Improvement In Sleep Quality Research Articles

Sleep architecture disturbance due to the use of benzodiazepines

Introduction Insomnia, which is characterized by difficulty in initiating or maintaining a physiological sleep, is a relevant clinical issue, affecting not only the elderly population (from 20% to 40%), but also the general population since 30% of adults report problems in sleeping properly. In addition, 30-40% of adults report complaints about sleep quality lifetime, and10-15% report chronic insomniaBenzodiazepines (BZDs) are commonly prescribed to treat insomnia and sleep disorders. BZDs show a rapid sedative and anxiolytic effect, successfully used in the acute treatment of insomnia as well as anxiety, agitation, or anxiety associated with any type of psychiatric disorder. Their use is associated with potential side effects such as residual daytime sleepiness, ataxia, and dizziness. Long-term BZDs use may lead to drug abuse, tolerance, drug dependency, and abstinence. For instance, BZDs abrupt withdrawal can lead to severe symptoms such as insomnia and/or rebound anxiety, an increase in heart rate and blood pressure, nausea and/or vomiting, sweating, diarrhea, convulsions, and other neurological and psychiatric symptoms.ObjectivesThis e-poster aimed to summarize evidence regarding the effect of BZDs treatment on human Sleep Architecture.MethodsA bibliopgraphical review was performed using PubMed platform. All relevant articles were found using the keywords: benzodiazepines, sleep architecture, insomnia.ResultsProlonged use of benzodiazepines leads to an increase of time spent in stages 2 and a decrease of time in stages 1, 3, and 4. The increased NREM stage 2 is associated with a subjective improvement in sleep quality. The decrease in NREM sleep time in stages 3 and 4 is usually associated with lesser “rest” for the brain, which leads to a lack of concentration.ConclusionsBZDs use modified sleep architecture in the short and long term.Disclosure of InterestNone Declared

Current aspects and future perspectives on polysomnography. Applicability in rehabilitation patients diagnosed with sleep related breathing disorders -A narrative review

Abstract: Background: Polysomnography is continually advancing technically, with its applica-bility expanding across various fields. This narrative review aims to highlight its recent develop-ments, current applications, and future perspectives from a clinical point of view. Methods: Relevant articles written in English published from 2015 to 2024 were searched in PubMed and Google Scholar. Results: Polysomnography remains the gold standard test in sleep disorders but in certain categories of patients it is not very accesible. Some of the home sleep tests (HSAT) perform closely to PSG testing. Identifying REM movement disorders early is important because it is a predictor factor for developing neurodegenerative diseases. Artificial intelligence (AI) cаn be used for diаgnosis by integrаting АI in weаrаble devices for remote monitoring, using it for fаster аnd а more аccurаte scoring, аs well аs using it to offer рersonаlized treаtment for eаch individuаl. Polysomnography can play a pivotal role in diagnosing sleep related breathing disorders in reha-bilitation patients to offer treatment, help in the improvement of sleep quality and consequently, offer better rehabilitation outcomes. Conclusions: Polysomnography opens up numerous possi-bilities for investigating sleep disorders, providing a comprehensive understanding of an indi-vidual's sleep health, and improving the management of sleep-related disorders

Interplay of Sleep Quality, Insomnia and Quality of Life in Individuals Undergoing Hemodialysis

Insomnia is the most commonly occurring disorder of sleep experienced by individuals with chronic kidney disease. It is associated with physical and psychological health issues specifically the ones on hemodialysis. Objective: To find out the frequency of insomnia in individuals undergoing hemodialysis and to examine the relationship between sleep quality and quality of life. Methods: It was a cross sectional study and non-probability purposive sampling technique was used for selecting the sample of patients undergoing hemodialysis from a dialysis center of Lahore. The sample consisted of both men and women (N=100) with age range 40 and above (M=51.40, SD=7.25). Insomnia, general sleep scale and quality of life scale were used to collect data from the participants. Results: Insomnia was found to be prevalent in 6% of the patients. Quality of Life (QOL) was significantly poor in individuals with insomnia and poor sleep quality as compared to the ones with better sleep. Older age, increasing duration of hemodialysis and poor sleep quality were significant predictors of quality of life in our sample. Conclusions: Insomnia and/or poor-quality sleep have a detrimental effect on patients’ quality of life in kidney disease. These findings can provide basis for awareness campaigns and health promotion programs aimed at timely diagnosis and management of insomnia and improvement in sleep quality as well as quality of life in individuals undergoing hemodialysis

