Reduce Sleep Disturbances Research Articles

Improved intensive care lighting and staff wellbeing: A pilot feasibility service evaluation

Background: The lighting environment in intensive care units (ICUs) is markedly different from natural light, potentially disrupting patients’ circadian rhythms and impacting staff wellbeing. New lighting technologies may mitigate these effects. Methods: A mixed methods service evaluation was conducted in a London ICU using Dyson Lightcycle™ luminaires (DLs) to evaluate staff wellbeing. Wellbeing assessments and user perceptions of the built environment were conducted using validated questionnaires before, during, and after DL deployment. Existing ambient light usage was measured using HOBO devices installed on the ceiling. Additionally, data on DL usage (including spectral data) were collected continuously using Raspberry Pi™ sensors. Results: DL usage was high (>70% per 24 h), primarily as supplementary lighting. Users found DLs easy to control and beneficial for clinical and administrative tasks. Participants assigned a 12.5% higher satisfaction score rated from 0 to 8 of lighting overall during deployment compared to pre-deployment (6.06 ± 0.29 and 5.06 ± 0.60, respectively; p = 0.20). Control variables for the built environment (noise, temperature and air quality) remained unchanged. Staff reported improvements in mood (38%, p < 0.001), fatigue (17.7%, p < 0.001), and sleep quality (21.2%, p = 0.01) during DL use. Discussion: In the first pilot feasibility service evaluation of its kind, the relationship between ICU lighting quality and staff wellbeing was investigated using DLs. We show that it is feasible to equip an ICU with a novel mode of lighting to evaluate both illuminance and user-centred outcomes. The study suggests a positive association between DL use and staff wellbeing, with notable improvements in mood, fatigue and sleep quality. The nature of the emitted light may enhance the space rather than simply illuminate, thus further adding to a feeling of wellbeing. These findings support data from studies which report effects of light brightness and colour on mood. Additionally, there appears to be a signal towards benefit to the user when additional lighting is provided, compared to the current overhead fluorescent luminaires prevalent in most ICUs. In this service evaluation these benefits were demonstrated in ICU staff operating the device. However, it is conceivable that effects such as improved mood and reduced sleep disturbance may have patient benefits too. Conclusion: Local lighting systems like DLs show promise in enhancing ICU staff wellbeing. Their impact on patient outcomes and the potential for broader implementation deserve further investigation in appropriately designed and powered larger-scale trials.

Network structure of sleep quality and its bridging association with anhedonia in adolescent major depression disorder.

Major depressive disorder (MDD) is a leading cause of disease burden in adolescents, with persistently rising prevalence. Anhedonia, core symptom of adolescent MDD, is associated with suicidality and poor clinical outcomes. Impaired sleep quality is proven to be a significant risk factor for adolescent MDD and potentially influence anhedonia symptoms. Understanding the interplay between sleep quality and anhedonia is crucial for early intervention and treatment. This cross-sectional study recruited 200 drug-naïve adolescent MDD patients from Xijing Hospital. Depression, anhedonia and sleep quality were assessed during outpatient visits, using the Hamilton Depression Rating Scale, Snaith-Hamilton Pleasure Scale, and Pittsburgh Sleep Quality Index, respectively. Network analysis was applied to construct sleep quality network and its co-occurrence network with anhedonia. Centrality indices were computed to indicate central symptoms. Adolescent MDD patients exhibited moderate depression and anhedonia levels, and are heavily accompanied with sleep complaints. The sleep quality network identified "subjective sleep quality" as the most central factor, mainly due to prolonged "sleep latency" and shortened "sleep duration". In the co-occurrence network, "sleep disturbances" had prominent bridging connection with anhedonia, suggesting its critical role in activating anhedonia symptoms. Subjective sleep quality was the most central sleep complaints in adolescent MDD, while sleep disturbances were prominently associated with anhedonia. These findings underscore the importance of reducing sleep disturbances to alleviate anhedonia symptoms under clinical settings. Network analysis provides a nuanced understanding of the complex relationship of sleep quality and its association with anhedonia in adolescent MDD.

Benefits of Remote-Based Mindfulness on Physical Symptom Outcomes in Cancer Survivors: Systematic Review and Meta-Analysis.

