Longer Sleep Time Research Articles

Effect of rooming-in kangaroo mother care on breastfeeding and behavioral status of full-term newborns.

We aimed to assess the effects of rooming-in kangaroo mother care (KMC) on the breastfeeding and behavioral status of full-term newborns. Full-term newborns born from June to December 2021 were divided into Group A (n = 50) and Group B (n = 50) using a random number table. The rooming-in routine nursing intervention and KMC were given to Group A (n = 50) and Group B, respectively. The outcomes were compared. The scores of breastfeeding knowledge, breastfeeding skills, and sense of responsibility for breastfeeding of Group B were higher than those of Group A (p < 0.05). The breastfeeding rate and lactation yield within 3 days of Group B were higher than those of Group A (p < 0.05). Compared with Group A, Group B had higher effective sucking times of newborns and lower behavioral status scores 1, 2, and 3 days after birth, and shorter duration of crying after invasive operation (p < 0.05). The newborns in Group B had better sleep quality, longer sleep time, and lower procedural pain score than those of Group A (p < 0.05). Rooming-in KMC improves the maternal breastfeeding self-efficacy, breastfeeding rate, and lactation yield, ameliorates the behavioral status and sleep quality of newborns, shortens the crying time and relieves the procedural pain.

Prevalence and Course of Idiopathic Hypersomnia in the Wisconsin Sleep Cohort Study.

Idiopathic hypersomnia (IH) is a CNS disorder of hypersomnolence of unknown etiology. Due to the requirement for objective sleep testing to diagnose the disorder, there are currently no population-based estimates of the prevalence of IH nor data regarding the longitudinal course of IH in naturalistic settings. Subjective and objective data from the Wisconsin Sleep Cohort study were used to identify cases with probable IH from participants with polysomnography and multiple sleep latency test data. Demographic, polysomnographic, and symptom-level data were compared between those with and without IH. Longitudinal trajectories of daytime sleepiness among those with IH were assessed to evaluate symptom persistence or remission over time. From 792 cohort study participants with available polysomnography and multiple sleep latency test data, 12 cases with probable IH were identified resulting in an estimated prevalence of IH of 1.5% (95% CI 0.7-2.5, p < 0.0001). Consistent with inclusion/exclusion criteria, cases with IH had more severe sleepiness and sleep propensity, despite similar or longer sleep times. Longitudinal data (spanning 12.1 ± 4.3 years) demonstrated a chronic course of sleepiness for most of the cases with IH, though pathologic somnolence remitted in roughly 40% of cases. These results demonstrate IH is more common in the working population than generally assumed with a prevalence on par with other common neurologic and psychiatric conditions. Further efforts to identify and diagnose those impaired by unexplained daytime somnolence may help clarify the causes of IH and the mechanisms underlying symptomatic remission.

Sleep problems and impact of obstructive hydrocephalus in newly diagnosed pediatric brain tumor patients

BackgroundPediatric brain tumor patients are at risk of developing sleep problems. Previous studies were conducted in longer-term survivors or without comprehensive sleep evaluations, therefore it remains unclear whether and when problems arise. Insights can facilitate timely interventions. The aim is to examine sleep problems and contributing factors shortly after diagnosis. MethodsChildren 6–16 years with a primary brain tumor (diagnosed ≤3 months) were recruited for a prospective study. Sleep was measured at home using wrist-worn actigraphy and questionnaires (PROMIS Sleep Disturbance and Sleep Related Impairment, self- and parent-reports). Mean PROMIS scores, prevalence of sleep problems (established by cut-off scores) and actigraphic outcomes were compared to norms (t-test, chi-square, linear regression). Risk factors were explored with multivariable linear regression models. ResultsSixty-nine children (68% male, mean age 11.6 ± 2.8 years, 53 ± 28 days after diagnosis) participated. Parents reported more child sleep disturbances (mean T = 53.7, P < .01) compared to norms. Rates of self- and parent-reported severe sleep disturbances were elevated (11% versus 5% in norms, P < .04). Parents also reported higher rates of moderate child sleep disturbance (31%) and sleep related impairment (42%) than norms (25%, P < .03). Actigraphy was comparable to healthy controls. Obstructive hydrocephalus was associated with longer sleep times (B=41.04, 95%CI 11.41;70.68) and shorter time since diagnosis with self-reported sleep disturbances (B=−.11, 95%CI −0.19;−0.03). ConclusionSleep problems are more frequently reported shortly after pediatric brain tumor diagnosis, compared to healthy controls. Attention for sleep around brain tumor diagnosis and impact of obstructive hydrocephalus is important, as sleep is vital for recovery and health-related quality of life.

