Common Sleep Disorder Research Articles

A critical review on clinical evidence of the efficacy of lavender in sleep disorders.

Sleep disorders are one of the most prevalent psychiatric diseases. Insomnia is the most common sleep disorder amongst the general population. It is also one of themost frequent complaints in primary healthcare centers. Lavender is called "the broom of the brain" in different oriental traditional medicines. It is one of the most used plants for patients with sleep disorders. This study reviews what is currently known about the use of lavender for sleep disorders in patients with different diseases, from cancers and end-stage renal disease to neurological-psychiatric diseases (e.g., depression, dementia, and autism), respiratory, cardiac, and metabolic diseases. Additionally, its most used administration route is the inhalation of its essential oil (i.e., aromatherapy) alone or in combination by massage. Some limitations of the reviewed literature were discussed briefly. Overall, this critical review provides promising evidence of the lavender efficacy for sleep disorders in a wide variety of populations and diseases. However, further clinical studies with robust design and longer durations of intervention are necessary for more evidence-based judgment on its effect on sleep problems and to investigate its mechanism of action.

Validation of Candidate Sleep Disorder Risk Genes Using Zebrafish.

Sleep disorders and chronic sleep disturbances are common and are associated with cardio-metabolic diseases and neuropsychiatric disorders. Several genetic pathways and neuronal mechanisms that regulate sleep have been described in animal models, but the genes underlying human sleep variation and sleep disorders are largely unknown. Identifying these genes is essential in order to develop effective therapies for sleep disorders and their associated comorbidities. To address this unmet health problem, genome-wide association studies (GWAS) have identified numerous genetic variants associated with human sleep traits and sleep disorders. However, in most cases, it is unclear which gene is responsible for a sleep phenotype that is associated with a genetic variant. As a result, it is necessary to experimentally validate candidate genes identified by GWAS using an animal model. Rodents are ill-suited for this endeavor due to their poor amenability to high-throughput sleep assays and the high costs associated with generating, maintaining, and testing large numbers of mutant lines. Zebrafish (Danio rerio), an alternative vertebrate model for studying sleep, allows for the rapid and cost-effective generation of mutant lines using the CRISPR/Cas9 system. Numerous zebrafish mutant lines can then be tested in parallel using high-throughput behavioral assays to identify genes whose loss affects sleep. This process identifies a gene associated with each GWAS hit that is likely responsible for the human sleep phenotype. This strategy is a powerful complement to GWAS approaches and holds great promise to identify the genetic basis for common human sleep disorders.

The Effects of CPAP Treatment on Resting-State Network Centrality in Obstructive Sleep Apnea Patients.

Background and ObjectivesObstructive sleep apnea (OSA) is the most common sleep disorder and previous studies have shown that OSA patients suffer from brain network impairments associated with cognitive deficits, and continuous positive airway pressure (CPAP) treatment can improve clinical symptoms. However, the relationship between CPAP treatment and brain network changes remains unclear. This study explored the characteristics of brain network changes in OSA patients before (pre-CPAP) and after one month of CPAP treatment (post-CPAP).MethodsWe collected data, including sleep monitoring, clinical assessment, and magnetic resonance imaging scans, from 21 OSA patients and 21 age-matched healthy controls (HCs). Voxel-level degree centrality (DC) was used to assess whole-brain network connectivity characteristics, a two-sample t-test was used to compare network differences between pre-CPAP OSA patients and HCs, and a paired sample t-test was used to compare the characteristics of brain network changes in OSA patients before and after treatment. The correlations between the DC value and each of the clinical variables were analyzed in the OSA patients.ResultsCompared with HCs, pre-CPAP OSA patients showed increased DC values in the bilateral cerebellar posterior lobes (CPLs) and decreased DC values in the right superior temporal gyrus, left superior frontal gyrus and right middle frontal gyrus. Compared with pre-CPAP OSA patients, post-CPAP OSA patients showed reduced DC values in the bilateral CPL and increased DC values in several brain regions in the frontal, temporal, and insular lobes after CPAP treatment. The Montreal Cognitive Assessment MoCA (MoCA) scores were positively correlated with the DC value of the bilateral cerebellum posterior lobe, right middle temporal gyrus, left superior temporal gyrus, left paracentral lobule and left paracentral lobule. Also, Pittsburgh Sleep Quality Index (PSQI) scores were negatively correlated with the DC value of the right middle temporal gyrus in post-CPAP OSA patients.ConclusionCPAP treatment can effectively reverse the compensatory response of the bilateral CPL and functional network damage brought about by OSA, which may provide potential neuroimaging biomarkers for CPAP treatment evaluation.

