Severe Sleep Disorders Research Articles

Opposite effects of low and high frequency deep brain stimulation of lateral hypothalamus on arousal and temperature in a monkey pilot study.

Deep brain stimulation is a well-established treatment for improving motor symptoms in Parkinson's disease. However, persistent non-motor symptoms, such as excessive daytime sleepiness, remain a significant challenge and necessitate further investigation. In this study, we conducted repeated measurements of daytime sleepiness using a modified multiple sleep latency test in a healthy monkey (macaca fascicularis), which was later rendered parkinsonian through MPTP administration. Deep brain stimulation targeting the lateral hypothalamic area revealed frequency-dependent modulation of both sleepiness level and core body temperature. High-frequency stimulation (80Hz) increased sleepiness in the healthy state, while low-frequency stimulation (20Hz) promoted wakefulness in the parkinsonian state. These findings suggest a promising therapeutic approach for addressing sleep/wake disturbances, not only in Parkinson's disease but also in other severe sleep disorders.

A Neurobiologia do Sono: A Importância do Sono no Desenvolvimento de Crianças com Transtorno do Espectro Autista

This article examines the neurobiological aspects of sleep in children with Autism Spectrum Disorder (ASD) based on a thorough literature review from PubMed, Scielo, and Google Scholar databases. Studies show that children with ASD experience more frequent and severe sleep disorders than their neurotypical peers, facing difficulties in falling asleep, maintaining sleep, and achieving restful sleep. As sleep is essential for neurological development and overall health, disturbances in this process significantly impact behavioral and cognitive skills. This paper reviews the neurobiological mechanisms underlying sleep disorders, including neurochemical and neuroanatomical aspects, as well as the consequences of disrupted sleep on development. It concludes that individualized interventions and interdisciplinary approaches are crucial for continuous improvement in quality of life and development in children with autism.

Encephalitis lethargica: clinical features and aetiology.

Encephalitis lethargica, an epidemic neurological illness, typically involved a severe sleep disorder and progressive parkinsonism. A century later, our understanding relies on seminal descriptions, more recent historical research and the study of small numbers of possible sporadic cases. Theories around infection, environmental toxins, catatonia and autoimmune encephalitis have been proposed. We aimed to describe the presentation of encephalitis lethargica and test these diagnostic and aetiological theories. Subjects with encephalitis lethargica were identified in the archives of the National Hospital for Neurology and Neurosurgery, UK between 1918 and 1946. Case notes were examined to establish illness temporality, clinical features and cerebrospinal fluid results. Controls from the archives were identified for 10% of cases, matching on discharge year, sex and neurologist. Clinical presentation was compared to modern diagnostic criteria for encephalitis lethargica, catatonia and autoimmune encephalitis. In a case-control design, a multilevel logistic regression was conducted to ascertain whether cases of encephalitis lethargica were associated with febrile illnesses and with environmental exposures. Six hundred and fourteen cases of encephalitis lethargica and 65 controls were identified. Cases had a median age of 29 years (interquartile range 18) and a median time since symptomatic onset of 3.00 years (interquartile range 3.52). Motor features were present in 97.6%, cranial nerve findings in 91.0%, ophthalmological features in 77.4%, sleep disorders in 66.1%, gastrointestinal or nutritional features in 62.1%, speech disorders in 60.8% and psychiatric features in 53.9%. Of the 167 cases who underwent lumbar puncture, 20 (12.0%) had a pleocytosis. The Howard and Lees criteria for encephalitis lethargica had a sensitivity of 28.5% and specificity of 96.9%. Among the cases, 195 (31.8%, 95% confidence interval 28.1-35.6%) had a history of febrile illness within one calendar year prior to illness onset, which was more common than among the controls (odds ratio 2.70, 95% confidence interval 1.02-7.20, P = 0.05), but there was substantial reporting bias. There was no evidence that occupational exposure to solvents or heavy metals was associated with encephalitis lethargica. Two hundred and seventy-six (45.0%) of the cases might meet criteria for possible autoimmune encephalitis, but only 3 (0.5%) might meet criteria for probable NMDA receptor encephalitis. Only 11 cases (1.8%) met criteria for catatonia. Encephalitis lethargica has a distinct identity as a neuropsychiatric condition with a wide range of clinical features. Evidence for a relationship with infectious or occupational exposures was weak. Autoimmune encephalitis may be an explanation, but typical cases were inconsistent with NMDA receptor encephalitis.

