Restorative Sleep Research Articles

Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial

Objective/BackgroundSleep problems challenge overall wellbeing. Magnesium has been implicated to benefit sleep, although the clinical evidences varied based on the magnesium source used. Magnesium L-threonate (MgT) is a promising intervention due to its brain bioavailability and effects on cognition, memory and mood. We investigated MgT supplementation on sleep quality and daily function. Patients/methodsEighty 35–55-year-olds with self-assessed sleep problems participated in a randomized, double-blind, placebo-controlled, parallel-arm study, taking 1 g/day of MgT or placebo for 21 days. Sleep and daily behaviors were measured subjectively using standardized questionnaires including the Insomnia Severity Index, Leeds Sleep Evaluation Questionnaire, and Restorative Sleep Questionnaire, and objectively using an Oura ring. The Profile of Mood States questionnaire and a daily diary were used to evaluate mood, energy and productivity, and record any safety concerns. ResultsThe MgT group maintained good sleep quality and daytime functioning, while placebo declined. From objective Oura ring measurements, MgT significantly (p < 0.05) improved vs placebo deep sleep score, REM sleep score, light sleep time, and activity and readiness parameters activity score, activity daily movement score, readiness score, readiness activity balance, and readiness sleep balance. From subjective questionnaires, MgT significantly (p < 0.05) improved vs placebo behavior upon awakening, energy and daytime productivity, grouchiness, mood and mental alertness. MgT was safe and well tolerated. ConclusionsThis showed MgT improved sleep quality, especially deep/REM sleep stages, improved mood, energy, alertness, and daily activity and productivity. These are consistent with how MgT works in neuron cells and animal models, suggesting broader positive impacts on overall brain health.

Sleep and hypertension - up to date 2024.

People spend one-third of their lives sleeping, and adequate, restful sleep is an essential component of a healthy life. Conversely, disruption of sleep has been found to cause various physical and mental health problems. Emerging research has shown that blood pressure (BP) during sleep is a stronger predictor of cardiovascular events than conventional office BP or daytime BP. Thus, management of both sleep health and nighttime BP during sleep is important for preventing cardiovascular events. However, recent studies demonstrated that nighttime BP is poorly controlled compared with office BP and daytime BP. This finding is understandable, given the challenges in monitoring BP during sleep and the multiplicity of factors related to nocturnal hypertension and BP variability. This review summarizes recent evidence and considers future perspectives for the management of sleep and hypertension.

Mirtazapine in Primary Insomnia: Case report and Literature review

Introduction: Insomnia is a prevalent sleep disorder characterized by difficulty in falling asleep, maintaining sleep, or achieving restorative sleep, despite adequate opportunities. This condition often results in significant daytime impairments, including fatigue, concentration difficulties, and irritability. Insomnia can be primary or comorbid with other disorders such as anxiety or depression. Case Presentation: A 27-year-old woman presented with severe and chronic insomnia, persisting for 14 years with recent exacerbation. Her symptoms included significant difficulty in initiating and maintaining sleep, resulting in an average of only 3-4 hours of sleep per night and complete sleep deprivation for periods exceeding half an hour over the past 5 days. This sleep deficit led to pronounced emotional instability, physical discomfort, and reduced appetite, although suicidal ideation was absent. She had a past history of drug use for different psychiatric illnesses. She was started on mirtazipine 30mg and showed abrupt improvement in her symptoms. She was discharged afterwards. Discussion: The patient's chronic insomnia and its secondary effects necessitate a comprehensive treatment approach. Mirtazapine, an antidepressant with potent histamine receptor antagonism, has shown efficacy in improving sleep quality across diverse patient profiles. However, side effects like weight gain and sedation require careful monitoring. Combining mirtazapine with prolonged-release melatonin has demonstrated enhanced outcomes, particularly in perimenopausal women. Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the first-line treatment due to its efficacy and long-term benefits. Conclusion: Mirtazapine can be a valuable option in the therapeutic arsenal for primary insomnia, but ongoing research is needed to refine treatment strategies. Personalized treatment plans considering patient history and response are crucial for effectively managing primary insomnia and improving patient outcomes.

Kavalactones support motivation to move during intensive training in males preparing for military special operations forces.