Many cancer survivors experience a wide range of symptoms closely linked to psychological problems, highlighting the need for psychological treatment, one of the most popular being mindfulness. The use of the internet has greatly increased in the last decade, and has encouraged the use of remote-based interventions to help people living with cancer access treatment remotely via devices. The primary aim of this study was to explore the efficacy of internet-based mindfulness interventions on the physical symptoms of people living with cancer, where physical symptoms are defined as distressing somatic experiences (eg fatigue, insomnia, and pain) regardless of the underlying cause. The secondary aim was to investigate interventions for the quality of life (QoL). This study followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Relevant articles were systematically searched using electronic databases, namely Scopus, Medline through PubMed, Cumulated Index in Nursing and Allied Health Literature (CINAHL) through EBSCOhost, and Cochrane Central Database. Randomized controlled and pilot trials involving adults and/or older adults with cancer and using remote-based mindfulness interventions compared to usual care were included. The quality of the trials included in this study was assessed using the revised Cochrane risk of bias, version 2.0. This study estimated the standardized mean difference (SMD) and mean difference (MD) with 95% CI. The I2 test was used to identify potential causes of heterogeneity. Publication bias was assessed using contour-enhanced funnel plots and the Egger linear regression test to reveal a small study effect. The initial search yielded 1985 records, of which 13 studies were ultimately included. After treatment, remote-based mindfulness significantly reduced fatigue (SMD -0.94; 95% CI: -1.56 to -0.33; P=.002), sleep disturbance (SMD -0.36; 95% CI: -0.60 to -0.12; P=.004), and improved physical function (SMD .25; 95% CI: 0.09 to 0.41; P=.002) compared to that observed before treatment. However, compared with usual care, remote-based mindfulness showed a statistically significant reduction only in sleep disturbance (SMD: -0.37; 95% CI: -0.58 to -0.16; P=.0006) after treatment. Moreover, remote-based mindfulness was not statistically significant in reducing pain both within and between groups. Remote-based mindfulness shows promise in reducing sleep disturbances; however, its impact on fatigue, pain, and physical function may be limited.

STUDI KASUS: FAKTOR PEMICU SERING BUANG AIR KECIL DAN DAMPAKNYA TERHADAP KUALITAS TIDUR IBU HAMIL TRIMESTER III

Pregnancy is a time of significant physiological, psychological, and emotional changes in a woman's body. As the fetus develops, the mother's body undergoes changes that affect various bodily functions, one of which is increased urinary frequency. This case study was conducted on 10 third-trimester pregnant women who experienced frequent urination and its impact on their sleep. The study aims to identify triggering factors and assess the impact on sleep quality in third-trimester pregnant women. Sleep disturbances caused by frequent waking to urinate can negatively affect the physical and mental well-being of pregnant women. The study involved several third-trimester pregnant women who reported frequent nighttime urination. The results show that the majority of the participants woke up 2-5 times each night to urinate, leading to fragmented sleep and reduced sleep duration and efficiency. These sleep disturbances are associated with excessive daytime sleepiness, fatigue, and a decline in the quality of life of the pregnant women. Additionally, the findings also indicate that physical factors such as the enlarged uterus pressing on the bladder and hormonal changes play a significant role in increasing urinary frequency. The obstetric care management in this case study recommends interventions such as education on fluid intake regulation, Kegel exercises, and relaxation techniques like yoga to reduce sleep disturbances. It is hoped that this case study can provide insights for healthcare professionals to offer more effective management to improve the sleep quality and overall well-being of pregnant women.

Evaluation of the safety and efficacy of herby angel tummy roll-on in managing infantile colic: a case series

Infantile colic is a benign condition of the second or third week of life characterized by abdominal discomfort. Infantile colic is characterized by persistent and unconsolable crying in an otherwise healthy and well-fed infant. About 20% of the newborn babies and infants are affected by this condition. This condition distress and challenges caregivers, leading to 10% to 20% of paediatric provider visits during the first few weeks of their lives. Current management options are limited and often involve oral administration which can be challenging for the caregivers. This study evaluated the safety and efficacy of the Herby Angel Tummy Roll-On, a topical treatment containing natural ingredients like Asafoetida, Ajwain, Rock salt, etc., designed to alleviate colic symptoms through a non-invasive approach. Four infants with recurrent colic episodes were monitored over one month, assessing improvements using the FLACC scale and other parameters such as frequency of interruptions, episodes of colic, and skin reactions. Significant improvements in symptoms were observed within a short duration, with no adverse skin reactions. The findings of this study suggest that the product effectively alleviated abdominal distension and pain, leading to a marked reduction in sleep disturbances in infants. It has a positive short-term effect on infantile colic.

