Insomnia Problems Research Articles

Qualitative Phytochemical Analysis, Acute Toxicity, and Antidepressant Efficacy of Datura stramonium (Solanaceae) whole Seeds using Swiss Albino Mice

Introduction: Depression is a condition that often consists of such main symptoms as lack of interest, worry, insomnia problems, appetite loss, low energy levels, and suicidal thoughts. The purpose of this experiment was to determine the qualitative phytochemical analysis, acute toxicity, and antidepressant efficacy of Datura stramonium (Solanaceae) whole seeds on Swiss albino mice using forced swim (FST) and tail suspension (TST) tests. Materials and Methods: The seeds of Datura Stramonium were harvested, air dried, ground, and extracted using N-hexane. In the anti-depressant investigation, 60 mice (8 weeks old) were used for the two models. Each model contained 30 mice (15 males and 15 females) weighing 25-30 g. The extract and standard drug were administered orally to mice for seven days. Group 1 received Normal saline (2 mg/ml), group 2 received Imipramine (15mg/kg), Groups 3, 4, and 5 received N-hexane Extract Datura stramonium Seed (NEDSS) (10, 20, and 40 mg/kg), respectively, for the two models. The period of mobility in the TST and FST was determined 24 hours following the last dose. Results: The antidepressant studies revealed that the NEDSS-treated groups had significant (P<0.01) increases in mobility, compared to the control group. Moreover, Group 5 obtained the best effect (40 mg/kg of NEDSS). Conclusion: An increase in the dose of NEDSS revealed subsequent increases in anti-depression actions. Furthermore, 40 mg/kg of NEDSS proved to be the most potent in the two models of depression. However, further research should be carried out to determine its mechanism of action using laboratory animals.

The Impact of Covid Pandemic on Trauma and Orthopedic Surgeons in Morocco

COVID-19 pandemic was a global health crisis without precedent, it had caused a severe human suffering. In this study we evaluated the impact of this pandemic on the quality of life of the trauma and orthopedic surgeons in Morocco. An anonym online questionnaire was sent, by e-mail, to the 645 surgeons’ members of the Moroccan society for orthopedic and trauma surgery. The questionnaire comprised 34 structured questions that inquired sociodemographic information and indicators of the quality of life of surgeons including: bad feeling, depression, anxiety, insomnia, bad diet, sedentary lifestyle, happy lessness and financial problems. SPSS 23 software was used to descriptive analysis of the data, and assessment of factors associated with bad quality of life of surgeons. The questionnaire was completed by 220 surgeons, for a mean response rate of 34%. The mean age of the respondents was 44±12 year, 45.4% were public, 12.3% military and 42.3% liberal. 78.2% of surgeons worked in the zone with high risk of epidemic. Sedentary lifestyle, anxiety, financial problems, bad diet, and insomnia were the main problems encountered respectively by 70.9%, 40.5%, 35%, 25% and 21.4% of surgeons. The juniors’ doctors were more exposed to the problems of sedentary lifestyle, bad diet and insomnia, than the seniors (p<0.05). The liberal doctors were more concerned by the financial problems (55.9%), than the public (21%) and military (14.8%) (p<0.001). Finaly, the trauma and orthopedic surgeons in Morocco didn’t escape to the bad effect of the COVID-19 pandemic on the hole humanity. Several measures are needed to decrease the impact of future pandemic.

