Improvement In Sleep Duration Research Articles

Design, development, and optimization of the Somnomat Casa: a rocking bed for sleep studies and nocturnal interventions in home settings

Abstract Vestibular Stimulation (VS) has been shown to positively affect various autonomic body functions, including sleep. In the past, VS was often investigated using large and complex rocking beds that would only allow for short intervention periods in constrained lab settings. In this work, we present an overview of the mechanics, kinematics, dynamics, and tuning of our latest rocking bed, the Somnomat Casa. Its compact dimensions, comparable to a standard single bed, its connectivity, and easy usability, allow for prolonged studies in home settings investigating the effects of VS during sleep. In a first six-month study with a 12-year-old boy suffering from primary mitochondrial disease with an associated severe sleep disorder, we observed significant improvements in sleep duration (+25 %) and quality of life, as well as a 75 % reduction in caregiving interactions and a 40 % reduction in overall caregiving time. Based on these promising findings, we are currently testing the Somnomat Casa with various patient groups for multiple months each, including elderly with insomnia, children with sleep disorders, Parkinson’s disease patients, and individuals with post-stroke insomnia.

The effect of facilitated tucking and white noise on stress and sleep of newborns receiving nasal continuous positive airway pressure

ObjectiveTo investigate the effects of facilitated tucking and white noise on stress and sleep in neonates receiving nasal continuous positive airway pressure (CPAP). MethodThis study was conducted as a randomised controlled experimental study of neonates receiving nasal CPAP in neonatal intensive care units. The study sample consisted of 108 newborns (facilitated tucking (n = 36), white noise (n = 36) and control (n = 36)) receiving nasal CPAP support in the NICU. The neonates' sleep parameters were recorded by actigraphy for 24 h. Data were collected using the Neonatal Descriptive Information Form, the Sleep Tracking Form and the Neonatal Stress Scale. Percentage, mean, chi-squared and one-way ANOVA were used for data analysis. ResultsIt was found that 50.9% of the newborns were female, their mean gestational age was 33.54 ± 3.38, their mean height was 43.56 ± 5.12, and their mean weight was 2139.23 ± 827.82. The total sleep time of the neonates in the facilitated tucking and white noise group increased by 3 h, their sleep efficiency increased by 20% and their mean stress scores decreased (p < 0.05). ConclusionFacilitated tucking and white noise each showed a similar improvement in sleep duration and sleep efficiency and a reduction in stress scores in neonates receiving nasal CPAP. Close monitoring of sleep in this population and supportive care practices are recommended. Practice implicationsThe findings of this study may help to reduce sleep problems and stress levels in the clinical care of neonates in the NICU through developmental nursing practices.

Effectiveness of a grid mattress on adults' sleep quality and health: A quasi-experimental intervention study.

Despite that 93% of people indicate that a mattress plays a pivotal role in achieving high-quality sleep, there is a scarcity of research investigating the influence of mattresses on sleep quality, pain, and mood in nonclinical poor sleepers. The purpose was to examine the effectiveness of a pressure-releasing medium-firm grid mattress on sleep and health outcomes (e.g., mood, pain, daytime fatigue) of adults with nonclinical insomnia symptoms using a quasi-experimental design. Participants were 39 adults (mean age = 45.29) with nonclinical insomnia (i.e., occasional sleeplessness). Following 1 week of baseline assessments on their current mattress, they slept on a pressure-relieving grid mattress for 8 weeks. Participants completed self-report assessments of the Pittsburgh Sleep Quality Index, Berlin Questionnaire, Insomnia Severity Index, Restorative Sleep Questionnaire, Perceived Stress Scale, Profile of Mood States, Daytime Fatigue Scale, Pain and Sleep Questionnaire, and Brief Pain Inventory at Baseline and Weeks 1, 2, 3, 4, and 8. Participants continually wore an Oura Ring to objectively assess sleep and daytime activity. The data were collected from January 2022 to April 2022 and were stored electronically. Repeated-measures analyses of variance were used to analyze mean time differences. Self-reported sleep quality, perceived pain, perceived stress, mood, and daytime fatigue improved significantly from Baseline to Week 8, p's < 0.05. Objective Oura Ring validated the self-reported sleep and daytime activity outcomes with improvements in sleep duration, time awake during the night, light sleep, deep sleep, and total sleep time, p's < 0.05. No significant time effects were evidenced for rapid eye movement sleep. No adverse events were reported. The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.

