Early Awakening Research Articles

Associations between C-reactive protein and individual symptoms of depression in a lower-middle income country.

Data on associations between inflammation and depressive symptoms largely originate from high income population settings, despite the greatest disease burden in major depressive disorder being attributed to populations in lower-middle income countries (LMICs). We assessed the prevalence of low-grade inflammation in adults with treatment-resistant depression (TRD) in Pakistan, an LMIC, and investigated associations between peripheral C-reactive protein (CRP) levels and depressive symptoms. This is a secondary analysis of two randomised controlled trials investigating adjunctive immunomodulatory agents (minocycline and simvastatin) for Pakistani adults with TRD (n = 191). Logistic regression models were built to assess the relationship between pre-treatment CRP (≥ or <3 mg/L) and individual depressive symptoms measured using the Hamilton Depression Rating Scale. Descriptive statistics and regression were used to assess treatment response for inflammation-associated symptoms. High plasma CRP (≥3 mg/L) was detected in 87% (n = 146) of participants. Early night insomnia (odds ratio 2.33, 95% CI 1.16-5.25), early morning waking (odds ratio 2.65, 95% CI 1.29-6.38) and psychic anxiety (odds ratio 3.79, 95% CI 1.39-21.7) were positively associated, while gastrointestinal (odds ratio 0.38, 95% CI 0.14-0.86) and general somatic symptoms (odds ratio 0.34, 95% CI 0.14-0.74) were negatively associated with inflammation. Minocycline, but not simvastatin, improved symptoms positively associated with inflammation. The prevalence of inflammation in this LMIC sample with TRD was higher than that reported in high income countries. Insomnia and anxiety symptoms may represent possible targets for personalised treatment with immunomodulatory agents in people with elevated CRP. These findings require replication in independent clinical samples.

Acute partial sleep deprivation attenuates blood pressure responses to cycling exercise.

Exaggerated blood pressure (BP) responses during exercise are independently associated with future development of hypertension. Partial sleep deprivation (PSD) can increase 24-h ambulatory BP, but the effects on exercise BP are unclear. We hypothesized that acute PSD would augment the BP response to constant load cycling exercise and a 20-min time trial. Twenty-two healthy adults (22 ± 3 yr old; 13 males; V̇o2peak, 43.6 ± 8.2 mL·kg-1·min-1) completed a randomized crossover trial in which they either slept normally (normal sleep-wake schedule for each participant) or sleep was partially deprived (early awakening, 40% of normal sleep duration). Each participant completed a 12-min warm-up consisting of two 6-min steps (step 1, 62 ± 25 W; step 2, 137 ± 60 W) followed by a 20-min time trial on a cycle ergometer. PSD did not alter power output during the 20-min time trial [(control vs. PSD) 170 ± 68 vs. 168 ± 68 W, P = 0.65]. Systolic BP did not differ during step 1 of the warm-up (141 ± 15 vs. 137 ± 12 mmHg, P = 0.39) but was lower following PSD during step 2 (165 ± 21 vs. 159 ± 22 mmHg, P = 0.004) and the 20-min time trial (171 ± 20 vs. 164 ± 23 mmHg, P < 0.001). These results were maintained when peak oxygen uptake (V̇o2peak) was included as a covariate. Systolic BP responses were modulated by sex (time × visit × sex interaction P = 0.03), with attenuated systolic BP during the warm-up and the 20-min time trial in males but not in females. In contrast to our hypothesis, acute PSD attenuates systolic BP responses during constant load and 20-min time trial cycling exercise; however, these observations appear to be primarily driven by changes in males.NEW & NOTEWORTHY A single night of partial sleep deprivation (PSD) can increase ambulatory blood pressure (BP) the following day. Despite this phenomenon, the present study found that acute PSD attenuates systolic BP responses to both constant load cycling and a 20-min cycling time trial in young healthy adults. Interestingly, the attenuated systolic BP responses following PSD appeared to be modulated by sex such that attenuations were observed in males but not in females.

Characteristics and factors associated with psychotic-like experiences in remission: a cross-sectional study of 4208 college students in China

ObjectivesPrevious research has extensively explored the factors associated with psychotic-like experiences (PLEs). However, the characteristics and associated factors of remitted PLEs, which refer to the absence of current PLEs following...

Sleep alterations in treatment-resistant depression patients undergoing ketamine treatment.