Deep Learning Forecasts the Occurrence of Sleep Apnea from Single-Lead ECG.

Sleep apnea is the most common sleep disorder that leads to serious health complications if not treated early. Forecasting apnea occurrence ahead in time provides the opportunity to take appropriate actions to control and manage it. A novel framework for forecasting the occurrence of apnea from single-lead electrocardiogram (ECG) based on deep recurrent neural networks is proposed. ECG R-peak amplitudes and R-R intervals are extracted and aligned using power spectral analysis, and recurrent deep learning models are developed to extract the most predictive ECG features and forecast the occurrence of apnea. The performance of the proposed approach was validated in forecasting apnea events up to five minutes in future on a dataset of 70 sleep recordings. A forecasting accuracy of up to 94.95% was achieved which was higher than the performance of conventional multilayer perceptron (p<0.05) and other state-of-the-art techniques. The proposed deep learning approach was successful in forecasting the occurrence of sleep apnea from single-lead ECG. It can therefore be adopted in wearable sleep monitors for the management of sleep apnea. Our developed algorithms are publicly available on GitHub.

Restless Legs Syndrome and Periodic Limb Movements of Sleep: From Neurophysiology to Clinical Practice.

This article summarizes restless legs syndrome (RLS), periodic limb movements of sleep, and periodic limb movement disorder. RLS is a common sleep disorder with a prevalence of 5% to 15% in the general population. RLS can present in childhood, and incidence increases with age. RLS can be idiopathic or secondary to iron deficiency, chronic renal failure, peripheral neuropathy, and medications such as antidepressants (with higher rates for mirtazapine and venlafaxine, while bupropion may reduce symptoms at least in the short term), dopamine antagonists (neuroleptic antipsychotic agents and antinausea medications), and possibly antihistamines. Management includes pharmacologic agents (dopaminergic agents, alpha-2 delta calcium channel ligands, opioids, benzodiazepines) and nonpharmacologic therapies (iron supplementation, behavioral management). Periodic limb movements of sleep are an electrophysiologic finding commonly accompanying RLS. On the other hand, most individuals with periodic limb movements of sleep do not have RLS. The clinical significance of the movements has been argued. Periodic limb movement disorder is a distinct sleep disorder that arises in individuals without RLS and is a diagnosis of exclusion.

Association between insomnia and subclinical atherosclerosis among Chinese steelworkers: a cross-sectional survey

BackgroundInsomnia is a common prevalent sleep disorder. Difficulty maintaining sleep or poor in quality in insomnia caused by disrupted or misaligned circadian rhythms may play an important role in the development of atherosclerosis. This study aimed to examine the association between insomnia and subclinical atherosclerosis in Chinese steelworkers.MethodsA total of 3240 subjects from a large enterprise located in northern China were included in this study. The Athens Insomnia Scale (AIS) was used to assess the status of insomnia. Subclinical atherosclerosis was evaluated using ultrasonographic measurements of carotid plaque. Multivariable logistic regression was used to identify association between insomnia and carotid atherosclerosis.ResultsThe overall prevalence of insomnia and carotid plaque were 35.3 and 31.7% in the study population. Compared with non-insomnia workers, significantly increased odds of carotid plaque were observed among insomnia workers after adjusting for potential confounders, odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.17 to 1.63. Exposure to current shift work and insomnia simultaneously can significantly elevated the odds of carotid plaque.ConclusionInsomnia is associated with elevated odds of carotid atherosclerosis in male steelworkers. Insomnia problems of workers should receive further attention in occupational worker health interventions.

Sleep Complaints Among School Children.

