Proper Sleep Research Articles

Improved Localized Sleep Scheduling Techniques to Prolong WSN Lifetime

A standard Wireless Sensor Networks(WSNs) comprises of low-cost sensor nodes embedded with small batteries. To enhance the network lifetime of WSN, the number of active nodes among the deployed nodes should be minimum. Along with this, it must be ensured that coverage of the targeted area would not get affected by the currently active nodes. Considering different applications of WSN, there is still a demand for full coverage or partial coverage of the deployed area. Irrespective of the circumstances, a proper sleep scheduling algorithm needs to be followed. Else, the active nodes will be tuckered out of the battery. Random distribution of the sensor nodes in a common area may have multiple active nodes. It is essential to identify the redundant number of active nodes and put them into sleep to conserve energy. This paper has proposed a methodology where the active sensor nodes form a hierarchical structure that heals itself by following a level-wise approach. In the meantime, it also detects the total number of redundant nodes in the coverage area. The performance of the proposed protocol is evaluated using the Castalia simulator. The simulation results show that the proposed level-wise periodic tree construction approach increases the network's durability in conjunction with the level wise approach.

Insights into the real-life experiences of people living with epilepsy: A qualitative netnographic study

A qualitative netnographic study of epilepsy conversations posted on public social media sites over a 12-month period was conducted in order to identify key themes and issues for people living with epilepsy (PWE). A total of 264,706 conversations posted online between 03 November 2018 and 03 November 2019, which had originated in the UK, Spain, France, Italy, and Germany, were identified using pre-defined and piloted search terms. A random sample of these posts was then analyzed using natural language processing, and qualitative in-depth and contextual analysis. Key themes that emerged related to: disease awareness among the general public; the psychological and physical impact of seizures; the importance of ensuring proper sleep; understanding disease burden through time; finding treatment and managing side effects; and dealing with depression and anxiety. People living with epilepsy highlighted that seizures have a significant impact on mental as well as physical health and can cause limitations to all aspects of life. Fear of having a seizure in public is a major concern for PWE and the anticipation of seizures can worsen anxiety, causing patients to limit social interaction and often leading to social isolation, which may further exacerbate anxiety and depression. People living with epilepsy therefore advocate that greater attention be paid to the mental health impact of epilepsy. Treatment and its side effects were also a major aspect of the online conversation of PWE. Some PWE believe there is a lack of awareness or sensitivity among healthcare professionals, who may underestimate their concerns or not take sufficient time to discuss their needs. These findings therefore help sign-post issues of importance to PWE and areas in which their care may be improved.

THERAPEUTIC ACTION OF HINGU IN RESPIRATORY SYSTEM: A LITERARY REVIEW

Man has been struggling to get remedies for various life-threatening disorders which are common in the day to day life of the busy world. Many lifestyle disorders such as diabetes mellitus, hypertension, dyslipidemia, thyroid dysfunction, respiratory disorders, skin diseases, etc. arise due to incompatible diet, polluted atmosphere, sedentary life style, lack of exercise, lack of proper sleep, etc. Ayurveda, the science of life, advices to follow Dinacharya, Ritucharya, Sadvritta etc for the benefit of the common man to enhance longevity. Ayurveda utilizes the wide range of herbal drugs either as single drug or in combination for the purpose of health care remedies. The phyto constituents present in these drugs play the major role in treating the diseases. Ferula foetida, known as Hingu in Ayurveda has promising therapeutic value due to the presence of chemical constituents like sulphide derivatives, volatile oil etc. Many studies revealed the various pharmacological actions of Hingu such as carminative, antispasmodic, antimicrobial, antioxidant, etc. This review highlights the available information on the drug Hingu by due consideration to the action of Hingu on the respiratory system and the formulations with Hingu as an ingredient as available in the Ayurvedic texts in treating respiratory disorders. Some other aspects are also discussed in the review.