This study examines self-reported sleep alterations in treatment-resistant depression (TRD) inpatients following intravenous ketamine administration. This is a post-hoc analysis of a naturalistic observational study, which enrolled 28 inpatients with treatment-resistant major depressive disorder and analyzed self-reported sleep changes (items 1-4; 'insomnia', 'nighttime restlessness', 'early morning waking', 'hypersomnia') in Inventory of Depressive Symptomatology 30-item (IDS SR-30) in responders and non-responders stratified per Montgomery-Åsberg Depression Rating Scale (MADRS) during short-term ketamine treatment. Responders, as well as non-responders, did not experience significant changes in IDS SR-30 sleep items ('insomnia', 'nighttime restlessness', 'early morning waking', 'hypersomnia') (p's > 0.05) at 7-day follow-up after eight intravenous ketamine infusions as compared to baseline. Neither responders, nor non-responders reported any significant alterations in sleep patterns during ketamine infusions. These findings are not in line with current literature, as so far modest improvements in sleep during ketamine treatment have been reported. Results should be interpreted with caution, primarily due to the small sample size.

Melatonin Bioavailability After Oral Administration of a New Delayed-Release Form in Healthy Male Volunteers.

Two main types of galenic formulation, immediate release and prolonged release, have been developed to optimize melatonin bioavailability. We recently described the kinetic profile of a prolonged-release form generating a peak of plasma melatonin 1 h (Tmax) after intake, followed by a prolonged decay over time. We have developed a new oral form of melatonin with the aim of producing a melatonin peak several hours after intake. The objective is to investigate melatonin bioavailability after administration of this new delayed-release form (DR form). In this single-centre open-label study, 12 healthy male volunteers received one tablet of the DR form containing 1.9 mg melatonin, 10 mg zinc and 200 mg lemon balm extract (Melissa officinalisL aerial parts). Blood samples were collected for 12 h, beginning at 8:00 am. Plasma concentrations of melatonin and 6-sulfatoxymelatonin (6-SMT), the main hepatic melatonin metabolite, were determined by radioimmunoassay. A progressive increase in plasma melatonin concentrations was observed from 20 min and a peak about 3 h after intake (Cmax 740 ± 824 pg/mL; Tmax 179 ± 60min). Concentrations remained high between 140 and 220 min, the concentration remaining physiologically significant (over 100pg/mL) up to 7 h after intake. The DR form was well tolerated. The melatonin release profile was consistent with what was anticipated for the DR form. The DR form generated a 2 h delayed Tmax compared with a prolonged-release form previously evaluated. This suggests that the DR form is suitable for the treatment of certain sleep disorders such as short sleep duration or early awakening. Registration number: NCT05419466.

The impact of insomnia on brain networks topology in depressed patients: A resting-state fMRI study

ObjectiveDepression and insomnia frequently co-occur, but the neural mechanisms between patients with varying degrees of these conditions are not fully understood. The specific topological features and connectivity patterns of this co-morbidity have not been extensively studied. This study aimed to investigate the topological characteristics of topological characteristics and functional connectivity of brain networks in depressed patients with insomnia. MethodsResting-state functional magnetic resonance imaging data from 32 depressed patients with a high level of insomnia (D-HI), 35 depressed patients with a low level of insomnia (D-LI), and 81 healthy controls (HC) were used to investigate alterations in brain topological organization functional networks. Nodal and global properties were analyzed using graph-theoretic techniques, and network-based statistical analysis was employed to identify changes in brain network functional connectivity. ResultsCompared to the HC group, both the D-HI and D-LI groups showed an increase in the global efficiency (Eglob) values, local efficiency (Eloc) was decreased in the D-HI group, and Lambda and shortest path length (Lp) values were decreased in the D-LI group. At the nodal level, the right parietal nodal clustering coefficient (NCp) values were reduced in D-HI and D-LI groups compared to those in HC. The functional connectivity of brain networks in patients with D-HI mainly involves default mode network (DMN)-cingulo-opercular network (CON), DMN-visual network (VN), DMN-sensorimotor network (SMN), and DMN-cerebellar network (CN), while that in patients with D-LI mainly involves SMN-CON, SMN-SMN, SMN-VN, and SMN-CN. The values of the connection between the midinsula and postoccipital gyrus was negatively correlated with scores for early awakening in D-HI. ConclusionThese findings may contribute to our understanding of the underlying neuropsychological mechanisms in depressed patients with insomnia.

The impact of the COVID-19 pandemic on the quality of sleep of medical residents in a tertiary care hospital.