Exploring the Relationship Between Sleep Quality and Musculoskeletal Pain in Internet-Addicted College Students

Background: The pervasive use of the internet among college students has raised concerns about internet addiction and its associated health implications. This addiction is characterized by excessive and obsessive internet usage that often leads to detrimental effects on physical, psychological, and social well-being. Among these effects, musculoskeletal discomfort and poor sleep quality are prevalent symptoms reported by this demographic. Objective: This study aims to explore the relationship between sleep quality and musculoskeletal pain in internet-addicted college students to identify potential interventions that can mitigate these adverse effects. Methods: A cross-sectional study was conducted with 171 students aged 16-20 years, who reported using screens for more than three hours daily and experienced idiopathic musculoskeletal pain. The study employed the Nordic Musculoskeletal Questionnaire (NMQ) and the Sleep Quality Scale (SQS) for data collection. Statistical analyses, including chi-square tests, were performed using SPSS Version 25 to explore associations between internet usage hours, sleep quality, and musculoskeletal pain. Results: The participants had a mean age of 17.99±1.37 years, with a balanced gender distribution (50.3% male, 49.7% female). Musculoskeletal pain was most frequently reported in the neck and shoulder regions (29.8% each), followed by the lower back (26.9%). Regarding sleep quality, 44.5% of students suffered from severe sleep disorders. Significant associations were found between the number of hours of internet usage and both the presence of musculoskeletal pain (p<0.001) and poor sleep quality (p=0.049). Conclusion: The findings indicate a significant correlation between excessive internet use and both increased musculoskeletal pain and deteriorated sleep quality among college students. These results underscore the need for targeted interventions to promote healthier internet use habits and improve the ergonomic and sleep hygiene practices among this population. Keywords: Internet addiction, musculoskeletal pain, sleep quality, college students, ergonomic health, cross-sectional study, SPSS analysis.

Design, development, and optimization of the Somnomat Casa: a rocking bed for sleep studies and nocturnal interventions in home settings

Abstract Vestibular Stimulation (VS) has been shown to positively affect various autonomic body functions, including sleep. In the past, VS was often investigated using large and complex rocking beds that would only allow for short intervention periods in constrained lab settings. In this work, we present an overview of the mechanics, kinematics, dynamics, and tuning of our latest rocking bed, the Somnomat Casa. Its compact dimensions, comparable to a standard single bed, its connectivity, and easy usability, allow for prolonged studies in home settings investigating the effects of VS during sleep. In a first six-month study with a 12-year-old boy suffering from primary mitochondrial disease with an associated severe sleep disorder, we observed significant improvements in sleep duration (+25 %) and quality of life, as well as a 75 % reduction in caregiving interactions and a 40 % reduction in overall caregiving time. Based on these promising findings, we are currently testing the Somnomat Casa with various patient groups for multiple months each, including elderly with insomnia, children with sleep disorders, Parkinson’s disease patients, and individuals with post-stroke insomnia.

The Association Between the 5-Hydroxytryptamine Receptor 2A Gene Variants rs6311 and rs6313 and Obstructive Sleep Apnea in the Iranian Kurdish Population.

