Sleep Daytime Research Articles

Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha w.r.t. Tinia Corporis - A Case Study

Ayurveda have been classified all the skin diseases under the broad heading of ‘Kushta’ which were sub classified into Mahakushta and Kshudrakushta. Hetu (Causative factors) of Dadru Kushta involves Vishamashana (Incompatible food), Vegavidharana (suppression of natural urges), Diwaswapa (daytime sleeping), intake of Atilavana, Atitikshnaahar (excessive salty or spicy food), intake of contaminated food, drinking cold water just after physical work or Atapsevana (exposure to sunlight). Lakshanas of Dadru include Kandu (Itching), Utsanna (elevated circular lesions), Mandala (Circular Patches), Raaga (Erythema), and Pidakas (Papule). The Samprapti of Dadru mainly involves vitiation of Pitta-kapha Doshas and Dushti of rasa and Raktavaha Strotas. A 56 year old male patient, came to OPD with the complaints of reddish circular patch on chest and back with sever itching and burning sensation since last 3 months. After examination patient was diagnosed as case of Dadru Kushth and was treated with Ayurvedic management protocol i.e., Abyantar Snehan with Nitya Virechan, Shaman Aushdhi and Bahirparimarjan Chikitsa for 1 month and was taken follow up after 14days. Dietary restriction was advised to avoid spicy and junk food along with personal hygiene to be maintained. After complete treatment of 1 month patient was assessed with parameter like raga (redness), Kandu (itching), Daha (burning sensation), and Utsana Mandal on a grade from 0 to 3 and there was significant improvement was noted. From this case study it can be concluded that use of Nitya Virechan with Snehapan with Panchatikta Ghruta and Shaman Aushdhi along with Bahya Chikitsa can treat Dadru Kushta.

Actigraphy as a modern method of disease diagnostics

Medicine of the 21st century has an extensive arsenal of means for diagnosing diseases. High-tech equipment is able to detect pathologies without clinical manifestations during the latent stage of disease development. Actigraphy is portable device based on accelerometer, used for tracking sleep parameters, and also, well established as a tool for tracking circadian rhythms of a person. Actigraphy is not an alternative to the use of polysomnography, however, it has advantages in ease of use, cost, and size of the device, in addition to allowing long-term continuous recording of night and daytime sleep over several days or weeks in the patient's home sleep environment. In addition to its primary function, the study of sleep characteristics, actigraphy is widely used as a method for detecting and monitoring diseases, including cognitive impairment, psychiatric disorders, cardiovascular pathologies, and respiratory diseases. In this review, we have compiled current information on the use of actigraphy as a tool for disease diagnosis. The described results allow us to summarize the useful characteristics of such a diagnostic tool and shed light on the application of this progressive and reliable method in medicine.

Development of a guide for continuous positive airway pressure use - A good fit: Making continuous positive airway pressure work for you.

Obstructive sleep apnea (OSA) is highly prevalent in veterans with mental illnesses such as post-traumatic stress disorder (PTSD). Untreated OSA reduces the effectiveness of the treatment of PTSD. Treatment of OSA has been shown to reduce daytime sleepiness and symptoms of PTSD and depression. Continuous positive airway pressure (CPAP) therapy is the most effective treatment for OSA. A large number of veterans cannot tolerate CPAP therapy due to anxiety and PTSD symptoms. Positive airway pressure (PAP) NAP, a daytime sleep study for patients with anxiety about starting CPAP and exposure-based cognitive behavioural interventions are the mainstay for the management of CPAP intolerance. However, these options are not readily available to veterans in rural areas, who constitute about 40% of veterans registered in the South Texas Veterans Health Care System (STVHCS). After getting local IRB exemption, we surveyed thirty (30) veterans in the outpatient clinic setting who could not tolerate CPAP therapy to evaluate the need for a tool to improve CPAP adherence. We reviewed the literature and conducted focused group meetings with local and national experts. We also convened consumer groups and stakeholder meetings, including primary care, sleep medicine, and mental health providers. After a comprehensive evaluation process, we compiled a concise self-help guide combining principles of cognitive behavioural therapy using a behavioural hierarchy approach towards CPAP desensitization. This guide can be used by veterans independently at their homes to improve CPAP use. A printer-friendly version is available for download on the South Central Mental Illness, Research, Education and Clinical Center (SC MIRECC) and the South Texas Veterans Healthcare System (STVHCS) website. The guide will be provided to veterans during the initial CPAP setup and available in clinic waiting rooms throughout the system. Our guide will serve as an effective self-help tool to improve CPAP adherence. It may result in the improvement of various medical and psychiatric conditions.