Correlates to Improvement in Sleep Duration in Acute Mania and Depression.

Correlates to Improvement in Sleep Duration in Acute Mania and Depression.

Can introduction of sleep hygiene videos improve sleep and concentration in 5th and 6th graders? Interventional study

BackgroundInsomnia is a very common condition in childhood with a prevalence of 25–50%. It can present as difficulty with initiating and maintaining sleep with frequent disruptions throughout the night. Sleep insomnia is known to affect children’s development and contribute to poor attention and memory. Establishing a good sleep routine will have a beneficial effect not just on the child’s wellbeing and development but the whole family.The objective of the study was to assess the effectiveness of sleep hygiene videos in improving sleep quality and subsequent cognitive function in children aged 10–11 years.Two cartoon videos on sleep hygiene were designed along with a child-friendly questionnaire to be filled by grade 5 and 6 students in two different schools in the city of Leeds, England. Questionnaires were filled prior to viewing the videos and 2 to 3 weeks afterward to assess response to the video contents. The videos were viewed in April and May 2022.ResultsIn the East of Leeds School, 49 students participated. In the North of Leeds School, 45 students participated. Significance of outcomes were analysed using the Wilcoxon signed-rank test. In the first school, there was a significant improvement in sleep duration, sleep disturbance, sleep latency, daytime dysfunction due to sleepiness and sleep efficiency (p < 0.05). In the second school, there was a significant improvement in sleep duration, sleep disturbance and sleep latency (p < 0.05).ConclusionPoor sleep function is a major issue in children. The results demonstrated that the use of sleep hygiene videos can support children with sleep difficulties and help them to modify their behaviour through self-health promotion.

App-Supported Sleep Coaching: Implications for Sleep Duration and Sleep Quality.

The present study evaluated whether completers of a 12-week app-based, personalized text supported sleep coaching program demonstrated improvements in sleep continuity, sleep duration, and reduced use of sleep aids. Data were obtained from Sleep Reset, a 12-week consumer product that offers app-based sleep education and monitoring, along with personalized text-based sleep coaching provided by live coaches. 564 completers were included in the study. Pre-post changes for sleep latency (SL), wake after sleep onset (WASO), number of awakenings (NWAK), total sleep time (TST), sleep efficiency (SE%) and use of "sleep aids" were evaluated. To evaluate whether the program produced meaningful results, the proportion of participants who demonstrated reductions in SL, WASO, and NWAK, and increases in TST and SE% were examined. Mean SL was reduced by 11 minutes, mean WASO was reduced by 28 minutes, mean SE% increased by 6.6%, and mean TST increased by about 44 minutes. Of those who reported using "sleep aids" during Week 1, 41% no longer used them by week 12. Those with low SE% at baseline demonstrated greater improvements in SL (16.2 vs 5.7mins), WASO (47.3 vs 7.2mins), SE% (11.2% vs 1.6%), and TST (65.3 vs 31.2mins). Those with ≤6 hours of sleep at baseline demonstrated greater improvements in WASO (36.8 vs 22.3mins), SE% (10.1% vs 4.3%), and TST (85.1 vs 25.5mins). Participants that completed the app-based, personalized text supported coaching intervention reported subjective improvements in sleep duration and quality that suggest more beneficial effects particularly in those with lower sleep efficiency or sleep duration at baseline. An effective sleep coaching program that utilizes trained sleep coaches with access to board-certified providers, may provide a valuable resource for subclinical populations.