Efficacy and safety of fezolinetant for moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy: phase 3b randomised controlled trial

ObjectivesTo assess the efficacy and safety of the non-hormonal, neurokinin 3 receptor antagonist, fezolinetant, to treat moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy.DesignPhase 3b randomised...

Urinalysis and perceived effects following 2-week use of a commercial broad-spectrum cannabidiol product.

A growing number of hemp-derived cannabidiol (CBD) products are available with negligible amounts (< 100 ppm) of delta-9-tetrahydrocannabinol (THC) due in part to consumer concerns regarding the risk of positive drug screens. There are, however, no published studies that report whether repeated use of these products may lead to positive urine drug tests for THC. There is also scant research on the effects of these products on physical and mental well-being. Twenty healthy adults consumed a hemp-derived broad-spectrum CBD product every day for 2 weeks. Participants attended study visits at the beginning and end of the 2-week period. At each visit, participants underwent urinalysis testing for CBD, THC, and metabolites (analyzed via liquid chromatography with tandem mass spectrometry) and completed a validated assessment of physical and mental well-being. Participants reported using an average of 1.09 ± 0.51 ml (34.20 ± 16.00 mg CBD) of study product per day. Neither tetrahydrocannabinol nor its metabolites were detectable in urine following the 2-week period of use. Ingestion of the broad-spectrum product was associated with a significant reduction in sleep disturbance and pain intensity symptoms (p < .05), which remained significant after correcting for possible confounds (i.e., age, sex, dosage). No adverse events were reported. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of acute and chronic therapeutic cooling on cognitive performance and well-being

PurposeResearch regarding the effect cold-water immersion (CWI) has on cognitive performance often uses excessive cooling protocols (>1-hour) to measure the detrimental impact prolonged cold exposure has on cognition. Previous studies have not considered shorter CWI protocols, similar to that used in recovery and wellness practices (∼10 min). AimsTo investigate a more ecologically valid CWI protocol on cognition, well-being and sleep in an acute and chronic manner. It was hypothesised that a therapeutic CWI protocol would improve well-being, and sleep and have no detrimental effect on cognition. MethodsThirteen healthy participants (20.85±2.15 years), (169.96±7.77 cm), (72.03±14.92 kg), (27.67±9.55 BF%) volunteered to complete a 4-week CWI protocol. Participants were immersed in cold water (10.42±0.59 °C) 3-times a week for 4-weeks. Cognitive performance (Stroop & TMT), well-being (WEMWBS, PSWQ, GAD-7, SHS) and sleep (PSQI) were measured acutely and chronically over the 4-week protocol along with thermoregulatory measures (Tsk, Tco, thermal comfort). ResultsResults show that CWI had no detrimental impact on cognitive performance, with Stroop performance & well-being seeing no differences acutely or chronically. Alternatively, the trail making test showed significant improvement from baseline (TMT-A 15.17±4.81-seconds, TMT-B 39.68±15.12-seconds) to week-3 (TMT-A 11.06±3.29-seconds, TMT-B 26.18±10.23-seconds). A reduction in sleep disturbances was seen from baseline scores of 7.85±3.44 AU to the end of week-3 measures 5.75±3.77 AU. ConclusionTherapeutic cooling can improve sleep quality when utilised in short frequent doses (3 times per week, for 4-weeks) and is not detrimental to cognitive performance, improving certain aspects of executive function.

Roles of social support and strain in predicting older adults’ sleep disturbances

Sleep disturbances impact the well-being of older adults, but there has been limited research on their longitudinal patterns and how they are affected by the quality of social relationships. This study explored longitudinal sleep disturbance patterns and examined the influence of social support and social strain on sleep disturbances in older adults using data from the Health and Retirement Study (HRS) spanning from 2010 to 2018. Group-based trajectory modeling identified distinct trajectory groups. Multinomial logistic regression and a fixed effects model investigated the relationship between sleep disturbances, social support, social strain, and sociodemographic factors. Three sleep disturbance trajectories were identified: high sleep disturbances, moderate sleep disturbances, and low sleep disturbances. Multinomial logistic regression showed that higher social support decreased the likelihood of classification in the high and moderate sleep disturbance groups. Conversely, higher social strain scores increased the likelihood of belonging to the high and moderate sleep disturbance groups. The fixed effects model confirmed the role of social support in predicting sleep disturbances over time, but social strain was not a significant predictor. These findings suggest the need for tailored interventions addressing social support to reduce sleep disturbances in this population.

