Sleep Feelings Research Articles

Adaptive servo-ventilation for the treatment of intrathecal baclofen-induced central sleep apnea: A case report.

Baclofen is a common muscle relaxant agent used in a number of neurological disorders acting at central level and potentially causing adverse respiratory events, still largely unknown at therapeutic doses. We present the case of a young woman with spastic tetraparesis secondary to perinatal asphyxia treated with a standard dose of intrathecal baclofen who developed nocturnal symptoms, somnolence and memory loss during the day. Nocturnal cardio-respiratory sleep monitoring showed a high number of central sleep apneas (CSA). The patient was adapted and treated with a positive air pressure device, Adaptative Servo-Ventilator, specific designed to treat CSA particularly in patients with heart failure. The treatment was well tolerated and within few days CSA was reversed. The patient reported a feeling of restful sleep and disappearance of morning tiredness. The efficacy of the treatment was verified with nocturnal cardio-respiratory monitoring after 2 months and complete resolution of all symptoms was also confirmed.

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.

Perceived Stress, Poor Sleep Quality, and Mental Well-being in Young Adults

This study intended to identify the correlation between perceived stress (PS), Poor sleep quality (PSQ), and mental health. The hypothesis indicated that there could be a link between PS, PSQ, and mental well-being in young people. A sample of 488 young adults aged between 19 and 25 years (M = 20.38 and SD = 1.76), men (n = 244) and women (n = 244), was obtained from different private and government sector universities. Convenience sampling strategy: Participants were approached and data was collected. PS, PSQ, and mental well-being were assessed using the Pittsburgh Sleep Quality Index, PS Scale, and Warwick. The Edinburgh Mental Well-Being Scale. Pearson product-moment correlation and moderation analysis using AMOS were used to test the hypotheses. Additional finding t-tests were used for independent samples. The study found that PS was positively connected with PSQ but unfavourably linked with mental well-being. Further research revealed substantial differences in young adults' feelings of stress, poor sleep, and mental health based on gender, university, and family structure.

Electroencephalography Microstate Class D is a Brain Marker of Subjective Sleep Quality for College Students with High Habitual Sleep Efficiency.

Subjective sleep quality is an individual's subjective sleep feeling, and its effective evaluation is the premise of improving sleep quality. However, people with autism or mental disorders often experience difficulties in verbally expressing their subjective sleep quality. To solve the above problem, this study provides a non-verbal and convenient brain feature to assess subjective sleep quality. Reportedly, microstates are often used to characterize the patterns of functional brain activity in humans. The occurrence frequency of microstate class D is an important feature in the insomnia population. We therefore hypothesize that the occurrence frequency of microstate class D is a physiological indicator of subjective sleep quality. To test this hypothesis, we recruited college students from China as participants [N = 61, mean age = 20.84 years]. The Chinese version of the Pittsburgh Sleep Quality Index scale was used to measure subjective sleep quality and habitual sleep efficiency, and the state characteristics of the brain at this time were assessed using closed eyes resting-state brain microstate class D. The occurrence frequency of EEG microstate class D was positively associated with subjective sleep quality (r = 0.32, p < 0.05). Further analysis of the moderating effect showed that the occurrence frequency of microstate class D was significantly and positively correlated with subjective sleep quality in the high habitual sleep efficiency group. However, the relationship was not significant in the low sleep efficiency group (βsimple = 0.63, p < 0.001). This study shows that the occurrence frequency of microstate class D is a physiological indicator of assessing subjective sleep quality levels in the high sleep efficiency group. This study provides brain features for assessing subjective sleep quality of people with autism and mental disorders who cannot effectively describe their subjective feelings.