Sleep duration and cardiovascular outcomes

Cardiovascular diseases (CVD) are the leading cause of death worldwide, causing approximately 17.9 deaths annually. Their risk factors are mainly related to an inappropriate lifestyle and include, among others, low physical activity, obesity, hypertension or type 2 diabetes. Nowadays, there is an increase in the incidence of CVD as well as sleeping disorders, so many studies have focused on finding the connection between these phenomena.&#x0D; The impact of sleep duration on the occurrence of cardiovascular diseases and their risk factors was analyzed based on a systematic analysis of the literature. The review was carried out using keywords, based on data contained in the Google Scholar search engine database, in the PubMed scientific database and medical electronic journals.&#x0D; The analyzed studies indicate that sleep duration, its both excessive shortening and lengthening, as well as poor quality, may be associated with CVD, their risk factors and increased overall mortality. Researchers point to the connection between sleep duration and development of hypertension, obesity and type 2 diabetes, with short sleep identified as a stronger risk factor. In addition long sleep was associated with poor health and overall worse results of the subjects more often than short sleep. This suggests that long sleep may not be the cause, but a consequence of yet undiagnosed, coexisting chronic diseases.&#x0D; The results indicate the need to assess sleep disorders as a goal for primary and secondary prevention of CVD and reduction of their risk factors. The importance of long sleep remains ambiguous, whether it is the reason for health deterioration or results from it and requires further research. Large intervention studies are also still needed to assess whether improvements in sleep duration and its quality can reduce cardiovascular risk and improve long-term health outcomes.

Equivalent Improvements in Sleep Duration and Sleep Quality Regardless of Program Delivery Modality: The SLeep Education for Everyone Program (SLEEP)

Sleep issues are pervasive, and treatment can be difficult to access, if available at all. The purpose of this study was to test whether the delivery modality (online vs. in person) of the SLeep Education for Everyone Program (SLEEP) influenced programmatic outcomes. A total of 60 participants completed the study, 28 in the online group and 32 in the in-person group. Across all participants, SLEEP improved sleep duration, sleep quality, and sleep hygiene behaviors (p < 0.001 for all). When comparing delivery modality, sleep duration and quality improved similarly between groups; however, sleep hygiene behaviors improved more in the in-person group (p = 0.033). Sleep hygiene scores did not correlate with sleep duration or quality after the program. Based on these findings, SLEEP appears to be equally effective in improving sleep duration and quality when delivered online or in person. These findings suggest that SLEEP can be delivered based on the organization's and participant's resources, needs, and preferred style of interaction.

Mitigating Rural Adolescent Trauma: Remote Delivery of a Trauma-Informed Yoga Intervention During COVID-19.

Given the prevalence of childhood trauma in rural Montana, this project is intended to help mitigate stressors that may contribute to poor behavioral and mental health in high school-aged children, which may be exacerbated by the collective trauma of the COVID-19 pandemic. The immediate goal was to measure physical and mental health outcomes in adolescents resulting from a remotely delivered trauma-informed yoga intervention designed to foster positive youth development. Our study builds on the successes from an initial feasibility pilot study one year prior in order to evaluate a more robust intervention comparing experimental and control group outcomes. Students at a small, rural high school in Montana volunteered to participate in a 6-week, twice-weekly trauma-informed yoga intervention in their physical education class. Validated survey measures, including the PHQ-A, GAD-7, and ACE-Q instruments, were utilized to measure mental health outcomes pre- vs. post-intervention. Salivary cortisol levels were also measured pre-, mid-, and post-intervention. Statistically significant declines in cortisol levels and improvements in sleep duration were noted when comparing experimental vs. control groups. Noteworthy declines in depression and anxiety levels were also seen when comparing the treatment to control groups. Descriptive differences between the control and experimental groups illustrate the mental health benefits of reduced anxiety and depressive symptoms in rural adolescents resulting from a remotely delivered trauma-informed yoga intervention. Our study holds the potential for a long-term public health impact in reducing adolescent rates of anxiety and depression while mitigating trauma in geographically isolated settings. Trial Registration: ClinicalTrials.gov identifier:NCT04664855.