Military special operators, elite athletes, and others requiring uninterrupted optimal performance currently lack options for sleep and mood support without performance-inhibiting effects. Kavalactones, derived from the root of the kava plant (Piper methysticum Forst), have been shown to elevate mood and wellbeing by producing a feeling of relaxation without addiction or cognitive impairment. In this placebo-controlled, crossover study (NCT05381025), we investigated the effects of 2 weeks of kavalactones use on cortisol (diurnal salivary), sleep (RSQ-W; Restorative Sleep Questionnaire, Weekly), mood (DASS-21; Depression Anxiety Stress Scale-21), and motivation state to expend (Move) or conserve (Rest) energy (CRAVE; Cravings for Rest and Volitional Energy Expenditure, Right Now) in a cohort of 15 healthy, physically fit young males engaged in a rigorous, two-a-day preparation class for special operations forces qualification. Cortisol, sleep, and mood were within normal, healthy parameters in this cohort at baseline. This remained unchanged with kavalactones use with no significant findings of clinical interest. However, a statistically similar, positive slope for within-group Move scores was seen in both groups during kavalactones loading (first group Move slope 2.25, second group Move slope 3.29, p = 0.299). This trend was seen regardless of order and with no apparent effects on the Rest metric (all p ≥ 0.05). Moreover, a significant between-group difference appeared after 1 week of kavalactones use in the first phase (p = 0.044) and persisted through the end of the first loading period (p = 0.022). Following the 10-day washout, this between-groups divergence remained significant (p = 0.038) but was reversed by 1 week after the crossover (p = 0.072), with Move scores once again statistically similar between groups and compared to baseline at study end. Furthermore, the group taking kavalactones first never experienced a significant decrease in Move motivation state (lowest mean score 21.0, highest 28.6, all p ≥ 0.05), while the group receiving kavalactones in the last 2 weeks of the study had Move scores that were statistically lower than baseline (lowest mean score 8.6, highest 25.9, all p ≤ 0.05) at all time points but the last (p = 0.063) after 2 weeks of kavalactones exposure. We report a novel finding that kavalactones may support performance by maintaining or rescuing the desire to expend energy in the context of significant physical and mental strain in well-conditioned individuals, even in a context of already normal cortisol, sleep, and mood.

Nonrestorative sleep and its association with insomnia severity, sleep debt, and social jetlag in adults: Variations in relevant factors among age groups

ObjectiveNonrestorative sleep (NRS) is unrefreshing sleep that is harmful to mental and physical health. Although few studies have reported the relationship between NRS and sleep problems, none have evaluated this relationship by age group. This study aimed to determine whether NRS could be associated with insomnia severity, sleep debt, and social jetlag and whether this relationship would vary with age. MethodsThe 1592 participants were allocated into age groups: 18–25 years (n = 317), 26–40 years (n = 405), 41–65 years (n = 454), and >65 years (n = 416). The study used Restorative Sleep Questionnaire to assess NRS, Athens Insomnia Scale to assess insomnia severity, Sleep Debt Index to assess sleep debt, and the absolute difference in midpoints of sleep between weekdays and days off to assess social jetlag. ResultsLogistic regression analysis was performed to determine the association between NRS and sleep problems. In the 18–25-year group, insomnia severity, sleep debt of ≥2 h, and social jetlag of ≥2 h; in the 26–40-year group, insomnia severity and sleep debt of ≥2 h; in the 41–65-year group, insomnia severity and sleep debt of ≥2 h; and in the >65-year group, insomnia severity were significantly associated with NRS. ConclusionNRS was associated with insomnia severity in all age groups, with sleep debt in the young and working-age groups and social jetlag in the young age group. Different approaches to improving the NRS are required for different age groups.

