparatus, 18 h/day), grid-floor control, and cage-control along with the same set of matched groups which received 1 mL PBS. In the grid-floor control group, as a control for CSD, animals were placed on stainless-steel-mesh grids positioned upon the CSD apparatus and then allowed to sustain the chance to sleep. After 21 days, their brains were removed for stereological estimations, Voronoi tessellation, and TUNEL assay. In an unbiased stereological approach, Cavalieri’s principle and an optical disector were used for estimating the volume and total cell number of the PVH, respectively. The Voronoi tessellation was measured using Image J software. ResultsSignificant reductions (P < 0.05) in the PVH volume and cell number, along with an increase in dead neurons, were found in CSD animals. The spatial pattern of two types of PVH neurons (parvocellular and magnocellular) showed random distributions after CSD, whereas curcumin not only increased the volume and neuronal number but also retrieved the spatial distribution to a regular one. ConclusionsCSD decreased the volume and altered the spatial arrangement of the neurons in PVH by increasing apoptosis and decreasing the cell number. However, oral use of curcumin could protect PVH from these changes.

Chronotype-Dependent Sleep Loss Is Associated with a Lower Amplitude in Circadian Rhythm and a Higher Fragmentation of REM Sleep in Young Healthy Adults.

In modern society, the time and duration of sleep on workdays are primarily determined by external factors, e.g., the alarm clock. This can lead to a misalignment of the intrinsically determined sleep timing, which is dependent on the individual chronotype, resulting in reduced sleep quality. Although this is highly relevant given the high incidence of sleep disorders, little is known about the effect of this misalignment on sleep architecture. Using Fitbit trackers and questionnaire surveys, our study aims to elucidate sleep timing, sleep architecture, and subjective sleep quality in young healthy adults (n = 59) under real-life conditions (average of 82.4 ± 9.7 days). Correlations between variables were calculated to identify the direction of relationships. On workdays, the midpoint of sleep was earlier, the sleep duration was shorter, and tiredness upon waking was higher than on free days. A higher discrepancy between sleep duration on workdays and free days was associated with a lower stability of the circadian rhythm of REM sleep and also with a higher fragmentation of REM sleep. Similarly, a higher tiredness upon waking on free days, thus under intrinsically determined sleep timing conditions, was associated with a lower proportion and a higher fragmentation of REM sleep. This suggests that the misalignment between extrinsically and intrinsically determined sleep timing affects the architecture of sleep stages, particularly REM sleep, which is closely connected to sleep quality.

Exploration of acupuncture treatment for insomnia induced by mental retardation: based on "trinity theory of shaoyang, sanjiao and haishi"

Insomnia induced by mental retardation is related to the synergistic dysfunction of "shaoyang, sanjiao and haishi (the period of the day from 9 pm to 11 pm) " in pathogenesis. Based on "trinity theory of shaoyang, sanjiao and haishi ", the acupoints of hand and food shaoyang meridians on the head and face (Fengchi [GB 20], Sizhukong [TE 23] and Jiaosun [TE 20]) and those on the four limbs (Sanyangluo [TE 8], Zhongzhu [TE 3], Qiuxu [GB 40] and Xiaxi [GB 43]) are selected to regulate the pivot function of shaoyang. Front-mu and back-shu points (Sanjiaoshu [BL 22], Danzhong [CV 17] and Tianshu [ST 5]), as well as auricular points (Gan [CO12], Dan [CO11] and Sanjiao [CO17]) are chosen to promote qi circulation of shaoyang and sanjiao meridians. In association with the relevant knowledge of time acupuncture at haishi, the circadian rhythm of sleep is set up and the appropriate sleep pattern is developed.

Circadian rhythm disturbance and delirium in ICU patients: a prospective cohort study