Sleep complaints are common among children. These include both night-time and daytime symptoms, such as trouble falling asleep, problems in maintaining sleep, snoring, and unusual events during sleep and daytime functioning impairment. However, sleep complaints in children are often overlooked and undertreated in clinical practice. Untreated sleep problems may further impact on children's development and will persist into adulthood in some cases. This review summarizes the common sleep complaints and disorders in school children, and provides an overview of the epidemiology, clinical features, consequences, and treatment of the sleep problems.

Sleep medicine in psychiatry and psychotherapy

Sleep medicine is across-disciplinary subject with high relevance for psychiatry and psychotherapy. The three most common sleep disorders (insomnia, sleep apnea syndrome and restless legs syndrome) are presented here with practical relevance. Cognitive behavioral therapy is the treatment of choice for insomnia, whereas symptomatic drug treatment (especially with GABA receptor agonists) should be used with caution. Sleep-related breathing disorders have ahigh prevalence of around 24% among psychiatric inpatients in Germany. Typical symptoms of obstructive sleep apnea syndrome should lead to astaged diagnostic process and, if necessary, cardiorespiratory polysomnography. It is not unusual for restless legs syndrome to be caused by psychopharmacological treatment. The primary form was usually treated with dopamine or dopamine agonists but due to the risk of augmentation, alternatives should be considered more often.

Factors Associated With Insomnia in Patients Undergoing Hemodialysis.

Introduction: Insomnia is the most common sleep disorder among patients on hemodialysis and has a strong relation with fatigue, depression, low immune system, increased risk of cardiovascular problems, and low quality of life. The aim of this study was to explore the factors associated with insomnia in patients undergoing hemodialysis. Methods: In this cross-sectional study, 100 patients on hemodialysis (75 males and 25 females) from a hemodialysis center in Greece were included. Insomnia was assessed via the "Athens Insomnia Scale (AIS)" and a questionnaire about demographic and clinical characteristics. The Kruskal-Wallis, Mann-Whitney tests, and Spearman's rho criterion were used to evaluate the association between insomnia score and patients' characteristics. Multiple linear regression was performed to assess the effect of characteristics on patients' insomnia.Results: Statistically significantly high levels of insomnia were found in patients over the age of 60 years (p = 0.002), in divorced/widowed patients (p = 0.007), in patients who had comorbid diseases (p = 0.001), in patients who felt tired after hemodialysis (p = 0.001), in those who had continuous fatigue (p = 0.001) and change in body image (p = 0.003), in those who often had itching (p = 0.007) and stiffness in joints (p = 0.001) and in patients who had limitations in the clothes they could wear (p = 0.001).Conclusions: The findings of this study showed that insomnia had a strong association with increased age of patients, comorbidities, fatigue, change in body appearance, pruritus, and limitation in clothes they could wear. Therefore, there is a necessity for early assessment of sleep quality and effective treatment of sleep disorders in hemodialysis patients in order to reduce morbidity and mortality and improve the quality of their life.

Rosacea, poor sleep quality, and obstructive sleep apnea: A commentary on potential interconnected features.

Although rosacea is classically considered a skin disorder, recent evidence shows that it is emerging as a systemic disease. The classical symptoms of burning, intense erythema, and flushing could be related to several systemic and metabolic comorbidities. We highlight the role of sleep disturbance as a possible trigger for rosacea, which could be explained by the inflammatory and stressful conditions that can be produced by poor sleep. In particular, we call attention to obstructive sleep apnea (OSA), a common multisystemic sleep disorder; it could be linked with rosacea in the context of the metabolic syndrome, which in turn is frequently associated with OSA. Obstructive sleep apnea may be accompanied by autonomic system activation and catecholamine release, which can aggravate rosacea. Poor sleep, resulting from any underlying cause, can have a range of effects including immunological modulation and intrinsic cutaneous changes (such as the impairment of skin barrier defense and modifications in the skin microbiome) that may trigger rosacea. Further studies on this subject could provide more evidence on these relationships and help to improve the patients' quality of life and management of this uncomfortable and potentially severe skin condition.