Self-Similarity Analysis of Heartbeat Fluctuations in Sleep Among Female Shift Workers

Cardiovascular signals exhibit self-similarity characteristics, which are influenced by changes in autonomic nervous system (ANS) regulation caused by shift work. This study aims to assess the self-similarity properties of inter-beat interval (IBI) in healthy female shift workers and non-shift workers in different sleep stages to detect alterations in heartbeat fluctuations due to shift work. Short- and long-term self-similarity properties of the IBI signal ([Formula: see text] and [Formula: see text] scaling exponents, respectively) were analyzed using Detrended Fluctuation Analysis. Time and frequency indices were also calculated. In addition, Principal Component Analysis (PCA) was employed to reduce dimensionality and evaluate group separability based on the obtained features. Most indices showed similar values in the different sleep stages for both groups, but [Formula: see text] during light sleep and sympathovagal balance during REM sleep showed a significant decrease in shift workers compared to non-shift workers ([Formula: see text]). In addition, PCA was able to separate shift workers from non-shift workers and differentiate between nighttime and daytime sleep of workers. This analysis aids in identifying cardiovascular impairment associated with shift work and suggests a loss of ANS self-similarity in shift workers, indicating reduced adaptive capacity. Such alterations in ANS behavior could lead to serious health consequences related to cardiovascular disease.

Impact of sleep quality on academic achievements of undergraduate medical students: a cross-sectional study from Saudi Arabia

BackgroundSleep is an active process that affects human health and quality of life. Sleep is essential for learning and memory consolidation. Good sleep is required for good academic performance. Sleep disorders are common among medical students, due to the high academic load, stressful life, and hectic schedule. Therefore, this study aims to assess sleep quality among medical students.MethodsA cross-sectional study was conducted among medical students at King Khalid University by using the Pittsburgh sleep quality index (PSQI) to assess sleep duration, sleep efficiency, sleep latency, and global PSQI score. Participants were enrolled from second to sixth year. Bivariate and multivariate logistic regression were used to predict factors related to poor sleep quality.ResultsOut of 514 medical students, 453 (88.1%) of students exhibited poor sleep quality. Fourth year students were less likely to have poor sleep quality (AOR, 0.381; CI, 0.158–0.934) p = 0.035 and students with regular sleep schedule were more likely to be good sleepers (AOR,0.349; CI, 0.129–0.940) p = 0.037. Additionally, students who had more than five courses per semester more frequently had daytime sleepiness p = 0.03. However, Insufficient sleep was not significantly affected by factors like gender, different age groups, number of courses per semester, daytime sleeping, and students with varying Grade Point Averages (GPA).ConclusionPoor sleep quality is common among medical students, which may affect academic performance and general health. It is essential to educate them about good sleep hygiene and time management skills.

Optimising lighting conditions to enhance seafarer adaptation to the '6-h on/6-h off' shift pattern: a balanced crossover study.