Lifestyle behavior of patients with noncommunicable diseases during COVID-19 pandemic: An observational study

CONTEXT: Coronavirus disease (COVID-19) poses an unprecedented challenge and adversely affects the lifestyle of people with noncommunicable diseases (NCDs) due to enforced restrictions by the governments. AIMS: The study aimed to assess the physical activity and prophylactic behavior, along with change in sleep, alcohol intake, and tobacco consumption during the enforced lockdown. MATERIALS AND METHODS: The study was conducted in August 2020 and recruited NCD patients visiting the institute's outpatient department. Questions were formed on prophylactic behavior, changes in sleep, and alcohol and tobacco consumption along with a validated scale of International Physical Activity Questionnaire (IPAQ) Short Form. RESULTS: The study recruited 413 patients with a mean age of 54.34 years. The median IPAQ score was 536 metabolic equivalent task-minutes/week, with 41.96% of the patients demonstrating low physical activity. A statistically significant difference between the IPAQ scores was found among different NCD groups (P = 0.009). There was a statistically significant decrease in number of hours of sleep during the pandemic as compared to before the pandemic (P = 0.000). Furthermore, there was a significant change in tobacco consumption (P = 0.000) and alcohol consumption (P = 0.000) during the pandemic. The patients followed preventive practices to a larger extent. CONCLUSION: The study highlighted that the NCD patients should follow an optimal physical activity schedule, take proper sleep, and continue following prophylactic behavior.

Lifestyle interventions for healthy brain aging: A protocol for systematic review and meta‐analysis

AbstractBackgroundThe main objective of the present protocol is to assess the lifestyle interventions (eating habits, physical exercise, social and cultural participation) on the brain health as people age.MethodsWe will look at the following database sources, “The Cochrane Library, PubMed, EMBASE, Web of Science, and Google Scholar,” for this protocol, which is standardized by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Protocols. Only Alzheimer's disease (AD) patients will be eligible, and no restriction will be placed on participant's gender, age, education, ethnicity, or other demographic characteristics. All the studies based on the impact of active intervention centered on lifestyle interventions, including eating habits, sleep patterns, and physical exercise on the cognitive and functional status in the elderly populations. The primary outcome is the effects of nutrition and lifestyle interventions on the patients with AD, and secondary outcomes include body mass index, body fat percentage, and muscle mass.ResultsIn this study, we hope to find lifestyle interventions, which could have a preventive effect on brain health as people age, in particular AD.ConclusionThe conclusion of our study would suggest that a healthy lifestyle interventions, defined on the basis of proper nutrition, sleep patterns, physical exercise, and social and cultural activities, can positively influence the cognitive consequences of healthy brain aging.

Effect of Certain Dinacharya Measures and Dietary Practices on Quality of Life of Elderly: A Cross Sectional Survey Study

Old age is sensitive period of life that needs extra care, so as to manage many of age related disorders that affect the quality of life of an elderly. As per Ayurveda, Ageing is a natural phenomenon. To achieve the goal of maintaining the health, Dinacharya (daily regimen), which includes certain measures like body massage, head and feet massage, incorporation of milk and ghee in diet due to their rejuvenating effect and many more simple and effective modes. Aims: To assess the effect of certain Dinacharya (daily regimen) and dietary practices on quality of life of elderly Methodology: Cross sectional survey of 100 elderly in age group 60-90yrs residing in and around Delhi NCR was conducted. The data was collected with the help of specially designed questionnaire about practices of daily regimens and EQ-5D-5L questionnaire to assess quality of life. Observations and Results: The study shows that 72 % subjects had poor to average score with respect to EQ 5D scale. Regular adoption of daily regimen in the form of exercise (36 % subjects), intake of milk (46 % subjects) Intake of ghee (13 % subjects), proper sleep (85 % subjects) and body massage with oil (39 % subjects) and head massage with oil (39 % subjects) is moderate. Conclusion: Old age being a vulnerable period of life, healthy regimen should be adopted as early as possible to experience less morbidity during old age. Extensive adaptation of daily regimen as mentioned in Ayurveda is needed to reduce the health care burden causes due to geriatric dependency.

Adolescent Sleep Problems and Susceptibility to Peer Influence

Susceptibility to peer influence among adolescents is associated with a variety of negative interpersonal and psychosocial outcomes. Although proper sleep is crucial for adolescent development and well-being, no study to date has examined the influence of sleep problems on susceptibility to peer influence. We assess this relationship using two waves of data ( n = 907; 50% male, 18% non-White) from the Study of Early Child Care and Youth Development (SECCYD). Results of a series of multivariate regression models demonstrate that sleep problems are positively associated with susceptibility to peer influence, net of pertinent demographic characteristics, theoretical controls, and prior susceptibility to peer influence. These findings suggest that efforts to improve sleep quality and quantity among adolescents, including educational sleep hygiene programs and later school start times, may serve to curtail susceptibility to peer influence and improve various aspects of wellbeing.

