Sleep Disruption Research Articles

Sleep and Immune System Crosstalk: Implications for Inflammatory Homeostasis and Disease Pathogenesis.

Sleep and immune function are interconnected aspects of health that mutually impact each other in disease development and inflammatory homeostasis. Different aspects of immunology are regulated by different sleep characteristics, impacting on specific aspects of immune function including cytokine production and T-cell activity. Ongoing disruptions of sleep have been linked to heightened inflammation and are suspected in the pathogenesis and disease course of a range of life-style-related illnesses, including diabetes and neurodegenerative diseases. This review provides a comprehensive overview of knowledge on the interaction of sleep with the immune system, its modulation of inflammatory balance, and the pathogenesis of many diseases. It emphasizes how sleep deficiency compromises immune function by means of a systemic, low-grade inflammatory response, while adequate sleep promotes intense immune responses and thus enables efficient pathogen clearance and the maintenance of immune memory. The mutual influence of sleep on the immune system underlines its critical involvement in health preservation and the course of disease. Sleep plays an indispensable role in immune health, mediating the efficiency of immune responses and the course of the regulation of inflammation. Chronic sleep deprivation can result in a low-grade inflammation that substantially contributes to the onset and exacerbation of metabolic and neurodegenerative disorders. The intimate linkage between sleep and immune function can be one strategic approach to therapy, improving health outcomes by leveraging this sleep-immune connection.

The Correlation Between Quality of Sleep and Quality of Life in Hemodialysis Patients; An Indonesian Sample

Background: Sleep quality is important clinical outcomes of hemodialysis patients. Nurse has importance role to maintains the quality of life in hemodialysis patients. Therefore, quality of sleep and quality of life in hemodialysis patients in research are needed in order to improve quality of life hemodialisys patients. Aim: To determine the correlation between quality of sleep and quality of life in hemodialysis patients. Method: Cross-sectional study. The Pittsburgh Sleep Quality Questionnaire (PSQI) and WHOQOL–BREF questionnaires were administered in this study. The Kendall Tau test was used to determine the correlation between sleep quality and quality of life. Results: Two hundred four respondents participated in this study. A total 90.2% of hemodialysis patients experienced mild sleep disturbances and, 48.3% of patients had a good quality of life category. A significant correlation between sleep quality and quality of life in hemodialysis patients was found (p=0.002). Conclusion: Lower levels of quality of sleep in hemodialysis patients have a negative effect on quality of life. Reducing sleep disruption through nursing intervention programs for hemodialysis patients is recommended during nursing care to increase quality of sleep in this vulnerable population. Identification of factors supporting sleep quality and intervention strategies are recommended for further research.

Scheduled feeding improves behavioral outcomes and reduces inflammation in a mouse model of Fragile X syndrome.

Fragile X syndrome (FXS) is a neurodevelopmental disorder caused by the abnormal expansion of CGG repeats in the fragile X mental retardation 1 (FMR1) gene. Many FXS patients experience sleep disruptions, and we sought to explore these symptoms along with the possible benefits of a scheduled feeding intervention using the Fmr1 knockout (KO) mouse model. These mutants displayed clear evidence for sleep and circadian disturbances including delay in the onset of sleep and fragmented activity rhythms with increases in cycle-to-cycle variability. The Fmr1 KO mice exhibited deficits in their circadian behavioral response to light with reduced masking, longer time to resetting to shifts in the LD cycle, altered synchronization to a skeleton photoperiod and lower magnitude light-induced phase shifts of activity rhythms. Investigation of the retinal input to the surprachiasmatic nucleus (SCN) with the neurotracer cholera toxin (β subunit) and quantification of the light-evoked cFos expression in the SCN revealed an abnormal retinal innervation of the SCN in the Fmr1 KO, providing a possible mechanistic explanation for the observed behavioral deficits. Interestingly, disruptions in social and repetitive behavior correlated with sleep duration and fragmentation. Understanding the nature of the deficits, we decided to apply a scheduled feeding regimen (6-hr/18-hr feed/fast cycle) as a circadian-based strategy to boast circadian rhythms independently of light. This intervention significantly improved the activity rhythms and sleep in the mutants. Strikingly, the scheduled feeding ameliorated social interactions and reduced repetitive behaviors as well as the levels of Interferon-gamma and Interleukin-12 in the Fmr1 KO mutants, suggesting that timed eating may be an effective way to reduce inflammation. Collectively, this work adds support to efforts to develop circadian based interventions to help with symptoms of neurodevelopmental disorders.