Biologics and oral systemic treatment preferences in patients and physicians for moderate-to-severe atopic dermatitis: a discrete choice experiment in the United Kingdom and Germany

Background: As the available treatments for moderate-to-severe atopic dermatitis (AD) expand, understanding patient and physician preferences becomes crucial for informed decision-making. Objective: To quantify patient and physician preferences for biologics and oral systemic AD treatment attributes. Materials and methods: We conducted a cross-sectional, online discrete choice experiment (DCE) involving 306 AD patients and 206 physicians throughout the United Kingdom and Germany. Qualitative interviews identified the key attributes for inclusion in the DCE. Each choice task comprised two hypothetical patient profiles. Data were analyzed using a random-parameters logit model. Results: Results indicated a significant emphasis on efficacy, with reducing sleep disturbance and itch ranking first and second among patients, and the reverse for physicians. Time to itch relief was the third most important efficacy attribute for both groups, but relatively more important for patients than for physicians. For both groups, the risk of eye problems was the most important safety concern of those included. Mode of administration was not of great importance compared to efficacy and safety attributes. Conclusions: Our findings suggest patients prioritize sleep disturbance, an attribute not captured in prior preference studies in AD, time to itch relief and itch. These findings emphasize the importance of addressing sleep-related issues, whilst also targeting fast itch control, to enhance patients’ well-being.

Sleep Quality in School-Aged Children: The Role of Environmental Factors and Screen Time

Sleep plays a vital role in the optimal functioning of our body and is crucial for overall well-being. However, many parents are unaware of the negative consequences of sleep deprivation in children. This study examines factors affecting sleep in children and their correlation with screen time. The aim is to evaluate the relationship between screen time and environmental factors impacting sleep quality among school-aged children.A cross-sectional observational study was conducted on children aged 6 to 12 years. Sleep quality was assessed using a 22-item, pre-validated, parent-administered Children’s Sleep Habits Questionnaire (CSHQ). Contributing factors, including a screen time questionnaire, were gathered from parents. Children with pre-existing sleep disorders, neurobehavioral disorders, and chronic illnesses were excluded. A CSHQ score above 41 was considered abnormal, indicating a sleep problem. Data were analyzed using the Chi-square test with SPSS version 20.0.In this study, 40.3% of children experienced sleep disturbances. The total mean sleep score was 39.56 ± 14.84, with private school children showing greater disruptions (41.78 ± 12.96) compared to public school children (37.14 ± 16.33; p = 0.001). Significant correlations were found between sleep quality, screen time exposure, and environmental factors such as lower socio-economic status, bed sharing, and room sharing.This study highlights that both excessive screen time and adverse environmental conditions negatively impact children's sleep quality. Efforts to increase awareness among parents, educators, and healthcare providers are needed to reduce sleep disturbances.

Clinical effectiveness of DREAMS START (Dementia Related Manual for Sleep; Strategies for Relatives) versus usual care for people with dementia and their carers: a single-masked, phase 3, parallel-arm, superiority randomised controlled trial