The COVID-19 pandemic has created unprecedented levels of stress and anxiety, which has a profound effect on sleep quality. However, limited data are available on the sleep quality of medical residents who work directly with patients infected with SARS-CoV-2. As sleep is a crucial brain state, our goal is to know the sleep quality of these medical residents. This study evaluated sleep quality among medical residents caring for COVID-19 patients at Hospital São Paulo, SP, Brazil. It used a validated questionnaire and assessed sleep habits and sociodemographic variables. The study focused on sleep latency, bedtime changes, early awakening, and discouragement. 150 resident physicians participated, 93 females and 57 males. We observed poor sleep quality in 72.7%, discouragement complaints in 91.33%, what was moderate or intense in 52.0%. Discouragement was associated with sleep fragmentation and awakening early in the morning; sleeping pill users had a greater sleep latency (p<0.00001). Poor sleep quality was linked to changes in bedtime and use of sleeping medications during social isolation in 2020 (p=0.037 and p<0.001, respectively). During the COVID-19 pandemic, more than two-thirds of resident physicians experienced poor sleep quality. They changed their bedtime, increased sleep latency, the use of hypnotics, feelings of discouragement, fragmented sleep, and early awakening in the morning. These findings should serve as a wake-up call for everyone, especially those in administrative roles. They are a matter of concern for medical residents, chief residents, supervising physicians, medical directors, and faculties. Maximās grātiās vōbīs agimus.

The Association of Mental Health Symptoms to Post-Traumatic Nightmares Among Treatment Seeking Active Duty Service Members.

Posttraumatic nightmares (PTNs) are common among service members with a history of combat or mission-related trauma and are associated with decreased well-being. Unfortunately, beyond establishing an association between mental health symptoms and PTNs, the existing literature fails to provide a more comprehensive understanding of factors associated with PTNs. The effectiveness of current recommended treatments is frequently debated, with the literature varying in levels of support. Treatment of PTN is complicated, given their association with a number of mental health difficulties including posttraumatic stress disorder (PTSD), anxiety, and depression. The present study sought to better delineate the association of these difficulties with PTNs, in an effort to inform and improve treatments for the nation's service members. This study utilized de-identified data collected during standard procedures for an interdisciplinary intensive outpatient program for service members with a history of traumatic brain injury and/or psychological health conditions (N = 1,550). Study analyses were performed under a Walter Reed National Military Medical Center institutional review board-approved protocol. Three cross-sectional forward likelihood ratio logistic regressions predicting the presence of PTNs were conducted while controlling for the alpha-blocker prazosin, as it is recommended for the treatment of PTSD-associated nightmares. Separate models were created for posttraumatic stress symptoms (PTSS), depression, and anxiety because of multicollinearity concerns. Additional variables considered for inclusion were psychological symptoms (e.g., suicide ideation, postconcussive symptoms), satisfaction with life, sleep (e.g., pain that disrupts sleep, early awakenings, sleepiness), demographics (e.g., sex, race/ethnicity, marital status, age), and military characteristics (e.g., rank, branch, special operator status, time in service). PTSS (odds ratio [OR]: 1.13), anxiety (OR: 1.19), and depression (OR: 1.19) were associated with increased odds of PTNs when controlling for prazosin. Each of the final models accounted for a significant amount of variance in the presence/absence of PTN. The included variables differed across models. The PTSS model included pain that disrupted sleep, postconcussive symptoms, special operator status, and early awakenings. The anxiety model included postconcussive symptoms, pain that disrupted sleep, special operator status, and prazosin use. The depression model included postconcussive symptoms, pain that disrupted sleep, special operator status, difficulty falling asleep within 30 min, and prazosin use. Although most variables were associated with an increased odds of PTNs, postconcussive symptoms in the PTSS model and special operator status in all 3 models were associated with decreased odds of PTNs. These findings are illustrated in Tables2 to 4. Findings support the association of PTSS, anxiety, and depression to PTNs, and, importantly, suggest that other factors may be equally or more important in understanding PTNs. Notably, increased odds of PTNs were observed among patients with pain that disrupts their sleep. The cross-sectional nature of the study allows examination of these co-occurring symptoms as they would present in the clinic, potentially informing assessment and treatment strategies; however, it precludes consideration of temporal relationships. Results highlight the importance of considering comorbid symptoms and relevant military characteristics to gain a more complete understanding of PTNs. Future research utilizing longitudinal methods are needed to inform the temporal/causal aspects of these relationships.