The '6-h on/6-h off' shift pattern could potentially disrupt the physiological rhythms and cognitive performance of seafarers, attributed to its shorter and more frequent shifts. Conversely, light exposure has been demonstrated to enhance cognitive abilities and synchronise physiological processes. Therefore, we studied the fatigue, cognition, sleep and rhythm of seafarers with different shifts to determine how light can benefit their performance. A total of 16 seafarers participated in a 2 × 2 crossover study, which involved two shift types (Morning-Evening and Day-Night) and two lighting conditions (static lighting and dynamic lighting). Sleepiness, cognition and fatigue were assessed every 2 h during '6-h on' period, using the Karolinska Sleepiness Scale, psychomotor vigilance task, critical flicker frequency and visual analogue scale for fatigue. Sleep was monitored during '6-h off' period, core body temperature was continuously tracked for rhythm throughout the shift protocol. For the Day-Night shift, the static mode with stable higher illuminance than dynamic lighting significantly reduced sleepiness (p = 0.01), objective fatigue (p = 0.001), subjective fatigue (fatigue level [p = 0.004] and visual fatigue [p = 0.001]) during the night period, while increasing sleep duration during the day (6:00 a.m. to 12:00 p.m.) and delaying the rhythm. For the Morning-Evening shift, dynamic lighting with lower illuminance significantly increased sleep duration during the night (12:00 a.m. to 6:00 a.m.) without causing a significant difference in performance. Overall, static lighting is more suitable for Day-Night shift seafarers due to lower sleepiness, fatigue and longer daytime sleep duration, while dynamic lighting is more suitable for Morning-Evening shift seafarers due to longer night-time sleep duration. Therefore, different lighting patterns should be adopted for seafarers during different shifts.

Impact of Varying Sleep Pressure on Daytime Sleep Propensity in Healthy Young and Older Adults.

Fixed sleep schedules with an 8 h time in bed (TIB) are used to ensure participants are well-rested before laboratory studies. However, such schedules may lead to cumulative excess wakefulness in young individuals. Effects on older individuals are unknown. We combine modelling and experimental data to quantify the effects of sleep debt on sleep propensity in healthy younger and older participants. A model of arousal dynamics was fitted to sleep data from 22 young (20-31 y.o.) and 26 older (61-82 y.o.) individuals (25 male) undertaking 10 short sleep-wake cycles during a 40 h napping protocol, following >1 week of fixed 8 h TIB schedules. Homeostatic sleep drive at the study start was varied systematically to identify best fits between observed and predicted sleep profiles for individuals and group averages. Daytime sleep duration was the same on the two days of the protocol within the groups but different between the groups (young: 3.14 ± 0.98 h vs. 3.06 ± 0.75 h, older: 2.60 ± 0.98 h vs. 2.37 ± 0.64 h). The model predicted an initial homeostatic drive of 11.2 ± 3.5% (young) and 10.1 ± 3.5% (older) above well-rested. Individual variability in first-day, but not second-day, sleep patterns was explained by the differences in the initial homeostatic drive for both age groups. Our study suggests that both younger and older participants arrive at the laboratory with cumulative sleep debt, despite 8 h TiB schedules, which dissipates after the first four sleep opportunities on the protocol. This has implications for protocol design and the interpretation of laboratory studies.

Temperature-dependent sleep patterns in Drosophila.

Sleep is a fundamental physiological process conserved through evolution, from worms to humans. Understanding how temperature influences sleep is essential for comprehending the complexities of animal behavior, physiology, and their adaptations to thermal environments. This study explores the impact of temperature on sleep behavior and patterns in Drosophila melanogaster. Through a comprehensive analysis, we assessed how temperatures during development and adulthood affect sleep duration and fragmentation. Our results show that exposure to non-optimal temperatures increases overall sleep duration, primarily by extending daytime sleep. Sleep patterns were also substantially modulated by developmental temperature. Flies that developed at 29°C exhibited longer sleep durations compared to those that developed at either 19°C or 25°C. In general, sleep was more prevalent than wakefulness under most conditions, particularly at non-optimal temperatures. At intermediate temperatures, sleep became more fragmented and episodes shorter. The interplay between sleep and wakefulness varied depending on both population and developmental temperature. Developmental and adult temperatures also influenced sleep latency, the time it takes to fall asleep. Interestingly, the impact of temperature on daytime sleep latency differed among populations, whereas nighttime sleep latency consistently increased with temperature for all groups. Flies that developed at 29°C showed shorter sleep latencies than those from other temperatures, both during the day and night. Finally, a strong negative correlation was observed between total sleep duration and daily locomotor activity across all groups and temperatures. These findings underscore the critical role of environmental temperature in regulating sleep behavior in Drosophila, with potential implications for understanding temperature-dependent sleep mechanisms in other organisms.