The individual and combined associations of health behaviours with health-related quality of life amongst junior high school students in China.

This study aimed to investigate the individual and joint associations of sedentary behaviour, physical activity (PA), sleep and breakfast eating on health-related quality of life (HRQoL) amongst Chinese junior high school students. Data were from 783 junior high school students who participated in a health behaviour and health survey in Jining city of Shandong province of China. HRQoL was measured by the EuroQol five-dimensional questionnaire, youth version (EQ-5D-Y). Multivariable logistic and linear regressions were applied to examine the associations between health behaviours and HRQoL. Multivariable regression analyses showed that using a computer ≥ 2 h a day (vs. < 2 h/day) is associated with increased likelihood of having health problems in the three EQ-D-Y dimensions, including walking, looking after self and doing usual activities. Lower PA is associated with more problems in feeling worried, sad or unhappy, and with a lower visual analogue scale (VAS) score. Students who had insufficient sleep time (e.g., <7 h/day), and skipped eating breakfast were more likely to experience lower HRQoL in the dimensions of having pain or discomfort, and feeling worried, sad or unhappy, and a lower VAS score than those students who had longer sleep time and no breakfast skipping. Students who reported having the combined ≥ 2 unhealthy behaviours relative to the peers with 0-1 unhealthy behaviours were more likely to have lower HRQoL. The findings in the present study underline the importance of promoting healthy behaviours in order to improve HRQoL amongst Chinese junior high school students.

Effects of benzodiazepine receptor agonists on cognitive function in patients with chronic insomnia

AbstractBackgroundTo investigate the effects of benzodiazepine receptor agonists on cognitive function in patients with chronic insomnia.MethodAccording to the history of taking hypnotic drugs, they were divided into no medication group (n = 62), benzodiazepines group (n = 57) and non‐benzodiazepines group (n = 53); all subjects The Pittsburgh Sleep Quality Scale, the Epworth Scale, and the Insomnia Severity Index were used to evaluate their sleep quality, and the Hamilton Anxiety and Depression Scale to evaluate their anxiety and depression. The conversion test, the auditory word learning test was used to evaluate the memory function, and the Stroop color word test and the connection function test were used to evaluate the executive function.ResultCompared with no medication, the non‐benzodiazepine group and the benzodiazepine group had longer sleep time throughout the night (P&lt;0.05), and the non‐benzodiazepine group and the benzodiazepine group. The anxiety and depression scores of the drug group were lower than those of the non‐drug group (P&lt;0.05), and the immediate memory and delayed memory scores of the benzodiazepine group and the non‐drug group were lower than those of the non‐benzodiazepine group (P&lt;0.05). 0.05), the dose and duration of medication in the benzodiazepine group were negatively correlated with immediate memory (P&lt;0.05), and the duration of medication in the benzodiazepine group was negatively correlated with prolonged memory (P&lt;0.05). Regression analysis showed that the immediate memory score of taking benzodiazepines was 2.612 times lower than that of the non‐drug group, and the delayed memory score of taking non‐benzodiazepines was 1.439 times higher Regression analysis showed that the immediate memory score of taking benzodiazepines was 2.612 times lower than that of the non‐drug group, and the delayed memory score of taking non‐benzodiazepines was 1.439 times higher than that of the non‐drug group (P&lt;0.05). The difference is statistically significant.ConclusionBenzodiazepines increase the risk of impaired immediate memory function in patients with chronic insomnia, and non‐benzodiazepines can improve their delayed memory function.