The effects of partial sleep deprivation on blood pressure responses during cycling are intensity dependent

Introduction: Exaggerated blood pressure (BP) responses during exercise are associated with increased risk of clinical cardiovascular outcomes. Partial sleep deprivation (PSD), defined as ≤6 hours of sleep, can increase 24-hour ambulatory BP but the effects on exercise BP have not been studied. We hypothesized that acute PSD would augment the exercise BP response to constant load exercise (below and above estimated lactate threshold) and during a 20-min time trial. Methods: Fourteen, healthy adults (22 ± 3 years; 9 males; VO2peak: 43.2 ± 9.5 ml/kg/min [25.3-60.9]) completed a randomized crossover trial where they slept normally (normal sleep-wake schedule for each participant), or sleep was partially deprived (early awakening, 40% of normal sleep duration). Prior to the testing visits, participants completed two familiarization visits under normal sleep conditions. Each participant completed a 12-minute warm (6-minutes below estimated lactate threshold [moderate intensity; 65 ± 24 W] and 6-minutes above estimated lactate threshold but below respiratory compensation point [heavy intensity; 147 ± 60 W]) followed by a time-trial where they were asked to cycle as far as possible in 20 minutes. BP was assessed at rest (BpTRU, Medical Devices) and on the cycle ergometer every 2 minutes during the warmup and 20-minute time-trial (Tango M2, SunTech Medical). Sleep timing and duration was assessed daily for 1-week prior to each testing visit using self-report and an accelerometer worn on the non-dominate wrist (wGT3X-BT, ActiGraph). Results: Resting systolic ( P=0.08) and diastolic BP ( P=0.06) tended to be higher following PSD (normal sleep: 105 ± 8/62 ± 8 mmHg vs. PSD: 107 ± 6/64 ± 7 mmHg). PSD did not alter VO2 during the moderate- (normal sleep: 1291 ± 394 ml/min vs. PSD: 1258 ± 364 ml/min) and heavy-intensity (normal sleep: 1903 ± 758 ml/min vs. PSD: 1893 ± 724 ml/min) warmup or 20-minute time-trial (normal sleep: 2713 ± 1120 ml/min vs. PSD: 2669 ± 1134 ml/min) or distance covered (normal sleep: 10.16 ± 2.024 km vs. PSD: 10.08 ± 2.145 km) and power output (normal sleep: 175 ± 79 W vs. PSD: 173 ± 79 W) during the 20-min time-trial (all P&gt;0.27). Systolic (normal sleep: 140 ± 17 mmHg vs. PSD: 136 ± 11 mmHg, P=0.14) and diastolic (normal sleep: 67 ± 11 mmHg vs. PSD: 69 ± 8 mmHg, P=0.44) BP did not differ during the moderate-intensity warmup following PSD. However, systolic BP was lower during the heavy-intensity warmup (normal sleep: 165 ± 25 mmHg vs. PSD: 155 ± 22 mmHg, P=0.008) and 20-minute time-trial (normal sleep: 174 ± 20 mmHg vs. PSD: 165 ± 25 mmHg, P=0.05) following PSD. No differences were observed in diastolic BP (all P&gt;0.57). Heart rate during the moderate-intensity warmup (normal sleep: 110 ± 11 bpm vs. PSD: 110 ± 10 bpm), heavy-intensity warmup (normal sleep: 137 ± 14 bpm vs. PSD: 136 ± 14 bpm), and time-trial (normal sleep: 171 ± 16 bpm vs. PSD: 169 ± 19 bpm) did not differ between conditions (all P&gt;0.39). Conclusion: In contrast to our hypothesis, these preliminary findings suggest that a single night of PSD results in lower systolic BP responses during heavy-intensity, but not moderate-intensity, cycling exercise. This research was supported by a Natural Science and Engineering Research Council (NSERC) of Canada Discovery Grant (P.J.M). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Abnormal amplitude of low-frequency fluctuations associated with sleep efficiency in major depressive disorder