Application of Benson therapy to sleep quality of chronic kidney disease (CKD) patients

Introduction: CKD currently has priority as a major health problem in the world community In patients with Chronic Kidney Failure, a common complaint that is often felt is sleep pattern disturbances. The quality of sleep of CRF patients is caused by stress and depression. Stress and depression occur a lot in CRF patients. The patient's poor sleep quality can affect daily activities. Sleep quality is a person's satisfaction with sleep such as the ability to stay asleep, ease to stay asleep without medical assistance. Objective: To improve sleep quality of patients with chronic renal failure. Methods: This research design uses a case study research design, this case study is a case study to explore the application of Benson therapy, patients are carried out Benson therapy for 10-15 minutes twice a day. This case study was conducted on October 2-October 14, 2023 in the HCU room of RSUD dr. Moewardi Surakarta by taking 2 patients with medical diagnoses of CKD with complaints of sleep difficulties. Results: There was an improvement in sleep quality in both patients after Benson's therapy. Conclusion: The effect of breath relaxation in Benson therapy for 10-15 minutes can improve the quality of sleep of CKD patients who are carried out 2 times a day for 3 consecutive days

Association of sugar-sweetened beverage consumption and sleep quality with anxiety symptoms: a cross-sectional study of Tibetan college students at high altitude.

Research on the association between sugar-sweetened beverages (SSBs) consumption and sleep quality with anxiety symptoms has been highly emphasized. However, past studies have focused on college students in plains areas, while fewer research studies have been conducted on Tibetan college students at high altitudes. Whether this association changes due to ethnicity or altitude is unclear. The present study will contribute to the prevention and intervention of depressive symptoms among Tibetan college students at high altitude. A self-assessment questionnaire was administered to 3,026 university students (1,491 boys students, 49.27%) on SSBs consumption, sleep quality and anxiety symptoms status in the Tibetan Plateau, a high-altitude region of China. Logistic regression analysis and ordered logistic regression analysis in generalized linear model were used to analyze the association between SSBs consumption and sleep quality with anxiety symptoms. The prevalence of anxiety symptoms among Tibetan college students at high altitude was 26.9%. SSBs consumption of ≤1 times/week, 2-5 times/week, and ≥ 6 times/week were 20.7, 28.1, and 45.7%, respectively, with statistically significant differences (χ2 value of 134.353, p < 0.001). Anxiety detection rates for Sleep quality of Good (PSQI ≤5), Moderate (PSQI 6-7), and Poor (PSQI >7) were 16.8, 19.8, and 32.0%, respectively, and the difference was also statistically significant (χ2 value was 73.761, p < 0.001). The ordered logistic regression analysis in the generalized linear model showed that, overall, the group of college students with SSBs ≤1 times/week and sleep quality of Good served as the reference group, and the group with SSBs ≥6 times/week and sleep quality of Poor (OR: 5.06, 95% CI: 3.75-6.83) had the highest risk of anxiety symptoms. SSBs consumption and sleep quality were associated with anxiety symptoms, and there was an interaction effect. Effective control of SSBs consumption and improvement of sleep quality may be important factors in preventing and reducing the occurrence of anxiety symptoms.

Exercise intervention in middle-aged and elderly individuals with insomnia improves sleep and restores connectivity in the motor network

Exercise is a potential treatment to improve sleep quality in middle-aged and elderly individuals. Understanding exercise-induced changes in functional plasticity of brain circuits that underlie improvements in sleep among middle-aged and older adults can inform treatment of sleep problems. The aim of the study is to identify the effects of a 12-week exercise program on sleep quality and brain functional connectivity in middle-aged and older adults with insomnia. The trial was registered with Chinese Clinical Trial Register (ChiCTR2000033652). We recruited 84 healthy sleepers and 85 individuals with insomnia. Participants with insomnia were assigned to receive either a 12-week exercise intervention or were placed in a 12-week waitlist control condition. Thirty-seven middle-aged and older adults in the exercise group and 30 in the waitlist group completed both baseline and week 12 assessments. We found that middle-aged and older adults with insomnia showed significantly worse sleep quality than healthy sleepers. At the brain circuit level, insomnia patients showed decreased connectivity in the widespread motor network. After exercise intervention, self-reported sleep was increased in the exercise group (P < 0.001) compared to that in the waitlist group. We also found increased functional connectivity of the motor network with the cerebellum in the exercise group (P < 0.001). Moreover, we observed significant correlations between improvement in subjective sleep indices and connectivity changes within the motor network. We highlight exercise-induced improvement in sleep quality and functional plasticity of the aging brain.

Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER)

ObjectivesTo evaluate the impact of a mentoring program to encourage staff-delivered sleep-promoting strategies on sleep, function, depression, and anxiety among skilled nursing facility (SNF) residents. DesignModified stepped-wedge unit-level intervention. Setting and ParticipantsSeventy-two residents (mean age 75 ± 15 years; 61.5% female, 41% non-Hispanic white, 35% Black, 20% Hispanic, 3% Asian) of 2 New York City urban SNFs. MethodsExpert mentors provided SNF staff webinars, in-person workshops, and weekly sleep pearls via text messaging. Resident data were collected at baseline, post-intervention (V1), and 3-month follow-up (V2), including wrist actigraphy, resident behavioral observations, Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) depression scale, Brief Anxiety and Depression Scale (BADS), Brief Cognitive Assessment Tool (BCAT), and select Minimum Data Set 3.0 (MDS 3.0) measures. Linear mixed models were fit for continuous outcomes and mixed-effects logistic models for binary outcomes. Outcomes were modeled as a function of time. Planned contrasts compared baseline to V1 and V2. ResultsThere was significant improvement in PSQI scores from baseline to V1 (P = .009), and from baseline to V2 (P = .008). Other significant changes between baseline and V1 included decreased depression (PHQ-9) (P = .028), increased daytime observed out of bed (P ≤ .001), and increased daytime observed being awake (P < .001). At V2 (vs baseline) being observed out of bed decreased (P < .001). Daytime sleeping by actigraphy increased from baseline to V1 (P = .004), but not V2. MDS 3.0 activities of daily living and pain showed improvements by the second quarter following implementation of SLUMBER (P's ≤ .034). There were no significant changes in BADS or BCAT between baseline and V1 or V2. Conclusions and ImplicationsSNF residents had improvements in sleep quality and depression with intervention, but improvements were not sustained at 3-month follow-up. The COVID-19 pandemic led to premature study termination, so full impacts remain unknown.

Implementation Outcomes for the SLUMBER Sleep Improvement Program in Long-Term Care

ObjectivesTo describe the implementation of a mentored staff-delivered sleep program in nursing facilities. DesignModified stepped-wedge unit-level intervention. Setting and ParticipantsThis program was implemented in 2 New York City nursing facilities, with partial implementation (due to COVID-19) in a third facility. MethodsExpert mentors provided staff webinars, in-person workshops, and weekly sleep pearls via text messaging. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework as a post hoc approach to describe key elements of the SLUMBER implementation. We measured staff participation in unit-level procedures and noted their commentary during unit workshops. ResultsWe completed SLUMBER within 5 units across 2 facilities and held 15 leadership meetings before and during program implementation. Sessions on each unit included 3 virtual webinar presentations and 4 in-person workshops for each nursing shift, held over a period of 3 to 4 months. Staff attendance averaged >3 sessions per individual staff member. Approximately 65% of staff present on each unit participated in any given session. Text messaging was useful for engagement, educational reinforcement, and encouraging attendance. We elevated staff as experts in the care of their residents as a strategy for staff engagement and behavior change and solicited challenging cases from staff during workshops to provide strategies to address resident behavior and encourage adoption when successful. Conclusions and ImplicationsEngaging staff, leadership, residents, and family of nursing facilities in implementing a multicomponent sleep quality improvement program is feasible for improving nursing facilities’ sleep environment. The program required gaining trust at multiple levels through presence and empathy, and reinforcement mechanisms (primarily text messages). To improve scalability, SLUMBER could evolve from an interdisciplinary investigator-based approach to internal coaches in a train-the-trainer model to effectively and sustainably implement this program to improve sleep quality for facility residents.