0820 Integrated Polysomnographic and Sleep Symptom-Based Cluster Subtypes Associated with Incident Atrial Fibrillation

Abstract Introduction While sleep disorders are implicated in atrial fibrillation (AF), the interplay and overlap of these disorders in AF risk remains unclear and a risk stratification challenge. Sleep-based clusters associated with AF can account for this complexity and translate to actionable approaches to identify at-risk patients. We hypothesized discrete phenotypes of symptoms and polysomnography (PSG)-based data differ in relation to incident AF. Methods Cleveland Clinic patients (age&amp;gt;18) who underwent PSG 11/27/2004-12/30/2015 were retrospectively examined. Clusters were identified using latent class analysis of 23 symptoms (e.g. related to sleep disordered breathing (SDB), sleepiness, REM intrusion, NREM parasomnias), Epworth Sleepiness Scale (ESS) score, and 24 measures of SDB and sleep architecture from PSG reports. Outcome was 5-year incident AF. Cox-proportional hazards models were adjusted for age, sex, race, body mass index, cardiovascular disease and risk factors, tobacco use, chronic obstructive pulmonary disease, anti-arrhythmic medication use, and positive airway pressure use. Results The sample included 43,433 patients: age 51.8±14.5, 51.9% (n=22,548) male, 74.4% (n=32,313) White, 7.3% (n=3,151) with baseline AF, and 4.3% (n=1,875) developed 5-year incident AF. Five clusters were identified and ranked by strength of AF association: 1) Hypoxemic (n=3,245): highest %time SaO2&amp;lt; 90% (T90), 2) Apneas+Arousals (n=4,592): most witnessed apneas, highest apnea hypopnea index (AHI), highest arousal index, least hypopneas, 3) Short sleep+NREM (n=6,126): shortest sleep time, longest REM latency, lowest %REM, 4) Hypopneas (n=2,661): most hypopneas, 5) Long sleep+REM (n=26,809): longest sleep time, shortest REM latency, highest %REM. Compared to ‘Long sleep+REM’, ‘Hypoxemic’ had 47% higher AF risk (HR=1.47,95%CI=1.27-1.69), and ‘Hypopneas’ did not differ (HR=1.05,95%CI=0.86-1.28). Conclusion Of five clusters identified, the ‘Hypoxemic’ subtype conferred the strongest AF risk with the highest degree of hypoxemia (highest T90, lowest minimum and mean SaO2), maximum end-tidal CO2, heart rate, and ESS score. Consistent with prior evidence of hypoxemia as an AF driver and cardiovascular risk of the sleepy phenotype, this constellation of symptoms and physiologic alterations illustrates risk in the clinical setting, providing potential value as a risk prediction tool. Future investigation should focus on external validation of these findings. Support (if any) Cleveland Clinic Neurological Institute Center for Outcomes Research &amp; Evaluation Pilot Grant, Transformative Research Resource Development Award

Prevalence of Sedentary Behavior and Factors Associated with Screen Time among Thai Youths Aged 14–17 Years: A Cross- Sectional Population-Based Survey

Objective: To investigate the prevalence of sedentary behavior (SB) and factors associating with meeting the screen time guidelines among the Thai youth using a nationwide population-based survey. Material and Methods: Data from a national representative sample of 3,900 Thai youths aged 14–17 years old across the country were drawn from the Thailand Physical Activity Children Survey. SB was classified into screen time and sitting down activity. The youths were classified as meeting the screen time guidelines if they spent less than 120 min on screen time activities. A logistic regression analysis was conducted to examine the relationship between sociodemographic factors and meeting the screen time guidelines. Results: Overall, 33.7% of Thai youths were highly sedentary; only 30.5% of them met the screen time guidelines. Regarding screen time activity, the participants spent the highest amount of time using online social media; meanwhile, doing homework was the sitting down activity taking the greatest proportion of their time. The youths who were older and engaged in more screen time activities were significantly more likely to meet the screen time guidelines. Moreover, those who resided in regions other than Bangkok and had longer sleep times were significantly more likely to meet the screen time guidelines. Conclusion: The prevalence estimates of meeting the screen time guideline among the Thai youth were low. Age, geographical region of residence, number of engagements in screen time activities, and sleep time were associated with meeting the screen time guidelines. Our findings indicate that public health policies and interventions are needed to reduce SB among Thai youths; particular attention should be paid to the associating factors of SB.