BackgroundSleep disturbance is one of the most frequent somatic symptoms in major depressive disorder (MDD), but the neural mechanisms behind it are not well understood. Sleep efficiency (SE) is a good indicator of early awakening and difficulty falling asleep in MDD patients. Our study aimed to investigate the relationship between sleep efficiency and brain function in MDD patients. MethodsWe recruited 131 MDD patients from the Fourth People's Hospital in Hefei, and 71 well-matched healthy controls who were enrolled from the community. All subjects underwent resting-state functional MRI. Brain function was measured using the fractional amplitude of low-frequency fluctuation (fALFF), sleep efficiency was objectively measured by polysomnography (PSG), and clinical scales were used to evaluate depressive symptoms and sleep status. Multivariate regression analysis was performed to assess the relationship between the amplitude of the low frequency fluctuation fraction and sleep efficiency. ResultThree brain regions with relevance to sleep efficiency in MDD patients were found: inferior occipital gyrus (Number of voxels = 25, peak MNI coordinate x/y/z = −42/-81/-6, Peak intensity = 4.3148), middle occipital gyrus (Number of voxels = 55, peak MNI coordinate x/y/z = −30/-78/18, Peak intensity = 5.111), and postcentral gyrus (Number of voxels = 26, peak MNI coordinate x/y/z = −27/-33/60, Peak intensity = 4.1263). But there was no significant relationship between fALFF and SE in the healthy controls. ConclusionThe reduced sleep efficiency in MDD may be related to their lower neural activity in the inferior occipital gyrus, middle occipital gyrus, and postcentral gyrus. The findings may provide a potential neuroimaging basis for the clinical intervention in patients with major depressive disorder with sleep disturbances.

The Lighter Touch: Less-Restriction in Sequentially Implemented Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions.

The prevalence of sleep difficulties among children with rare genetic neurodevelopmental conditions (RGNC) is high. Behavioral interventions are commonly used in the treatment of sleep difficulties in children with neurodevelopmental conditions such as autism, however, research is scarce in children with RGNC. The range of co-occurring complexities within this population, means there is a need for research to not only determine the effectiveness of behavioral sleep interventions, but also which components might be the least restrictive (i.e., intensive/aversive) and minimally sufficient. This study used a single-case multiple baseline design to investigate the effectiveness and acceptability of behavioral sleep interventions, indicated within a Functional Behavior formulation in eight children with RGNC (M = 7.3years). Intervention components were sequentially administered across up to three phases, based on the principle of less restriction (from least to relatively more intensive) to determine what might be minimally sufficient. Results showed an improvement in sleep onset latency, night wakings, early morning waking and unwanted bed-sharing for 7/7, 6/7, 3/3 and 3/3 children respectively. Improvement was observed for most participants following the less restrictive phases of intervention (circadian modifications, antecedent modifications and positive reinforcement), however, more restrictive, albeit modified, extinction procedures were still implemented for five participants. Improvements were maintained at follow-up and interventions were deemed acceptable to parents. Less restrictive function-based behavioral strategies are an effective, and in some cases sufficient, contribution to a sequence of interventions for a range of sleep difficulties. They should be implemented first, before more restrictive strategies.

Stress-responsive Psychobiological Markers During Pregnancy and Fetal and Infant Outcomes Across Countries

The prenatal period is a sensitive window of development that is open to both opportunity and risk for predicting later developmental outcomes. There are multiple stress-responsive physiological systems during pregnancy that may mediate the link between stress exposure and physical and mental health. Alterations in these systems during gestation due to elevated stress exposure can lead to poorer health in both the gestational parent and the offspring. In this symposium, we examine stress-responsive psychobiological systems during pregnancy and their association with differential developmental outcomes during gestation, at birth, and in infancy by a multinational group of researchers. The first presentation by the symposium chair, Özlü Aran (University of Denver, USA), will focus on the trajectories of placental corticotropin-releasing hormone (pCRH), a stress-responsive hormone released by placenta, and their association with birth outcomes as well as infant socioemotional development at 6 months postpartum. In the second presentation, Dr. Elif Aysimi Duman (Boğaziçi University, Turkey) will highlight intergenerational associations of parental early life stress and gestational parent prenatal cortisol awakening response with infant development at 4 months postpartum. This study underscores psychosocial risk (i.e., pregnancy-related worries) and protective factors (i.e., fetal bonding) in addition to prenatal HPA activity during gestation. In the third presentation, Dr. Sameera Abuaish (Princess Nourah bint Abdulrahman University, Saudi Arabia) will extend research findings beyond HPA axis by demonstrating the association between gestational parent body mass index (BMI) and prenatal mood and immune functioning, while also linking BMI to both fetal and infant outcomes. Consistent with the ISPNE’s 2023 symposium translational psychoneuroendocrinology themes, these presentations apply basic scientific methods to understand better health outcomes for gestational parents and their offspring with a focus on stress-responsive physiological systems during pregnancy. Together, they underscore the importance of early life stressors as well as prenatal stressors and their potential impact over generations among individuals across countries and cultures. Finally, these presentations will be discussed by a leading investigator, Dr. Jenalee Doom (University of Denver, USA), who has expertise on early life stress and the biological embedding of early experiences across development with a special focus on mental and physical health.

