Sleep Index Research Articles

Correlation Between Post-Traumatic Stress Disorder and Sleep Hygiene in Adults Surviving the 2023 Kahramanmaraş Earthquakes.

On February 6, 2023, two major earthquakes with magnitudes of 7,7 and 7,6 struck the Kahramanmaraş region in Turkey. Over 50.000 people lost their lives and more than half a million buildings were damaged as a result of these earthquakes. Earthquake survivors may develop post-traumatic stress disorder and sleep hygiene problems. This study aims to evaluate the correlation between post-traumatic stress and sleep hygiene among surviving adults six months after the February 6th Kahramanmaraş Earthquakes in Turkey. This study was conducted with 1004 earthquake survivors in 11 provinces influenced by the February 6th Kahramanmaraş earthquakes in Turkey. The data was collected with Personal Information Form, Impact of Events Scale-Revised, and the Sleep Hygiene Index. It has been determined that 54.1% of earthquake survivors scored ≥ 33 on the Impact of Events Scale-Revised. The level of post-traumatic stress disorder was high and their sleep hygiene index level was above average among earthquake survivors. A strongly significant positive correlation was observed between the Impact of Events Scale-Revised and the Sleep Hygiene Index. It is recommended to plan and implement community-based psychological interventions to reduce post-traumatic stress disorder and improve sleep hygiene among survivors after earthquakes.

A replicate crossover trial on the inter-individual variability of sleep indices in response to acute exercise undertaken by healthy men.

Using the necessary replicate-crossover design, we investigated whether there is inter-individual variability in home-assessed sleep in response to acute exercise. Eighteen healthy men (mean(SD): 26(6) years) completed two identical control (8-h laboratory rest, 08:45-16:45) and two identical exercise (7-h laboratory rest; 1-h laboratory treadmill run [62(7)% peak oxygen uptake], 15:15-16:15) trials in randomised sequences. Wrist-worn actigraphy (MotionWatch 8) measured home-based sleep (total sleep time, actual wake time, sleep latency, sleep efficiency) two nights before (nights 1-2) and three nights after (nights 3-5) the exercise/control day. Pearson's correlation coefficients quantified the consistency of individual differences between the replicates of control-adjusted exercise responses to explore: (1) immediate (night 3 minus night 2); (2) delayed (night 5 minus night 2); and (3) overall (average post-intervention minus average pre-intervention) exercise-related effects. Within-participant linear mixed models and a random-effects between-participant meta-analysis estimated participant-by-trial response heterogeneity. For all comparisons and sleep outcomes, the between-replicate correlations were non-significant, ranging from trivial-to-moderate (r range = -0.44 to 0.41, P≥0.065). Participant-by-trial interactions were trivial. Individual differences SDs were small, prone to uncertainty around the estimates indicated by wide 95% confidence intervals and did not provide support for true individual response heterogeneity. Meta-analyses of the between-participant, replicate-averaged condition effect revealed that, again, heterogeneity (τ) was negligible for most sleep outcomes. Control-adjusted sleep in response to acute exercise was inconsistent when measured on repeated occasions. Inter-individual differences in sleep in response to exercise were small compared to the natural (trial-to-trial) within-subject variability in sleep outcomes.

Association of Sleep Duration and BMI with Periodontitis in Nurses Working in Day and Night Shifts and Its Impact on Co-morbidities

Background: Gender imbalances persist in high-ranking leadership roles, particularly in Aim: To evaluate the association between duration of Sleep and Body-Mass Index (BMI) as potential risk factors with Periodontitis and other co morbidities in duty nurses. Methodology: An observational study was carried out on 42 duty nurses working in hospital. Two Questionnaires (PSQI) Pittsburgh Sleep Quality Index and (ESS) Epworth-Sleepiness Scale were subjectively filled. Study was conducted in 2 phases in the same duty nurses. Phase 1 Duty nurses in morning shift underwent evaluation for periodontal health, BMI and Waist -Hip ratio was recorded. Blood Samples were drawn for analysis of C-Reactive protein, lipid profile and Fasting Blood Sugar. Participants were asked to maintain sleep diary for 6 months. Phase 2: Same Duty Nurses working in Night Shift after 6 months of sleep diary maintenance underwent evaluation of same parameters as phase 1. All-the data were tabulated and sent for statistical-analysis. Results: The result showed that, the association of duration of sleep to Periodontitis was statistically significant in the morning-shift and night-shift (p=0.001), although association of Body Mass Index to periodontitis was statistically significant in the night shift with p value=0.001 than in the morning-shift. The association of Plaque Index and Gingival-Index with duration of sleep and BMI was statistically significant. The parameters taken to study the co-morbidities showed statistical significant difference between the two shifts except WHR ratio, LDL, HDL, Triglyceride, Plaque index. Conclusion: There is an association of Duration of Sleep and Body Mass Index as a potential risk factor for periodontitis and other co-morbidities (Cardiovascular disease and Diabetes) in duty nurses, however the association is much stronger in duty nurses working in night shift than morning shift.