Examining The Impact Of Anxiety And Depression On Sleep Quality Among Healthcare Providers

Background: Anxiety and depression can significantly impact sleep quality. This can lead to difficulties falling asleep, staying asleep, or experiencing restful sleep. Racing thoughts, worry, and physical symptoms like increased heart rate can make it hard to relax and drift off to sleep, which will affect the quality performance of healthcare providers. Aims: Our objective was to study the influence of anxiety, and depression on sleep quality and to find the factors of sleeping quality to give a recommendation that would reflect well on the healthcare providers’ job satisfaction. Methods: A descriptive cross-sectional design was used utilizing a self-administered questionnaire. Data was collected from healthcare providers using the Zung Self-Rating Depression Scale (SDS). and the Generalized Anxiety Disorder Scale-7. In this study, 350 questionnaires were distributed to qualified respondents, and a total of 190 valid questionnaires (excluded incomplete questionnaires) were returned, indicating a valid response rate of 54%. Results: Statistics showed that more than a quarter of respondents had at least a mild level of depression, which is about 26.9%. Noticed that respondents with sleep disorders (mean = 2.35), and mental disorders (mean = 2.42) showed significantly higher levels of depression as compared to those without the disorder. In addition, 26.4% of respondents had at least a mild level of anxiety. Respondents with sleep disorders (mean = 2.32), and mental disorders (mean = 2.50) showed significantly higher levels of anxiety as compared to those without disorders. There were 13.7% of respondents having mild sleep problems, while 7.9% of respondents having severe sleep problems. Conclusion: Both anxiety and depression can disrupt sleep quality, making it essential to address these mental health conditions to improve overall well-being and sleep patterns.

Four-year longitudinal culinary and lifestyle medicine track for undergraduate medical students: development and implementation

ABSTRACT The importance of culinary and lifestyle medicine education to combat the growing burden of chronic disease is gaining recognition in the United States. However, few medical schools offer in-depth training with a 4-year longitudinal track. The Culinary and Lifestyle Medicine Track (CLMT) is a 4-year curriculum thread created at West Virginia University School of Medicine to address the need for comprehensive culinary and lifestyle medicine education. CLMT teaches concepts of healthy nutrition, physical activity, stress management, and restorative sleep. CLMT students complete approximately 300 h of in-person and virtual culinary and lifestyle medicine education, including hands-on teaching kitchens, distributed over the preclinical and clinical years. Students are selected into the track prior to matriculation after an application and interview process. The students have exceeded expectations for scholarly and community activity. Track graduates have entered into primary care as well as specialty and surgical residencies, demonstrating that lifestyle education plays a role for students interested in a wide range of careers. Exit survey responses from learners reflected tangible and intangible benefits of participation and offered constructive feedback for improvement. Presented here are the components of the curricular design, implementation, and initial outcomes.

Association between non-restorative sleep and psychotic-like experiences among Chinese college students: A latent profile and moderated mediation analysis

BackgroundNon-restorative sleep (NRS) is a core symptom of insomnia that has considerable consequences for daily life. However, the association between NRS and psychotic-like experiences (PLEs) remains unclear. The current study was designed to explore the relationship between NRS and PLEs as well as the mediation/moderation role of rumination and resilience among college students in China. Methods3060 college students were recruited from two universities in South China from September 21st to October 26th, 2022. Non-restorative Sleep Scale, 8-item Positive Subscale of the Community Assessment of Psychic Experiences, Ruminative Response Scale, and 10-item Connor-Davidson Resilience Scale were administered. Latent profile analysis and moderated mediation analysis were performed. Results11.3 % participants reported frequent PLEs in the past one month. Three profiles of rumination were identified and named as “low rumination” group (27.7 %), “medium rumination” group (55.3 %), and “high rumination” group (16.9 %). NRS directly predicted PLEs, and rumination played a significant mediation role between NRS and PLEs. Resilience significantly moderated the association between NRS and rumination as well as the association between NRS and PLEs. ConclusionsNRS, rumination and resilience are important predictors to PLEs. Strategies on increasing restorative sleep, decreasing rumination, and enhancing resilience are of great significance in the prevention of PLEs.

Poor sleep quality is an important modifiable risk factor for dementia: Population attributable fraction of poor sleep in a Brazilian population-based study.