BackgroundPatients treated in the intensive care unit (ICU) may experience a reversal of day and night. The circadian rhythm in ICU patients can be disturbed.MethodsTo explore the relationship between ICU delirium and the circadian rhythms of melatonin, cortisol and sleep. A prospective cohort study was carried out in a surgical ICU of a tertiary teaching hospital. Patients who were conscious during the ICU stay after surgery and were scheduled to stay in the ICU for more than 24 h were enrolled. Serum melatonin and plasma cortisol levels were measured three times a day by drawing arterial blood on the first three days after ICU admission. Daily sleep quality was assessed by the Richard-Campbell Sleep Questionnaire (RCSQ). The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was performed twice a day to screen for ICU delirium.ResultsA total of 76 patients were included in this study, and 17 patients developed delirium during their ICU stay. Melatonin levels were different at 8:00 (p = 0.048) on day 1, at 3:00 (p = 0.002) and at 8:00 (p = 0.009) on day 2, and at all three time points on day 3 (p = 0.032, 0.014, 0.047) between delirium and non-delirium patients. The plasma cortisol level in the delirium patients was significantly lower than that in the non-delirium patients at 16:00 on day 1 (p = 0.025). The changes in melatonin and cortisol secretion levels exhibited obvious biological rhythmicity in non-delirium patients (p < 0.001 for melatonin, p = 0.026 for cortisol), while no rhythmicity was found in melatonin and cortisol secretion levels in the delirium group (p = 0.064 for melatonin, p = 0.454 for cortisol). There was no significant difference in RCSQ scores in the first three days between the two groups.ConclusionsThe disturbance of the circadian rhythm of melatonin and cortisol secretion was associated with the development of delirium in ICU patients. Clinical staff should pay more attention to the importance of maintaining patients’ normal circadian rhythms in the ICU.Trial registrationThe study was registered with the US National Institutes of Health ClinicalTrials.gov(NCT05342987) (25/04/2022).

0295 Association between circadian rhythm of skin temperature and actigraphic sleep in free-living conditions: the HEIJO-KYO study

Abstract Introduction Skin temperature manipulation with little or no change in core body temperature affects sleep-wake states. However, the significance of 24-hour variation in skin temperature to sleep quality is unclear. We aimed to evaluate whether the circadian rhythm of distal skin temperature (DST) affects sleep quality in free-living conditions and to provide additional evidence about the relationship between thermal input to the skin and sleep-wake states. Methods In this cross-sectional study of 2,177 community-dwelling adults (Mean age 68.8 [SD 8.0] years), we measured DST using a temperature logger (Thermochron iButton, Maxim) at 3-minute intervals for seven consecutive days to calculate non-parametric indicators of circadian rhythm: intradaily variability (IV), interdaily stability (IS), and relative amplitude (RA). The participants underwent simultaneous 7-day wrist actigraphy (GT3X-BT, ActiGraph) to measure sleep objectively. The association between non-parametric indicators and 7-day means of sleep measures was evaluated using multivariable linear regression models. Results Lower quartiles of IV and higher quartiles of IS and RA were significantly associated with higher sleep efficiency, shorter wake after sleep onset, and longer total sleep time (all p &amp;lt;.001). After adjusting for potential confounders, including physical activity and outdoor temperature, the coefficients for the linear trend of sleep efficiency were −1.07 (95% confidence interval [CI]: −1.45, −0.69), 1.08 (95% CI: 0.75, 1.41), and 1.33 (95% CI: 0.83, 1.84) in IV, IS, and RA, respectively (all p &amp;lt;.001). Conclusion Circadian rhythms of DST with higher fluctuation, lower regularity across days, and blunted amplitude were associated with worse sleep quality. Our findings may be applied in thermoregulatory interventions to enhance sleep quality. Support (if any)

Circadian rhythm sleep-wake disorders and the risk of dyslipidemia among railway workers in southwest China: A cross-sectional study