Examining the Reciprocal Association Between Worry and Sleep: Disaggregating Between- and Within- Person Effects

Studies investigating the reciprocal association between worry and sleep have yielded mixed findings and suffered from methodological limitations. The purpose of this study was to assess the reciprocal association between worry and various indices of sleep (i.e., sleep onset latency (SOL), total sleep duration (TSD), sleep quality (SQ), and morning lingering (ML)). In a longitudinal daily assessment study, participants (N=182) completed a sleep diary and a measure of worrisome thinking three times per day for seven days. We used linear mixed effects models to examine worry predicting sleep, and Tobit regression models to examine sleep predicting worry, and controlled for previous day report of the outcome variable and person- and day- level effects. Results indicate that greater person-level worry, but not day-level worry, was significantly associated with longer SOL, worse SQ, and longer ML. Furthermore, greater person-level SOL, TSD, and ML was associated with greater worry, and greater person-level SQ was associated with less worry. Finally, we found that shorter day-level TSD and lower day-level SQ was associated with greater next-day worry. These findings support a reciprocal person-level association between worry and sleep (except for TSD), and a unidirectional day-level association between TSD and SQ as predictors of worry.

Associations of polysomnographic measures of obstructive sleep apnea, and nocturnal oxygen saturation with incident type 2 diabetes mellitus in middle-aged and older men.

Obstructive sleep apnea (OSA) has been associated with incident type 2 diabetes mellitus (T2DM); however, few prospective epidemiological studies have accounted for important T2DM predictors including pre-diabetes status and testosterone. Participants in the longitudinal Men Androgens Inflammation Lifestyles Environment and Stress (MAILES) study, who underwent eight-channel home-based polysomnography (PSG) in 2010-2011 (n = 824) and were free of diabetes at baseline were included in the analysis (n = 682). From 2015 to 2021, 78.6% (n = 536) completed at least one follow-up assessment. Incident T2DM was determined by self-reported doctor diagnosis, diabetes medications, plasma glucose (fasting ≥7.0 mmol/L or random ≥11.0 mmol/L) or glycated haemoglobin ≥6.5%. Conservative hierarchical Poisson regression models adjusted associations of PSG metrics (categorical and continuous) for age, waist circumference, baseline fasting glucose and testosterone concentrations. In all, 52 men (9.7%) developed T2DM over a mean (range) of 8.3 (3.5-10.5) years. Significant age- and waist circumference-adjusted association of incident T2DM with rapid eye movement (REM) sleep apnea-hypopnea index (AHI) ≥20 events/h (incidence rate ratio [IRR] 1.5, 95% confidence interval [CI] 0.8-2.8; p = 0.23] and highest quartile of delta index (IRR 2.1, 95% CI 0.95-4.6; p = 0.066) were attenuated after adjustment for baseline glucose and testosterone, and the association with the lowest quartile of mean oxygen saturation persisted (IRR 4.2, 95% CI 1.7-10.3; p = 0.029). Categorical measures of AHI severity, oxygen desaturation index, and hypoxia burden index (HBI) were not independently associated with incident T2DM. Associations with T2DM were similar when continuous PSG variables were used; however, HBI was significant (IRR 1.015, 95% CI 1.006-1.024; p = 0.007). In a sub-sample with OSA treatment data (n = 479), these significant associations persisted after excluding adequately treated OSA (n = 32). Understanding underlying OSA endotypes generating hypoxaemia may identify opportunities for diabetes prevention.