Evaluation of an occupation-based sleep programme for people with Insomnia.

Sleep problems are a health issue worldwide. Based on the Person-Environment-Occupation-Performance model, we developed an occupation-based sleep programme to promote awareness of sleep hygiene factors, promote an environment conductive to sleep, and restructure participation in daytime activities with a focus on occupational balance. This study uses a non-equivalent group design to evaluate the effectiveness of an occupation-based sleep intervention among community-dwelling adults with insomnia, when compared with a treatment-as-usual (TAU) group which focused on sleep hygiene, and relaxation. When compared with the TAU group (n = 20), the intervention group (n = 22) had significant improvement in sleep duration, occupational balance, and reduction in mood symptoms at both post treatment and 1-month follow up. The results demonstrated that an occupation-based programme is an effective treatment for insomnia disorder and demonstrated the role which occupational therapy could play in primary health care service.

A randomized, double-blind, placebo-controlled, cross-over pilot study to investigate the efficacy of Rest-ZZZ formula in healthy participants with occasional sleeplessness

The purpose of this study was to investigate the safety and efficacy of Rest-ZZZ, a natural sleep supplement, in healthy adults without a diagnosed sleep disorder. This randomized, double-blind, placebo-controlled, cross-over study consisted of three 7-day supplementation periods with either Rest-ZZZ, Diphenhydramine (DPH), or Placebo, with a 7-day washout. Twenty-seven participants were randomized to one of three intervention sequences and the Healthy People Sleep Quality Index (HPSQI), Quality of Life (QoL), and Profile of Mood States (POMS) questionnaires were assessed at the beginning and end of each supplementation period. Rest-ZZZ and Placebo showed improvements in sleep-related QoL (p ≤ 0.044) and total mood disturbance (TMD) (p = ≤ 0.028). Fatigue–Inertia was reduced by all study products (p ≤ 0.031). DPH did not result in any significant improvements on sleep quality parameters. A subgroup analysis of participants ≤ 45 years found enhanced efficacy of Rest-ZZZ and improvement in sleep-related QoL vs. Placebo (p = 0.007), as well as improvements in sleep duration (p = 0.007), sleep debt (p = 0.011), and sleep-related QoL (p = 0.033). DPH supplementation resulted in significant improvement in only sleep debt (p = 0.038). Rest-ZZZ had a safe hematology and chemistry profile. Rest-ZZZ resulted in restful sleep that generated corresponding improvements in sleep-related QoL and overall mood. Rest-ZZZ is an efficacious sleep supplement with a favorable safety profile, particularly in those aged 25–45 years.

Electrophysiological Evidence of Local Sleep During Yoga Nidra Practice.