Characteristics and patient-reported outcomes of long-term cancer survivors after apatinib-based therapy: an online survey

BackgroundData on long-term cancer survivors treated with apatinib are lacking. This study aimed to describe the characteristics of long-term cancer survivors after apatinib-based therapy, and to know about their satisfaction degree with apatinib and severity of depression and insomnia.MethodsPatients with solid tumors who had received apatinib-based therapy for at least 5 years were invited to complete an online questionnaire. Characteristics of patients and treatment, knowledge of apatinib, satisfaction degree, and severity of depression and insomnia assessed by Patient Health Questionnaire-9 and Insomnia Severity Index were collected.ResultsBetween December 8, 2023 and March 1, 2024, a total of 436 patients completed the online questionnaire. Most patients were satisfied with the efficacy (96.6%) and safety (93.1%) of apatinib, were willing to continue apatinib treatment (99.5%), and would recommend apatinib to other patients (93.3%). Continuous apatinib treatment resulted in significant negative impact on daily life, work, or study in only two (0.5%) patients. Almost all patients currently had no or mild depression (97.0%) and insomnia (97.9%) problems. The most common patient-reported adverse events were hand-foot syndrome (21.3%) and hypertension (18.3%).ConclusionsOur survey showed a high satisfaction degree with apatinib in long-term cancer survivors. Long-term apatinib treatment resulted in almost no negative impact on patient’s quality of life.

Is physical activity an effective remedy for insomnia? - a review

Introduction and purpose This article explores the impact of physical activity on insomnia and sleep quality. It reviews existing research to clarify how exercise affects sleep patterns, identifies mechanisms through which exercise improves sleep, and evaluates practical recommendations for integrating physical activity into insomnia treatment. The goal is to offer valuable insights for individuals and healthcare professionals on using exercise as a non-pharmacological method to manage insomnia. State of knowledge The article reviews the literature on sleep, with a particular focus on the issue of insomnia. By understanding the causes of sleep disorders, it is possible to implement targeted diagnostics and subsequent treatment. The impact of physical activity on the overall problem of insomnia is also highlighted. Material and Methods A review of literature from 2004 to 2024 was conducted using databases such as PubMed, Science Direct, and Google Scholar. Keywords included "insomnia," "sleep disorder," and "sleep impairment." The review focused on English-language primary research articles from peer-reviewed journals. Summary The review highlights the role of physical activity in managing insomnia, emphasizing its positive effects. Evidence indicates that regular exercise significantly reduces the risk and severity of insomnia and improves sleep quality. This underscores the effectiveness of physical activity as a valuable non-pharmacological approach to enhancing sleep and overall well-being. Keywords Insomnia; physical activity; sleep disorders; quality of sleep; sport

Independent-Nursing Activities: Aromatherapy, Hand Massage, and Music Therapy for Insomnia Elderly.

The elderly are an age group presenting a substantial risk of experiencing sleep problems. About 81.6% of the elderly from the author’s previous research showed poor sleep quality contributed to various diseases. The current approaches regarding sleep hygiene in society are keen to start mostly with an alternative or complementary therapy rather than consuming sleeping pills. Previous studies showed the possibility of strengthening productivity by combining three-intervention of nursing to relax the body and stimulate the brain’s waves for sleeping. This case study aimed to analyze the application of evidence-based practice as the primary intervention in dealing with Insomnia elderly at one of the social institutions in 2019. The procedure was a combination of aromatherapy, hand massage, and music therapy for 30-minute each repetition five times a week for five weeks at the same time for three women with sleep disorders: a Chinese senior (Mrs. S, 79 y/o), a wheelchair user (Mrs. N, 76 y/o), and well-spoken elderly (Mrs. A, 60 y/o). The therapy was measured subjectively and objectively amid participants’ opinions, achievement of nursing outcomes, and the Pittsburgh Sleep Quality Index (PSQI) instrument within three periods. The assessment in PSQI showed a significant-decreasing score for each participant: (1) 19-9-6, (2) 13-9-5, and (3) 18-10-5, respectively, during the pre-mid-post assessment. This modified intervention was provided to enhance the effectiveness of therapy from the previous study such as the lengthy duration, frequency, and scheduling. Social institutions as a form of service for the elderly can encourage nurses or nursing students to apply this combined intervention to overcome the problem of Insomnia. The recommendation is to continue playing passive music at night as a bedtime ritual regularly performed each day. The benefits are reducing pre-bedtime (sleep onset latency), improving sleep quality, and allowing older people to be better and more productive during the day.