Сезонные изменения качества сна студентов как предикторы «адаптационной» инсомнии

Background: Sleep disorders occur even at a young age and may result from environmental factors such as circannual fluctuations in hormonal background and social sleep restriction, leading to the development of insomnia. The aim of the study: To assess the quality of sleep in young people (medical students), living in the city of Vladikavkaz in the spring and autumn seasons of the year for identifying predictors of insomnia. Materials and methods: With the help of the Pittsburgh questionnaire to determine the indices of sleep quality, we conducted a survey of 435 2-3 year medical students of the North Ossetian State Medical Academy (age 20.1±0.08) in seasons with a multidirectional photoperiod trend. In the spring period, 270 students were surveyed, in the autumn – 165. C17 components were assessed from 0 to 3 points, in total they determined the overall sleep quality index (Global Score PSQI, (GS)). We analyzed the sleep time of students, the relationship with latency and sleep duration. Results: The total score (GS) in the spring season was 7.19 (boys – 6.07; girls – 7.51), in autumn – 5.69 (boys – 5.59; girls – 5.75). “Bad sleep” is noted by 66.7% of respondents in spring, and 46.4% in autumn. The main contribution to the proportion of students with poor sleep quality in the spring is made by girls – 71.4%, in autumn, the proportion of students with a good quality of sleep increases, both among girls and boys. In the overall negative assessment of the quality of sleep in the spring, the leading role is played by sleep latency (contribution of 21.5%), in addition, the time of going to bed in 69.7% of medical students shifts to a period after 24:00, provoking a violation of circadian rhythms organism. Conclusion: The overall sleep quality index and the components of the PSQI questionnaire during the survey of medical students have a seasonal dependence. In all the studied seasons, students had a “poor” quality of sleep (more than 5 points), but in autumn, sleep characteristics improved by 21% according to Global Score points. In both seasons, students have 3 groups of symptoms out of 5 main criteria for the diagnosis of insomnia syndrome, which allows us to regard violations of the main components of the sleep index as predictors of the development of adaptive (acute) insomnia.

Effectiveness of a parent-focused intervention targeting 24-hour movement behaviours in preschool-aged children: a randomised controlled trial

BackgroundInterventions focusing on individual behaviours (physical activity, sedentary behaviour, sleep) of preschool-aged children have been widely studied. However, there is a lack of understanding about integrated interventions that target all three 24-hour movement behaviours. This is the first study to assess the effectiveness of an intervention aimed at improving all three 24-hour movement behaviours among preschoolers in Hong Kong.MethodsA 12-week randomised controlled trial with a 12-week follow-up was conducted. Parent-child pairs were randomised to integrated approach (targeting all three behaviours), dyadic approach (targeting physical activity and sedentary behaviour including screen time), or wait-list control group. Utilising the Internet-based delivery, this intervention consisted of education materials, workshops, and interactive questionnaires and reminders. Two intervention groups employed the same strategies, with the only difference being that the integrated approach targeted sleep in addition to physical activity and sedentary behaviour. The outcomes were preschoolers’ overall 24-hour movement behaviours which were assessed by the Activity Sleep Index (ASI), movement behaviour composition, and absolute duration of movement behaviours. Generalised estimating equations were conducted to evaluate the intervention.ResultsA total of 147 preschoolers (4.8 ± 0.9 years old, 56.5% boys) and their parents were included. Preschoolers in all groups had a lower ASI at follow-up compared with baseline. Preschoolers in the integrated approach had a smaller decline in ASI at follow-up, compared to that in the control group (3.41; 95% confidence interval [CI] = 0.07, 6.76). Preschoolers in both intervention groups had a smaller reduction of the composition of time spent in physical activity at follow-up, and a decreased screen time at postintervention and follow-up. No significant differences were found for the sleep subcomponent. Furthermore, preschoolers in the dyadic approach had a smaller increase in the sedentary behaviour subcomponent (vs. control: − 0.21; 95% CI = − 0.37, − 0.05) at follow-up.ConclusionsBoth intervention groups showed a decrease in screen time at postintervention, but there were no significant changes in other behaviours. The favourable changes observed at follow-up demonstrated the effectiveness of both intervention approaches on alleviating the decline in the composition of time spent in physical activity and reducing screen time and revealed the possible effectiveness of the integrated approach in promoting overall movement behaviours among preschoolers.Trial registrationThe study is prospectively registered at the Chinese Clinical Trial Registry (ChiCTR2200055958).