The populational impact of poor sleep quality and the risk of dementia is unclear. We analyzed the Population Attributable Fraction (PAF) of poor sleep quality for dementia, and its association with other two sleep parameters through self-reported and single questions collected in a large-scale Brazilian cohort (ELSI-Brazil). A subset of the ELSI-Brazil with complete responses to sleep quality was retrieved for this study. This is a large representative sample of the Brazilian elderly population with an extensive assessment of sociodemographic and health risk variables. Prevalence of poor sleep quality was estimated according to the complex sample design, and its PAF was measured using a meta-analytic relative risk. A total of 6024 (56.3% women, mean 62.8±9.5years of age) individuals had complete responses. The prevalence of poor sleep quality was 24.9% (95%CI 23%-26%), and the PAF of poor sleep quality including other 10 modifiable risk factors of dementia was 52.5% in Brazil. Secondary analyses identified that sleep quality, restorative sleep and sleep drug usage varied considerably according to age ranges, race, and gender. Poor sleep quality is an important populational modifiable risk factor for dementia in Brazil. Targeted interventions may provide an important impact in preventing dementia in low- and middle-income countries.

Melatonin use in infants and toddlers

Background Melatonin use in the pediatric population is on the rise in the United States, where it is available as an over-the-counter and online supplement. There are no data regarding the safety and efficacy of melatonin in children less than 2 years old. The aim of this study was to examine various aspects of melatonin use by caregivers of infants and toddlers in the US. Methods Caregiver users of the Nanit baby monitoring system with a child aged 0-36 months were invited to complete an online survey regarding melatonin use, sources of information/recommendations about melatonin, formulations used and reasons for administering melatonin to their child. Participants also completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R). Results A total of 3063 caregivers (1.93%) responded to the survey, of whom 1.7% had ever used melatonin for their child. About half of those caregivers had received a recommendation for melatonin from a source other than a healthcare professional. Caregiver perception of ‘sleep as a problem’ as assessed by the BISQ-R was not significantly different between those who had or had not used melatonin for their child, and reasons for use included non-supported indications such as sleeping later or promoting “more restful and better sleep”. Conclusions The results of this study support mounting concerns regarding the widespread use of melatonin in the US pediatric population, especially given the lack of regulatory oversight and the documented inaccuracy of label claims versus actual melatonin content.

The Effectiveness of Hammock Positioning in Regulating Behavioral Patterns in Preterm: A Systematic Review

Background- Preterm newborns benefit from supportive developmental techniques such as hammock placement, which give them a sense of being in the womb that promotes calm, relaxation, and deep restful sleep. Objective- To identify and synthesize the available evidence on the effect of hammock positioning in regulating behavioral patterns and sleep in preterm infants admitted to the NICU Data Sources: We searched the Google Scholar, Pubmed, and Scopus databases for reports of primary research studies using a three-step strategy. We also searched for and reviewed the reference lists of retrieved articles. Methods: We included data from randomized controlled trials, Quasi-experimental and Comparative study measuring the effects of hammock positioning on physiological stress outcomes, defined as oxygen saturation, body temperature, heart rate and respiratory rate, Sleep-wakefulness, and behavioral pattern. The PRISMA model was used to conduct data extraction. We performed a narrative synthesis of all studies when data were available from multiple studies. Results: Five studies were eligible for inclusion. Infants who received hammock positioning has shown to have a higher mean heart rate, oxygen saturation and temperature, Sleep-wakefulness and improved behavioral patterns. Conclusions: Current evidence suggests that hammock positioning in the neonatal intensive care unit setting is a safe method that may significantly affect some of the physiological parameters of stress, improved behavioral patterns and Sleep-wakefulness in preterm infants. However, due to clinical heterogeneity, further studies are needed to assess the effects of physiological stress in the neonatal intensive care unit on the development of preterm infants.

Insomnia symptoms and increased risk of all-cause mortality by age and sex.

Prior research suggests that insomnia may increase the risk of death. However, the potential influence of age and sex is unclear. This study aimed to investigate the association of insomnia symptoms with all-cause mortality by age and sex. This prospective cohort was drawn from the Health and Retirement Study, a survey of Americans older than 50 years and their spouses of any age from 2002 to 2018. Insomnia symptom scores were based on difficulties initiating sleep, difficulty maintaining sleep, waking up too early, and restorative sleep. Cox proportional hazards regression models were employed to investigate the association between insomnia symptoms and all-cause mortality stratified by age and sex. A total of 33004 participants were included with a mean age of 61.7 years and 56.8% females. Over a mean follow-up of 8.4 years, 8935 (27.1%) deaths were recorded. After adjusting for confounding, males with insomnia symptom scores ranging from 5 to 8 had a 71% increased risk of death (HR=1.71, 95% CI: 1.27, 2.30) compared to their counterparts without insomnia symptoms. Similarly, males aged ≥60, and females aged <60 with insomnia symptoms ranging from 5-8 had an increased risk of death compared to their counterparts without insomnia symptoms (HR=1.15, 95%: 1.02, 1.31, and HR=1.38, 95% CI: 1.00, 1.90, respectively). However, there was no increased risk of death for females aged ≥60 (HR=0.94, 95% CI: 0.84, 1.06). These findings suggest that insomnia symptoms may serve as predictors of low life expectancy.