Introduction: Sleep is one of the most significant parts of everyone's life. Most people sleep for about one-third of their lives. Sleep disorders negatively impact the quality of life. Obstructive sleep apnea (OSA) is a severe sleep disorder that significantly impacts the patient's life and their family members. This study aimed to investigate the relationship between rs6313 and rs6311 polymorphisms in the serotonin receptor type 2A gene and OSA in the Kurdish population. Materials and Methods: The study's population comprises 100 OSAsufferers and 100 healthy people. Polysomnography diagnostic tests were done on both the patient and control groups. The polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) was used to investigate the relationship between OSAand LEPR gene polymorphisms. Results: Statistical analysis showed a significant relationship between genotype frequencies of patient and control groups of rs6311 with OSAin dominant [odds ratio (OR) = 5.203, p < 0.001) and codominant models (OR = 9.7, p < 0.001). Also, there was a significant relationship between genotype frequencies of patient and control groups of rs6313 with OSAin dominant (OR = 10.565, p < 0.001) and codominant models (OR = 5.938, p < 0.001). Conclusions: Findings from the study demonstrated that the two polymorphisms rs6311 and rs6313 could be effective at causing OSA; however, there was no correlation between the severity of the disease and either of the two polymorphisms.

Nocturnal vestibular stimulation using a rocking bed improves a severe sleep disorder in a patient with mitochondrial disease.

Mitochondrial diseases are rare genetic disorders often accompanied by severe sleep disorders. We present the case of a 12-year-old boy diagnosed with a severe primary mitochondrial disease, exhibiting ataxia, spasticity, progressive external ophthalmoplegia, cardiomyopathy and severely disrupted sleep, but no cognitive impairment. Interestingly, his parents reported improved sleep during night train rides. Based on this observation, we installed a rocking bed in the patient's bedroom and performed different interventions, including immersive multimodal vestibular, kinesthetic and auditory stimuli, reminiscent of the sensory experiences encountered during train rides. Over a 5-month period, we conducted four 2-week nocturnal interventions, separated by 1-week washout phases, to determine the subjectively best-perceived stimulation parameters, followed by a final 4-week intervention using the optimal parameters. We assessed sleep duration and quality using the Mini Sleep Questionnaire, monitored pulse rate changes and used videography to document nocturnal interactions between the patient and caregivers. Patient-reported outcome measures, clinical examinations and personal outcomes of specific interests were used to document daytime sleepiness, restlessness, anxiety, fatigue, cognitive performance and physical posture. In the final 4-week intervention, sleep duration increased by 25%, required caregiver interactions reduced by 75%, and caregiving time decreased by 40%. Subjective fatigue, assessed by the Checklist Individual Strength, decreased by 40%, falling below the threshold of severe fatigue. Our study suggests that rocking beds could provide a promising treatment regime for selected patients with persistent severe sleep disorders. Further research is required to validate these findings in larger patient populations with sleep disorders and other conditions.

The impact of chronic insomnia disorder on menstruation and ovarian reserve in childbearing-age women: A cross-sectional study.

Diminished ovarian reserve (DOR) is a disorder characterized by impaired ovarian function. Sleep disorders are disruptions of the circadian rhythm, which appears to be closely linked to reproductive systems. This study aimed to investigate the impact of poor sleep quality on the ovarian reserve of childbearing-age women. A cross-sectional study was conducted in China from June 2021 to March 2023. In total, 102 participants diagnosed with chronic insomnia disorder were included in the study. Questionnaires were administered to assess participants' menstrual patterns, insomnia severity, anxiety, and depression. The anti-Müllerian hormone level and the basal antral follicle count were measured for ovarian reserve evaluation. Correlation analysis and ordinal logistic regression analysis were conducted. The women with insomnia presented high percentages of hypomenorrhea, premenstrual syndrome, and dysmenorrhea (78.4%, 74.5%, and 46.1%, respectively). Severe sleep disorder in the past month was identified as an independent risk factor for hypomenorrhea and premenstrual syndrome (odds ratio [OR], 2.64 and OR, 2.688; p<0.05). The prevalence of DOR among women with insomnia (33.3%) was significantly higher than the average reported in previous studies for young women. Insomnia duration exceeding 1 year was determined to be an independent risk factor for DOR in women aged 36 to 40 years (OR, 4.5; p=0.033). This study highlights the association between sleep disorders and menstrual problems. Prolonged poor sleep quality in women aged 36 to 40 years was identified as a significant risk factor for DOR. We should pay more attention to improving sleep quality in order to maintain normal ovarian function.