Pharmacological Treatment of Primary Insomnia in Senior Citizens in Spain

The article examines the problem of primary insomnia in older adults in Spain, focusing on its prevalence and health consequences. It highlights that, unlike secondary insomnia, primary insomnia has no identifiable cause and may be related to factors such as stress, emotional distress, travel and shift work. Using data from the Spanish National Institute of Statistics, the prevalence of insomnia in older adults is analysed, highlighting a higher incidence in women and the 75+ age group. The importance of addressing this problem is emphasised, as insomnia in older adults is associated with serious consequences such as depressive episodes, increased risk of falls, cognitive impairment and reduced quality of life. The study aims to comprehensively examine the management of primary insomnia in this population, evaluating the efficacy of various pharmacological treatments, such as cognitive behavioural therapy, benzodiazepines, benzodiazepine receptor agonists (Z-drugs), antidepressants, melatonin and other options. The pros and cons of each treatment are discussed, including special considerations for older adults. The article highlights the importance of future research to improve the understanding and management of chronic insomnia, underlining the need for large-scale studies of high methodological quality to establish appropriate pharmacological management.

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study.

Healthcare workers (HCWs) are at increased risk of contracting coronavirus disease 2019 (COVID-19) as well as worsening mental health problems and insomnia. These problems can persist for a long period, even after the pandemic. However, less is known about this topic. To analyze mental health, insomnia problems, and their influencing factors in HCWs after the COVID-19 pandemic. This multicenter cross-sectional, hospital-based study was conducted from June 1, 2023 to June 30, 2023, which was a half-year after the end of the COVID-19 emergency. Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs. Symptoms such as anxiety, depression, and insomnia were evaluated by the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index. Factors influencing the symptoms were identified by multivariable logistic regression. A total of 2000 participants were invited, for a response rate of 70.6%. A total of 1412 HCWs [618 (43.8%) doctors, 583 (41.3%) nurses and 211 (14.9%) nonfrontline], 254 (18.0%), 231 (16.4%), and 289 (20.5%) had symptoms of anxiety, depression, and insomnia, respectively; severe symptoms were found in 58 (4.1%), 49 (3.5%), and 111 (7.9%) of the participants. Nurses, female sex, and hospitalization for COVID-19 were risk factors for anxiety, depression, and insomnia symptoms; moreover, death from family or friends was a risk factor for insomnia symptoms. During the COVID-19 outbreak, most [1086 (76.9%)] of the participating HCWs received psychological interventions, while nearly all [994 (70.4%)] of them had received public psychological education. Only 102 (7.2%) of the HCWs received individual counseling from COVID-19. Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic, they still faced challenges and greater risks than did the general population. Identifying risk factors would help in providing targeted interventions. In addition, although a major proportion of HCWs have received public psychological education, individual interventions are still insufficient.

Potentiation of the depressant effect of alcohol by flunitrazepam in rats: an electrocorticographic, respiratory and electrocardiographic study.

Alcohol, a widely commercialized psychotropic drug, and the benzodiazepine Flunitrazepam, an anxiolytic widely prescribed for patients with anxiety and insomnia problems, are well known drugs and both act on the central nervous system. The misuse and the association of these two drugs are public health concerns in several countries and could cause momentary, long-lasting and even lethal neurophysiological problems due to the potentiation of their adverse effects in synergy. The present study observed the result of the association of these drugs on electrophysiological responses in the brain, heart, and respiratory rate in Wistar rats. 8 experimental groups were determined: control, one alcohol group (20% at a dose of 1ml/100g VO), three Flunitrazepam groups (doses 0.1; 0.2 and 0.3mg/kg) and three alcohol-Flunitrazepam groups (20% at a dose of 1ml/100g VO of alcohol, combined with 0.1; 0.2 and 0.3mg/kg of Flunitrazepam, respectively). The results showed that there was a more pronounced reduction in alpha and theta wave power in the alcohol-Flunitrazepam groups, a decrease in the power of beta oscillations and greater sedation. There was a progressive decrease in respiratory rate linked to the increase of Flunitrazepam dose in the alcohol-Flunitrazepam associated administration. It was observed alteration in heart rate and Q-T interval in high doses of Flunitrazepam. Therefore, we conclude that the association alcohol-Flunitrazepam presented deepening of depressant synergistic effects according to the increase in the dose of the benzodiazepine, and this could cause alterations in low frequency brain oscillations, breathing, and hemodynamics of the patient.