Prevalence And Risk Factors Of Poor Quality Of Sleep In Working Women: A Cross-Sectional Study

Objective: An overwhelming number of working women report sleep difficulties, which in turn lead to various health issues. However, there is a dearth of studies focusing on increasing health problems. Consequently, the objective of the current investigation was to ascertain the potential determinants that contribute to this escalating health concern. Methodology: A sample of 343 working women aged 25 to 50 years were recruited from the community. They completed an online/offline assessment performed for demographic details along with self-reported questionnaires (Pittsburgh Sleep Quality Index (PSQI), PROMIS 8b, Epworth Sleepiness Scale (ESS), Dysfunctional Attitudes and Beliefs about sleep (DBAS), Sleep Hygiene Index (SHI), International Physical Activity Questionnaire (IPAQ), and Short-Form (SF) – 12. Sleep quality, sleep health, daytime sleepiness, attitudes and beliefs about sleep, sleep hygiene, physical activity level and quality of life were examined respectively, as predictors of poor quality of sleep. Results: The results revealed that 83.1% of the working women were poor sleepers. Linear regression analysis identified that sleep health, daytime sleepiness, attitudes and beliefs about sleep, and physical component scores of Quality of Life (QoL) were significant predictors of poor sleep quality. Conclusion: Poor sleep quality is correlated with factors such as daytime sleepiness, sleep health, attitudes and beliefs about sleep, and the physical component scores of quality of life in working women.

The effects of sleep deprivation on the balance system: following normal sleep, 24h of sleep deprivation, and rest under eyes-open and eyes-closed conditions.

This study investigated the effects of sleep deprivation (SD) on balance after normal sleep, 24h of SD, and subsequent rest under eyes-open (EO) and eyes-closed (EC) conditions. Our aim was to ascertain whether the reduced efficiency of balance control following SD is generalized or selective. Nineteen participants (12 females, 7 males) completed the Pittsburgh Sleep Quality Index (PSQI). The mean ages for male participants were 24.14 ± 0.37years, their height was 180.71 ± 5.46cm, and weight of male participants were 81.71 ± 13.42kg. For female participants, the mean ages were 24.41 ± 4.01years, their height was 163.66 ± 2.64cm, and their weight was 59.54 ± 9.18kg. Stance analyses were conducted after normal sleep, 24h of SD, and subsequent rest of both the EO and EC. Participants performed a normal balance test, a second test while holding cubes and counting backwards from 200 by sevens, and a third test after rest under EO and EC. Independent samples t-tests showed significant height and weight differences between sexes (p < 0.05), with females generally smaller. No significant differences were found in age, daytime sleep duration, or PSQI score (p > 0.05). Significant differences in parameters such as length of the minor axis (lomna), angle, and area were observed in EO and EC across the three days, revealing the interplay between visual stimuli, cognitive tasks, and parameter stability. SD has multifaceted impacts on motor and cognitive performance, even when attentional and sensory resources are not strained. Our findings elucidate the nuanced impact of SD on cognitive performance, and suggest the efficacy of external factors in mitigating its effects on postural control.

Longitudinal pathways linking peer victimization to academic efficacy in adolescence: Indirect effects via sleep

Although past research links greater peer victimization to poorer academic achievement, much less is known about if or how peer victimization contributes to adolescents’ academic efficacy, a potentially malleable predictor of academic success. Informed by the biopsychosocial framework of sleep that emphasizes the interplay of interpersonal dynamics and bioregulatory processes in shaping developmental outcomes, the current study investigated pathways from peer victimization to academic efficacy across adolescents’ first 2 years of high school, testing sleep as a potential underlying mechanism. Participants were 388 ninth-grade adolescents ( Mage = 14.05, SD = 0.41; 61% female) who completed five online assessments of peer victimization, sleep, and academic efficacy across ninth and 10th grades. Multilevel mediation models indicated that higher levels of peer victimization during ninth grade predicted increased daytime dysfunction and sleep disturbances at the beginning of 10th grade, which, in turn, predicted poorer academic efficacy by mid-year of 10th grade. No significant indirect effects were found for the models testing sleep duration and latency as mediators. The findings highlight specific dimensions of sleep as potential modifiable targets for interventions that could mitigate the harmful impact of peer victimization on adolescents’ academic efficacy.

Overexpression of α-synuclein in PDF neurons alters sleep-wake pattern by regulating lipid metabolism in Drosophila.