Correlation Analysis of Characteristics of Intestinal Microbiota and Cytokine Levels in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome.

The aim of this study was to analyze the relationship between the characteristics of the intestinal microbiota and cytokine levels in individuals with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS) as well as to investigate intestinal microbiota imbalances in patients with OSAHS and the associated mechanisms. Based on their sleep apnea hypopnea index (AHI), a total of 37 adults were assigned to a control group, a mild OSAHS group, or a moderate-to-severe OSAHS group. Fecal samples were collected to characterize the intestinal microbiota using metagenomic next-generation sequencing (mNGS), while blood samples were collected to detect levels of interleukin-17a (IL-17a), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each group. 1. There was no significant difference in the Shannon index among the three groups (P > 0.05). The three groups showed significant difference in the relative abundance of Faecalibacterium prausnitzii and Bifidobacterium adolescentis (with F values of 3.955 and 7.24, respectively, P < 0.05), while showed no significant difference in the relative abundance of B. pseudocatenulatum, Bifidobacterium longum, Klebsiella pneumoniae, and Haemophilus parainfluenzae (P > 0.05). 2. The three groups showed significant difference in the expression of serum IL-17A and TNF-α levels (with F values of 18.119 and 10.691, respectively, P < 0.05), while showed no significant difference in the expression of IL-10, IL-6, and CRP levels (P > 0.05). 3. Multiple linear regression analysis revealed that the relative abundance of F. prausnitzii was correlated with changes in BMI and AHI (with β values of 2.585 and -0.157, respectively, P < 0.05), while the relative abundance of B. adolescentis was correlated with changes in IL-17a (with β value of -0.161, P < 0.05). The study revealed a significant correlation between intestinal microbiota abundance and cytokine levels, suggesting that gut microbiota disruption in OSAHS patients may be linked to systemic chronic inflammation.

Can sleep hygiene interventions affect strength and power outcomes for female athletes?

AbstractImproved sleep can enhance sprint, endurance, and sports-specific skills; however, it is yet to be investigated whether improved sleep indices could enhance strength and power performance. Sleep hygiene (SH) is growing in popularity as a tool to enhance sleep indices amongst athletic cohorts, yet the optimal delivery strategy of sleep hygiene education is yet to be determined. Using a randomised, controlled design with repeated measures, this study recruited 34 female footballers playing in WSL or WSL academy league. Participants were split into 3 groups: one receiving both group-based and individualised sleep hygiene education, one receiving only group-based SH education and a control group receiving no education. Monitoring of sleep (actigraphy, diaries) and physical performance (countermovement jump, isometric mid-thigh pull) was carried out at week 1, week 4 and week 7. Split-plot ANOVAs were used to assess for differences between groups × weeks, and groups × time. Individualised sleep hygiene education resulted in significantly improved sleep duration (p = 0.005), latency (p = 0.006) and efficiency (p = 0.004) at week 7 compared to controls, whilst also resulting in significantly improved countermovement jump scores (p = 0.001) compared to control. Results of this study suggest that jump performance may be affected by sleep factors, and that individualised SH may be superior to group-based SH, providing information to coaches regarding training optimisation and the efficacy of SH education methods.

Sex-based disparities in dopamine agonist response in patients with restless legs syndrome.