Increasing Restorative Sleep Among Adults With Depressive Symptoms: A Quality Improvement Project.

The Centers for Disease Control and Prevention estimates that 34.8% of adults in the United States experience non-restorative sleep. The restorative theory of sleep is based on sleep as a means for the restoration of cellular function that is needed for activities when awake. Non-restorative sleep leads to awakening feeling unrefreshed and not ready for the activities of the day three or more times weekly. Aims: The aim of this quality improvement project was to increase restorative sleep by increasing the average amount of sleep over units of 24 h, decreasing perceived insufficient sleep, and decreasing episodes of unintended daytime sleep among patients with depressive symptoms ages 18 to 80 years in an outpatient mental health clinic. Methods: Ten patients with depressive symptoms and reporting non-restorative sleep volunteered to participate in the project. Participants kept a sleep diary and followed principles of healthy sleep such as limiting time in bed and going to bed at the same time nightly. The change in and the average amount of sleep over 24 h and daytime sleepiness were evaluated using the Behavioral Risk Factor Surveillance System. Results: All participants achieved at least one more day of restorative sleep, with nine increasing restorative sleep by at least 30 min per day, and nine having no episodes of unintentionally falling asleep.

Are principals really tireless? Conceptualizing the role of sleep in school leadership

The purpose of this conceptual paper is to highlight the impacts of psychological and biological health on the principalship, particularly as it relates to sleep. Job-related stress, heavy workloads, and unpredictable work schedules can impact principals’ mental health, diet, and consumptive behaviors, which can disrupt the much-needed restorative sleep for healthy cognition, physiological functioning, and efficacious leadership. We turn the field's attention towards the importance of quality sleep and how it impacts personal health and occupational performance. We provide a robust interdisciplinary review of literature on precursors and outcomes of poor sleep quality as it pertains to school leaders both personally and professionally. Empirical recommendations for improving sleep quality along with recommendations for preparation programs and the field of educational leadership are discussed.

Sub-fertility and life style factors which affecting sub-fertility among women in Regional Director of Health Service area, Colombo

Sub-fertility and life style factors which affecting sub-fertility among women in Regional Director of Health Service area, Colombo

Prevalence of work-related burnout and associated factors among police officers in central Gondar zone, Northwest Ethiopia, 2023.

Work-related burnout is a state of physical and psychological fatigue and exhaustion resulting from chronic workplace stress related to work. The police workforce is vulnerable to this psychosocial hazard, which affects service delivery by police workers. However, there is little evidence about the prevalence of work-related burnout and associated factors among police officers in Ethiopia. Therefore, this research investigated the prevalence and predictor variables of work-related burnout among police officers in central Gondar zone, Northwest Ethiopia, 2023. An institution-based cross-sectional study was carried out from April 12 to May 12, 2023. A sample of 633 police officers was recruited through multistage random sampling techniques. To measure work-related burnout, a standardized, self-administered Copenhagen Burnout Inventory was used. To enter the collected data, EpiData V 4.6 and to analyze SPSS V 26 were used. To examine the association between work-related burnout and its predictor variables, both bivariable (p < 0.2) and multivariable (<0.05) logistic regression analyses were performed, and statistical significance was established via multivariable logistic regression. The response rate in this study was 96.05% (n = 608). The majority, 452 (74.3%) of the police officers, were male; the median (IQR) age of participants was 28. In the past six months, 45.7% of the police officers had experienced work-related burnout (n = 278). Being female, having a high job demand, having a high level of organizational police stress, having a moderate level of operational police stress, having a high level of operational police stress, experiencing job dissatisfaction, and sleeping troubles were risk factors significantly related to the occurrence of work-related burnout among police officers. According to this study, a significant number of police officers suffer from burnout due to their work. Police officers' work-related burnout was found to be influenced by factors such as sex, job demands, job satisfaction, workplace stress, organizational police stress, and sleeping troubles. To address this problem, improving the handling of work pressure, developing a stress management program, finding joy at work by improving interpersonal relationships and working conditions, offering support and inspiration to female police officers, and ensuring sufficient and restful sleep are advised.