Parental Perspectives From the Survey of Sleep Quality in the PICU Validation Study on Environmental Factors Causing Sleep Disruption in Critically Ill Children.

Sleep promotion bundles being tested in PICUs use elements adapted from adult bundles. As children may react differently than adults in ICU environments, this study investigated what parents report disrupted the sleep of their child in a PICU. Secondary analysis of a multicenter validation study of the Survey of Sleep quality in the PICU. Four Northeastern U.S. PICUs, one hospital-based pediatric sleep laboratory. Parents sleeping at the bedside of a child in the PICU or hospital-based sleep laboratory. Anonymous one-time survey eliciting parts of hospital or ICU environments that have been described as disruptive to sleep in validated adult ICU and pediatric inpatient questionnaires. Level of sleep disruption was scored by Likert scale, with higher scores indicating more disruption. Age, demographics, baseline sleep, and PICU exposures were used to describe causes of sleep disruption in a PICU. Of 152 PICU parents, 71% of their children's sleep was disrupted significantly by at least one aspect of being in the PICU. The most prevalent were "being in pain or uncomfortable because they are sick" (38%), "not sleeping at home" (30%), "alarms on machines" (28%), and "not sleeping on their home schedule" (26%). Only 5% were disrupted by excessive nocturnal light exposure. Overall sleep disruption was not different across four PICUs or in those receiving sedation. The validation study control group, healthy children undergoing polysomnography, had less sleep disruption than those in a PICU despite sleeping in a hospital-based sleep laboratory. There are multiple aspects of critical care environments that affect the sleep of children, which are different from that of adults, such as disruption to home schedules. Future interventional sleep promotion bundles should include sedated children and could be applicable in multicenter settings.

Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION): Study protocol for a randomized controlled trial of a web-based platform integrating nutrition, physical activity, and mindfulness for individuals with obesity

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m2 and aged 40–65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity.

Dopamine D2 receptors in the accumbal core region mediates the effects of fentanyl on sleep-wakefulness

Fentanyl, a potent analgesic and addictive substance, significantly impacts sleep-wakefulness (S-W). Acutely, it promotes wake, whereas chronic abuse leads to severe sleep disruptions, including insomnia, which contributes to opioid use disorders (OUD), a chronic brain disease characterized by compulsive opioid use and harmful consequences. Although the critical association between sleep disruptions and fentanyl addiction is acknowledged, the precise mechanisms through which fentanyl influences sleep remain elusive. Recent studies highlight the role of the dopaminergic system of the nucleus accumbens (NAc) in S-W regulation, but its specific involvement in mediating fentanyl’s effects on S-W remains unexplored. We hypothesized that dopamine D2 receptors mediate fentanyl-induced effects on S-W. To test this hypothesis, male C57BL/6J mice, instrumented with sleep recording electrodes and bilateral guide cannulas above the accumbal core region (NAcC), were utilized in this study. At dark onset, animals were bilaterally administered sulpiride (D2 receptors antagonist; 250 ng/side) in the NAcC followed by an intraperitoneal injection of fentanyl (1.2 mg/Kg). S-W was examined for the next 12 h. We found that systemic administration of fentanyl significantly increased wakefulness during the first 6 h of the dark which was followed by a significant increase in NREM and REM sleep during the second 6 h of the dark period. D2-receptor blockade significantly reduced this effect as evidenced by a significant reduction in fentanyl-induced wakefulness during first 6 h of dark period and sleep rebound during the second 6 h. Our findings suggest that D2 receptors in the NAcC plays a vital role in mediating the fentanyl-induced changes in S-W.