This study aimed to investigate sex-related differences in the response to ropinirole and pramipexole in patients with restless legs syndrome (RLS). By analysing clinical parameters and polysomnographic (PSG) findings, we sought to elucidate the potential factors related to sex disparities modulating treatment responses and sleep quality in RLS. A total of 41 drug-free patients with RLS, aged ≥18 years, underwent two consecutive nocturnal PSG recordings, without medication at baseline; before the second night, 26 patients received an oral dose of 0.25 mg pramipexole whereas 15 received 0.5 mg ropinirole. After each PSG recording, patients self-evaluated the severity of their previous night symptoms by means of an ad hoc visual analogue scale (VAS). At baseline, sleep efficiency and percentage of Stage N2 tended to be higher in females while wakefulness after sleep onset was significantly higher in males. After treatment, total leg movements during sleep (LMS), periodic LMS (PLMS), and periodicity indexes were significantly lower in females than in males. The VAS score was lower after treatment in all patients, without differences between the two sexes. This study demonstrates a higher acute responsiveness of PLMS to dopamine agonists (pramipexole and ropinirole) in females than in males with RLS. These findings might be explained by differential sex-related expression of dopamine receptors, especially D3, within the central nervous system. In addition, our findings provide translational hints toward a better tailored and sex-specific approach to the treatment of RLS associated with PLMS, with dopamine agonist possibly associated with a better outcome in females than in males.

Novel advances in assessment and treatment of obstructive sleep apnea

The current indicators for assessing obstructive sleep apnea are sleep apnea-hypopnea index (AHI) and the lowest nocturnal oxygen saturation, but they do not comprehensively reflect the severity of the disease. The main treatments for OSA are continuous positive airway pressure, mandibular advancement devices and surgery, which have poor compliance and limited effectiveness. Therefore, there is a need to explore novel methods to assess and treat OSA. This article systematically summarized recent advances in this field.

German translation, cultural adaptation for Austria and validation of the Neurological Sleep Index - Multiple Sclerosis (NSI-MS).

To translate, culturally adapt, and validate the Neurological Sleep Index - Multiple Sclerosis (NSI-MS) for use in Austrian German-speaking populations with multiple sclerosis (pwMS). Following established guidelines, the NSI-MS diurnal sleepiness (DS), non-restorative nocturnal sleep (NRNS), and fragmented nocturnal sleep (FNS) scales underwent forward-backward translation, with content and face validity, and cultural adaptation to Austria established. Construct validity was evaluated using Rasch analysis. Known-groups validity was examined, and comparisons were made with scales measuring MS fatigue, daytime sleepiness, sleep quality, anxiety, and depression. Reliability was assessed through Cronbach's alpha, Person Separation Index, Lin's concordance correlation coefficient, measurement error, and floor and ceiling effects. Data were merged with a historic English dataset for comparison between English/German language versions. The translation and cultural adaptation of the NSI-MS-G were successful. Pretesting involved 30 pwMS, while the validation included 400 pwMS with mild-to-severe disability. The DS, NRNS, and FNS scales exhibited good fit parameters, were unidimensional, and invariant. NSI-MS-G scales demonstrated excellent convergent and known-groups validity, internal consistency, person separation reliability, test-retest reliability, adequate measurement error, and low floor and ceiling effects. Pooling English and German datasets revealed that person estimates for the NRNS and FNS scales are equivalent across versions, unlike the DS scale. The NSI-MS-G demonstrates validity, reliability, and responsiveness in assessing DS, NRNS, and FNS in pwMS, generating interval-level data, and shows equivalence between its English and German versions. Register: German Clinical Trials Register (DRKS); URL: https://drks.de/search/en/trial/DRKS00025573; Identifier: DRKS00025573.

Decreased Delta/Beta ratio index as the sleep state-independent electrophysiological signature of sleep state misperception in Insomnia disorder: A focus on the sleep onset and the whole night