Background and ObjectivesYoga nidra is a technique sages use to self-induce sleep. Classically, sleep is characterized by three cardinal electrophysiological features, namely, electroencephalography (EEG), electromyography (EMG), and electrooculography (EOG). As the literature on electrophysiological characterization of Yoga nidra is lacking, it is not known whether it is a sleep or awake state. The objective of the study was to electrophysiologically characterize yoga nidra practice.Materials and MethodsThirty subjects underwent five initial supervised yoga nidra sessions and then continued practice on their own. The subjects completed their sleep diaries for 2 weeks before and during the intervention. The electrophysiological characterization was done after 2 weeks of yoga nidra practice using 19 EEG channels polysomnography for pre-yoga nidra, yoga nidra practice and post-yoga nidra. Polysomnographic data were scored for sleep-wake stages as per standard criteria. Power spectral density (PSD) was calculated from various frequency bands in different time bins. EEG data were grouped by areas, namely, central, frontal, prefrontal, parietal, temporal, and occipital in time bins. Sleep diary parameters were also compared for pre-post-yoga nidra training.ResultsAfter 2 weeks of yoga nidra practice, awake was scored throughout the session (n = 26). PSD results (mean difference in dB between different time bins; P value) showed significant changes. When compared to pre-yoga nidra, there was an increase in delta power in the central area (1.953; P = 0.033) and a decrease in the prefrontal area (2.713; P = 0.041) during yoga nidra. Sleep diary showed improvement in sleep duration (P = 0.0001), efficiency (P = 0.0005), quality (P = 0.0005), and total wake duration (P = 0.00005) after 2 weeks of practice.Interpretations and ConclusionsYoga nidra practice in novices is electrophysiologically an awake state with signs of slow waves locally, often referred to as local sleep.Clinical TrialClinical Trial Registry of India, http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php? trialid = 6253, 2013/05/003682.

0694 Safety and Efficacy of Ashwagandha for sleep: A Systematic Review

Abstract Introduction Ashwagandha has been around for about two thousand years. It is known as Indian Ginseng, winter cherry, and poison gooseberry. In recent years, the benefits of Ashwagandha tohave been explored in various studies due to the popularity of alternative therapeutic options in masses worldwide. Sleep is vital to the rejuvenation of the mind and body by replenishing the energy to carry on life activities. Sleep disorder is a major limitation in living life to full potential and Ashwagandha, known as beneficial for reducing stress and anxiety, is proven to improve the quality of sleep in individuals. In this systematic review, we study the efficacy of Ashwagandha in improving sleep and its safety for its users. Methods A literature search was conducted using relevant MeSH keywords, “Withania” and “Aswagandha” in the context of “Sleep,” “Sleep-Wake Disorders,” or “Sleepiness” in PubMed, PubMed Central, Medline, Web of Science, Biosis, and SciELO databases. We identified all published relevant articles from inception until 11/20/2021 and included 8 studies in our final qualitative synthesis review. Results Ashwagandha has been shown to have beneficial effects in decreasing time to fallasleep, improving duration, quality of sleep, and mood upon awakening. Many studies demonstrated these beneficial effects with clinical significance using multiple rating scales of assessment. Most studies explored the safety profile of Ashwagandha for the subjects. In most studies, there were no adverse events reported, and its use is termed safe and beneficial. Few studies reported some minor side effects, such as in a randomized clinical trial, RCT, by Deshpande A. et al. (2020), headaches, fever, acid reflux, and allergic dermatitis were reported.1A randomized clinical trial by Langade D. et al. in 2019 showed that Ashwagandha shortens the sleep onset latency significantly (p,0.019) after 10 weeks of with test [29.00(7.14)] compared to placebo [33.94(7.65)]. There was a significant improvement in sleep efficiency, SE scores at 83.48 (2.83) after 10 weeks 75.63(2.70) for the test at the baseline compared to placebo.2 In another pilot study by Sharma H. et al. (2007), there was a significant improvement in sleep duration, sleep quality (91.67%, p&amp;lt;0.001), and mood upon awakening (88.89%, p&amp;lt;0.001).3 Conclusion The findings support the efficacy of Ashwagandha for improving sleep quality. Due to the limited availability of data and well-designed studies warrants further research through cohort studies and clinical trials to determine the exact mechanism of action and benefits for sleep. Support (If Any)

An Individualized Intervention Increases Sleep Duration in Professional Athletes.