Innovation in Health Programming: College Students Benefit from an Array of Complementary Approaches to Health Improvement Framed by the Biopsychosocial-Spiritual Model

ABSTRACT Background The American Psychological Association reports that Generation Z are suffering mentally and physically more than any other group. Purpose Measure the effects of a 16-week, online college-level “Complementary Therapies in Health Course” through the lens of the biopsychosocial-spiritual model on measures of health and aspects of well-being in college students. Methods A mixed method, controlled, repeated measures study delivered in an online synchronous college-level health course. The course curriculum included the science and practice of compassion, happiness, mindfulness, meditation, yoga, service, gratitude, longevity, movement, and more. Results 42 students 18–23 participated. A significant between subjects cross-over effect demonstrating improvements in the intervention group and deterioration in the control group was found using the Self Compassion Scale (p < .005), Self-Compassion subscale of Judgment (p < .001), Spiritual Well-being Scale (p < .047), and the Pemberton Happiness Index (p < .007). The Self Compassion Scale also revealed a within subjects significant effect (p < .001). Qualitative data revealed improvements in compassion, feelings of happiness, sleep, exercise and health habits, gratitude, mindfulness, spiritual feelings, and more. Discussion Health education predicated on the biopsychosocial-spiritual model is efficacious. Translation to Health Education Practices A whole person, complementary health approach to education programming has widespread, positive effects on college students. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Associations between adolescents’ energy drink consumption frequency and several negative health indicators

BackgroundThe purpose of this study was to identify how various negative health indicators are associated with energy drink consumption frequency among 13- and 15-year-old Finnish adolescents.MethodsData (N = 2429) from the nationally representative international Health Behaviour in School-aged Children study (2018) were analyzed via descriptive analysis and logistic regression analyses, with control for salient covariates. Relative risks (RR) were derived from the adjusted odds ratios.ResultsEven infrequent energy drink consumption was associated with various negative health indicators. Moreover, as compared to non-users, frequent energy drink consumers were more likely to report several health-compromising behaviors: current smoking (RR = 9.85, 95% CI: 5.68–16.02), current snus use (RR = 3.62, 95% CI: 1.80–6.85), cannabis use (RR = 3.42, 95% CI: 1.69–6.52), alcohol consumption (RR = 3.08, 95% CI: 2.49–3.71), problematic social media use (RR = 2.53, 95% CI:1.68–3.72), short sleep (RR = 2.12, 95% CI: 1.69–2.60), skipping breakfast (RR = 1.87, 95% CI: 1.51–2.29), drunkenness (RR = 1.59, 95% CI: 1.11–2.23), inadequate tooth brushing (RR = 1.28, 95% CI: 1.05–1.54). In addition, frequent energy drink consumption was associated with perceived negative health indicators: feelings of insufficient sleep (RR = 1.56, 95% CI: 1.11–2.15), low self-rated health (RR = 1.48, 95% CI: 1.15–1.87), and multiple health complaints (RR = 1.31, 95% CI: 1.07–1.56).ConclusionsEnergy drink consumption, even infrequent, was associated with several negative health indicators, and the reporting of these increased with the frequency of energy drink consumption. The findings support the concerns of health authorities regarding the negative associations between energy drink consumption and health, even among persons as young as 13 years. There is evidence to support specific policy level actions, including restrictions on the sale of energy drinks to adolescents. This measure has been proposed in a Finnish government program, but implementation has yet to occur. Moreover, marketing of these beverages in platforms that are popular among adolescents (e.g., the social media) should be rigorously evaluated, and comprehensive interventions and actions implemented to ensure that adolescents, parents/guardians, and professionals working with adolescents (e.g., in schools) have a good understanding of the links between energy drink consumption and health.

The Interplay Among Natural Menopause, Insomnia, and Cognitive Health: A Population-Based Study.