Parkinson's disease (PD) is a complex neurodegenerative disorder, characterized by the aggregation of α-synuclein (α-syn). Current research increasingly indicates the prevalence of sleep-wake disorders in early-stage PD, although the underlying pathogenic mechanisms remain unclear. In this study, transgenic Drosophila models were utilized to observe excessive daytime sleepiness and impaired anticipation in flies overexpressing α-syn in pan-neurons and circadian clock neurons. Additionally, deficits in projection of Pigment Dispersing Factor (PDF) neuron terminals, which are involved in Drosophila sleep and circadian rhythm, were identified. An imbalance in lipid metabolism homeostasis was detected in the brains of α-syn overexpressing mutants. Ultimately, the inhibition of Sterol Regulatory Element-Binding Protein (SREBP) activity led to an improvement in the reduced daytime sleep duration phenotype. Our results suggest that lipid pathways play a role in sleep-wake disorders triggered by α-syn mutation and aggregation, thereby providing valuable insights into potential therapeutic avenues for disrupted sleep patterns associated with PD.

Association Between Physical Activity and Sleep Health Among Community-Dwelling Adults Aged ≥50 in Ghana: The Mediating Role of Psychosomatic Factors

ABSTRACT Objectives Data on the direct and indirect associations between physical activity (PA) and sleep quality in old age via psychosomatic mechanisms (e.g. mobility, pain, loneliness, depression, and anxiety) remain scarce in low- and middle-income countries (LMICs). We explored the association of PA with poor sleep quality (PSQ) among individuals aged ≥ 50 in Ghana and explored the potential mediating factors in this association. Methods We analyzed community-based data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. We assessed PA using the International Physical Activity Questionnaire (IPAQ). Two items on nighttime and daytime sleep problems in the last 30 days were used to measure PSQ. Multivariable ordinary least square (OLS) regressions and bootstrapping models were performed to evaluate the associations. Results Overall, 1,201 participants (Mage = 66.15 ± 11.58 years; 63.3% female) were included in the analysis. PA was independently associated with decreased PSQ in the overall sample (B = −0.181, 95%I = −0.271 to −0.092) and in women (B = −0.195, 95%I = −0.305 to −0.084). The association was stronger in the ≥ 65 (B = −0.138) than in the 50–64 age group (B = −0.213). Mobility (37.06%), pain (23.66%), loneliness (6.71%), and comorbid anxiety and depression (8.95%) mediated the PA-PSQ association. Conclusions PA was associated with decreased PSQ levels, which was particularly explained by psychosomatic factors. Clinical implications Clinicians encourage older adults to engage in regular PA and manage psychosomatic problems may improve their sleep health.

Sleep duration among breastfed, goat milk-based or cow's milk-based infant formula-fed infants: Post hoc analyses from a double-blind RCT.

To determine total, night- and daytime sleep duration and waking frequency among infants exclusively fed goat milk-based infant formula (GMF) or cow's milk-based infant formula (CMF) enroled in a randomised controlled trial and compare these to a human milk (HM) fed reference group. Post hoc analysis from a double-blind randomised controlled trial in 304 healthy term infants was performed. Formula-fed infants were randomly assigned to receive exclusively GMF or CMF for a period of 112 days and compared to a reference group fed HM. Sleep was assessed using a 3-day 24-h diary before the five visits throughout the trial. The association between feeding type and sleep was studied longitudinally and cross-sectionally at the five visits. All models were adjusted for infant sex and study site of enrolment. For associations between formula-fed infants and the non-randomised HM group, additional adjustments were made. Total sleep duration slowly and similarly decreased over the course of study duration for all groups, with a decrease of about an hour between the first and last measurement. Longitudinally, daytime sleep duration was significantly longer for GMF (mean 8.6 h, standard error [SE] 0.17) and HM (8.8, 0.18) fed infants as compared to CMF (8.1, 0.17; p < 0.05). Cross-sectional analyses show that infants fed GMF or HM had higher total sleep duration than infants fed CMF at all visits, with significant differences between the groups at Visits 3 and 4. In infants fed GMF a significantly longer daytime sleep duration and a non-significant trend towards a longer total sleep duration were found when compared to infants fed CMF. These findings suggest that nutrition plays a role in sleep duration.