Racial disparity in sleep apnea-related mortality in the United States

BackgroundSleep apnea is one of the most common sleep disorders in the United States (US). Although the prevalence, risk factors, and clinical presentations of sleep apnea vary by racial groups, the racial disparity in sleep apnea-related mortality remains unclear. MethodsSleep apnea-related mortality for 1999–2019 was obtained from the National Center for Health Statistics provided by the Centers for Disease Control and Prevention. We examined the mortality trends for sleep apnea using Joinpoint regression analysis and compared the associated outcomes and multiple causes of death between Blacks and Whites. ResultsFor 1999–2019, sleep apnea was documented as the underlying cause of death in 17,053 decedents, with 2593 Blacks and 14,127 Whites. The overall age-adjusted mortality rates in all population, Blacks, and Whites were 2.5, 3.5, and 2.4 per 1,000,000 population, respectively (P < 0.001). Both Blacks and Whites had the highest mortality rates in the Midwest and the lowest in the Northeast. Despite the flattened mortality trend in the last decade overall, Black males had a continuous mortality increase over the study period (Annual Percentage Change 2.7%, 95% CI: 1.2–4.2). For both genders of sleep apnea decedents, Blacks were more likely to have multiple cause of death of Cardiac Arrest, Hypertension, Obesity, and Chronic Renal Failure, but Arrhythmia was more common in Whites (P < 0.05). ConclusionsThere is a significant racial disparity in sleep apnea-related mortality in the US. The uptrend in mortality in Black males and associated outcomes related to cardiovascular disease should raise concerns specifically in Blacks with sleep apnea.

Mechanism of SMND-309 against lung injury induced by chronic intermittent hypoxia

IntroductionObstructive sleep apnea–hypopnea syndrome (OSAHS) is a common sleep disorder that causes severe physiological disturbance. Evidence showed that OSAHS is an important associated comorbidity that can affect the survival of patients with pulmonary fibrosis. Until now, the potential mechanisms by which OSAHS accelerates the progression of lung fibrosis remain unclear. By constructing a pathological model of chronic intermittent hypoxia (CIH), the present study aimed to explore the pathological progress and potential mechanism of lung injury caused by OSAHS. Meanwhile, SMND-309 was given for treatment to evaluate its potential therapeutic role in CIH-induced lung injury. MethodsMice were randomly divided into (C57BL/6 wild-type) WT+(room air) RA, WT + CIH, SMND-309 + RA, and SMND-309 + CIH groups. The WT + CIH and SMND-309 + CIH groups were exposed to CIH condition for 12 weeks, while the other groups were processed in normal oxygen at the same time. The SMND-309 + RA and SMND-309 + CIH groups were intraperitoneally injected with SMND-309 at the last week of the modeling period. After 12 weeks of treatment, three mice from each group were perfused through the heart. Lung tissues were isolated, fixed, sectioned, and stained with H&E, Masson, and immunofluorescence stain. The rest of the lung tissues were harvested for Western blot and ELISA assays. ResultsCIH treatment increased the expression of pro-inflammatory factors (TNF-α and IL-6), resulting in lung tissue structure disorder, inflammatory cell infiltration, increased pulmonary capillary permeability, and pulmonary edema. The activation of the NF-κB signaling pathway played a crucial role in the process of inflammation. Noticeably, we observed M2 macrophage accumulation in the lung after CIH exposure, which promoted epithelial–mesenchymal transition (EMT) and pulmonary tissue fibrosis. ELISA assays showed the increased expression of TGF-β, IL-10, and IL-4 in the CIH group. SMND-309 inhibited pulmonary inflammation, reduced the accumulation of M2 macrophage, alleviated collagen deposition andlung damage. ConclusionCIH could induce chronic lung inflammation, promote the activation of M2 macrophages, trigger the occurrence of EMT, and accelerate the deposition of lung collagen, eventually leading to lung tissue damage. This study presents a possible explanation by which interstitial lung diseases, particularly idiopathic pulmonary fibrosis (IPF) with OSAHS, are usually associated with fast progress and poor prognosis. SMND-309 showed a good protective effect on CIH-induced lung damage.