A - 139 A Neuropsychological Case Study of an Individual Diagnosed with Langerhans Cell Histiocytosis

Abstract Objective Langerhans cell histiocytosis (LCH) is a rare, idiopathic, cancer-like condition resulting from an overproduction of Langerhans cells. Disseminated LCH can spread across various anatomical systems, and prognosis is mainly dependent on organ involvement. Due to the rarity of this condition, potential neuropsychological effects are not fully understood. However, current research suggests that individuals with LCH are prone to develop various comorbid neuropsychiatric problems such as depression, anxiety, and impaired intellectual functioning. Method The current case is an 18-year-old, right-handed, Hispanic female who was diagnosed with LCH (brain and bone) in 2020. Cognitive symptoms began in 2016 at age 11. She was initially diagnosed with a low-grade glioma after a biopsy of a supracellular mass in 2017 but has developed various comorbid conditions since then. These include panhypopituitarism, NMDA encephalitis with behavioral disturbance, encephalomalacia, and epilepsy. She has undergone two 9-month rounds of chemotherapy and has been followed for neuroimaging with MRI and CT since 2017. Results Neuropsychological test findings from January 2024 indicated global deficits in intellectual functioning. Severe disruptions in sleep–wake cycle were also evident during testing. Although language abilities were relatively well preserved, abstract reasoning and executive functioning were greatly impaired. Psychological screeners also suggested anxiety and depression. Conclusions This case provides evidence of neurocognitive and psychiatric symptoms that can occur as a result of LCH and frequent comorbid health conditions. Neuropsychological testing can help monitor these effects on individuals with LCH across the lifespan.

Evaluation and management of dyspnea as the dominant presenting feature in neuromuscular disorders.

Dyspnea is a common symptom in neuromuscular disorders and, although multifactorial, it is usually due to respiratory muscle involvement, associated musculoskeletal changes such as scoliosis or, in certain neuromuscular conditions, cardiomyopathy. Clinical history can elicit symptoms such as orthopnea, trepopnea, sleep disruption, dysphagia, weak cough, and difficulty with secretion clearance. The examination is essential to assist with the diagnosis of an underlying neurologic disorder and determine whether dyspnea is from a cardiac or pulmonary origin. Specific attention should be given to possible muscle loss, use of accessory muscles of breathing, difficulty with neck flexion/extension, presence of thoraco-abdominal paradox, conversational dyspnea, cardiac examination, and should include a detailed neurological examination directed at the suspected differential diagnosis. Pulmonary function testing including sitting and supine spirometry, measures of inspiratory and expiratory muscle strength, cough peak flow, sniff nasal inspiratory pressure, pulse oximetry, transcutaneous CO2, and arterial blood gases will help determine the extent of the respiratory muscle involvement, assess for hypercapnic or hypoxemic respiratory failure, and qualify the patient for noninvasive ventilation when appropriate. Additional testing includes dynamic imaging with sniff fluoroscopy or diaphragm ultrasound, and diaphragm electromyography. Polysomnography is indicated for sleep related symptoms that are not otherwise explained. Noninvasive ventilation alleviates dyspnea and nocturnal symptoms, improves quality of life, and prolongs survival. Therapy targeted at neuromuscular disorders may help control the disease or favorably modify its course. For patients who have difficulty with secretion clearance, support of expiratory function with mechanical insufflation-exsufflation, oscillatory devices can reduce the aspiration risk.