Predicting anxiety, depression, and insomnia among Bangladeshi university students using tree-based machine learning models.

Mental health problem is a rising public health concern. People of all ages, specially Bangladeshi university students, are more affected by this burden. Thus, the objective of the study was to use tree-based machine learning (ML) models to identify major risk factors and predict anxiety, depression, and insomnia in university students. A social media-based cross-sectional survey was employed for data collection. We used Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index (ISI-7) scale for measuring students' anxiety, depression and insomnia problems. The tree-based supervised decision tree (DT), random forest (RF) and robust eXtreme Gradient Boosting (XGBoost) ML algorithms were used to build the prediction models and their predictive performance was evaluated using confusion matrix and receiver operating characteristic (ROC) curves. Of the 1250 students surveyed, 64.7% were male and 35.3% were female. The students' ages ranged from 18 to 26 years old, with an average age of 22.24 years (SD = 1.30). Majority of the students (72.6%) were from rural areas and social media addicted (56.6%). Almost 83.3% of the students had moderate to severe anxiety, 84.7% had moderate to severe depression and 76.5% had moderate to severe insomnia problems. Students' social media addiction, age, academic performance, smoking status, monthly family income and morningness-eveningness are the main risk factors of anxiety, depression and insomnia. The highest predictive performance was observed from the XGBoost model for anxiety, depression and insomnia. The study findings offer valuable insights for stakeholders, families and policymakers enabling a more profound comprehension of the pressing mental health disorders. This understanding can guide the formulation of improved policy strategies, initiatives for mental health promotion, and the development of effective counseling services within university campus. Additionally, our proposed model might play a critical role in diagnosing and predicting mental health problems among Bangladeshi university students and similar settings.

Too little or too much nocturnal movements in Parkinson’s disease: A practical guide to managing the unseen

Nocturnal and sleep-related motor disorders in people with Parkinson’s disease (PD) have a wide spectrum of manifestations and present a complex clinical picture. Problems can arise due to impaired movement ability (hypokinesias), e.g. nocturnal hypokinesia or early-morning akinesia, or to excessive movement (hyperkinesias), e.g. end-of-the-day dyskinesia, parasomnias, periodic limb movement during sleep and restless legs syndrome. These disorders can have a significant negative impact on the sleep, daytime functional ability, and overall quality of life of individuals with PD and their carers. The debilitating motor issues are often accompanied by a combination of non-motor symptoms, including pain and cramping, which add to the overall burden. Importantly, nocturnal motor disorders encompass a broader timeline than just the period of sleep, often starting in the evening, as well as occurring throughout the night and on awakening, and are not just limited to problems of insomnia or sleep fragmentation. Diagnosis can be challenging as, in many cases, the ‘gold standard’ assessment method is video polysomnography, which may not be available in all settings. Various validated questionnaires are available to support evaluation, and alternative approaches, using wearable sensors and digital technology, are now being developed to facilitate early diagnosis and monitoring. This review sets out the parameters of what can be considered normal nocturnal movement and describes the clinical manifestations, usual clinical or objective assessment methods, and evidence for optimal management strategies for the common nocturnal motor disorders that neurologists will encounter in people with PD in their clinical practice.