A comparison of the efficacy and safety of natural orifice specimen extraction and conventional laparoscopic surgery in patients with sigmoid colon/high rectal cancer

This study aimed to investigate the efficacy and safety of natural orifice specimen extraction surgery (NOSES) compared to conventional laparoscopic radical resection in the treatment of patients with sigmoid colon/high rectal cancer. The control group (n = 62) underwent traditional laparoscopic radical resection, and the observation group (n = 62) underwent transanal NOSES laparoscopic radical resection. The operation length; amount of bleeding; number of lymph node dissections and days of hospitalization after surgery; visual pain scores on the first and third days after surgery; first leaving bed, anal exhaust, eating a liquid diet, and effective sleep times; and the postoperative complications (abdominal or incision infection or anastomotic fistula) of the two groups of patients were compared and analyzed. The effective sleep time of the observation group on the first day after the operation was 12.3 ± 2.9 h, which was longer than that of the control group (10.6 ± 3.2 h), and the difference was statistically significant (p < 0.001). The pain degree of the two groups on the third day after the operation was lower than that on the first day, and the pain score of the observation group was lower than that of the control group (2.0 ± 1.0 vs. 3.2 ± 1.2, p < 0.001). The postoperative hospital stay in the observation group was significantly shorter than that in the control group (9.7 ± 2.3 vs. 11.2 ± 2.6, p < 0.001). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (3.2% vs. 12.9%, p = 0.048). In addition, it was found that the first leaving bed, anal exhaust and liquid diet times in the observation group were significantly shorter than those in the control group (p < 0.001). Laparoscopic radical resection NOSES in patients with sigmoid colon cancer or high rectal cancer leads to lower postoperative pain and longer sleep time than in patients who undergo traditional laparoscopic radical surgery. The complication rate of this procedure is low, and the curative effect is safe and positive.

SLEEP, COGNITION, AND BRAIN FUNCTION IN OLDER ADULTS WITH CHRONIC KIDNEY DISEASE AND MILD COGNITIVE IMPAIRMENT

Abstract Older adults with chronic kidney disease (CKD) are at risk for cognitive impairment and commonly report sleep disturbances. The association between sleep and brain function remains unclear. This cross-sectional study investigated the relationship between sleep, cognition, and brain function in older adults with CKD and mild cognitive impairment (MCI). Older adults with CKD and MCI (n=37, age=68 + 4.93, eGFR=43.7 + 10.98, 73%=Black, 70%=Female), were evaluated via a comprehensive cognitive function battery and brain MR-imaging. Seven-day actigraphy was scored utilizing the Cole-Kripke algorithm to evaluate sleep quality and duration. Ordinary least square regression controlling for age and education quality indicated that &amp;gt;9 hours of sleep, as compared to &amp;lt; 7 hours of sleep, was associated with worse executive function (unstandardized beta=-6.86, 95% CI:-13.19, -0.53, p=.04). Less sleep (&amp;lt; 8 hours) was associated with better learning/memory (unstandardized beta=2.61, 95% CI: 0.84, 4.38, p=.01). Better sleep efficiency was associated with increased global cerebral blood flow (unstandardized beta=3.30, 95% CI: 0.65, 5.95, p=.02). Longer sleep time (&amp;gt;9 hours), as compared to shorter sleep time (&amp;lt; 7 hours), was associated with worse mean diffusivity (unstandardized beta=0.12, 95% CI: 0.03, 0.20, p=.01). Shorter sleep time (&amp;lt; 8 hours, compared to &amp;gt;=8 hours) was associated with better fractional anisotropy of the cingulum (unstandardized beta=0.03, 95% CI: 0.01, 0.05, p=&amp;lt;.001). Sleep duration and quality may be related to cognition and brain function in older adults with CKD and MCI providing a possible avenue for interventions to improve cognitive outcomes in this population.