A - 91 Nocturnal Motor Activity and Wake after Sleep Onset and Neuropsychological Health in Veterans with Gulf War Illness

Abstract Objective To examine the association between actigraphy-based sleep parameters and neuropsychological health in Veterans with Gulf War Illness (GWI). Methods Objective sleep data was obtained from 85 GW Veterans (Mage = 54.2, 79% Male) using an actigraphy monitor (Phillips Respironics Actiwatch-2) worn for 24 hours/day for seven consecutive days. Actigraphy data was manually scored to define time in bed (TIB), and total sleep time (TST), wake after sleep onset (WASO), number of awakenings (NWAK), and motor activity counts (MAC) during sleep were derived using the device software. Participants completed a battery of questionnaires: Patient Health Questionnaire (PHQ-9), Posttraumatic Symptom Checklist (PCL-5), and Pittsburgh Sleep Quality Index (PSQI). Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Correlation analysis was conducted to discover associations between sleep parameters, self-reported measures, and cognitive function. Results MAC was positively correlated with elevated scores on PSQI (r = 0.35, p &amp;lt; 0.01), PHQ-9 (r = 0.26, p &amp;lt; 0.05), and PCL-5 (r = 0.26, p &amp;lt; 0.05), and negatively correlated with RBANS Total Index score (r = −0.27, p &amp;lt; 0.05). WASO was also positively correlated with PSQI scores (r = 0.29, p &amp;lt; 0.01). TIB and TST were positively correlated with age (r = 0.25, r = 0.28; all p &amp;lt; 0.05). Conclusion Objective parameters of disrupted sleep – nocturnal MAC and WASO – were associated with greater self-reported sleep disturbance. MAC was additionally correlated with increased self-reported symptoms of depression and PTSD, as well as lower performance on a measure of objective cognitive function. This study identifies aspects of sleep disruption as potential sleep intervention targets related to both mood and cognitive symptoms.

The impacts of cancer treatment on lifestyle habits and mental health in Vietnamese women: an exploratory qualitative study.

This qualitative study explores the experiences of women after cancer treatment in terms of habit changes and mental health impact. The study involved 10 women who had undergone cancer treatment, recruited from three major hospitals in Hanoi, Vietnam. Data were collected through semi-structured interviews, which were transcribed and analyzed using thematic analysis. The findings of the study shed light on the various factors influencing lifestyle behavior and mental health changes among women after cancer treatment. Ten participants, aged 39 to 64 years, shared experiences including dietary changes, sleep disruptions, and reliance on non-scientific sources for health decisions. Initially shocked by their diagnosis, many transitioned to acceptance, adopting a "giving-in" attitude. Cultural beliefs, word-of-mouth sharing, and social support networks played significant roles in shaping post-treatment lifestyle changes, coping mechanisms, information-seeking behaviors, and mental health. The study highlights the need for accessible and scientifically verified information for women after cancer treatment to make informed decisions about their health. It emphasizes the importance of addressing traditional beliefs and promoting evidence-based practices. Moreover, the study underscores the importance of social support and relationships in coping with the challenges of post-cancer experiences.

Sleep disruption in patients with active and treated endogenous Cushing’s syndrome