The Effect of Cognitive Behavioral Therapy on Insomnia in Patients with Schizophrenia: A Randomized Controlled Trial

Abstract Background: Insomnia is a common feature of schizophrenia. Patients with schizophrenia also encounter the problem of insomnia, which impairs their cognitive functioning, quality of life, mental well-being, and functional recovery. Studies support pharmacological treatment of insomnia with certain drugs; however, these hypnotic medications also have adverse effects. There are no grounded recommendations about insomnia treatment in this clinical setting and research in nonpharmacological areas is sparse. To the best of our knowledge, this is the first study to see the effect of cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia patients in an Indian population. Aims: To evaluate the effects of CBT-I in schizophrenia patients. Materials and Methods: It is a randomized controlled study. Forty schizophrenic patients were recruited and were randomly allocated into two groups. The CBT-I group (n = 20) received four sessions of CBT-I in addition to treatment as usual, whereas the control group (n = 20) received. no additional intervention. The Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) were administered at baseline, week 4, and week 8. Results: Both the groups showed significant time–group interactions on the ISI and PSQI. Post hoc testing showed that, compared to the control group, the CBT-I group showed significant reductions in ISI at both week 4 and week 8. Conclusion: CBT-I was effective for reducing insomnia symptoms in patients with schizophrenia and the effect lasted for 4 weeks after the intervention.

ASSESSMENT OF SLEEP QUALITY IN UKRAINIANS DURING THE MARTIAL LAW AND THE RISK OF CARDIOVASCULAR COMPLAINTS DEVELOPMENT IN THE CONTEXT OF CLINICALLY SEVERE INSOMNIA

The aim: To study the problem of insomnia in Ukrainians during the first 11 months of the martial law in the country. To determine the predominant type of insomnia in the population. To calculate and assess the risk indicator for the development of cardiovascular complaints in the context of deteriorating sleep quality during the martial law and the risk ratio.
 Materials and methods: Anamnestic, statistical and calculative methods were used. 321 participants from Ukrainian population took part in an anonymous online survey. 210 respondents were female (65.4 %) and 111 were male (34.6 %). The age distribution was as follows: 18-19 years old (23.1 %), 20-21 years old (14 %), 22-23 years old (28.7 %), 24-25 years old (8.1 %), 26-27 years old (6.2 %), 28-29 years old (6.2 %), 30 years and older (13.7 %). The questionnaire included several sections: general questions regarding the respondents’ characteristics and presence of sleep disorders; questions of the Pittsburgh Sleep Quality Index (PSQI) [2]; subjective assessment of the sleep quality of the respondents during the first 11 months of the martial law and the presence of cardiovascular complaints that appeared or intensified during this period; details of mentioned complaints.
 Results: 245 respondents (76.3 % of 321) of the entire sample reported about sleep disturbances that developed after February 24, 2022. According to the PSQІ, only 17 respondents (7 %) scored 0-7 points, indicating the absence of insomnia, 180 respondents (73 %) scored 8-14 points, suggesting subclinical insomnia, 48 respondents (20 %) scored 15-21 points, indicating clinically significant insomnia. 209 (85.3 %) attributed these changes to the wartime events in the country. The most significant deterioration in sleep quality during the first 11 months of martial law in the country was observed in March 2022 and the best level of sleep quality was indicated in July. The odds ratio in risk calculation was 3.01; the significance level of the obtained data is 0.006.
 Conclusions: Subclinical insomnia dominates among Ukrainians during the martial law in the country. There is an increased risk of cardiovascular complaints in the population of Ukraine in the presence of clinically significant sleep disorders related to the martial law. Prolonged exposure to stress for Ukrainians can result in deteriorating sleep quality and increasing in cardiovascular complaints.

Insomnia among female flight attendants: Related factors and its association with mental health.