372 Selecting Goats for Juniper Consumption Increases Pentobarbital-Induced Sleep Time

Abstract A sodium pentobarbital-induced sleep time (ST) study was conducted on intact males, Boer x Spanish goats (n = 30), selected for high (J+) or low juniper (J-) consumption with the objective to compare the Phase I detoxification system of the genetic divergent lines (EBV of 13.1 ± 0.2 and -14.2 ± 0.3, respectively). The ST study was conducted following a minimum period of 21 days on three different diets: grazing juniper infested rangeland (JIR), forage diet with no monoterpenes (M0), and forage diet with 8 g/kg added camphor, sabinene, and α-pinene monoterpenes in a ratio of 5:4:1 (M+). Fecal samples from goats on the JIR and M+ diets were analyzed for camphor and sabinene, and, when on the JIR diet, analyzed for percentage juniper in the diet using previously developed NIRS calibrations. Data were submitted to ANOVA analysis with repeated measures, assuming as significant when alpha was less than 10% (P &amp;lt; 0.10) by the F test. Percentage of juniper in the diet of J+ goats on JIP (38.6 ± 3.4%) was greater (P &amp;lt; 0.001) than J- goats (28.0 ± 3.8%). The J+ goats slept 15.1 (P = 0.02), 14.3 (P = 0.06), and 15.8 (P = 0.06) minutes longer than J- goats on JIR, M0, and M+ diets, respectively. There was no difference in ST between diets, and there was no interaction line × diet. Goats from the J+ line had higher concentrations of camphor in their feces on the JIR (P = 0.07) and M+ (P = 0.09) diets, while sabinene concentration was similar. Goats selected for juniper consumption had longer ST than J- goats which indicates a less efficient Phase I detoxification system, probably because there were less monoterpenes in the blood to be metabolized in the liver by the cytochromes P450 enzymes.

Consequences of Preoperative Oral Carbohydrate Consumption in Septal Deviation Patients Undergoing Endoscopic Septoplasty: A Retrospective Cohort Study

Multiple reports have demonstrated the benefits of preoperative oral carbohydrates (CHO) in patients receiving open abdominal, thoracic, and orthopedic surgeries. However, thus far, no reports have investigated the benefits of CHO in patients undergoing nasal endoscopic surgery. Our goal was to evaluate the outcome of preoperative oral of administration of CHO in septal deviation patients, undergoing endoscopic septoplasty, under general anesthesia. A retrospective cohort study from a prospectively collected database. Consecutive 400 septal deviation patients, undergoing endoscopic septoplasty, were randomly assigned to receive CHO or plain water (80 CHO cohort vs. 320 control cohort) before general anesthesia. The primary outcome was the risk of acute postoperative hypertension (APH). The secondary outcomes included length of hospital stay (LOS), hospitalization cost, sleep time the day before surgery, fluid infusion volume on surgical day, as well the incidence of postoperative nausea and vomiting (PONV) and aspiration. Patients in the CHO cohort experienced a lower risk of both diastolic blood pressure (DBP)-based APH (OR, 0.49; 95% CI, 0.25 to 0.96; P = 0.0375) and total APH (OR, 0.49; 95% CI, 0.26 to 0.92; P = 0.0258), lower LOS, lower hospitalization cost, longer sleep time and less fluid infusion volume after adjusting for gender, age, BMI, preoperative blood pressure and pulse. Besides, data showed no significant differences in the incidence of (P = 0.4173) and aspiration (P > 0.99). Preoperative CHO administration can reduce APH risk in patients undergoing endoscopic septoplasty under general anesthesia. Besides, preoperative CHO administration can improve other clinical outcomes, such as, LOS, hospitalization cost, sleep time, and fluid infusion volume. Moreover, CHO safety was confirmed in our study. In the future, additional investigation is necessary to confirm our results.

The Impact of Sleep Pattern in School/Work Performance During the COVID-19 Home Quarantine in Patients With Narcolepsy.