Sargent, C, Lastella, M, Schwerdt, S, and Roach, GD. An individualized intervention increases sleep duration in professional athletes. J Strength Cond Res 35(12): 3407-3413, 2021-Athletes typically obtain less sleep than is generally recommended for healthy adults. The aim of this study was to determine whether individualized feedback could increase sleep duration in professional cricket players in the 3 weeks before the start of the domestic season. Players were randomly assigned to a control group (i.e., no individual feedback; n = 8) or an intervention group (i.e., individual feedback about bedtime, wake time, and sleep duration; n = 7). Night-time sleep and daytime naps were monitored using wrist activity monitors in conjunction with self-report sleep diaries for 1 week before, and 1 week after, the feedback intervention. Cumulative sleep duration was calculated as the sum of the sleep duration for a night-time sleep episode and any naps that occurred on the following day. Differences in cumulative sleep duration before and after the intervention were examined using a mixed-effects analysis of variance. There was an interaction between group and week for cumulative sleep duration (p = 0.039; η2 = 0.6; large). The average cumulative sleep duration was longer (+36 minutes) in the intervention group in week 2 compared with week 1. Individualized feedback can be used to increase sleep duration in professional cricket players. In future, it will be important to determine whether improvements in sleep duration can be maintained throughout the season.

613 Variation in Sleep Beliefs and Behaviors Among Caregiver-Child Dyads Participating in a Sleep Extension Intervention

Abstract Introduction Given the high prevalence and poor outcomes of insufficient child sleep, effective interventions for the pediatric primary care setting are needed. Collecting family perspectives on intervention strategies is critical to understand and enhance outcomes, particularly among children who do not experience improvements. This study examined variation in qualitative family sleep beliefs and behaviors by quantitative child sleep outcomes of a sleep extension intervention. Methods A total of 24 caregiver-child dyads (child age 9–12 years, M age 11.3 (SD:1.0) years; 46% male; 50% non-Latinx White; 29% Black) participated in a mobile health sleep extension intervention, between March-December 2019, and completed post-intervention semi-structured telephone interviews to solicit intervention perceptions. The intervention used a 25 factorial design consisting of sleep duration goals and weekly performance feedback, with random assignment to sleep health promotion messaging and financial incentive conditions. Sleep duration was assessed via Fitbit Flex 2 devices during 2-week baseline and 7-week intervention periods. We developed a codebook using a grounded theory approach and conducted coding in NVivo. We compared preliminary qualitative themes among children who showed a &amp;gt;=30-minute improvement in sleep duration (‘responders’) versus those who did not (‘non-responders’). Results Of the 24 dyads, 38% (N=9 dyads) were classified as non-responders. Preliminary qualitative themes included: family beliefs about sleep and electronics usage; the study impact on sleep behaviors; and an enhanced awareness of child sleep. Intervention responder and non-responder dyads similarly described family restrictions on evening electronics usage (e.g., electronic parental controls; physical removal of devices) to benefit child sleep. However, more children classified as intervention responders described the benefits of these restrictions and expressed beliefs about the negative impacts of electronics on sleep. Whereas caregivers of both responders and non-responders described efforts to remind their child to go to bed earlier during the intervention, caregivers in the responder group described being more focused on and active in child sleep extension strategies. These included setting bedtime reminders and adjusting family activities to ensure an extended sleep schedule. Conclusion Addressing caregiver-child beliefs about sleep behaviors and engagement in sleep extension strategies could augment sleep extension intervention outcomes in future research. Support (if any) K01HL123612 (JAM), CHOP (JAM), K23HD094905 (AAW)