Sleep and mental health are very important in the aviation industry. Reports show that gender is one of the risk factors of insomnia, and most Asian flight attendants are female. Therefore, it is necessary to understand insomnia, and the correction to mental health among female flight attendants. To investigate the prevalence of insomnia in female flight attendants and its association with mental health. We used a cross-sectional design. We recruited 412 female flight attendants with more than 3 months of working experience. We collected the socio-demographic and work-related data, measured insomnia and mental health by the Athens Insomnia and Brief Symptom Rating Scales. Descriptive statistics, single-factor analysis of variance, Pearson's correlation analysis, and structural equation modeling were performed to analyze the relationships. There are 45.4% of female flight attendants having insomnia, and 24.8% had suspicious insomnia. The most considerable and serious insomnia problem was falling asleep (15.3%, 4.9%). Factors related to insomnia include smoking, drinking, family load (e.g., housekeeping and caring for family), economic stress and late-night/early morning workdays during last month. Also, insomnia had a direct association with mental health (T = 17.11, p < 0.001). We found that insomnia is negatively correlated with the above factors and mental health. We recommend that airline industries can run their sleep-education programs and provide relevant mental-health-promotion programs for flight attendants.

Surveying the problem of insomnia and the need for traditional medicine treatment of regular students at the Hue University of Medicine and Pharmacy

Background: Good sleep is important for health and overall quality of life. However, sleep disorders are currently widespread and have particularly serious consequences, especially for students. Objectives: Surveying sleep quality according to the Pittsburgh scale (PSQI) and find out some related factors according to traditional medicine of regular students at the University of Medicine and Pharmacy, Hue University. Methods: A cross-sectional descriptive study on 421 regular students from 10 majors of the Hue University of Medicine and Pharmacy. Results: The percentage of students having poor sleep quality according to the PSQI scale was 57%. According to traditional medicine, heart blood deficiency accounted for the highest proportion with 30.4%, next are the deficiency of heart and spleen (22.1%), kidney yin deficiency (20.8%), qi deficiency of heart and gallbladder (14.6%) and stomach disharmony has the lowest rate with 12.1%. The percentage of students who need treatment with traditional medicine was 52.9%, acupress massage and herbal medicine were the two methods with the highest demand for treatment. Conclusion: Assessing sleep quality according to the PSQI scale the percentage of students with poor sleep quality was 57%. Heart blood deficiency accounted for the highest proportion. The demand for treatment of insomnia by traditional medicine was relatively high. Key words: sleep quality, medical student, Pittsburgh sleep quality scale (PSQI), the need for treatment, Hue University of Medicine and Pharmacy.

Stop (to Work) and Go (to Recover) During Mandatory Work From Home: A Three-Wave Study.

During the COVID-19 pandemic, many workers have been forced to work from home. In this situation, the boundaries between work and private life have become particularly blurred, and recovering from work was even more difficult than in traditional times, with negative consequences for workers' health. Among the psychological experiences that might underlie the recovery process, mastery played a crucial role as people sought new stimuli and challenging situations. However, there are few articles that have explored the role of this specific recovery experience, its antecedents, and the health consequences under conditions of work from home. Therefore, in this multiwave study, we aimed to investigate the role of mastery as a mediator between supervisor support and insomnia problems. The study was conducted during the COVID-19 pandemic in Italy and had a three-wave design. A convenience sample of 130 employees (67% women) completed an online questionnaire. Hypotheses were tested using a three-wave autoregressive cross-lagged panel model. According to the results, supervisor support at Time 1 was positively related to mastery at Time 2, which in turn showed a negative association with insomnia at Time 3. The results demonstrated that mastery experiences have played a crucial role during COVID-19 mandatory work from home, which points to some potential implications for workers' health in the adoption of teleworking beyond the emergency situation.

The relationship between sleep problems and sexual dysfunction among pregnant women in Turkey.