The interrelationships among age at menopause, sleep, and brain health have been insufficiently studied. This study sought to examine the influence of age at natural menopause and insomnia symptoms on long-term cognitive function among US women. Our study included a nationally representative cohort of US adults age 50+ from the Health and Retirement Study (2008-2018). We restricted this cohort to 5880 women age 50+, from a diverse racial and ethnic groups. Age at menopause was retrieved from baseline (2008) for women having natural menopause. Five questions were used to identify women with insomnia symptoms (2010 and 2012): trouble falling asleep, nighttime awakenings, early morning awakenings, feelings of nonrestorative sleep, and use of sleep aids. A battery of four neuropsychological tests was conducted biennially (years) to evaluate cognitive function. Longitudinal associations between age at natural menopause and cognitive function were estimated with mixed effects models with a random intercept. Insomnia symptoms were examined as potential mediators or modifiers in the pathway between age at menopause and cognition. One year earlier in age at menopause was associated with a 0.49 lower mean in composite cognitive score, in any given survey year (adjusted p = 0.002). Earlier age at menopause was associated with higher risk of developing insomnia symptoms (eg, trouble falling asleep OR = 0.97; 95% CI: 0.96, 0.99), and insomnia symptoms were associated with worse cognitive performance (eg, trouble falling asleep, beta = -0.5, p-value = 0.02). Therefore, insomnia symptoms could potentially mediate the association between age at natural menopause and cognition. Earlier age at menopause is associated with a lower score in cognitive performance. This association may be mediated by insomnia symptoms. Our findings spotlight that among women who experience early menopause, there is the need for studies of sleep-based interventions to mitigate cognitive decline.

Partially hydrolyzed guar gum is associated with improvement in gut health, sleep, and motivation among healthy subjects.

Partially hydrolyzed guar gum dietary fiber is well recognized for a number of health benefits. In the present study, we aim to investigate the effects of partially hydrolyzed guar gum on constipation, intestinal microbiota as well as mental health in healthy subjects. In the randomized, parallel, double-blind, and placebo-controlled study the enrolled healthy men and women volunteers took either 3 g/day (T3) or 5 g/day (T5) of dietary fiber intakes for eight consecutive weeks compared to placebo (T0). The fecal characteristics, fecal microbiota, defecation characteristics, and quality of life (QOL) questionnaire were investigated. The results revealed a significant suppression in fecal potent harmful mucolytic bacteria in the T3 and T5 groups compared to the T0 group. The defecation frequency, excretory feeling, and scores of sleep and motivation questionnaire were also improved in the dietary fiber intake groups, showing a significant difference in the T5 group compared to the T0 group. In summary, the consumption of partially hydrolyzed guar gum dietary fiber is found effective in suppressing the potent harmful mucolytic bacteria that could be associated with the improvement of constipation-related symptoms including mental health in terms of sleep and motivation among the healthy subjects.

Paternal Postpartum Depression

This is a case study of a 28-year-old man without former psychiatric history who presented to the emergency room for persistent thoughts of harming himself and his 2-month-old son for the past 1.5 months. He had also been experiencing anhedonia, feelings of guilt, decreased concentration, interest, sleep, and energy over the past month following the birth of his son. He was diagnosed with major depressive disorder and admitted to inpatient psychiatry ward to mitigate safety concerns. During his admission, his diagnosis was amended to postpartum depression based on onset of symptoms and association with the birth of his son. He was started on 10 mg vortioxetine and was discharged once suicidal and homicidal ideations resolved. He was provided outpatient services to include Cognitive Behavioral Therapy and continued medication management on vortioxetine. Outpatient treatment course resulted in complete resolution of symptoms. [ Psychiatr Ann . 2022;52(11):484–486.]

0057 Age at menopause and insomnia in a racially diverse cohort

Abstract Introduction Menopause is related to major hormonal, physical, and psychological changes for women, each of which could influence their sleep. However, sleep in women post-menopause may differ by race and ethnicity. We aimed to examine associations between age at menopause and insomnia symptoms among US women by race and ethnicity. Methods We utilized 2008-2012 data from the Health and Retirement Study, a nationally representative cohort of US adults age 50+, restricted to women with natural transition to menopause. Age at menopause was retrieved from baseline information (2008) and was used to categorized women into premature menopause (age≤40y), early menopause (age 41-45y), and normal menopause (age&amp;gt;45y). An insomnia composite score was constructed from 2010 and 2012 survey items that assessed insomnia symptoms (i.e., trouble falling asleep, nighttime awakenings, early morning awakenings, and feelings of nonrestorative sleep). Insomnia items that were reported as “most of the time” were considered positive and contributed to the composite score (range: 0-4). We estimated associations between age at menopause and insomnia symptoms using linear regression models and logistic regression models for continuous and binary outcomes, respectively. Models were stratified by White/non-White race and were adjusted for age, education, physical activity, parity, marital status, and survey year. Results Among 4,435 women, 338, 701, and 3,396 reported premature, early, and normal menopause, respectively. In White women, premature menopause was associated with a higher mean composite insomnia score than those who had normal menopause (b=0.20, p=0.03). However, this association was not seen in non-Whites. For individual insomnia survey items, premature menopause in White women was associated with greater odds of nonrestorative sleep (OR=1.98, 1.30-3.03) compared with normal menopause. In contrast, a premature menopause was not associated with nonrestorative sleep in non-Whites. Premature menopause was not associated with other individual insomnia symptoms for both groups. Conclusion Premature transition to menopause is associated with increased insomnia symptoms in White women. Among individual insomnia features, premature menopause had the greatest impact on nonrestorative sleep. Given the importance of sleep quality for various health outcomes, our findings highlight a need for more dedicated sleep assessments in women who experience premature menopause. Support (If Any)