ABSTRACT Railway workers are more likely to have an irregular work schedule, which had an effect on their circadian rhythm of sleep, and may lead to circadian rhythm sleep-wake disorders (CRSWDs). The association between CRSWDs and dyslipidemia in railway workers is poorly understood. The objective of this research is to study the association between CRSWDs and the risk of dyslipidemia. This cross-sectional study was conducted among railway workers in Southwest China. CRSWDs were assessed by the morningness-eveningness questionnaire self-assessment version (MEQ-SA). The blood samples were collected in the morning and the lipids of participants were measured. Associations of CRSWDs with dyslipidemia and its components were analyzed. A total of 8079 participants were enrolled in this study, and the results revealed that shift work sleep disorder (SWD) and advanced sleep-wake phase disorder (ASWPD) were associated with a higher risk of dyslipidemia (OR 1.17, 95%CI 1.06–1.29, P < 0.01; OR 1.68, 95%CI 1.09–2.64, P < 0.05) after adjusting for sociodemographic characteristics and lifestyles, in comparison with the control group. As for its components, the SWD group was associated with a higher risk of elevated total cholesterol, triglycerides, and low-density lipoprotein than the control group, while the ASWPD group was associated with a higher risk of elevated total cholesterol, and low-density lipoprotein (P < 0.05). In summary, SWD and ASWPD participants were associated with a higher risk of dyslipidemia in railway workers in Southwest China. Abbreviation: TG: triglyceride; TC: Total cholesterol; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; FPG: fasting plasma glucose. MEQ-SA: morningness-eveningness questionnaire self-assessment version; IPW: inverse-probability weighting; HDS: healthy diet scores; FFQ: food frequency; PA: physical activity; IQAP-SF: international physical activity questionnaire short form; MET-min/wk: metabolic equivalent task minutes per week; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; HBP: hypertension; DM: diabetes; CVD: cerebrovascular disease; OR: odds ratios; CI: confidence intervals.

Biomarkers of neuroinflammation in patients with chronic cerebral ischemia during the therapy with vinpocetine (study INFLAMARK)

To evaluate the effect of vinpocetine therapy on clinical manifestations of chronic cerebral ischemia (CCI) and the blood concentrations of neuroinflammation markers (S100B, IL-1β). The study included 30 patients (mean age 61.6 [56.9; 67.9] years) with CCI that received vinpocetine (30 mg/day) for 3 months. Brain changes according to magnetic resonance imaging data were assessed using the STRIVE protocol. We analyzed the dynamics of changes in the clinical questionnaires: Montreal Cognitive Assessment Scale (MoCA), Hospital Anxiety and Depression Scale (HADS), Asthenic State Scale (ASS), Epworth Sleepiness Scale (ESS), general impressions of treatment (Global Rating of Change Scale, GRC). In 3 months after vinpocetine therapy there was a significant improvement in cognitive status (MoCA: 25.1±2.1 vs 26.6±1.4 p<0.05), emotional state (HADS: 8.4±1.4 vs 7.1±1.8 (p<0.05)), daytime sleep parameters (ESS 8.4±2.1 vs 6.2±2.3 p<0.05) and reduction in asthenia (ASS: 72.2±18.1 vs 52.3±9.3, p<0.05). A significantly larger proportion of patients assessed the improvement from therapy as «moderate» and «pronounced» (GRC, n=22, 73.3%). Concentrations of S100B and IL-1β decreased significantly by the time therapy was completed. The overall severity of cerebrovascular changes according to MRI was significantly associated with blood levels of S100β, but not IL-1β: β=0.504, p=0.026, 95% CI 0.149-0.901, mainly due to periventricular changes in white matter (β=0.562, p=0.035, 95% CI (-0.024-0.820). Blood levels of S100β correlated with MoCA test results (r=0.6795), and IL-1β correlated with ESS scores (r=0. 6657). The use of vinpocetine can significantly reduce the severity of cognitive and affective disorders, asthenia, normalize the circadian rhythm of sleep, suppress the expression S100β and IL-1β in patients with CCI. One of the vinpocetine's mechanisms of action may be the inhibition of neuroinflammation.

3.5 Circadian Rhythms Sleep Disorders

Circadian rhythm sleep wake disorders (CRSWD), defined as inappropriately timed sleep due to misalignment between the internal rhythm and the required timing of the patient’s school or social activities, are common in adolescents with mental health disorders. Interventions that target circadian disruptions improve the mental health of patients with mental health disorders and increase the effectiveness of psychiatric interventions. The objectives of the presentation are to: 1) define CRSWD and characterize their comorbidity with mental health disorders in adolescents; 2) briefly explain the key processes related to circadian rhythms in sleep and wakefulness; and 3) review methods for diagnosing and treating CRSWD.