PurposeSleep State Misperception (SSM) is described as the tendency of Insomnia Disorder (ID) patients to overestimate Sleep Latency (SL) and underestimate Total Sleep Time (TST). Literature exploring topographical components in ID with SSM is scarce and does not allow us to fully understand the potential mechanisms underlying this phenomenon. This study aims to evaluate the existence of sleep EEG topography alterations in ID patients associated with SSM compared to Healthy Controls (HC), focusing on two distinct periods: the Sleep Onset (SO) and the whole night. MethodsTwenty ID patients (mean age: 43.5 ± 12.7; 7 M/13F) and 18 HCs (mean age: 41.6 ± 11.9; 8 M/10F) underwent a night of Polysomnography (PSG) and completed sleep diaries the following morning upon awakening. Two SSM indices, referring to the misperception of SL (SLm) and TST (TSTm), were calculated by comparing objective and subjective sleep indices extracted by PSG and sleep diary. According to these indices, the entire sample was split into 4 sub-groups: ID +SLm vs HC –SLm; ID +TSTm vs HC –TSTm. ResultsConsidering the SO, the two-way mixed-design ANOVA showed a significant main effect of Groups pointing to a decreased delta/beta ratio in the whole scalp topography. Moreover, we found a significant interaction effect for the sigma and beta bands. Post Hoc tests showed higher sigma and beta power in anterior and temporo-parietal sites during the SO period in IDs +SLm compared to HC –SLm.Considering the whole night, the unpaired t-test revealed in IDs +TSTm significantly lower delta power during NREM, and lower delta/beta ratio index during NREM and REM sleep compared to HCs –TSTm.Finally, we found diffuse significant negative correlations between SSM indices and the delta/beta ratio during SO, NREM, and REM sleep. ConclusionThe main finding of the present study suggests that higher SL overestimation and TST underestimation are both phenomena related to diffuse cortical hyperarousal interpreted as a sleep state-independent electrophysiological correlate of the SSM, both during the SO and the whole night.

Discrepancy Between Desired Time in Bed and Desired Total Sleep Time, Insomnia, Depression, and Dysfunctional Beliefs About Sleep Among a Clinical Sample of Patients With Insomnia.

This study investigated whether the discrepancy between desired time in bed and desired total sleep time (DBST) index could be a meaningful indicator for assessing insomnia severity in a clinical sample of patients with insomnia. Furthermore, we sought to identify the mediators of the association between DBST and insomnia severity in individuals with insomnia. We collected the medical records of 127 patients with insomnia. Each participant's DBST index was calculated using sleep indices, including time and duration variables. Psychological symptoms were investigated using the Insomnia Severity Index (ISI), Patients Health Questionnaire-9 items (PHQ-9), Generalized Anxiety Disorder-7, Dysfunctional Beliefs and Attitudes about Sleep-16 items (DBAS-16), and Epworth Sleepiness Scale. The DBST index was significantly correlated with the ISI (r=0.20, p<0.05), desired total sleep time (r=-0.52, p<0.001), and desired time in bed (r=0.32, p<0.01). Linear regression analysis revealed that insomnia severity was associated with age (β=-0.18, p=0.018), DBST (β=0.23, p=0.003), PHQ-9 (β=0.23, p=0.031), and DBAS-16 (β=0.42, p<0.001). The DBST directly influenced insomnia severity, although indirect effects of mediators were not significant. The DBST index directly influenced insomnia severity regardless of the mediating effects of psychological factors among a clinical sample of patients with insomnia. This finding implies that the DBST index can be a simple measure of insomnia severity, even among patients with insomnia.

Sleep quality in cancer patients: a common metric for several instruments measuring sleep quality.

Sleep problems are frequently observed in cancer patients. Multiple questionnaires for assessing sleep quality have been developed. The aim of this study was to present transfer rules that allow the conversion of the patients' scores from one questionnaire to another. In addition, we anchored this common metric to the general population. A sample of 1,733 cancer patients completed the following questionnaires: Pittsburgh Sleep Quality Index, Insomnia Sleep Index, Jenkins Sleep Scale, EORTC QLQ-C30, and the sleep scale of the EORTC QLQ-SURV100. The methods for establishing a common metric were based on Item Response Theory. The main result of the study is a figure that allows the conversion from one of the above-mentioned sleep scales into another. Furthermore, the scores of the questionnaires can be transferred to theta scores that indicate the position within the group of cancer patients and also to T scores that indicate the position in relation to the general population. The correlations between the sleep scales ranged between 0.70 and 0.85. The conversion rules presented in the study enable researchers and clinicians to directly compare single scores or mean scores across studies using different sleep scales, to assess the degree of sleep problems with regard to the general population, and to relate cutoff scores from one questionnaire to another.

Exploring the Effects of Sensorimotor Training and Relaxation Therapy on Postural Control, Balance, Sleep, and Stress in Sedentary Young Adults: Rationale, Design, and Methodology.