0080 Influence of neighborhood safety on stress and sleep

Abstract Introduction Our health is influenced by the environment in which we live. Due to socioeconomic differences, disparities exist across neighborhoods, with certain groups experiencing higher detriments to their health compared to others. Emotional distressing experiences due to the neighborhood in which we live cause stress levels to rise. Given the psychological and physiological impact of stress, high levels of stress can be a contributing factor for poor sleep. We investigated the influence of feelings of neighborhood safety on stress and sleep and the ethnic differences found in each of these outcomes. In addition, we ask whether feelings of neighborhood safety mediate the association between stress and sleep. Methods 1,606 participants were recruited online through Amazon Mechanical Turk to participate in a questionnaire. Components of this survey included demographic data, the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and the Neighborhood Questionnaire Neighborhood Safety Subscale. Results We found that as neighborhood safety levels rise, stress levels lower. Further, ethnic differences were found for feelings of neighborhood safety, stress, and sleep: Latino participants had the lowest feelings of neighborhood safety, highest stress levels, and worst sleep. We also found that stress mediates the association between neighborhood safety and sleep. Conclusion Our results highlight the contribution of feeling safe in one's own neighborhood on stress and sleep outcomes. Given the ethnic differences present in each of our outcomes, future work should investigate neighborhood characteristics influencing neighborhood safety as possible areas of intervention benefitting sleep. Support (If Any)

Le sommeil des étudiants français en période de COVID-19 : Influence des deux premiers confinements sur la quantité et la qualité de sommeil

The COVID-19 pandemic resulted in two periods of confinement during the year 2020 that led to changes in lifestyle patterns. The purpose of our study was to assess the impact of the lockdowns on the quantity (i.e., schedule and time in bed) and quality (i.e., difficulties and parasomnias) of sleep in French college students. During the first and second lockdowns, students were asked to answer an online questionnaire consisting of 23 questions. This questionnaire gathered information on the real and ideal schedules of getting up and going to bed, the time in bed, as well as the parasomnias and difficulties related to sleep (difficulties in falling asleep, waking up, lack of sleep feeling). The results showed that students slept later and spent more time in bed on week-ends than during the week, with these effects being more pronounced during the first confinement than during the second. The majority of students reported poor sleep quality, difficulty falling asleep, early awakening, and a feeling of sleep deprivation. The most common parasomnias were episodes of nightmares and sleepiness. Sleep difficulties and reported parasomnias were greater during the second confinement than during the first. Sleep debt, was still present during the lockdowns. The reported sleep difficulties and parasomnias reflect poor sleep quality, despite the reduction in social constraints. Explanatory hypotheses as well as prevention perspectives regarding sleep hygiene were considered.

Impacts of COVID-19 on caregivers of childhood cancer survivors.