Attitudes Towards Unhoused Park Users and Preferences for Public Space Management: Applying the Potential for Conflict Index2 Approach

While parks and other public spaces are important to people experiencing homelessness for many reasons, there is a relative lack of research focused on their equitable management for this vulnerable user group. We contextualize our work in this gap, through the application of the Potential for Conflict Index2 (PCI2) approach. Using community survey data, we sought to understand perceived acceptability of various responses to scenarios involving unhoused park users among members of the housed public. Results indicate that respondents largely view people experiencing homelessness as legitimate park users, support their right to use parks in a variety of ways that align with norms of acceptable behavior in public spaces, and favor a variety of responses specific to the scenario at hand. Potential for conflict was greatest with overnight occupation and daytime sleeping, where those with positive and negative attitudes toward people experiencing homelessness held different priorities and endorsed different responses.

A meta-analytic review of cognitive behavior therapy and motivational interviewing for adolescent and young adult sleep concerns.

Cognitive behavioral therapy (CBT) is an evidenced-based treatment for sleep concerns but may be insufficient on its own to resolve adolescent sleep problems - combining this treatment with motivational interviewing may result in more robust improvements to sleep in adolescents and young adults (AYA). This study aimed to conduct the first meta-analysis of integrated CBT and motivational interviewing (MI) for AYA sleep concerns. Following PRISMA guidelines, PsycINFO, PubMed, and Google Scholar were searched through January 2024. Cohen's d was computed for effect sizes. Eligible articles included AYA utilized an integration of CBT and MI, reported quantitative outcomes related to sleep, and were published in peer-reviewed journals and available in English. Four studies were eligible for the meta-analysis (N = 435). Results showed a small-medium effect size for reduced daytime sleepiness (d = 0.39, p = .001) and increased total sleep time (d = 0.25, p = .008) following integrated CBT and MI. Risk of bias was assessed using CMA. The findings suggest integrated CBT and MI is beneficial for AYA daytime sleepiness and sleep duration, more effective than CBT alone and other control groups. These findings contribute to the understanding of effective interventions for AYA sleep concerns, offer practical insights for practitioners, and highlight the need for further investigation into the integration of CBT and MI.

Patterns of Interhemisphere Interactions on Waking from Brief Episodes of Daytime Sleep

Patterns of Interhemisphere Interactions on Waking from Brief Episodes of Daytime Sleep

Samelisant (SUVN-G3031), A Histamine 3 Receptor Inverse Agonist: Results from The Phase 2 Double-Blind Randomized Placebo-Controlled Study for The Treatment of Excessive Daytime Sleepiness in Adult Patients with Narcolepsy

Narcolepsy is a rare, chronic neurological disorder characterized by a dysregulated sleep-wake cycle, with core clinical features including excessive daytime sleepiness (EDS), cataplexy, hypnopompic/hypnagogic hallucinations, and sleep paralysis. Several treatment options are available for the symptomatic management of narcolepsy, but they have limitations. Comorbidities of narcolepsy further limit the treatment choices. Blocking of histamine 3 (H3) receptors has been demonstrated to be a viable approach for the management of symptoms of narcolepsy. Samelisant (SUVN-G3031) is a new H3 receptor inverse agonist. The efficacy, safety, tolerability, and pharmacokinetics of Samelisant in narcolepsy patients were evaluated in a phase 2, double-blind, placebo-controlled study (ClinicalTrials.gov identifier: NCT04072380). Patients diagnosed with narcolepsy according to the International Classification of Sleep Disorders criteria and having an Epworth Sleepiness Scale (ESS) score of ≥12 and a mean Maintenance of Wakefulness Test (MWT) time of <12min across the 4 sessions at baseline were enrolled. The total study duration was up to 7 weeks, which included a screening period of 4 weeks, a treatment period of 2 weeks, and a safety follow-up 1 week after the last study drug administration. The primary efficacy measure was the change in total ESS score compared to placebo. Secondary and exploratory assessments included the Clinical Global Impression of Severity, MWT, Clinical Global Impression of Change, Patient Global Impression of Change and cataplexy rate. Safety assessments included monitoring adverse events (AEs) and laboratory assessments. Of the 426 patients screened, 190 were randomized. The safety and intention-to-treat population included 188 and 164 patients, respectively. A statistically significant treatment effect of Samelisant was observed on the primary endpoint, indicating improvements in EDS. The treatment's impact on EDS was also evident on the other patients' and clinicians' perspectives scales. The AEs reported in ≥5% patients in any treatment groups were insomnia, abnormal dreams, nausea, and hot flush. Global phase 3 studies and long-term safety and efficacy assessments of Samelisant are planned to reaffirm the current findings.