Sleep disturbances are common and distressing for people with dementia and their families. Non-pharmacological interventions should be first-line management, avoiding harmful pharmacological side-effects, but there is none with known effectiveness. We aimed to establish whether DREAMS START, a multicomponent intervention, reduced sleep disturbance in people with dementia living at home compared with usual care. We conducted a phase 3, two-arm, multicentre, parallel-arm, superiority randomised controlled trial with masked outcome assessment, recruiting dyads of people with dementia and sleep disturbance and family carers from community settings. Randomisation to the DREAMS START intervention (plus usual treatment) or usual treatment was conducted at dyadic level, blocked, and stratified by site, with a web-based system assigning allocation. DREAMS START is a six-session, manualised intervention delivered face to face or remotely by non-clinically trained graduates over an approximately 3-month period. The primary outcome was sleep disturbance measured by the Sleep Disorders Inventory (SDI) at 8months. Analyses were on the intention-to-treat population. This trial is registered with ISRCTN13072268. Between Feb 24, 2021, and March 5, 2023, 377dyads were randomly assigned (1:1), 189to usual treatment and 188to intervention. The mean age of participants with dementia was 79·4years (SD 9·0), and 206 (55%) were women. The mean SDI score at 8months was lower in the intervention group compared with the usual treatment group (15·16 [SD 12·77], n=159, vs 20·34 [16·67], n=163]; adjusted difference in means -4·70 [95% CI -7·65to -1·74], p=0·002). 17 (9%) people with dementia in the intervention group and 17 (9%) in the control group died during the trial; the deaths were unrelated to the intervention. To our knowledge, DREAMS START is the first multicomponent intervention to improve the sleep of people living at home with dementia more than usual clinical care. It had sustained effectiveness beyond intervention delivery. The intervention's delivery by non-clinically trained graduates increases the potential for implementation within health services, adding to usual clinical care. National Institute for Health and Care Research Health Technology Assessment.

How Shift Nurses' Presenteeism is Related to Insomnia and Care Left Undone: A Cross-Sectional Study Using Generalised Structural Equation Modelling.

To examine the association between nurses' insomnia, presenteeism and care left undone and explore the mediating effect of presenteeism on the relationship between insomnia and care left undone among nurses in acute care hospitals, applying a dynamic model of presenteeism and absenteeism. A cross-sectional design. A secondary data analysis was conducted using online survey data collected in January 2023. Participants were 1154 registered nurses who provided direct nursing care to patients in tertiary or general hospitals (hospitals with 300 or more beds) in South Korea. Poisson regression analysis was used to examine the association between nurses' insomnia, presenteeism and care left undone. Generalised structural equation modelling was performed to examine the mediating effect of presenteeism on the relationship between insomnia and care left undone. The prevalence of insomnia was 15.3%. More than half of the participants (63.7%) reported experiencing presenteeism in the past 4 weeks. All reported at least one nursing care left undone during their last shift. Insomnia and presenteeism were positively associated with care left undone, and presenteeism mediated the relationship between insomnia and care left undone among nurses in acute care hospitals. Nurses experienced insomnia and presenteeism, related to higher rates of care left undone. Nurses' insomnia had a direct effect on care left undone and an indirect effect through presenteeism. Nurse managers and administrators need to make greater efforts to reduce insomnia and presenteeism among nurses, thereby reducing care left undone and improving patient safety in acute care settings. Nurse managers and administrators should consider proactive interventions to address nurses' insomnia and foster a workplace with healthy systems and culture to reduce sleep disturbance and presenteeism, which can effectively decrease care left undone. STROBE guidelines. No patient or public contribution.

Impact of daily music on comfort scores in preterm infants: a randomized controlled trial.

Premature birth heightens neurodevelopmental risks, theorized to partly stem from altered sensory inputs and disrupted sleep patterns. Modifying the acoustic milieu through music intervention (MI) offers promise to improve neonatal comfort, reduce sleep disturbances, and stabilize physiological parameters. This study explores the impact of non-pharmacological MI on these health indicators within the Neonatal Intensive Care Unit (NICU). A single-blinded RCT was conducted. Premature infants (34 > GA > 29 wks) were randomly assigned to either receive 8 min of daily MI or placebo for up to 15 days. Validated behavioral comfort scores were visually obtained by a blinded observer before and after intervention. Additionally, physiological signs (HR, RR, SatO2) were recorded. Differences between the groups were analyzed using χ² tests and t-tests. In total 56 preterm infants were included. After intervention, comfort levels increased significantly in the MI compared to placebo group (p = 0.000). Neonates receiving MI transitioned from wakefulness to a state of sleep significantly more compared to placebo (p = 0.002). Physiological parameters remained stable. This study adds to existing literature demonstrating that a music intervention in a NICU setting can enhance comfort and sleep of premature infants without adversely affecting physiological parameters. The study demonstrates that music interventions (MI) in a Neonatal Intensive Care Unit (NICU) setting can significantly increase comfort levels and positively impact the sleep of premature infants without negatively impacting their physiological parameters. This research increases evidence for non-pharmacological interventions, specifically music, as beneficial for the well-being of premature infants in NICU settings. It replicates and expands upon previous methodological designs, providing more robust evidence of MI's positive effects on this vulnerable population. The positive outcomes of music intervention could influence hospital policies by integrating non-pharmacological practices into standard neonatal care protocols to enhance developmental support for premature infants.