Patients’ perceptions of the importance of improvements and side effects from mandibular advancement device therapy for obstructive sleep apnea and snoring

ABSTRACT Objective To assess which improvements and side effects are considered most important by patients with OSA treated with a MAD. Methods A specific questionnaire consisting of 20 questions, including 10 questions on improvements and 10 on side effects, was developed and mailed to all subjects (54). Results 42 patients, participated in the survey by answering the questionnaire. The results showed that patients placed greater importance on the positive outcomes of treatment, with the most significant being the reduction in snoring and improvement in sleep quality. On the other hand, the side effects of difficulty speaking with the device, tooth mobility, and foreign body sensation were considered important. Conclusions The advantages perceived by the patients appear to outweigh the disadvantages, especially the reduction of snoring, increased productivity, and improved social and intellectual life. Most significant side effects are reversible and short-term, while occlusal changes, is not considered important by patients.

Melatonin and melatonin receptor agonists in the treatment of nocturia: A systematic review.

Causes of nocturia may extend beyond primary bladder pathology and it has been commonly associated as a side effect of sleep disorders. This has led to the study of melatonin and melatonin receptor agonists as a primary treatment for nocturia hypothesized to be secondary to sleep disorders. We aim to systematically review the efficacy and reported safety of melatonin and melatonin receptor agonists in the treatment of nocturia. A search strategy of EMBASE and Pubmed/Medline databases was utilized to identify eligible studies. Two thousand and twenty-eight unique references were identified in concordance with the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines for systematic reviews, of which nine papers met the inclusion criteria. The Cochrane Collaboration risk of bias criteria in the open label and nonplacebo studies was used to assess bias. The nine studies identified included 3 randomized double-blinded placebo-controlled trials, 2 randomized non-placebo trial, and 4 prospective open-label trials. Three utilized the melatonin-receptor agonist ramelteon (8 mg) and six utilized melatonin (four 2 mg extended release, two 2 mg normal release). Nocturia improved in 8 studies varying from moderate to low efficacy related to reduction in nocturia episodes. Five studies evaluated sleep parameters finding improvement in both nocturia and sleep quality. Male subjects represented 76.8% of 371 total subjects in prospective and randomized trials. Ramelteon and melatonin were both reported as well tolerated during nocturia treatment. A meta-analysis was not able to be performed due to the heterogeneity of bladder diagnoses. At this time, there is insufficient evidence to routinely recommend melatonin as an effective treatment for nocturia given the limitations of current clinical studies. Randomized placebo-controlled trials and prospective open label studies in non-neurogenic populations report a trend towards nocturia improvement with good tolerability and rare side effects. Therefore, further larger scale randomized trials with focused urologic diagnoses in well-characterized patient populations are warranted.

Rehabilitation of a breast carcinoma survivor

A 37-year-old breast cancer survivor who had undergone primary treatment consisting of surgery, radiotherapy and chemotherapy 5 years ago was recruited for the study. The patient was given a multicomponent exercise programme comprising aerobic, resistance and flexibility exercises for 12 weeks (three times per week). Sleep quality, muscle strength, functional capacity, the severity of oedema, pain and subjective fatigue were measured before and after the completion of the exercise programme. Considerable improvements in sleep quality (50%), fatigue (28%) and quality of life (172%), as well as slight improvements in muscle strength, oedema and functional capacity, were observed after 12 weeks of the multimodal exercise intervention. The multicomponent intervention was found to be effective in improving various physiological aspects associated with breast cancer survivors after the completion of primary treatment. However, in the future, there will be a strong need for adequately sampled, randomised and controlled trials to validate current findings.

Intensive support does not improve positive-airway pressure use in spinal cord injury/disease: a randomized clinical trial.