An innovative fan control strategy aimed at responding to human physiological characteristics for comfort sleeping

• Comfortable air speed interval of the fan under 6 operating conditions. • The trend of the skin temperature during sleep can be divided into 5 stages. • The dynamic air supply control strategy of fans can improve people's sleep quality. A comfortable sleeping environment can improve sleep quality. Electric fans are widely accepted as an effective method in South China to improve the thermal environment in summer when people are sleeping. To determine the proper fan control strategy under the all-night blowing mode, pre-sleep and during-sleep experiments were performed in a climate room. Under 6 operating conditions (28/30/32 °C, 50 %/80 % RH), subjective sensations (thermal sensation votes and sleep quality indexes) were recorded and objective physiological parameters (brain waves and skin temperature) were monitored. The results showed that the comfortable air speed interval before sleep was 0.15–1.44 m/s. The skin temperature showed a clear trend of first rising, then falling, stabilising, rising again, and finally rising with fluctuations throughout the night. Based on the characteristics of physiological parameters in different sleep periods, the sleeping time was divided into 5 stages to perform linear regression, and a dynamic air supply control strategy for fans that imitated the circadian rhythm of sleep was proposed. Compared with steady-state blowing, the sleep efficiency and proportion of deep sleep under this optimisation control strategy increased by 3.24 % and 3.59 %, respectively. This study provides a reference for fan control in a sleep environment.

Sleeping Trends &amp; Academic Performance among Medical Students

Background: Improper sleep and sleeping in the daytime affect intellectual ability of a student and have a undesirable effect on the academic performance. Aim: To define relationship between improper sleep and educational performance. Study design: A Cross sectional study Place &amp; duration of study: 4 months in Lahore Medical &amp; Dental College, Lahore, Pakistan Methodology: This study conducted on 103 medical students. All from fourth year MBBS studying at Lahore Medical &amp; Dental College, Lahore. The students who participated in the study given to complete Pittsburgh Sleep Quality Index (PSQI) questionnaire to find out the quality of their sleep. Their third year annual result obtained to see their academic performance. Results: The no of students that initially participated in the study was 133, however 103 (77%) completed the questionnaires. From the responses received 18.4% students use to be in bed before 11:00 pm, 39.8% went to bed between 11:00 pm and an hour after midnight; and 41.7% went to bed after 2 to 4 am. Most of the students, 75.7% woke up between 5:00 am &amp; 7:00 am and only 1.3% students woke up at or after 8:00 am. There was another class of 21 students, representing 20% reported using sleeping pills. Time taken from fully awake to deep sleep mentioned by 33.0% of the students was less than 15 minutes. Half an hour reported by 46.6% students, 60 and above minutes reported by 20.4% students. Washroom usage at night reported as not causing severe sleep disturbance. 42.7% never have to get up for use of washroom during last one month. 32% and 17.5% were those who have to get up to use washroom once or twice a week. Conclusion: Due to disturbed circadian rhythm of sleep, caused by academic busyness the lack of sleep and its quality caused. . The disturbed sleep in our study was however not associated with academic performance. Keywords: Undergraduate medical students, academic performance, sleeping habits.

Efficacy of Different Concentrations of Withanolides in Ashwagandha Supplements for Insomnia and Enhancing Energy Level

ObjectivesAshwagandha was found to have promising results in treating insomnia and bringing forward circadian rhythms. However, anyone with insomnia responded differently to various concentrations of withanolides in Ashwagandha supplements. In this study, the concentration of withanolides in Ashwagandha and total sleep time improvement, sleep circadian rhythms, and energy level elevation were investigated in sleep deprived subjects.MethodsA total of 132 participants with insomnia aged between 18 and 50 were selected for inclusion in the study. Unstandardized Ashwagandha supplements were distributed to group A (n=39). Ashwagandha with 5% of withanolides was assigned to group B (n=53), and group C (n=40) received ashwagandha contained 2.5% of withanolides. The data were collected from self-reported questionnaires and analyzed using the Shapiro-Wilk test and the Wilcoxon signed-rank test with R Studio 4.1.2.ResultsGroup B showed the greatest improvement in sleep quality. In the beginning, 38% of participants slept less than 6 hours, decreasing to 26% after the trial (p=0.007197). 42% of the participants slept before 12am at baseline, increasing to 64% at the end (p=0.0004883). More participants in group C were able to sleep more than 7 hours (p-value=3.426e-05) and those with high energy levels increased dramatically from 13% to 40% (p-value=0.0001221). However, some people have reported acne and oiliness as side effects.ConclusionsAshwagandha with higher levels of withanolides has been shown to be more effective in treating insomnia. Moderate levels may improve both energy levels and total sleep time, while unstandardized ashwagandha may only be effective in increasing energy levels.Funding SourcesThe company Nutripacks sponsored this testing trial.