Neurocognitive Effects of Sleep Disruption in Children and Adolescents.

A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.

Association of Insufficient or Excess Sleep with Type 2 Diabetes Mellitus in the Presence of Periodontitis.

We aimed to investigate the effects of sleep duration on impaired fasting glucose and diabetes in Korean adults with periodontal disease. This cross-sectional study was performed using data for 10,465 subjects aged >19 years who completed the periodontal examination and questionnaires in the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The effect of sleep was confirmed by a complex-sample multinomial logistic regression analysis. Confounding variables were age, sex, household income, education level, smoking status, and sleep duration. Of all participants, 25.7% had periodontitis, of which 28.6% had fasting serum glucose disorder and 14.2% had diabetes. Among participants with periodontitis, the prevalence of diabetes was 1.49 times higher in participants with an average sleep duration of ≥8 h than those with an average sleep duration of 6–7 h. The prevalence of diabetes among participants without periodontitis was 1.49 times and 1.57 times higher in participants with an average sleep duration of ≤5 and ≥8 h, respectively, than those with an average sleep duration of 6–7 h. We found that altered sleep duration may be a risk factor for diabetes and that proper sleep duration is important to control diabetes incidence.

Adaptive pursuit learning for energy‐efficient target coverage in wireless sensor networks

SummaryWith the proliferation of technologies such as wireless sensor networks (WSNs) and the Internet of things (IoT), we are moving towards the era of automation without any human intervention. Sensors are the principal components of the WSNs that bring the idea of IoT into reality. Over the last decade, WSNs are being used in many application fields such as target coverage, battlefield surveillance, home security, health care monitoring, and so on. However, the energy efficiency of the sensor nodes in WSN remains a challenging issue due to the use of a small battery. Moreover, replacing the batteries of the sensor nodes deployed in a hostile environment frequently is not a feasible option. Therefore, intelligent scheduling of the sensor nodes for optimizing its energy‐efficient operation and thereby extending the life‐time of WSN has received a lot of research attention lately. In particular, this article investigates extending the lifetime of the WSN in the context of target coverage problems. To tackle this problem, we propose a scheduling technique for WSN based on a novel concept within the theory of learning automata (LA) called pursuit LA. Each sensor node in the WSN is equipped with an LA so that it can autonomously select its proper state, that is, either sleep or active, with an aim to cover all targets with the lowest energy cost possible. Our comprehensive experimental testing of the proposed algorithm not only verifies the efficiency of our algorithm, but it also demonstrates its ability to yield a near‐optimal solution. The results are promising, given the low computational footprint of the algorithm.

Association of screen time and sleep duration among Spanish 1-14 years old children.

Due to the change in screen time usage in the last decade, there is needed to add more evidence about the relationship of screen time and sleep duration. To assess the association between screen time and sleep duration among Spanish children between 1 and 14years old. We used data from the 2017 Spanish National Health survey, conducted on a representative sample of the Spanish population. We categorised daily leisure screen time as 0-59, 60-119, 120-179, and ≥180minutes. We classified sleep duration, depending on the age, as proper sleep duration and short sleep duration. We calculated unadjusted, and adjusted prevalence ratio (PR) and 95% confidence interval (CI) of short sleep duration according to daily leisure screen time after adjusting for potential confounders. PR's were derived from fitting generalised linear models with Poisson distribution and robust variance. Of the 5517 Spanish children aged 1-14years, 44.3% spent 120minutes or more of daily leisure screen time and 23.6% had short sleep duration. 24.5% and 28.2% of children spending between 120 and 179minutes and exceeding 180minutes of daily leisure screen time suffered short sleep duration, respectively. In the adjusted model, higher patterns of daily leisure screen time were associated with short sleep duration: adjusted PR120-179 =1.34 (95% CI 1.18, 1.54) and adjusted PR≥180 =1.48 (95% CI 1.27, 1.73). Around one out of four Spanish children between 1 and 14years old, exceeding 120minutes of daily leisure screen time, had short sleep duration. More scientific research is needed for institutions to work on providing novel healthcare programmes that consider these new determinants of child health.