Modification of a parent-report sleep scale for individuals with CDKL5 deficiency disorder: a psychometric study.

Sleep difficulties are common in CDKL5 deficiency disorder, a developmental and epileptic encephalopathy. This study evaluated the factor structure of the Disorders of Initiating and Maintaining Sleep (DIMS), Disorders of Excessive Somnolence (DOES), and Sleep Breathing Disorders domains of the Sleep Disturbance Scale for Children for CDKL5 deficiency disorder. A cross-sectional psychometric study design was used. Data were collected for 125 individuals aged 3 years or older who attended a United States Centers of Excellence clinic or registered with the International CDKL5 Disorder Database. The median age was 10.3 years (range 3.2-40.7 years) and 105 (84%) were female. Two of the 3 Sleep Breathing Disorders items were not observed by most respondents and analysis was restricted to the DIMS and DOES domains. Using all items in the initial confirmatory factor analysis, 2 items in the DIMS domain and 1 item in the DOES domain loaded poorly. After deleting these items and repeating the analysis, item loading (.524-.814) and internal consistency (DIMS: .78, DOES: .76) statistics were good. The square of the interdomain correlation coefficient was .17, less than average variance extracted values for both domains and indicating good discriminant validity. The Tucker-Lewis and Comparative Fit indices were slightly lower than the threshold of > .9 for establishing goodness of fit. The modified DIMS and DOES domains from the Sleep Disturbance Scale for Children could be suitable clinical outcome assessments of insomnia and related impairments in CDKL5 deficiency disorder and potentially other developmental and epileptic encephalopathy conditions. Saldaris JM, Demarest S, Jacoby P, etal. Modification of a parent-report sleep scale for individuals with CDKL5 deficiency disorder: a psychometric study. J Clin Sleep Med. 2024;20 (12):1887-1893.

The impact of constipation management on the quality of life of Alzheimer’s patients

AbstractBackgroundPatients with Alzheimer’s disease due to the peculiarities of this disease do not report constipation.MethodIn a study of 11 women with Alzheimer’s disease, aged 70‐75 years, we found that all of them had a tendency towards constipation. We divided the patients into two groups: a control group of 6 women who received help when they complained of constipation symptoms and an experimental group of 5 female patients who were routinely assessed by caregivers on their fecal status using the Bristol Scale. Through a combination of diet, physical exercises, and medication, we were able to maintain the type of feces in the experimental group at a level of 3‐5 on the Bristol Scale. The Neuropsychiatric Inventory Questionnaire (NPI‐Q) was filled out by nursing staff under medical supervision every month, and both groups of patients completed a monthly Quality of Life Scale.ResultAfter 3 months, we found that the patients in the control group did not seek help in a timely manner, despite receiving instructions. In contrast, the experimental group showed improvements in sleep, mood, and social communication. The NPI‐Q results showed that sleep normalized in the experimental group within 3‐4 weeks, with no early awakenings, difficulty falling asleep, or daytime sleep observed until the end of the study. Additionally, after 4‐5 weeks, the mood of these patients improved, and they showed less anxiety. They also became more cooperative and willing to help with their own care. In contrast, the control group experienced periodic anxiety, bad mood, dysphoria, sleep disorders, and resistance to nursing care. Furthermore, the experimental group subjectively assessed their quality of life higher than the control group.ConclusionIn conclusion, patients with Alzheimer’s disease require additional methods of control for the prevention and early detection of constipation. The timely application of these methods can greatly improve their subjective assessment of their quality of life, as well as their sleep, mood, and social communication. One such method is the use of the Bristol Scale by medical staff.