Sexual dysfunction and sleep problems are common in women. Nevertheless, the relationship between sleep problems and sexual dysfunction during pregnancy has yet to be fully clarified. The aim of this study was to evaluate the relationship between sleep problems and sexual dysfunction in pregnant women. The study had a cross-sectional design and the sample was determined by employing the G*Power program on the basis of the findings of a related study. Taking the correlation value between the Female Sexual Function Index (FSFI) and the Insomnia Severity Index (ISI) into account, it was found that the minimum sample size was 219 pregnant women. Healthy pregnant women who were literate, did not have a diagnosed psychiatric disease, did not have a mental disability or communication problems, were in the gestation period, were not restricted by their doctors in terms of engaging in sexual activity, and who were willing to participate were included. The study included those pregnant women who consecutively attended the NST polyclinic in a maternity hospital in a province in the Black Sea region of Turkey between January 2022 and August 2022. The Sociodemographic Information Form, the Pittsburgh Sleep Quality Index (PSQI), the ISI, and the FSFI were used to collect data. A total of 220 pregnant women took part. The women had a mean age of 27.4 ± 6.3. Of the pregnant women, all had poor sleep quality: 61% had insomnia problems; 30% had sexual dysfunction. When the relationships between the PSQI, ISI and FSFI were examined, there was a statistically significant positive correlation between the mean PSQI and ISI scores (p = 0.000). A statistically significant negative correlation was determined between the mean ISI and FSFI scores (p = 0.044). According to the multiple regression analysis, age did not significantly predict sexual function (β = -0.112; t = -1.639; p = 0.103); insomnia severity predicted sexual function negatively (β = -0.146; t = -2.136; p = 0.034). The explained variance was 2.6%. The findings suggest that sleep quality as measured by the PSQIdoes not correlate with female sexual dysfunctionin pregnant women. However, severity of insomnia does correlate with sexual dysfunction.

Sleep disorders and severity of insomnia in emergency medical personnel

As part of this work, an analysis of the existing scientific literature on the problem of sleep disorders and insomnia in medical personnel was carried out, which showed that the real problem in emergency medical personnel has not been studied enough — basically, the study of insomnia is carried out on patients and hospital staff. The article describes the results of a survey of emergency medical personnel for the presence of insomnia and the factors causing it, sleep disorders and the severity of insomnia in accordance with the Pittsburgh Sleep Disorders Index and the Insomnia Severity Index. The study involved 60 emergency medical personnel aged 23 to 67 years, of which 70 % were women. The main identified factors leading to the development of insomnia, presented in more than 45 % of respondents, are listed in descending order of importance: overload at work, the presence of bad habits, severe stress, the presence of children or relatives who constantly need care, low physical activity. The main factors influencing sleep disorders in 47 % of respondents were also identified: a feeling of pain, cold, a feeling of warmth in 53 %, night awakenings and toilet visits. All of the above factors affect the daily activities and emotional mood of employees, which affected the daily life of 92 % of employees. The data obtained as a result of the study indicate that 93 % of emergency medical personnel have sleep disorders of varying severity, and 21 % of them already have clinically pronounced insomnia.

Effectiveness of internet-based CBT-I for the treatment of chronic subthreshold to moderate insomnia.

To study the effectiveness of the first internet-based cognitive behavioral therapy for insomnia (CBT-i) in Thailand, using the Nitra application, for chronic subthreshold to moderate insomnia treatment. An interventional study without a control group was conducted between January and June 2022. Participants were adults aged 18 years old and older with subthreshold to moderate severity of chronic insomnia (insomnia severity index (ISI) of 8-21) and had mean sleep efficiency <85% from baseline sleep diaries. Baseline sleep characteristics were obtained from questionnaires and sleep diaries from the Nitra application for 2 weeks. Eligible participants continued using the Nitra application for 4 weeks during the intervention period. Interventions including sleep restriction, stimulus control, cognitive restructuring, relaxation techniques, and sleep hygiene education were implemented via the pre-programmed Nitra application. Post-intervention sleep characteristics were also obtained from questionnaires and sleep diaries from the Nitra application for another 1 week. A total of 40 participants completed the study. All participants had a baseline sleep efficiency of less than 85% with the majority of the participants having a sleep-onset insomnia problem (98%). For the primary outcome, sleep efficiency was significantly improved after using the Nitra application (p < 0.001). Self-reported total sleep time, sleep onset latency, wake after sleep onset, early morning awakening, ISI, Pittsburgh Sleep Quality Index (PSQI), and average subjective sleep quality were also significantly improved (p < 0.001 for all parameters except p = 0.017 for total sleep time and p = 0.018 for wake after sleep onset). Participants who had a low baseline ISI and went to bed and woke up within 30 minutes of a designated bedtime and wake-up time recommended by the Nitra application for ≥70% of all nights demonstrated an increased chance of achieving normal sleep efficiency after using the Nitra application. This first internet-based CBT-i in Thailand, using the Nitra application, effectively improved sleep efficiency and other sleep parameters in chronic subthreshold to moderate insomnia.