091 The Feasibility of At-home Sleep Extension in Adolescents and Young adults: A Meta-Analysis and Systematic Review

Abstract Introduction Insufficient sleep duration has negative consequences for health and performance and is alarmingly common in adolescents and young adults. The primary aim of the meta-analysis and systematic review was to assess whether at-home sleep extension is a feasible means to improve sleep duration and daytime sleepiness without negative consequences for sleep quality or efficiency in adolescents and young adults. An additional aim of the review was to provide a qualitative summary of the health and performance outcomes associated with at-home sleep extension. Methods Peer-reviewed journal articles and doctoral dissertations available in English were searched and screened. Eligible studies had at least five consecutive days of at-home sleep extension, measurement of sleep duration during baseline/habitual sleep and extension of sleep opportunity, and participants 13–30 years of age. Information on primary sleep outcome (i.e., sleep duration), available secondary sleep outcomes (i.e., sleep opportunity, sleep efficiency, sleep quality, daytime sleepiness), and health and performance outcomes were extracted for quantitative synthesis and qualitative review. Results Of the 2254 articles assessed for eligibility, 17 studies (seven in adolescents and ten in young adults) met the eligibility criteria for this review. The average number of days of sleep manipulation was 14.29 (range: 5 to 49 nights). At-home extension of sleep opportunity reliably increased objective (ES = 0.97) and subjective sleep duration (ES = 2.19) and sleep quality (ES = 0.24), and decreased daytime sleepiness (ES = -0.39), when compared to unmanipulated sleep opportunity. Sleep extension was also found to have additional health (e.g., lower psychological stress) and performance benefits (e.g., better athletic performance) across ages and populations. A potential upward publication bias was found based on the distribution of within-subject effect sizes of actigraphic sleep duration. Conclusion The review indicates that at-home sleep extension is feasible in adolescents and young adults to improve sleep duration and daytime sleepiness, and maintain or improve sleep quality. However, the degree of improvement in sleep duration, sleep quality, and daytime sleepiness varied by study population and sleep extension method. Future research should investigate how variations in population and methods of sleep extension impact health and performance outcomes. Support (if any):

Effect of acupuncture on the daytime function in patients with post-stroke sleep-wake disturbance: A randomized controlled trial: 针刺对中风后睡眠-觉醒障碍患者日间功能的影响:随机对照试验

ObjectiveTo explore the improvements in sleep duration, drowsiness and daytime fatigue in patients with sleep-wake disturbance after ischemic stroke treated by needling at Băihuì (百会GV20) and Sìshéncōng (四神聪EX-HN1). MethodsA total of 81 patients with post-stroke sleep-wake disturbance were randomly divided into 2 groups, i.e. a control group (39 cases) and a treatment group (42 cases). In the control group, the basic treatment for ischemic stroke was administered. In the treatment group, on the base of the treatment as the control group, acupuncture was applied to GV20 and EX-HN1. The treatment was given once a day, 30 min each time, totally for 4 weeks. The daytime sleep duration, sleep need, Epworth Sleepiness Score (ESS) and Fatigue Severity Scale (FSS) score were observed in the patients of two groups before and after treatment. The therapeutic effects were observed. ResultsAfter treatment, the daytime sleep duration and sleep need were all reduced to different extents in the patients of two groups. The daytime sleep duration and sleep need in the treatment group were lower than those in the control group (all P < 0.05). After treatment, ESS of two groups were reduced significantly to be (11.21 ± 3.33) points and (6.40 ± 2.11) points, respectively (both P < 0.05) and the FSS scores reduced significantly to be (33.62 ± 9.17) points and (21.45 ± 8.17) points, respectively (both P < 0.05). ConclusionAcupuncture at GV20 and EX-HN1 effectively reduces daytime sleep duration, relieves drowsiness and daytime fatigue and improves daytime function of the patients with post-stroke sleep-wake disturbance.

The feasibility of an exercise intervention to improve sleep (time, quality and disturbance) in people with rheumatoid arthritis: a pilot RCT.