Correlation between symptoms and cognitive function changes in patients with primary insomnia and pathways in gut microbiota

BackgroundPrimary insomnia (PI) refers to syndromes of difficulty falling asleep, poor sleep quality, early awakening, and difficulty falling asleep after waking up. Although there have been numerous studies, the specific etiology and pathogenesis of PI are still misunderstanding. In recent years, the gut microbiota has been proved to be involved in the metabolism of many mental disorders. But the specific mechanisms of its involvement in PI have not been fully elucidated. This study aims to explore the relationship between the gut microbiota and the symptoms, cognitive function changes in PI. MethodsIn this study, the gut microbiota of PI patients and healthy controls was profiled by performing stool 16s rRNA gene sequencing. The co-occurrence network was constructed by using Weight Gene Co-expression Network Analysis (WGCNA) algorithm. The correlation between gut microbiota associated pathways and traits in PI were predicted. ResultsWGCNA results demonstrated several Operational Taxonomic Units (OTU) modules are correlated to symptoms. By using PICRUSt2 software, we predicted the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of microbiota in modules. For instance, sleep efficiency may be correlated with the presence of Insulin signaling pathway, Flavonoid biosynthesis, Ascorbate and aldarate metabolism, Nitrotoluene degradation, Biotin metabolism, RNA polymerase and Chlorocyclohexane and chlorobenzene degradation. Total sleep time may be correlated with the presence of Tyrosine metabolism, Propanoate metabolism, Carbon fixation pathways in prokaryotes, Carotenoid biosynthesis, Systemic lupus erythematosus, Nitrotoluene degradation and Biosynthesis of unsaturated fatty acids. The severity of insomnia may be correlated with Insulin signaling pathway, Flavonoid biosynthesis, Ascorbate and aldarate metabolism, Nitrotoluene degradation, Biotin metabolism and RNA polymerase. Change of name score in Montreal Cognitive Assessment (MoCA) may be correlated with Tyrosine metabolism, Propanoate metabolism, Carbon fixation pathways in prokaryotes, Carotenoid biosynthesis, Systemic lupus erythematosus, Nitrotoluene degradation, Biosynthesis of unsaturated fatty acids, Apoptosis, Steroid hormone biosynthesis, Geraniol degradation, Protein digestion and absorption and Bisphenol degradation in Gut Microbiota (GM). ConclusionThis study revealed the potential relationships between gut microbiota and PI. By using pathway prediction and enrichment analysis, we concluded many metabolic pathways may associated with some important traits of insomnia patients, including sleep efficiency, severe insomnia, total sleep time and change of name score in MoCA. The metabolic pathways include Insulin signaling pathway, Flavonoid biosynthesis, Ascorbate and aldarate metabolism, Nitrotoluene degradation, Biotin metabolism, RNA polymerase and Chlorocyclohexane, chlorobenzene degradation, Tyrosine metabolism, Propanoate metabolism, Carbon fixation pathways in prokaryotes, Carotenoid biosynthesis, Systemic lupus erythematosus, Biosynthesis of unsaturated fatty acids, Apoptosis, Steroid hormone biosynthesis, Geraniol degradation, Protein digestion and absorption and Bisphenol degradation.Our study demonstrated that PI patients demonstrate significant changes in gut microbiota, which will help delineate the relationship between gut microbiota and syndromes of PI.

Prevalence of sleep disorders in teenage girls in Irkutsk (questionnaire data)

Background. Adequate sleep ensures a person’s physical and psycho-emotional well-being. Adolescence is one of the critical stages of life. The exclusive attention of specialists and leveling the impact of adverse factors on the body during this period is the key to the proper development and preservation of the health of adolescents. Meanwhile, sleep problems in teenage girls remain poorly understood.The aim. To study the features of the sleep regime and quality of sleep of teenage girls in the city of Irkutsk.Materials and methods. A survey of 422 teenage girls in the city of Irkutsk was conducted using a translated version of a questionnaire about adolescent sleep habits to subjectively assess their sleep and wakefulness. Two groups were formed: group I – girls with sleep problems (n = 171); group II – girls without sleep problems (n = 251).Results. Sleep disorders among teenage girls in the city of Irkutsk occurred with a frequency of 40.52 %. In most cases, a complex effect of various unfavorable factors on the sleep process has been identified. The adolescents with sleep disorders we examined were characterized by higher rates of sleep latency, later bedtime, earlier awakening, decreased time of night sleep, as well as changes in the sleep shift indicator towards its increase. These violations were noted both on weekdays and on weekends.Conclusions. Sleep problems were reported in 40.52% of respondents. The complex impact of various unfavorable factors on sleep quality has been revealed. The features of sleep hygiene of teenage girls are reflected. The group of girls with sleep problems was characterized by increased sleep latency, later bedtime, earlier awakening, reduced sleep time, and an increase in sleep shift.