ObjectivesNarcolepsy patients were observed improvements in their academic performance during the COVID-19 home quarantine. Therefore, we aim to investigate the influence of sleep behavioral changes on school/work performance in narcolepsy patients during the home quarantine.MethodsPatients admitted to Shandong Provincial Qianfoshan Hospital from Jan 1, 2017 to Jan 1, 2021 who were diagnosed with narcolepsy were studied by online questionnaires in two different periods (during and 1 year after the COVID-19 home quarantine), including five aspects: (1) changes in school/work performance (percentile ranking in class/Sheehan Disability Scale 1, SDS1); (2) daytime functions; (3) clinical symptoms; (4) psychological moods; (5) medication situations.ResultsA total of 46 narcolepsy patients 34 (73.9%) narcolepsy type 1, 12 (26.1%) narcolepsy type 2 with average age of 20.76 ± 8.99 years and an equal number of age and gender matched control subjects were enrolled. During the COVID-19 home quarantine, the narcolepsy patients were found that they altered sleep patterns, including later get up time (P < 0.001), longer total sleep time (TST, P = 0.001), better sleep quality (PSQI, P = 0.001), and lower anxiety level (P = 0.005). Their school/work performance improved parallelly [with better percentile ranking (P = 0.001) and lower SDS1 scores (P = 0.002)]. The results of multiple linear stepwise regression analysis showed a linear regression relationship between TST [efficient (95%) −7.356 (−13.570 to 1.143)], SDS1 score [efficient (95%) 6.580 (2.346–10.815), P = 0.004] and the percentile ranking after adjusting for potential effects. Both the improvements of sleep behavior and school/work performance disappeared after the end of COVID-19 home quarantine. No similar fluctuation was found in the control group.DiscussionChanges in sleep pattern during the COVID-19 home quarantine, such as longer sleep time and later wake-up time, can reduce the degree of daytime sleepiness and increase the degree of daytime wakefulness of narcolepsy patients, which can alleviate the impact of the disease on school/work performance.

Fatigue after neurosurgery in patients with a brain tumor: The role of autonomic dysregulation and disturbed sleep

BackgroundFatigue is prevalent in patients with a brain tumor and high levels of fatigue persist after neurosurgical tumor resection. The underlying mechanisms are insufficiently understood and this study examines the role of autonomic nervous system dysregulation and objective sleep characteristics in fatigue among post-surgical patients.MethodsPatients undergoing craniotomy (N = 52; age 52.1 ± 15.0 years; 44% women) were evaluated at 3 months after surgery (median = 86 days). Fatigue was measured using the Multidimensional Fatigue Inventory. Autonomic nervous system indices were based on 24-h heart rate variability (HRV) analysis. Sleep parameters were measured using actigraphy: total sleep duration, efficiency, onset latency and wake after sleep onset (WASO). Data analyses of this cross-sectional study included correlation and multiple regression analysis.ResultsFatigue scores were significantly elevated in tumor resection patients compared to healthy reference norms (p's < 0.05) with no differences between patients with glioma (N = 32) versus meningioma (N = 20). Associations between HRV indices and fatigue were non-significant (r values <0.16, p values > 0.25). Sleep duration was associated with physical fatigue (r = 0.35, p = 0.02), whereas WASO was associated with mental fatigue levels (r = 0.40, p = 0.006). Disturbed sleep measures were associated with HRV indices of reduced parasympathetic nervous system activity in glioma patients but not in meningioma patients.ConclusionsMultiple nocturnal awakenings may result in mental fatigue and longer sleep time was associated with physical fatigue, which may reflect compensatory sleep patterns. Future intervention studies addressing sleep quality may be beneficial in treating fatigue in patients following neurosurgery for tumor resection.

Dampak Situasi Pandemi COVID-19 terhadap Tumbuh Kembang Anak

This study aims to determine the impact of the COVID-19 pandemic situation on children's growth and development. The method used is a systematic study examining 11 articles related to the effects of the COVID-19 pandemic on children's growth and development using ProQuest, CINAHL, Wiley, PubMed and ScienceDirect. The results showed that the COVID-19 pandemic had an impact on children's growth, social development of children's independence, language, fine motor skills, and gross motor skills. In conclusion, the destructive effects experienced by children while at home are stress, no opportunity to play with friends, reduced activity, weight gain, longer sleep time, increased sitting time and increased screen time. The good impact of this pandemic on individual children is that there is a positive adaptation to the process of growth and development through the maturation process and the social bonding of children and parents becomes closer.&#x0D; Keywords: Children, Parents, COVID-19 Pandemic, Stimulation of Growth

Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia.