ContextThe hypothalamic-pituitary-adrenal axis is a critical regulator of circadian rhythm in humans. Impaired sleep adversely affects metabolic, emotional, and cognitive health.ObjectiveTo characterize sleep disturbances in patients with active and treated Cushing’s syndrome (CS), and identify factors associated with impaired sleep in treated patients.DesignSingle-center cross-sectional study.MethodsPatients with pituitary or adrenal CS enrolled in an observational study completed Nottingham Health Profile (NHP), CushingQoL, and Hospital Anxiety and Depression assessments. Cross-sectional analysis was conducted including patients with active and treated disease.Results113 (94 female) patients with CS were included, 104 pituitary and 9 adrenal, with mean age at diagnosis of 43.9 ± 13.4 years. Mean and maximum duration of follow up was 5.1 and 23 years. Mean NHP sleep score was lower (i.e., improved) in patients with treated vs. active disease (29.6 ± 30.2 vs. 51.9 ± 30.9, p = 0.0005), as was CushingQoL sleep score (p = 0.015), but 41.5% of patients with treated disease stated they often or always had trouble sleeping. The proportion of treated vs. active patients taking medication for sleep, mood, or pain was not different. Neither NHP nor CushingQoL pain scores were lower in treated vs. active patients (p = 0.39 and 0.53). In patients with treated CS, anxiety and depression correlated with worse sleep scores.ConclusionsPatients with treated CS report improved sleep quality compared to those with active disease, but almost half of treated patients still report sleep challenges. The need for sleep medications, reported by one third of patients, was not different after CS treatment. Ongoing mood disturbances may play a role in persistent sleep disruption. Further work should focus on determinants of sleep impairments in treated CS patients.

Perception, use of social media, and its impact on the mental health of Indian adolescents: A qualitative study.

Mental illness is a health challenge faced by adolescents that has grown worse after the Coronavirus disease 2019 pandemic. Research on social media and young people's mental health has recently increased, and numerous studies have examined whether frequent use of social media is linked to issues such as anxiety, stress, depression, eating disorders, insomnia, frustration, feeling alone, and externalizing problems among adolescents. This influence of social media on adolescents' lives is clear, with many platforms like Facebook, Instagram, and YouTube playing an important role in daily interactions and self-expression. Even though social media offers numerous benefits, such as connectivity and information sharing, excessive usage can have detrimental effects on mental health, particularly among adolescents. To study the impact of social media on the mental wellbeing of adolescents, and the associated potential dangers in India. A total of 204 adolescents aged 14 years to 23 years were included in the study. This study explored the intricate relationship between social media usage and adolescent mental health in India. The study employs a cross-sectional survey design to capture a snapshot of adolescent mental health and social media usage patterns. Data collection involved administering structured questionnaires and the analysis utilized quantitative methods, including descriptive statistics. Excessive use of social media is correlated with increased stress, anxiety, and depression. Adolescents engage in compulsive behaviors such as scrolling in the middle of the night, which negatively impacts their mental and physical health, and leads to significant sleep disruption. Findings from the study aim to provide insights into the current state of adolescent mental health and inform strategies to promote positive wellbeing in the Indian population. The study underscores the need for further research to better understand the complex interplay between social media and adolescent mental health, and need for effective strategies to combat online harassment.

FP1.10 - Functional Outcomes of a Standard vs Modified Brooke Ileostomy – A Quality of Life Study

Abstract Aim Previous studies have shown that IBD patients with a modified Brooke ileostomy, where there is retention of the ileocolic sphincter, may have improved stoma function by preserving a functional high pressure zone. This study aims to review functional outcomes through a patient-reported quality of life survey. Methods This cohort study was conducted across two sites, one performing Standard Brooke Ileostomy (SBI), and the other Modified Brooke Ileostomy (MBI), as standard practice. Patients with diagnosis of colitis were identified from a prospectively collected database. A stoma activity log and a validated stoma Quality of Life survey (PRATO) was sent, with 23 responses obtained (14 MBI, 9 SBI). Activity log included bag emptying, hours of interrupted sleep, and number of visits to stoma nurse. Results For QoL survey (minimum score 20, max 80), patients with MBI scored higher (mean 55.36), compared to SBI (mean 48.22), (p=0.037). Bag emptying over 24 hours was similar (MBI mean 5.71, SBI mean 5.86), as was bag emptying overnight (MBI mean 1 (range 0-3), SBO mean 1 (range 1-2). MBI patients reported longer mean uninterrupted sleep (7.07 hours vs 5.43 hours (p=0.005)). MBI patients required fewer stoma nurse visits in the first year (mean 5.3, median 5, range 0-13). SBI (mean 10.7, median 10, range 2-33). Conclusion A practice of Modified Brooke Ileostomy has comparable patient reported quality of life outcomes to a standard Brooke Ileostomy and performs better overall in terms of less interruption to sleep and lower disruption of daily life through hospital visits.