Salivary Melatonin Changes in Oncological Patients: A Systematic Review.

Melatonin is known as a regulator of circadian sleep and waking rhythm. This hormone secreted by the pineal gland also has protective, oncostatic, and antioxidant properties. This systematic review was designed to answer the question “Is there a relationship between salivary melatonin changes and oncological diseases?”. Following the inclusion and exclusion criteria, ten studies were included, according to PRISMA statement guidelines. In all included studies, the diagnostic material was unstimulated whole saliva, in which the melatonin changes were determined by different laboratory methods. Most studies concerned changes in melatonin levels in patients with brain tumours due to a direct effect on the circadian rhythm centres. Other studies focused on disorders of melatonin secretion and its inclusion as a diagnostic marker in patients with prostate cancer and oral squamous cell carcinoma. The association between melatonin changes and sleep quality and chronotype in patients with newly diagnosed lung cancer and lymphoma survivors was also investigated. In conclusion, our systematic review may suggest trends for melatonin secretion alterations in oncological patients. However, due to the significant heterogeneity of the included reports, it is not possible to clearly determine a link between changes in salivary melatonin levels and the oncological diagnosis.

Melatonin pretreatment prevents propofol-induced sleep disturbance by modulating circadian rhythm in rats

Postoperative sleep disorder frequently occurs in patients after surgery. Sleep disturbance aggravates pain, anxiety, and delirium, which is an important risk factor for poor recovery. Circadian rhythm disorder induced by general anesthesia plays important role in postoperative sleep disorders. A large number of clinical studies have shown that various forms and duration of general anesthesia can lead to postoperative sleep disorders. In this study, the effect of prolonged propofol anesthesia on biological rhythm was comprehensively evaluated by wireless physiological telemetry system, and the therapeutic effect of exogenous melatonin pretreatment was further investigated. The results showed that prolonged propofol anesthesia had significant impacts on the circadian rhythm of sleep, body temperature, locomotor activity and endogenous melatonin secretion within 24 h following anesthesia, resulting in diminished oscillation amplitude. In hypothalamus, the expression of circadian factor PER and CRY were inhibited by propofol, possibly through activation of CAMK-CREB signaling pathway. Post-translational factors GSK-3β, SIRT1, AMPK were also involved in the regulation of circadian factors after propofol anesthesia. Melatonin pretreatment could restore circadian rhythm process by regulating circadian factor expression through post-translational modulation and prohibit the over-synthesis of melatonin in pineal gland. This study verified the effects of anesthetics on circadian rhythm and further evaluated the potential therapeutic effect of melatonin on postoperative circadian rhythm and sleep disorders.

Association of healthy beverage index with circadian rhythm and quality of sleep among overweight and obese women: a cross-sectional study.

Circadian rhythm is a behavioral, physiological, and molecular change with a cycle length of approximately 24h. Changes to the circadian rhythm can result in sleep difficulty. The healthy beverage index (HBI) is a holistic concept for evaluating the quality of overall beverage intake and its association with health-related outcomes in nutritional epidemiological studies. This study aimed to assess the relationship of HBI with circadian rhythm and sleep quality among overweight/obese women. The current study was conducted among 208 overweight and obese women between 18-48years in Tehran, Iran. We evaluated potential HBI with a valid food frequency questionnaire. Following standard procedures, trained personnel assessed anthropometric measures, blood samples, and other baseline characteristics. The Pittsburgh Sleep Quality Index and the morning-eveningness questionnaire were applied to evaluate sleep quality and circadian rhythm respectively. The mean (SD) BMI for this study was 30.8 (4.2) kg/m2. We observed that subjects in the least tertile had significantly high levels of triglyceride (p = 0.04) and low-density lipoprotein (p = 0.009). High-density lipoprotein was significantly different across the tertiles (p = 0.003). After adjusting for potential covariates, subjects in the second tertile of HBI had 5.07 odds of having the worst quality of sleep as compared to those in the third tertile, p < 0.05. We also observed a significant inverse association between the HBI and the "moderately evening type" participants (OR 0.86; 95% CI 0.68-0.99; p: 0.02) after adjusting for potential confounders. Healthy beverage consumption may have the potential of improving sleep quality among overweight and obese subjects. Level IV, evidence obtained from a descriptive study.