A comprehensive examination of personality factor and facet associations with daily stress processes

Although psychosocial stress is a putative mechanism for personality-health associations, research has been limited by a lack of comprehensive, fine-tuned assessment. In the current study, a large sample (n = 655) of young adults completed facet-level personality assessment followed by a 14-day experience sampling of stress exposure, emotional stress reactivity, pre-sleep arousal, and sleep. Multilevel model analyses confirmed that neuroticism, across facets, was the strongest predictor of daily stress. Facet-level analyses indicated that assertiveness, trust, and self-control were particularly relevant to daily stress. Personality moderated stress exposure associations with pre-sleep arousal (conscientiousness, aesthetic chill proneness) and restorative sleep (openness, aesthetic chill proneness). Findings confirm the significance of personality in daily stress. Future directions and implications for stress intervention are discussed.

Associations between lifestyle factors and COVID-19 infection rates: a cross-sectional analysis in the USA

IntroductionThe COVID-19 pandemic has underscored the vital connection between lifestyle factors and health outcomes, highlighting the need to understand how lifestyle choices influence both chronic and infectious diseases. Despite known...

Sleep Delta power, age, and sex effects in treatment-resistant depression

Electroencephalographic (EEG) deficits in slow wave activity or Delta power (0.5–4 Hz) indicate disturbed sleep homeostasis and are hallmarks of depression. Sleep homeostasis is linked to restorative sleep and potential antidepressant response via non-rapid eye movement (NREM) slow wave sleep (SWS) during which neurons undergo essential repair and rejuvenation. Decreased Low Delta power (0.5–2 Hz) was previously reported in individuals with depression. This study investigated power levels in the Low Delta (0.5-<2 Hz), High Delta (2–4 Hz), and Total Delta (0.5–4 Hz) bands and their association with age, sex, and disrupted sleep in treatment-resistant depression (TRD). Mann-Whitney U tests were used to compare the nightly progressions of Total Delta, Low Delta, and High Delta in 100 individuals with TRD and 24 healthy volunteers (HVs). Polysomnographic parameters were also examined, including Total Sleep Time (TST), Sleep Efficiency (SE), and Wake after Sleep Onset (WASO). Individuals with TRD had lower Delta power during the first NREM episode (NREM1) than HVs. The deficiency was observed in the Low Delta band versus High Delta. Females with TRD had higher Delta power than males during the first NREM1 episode, with the most noticeable sex difference observed in Low Delta. In individuals with TRD, Low Delta power correlated with WASO and SE, and High Delta correlated with WASO. Low Delta power deficits in NREM1 were observed in older males with TRD, but not females. These results provide compelling evidence for a link between age, sex, Low Delta power, sleep homeostasis, and non-restorative sleep in TRD.

Lifestyle Medicine Approach to Wound Management.

Chronic wounds impact 4.5% of the US population, necessitating a comprehensive understanding of their types and underlying mechanisms. Diabetic foot ulcers (DFUs), prevalent in 25% of individuals with diabetes, contribute significantly to lower limb amputations. The pathophysiology involves neuropathy, peripheral arterial disease, impaired immunity, glycemic control, and mechanical stress. Lifestyle medicine emerges as a pivotal aspect of care, offering both prevention and treatment by integrating plant-predominant nutrition, physical activity, stress management, avoidance of harmful substances, restful sleep, and social connectedness. These interventions impact gene interactions, immune function, and tissue regeneration, playing a crucial role in chronic wound management. The standard of care involves a multidisciplinary approach, emphasizing infection and vascular management, pressure offloading, conducive wound healing environments, and lifestyle adjustments. As diabetes prevalence rises, a proactive integration of lifestyle interventions is crucial, offering a promising avenue to alleviate the growing healthcare burden associated with chronic wounds.