PurposeWe sought to assess the impact of disruptions due to coronavirus disease 2019 (COVID‐19) on caregivers of childhood cancer survivors.MethodsA 13‐question survey containing multiple‐choice, Likert‐type, and free‐text questions on experiences, behaviors, and attitudes during the COVID‐19 outbreak was sent to childhood cancer caregivers and completed between April 13 and May 17, 2020. Ordered logistic regression was used to investigate relationships between demographics, COVID‐related experiences, and caregiver well‐being.ResultsCaregivers from 321 unique families completed the survey, including 175 with children under active surveillance/follow‐up care and 146 with children no longer receiving oncology care. Overall, caregivers expressed exceptional resiliency, highlighting commonalities between caring for a child with cancer and adopting COVID‐19 prophylactic measures. However, respondents reported delayed/canceled appointments (50%) and delayed/canceled imaging (19%). Eleven percent of caregivers reported struggling to pay for basic needs, which was associated with greater disruption to daily life, greater feelings of anxiety, poorer sleep, and less access to social support (p < .05). Caregivers who were self‐isolating reported greater feelings of anxiety and poorer sleep (p < .05). Respondents who expressed confidence in the government response to COVID‐19 reported less disruption to their daily life, decreased feelings of depression and anxiety, better sleep, and greater hopefulness (p < .001)ConclusionsCaregivers are experiencing changes to medical care, financial disruptions, and emotional distress due to COVID‐19. To better serve caregivers and medically at‐risk children, clinicians must evaluate financial toxicity and feelings of isolation in families affected by childhood cancer, and work to provide reliable information on how COVID‐19 may differentially impact their children.

ЗДОРОВ’Я ТА ПСИХОЛОГІЧНИЙ ДОБРОБУТ ОСІБ ІЗ ХРОНІЧНИМИ ЗАХВОРЮВАННЯМИ ШЛУНКОВО-КИШКОВОГО ТРАКТУ ПІД ЧАС КАРАНТИННИХ ОБМЕЖЕНЬ COVID-19

The article aims to examine health outcome and well-being in individuals with chronic gastrointestinal disorders during COVID-19 pandemic. The study applies Patient-Reported Health Outcome Measure-Core Thrive Items to assess health outcome and well-being in 18 patients with chronic gastrointestinal disorders at Volyn Regional Clinical Hospital (Lutsk, Ukraine). The measure assesses the overall health and impact of primary condition, core symptoms (pain, depressed mood, anxious mood, fatigue, stress), mobility (walk ability), sleep (fall and stay asleep), abilities (thinking, emotions, personal needs, responsibilities, social activity) and thriving (feeling good about yourself, meaning of life, connectedness, high life standards) during last month which coincides with adaptive quarantine restrictions in Ukraine. There was a significant negative correlation between period of disease, age of individuals and overall health, and positive correlation between age and period of disease. Negative correlation was also found between core symptoms and good sleep. In addition, there is a positive correlation between good sleep and abilities, particularly thinking, emotions, personal needs, responsibilities, and social activity. The difference in health outcome and well-being between the female and male groups was not significant. Findings of our study capture that the highest indices of poor health outcome and wellbeing are aligned with feelings of pain, bad sleep and chronic fatigue. It is somewhat surprising that no depressed mood and anxious state were noted in individuals with chronic gastrointestinal disorders during COVID-19 pandemic. The high indices of connectedness were found, which aligned with strong relations between individuals with chronic gastrointestinal disorders and their family members. Therefore, a further study could assess the long-term effects of Expressed Emotion and positive relationship between family members and these patients on health outcome and well-being during COVID-19 pandemic.

Levels of burnout and its association with resilience and coping mechanisms among orthopaedic surgery residents: a single institution experience from Singapore.