Postural control (PC) and sleep are critical in several aspects of health. Poor sleep negatively influences PC and balance, which is necessary for performing various tasks, from reaching to mobility. Moreover, sleep disturbances and consequent PC and balance deterioration are associated with job accidents, traffic accidents, falls, and injuries. Healthy adults who have inadequate sleep show a decline in optimal functioning, even in the absence of medical illnesses. This suggests that getting enough sleep, both in duration and quality, is essential to maintain optimal health. Moreover, inadequate sleep has also been observed to have a bidirectional relationship with stress levels. However, there is insufficient evidence regarding the impact of non-pharmacological treatments to improve PC, sleep, and stress in the sedentary young adult (YA) population. This article describes the protocol for a study to investigate the effects of sensorimotor training and relaxation therapy on various static and dynamic PC tests, balance measures, and subjective and objective indices of sleep and stress among sedentary YAs with impaired sleep quality. The protocol is also designed to evaluate the effect of these therapies on fatigue, salivary cortisol levels, anxiety, and depression. Methods for assessing the sleep architecture, static and dynamic PC, balance, and stress are described along with the methods of scoring with the primary goal of providing a standardized set of assessment and scoring procedures according to the latest guidelines and gold-standard techniques and measures that can be used reliably at different laboratories. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Postural control assessment Basic Protocol 2: Balance assessment Basic Protocol 3: Sleep architecture assessment Basic Protocol 4: Salivary cortisol analysis.

Higher Levels of Morning and Daytime Light Exposure Associated with Positive Sleep Indices in Professional Team Sport Athletes.

Light exposure techniques have been recommended to combat sleep issues caused by disruption to circadian regularity in the athletic population, although studies are lacking. A total of 17 professional male Australian Football athletes (age ± SD: 22 ± 3 years) wore a wrist actigraph to measure sleep parameters, and a wearable light sensor to measure melanopic equivalent daylight illuminance (mEDI, in lux) for 14 days. Participants completed three sleep questionnaires at the end of the data collection period and completed well-being surveys 6 times. The Sleep Regularity Index (SRI) for each player was also calculated from actigraphy data. Light exposure data were organised into three different timeframes: morning (wake time + 2 hours), daytime (end of morning to 6 pm), and evening (2 hours leading up to bedtime) for analysis. Repeated measures correlation was conducted for objective sleep measures and mEDI values per timeframe. Pearson's correlation was conducted on subjective sleep measures and well-being measures against mEDI values per timeframe. Higher morning light was associated with significantly (p < 0.001) greater total sleep time (r = 0.31). Higher daytime light exposure was associated with higher subjective sleep quality (r = 0.48, p < 0.05). Higher evening light exposure was associated with higher Athlete Sleep Screening Questionnaire (ASSQ) global scores (r = 0.52, p < 0.05). There were no other significant correlations between light exposure and sleep or well-being measures (p > 0.05). Higher morning and daylight exposure levels were associated with various positive objective and subjective sleep measures in professional team sport athletes, supporting the need for education on optimising light exposure to improve circadian function, sleep, and health.

The relationship between rapid eye movement electromyogram activity and sleep stability in rapid eye movement sleep behavior disorder

Objective: To investigate the relationship between the types of electromyogram (EMG) activity and sleep stability during rapid eye movement (REM) in patients with rapid eye movement sleep behavior disorder(RBD). Methods: One hundred and three patients with RBD who met the inclusion and exclusion criteria at the Second Affiliated Hospital of Air Force Military Medical University from January 2017 to December 2019 were retrospectively analyzed. The general situation, clinical symptoms, sleep and emotion questionnaires and nocturnal PSG data were collected. According to the different proportions of tonic and phasic EMG activity, the group with a higher proportion of tonic EMG than phasic EMG was defined as the tonic dominant group, and the group with a higher proportion of phasic EMG than tonic was defined as the phasic dominant group. The sleep instability index was calculated according to the ratio of the number of transitions from sleep to wakefulness to the total sleep time of each sleep stage. Multiple linear regression was used to explore the relationship between REM EMG activity and sleep instability index. Results: A total of 35 idiopathic RBD (iRBD) patients were included, aged(54.5±18.2)years, with 17 males and 18 females. There were 27 RBD with Parkinson's disease (PD), with an average age of (59.4±7.9)years, including 17 males and 10 females. Additionally, there were 41 RBD patients with narcolepsy, aged (21.2±13.2)years, consisting of 22 males and 19 females. Both iRBD and RBD patients with PD had lower objective total sleep time, sleep latency, sleep efficiency, wake time after sleep onset and the percentage of N3 sleep compared to RBD with episodic sleep disorder (all P<0.05). N1-W index[M(Q1, Q3),10.6 (6.5, 16.9)/h vs 7.3 (4.7, 10.5)/h], N2-W index [4.0 (2.2, 5.6)/h vs 2.3 (1.5, 3.9)/h], NREM-W index [ (5.8±2.9)/h vs (4.5±3.2)/h] and REM-W index[ 3.9 (1.9, 7.3)/h vs 2.7 (1.0, 4.0)/h] in the phasic dominant group were higher than those in the tonic dominant group. After adjusting for confounding factors, the effect of phasic EMG dominant group on REM-W was higher than that in the tonic dominant group (β=2.05, 95%CI: 0.09-3.26, P=0.012). Conclusion: In RBD patients, the phasic EMG activity has a significant impact on sleep stability, especially on REM sleep stability.