Treatment of sleep-disordered breathing (SDB) with positive airway pressure (PAP) therapy has unique clinical challenges in individuals living with spinal cord injuries and diseases (spinal cord injury [SCI]/D). Interventions focused on increasing PAP use have not been studied in this population. We aimed to evaluate the benefits of a program to increase PAP use among Veterans with SCI/D and SDB. Randomized controlled trial comparing a behavioral Intervention (n = 32) and educational control (n = 31), both including one face-to-face and five telephone sessions over 3 months. The intervention included education about SDB and PAP, goal setting, troubleshooting, and motivational enhancement. The control arm included non-directive sleep education only. Primary outcomes were objective PAP use (nights ≥4 hours used within 90 days) and sleep quality (Pittsburgh Sleep Quality Index [PSQI] at 3 months). These did not differ between intervention and control (main outcome timepoint; mean difference 3.5 [-9.0, 15.9] nights/week for PAP use; p = .578; -1.1 [-2.8, 0.6] points for PSQI; p = .219). Secondary outcomes included fatigue, depression, function, and quality of life. Only fatigue improved significantly more in the intervention versus the control group (p = .025). Across groups, more PAP use was associated with larger improvements in sleep quality, insomnia, sleepiness, fatigue, and depression at some time points. PAP use in Veterans with SCI/D and SDB is low, and a 3-month supportive/behavioral program did not show significant benefit compared to education alone. Overall, more PAP use was associated with improved symptoms suggesting more intensive support, such as in-home assistance, may be required to increase PAP use in these patients. Title: "Treatment of Sleep Disordered Breathing in Patients with SCI." Registration number: NCT02830074. Website: https://clinicaltrials.gov/study/NCT02830074?cond=Sleep%20Apnea&term=badr&rank=5.

Factors associated with sleep quality in patients undergoing cardiac surgery: A longitudinal study.

Poor sleep quality is associated with multiple factors in cardiac surgery patients. To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery. A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery. The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = -0.93, p = .023) and 3 months postsurgery (B = -1.50, p < .001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = -2.59, p < .001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE-I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation. Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors. Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery.

Exploring the link between vitamin D deficiency and obstructive sleep apnea: A comprehensive review.

Despite the high prevalence and significant health burden of obstructive sleep apnea (OSA), its underlying pathophysiology remains incompletely understood. This comprehensive review explores the emerging connection between vitamin D deficiency and OSA, discusses potential mechanisms underlying this association, and explores the therapeutic implications of these findings. Recent research has consistently highlighted the high incidence of vitamin D deficiency among patients with OSA, which often occurs independently of geographical location. This suggests that factors beyond lack of sunlight exposure may be involved. This review also discusses how reduced vitamin D may be associated with more severe manifestations of OSA. In addition, it explores the potentiality of using vitamin D supplements as a therapeutic strategy for OSA, noting that some studies have found improvements in sleep quality and a reduction in OSA severity. Potential mechanisms are proposed, including the role of vitamin D deficiency in promoting inflammation, oxidative stress, hypoxia, impairing immune function, muscle function, and gene polymorphism of vitamin D receptors, all of which could contribute to the pathogenesis of obstructive sleep apnea. The paper underscores the need for future research to validate these observations, to determine optimal vitamin D supplementation dosage and duration, to explore potential side effects and risks, and to investigate potential interactions with other treatments.

Effects of Pranayama on Cancer Patients: A Narrative Review of Clinical Outcomes.

Pranayama, a set of yogic breathing techniques, is being studied as a potential supportive care option for cancer patients. This review intends to evaluate the effectiveness of Pranayama in enhancing the quality of life and well-being of cancer patients based on evidence from randomized controlled trials. We thoroughly searched databases for studies published between 2013 and 2023. We focused on randomized controlled trials that compared Pranayama interventions with non-yoga control groups. We assessed the primary outcomes, including psychological well-being, quality of life, physiological parameters, and treatment-related side effects. The review indicates that practicing Pranayama can lead to significant improvements in antioxidant levels, stress, anxiety, sleep quality, and overall quality of life for cancer patients. However, the evidence comes from a limited number of studies, which vary in sample sizes and methodologies. Pranayama shows promise as a complementary therapy for cancer patients, potentially enhancing their well-being and quality of life. Nonetheless, the current evidence base is limited, necessitating further research with larger sample sizes and more rigorous study designs to confirm these findings and elucidate the underlying mechanisms.