Open-Label Placebo Injection for Chronic Back Pain With Functional Neuroimaging

Chronic back pain (CBP) is a leading cause of disability. Placebo treatments often provide as much pain relief as bona fide treatments, such as steroid injections. Open-label (honestly prescribed) placebos (OLPs) may relieve CBP without deception, but OLP mechanisms remain poorly understood. To investigate the long-term efficacy and neurobiological mechanisms of OLP for CBP. A randomized clinical trial of CBP with longitudinal functional magnetic resonance imaging (MRI) comparing OLP with usual care, with 1-year follow-up, was conducted in a university research setting and a community orthopedic clinic. Participants were individuals aged 21 to 70 years with CBP. The trial was conducted from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Data analysis was performed from April 2020 to May 2024. The primary analysis was conducted on an intention-to-treat sample. Participants randomized to OLP received a 1-time subcutaneous lumbar saline injection presented as placebo accompanied by information about the power of placebo to relieve pain, alongside their ongoing care. Usual care participants continued their ongoing care. The primary outcome was pain intensity (0-10, with 0 indicating no pain and 10 the most intense) at 1 month posttreatment. Secondary outcomes included pain interference, depression, anxiety, anger, and sleep quality. Functional MRI was performed before and after treatment during evoked and spontaneous back pain. A total of 101 adults (52 [51.4%] females; mean [SD] age, 40.4 [15.4] years) with moderate severity CBP (mean [SD], 4.10 [1.25] intensity; duration, 9.7 [8.5] years) were enrolled. Compared with usual care, OLP reduced CBP intensity posttreatment (relative reduction, 0.61; Hedges g = 0.45; 95% CI, -0.89 to 0.04; P = .02). Through 1-year follow-up, pain relief did not persist, although significant benefits were observed for depression, anger, anxiety, and sleep disruption (Hedges g = 0.3-0.5; all P < .03). Brain responses to evoked back pain for OLP vs usual care increased in rostral anterior cingulate and ventromedial prefrontal cortex and decreased in somatomotor cortices and thalamus. During spontaneous pain, functional connectivity analyses identified OLP vs usual care increases in ventromedial prefrontal cortex connectivity to the rostral ventral medulla, a pain-modulatory brainstem nucleus. No adverse effects of treatment were reported by participants. In this randomized clinical trial of OLP vs usual care, a single nondeceptive placebo injection reduced CBP intensity for 1 month posttreatment and provided benefits lasting for at least 1 year posttreatment. Brain mechanisms of OLP in a clinical population overlap with those of deceptive placebos in healthy volunteers, including engagement of prefrontal-brainstem pain modulatory pathways. ClinicalTrials.gov Identifier: NCT03294148.

Sleep disturbances based on patient reported outcomes in patients with breast cancer.

Sleep disturbances are common in patients with breast cancer, but comprehensive evaluations with patient-reported outcomes (PRO) and sleep evaluation with polysomnography (PSG) are lacking. This study describes sleep disruption using PROs and PSG to identify underlying sleep disorders. A retrospective review of patients with breast cancer undergoing formal sleep evaluation from 4/1/2009 to 7/31/2014 was performed. Clinical characteristics, PROs using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and PSG data were reviewed. 404 patients were identified with 43% early, 30% locally advanced and 17% metastatic disease. PSQI revealed poor sleep in 75%, and ESS demonstrated daytime sleepiness in 55%. Sleep aid use was reported by 39%, and pain medication use in 22%. Most patients (50.2%) had multiple sleep disorders. Insomnia (54.5%) was the most frequent sleep disorder, followed closely by obstructive sleep apnea (OSA) (53.7%). PSG was performed in 74%. Multivariate analysis linked poor sleep to use of sleep aids [OR 7.7, 95% CI 3.9 to 15.2], anxiety disorder [OR 4.8, 95% CI 1.7 to 14.0], and metastatic disease [OR 2.8, 95% CI 1.1 to 6.6]. Daytime sleepiness correlated with known diagnosis of OSA [OR 1.9, 95% CI 1.0 to 3.3] and sleep aid use [OR 0.6, 95% CI 0.4 to 0.9]. Poor sleep was associated with sleep aid use, anxiety disorder and metastatic disease. Insomnia was the most common sleep disorder, followed by OSA (mostly mild). Education about sleep health and proactive screening for sleep symptoms would be beneficial in patients with breast cancer.