Nomadicating the Index of Sleep and wakefulness from the Pyramid Creating and Maintaining the Health of Islamic Islamism

Introduction: The present study entitled Nomadicating of the sleep and wakefulness index from the source of the creating and maintaining of the health of Islamic baring has been done using a qualitative analytical-descriptive research method based on library studies. Unfortunately, the results indicated that despite the precise and expansive attention that the verses and recommendations of the great elites have emphasized on the importance of the well-being of the soul in the creating and maintaining of the health, and the scientific and practical solutions attributed to this, most of this material is neglected. Most people and every day diseases and clinical interventions are at the level of quality and life expectancy of human beings. However, the results of this study suggest that new scientific findings, as needed, should address issues related to sleep and behavior, including forbidden sleep time, places where prohibition of sleeping, proper sleep, sensitive hours, wakefulness, and effects of the mental and psychological state of people from the above mentioned nature in these situations, as well as the rituals before going to bed, waking up and recovering properly from the bed in order to minimize the sudden increase in blood pressure and its links with people's mood, the amount of sleep and the permission or unauthorized sleep during the day, etc. In this research, the answers of many people in this regard were provided.

Management Of Diet During Covid-19 Pandemic

The COVID-19 is causing many changes in the daily lives of people around the world, but some things can be done to maintain a healthy lifestyle in these difficult times by taking a proper diet during COVID pandemic. It is difficult to follow any of the physical activities during the lockdown period, as successfully as before. This inertia may lead to indigestion and related health issues. The proper diet planning is an utmost aspect which includes the food habits, nutrition, wholesome diet, low calory diet healthy diet, Easily digested diet and the schedule of food. Dietary measures include various things like the type of diet, time to consume, the interval between two food, intake of food, nutrition values, proper calory intake. āyurveda prescribes food regime as a part of the treatment. The crucial concept of āyurveda regarding the type of diet is in the form of sattvic, rajasic and tāmasik food that helps a person maintain the physical equilibrium to sustain and manage good health in critical conditions like COVID-19. Sleep is an essential component of healthy living. There is a strong relationship between the gut and the mind. Proper sleep is vital to digest the food and enhances immunity in the lockdown period. Scheduling of the diet and its management plays a significant role in good health. Thus, administration of diet is the leading factor during COVID-19 pandemic.

In Response.

Thank you for the opportunity to respond to the letter by Dr Subedi1 wherein he has raised some very important points about managing the coronavirus disease 2019 (COVID-19) pandemic when working in a low-resource environment. It seems that Nepal has been very effective in coping with the pandemic thus far. Nevertheless, as in other countries, there are huge stresses placed on all health care workers (HCWs), both physically and mentally. As he says, governments need to recognize them for their commitment and loyalty to their patients. Certainly, the general populations in many countries have done so as evidenced by the singing (Italy), playing of musical instruments (Spain), and even banging of pots and pans (United States and Canada). But HCW, and others maintaining systems during the crisis, need more than that. He outlines some of the important things, such as proper sleep, food, and connections with loved ones. We could add others such as peer support and professional support when necessary. National and international anesthesia societies have also addressed this issue2,3 as have publications in journals such as Anesthesia & Analgesia.4 Another interesting point raised by Dr Subedi1 is that of the role of private hospitals versus public during the pandemic. Each country will have come to its own solution on this problem. He cites South Korea as being an example of excellent coordination between the 2 sectors. The Republic of Ireland chose a different route which certainly gained public support5 but was not without its challenges.6 In low-income countries, private hospitals may be much better equipped than public hospitals; in such cases, governments will need to negotiate with them as to how they may best serve their nation’s needs. Finally, there is the issue of inadequate supplies of personal protective equipment (PPE). This has been a problem almost everywhere but nowhere more so than in low-resource environments. Governments have rapidly reduced barriers to local production. Companies have been very creative but still the deficit exists. Much has been written about how to extend the life of PPE.7,8 Use of proper PPE is essential in protecting HCWs everywhere but especially in countries where they are a scarce commodity to be treasured and safeguarded. As noted in our article,9 the loss of HCWs after an epidemic can be substantial and can have long-lasting effects on the health care systems they serve. The pandemic of COVID-19 is challenging governments, health care systems, and HCWs as never before. We need to support each other as we find our way through this. It seems that the old advice of Semmelweis to wash our hands frequently and the new advice of public health to work together by staying apart will serve us all well. Choon-Looi Bong, MBChB, FRCADuke-National University of Singapore (NUS) Medical SchoolSingaporeYong Loo Lin School of MedicineSingaporeDepartment of Paediatric AnaesthesiaKK Women’s and Children’s HospitalSingapore Christopher Brasher, MBBS, FANZCAUniversity of MelbourneMelbourne, Victoria, AustraliaDepartment of Anaesthesia and Pain ManagementRoyal Children’s HospitalMelbourne, Victoria, Australia Edson Chikumba, MBChB, MMed (Anaesthesia)Department of Anaesthesia and Critical Care MedicineCollege of Health SciencesUniversity of ZimbabweHarare, Zimbabwe Robert McDougall, MBBS, FANZCAUniversity of MelbourneMelbourne, Victoria, AustraliaDepartment of Anaesthesia and Pain ManagementRoyal Children’s HospitalMelbourne, Victoria, Australia Jannicke Mellin-Olsen, MD, DPHWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomBaerum HospitalOslo, Norway Angela Enright, MBBCh BAO, FRCPCDepartment of AnesthesiaUniversity of British ColumbiaRoyal Jubilee HospitalVancouver, British Columbia, Canada[email protected]