Introduction:Burnout has implications for surgeon wellbeing and patient care. We aimed to: (a) describe burnout levels among orthopaedic surgery residents in an Accreditation Council for Graduate Medical Education-International (ACGME-I) accredited programme; and (b) determine associations between burnout levels and resident characteristics, resilience and coping mechanisms.Methods:This is a grant-funded, cross-sectional questionnaire-based study that included 44 orthopaedic surgery residents. Burnout was measured using Maslach Burnout Inventory and resilience was determined using the Short Grit Scale. Coping mechanisms were determined using the Brief Coping Orientation to Problems Experienced scale.Results:20 (45.5%) residents fulfilled the criteria for burnout. High levels of emotional exhaustion (EE) and depersonalisation (DP) correlated with stressors, such as inadequate sleep (EE: r = 0.43, P <0.01; DP: r = 0.33, P <0.05), conflict between family and work (EE: r = 0.40, P <0.01; DP: r = 0.40, P <0.01), financial pressure (DP: r = 0.46, P <0.01), and conflict with residents (EE: r = 0.35, P <0.05; DP: r = 0.34, P <0.05) and faculty (EE: r = 0.44, P <0.01; DP: r = 0.35, P<0.05). Severe burnout was associated with lower grit scores (p <0.05). Coping mechanisms, such as planning and positive reframing, were protective while behavioural disengagement and substance use may increase burnout risk.Conclusion:Burnout was high in our ACGME-I accredited programme. Stressors associated with higher burnout included feeling of inadequate sleep, poor work-life balance, poor relationships with fellow residents/faculty and financial pressures. Residents should be educated on protective coping mechanisms and regular screening to detect burnout should be performed.

Anxiety and depression related to yog nidra among professional students

Background: Anxiety is one's response to stress. Its symptoms can be psychological, physical, or environmental challenges. Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feeling of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Yog nidra is probably the best known technique to induce complete physical and emotional relaxation. Aim: The aim of this study was to explore the effectiveness of yog nidra for reducing anxiety and depression among first-year professional students. Materials and Methods: The level of anxiety was measured by using State, Trait, and Free-Floating Anxiety Scale developed by Tripathi and Rastogi (1986). The Hindi version of Beck Depression Inventory by Arora and Prashant (1988) was used to assess the depression level of participants. The study was conducted in three phases. In Phase-1 (preintervention), data were obtained from 201 students. In the Phase-2 (intervention phase), the participants were selected on the basis of high scores on the measures of anxiety and depression and divided into intervention (28 students) and non-intervention groups (30 students). The intervention group was given yog nidra training regularly for 5 weeks. Posttest was conducted after 5 weeks of the intervention. Results: The results showed a reduction in mean scores on the measures of anxiety and depression within the intervention group but not in the nonintervention group, which indicated the effectiveness of practicing yog nidra for reducing anxiety and depression and its positive effects among professional students. Conclusion: A dramatic effect of practicing yog nidra was observed among students for reducing anxiety and depression.

Excessive sleepiness and associated symptoms in the U.S. adult population: prevalence, correlates, and comorbidity

ObjectiveThis study examined the prevalence, sociodemographic features, patterns of comorbidity, and impact on functional impairment of excessive sleepiness (Ex.S) and associated symptoms in a nationally representative sample of adults using the National Comorbidity Survey Replication (NCS-R) dataset. MethodsParticipants ≥18 years (n = 5,962) were queried about their sleep using the Composite International Diagnostic Interview (CIDI). Specifically, respondents were questioned about feeling sleepy during the day and falling asleep in permissive situations, feelings of insufficient sleep despite adequate time in bed, and/or difficulty waking up. Those endorsing daytime sleepiness and at least one additional symptom were considered to have Ex.S plus associated symptoms. Associations between Ex.S plus associated symptoms and sociodemographics, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorders, chronic physical conditions, and functional impairment were examined. ResultsThe prevalence of Ex.S plus associated symptoms in U.S. adults was 23.34% (standard error [SE] = 0.88) and significantly co-occurred with insomnia-related symptoms after adjusting for confounders (Odds ratio [OR] = 5.65; 95% confidence interval [CI] = 4.55-7.02). The presence of Ex.S and associated symptoms was more common in women, particularly younger women, those with lower family income, and the unemployed (all P<.001). After controlling for demographic characteristics and other confounders, Ex.S plus associated symptoms was associated with having a DSM-IV mental disorder (OR = 4.25; 95% CI = 3.53-5.10), a chronic physical condition (OR = 2.57; 95% CI = 1.94-3.42) and greater disability (P<.001). ConclusionEx. S with associated symptoms was common, frequently co-occurred with other mental and physical conditions, and was associated with substantial disability. Dissipation of some associations after controlling for insomnia-related symptoms indicated that physical-mental comorbidity and disability were greater among individuals with more pervasive sleep disturbances.