Effects of Exercise on Cardiopulmonary Function in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated episodes of apnea and hypopnea during sleep. Snoring and daytime sleepiness are the most common manifestations of OSA. Patients with OSA are considered to have poor cardiopulmonary function. Exercise has been proposed as a treatment for OSA that could lower apnea hypopnea indices (AHI) and improve sleep quality. Study shows that constantly aerobic exercise improved cardiopulmonary function in patients with chronic heart failure. However, whether exercise training will benefit cardiopulmonary functioning in patients with OSA is still in doubt. The purpose of this review is to investigate the effect of exercise on cardiopulmonary functioning in adults with OSA by summarizing the results of clinical trials. A systematic review of the PubMed, Web of science, Wan Fang and CNKI databases was conducted for randomized controlled trials (up to October, 2021; language in English or Chinese) comparing exercise treatments to no exercise treatments for patients with OSA. Focused outcomes included AHI, VO2peak, mean oxygen saturations (SaO2mean%), lowest oxygen saturations (SaO2min%), sleep quality (PSQI scale), and quality of life (ESS scale). Pooled data were assessed by using random-effects. This study adhered to the PRISMA guidelines. Of 262 identified studies, 12 were eligible and included in final analysis (N = 530 adult participants). Compared to no exercise treatment, exercise yielded an improved mean reduction in AHI of 6.69 [95%CI: -8.50 to -4.87], an improved mean increases in VO2peak of 0.98 [95%CI: 0.39, 1.57], besides, PSQI and ESS scores decreased by 2.1 [95%CI: -3.95 to 0.24] and 6.69 [95%CI: -8.50 to 4.87], respectively. Although SaO2min% and SaO2mean% were improved by exercise, the improvement was clinically small. Exercise can improve multiple aspects of functioning in patients with OSA, including AHI, sleep quality, quality of life, and cardiopulmonary functions. Exercise is thus recommended as a potential therapeutic strategy to improve conditions of patients with OSA.

Prevalence of common sleep disorders in a middle-aged community sample.

There is a paucity of contemporary prevalence estimates for common sleep disorders of insomnia, obstructive sleep apnea (OSA), and restless legs syndrome. We aimed to assess the prevalence of clinically significant common sleep disorders in a middle-aged community sample. Parents of participants in the community-based Raine Study underwent assessments between 2015 and 2017, including comprehensive questionnaires, anthropometric measures, and in-laboratory polysomnography. Clinically significant sleep disorders were defined as chronic insomnia using the Pittsburgh Sleep Symptom Questionnaire-Insomnia with duration criterion ≥ 3 months; OSA as apnea-hypopnea index ≥ 5 events/h with excessive sleepiness (Epworth Sleepiness Scale ≥ 11) or apnea-hypopnea index ≥ 15 events/h (even in the absence of symptoms); restless legs syndrome when participants endorsed the International Restless Legs Syndrome Study Group diagnostic criteria (2003) with symptoms ≥ 5 times/month involving moderate-severe distress. At least 1 sleep-related assessment was completed by 1,005 (female = 586, 58.3%) middle-aged (45-65 years) participants, 72.5% of eligible Raine Study parents. The respective prevalences for clinically significant disease in females and males were as follows: OSA, 24.0% (95% confidence interval [CI]: 20.5-27.7) and 47.3% (95% CI: 42.2-53.4); insomnia, 15.8% (95% CI: 13.1-19.0) and 9.3% (95% CI: 6.8-12.4); restless legs syndrome, 3.7% (95% CI: 2.4-5.4) and 2.2% (95% CI: 1.1-3.9). At least 1 sleep disorder was present in 42.9% of those with complete data on all assessments (n = 895). Common sleep disorders are highly prevalent, to a clinically important extent, in an Australian community sample of middle-aged adults. Contemporary OSA prevalence is notably higher than previously reported and further work is needed to determine the communal impact of OSA. McArdle N, Reynolds AC, Hillman D, etal. Prevalence of common sleep disorders in a middle-aged community sample. J Clin Sleep Med. 2022;18(6):1503-1514.