The Potential Usefulness of Peripheral Somatosensory Stimulation in Improving Sleep Quality in Patients with Insomnia

Background Insomnia and other sleep disorders represent a major cause of disability and impaired productivity. We evaluated the impact of peripheral somatosensory stimulation (PSS) on sleep quality in 12 patients with varying degrees of insomnia. Methods Twelve adult patients underwent daily PSS therapy for a 4-week period and were evaluated using the Insomnia Severity Index at baseline (prior to initiation of therapy) and then at the conclusion of the treatments. All data were obtained through a self-reported 7-question survey evaluating overall severity of insomnia symptoms and the impact of sleep patterns on satisfaction with sleep, daily functioning, and overall quality of life. Changes from baseline insomnia scores were analyzed using cumulative link mixed models (CLMMs). Results Seven men and five women completed one month of PSS therapy. Mean age was 55.1 (range 29 to 80 years). No adverse events were described by the patients. The average total change from baseline score was -10.3 points (baseline: 16.5 vs. week 4: 6.2). Patients had statistically significant improvements for every individual survey question by week 4. The median composite score was improved from baseline, with an overall median score of 2 (IQR: 1.25 – 2.75, min-max: 1-4) at baseline compared to 0.5 (IQR: 0 – 0.25, min-max: 0-2) by week 4 (MD = -1 95% CI: , p &lt; 0.001), signaling typically moderate insomnia at baseline vs. typically minimal to no symptoms by week 4. The predicted probability of obtaining the best outcome (score=0) was 9% at baseline vs. 53% by week 4. The overall cumulative odds ratio was 11.9 (p &lt; 0.001), suggesting that on average, the odds of moving from one score to a lower (improved) score at week 4 compared to the baseline are approximately 12 times higher than moving to a neutral or worse score. Conclusions PSS stimulation appeared to have a significantly favorable effect on sleep quality in this group of patients. Symptoms related to ability to fall asleep, remain asleep, and overall quality of sleep were all improved with PSS therapy. We suggest that further investigation into the potential usefulness of PSS therapy in patients with sleep disorders is warranted.

The Impact of Omega-3 on Improving Sleep Quality: A Systematic Review of Current Clinical Research

Introduction: Omega-3 fatty acids are known to improve cardiovascular and metabolic outcomes. While studies have suggested that omega-3 may also enhance sleep quality and regulate melatonin, the data on its efficacy for individuals with poor sleep quality or related disorders must be more consistent. We aim to pave the way for future investigations, ultimately contributing to the clinical management of sleep health. Methods: 87 articles were retrieved from MEDLINE and Cochrane databases through a systematic search strategy, and 19 articles from 2002 to 2022 were included. Inclusion criteria encompassed randomized controlled trials (RCTs) and observational studies focused on the impact omega-3 on outcomes related to sleep clinical parameters. Exclusion criteria included preclinical studies and literature reviews. Results: The review identified 19 eligible studies, consisting of 9 RCTs and ten observational studies. The results displayed a complex relationship between omega-3 supplementation and sleep quality, with some studies suggesting positive effects, particularly in specific subpopulations. In contrast, others showed no significant impact or even negative effects on sleep. Among the RCTs, 7 showed positive and promising results in favor of omega-3 supplementation for sleep quality, while 1 RCT indicated the need for further studies, and 1 RCT suggested no benefit of omega-3 on sleep quality. Among observational studies, 7 reported positive and promising outcomes with omega-3 supplementation, 2 indicated no benefit in improving sleep quality, and 1 suggested further studies. Conclusion: Based on the available data, our systematic review found that omega-3 improved sleep quality in 74% of the included clinical research; however, such evidence still needs to be conclusive due to high heterogeneity among study designs. Therefore, well-designed clinical studies are required to confirm this conclusion.

Residential greenspace exposure, particularly green window-views, is associated with improved sleep quality among older adults: Evidence from a high-density city