CONCEPTUAL STUDY OF SIGNIFICANCE OF NIDRA ON HEALTH

Sleep or Nidra is essential for our well being and occupies about one third of our life span. Sleep affects how we feel and perform on daily basis, which has major impact on our overall quality of liveliness. Getting enough quality of sleep at right times can protect our physical and mental health, quality of life and safety. The way we feel when we are awake depend in part on what happens when we are asleep. The constructive effects of natural sleep have been deeply considered and interpreted by Ayurvedic literature as well as modern researches. Certain people have considered sleep as a mere break down time when our brain takes rest. Some of the conditions like obesity, cardiovascular diseases, diabetes etc. occur due to long periods of sleep deprivations. The present article is aimed to highlight the significance of proper sleep and effect of sleep deprivation on health in view of Ayurveda and contemporary science.

Demographic and Socioeconomic Influences on Sleep Patterns among Adolescent Students

Although proper sleep is an important topic in adolescent health, little is known about the sleep patterns of adolescents from a longitudinal and non-Western perspective. To fill this gap, the present research conducted a longitudinal study of the impact of demographic and socioeconomic factors on sleep patterns among Korean adolescent students. The relationship could positively or negatively affect sleep. Therefore, it is important to understand which demographic and socioeconomic factors are related to sleep patterns. This study used nationally representative panel data from the Korean Children and Youth Panel Survey. A series of descriptive analyses were conducted to provide overall characteristics of the sample. Furthermore, mixed effect regression analysis techniques were employed to test the relationship between demographic and socioeconomic factors and sleep patterns. Paternal employment status was associated with adolescent sleep patterns, while maternal employment status was not. Adolescents with both parents working compared to adolescents with one parent or none working showed different sleep patterns on weekdays but not on weekends. Both parents possessing college degrees, household income, living in an urban area, and family type were associated with adolescent sleep pattern indicators to varying degrees. Some of these associations varied according to adolescent sex. This study provides insight into the impact of demographic and socioeconomic factors on weekend and weekday sleep patterns among adolescent students by sex. These findings provide information for the promotion of healthy sleep in adolescents by addressing demographic and socioeconomic factors.

Sleep Habit/Sleepiness Questionnaires: A Useful Tool to Identify Correlation Between Sleep, Academic Performance and Obesity Promotion in Improving Health

Abstract Objectives Identify, compare sleep habit questionnaires for use in a study of college student's body compositions, and academic performances. Methods Decades of research supports the importance of proper sleep habits for college students for optimum academic performances and maintaining a healthy lifestyle. Instrument that can identify students who experience sleep disturbances and who do not get enough sleep is important in preventing obesity in college students during their college experience and afterwords. Some surveys were created for the clinical setting to determine if further diagnostics testing is necessary, while others were designed for use in academic research to be used individually, combined into composite measure of sleep or as covariates. Available instruments measure many different variables from day time sleepiness to chronotype and jet-lag. No single survey stands out as an all -encompassing sleep different aspect of sleep. No cross comparison of instruments measuring the same variable is therefore possible. Sleep survey is considered ensuring that the chosen survey was designed to measure the variables of interest. Following scales were used in the study: Standford Sleepiness Scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Horne-Ostberg Moringness Eveningness Questionnaire, Munich Chronotype Questionnaire. Results Students not meeting public health recommendations for sleep quality and quantity were found to have a significantly lower grade point average and individuals with sleep disturbances and short sleep duration have a significantly higher incidence of obesity. Conclusions Each instrument was created to measure a specific but different aspect of sleep. When conducting research with these tools, another questionnaire may be necessary to provide data specifically about the the subject's sleep habits. The Pittsburgh Sleep quality index has seen through use both clinically and in research. However, it requires another questionnaires to provide data on other variables. Each questionnaire effectively measures the concept it was designed to measure. Therefore, the choice of appropriate instrument should be based on the question, “which survey measures the variable that I wish to measure?”, not which survey is the best? Funding Sources NIMHD BRIC Grant 2009–2013 Central State University.