New Rechargeable Lithium-ion AA Battery: More Economic and Eco-friendlier for Home Sleep Apnea Test

Background: Sleep Apnea is a common sleep disorder and Home Sleep Apnea Test (HSAT) is one of the relatively safe and convenient diagnostic screening tools of Sleep Apnea. Nowadays popular devices for HSAT suggesting to use AA batteries for power supply and disposable alkaline battery is recommended in the guideline of most devices. In 2019, a new type of rechargeable AA battery based on lithium-ion was successfully developed and put into the market. Here is the report of 2 years running, observing the performance of the new rechargeable lithium-ion AA battery, in order to proof the possibility and the advantage of the new lithium-ion battery replacing the existing battery. Method: Used Embla MPR PG with ST module to emulate an HSAT for 10 times and log the longest recording time of different battery. And analyze the voltage log of HSAT by Embla X100 in the past 3 years. Evaluate whether the new Rechargeable Lithium-ion battery is competent for HSAT by the longest recording time and the battery status during HSAT. Result: After 2 years of continuous use, the performance of Rechargeable lithium-ion battery was similar to that of Disposable alkaline battery. And Rechargeable lithium-ion battery had a constant voltage throughout the whole recording phase. Conclusion: The new rechargeable lithium-ion AA battery can perfectly replace the traditional disposable alkaline battery in the application of HSAT due to the un-obvious attenuation in 2 years. It also has great advantages in environmental protection and cost saving.

Patient preferences in obstructive sleep apnea-a discrete choice experiment.

Obstructive sleep apnea (OSA) is one of the most common chronic sleep disorders, which can be treated by different interventions. It is known that acceptance and adherence to these therapies is influenced by a variety of factors. However, there is a limited understanding of patient preferences and decision-making in the context of OSA treatment. A discrete choice experiment was conducted on patientswith OSA recruited from a tertiary sleep center to evaluate preferences for different treatment attributes. Participants received four different choice tasks with three hypothetical treatments, each defined by seven attributes. A random-effects logit model was used to estimate the influence of the different attributes on the choice decisions. Multivariate logistic regression analysis was carried out to evaluate interactions with medical variables. In a cohort of 241 subjects with OSA, preferences for treatment attributes and utilities derived from them differed. Most relevant attributes were Reduction in risk of comorbidities, Improvements of daytime sleepiness, Requirement for surgery, and Occurrence of treatment-related side effects. Demographic or medical variables, such as age, gender, or apnea-hypopnea index, did not influence the choice decision. Multivariate logistic regression revealed significant differences in preferences depending on OSA disease history (p = .025) and presence of OSA symptoms (p = .033). The study identified preferences for attributes of OSA and their utilities from a patient perspective. Relevant differences of preferences in subgroups of patients withOSA were identified, which may be important to consider in selecting appropriate treatments that lead to high rates of acceptance and adherence.

A study of perceived stress level and sleep quality among physicians in a hospital of West Bengal, during the second wave of the present coronavirus disease-19 pandemic

Background: Stressful life events may lead to insomnia, a very common sleep disorder. Aim and Objectives: The aim of the study was to study the correlation of perceived stress levels and sleep quality among physicians during the coronavirus disease-19 Pandemic. Materials and Methods: Physicians working in Burdwan Medical College were selected as a study group and age, sex-matched controls were selected from other non-medical workers. This online survey was conducted using Google Forms. The form was shared with participants using emails and WhatsApp. In the first section of the form the importance of the study was explained and informed consent was taken from the participants. In the second part of the form, subjects were asked to fill up demographic details and relevant history; in the third part, participants were asked to fill up two scales: Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Results: 128 doctors and 114 other staff participated in the present study. Doctors had significantly higher PSS and PSQI levels as compared to the other group. Doctors’ PSQI: Mean ± SD = 7.59 ± 4.37 and other staff PSQI: Mean ± SD = 5.77 ± 2.75; P: 0.00013**. Doctors’ PSS: 18.43 ± 4.04 and other staff PSS: 15.14 ± 1.7; P < 0.0001**. PSS and PSQI levels were positively correlated in both groups with r values of 0.975 for Doctors and 0.544 for other staff, respectively. Conclusions: Doctors were found to have higher PSS and PSQI levels as compared to the control group. PSS levels were found to be positively correlated with PSQI levels and more so among doctors.