Current rheumatology guidelines recommend exercise as a key component in the management of people with RA, however, what is lacking is evidence on its impact on sleep. Objective is to assess the feasibility of a walking-based intervention on TST, sleep quality, and sleep disturbance and to generate potential effect size estimates for a main trial. Participants were recruited at weekly rheumatology clinics and through social media. Patients with RA were randomized to a walking-based intervention consisting of 28 sessions, spread over 8weeks (2-5 times/week), with 1 per week being supervised by a physiotherapist, or to a control group who received verbal and written advice on the benefits of exercise. Primary outcomes were recruitment, retention, protocol adherence and participant experience. The study protocol was published and registered in ClinicalTrials.gov NCT03140995. One hundred and one (101) people were identified through clinics, 36 through social media. Of these, 24 met the eligibility criteria, with 20 randomized (18% recruitment; 100% female; mean age 57 (SD 7.3years). Ten intervention participants (100%) and eight control participants (80%) completed final assessments, with both groups equivalent for all variables at baseline. Participants in the intervention group completed 87.5% of supervised sessions and 93% of unsupervised sessions. No serious adverse events were related to the intervention. Pittsburgh Sleep Quality Index global score showed a significant mean improvement between the exercise group-6.6 (SD 3.3) compared to the control group-0.25 (SD 1.1) (p = 0.012); Intervention was feasible, safe and highly acceptable to study participants, with those participants in the exercise group reporting improvements in sleep duration and sleep quality compared to the control group. Based on these findings, a fully powered randomized trial is recommended. Trial registration number: ClinicalTrials.gov Identifier: NCT03140995 (April 25th, 2017).

Reversing the Deconditioning Effects of the Pandemic in the Elderly via Telerehabilitation

Objective: To investigate the effect of a structured home-based interactive telerehabilitation program on physical activity (PA) level, sleep, and quality of life (QoL) in older individuals who were in home confinement during the pandemic. Materials and Methods: A total of 23 participants in the age range of 65–90 (mean: 72.47 ± 5.58) years (15 females) were included in the study. A telerehabilitation exercise program was administered three times per week for 8 weeks. PA levels and sleep parameters were evaluated (using the Sensewear Armband) at baseline and at the end of the 8th week. In addition, the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used for self-reported evaluation of sleep, and the World Health Organization QoL Instrument-Older Adults Module was administered to evaluate the QoL. Results: Comparing pre- and postexercise evaluation results demonstrated a significant increase in PA levels and significant improvements in sleep duration, sleep latency, and daytime sleepiness. In addition, a significant increase was observed in the total QoL scores. Conclusion: The telerehabilitation exercise program seems to be an effective method to increase PA levels, improve sleep-related parameters, and enhance QoL in older adults affected by home confinement during the pandemic.

Vitamin D status and its longitudinal association with changes in patterns of sleep among middle-aged urban adults

Objective. We examined relationships of vitamin D status with over time changes in patterns of sleep in a longitudinal study of Whites and African-American urban middle-aged adults, while further testing effect modification by age group, sex and race and the potential roles of dietary and supplemental vitamin D.Methods. Data on 1,760 middle-aged participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS study: Age range at v2: 33-71y, mean±SD:53.0±8.8, % women: 58.4%, % African-American:60.3%) were used, with complete baseline 25-hydroxyvitamin D [25(OH)D] serum concentration data, initial selected covariates and mediators, and initial and/or follow-up data on five sub-scales (sleep duration, daytime dysfunction, sleep disturbance, sleep latency and sleep quality) of the Pittsburgh Sleep Quality Index. Mean±SD time between initial and follow-up visits: 4.1±1.5 years. Time-interval multiple mixed-effects linear regression models were used.Results. Upon multiple testing adjustment, among Whites, initial 25(OH)D was associated with better sleep duration [25(OH)D × TIME γ±SE: -0.027±0.011, P=0.017] and sleep quality [25(OH)D × TIME γ±SE: -0.026±0.010, P=0.008] over time, with heterogeneity by race found for both relationships (P<0.05 for 25(OH)D × TIME × Race in the un-stratified model). These relationships remained unaltered after further adjustment for dietary and supplemental vitamin D, indicating that this association may be largely explained by sunlight exposure.Limitations. Limitations included small sample size, selection bias, residual confounding and lack of objective sleep measures.Conclusions Vitamin D status, possibly through mechanisms involving sunlight exposure, was linked to a potential improvement in sleep duration and quality among White urban adults.