Regulation of dermal circadian pathways by a novel topical formulation.

Skin health is impacted by a wide range of intrinsic and extrinsic factors (J Dermatol Sci, 2017, 85, 152), including those that impact circadian rhythm, such as sleep disruption (Textbook of Aging Skin, 2016), UV (Biomed Aging Pathol, 2013, 3, 161) and blue light (Int J Cosmet Sci, 2019, 41, 558). Disruption of the skin's endogenous circadian balance, even by a consistently late bedtime, has deleterious effects on multiple measurements of skin health, including hydration, skin barrier protection, microbiome counts and skin regeneration, among others (Clin Cosmet Investig Dermatol, 2022, 15, 1051). Skin repair processes occur at night and help to maintain important aspects of skin health (FEBS Lett, 2021, 595, 2413). Interest is increasing in the development of topical products that help restore proper circadian function. This study demonstrates that a proprietary topical formulation regulates new and established gene and protein biomarkers of circadian entrainment and circadian rhythm, demonstrating the product's potential to maintain appropriate dermal diurnal balance.

Sleep and circadian disruption in bipolar disorders: From psychopathology to digital phenotyping in clinical practice.

Sleep and biological rhythms are integral to mood regulation across the lifespan, particularly in bipolar disorder (BD), where alterations in sleep phase, structure, and duration occur in all mood states. These disruptions are linked to poorer quality of life, heightened suicide risk, impaired cognitive function, and increased relapse rates. This review highlights the pathophysiology of sleep disturbances in BD and aims to consolidate understanding and clinical applications of these phenomena. It also summarizes the evolution of sleep and biological rhythms assessment methods, including ecological momentary assessment (EMA) and digital phenotyping. It underscores the importance of recognizing circadian rhythm involvement in mood regulation, suggesting potential therapeutic targets. Future research directions include elucidating circadian clock gene mechanisms, understanding environmental impacts on circadian rhythms, and investigating the bidirectional relationship between sleep disturbances and mood regulation in BD. Standardizing assessment methods and addressing privacy concerns related to EMA technology and digital phenotyping are essential for advancing research. Collaborative efforts are crucial for enhancing clinical applicability and understanding the broader implications of biological rhythms in BD diagnosis and treatment. Overall, recognizing the significance of sleep and biological rhythms in BD offers promise for improved outcomes through targeted interventions and a deeper understanding of the disorder's underlying mechanisms.

A study on prevalence of insomnia among middle aged women attending a tertiary care hospital, West Bengal

Background: Insomnia is one of the common but neglected conditions seen in family practice. During the menopausal transition, significant sleep disruptions are provoked by sleep disorders. Insomnia is estimated to affect up to 30% of the general population and women are almost twice as likely as men to develop it. Objective was to find the prevalence of insomnia among middle-aged women. Methods: This descriptive, cross-sectional study was done for 3 months at general OPDS and IPDs of a tertiary care hospital among 40-60-year-old women fulfilling inclusion criteria. The sampling technique was convenience sampling. Data were analyzed using Microsoft Office Excel and analyze by SPSS version 25. Results: Of 310 participants, 45% had insomnia based on AIS-8. The maximum number of study participants fall under the age group of 40-45 years (33.23%) and under the socio-economic group lower-middle class (25.81%) according to the modified B. G. Prasad scale. Conclusions: The study concludes a significant occurrence of insomnia in middle-aged women in addition to menopausal symptoms. Implementation of appropriate health educational programs for preventing insomnia in such women is necessary.