0211 Sleep-Preparatory Behaviors Modulate Sleep Physiology in Mice

Abstract Introduction Prior to sleep, animals perform various sleep-preparatory behaviors, yet little is known about their contribution to sleep physiology. Sleep hygiene, which involves proper sleep preparation, is an effective treatment for insomnia in humans. The high prevalence of sleep disorders and drawbacks of available pharmacological interventions necessitate a better understanding of the ecological and evolutionary contexts of sleep. Nest-building is a sleep-preparatory behavior performed by many species. In this study, we aimed to determine whether the presence of a nest modulates sleep. Specifically, we investigated the effects of a nest on sleep/wake architecture and activity in wake-promoting neurons in mice. Methods To examine the role of nesting in sleep/wake architecture, we recorded EEG/EMG activity over 24 hrs (n=14, 7 males and 7 females) in the presence/absence of a nest. To determine whether the lack of a nest activates wake-promoting neurons, we utilized TRAP (targeted recombination in active populations) technology to label neurons activated by nest removal (n=4 mice per experimental group). Results Mice without nests exhibited increased latencies to NREM and REM sleep and spent less time asleep during the inactive/light phase. Mice without nests also exhibited shorter episodes of NREM and REM sleep and more transitions between arousal states. Additionally, our preliminary results suggest that nest removal significantly increases population activity in multiple brain regions, including several cortical and thalamic regions. Conclusion Our findings support the hypothesis that the presence of a nest facilitates and consolidates sleep. The causal role of specific neuronal populations in sleep fragmentation in the absence of a nest remains to be elucidated. Taken together, our findings provide the first evidence for a role of sleep-preparatory behaviors in the facilitation and consolidation of sleep and could shape the development of novel treatments for sleep disorders. Support This work is supported by the Sloan Alfred P. Foundation, the Brain and Behavior Research Foundation, and the Eisenberg Translational Research Award.

The effect of sleep impairment on gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies

This systematic review and meta-analysis evaluated the influence of sleep duration or impairment (poor sleep quality, snoring, and obstructive sleep apnea [OSA]) on gestational diabetes mellitus (GDM) risk. PubMed, Embase, EBSCO, and WOS databases were searched up to March 4th, 2019. Cohort studies were included and relative risk (RR) with 95% confidence interval (CI) were used as the measure of effects. Heterogeneity was assessed by the Chi-squared and I2 tests. Subgroup analyses, sensitivity analysis, and dose-response analysis were performed. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A total of 16 studies with 2,551,017 pregnant women and 142,103 GDM cases were included in this study. Both short and long sleep duration were associated with increased risk of GDM. There was a U-shaped relationship between sleep duration and GDM risk (P-nonlinearity < 0.001), and pregnant women with 8 h of sleep presented lower GDM risk. Poor sleep quality, snoring and OSA also increased the subsequent risk of GDM. Pregnant women should be made aware of the benefits of proper sleep, and those with poor sleep quality, snoring, and OSA should be screened for GDM.

Over view for the truth of COVID -19 pandemic: A guide for the Pathologists, Health care workers and community'.

Pakistan is in the grip of COVID-19, due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) since 26 February 2020, and the number of infected people and mortality is rising gradually. The health workers, doctors, pathologists and laboratory staff are front line fighters who are facing the risk. Few things are important for public and health workers, human behavior is at the core of preparedness and response i.e, personal protective measures, (handwashing, face masks, respiratory etiquette, surface and objects cleansing), social distancing and travel measures because the virus spreads through the respiratory channels, eyes, nose and mouth. While working in the Pathology labs, use the personal protection equipment (PPE), during the work in the duty. Avoiding the over duties and long shifts. It is good to keep the immune system healthy by taking a healthy balanced diet, vitamin supplements, and a night of proper sleep. It is also important to avoid taking food during duties and avoid making close contact without wearing safety dress.