Preliminary evidence suggests a potential link between greenspace exposure and better sleep quality. Here we aimed to investigate the specific associations between residential greenspace exposure, green-window views, and sleep quality among older adults and determine whether these associations were mediated through mitigation (i.e., perceived noise annoyance, air pollution, and artificial light pollution) and restoration (i.e., psychological stress) pathways. A total of 1007 older adults with an average age >70 years were recruited from 40 residential communities in the Old City District of Nanjing, China. We developed a set of fine-grained greenspace exposure indices based on 3D point cloud data derived from unmanned aerial vehicle photogrammetry, incorporating vegetation coverage and green volume ratio at the community level and green window ratio at the individual level. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. We examined the complex interrelationships between residential greenspace exposure, environmental stressors (air pollution, artificial light pollution, and noise), perceived mental stress, and sleep quality using multilevel linear regression models. The results suggested the following: (1) Vegetation coverage, green volume ratio, and green window ratio were significantly associated with sleep quality in older adults. (2) The green window ratio was more strongly associated with improved sleep quality than other greenspace exposure metrics. (3) These associations may be partially explained by noise mitigation and mental stress reduction. In conclusion, it seems advantageous to consider immediate residential greenspace, particularly through green-window views, as part of the interventions aimed at supporting sleep quality improvement among older adults.

Efficacy of cranial electrotherapy stimulation in patients with burning mouth syndrome: a randomized, controlled, double-blind pilot study.

The Burning mouth syndrome (BMS) is a chronic pain syndrome characterized by a burning sensation in the oral mucous membranes. The etiology and pathophysiology of BMS is largely unexplained. To date, there is no evidence-based treatment strategy for BMS. Cranial electrical stimulation (CES) represents a non-invasive treatment option with a low side effect profile that is approved for the treatment of pain, depression, anxiety disorder and insomnia. It has shown efficacy in studies for chronic pain such as fibromyalgia and neuropathic pain after spinal cord injury. This study aimed to investigate the therapeutic effectiveness of CES in combination with local transcutaneous electrical nerve stimulation (TENS) as an adjunct therapy in patients with BMS compared to sham stimulation. This randomized, double-blind, sham-controlled pilot study enrolled 22 patients, aged 18 years and over, with the diagnosis of BMS meeting the ICHD-3 criteria from August 2020 to June 2021. The study duration was 4 weeks (28 days) per participant. After randomization, the active group participants (n = 11) received a 100 μA CES treatment for 60 min a day whereas the devices in the Sham group did not emit electricity. Simple linear regression was used to determine whether the interventions promoted significant differences in pain intensity. The linear regression showed that the period of stimulation significantly predicted decrease in the intensity of pain in the active group [β = -0.036; t(26) = -7.219; p < 0.001] as in the sham group [β = -0.026; t(26) = -2.56; p < 0.017]. With the applied cutoff of 30% pain reduction within the stimulation period, both the active and sham groups had 36% responders (n = 4) (Fisher's exact test, p = 1.00). In both groups (active stimulation and sham group), a significant decrease in the intensity of pain, somatic symptoms and an improvement in sleep quality over the study period was observed. Subjects reported no adverse events during the study. Although CES is an easily applicable and safe therapeutic option for chronic facial pain, active stimulation was not superior to sham stimulation. Among other reasons, this could be due to the short double-blinded treatment period, duration of the daily stimulation session or the small sample size.

Bifidobacterium longum 1714 improves sleep quality and aspects of well-being in healthy adults: a randomized, double-blind, placebo-controlled clinical trial

Stress and sleep are linked with overall well-being. Bifidobacterium longum 1714 has been shown to influence stress responses and modulate neural responses during social stress, and influence sleep quality during examination stress in healthy adults. Here, we explored the ability of this strain to alter sleep quality in adults using subjective and objective measures. Eighty-nine adults (18–45y) with impaired sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI) and with a global score ≥ 5 were randomized to receive B. longum 1714 or placebo daily for eight weeks. Assessing the effect of the strain on PSQI global score was the primary objective. Secondary objectives assessed sleep quality and well-being subjectively and sleep parameters using actigraphy objectively. While PSQI global score improved in both groups, B. longum 1714 significantly improved the PSQI component of sleep quality (p < 0.05) and daytime dysfunction due to sleepiness (p < 0.05) after 4 weeks and social functioning (p < 0.05) and energy/vitality (p < 0.05) after 8 weeks, compared to placebo. No significant effect on actigraphy measures were observed. The 1714 strain had a mild effect on sleep, demonstrated by a faster improvement in sleep quality at week 4 compared to placebo, although overall improvements after 8 weeks were similar in both groups. B. longum 1714 improved social functioning and increased energy/vitality in line with previous work that showed the strain modulated neural activity which correlated with enhanced vitality/reduced mental fatigue (ClinicalTrials.gov: NCT04167475).