To assess the impact of coronavirus disease 2019 (COVID-19)-related restrictions on narcolepsy type 1 (NT2), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH). Participants with NT1, NT2, and IH followed in a university hospital completed an online 78-question survey assessing demographic, clinical, and occupational features of the population during the first COVID-19-related lockdown. A total of 219 of 851 (25.7%) respondents of the survey reported a mean increase of 1.2 ± 1.9 hours (P < .001) in night sleep time and a mean decrease of 1.0 ± 3.4 points (P < .001) on the Epworth Sleepiness Scale during lockdown. Bedtime was delayed by 46.1% of participants and wakeup time was delayed by 59.6%, driven primarily by participants with IH. Teleworkers (but not in-person workers) reported a mean increase of 0.9 ± 1.2 hours in night sleep (P < .001) and a mean decrease in sleepiness score of 1.6 ± 3.1 (P < .001). Cataplexy improved in 54.1% of participants with NT1. Sleepiness correlated with psychological wellness (r = .3, P < .001). As many as 42.5% enjoyed the lockdown, thanks to reallocation of time usually spent commuting toward longer sleep time, hobbies, and family time, and appreciated a freer napping schedule. Conversely, 13.2% disliked the lockdown, feeling isolation and psychological distress. Extended sleep time, circadian delay (in patients with IH), and teleworking resulted in decreased symptoms of central hypersomnias. These findings suggest that people with IH, NT1, and NT2 may benefit from a decrease in social and professional constraints on sleep-wake habits, and support advocacy efforts aimed at facilitating workplace and schedule accommodations for this population. Nigam M, Hippolyte A, Dodet P, etal. Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia. J Clin Sleep Med. 2022;18(1):255-263.

Association between sleep duration and mild cognitive impairment in people aged 55 and above in 4 provinces of China

Objective To explore the association between sleep duration and mild cognitive impairment(MCI) in people aged 55 and above in 4 provinces of China. Methods A stratified multi-stage cluster random sampling method was adopted. From May to August 2018 in 32 survey districts and counties in 4 provinces of Hebei, Zhejiang, Shaanxi, and Hunan, 5334 55-year-old and older persons who met the inclusion criteria were randomly selected. Among them, there were 2362 males and 2972 females, with an average age of(67. 43±7. 48) years. A questionnaire survey was conducted to collect their basic information, lifestyle, disease history, sleep duration, etc. MCI were screened based on the Montreal cognitive assessment(MoCA). Multivariate Logistic regression was used to analyze the association between sleep duration and MCI. Results 16. 76% of them slept for less than 7. 0 hours, 19. 10% of the middle-aged and elderly people slept for 9 hours or more, and 36. 24% of them were found to be MCI. After adjusted the area, age, gender, education level, work status, family monthly income per capita, smoking, drinking, physical activity, meditation time, depression, hypertension, diabetes, myocardial infarction and stroke, the result of multivariate Logistic regression analysis shown that, compared with 7. 0-7. 9 hours of sleep, the risk of MCI among middle-aged and elderly people over 55 years old with l6. 0 hours and 8. 0-8. 9 hours of sleep were 1. 417 times(95%CI 1. 012-1. 984)and 1. 191 times(95%CI 1. 001-1. 418)of the former, respectively, and the differences were statistically significant(Pl0. 05). The risk of men suffering from MCI for sleep duration l6. 0 hours was 2. 083 times(95%CI 1. 145-3. 789)that of the former, and the risk of women suffering from MCI for sleep duration ≥ 9. 0 hours was 1. 741 times(95%CI 1. 301-2. 331)that of MCI. The differences are statistically significant(Pl0. 05). Conclusion Shorter or longer sleep time is an important factor independently related to MCI. Insufficient sleep in men and longer sleep time in women can increase the risk of MCI.

Sleep Bruxism Episodes in Patients with Obstructive Sleep Apnea Syndrome Determined by In-Laboratory Polysomnography

Findings on sleep bruxism (SB) in patients with obstructive sleep apnea syndrome (OSAS) are controversial, and some of these findings have relied on in-laboratory polysomnography (PSG). We aimed to identify the factors associated with SB episodes in 100 patients with OSAS using in-laboratory PSG records. Subjects with OSAS were divided into those with and without SB episodes. We analyzed the differences in patient characteristics and PSG indices. Age, gender, height, weight, body mass index, neck, waist, and hip circumferences, and the rates of hypertension and diabetes mellitus were not significantly different between the two groups. A greater proportion of stage N2 sleep in the total sleep time, longer total sleep time, longer sleep time in a supine position, shorter sleep time in a nonsupine position, lower apnea–hypopnea index (AHI), lower AHI regardless of sleeping position, lower AHI during nonrapid eye movement sleep, and higher mean oxygen saturation level were associated with SB episodes in patients with OSAS. Among these factors, longer sleep time in a supine position remained a statistically significant factor in multivariate analysis. We conclude that longer sleep time in a supine position (especially &gt;280 min) might be associated with SB episodes in patients with OSAS.