Objective assessment of fatigue, sleep and insomnia in breast cancer survivors on estrogen deprivation therapy.

TPS12145 Background: Fatigue, insomnia and sleep problems are common among breast cancer survivors (BCS). These symptoms remain underassessed, underreported and undertreated. Validated and objective measures of sleep metrics have yet to be widely incorporated into BCS studies to help examine the role that these play on patient patient reported fatigue and insomnia. While more than 50% of BCS experience fatigue and insomnia, most research on BCS fatigue is limited to short-term, self-report data that does not objectively assess sleep metrics. Estrogen Deprivation Therapy (EDT) has been shown to exacerbate sleep problems and contribute to perceptions of fatigue and insomnia, yet there is a paucity of research examining the specific effects of EDT on sleep metrics over time, especially objective measures. Wrist actigraphy is a non-invasive, objective measure of rest/activity cycles and sleep via a wrist-worn device. This study utilizes a novel instrument, called Readiwatch (Fatigue Sciences). It is widely validated in the military and in industry but has not been used in patient studies. The Readiwatch assesses fatigue and estimates cognitive performance, based on the Sleep Activity and Task Effectiveness (SAFTE) model developed in conjunction with the Department of Defense in 2004. The Readiwatch syncs with the Fatigue Avoidance Scheduling Tool (FAST) app on the participant’s smartphone to provide a score, called Readiscore, based on previous sleep and activity. It has been shown to have greater than 92% accuracy with lab polysomnography results. The Readiscore also serves as a “cognition” measure that represents the person’s cognitive capacity based on sleep metrics. This novel, objective feedback to the BCS could be very accessible and useful in community medical practice. Methods: This single-center, pilot study of BCS, receiving endocrine therapy, possessing a smartphone and Scoring &gt;8 on the Insomnia Severity Index (ISI), has enrolled 25 of 50 planned participants. Participants wear the Readiwatch for two months to objectively assess their sleep metrics. Patient reported levels of fatigue and insomnia will be assessed prior to, midway, and following the two-month period. Participants document their self-reported experiences through surveys and track their own sleep and fatigue metrics using their smartphone app. At the conclusion of the study participants are provided with personalized feedback about their sleep metrics, along with detailed information related to sleep hygiene. Data analysis will model the effect of actigraphy fatigue measures on reported pain, anxiety, depression, and cognitive impairment and will also examine sleep metrics, perceptions of fatigue and insomnia scores in relation to type of EDT the patient is currently undergoing to determine if there are specific types of adjuvant therapy that are associated with fewer fatigue and insomnia problems.

The Influence of Environmental Index on Sleep Quality

With the changes of the times, people have given different definitions of sleep. After recent years of research, modern medicine generally believes that sleep makes energy storage, which is conducive to the recovery of human's mental and physical strength. Good sleep is not only the basis for the maintenance of health and physical strength, but also the guarantee of a high degree of production capacity. However, in today's society, the problem of insomnia bothers many people. There are many factors affecting insomnia. The purpose of this paper is to study the effect of environmental index on human sleep quality, and to develop devices to improve sleep environment.