Associations between food insecurity and Sleep Duration, Quality, and Disturbance among older adults from six low- and middle-income countries.

Although food insecurity has been associated with poor sleep outcomes in young and middle-aged adults, few studies have examined this relationship in older adults. This study aimed to examine the relationship between food insecurity and sleep duration, quality, and disturbance among older adults in six low-income countries (LMICs). We analyzed nationally representative cross-sectional data from 33,460 adults (≥50 years) from the Study on global AGEing and adult health (SAGE). Food insecurity (FI) was assessed using two questions regarding the frequency of eating less and hunger caused by a lack of food. Sleep outcomes included self-reported sleep duration, sleep quality, and sleep disturbances (difficulty falling asleep, frequent sleep interruptions, and early awakening) assessed based on self-reports over two nights. Multivariable logistic regression was used to assess country-specific relationships between food insecurity and sleep outcomes, and random-effects models were used to estimate pooled associations. The prevalence of FI among older adults in the overall population was 16.2%. In pooled analyses, FI was significantly associated with long sleep duration ≥ 9 h (OR=1.58, 95% CI: 1.30 to 1.93; P=0.001). There were also significant pooled associations between FI and poor sleep quality (OR=1.34, 95% CI: 1.14 to 1.56; P < 0.001) and sleep disturbances (OR=1.44, 95% CI: 1.08 to 1.91; P = 0.014). In conclusion, the current study found that FI is adversely associated with sleep duration, quality and disturbances in older adults, with some heterogeneity by country. The findings suggest food policies and intervention programs are needed for vulnerable households.

The Association between Caffeine Consumption from Coffee and Tea and Sleep Health in Male and Female Older Adults: A Cross-Sectional Study.

Poor sleep health is common in older adults and is associated with negative health outcomes. However, the relationship between caffeine consumption and sleep health at an older age is poorly understood. This study investigated the association between caffeine consumption and sleep health in community-dwelling older males and females in The Netherlands. Cross-sectional analyses were performed using data from 1256 participants aged 61-101 years from the Longitudinal Ageing Study Amsterdam. Self-reported questions assessed sleep disturbances (including sleep latency, continuity, and early awakening), sleep duration, and perceived sleep quality. Caffeine consumption was determined with questions about frequency, quantity, and type of coffee and tea consumption. Logistic and linear regression models were used, controlling for potential confounders, and interaction by sex and age was tested. Caffeine consumption showed significant interactions with sex (p < 0.005) in association with sleep health outcomes. Older females who abstained from caffeine consumption reported more sleep disturbances (β = 0.64 [95%CI 0.13; 1.15]) and had greater odds of short sleep duration (<7 h/day) (OR = 2.26 [95% CI 1.22; 4.20]) compared to those who consumed caffeine. No associations were observed for long sleep duration (>8 h/day) and perceived sleep quality. No associations were observed in older males. Caffeine abstinence was associated with more sleep disturbances and short sleep duration in older females, but not in males. The observed association in older females may reflect reverse causation, suggesting that females may have different motivations for discontinuing caffeine consumption than males.

Effectiveness of the 30-Degree Lateral Sleeping Position on Sleep Quality in Elderly Individuals Post-Stroke

Background: Post-stroke conditions can have an impact on the sleep quality of the elderly. Sleep disorders are a common health problem for the elderly, requiring serious attention. Poor sleep quality in the elderly is caused by increased sleep potential, reduced sleep efficiency, and early awakenings due to the ageing process.&#x0D; Objective: This research aims to determine the effectiveness of a 30-degree lateral sleeping position compared to a supine sleeping position on the sleep quality of elderly individuals post-stroke.&#x0D; Method: The design of this research uses a quasi-experiment design with a non-equivalent control group design approach. The study will be conducted in 2023 in Ekasari Village, Jembrana Regency, Bali. The total research population is 126 elderly individuals, and the sample size meeting the criteria is 64 respondents, divided into 32 respondents in the intervention group and 32 respondents in the control group. Data analysis in this study uses the Mann-Whitney U Test.&#x0D; Results: The Mann-Whitney U Test shows a difference between the intervention and control groups (p = 0.000, Z score = -4.830), which means that the 30-degree lateral sleep position is better at helping older people who have had a stroke sleep better than the supine sleep position.&#x0D; Conclusion: Post-stroke elderly individuals tend to experience an improvement in sleep quality when they sleep in the lateral position of 30 degrees. Therefore, elderly people who are having sleep quality issues can adopt this sleeping position to improve their sleep.