Adolescent football players’ sleep, wellness and school physical activity over different phases of the year

This study aimed to examine differences in sleep and perceived wellness between a group of adolescent academy football (soccer) players from sport high schools (SHS) and regular high schools (RHS) during different phases of the year, with a secondary focus on their school physical activity (s-PA) levels. Data were collected from 51 adolescent football players from one youth Australian academy in two blocks of two weeks (four weeks total). Subjective sleep quantity and quality, wellness and s-PA were assessed through validated daily questionnaires and weekly surveys. MANOVAs and ANOVAs for repeated measures were conducted to assess sleep and wellness variables across different weeks (school vs. holidays, early vs. late season) and between groups (SHS vs. RHS). No differences in sleep or muscle pain were found between players at SHS and RHS (p &gt; 0.05). No effect of week (school vs. holidays, early season vs. late season) on sleep quality or wellness was found, nor did hours of s-PA affect sleep duration (all p &gt; 0.05). Total sleep time was within recommended guidelines and significantly longer sleep times were experienced during the holidays compared to school term (p = 0.002). Overall, adolescent academy football players reported sleep quantities within recommended ranges and had greater sleep volumes during the holidays rather than during school. School type (SHS vs. RHS) and hours of s-PA had no effect on the players sleep within our cohort. Additionally, it appears perceptual wellness in this population is unaffected by time of season, or school compared to holidays.

The effects of COVID-19 stay-at-home order on sleep, health, and working patterns: a survey study of US health care workers.

By March 2020, COVID-19 forced much of the world to stay at home to reduce the spread of the disease. Whereas some health care workers transitioned to working from home, many continued to report to work in person as essential employees. We sought to explore changes in sleep, health, work, and mood in health care workers during the stay-at-home orders. We developed a cross-sectional online survey administered to health care workers. The survey assessed changes in sleep, work, screen time, media exposure, diet, exercise, substance use, and mood. The survey data were collected between March 28, 2020, and April 29, 2020. A total of 834 of 936 individuals completed the entire survey. Respondents were from 41 US states. Mood after the stay-at-home orders worsened, and screen time and substance use increased. Total sleep time shortened in those continuing to work in person (P < .001), whereas it was unchanged in those working from home (P = .73). Those working from home went to bed later, woke up later, and worked fewer hours. Reduced total sleep time and increased screen time before bed were associated with worse mood and screen time. Longer sleep time was associated with better mood. Health care workers' mood worsened regardless of whether work was in person or remote, although total sleep time was shorter for those working in person. Those working from home may have shifted their sleep time to be more in line with their endogenous circadian phase. Peer or other support services may be indicated to address sleep, mood, and health behaviors among health care workers during these unprecedented times.

The Effects of Intensity of Physical Activity on Mental Health

Modern, complicated society has brought various stressors, and consequentially, more and more people are suffering from mental health problems. The purpose of this study is to investigate the effects of physical activity at different intensities (high, moderate and low) on mental health-related factors (self-rated health, stress, sleep time, and depression). The raw data of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. Data of 1,622 samples were extracted for analysis regarding self-rated health, stress, sleep time, and depression in adults aged over 20 years who participated in physical activity. The collected data were analyzed using SPSS 18.0. The differences between the groups were verified through the analysis of variance and post-hoc analysis. All statistical significance levels were set at .05. There were statistically significant differences in self-rated health status, sleep time, and depression between intensities of physical activity (p &lt; .05). Specifically, the self-rated health status and depressive moods present the lowest score in the high-intensity physical activity group among 3 groups. The moderate-intensity of physical activity group showed the longest sleep time. In conclusion, it is necessary to pay attention to the selecting appropriate intensity of physical activity to manage mental health.