Changes in sleep difficulties among the U.S. population from 2013 to 2017: results from the National Health Interview Survey

ObjectivesThis study sought to evaluate how sleep difficulties have changed over time and to evaluate if these changes relate to changes in sleep duration. DesignNational Health Interview Survey administered annually from 2013 to 2017 by the National Center for Health Statistics. SettingU.S. national adult population. Participants164,696 U.S. adults sampled across the nation using multistage area probability design. MeasurementsSelf-reports of difficulties falling asleep, trouble staying asleep, use of sleep medication, feelings of restorative sleep, and sleep duration collected each year. ResultsFrom 2013 to 2017, the prevalence of reporting any days with difficulty falling asleep (B = .01, p <.01), trouble staying asleep (B = .02, p < .001), increased, yet waking feeling rested also increased (B = .01, p = .004), while average sleep duration decreased (B = -.02, p < .001). Moreover, changes in these sleep difficulties were independent of sleep duration and primarily occurred in healthy sleepers. ConclusionsMultiple aspects of sleep difficulties show an undesirable trajectory in the U.S. adult population. Moreover, these trends appear to be independent of sleep duration and are primarily occurring in healthy sleepers. Future research should simultaneously consider how multiple aspects of sleep are changing and further examine the sources of these changes.

Impact Of Phenotypic Heterogeneity Of Insomnia On The Patients' Response To Cognitive-Behavioral Therapy For Insomnia: Current Perspectives.

Insomnia is one of the most common mental disorders and the most frequent sleep disorder encountered in clinical practice, with a prevalence of about 7% in the European population. Insomnia Disorder (ID) is defined as a disturbance of sleep initiation or maintenance, followed by a feeling of non-restorative sleep and several diurnal consequences ranging from occupational and social difficulties to cognitive impairment. Cognitive-Behavioral Therapy for Insomnia (CBT-I) is considered the first-choice therapy for this disorder because its effectiveness has been proven to be greater in the long term with fewer side effects in comparison to pharmacotherapy. Although its effectiveness has been well established, it has been reported that nearly 40% of patients do not achieve remission after treatment. This finding could be the consequence of heterogeneity of ID between patients. It has been proposed that this heterogeneity might be ascribable to indices that are not related to sleep quality and quantity, such as comorbidities, life events, and personality traits. However, several works focused on the role of sleep markers, in particular objective total sleep time, for the phenotypization of ID and treatment response. The aim of this work is to summarize the available scientific literature regarding the impact of ID subtype on CBT-I response.

Postural Control Follows a Bi-Phasic Alteration Pattern During Mountain Ultra-Marathon.

It is well knows that postural control (PC) is deteriorated with neuromuscular fatigue, altitude or sleep deprivation induced by a mountain ultra-marathon (MUM). Several regulatory mechanisms have also been reported during this type of event and the changes in PC at different points of MUM remain unknown. The purpose of this study was to investigate the time course of PC during an extreme MUM. We tested the hypothesis that PC alteration would not increase linearly.Methods: 16 participants (age 45.1 ± 9.6 years) were tested bipedaly on a posturographic platform for 51.2 s with eyes open every ∼50 km. Both traditional and stabilogram diffusion analyses (SDA) were performed. A visual analog scale (VAS) was used for a subjective evaluation of global fatigue, sleep feeling and pain.Results: The main parameters (center of pressure trajectory analysis) increased significantly (p < 0.001, d = 1.56, very large) until km 100. This was confirmed by SDA in the antero-posterior plane. Short term effective diffusion coefficient significantly increased (p < 0.001, d = 1.07, very large) as critical point (p < 0.01, d = 1.57, very large). From km 100 to 200, a different response was observed with a continuous decrease in most of the PC parameters. This was confirmed by SDA in the antero-posterior plane. Short term effective diffusion coefficient significantly increased (p < 0.001, d = 1.39, very large) as critical point (p < 0.01, d = 1.51, very large).Conclusion: Posture alteration is progressively increased until 100 km. After this point, compensatory mechanisms appear to limit the posture degradation. This bi-phasic response is of interest for better understanding the coping with extreme fatigue.