Overtime work is related to nonrestorative sleep independently of short sleep time among a Japanese occupational population.

The symptoms of insomnia are defined as difficulty falling asleep, difficulty staying asleep, and early awakening. Although also a symptom of insomnia, nonrestorative sleep (NRS) is clearly more associated with objective indices than other insomnia symptoms. However, the link between NRS and overtime work duration is poorly understood. The results of a single year's medical examinations were investigated for 26,144 Japanese office workers who were 30 to 59years old. NRS status and lifestyle were collected through a computer-assisted medical interview. The subjects were asked about the presence or absence of NRS and their lifestyles in the most recent two to three months. The subjects were asked about their sleep times and average overtime durations per month (< 20h/month, ≥ 20 but < 40h/month, ≥ 40 but < 60h/month, and ≥ 60h/month). The relationships between NRS and overtime work duration adjusted for sleep time were also analyzed. The proportion of subjects with NRS showed a stepwise increase as overtime work hours increased. A logistic regression analysis was performed using NRS as an objective variable. The multivariate analysis demonstrated that overtime work duration (OR, 1.13; 95% CI 1.10-1.17; P < 0.001; per one-category increase) was an independent determinant of NRS. For office workers, long hours of overtime work increased the NRS prevalence at any sleep duration.

O046 Adherence to Dietary Guidelines Predicts Sleep outcomes in Older Australian Women: Findings from the Australian Longitudinal Study on Women’s Health

Abstract Introduction Sleep quality and quantity is impacted by age, with women more susceptible to these age-related changes. Poor sleep in older adults is linked to adverse health outcomes and a greater risk of all-cause mortality. Given the ageing population in Australia, strategies to improve sleep in older adults is critical. Diet is a modifiable lifestyle factor that may improve sleep. This study investigated the relationship between adherence to dietary guidelines and sleep problems in older Australian women. Method Data from n=7956 Australian women from the 1946-1951 cohort of the Australian Longitudinal Study on Women’s Health were included (mean age±SD: 70.8±1.5 years). Participants completed a food frequency questionnaire, reported as a diet quality score (0-100, with 100 indicating best diet quality). Sleep problems were measured with five questions that asked about early waking, time taken to fall asleep, sleep quality, wake after sleep onset, and worry related awakenings at night. Results At least one sleep problem was reported by 70.2% of participants, and 20.5% reported between 3-5 sleep problems. Overall adherence to dietary guidelines was poor, with an average diet quality score of 56.9±10.7. Linear regression revealed that better adherence to dietary guidelines was associated with fewer sleep problems (β: –0·065, 95 % CI: –0·012, –0·005). Discussion While dietary adherence in older Australian women was poor, adherence to dietary guidelines was associated with fewer symptoms of sleep problems. To improve the sleep and overall health of older Australian women, strategies to improve dietary adherence should be prioritised.

Predictors of cognitive behavioral therapy for insomnia (CBT-I) effects in insomnia with major depressive episode

Insomnia plays a critical role in the onset and maintenance of Major Depressive Episode (MDE). Cognitive behavioral therapy for insomnia (CBT-I) can successfully improve the sleep of patients with insomnia and MDE. Nonetheless, the factors influencing CBT-I's effects in MDE remain uncertain. This study aimed to identify predictors of insomnia improvement following CBT-I, as well as predictors of insomnia response, remission in patients with MDE and specific insomnia subtypes. Initially, we compared a 4-session weekly CBT-I treatment to baseline sleep education (SE) in a control group. This confirmed CBT-I's positive effects and the need to explore predictive factors. Notably, treatment-resistant depression (TRD) predicted reduced insomnia severity with CBT-I. Patients exhibiting seasonal fluctuations in depressive symptoms and sleep patterns throughout the year, or having daytime dysfunction, experienced enhanced CBT-I efficacy, especially for early awakenings insomnia. Conversely, shorter sleep duration predicted a less favorable response to CBT-I, less improvement in daytime dysfunction and sleep disturbance worries. Additionally, MDE with suicide attempts predicted a poorer improvement of daytime dysfunction. Further research is essential to comprehensively grasp the mechanisms behind CBT-I's heightened effectiveness in MDE patients with TRD and seasonal fluctuations.