Patient-perceived factors on treatment satisfaction in early onset scoliosis treated surgically with a minimum of ten years

BackgroundThe prognosis of surgically treated subjects with early onset scoliosis (EOS) into adulthood has been lacking. We aimed to investigate the patients’ perspectives on satisfaction with surgical treatment.MethodologyWe included all surgical candidates with EOS who had undergone index spinal surgery for scoliosis correction between 2009 and 2013. The minimum duration of postoperative follow-up was 10 years at the time of survey completion. Three questionnaires were used in this study, comprising the revised Scoliosis Research Society questionnaire (SRS-22r), the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and the World Health Organization Quality of Life (WHOQOL-BREF). Measures of treatment satisfaction were retrieved from SRS-22r.ResultsThere were 29 participants who completed the survey, and thereby included in the study (i.e., a response rate of 43% and a dropout rate of 6%). Amongst them, 14, 11, and 4 individuals received posterior spinal fusion (PSF), magnetically controlled growing rods (MCGR), and traditional growing rods, respectively. The average duration after the index spinal surgery was 12.6 ± 2.2 years. Our findings revealed that self-image (across all treatment groups), sleep disruption (only in PSF), and social aspects (in both PSF and MCGR) were significantly worse when compared to the normative values. According to the multivariable linear regression model (R-square = 0.690, p < .001), an increase in SRS-22r mental health (p = .008) and PROMIS-29 social participation scores (p = .004) corresponded to 0.511 and 0.055 points increases in satisfaction. Every unit increase in PROMIS-29 fatigue (p = .043) and WHOQOL-BREF physical domain scores (p = .007) was in conjunction with 0.019 and 0.040 points decreases in satisfaction. SRS-22r self-image (p = .056) and WHOQOL-BREF environmental domain scores (p = .076) were included in the model but did not reach statistical significance.ConclusionsTo improve the long term quality of life in surgical candidates with EOS, we demonstrated that mental health, social participation, fatigue, and physical health were significant factors associated with treatment satisfaction. Interestingly, demographic and radiographic parameters did not have a significant effect in our cohort.

Acute sleep disruption reduces fear memories in male and female mice.

Sleep problems are a prominent feature of mental health conditions including post-traumatic stress disorder (PTSD). Despite its potential importance, the role of sleep in the development of and/or recovery from trauma-related illnesses is not understood. Interestingly, there are reports that sleep disruption immediately after a traumatic experience can reduce fear memories, an effect that could be utilized therapeutically in humans. While the mechanisms of this effect are not completely understood, one possible explanation for these findings is that immediate sleep disruption interferes with consolidation of fear memories, rendering them weaker and more sensitive to intervention. Here, we allowed fear-conditioned mice to sleep immediately after fear conditioning during a time frame (18 h) that includes and extends beyond periods typically associated with memory consolidation before subjecting them to 6-h of sleep disruption. Mice exposed to this delayed regimen showed dramatic reductions in fear during tests conducted immediately after sleep disruption, as well as 24 h later. This sleep disruption regimen also increased levels of mRNA encoding brain-derived neurotrophic factor (BDNF), a molecule implicated in neuroplasticity, in the basolateral amygdala (BLA), a brain area implicated in fear and its extinction. These findings raise the possibility that the effects of our delayed sleep disruption regimen are not due to disruption of memory consolidation, but instead are caused by BDNF-mediated neuroadaptations within the BLA that actively suppress expression of fear. Treatments that safely reduce expression of fear memories would have considerable therapeutic potential in the treatment of conditions triggered by trauma.