Workplace Violence and Burnout among Health Workers Two Years after the COVID-19 Outbreak in Wuhan, China: The Chain Mediation Effect of Sleep Disturbance and Work Ability.

Health workers (HWs) faced considerable psychosocial hazards during the COVID-19 pandemic, which profoundly affected their occupational health and job performance. The potential indirect relationship between workplace violence (WPV) and burnout among HWs needs to be further explored. The purpose of this study is to examine the chain mediating effects of sleep disturbance and work ability in the relationship between WPV and burnout among HWs. A cross-sectional study was conducted in a secondary hospital two years after the COVID-19 outbreak in Wuhan, China. A sample of 571 HWs was recruited using a cluster sampling method, achieving a response rate of 80.06%. Participants completed self-report questionnaires that included demographic information and measures of WPV, burnout, sleep disturbance, and work ability. The prevalence rates of burnout and WPV among HWs two years after the COVID-19 outbreak were 37.30% and 31.52%, respectively. WPV was significantly associated with burnout (β = 0.446, p < 0.001). Sleep disturbance was identified as a mediator in the relationship between WPV and burnout (β = 0.063, 95% CI: 0.027-0.105), accounting for 14.13% of the total effect. Similarly, work ability also played a mediating role in this relationship (β = 0.142, 95% CI: 0.065-0.225), accounting for 31.84%. Additionally, both sleep disturbance and work ability exhibited a chain mediation effect on the association between WPV and burnout (β = 0.020, 95% CI: 0.008-0.036), and the total indirect effect accounted for 50.67%. Among Chinese HWs, WPV exerts significant direct and indirect effects on burnout symptoms, mediated by sleep disturbance and work ability. This finding provides valuable empirical insights for designing interventions to mitigate the adverse effects of psychosocial factors such as WPV and burnout among HWs. After exposure to WPV, measures focused on reducing sleep disturbance and enhancing work ability may prove effective in alleviating burnout in subsequent interventions.

A systematic review of yoga for the treatment of gastrointestinal disorders.

Several studies have reviewed yoga for the treatment of disorders of gut-brain interaction (DGBI) with most demonstrating a benefit for symptom reduction; however, yoga has been studied beyond DGBI. The aim of this systematic review is to provide a comprehensive summary of yoga as treatment for gastrointestinal conditions. We conducted literature searches in PubMed and Embase and included yoga trials of adults with a diagnosis of a gastrointestinal disorders and diseases. We identified 1275 articles; 12 studies were eligible. Most studies compared yoga to controls, for patients with different GI conditions (irritable bowel syndrome, ulcerative colitis, chronic pancreatitis, and gastrointestinal cancer). The type, method, and duration of yoga used varied. Across IBS studies, most demonstrated that yoga improved IBS symptom severity, mood-related symptoms, and quality of life compared with controls. In one study of inflammatory bowel disease, yoga improved quality of life compared to controls. Two studies of gastrointestinal cancer demonstrated that yoga led to a reduction in sleep disturbance and mood symptoms. One study of chronic pancreatitis found that yoga led to improvements in quality of life, stress, mood changes, alcohol dependence, and appetite. Yoga was generally safe, and no serious adverse events were attributed to the intervention. In conclusion, yoga appears to be safe and has potential to improve functioning across a spectrum of gastrointestinal diseases; however, current studies are limited by heterogeneity and methodological weaknesses. Further research is needed to evaluate the impact of yoga on health outcomes for a broader range of gastrointestinal conditions.

Identifying trajectories of change in sleep disturbance during psychological treatment for depression