Ensemble Computational Intelligent for Insomnia Sleep Stage Detection via the Sleep ECG Signal

Insomnia is a common sleep disorder in which patients cannot sleep properly. Accurate detection of insomnia disorder is a crucial step for disease analysis in the early stages. The disruption in getting quality sleep is one of the big sources of cardiovascular syndromes such as blood pressure and stroke. The traditional insomnia detection methods are time-consuming, cumbersome, and more expensive because they demand a long time from a trained neurophysiologist, and they are prone to human error, hence, the accuracy of diagnosis gets compromised. Therefore, the automatic insomnia diagnosis from the electrocardiogram (ECG) records is vital for timely detection and cure. In this paper, a novel hybrid approach based on the power spectral density (PSD) of the heart rate variability (HRV) is proposed to detect insomnia in three classification scenarios: (1) subject-based classification scenario (normal Vs. insomnia), (2) sleep stage-based classification (REM Vs. W. stage), and (3) the combined classification scenario using both subject-based and sleep stage-based features. The ensemble learning of random forest (RF) and decision tree (DT) classifiers are used to perform the first and second classification scenarios, while the linear discriminant analysis (LDA) classifier is used to perform the third combined scenario. The proposed framework includes data collection, investigation of the ECG signals, extraction of the signal HRV, estimation of the PSD, and AI-based classification via hybrid machine learning classifiers. The proposed framework is fine-tuned and evaluated using the free public Physio Net dataset over fivefold trails cross-validation. For the subject-based classification scenario, the detection performance in terms of sensitivity, specificity, and accuracy is recorded to be 96.0%, 94.0%, and 96.0%, respectively. For the sleep stage-based classification scenario, the detection evaluation results are recorded equally with 96.0% for ceiling level accuracy, sensitivity, and specificity. For the combined classification scenario, the LDA classifier have achieved the best insomnia detection accuracy of 99.0% of the three cases as discussed. In future, the proposed approach could be applicable for mobile observation schemes to automatically detect insomnia disorder.

The Prevalence of Insomnia in University Students and Its Relationship with Quality of Life: A University Sample

Aim: The goal of this study was to find out how common sleep disorders are among university students and to see how they relate to depression, anxiety, stress levels, personality factors, and overall quality of life. Materials and Methods: This study comprised a total of 856 students. Initially, Pittsburg Sleep Quality Index (PSQI) and a Sociodemographic Data Form were applied. Those with a PSQI score of ≥6 were scheduled for a second interview and a psychiatric interview was conducted. The participants were divided into two groups as those diagnosed with insomnia (n=104) and control group (n=95). Both groups were applied Insomnia Severity Index (ISI), Depression Anxiety Stress Scale (DASS), Eysenck Personality Questionnaire-Revised/Abbreviated Form (EPQR-S), and Short Form-36 (SF-36). Results: Point prevalence of insomnia among study participants was 12.1%. Insomnia was more common in those who have just started university, were staying in dormitories, had a physical disorder, were smoking, had no regular breakfast habits, and were using electronic media more frequently. When compared to the control group, the ISI scores, DASS depression, anxiety, and stress scores, and EPQR-S neuroticism scores were statistically substantially higher in the insomnia group. Physical function, role limitation (physical), pain, general health, vitality (energy), social function, role limitation (emotional), and mental health were statistically substantially lower in the insomnia group than in the control group on the SF-36 subscales. Conclusion: Insomnia is a prevalent affliction among college students. In students with insomnia, depression and anxiety disorders are more common. Insomnia is also linked to a low quality of life and certain personality features.

The frequency of insomnia and associated factors among schoolteachers in the Makkah region, Saudi Arabia

Background: Insomnia is a common sleep disorder among schoolteachers. We aimed to investigate the frequency and prevalence of insomnia among schoolteachers in western Saudi Arabia. Methods: An online survey was distributed to schoolteachers in the Makkah region. The validated insomnia severity index was used to find the frequency of insomnia among teachers. Results: A total of 499 teachers participated in this study, with a mean age of 45.6 (SD = 8.45). Most had no clinically significant or subthreshold insomnia (50.10% and 36.27%, respectively), while 1.40% of the teachers reported severe insomnia and 12.22% reported moderate insomnia. Most of the teachers had a reasonable awareness of insomnia (99.93%). Moreover, past histories of insomnia and depression were significantly associated with insomnia (p-value = 0.000). Conclusion: Insomnia is a common sleep issue among schoolteachers, according to our findings. Accordingly, annual screening programs are necessary for its early detection. Furthermore, we suggest that future studies estimate the prevalence of insomnia among teachers nationally.