Sleep Duration and Sleep Hygiene Among Rural and Urban Residents in District Etawah of Uttar Pradesh: A Community Based Comparative Cross-sectional Study

Background: Sleep deprivation include physical effects (sleepiness, fatigue) cognitive impairment (deterioration of performance, attention and motivation) and mental health issues. Objectives: To assess and compare sleep duration and sleep hygiene with their associated factors among rural and urban residents of a district of Uttar Pradesh. Material and Methods: This cross?sectional study was conducted in Etawah district, UP, from January 2022 to June 2022. All residents of rural and urban areas were included using multistage sampling. Study tool included a questionnaire which collected sociodemographic information, sleep duration, and sleep hygienic practices using sleep hygiene index. Results: In this study, 240 participants each from the rural and urban areas were included. The mean duration of sleep among the participants in rural and urban areas was 7.40±1.22 and 8.18±1.30 h during the workdays whereas, 7.30±1.30 and 8.11±1.35 h during the weekends respectively. About 40% were having unhygienic sleep practices. Most of the study participants had the history of sleep duration less than 8 hr. among the comparison groups. Graduated participants had the more sleep problems. Conclusions: Particularly among the elderly, inadequate sleep duration and differences in sleep rhythm between weekdays and weekends were seen.

Association between sleep microarchitecture and cognition in obstructive sleep apnea

Abstract Study Objectives Obstructive sleep apnea (OSA) increases the risk of cognitive impairment. Measures of sleep microarchitecture from EEG may help identify patients at risk of this complication. Methods Participants with suspected OSA (n = 1142) underwent in-laboratory polysomnography and completed sleep and medical history questionnaires, and tests of global cognition (Montreal Cognitive Assessment, MoCA), memory (Rey Auditory Verbal Learning Test, RAVLT) and information processing speed (Digit–Symbol Coding, DSC). Associations between cognitive scores and stage 2 non-rapid eye movement (NREM) sleep spindle density, power, frequency and %-fast (12–16Hz), odds-ratio product (ORP), normalized EEG power (EEGNP), and the delta:alpha ratio were assessed using multivariable linear regression (MLR) adjusted for age, sex, education, and total sleep time. Mediation analyses were performed to determine if sleep microarchitecture indices mediate the negative effect of OSA on cognition. Results All spindle characteristics were lower in participants with moderate and severe OSA (p ≤ .001, vs. no/mild OSA) and positively associated with MoCA, RAVLT, and DSC scores (false discovery rate corrected p-value, q ≤ 0.026), except spindle power which was not associated with RAVLT (q = 0.185). ORP during NREM sleep (ORPNREM) was highest in severe OSA participants (p ≤ .001) but neither ORPNREM (q ≥ 0.230) nor the delta:alpha ratio were associated with cognitive scores in MLR analyses (q ≥ 0.166). In mediation analyses, spindle density and EEGNP (p ≥ .048) mediated moderate-to-severe OSA’s negative effect on MoCA scores while ORPNREM, spindle power, and %-fast spindles mediated OSA’s negative effect on DSC scores (p ≤ .018). Conclusions Altered spindle activity, ORP and normalized EEG power may be important contributors to cognitive deficits in patients with OSA.