BackgroundSleep disturbance may impact response to psychological treatment for depression. Understanding how sleep disturbance changes during the course of psychological treatment, and identifying the risk factors for sleep disturbance response may inform clinical decision-making. MethodThis analysis included 18,915 patients receiving high-intensity psychological therapy for depression from one of eight London-based Improving Access to Psychological Therapies (IAPT) services between 2011 and 2020. Distinct trajectories of change in sleep disturbance were identified using growth mixture modelling. The study also investigated associations between identified trajectory classes, pre-treatment patient characteristics, and eventual treatment outcomes from combined PHQ-9 and GAD-7 metrics used by the services. ResultsSix distinct trajectories of sleep disturbance were identified: two demonstrated improvement, while one showed initial deterioration and the other three groups displayed only limited change in sleep disturbance, each with varying baseline sleep disturbance. Associations with trajectory class membership were found based on: gender, ethnicity, employment status, psychotropic medication use, long-term health condition status, severity of depressive symptoms, and functional impairment. Groups that showed improvement in sleep had the best eventual outcomes from depression treatment, followed by groups that consistently slept well. LimitationSingle item on sleep disturbance used, no data on treatment adherence. ConclusionsThese findings reveal heterogeneity in the course of sleep disturbance during psychological treatment for depression. Closer monitoring of changes in sleep disturbance during treatment might inform treatment planning. This includes decisions about when to incorporate sleep management interventions, and whether to change or augment therapy with interventions to reduce sleep disturbance.

Tirzepatide shown to be effective at reducing sleep disturbances in patients with obstructive sleep apnoea

Tirzepatide shown to be effective at reducing sleep disturbances in patients with obstructive sleep apnoea

The effects of time-restricted eating on sleep in adults: a systematic review of randomized controlled trials.

Time-restricted eating (TRE), a dietary pattern reducing the duration of daily food consumption, has recently gained popularity. Existing studies show the potential benefits of TRE for cardiometabolic health. Uncertainty remains about whether these benefits are solely from altered meal timing or influences on other health behaviors, including sleep. Despite growing scientific interest in the effects of TRE on sleep parameters, the topic has not been systematically explored. This review examined the effects of TRE interventions (daily fasting duration ≥14 h) lasting at least 8 weeks on objective and subjective sleep parameters. Six randomized control trials were identified through Pubmed, Embase, Google Scholar, and Scopus through September 2023. Of the included studies, three employed objective sleep measures using wearables and five studies assessed sleep subjectively through self-report questionnaires. Only one study reported significant improvements in subjective sleep quality following a TRE intervention. Additionally, one study found significant decreases in sleep duration, two studies found significant decreases in sleep efficiency, and one found significant increases in sleep onset latency. Current evidence indicates that short to mid-term TRE does not typically worsen sleep parameters. However, some populations may experience reduced sleep disturbances, while others may experience reductions in sleep efficiency. Longer duration studies with objective sleep assessments are needed to better understand the effects of TRE on sleep parameters.

Dose-Response Effects on LBP, Sleep, and Depression of Online Pre-Partum and Post-Partum Pilates-Based Programs

ABSTRACT Purpose: Pilates-based programs can help pregnant women deal with the physical and psychological burden derived by major changes in their body. This study was designed to primarily test, in pregnant women, the dose-response and health effects of both pre-partum and post-partum, online Pilates-based program on weight control, low back pain (LBP) severity, sleep disturbances, mood and depression levels. Methods: A total of 136 pregnant women were screened for eligibility (low-risk pregnancy; aged 18–45 years; single pregnancy; 20–28-week gestational age, normal BMI). Participants completed an online Pilates-based program during pregnancy and after delivery, through an online platform guided by a Pilates, Yoga and Lagree certified instructor. Main outcomes (weight control, LBP disability, sleep quality, mood, and mental health) were assessed at baseline and at the completion of pre- and post-partum programs. Results: Regarding pre-partum, significant gains in weight were observed only in low- and intermediate-amount exercisers. Only high-amount exercisers did not display significant increase in LBP-related disability (+42.7%; p = .21) unlike low (+12.2%; p < .0001) and intermediate exercisers (+9.6%; p < .0001). Sleep disturbances increased significantly in low- (+24.3%; p = .005) but not in intermediate- (+4.6%; p = .50) and high-amount exercisers (−0.1%; p = .91). Regardless of the amount of exercise, depression scores improved in all groups. Following post-partum intervention (n = 40), only intermediate-amount exercisers showed significant reductions in sleep disturbances (−24.1%; p = .003) and depression (15.9%; p = .04). Conclusions: Approximately 270 min/week of an online Pilates-based program were needed to prevent LBP worsening, and sleep deterioration in pregnant women. A different pattern was outlined for those women resuming the Pilates-based intervention at post-partum, with 150 min/week emerging as the “dose” of exercise capable of inducing the largest improvements in LBP, sleep, and mood disturbances.