Sleep disorders and cancer incidence: examining duration and severity of diagnosis among veterans.

Sleep disruption affects biological processes that facilitate carcinogenesis. This retrospective cohort study used de-identified data from the Veterans Administration (VA) electronic medical record system to test the hypothesis that patients with diagnosed sleep disorders had an increased risk of prostate, breast, colorectal, or other cancers (1999-2010, N=663,869). This study builds upon existing evidence by examining whether patients with more severe or longer-duration diagnoses were at a greater risk of these cancers relative to those with a less severe or shorter duration sleep disorder. Incident cancer cases were identified in the VA Tumor Registry and sleep disorders were defined by International Classification of Sleep Disorder codes. Analyses were performed using extended Cox regression with sleep disorder diagnosis as a time-varying covariate. Sleep disorders were present among 56,055 eligible patients (8% of the study population); sleep apnea (46%) and insomnia (40%) were the most common diagnoses. There were 18,181 cancer diagnoses (41% prostate, 12% colorectal, 1% female breast, 46% other). The hazard ratio (HR) for a cancer diagnosis was 1.45 (95% confidence interval [CI]: 1.37, 1.54) among those with any sleep disorder, after adjustment for age, sex, state of residence, and marital status. Risks increased with increasing sleep disorder duration (short [<1-2 years] HR: 1.04 [CI: 1.03-1.06], medium [>2-5 years] 1.23 [1.16-1.32]; long [>5-12 years] 1.52 [1.34-1.73]). Risks also increased with increasing sleep disorder severity using cumulative sleep disorder treatments as a surrogate exposure; African Americans with more severe disorders had greater risks relative to those with fewer treatments and other race groups. Results among patients with only sleep apnea, insomnia, or another sleep disorder were similar to those for all sleep disorders combined. The findings are consistent with other studies indicating that sleep disruption is a cancer risk factor. Optimal sleep and appropriate sleep disorder management are modifiable risk factors that may facilitate cancer prevention.

Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper.

Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri- and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid-life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri- and postmenopause, worldwide.

Sleep disorders in patients with multiple sclerosis in Spain

ObjectiveThis study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. MethodsThe Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. ResultsThe prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44–54 years and 55–68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0–3, 3–6, and >6, respectively. ConclusionOur results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.

Features of fibromyalgia in patients with rheumatoid arthritis

To determine the features of fibromyalgia (FM) in patients with rheumatoid arthritis (RA). Seventy-six patients participated in the study. The patients were divided into 2 groups: RA+FM (n=55), FM (n=21). Anamnesis of life and disease was carefully collected in all patients. The intensity (according to VAS) and phenotype (Pain DETECT, DN4) of pain syndrome (PS), the presence of symptoms of central sensitization (CSI), fatigue (FSS), signs of anxiety and depression (HADS), sleep quality (PSQI), cognitive functions (DSST) and quality of life (QoL) (EQ-5D, FIQR) were also evaluated. The average age of patients in the FM group was significantly lower (42 [35; 53] vs. 50 [42.5; 59], p=0.042). Patients with «pure» FM without RA were more often divorced and had no children (p=0.045 and p=0.02, respectively). The duration of PS in the groups did not differ (11 [7; 17] vs. 8 [5; 13] years, p=0.429), however, patients with «pure» FM waited longer for diagnosis (115 [40; 198] vs. 20 [5.5; 59] months, p<0.001), and they also were less likely to be recognized as disabled (p=0.003). Patients of both groups had equally severe fatigue, anxiety, depression, sleep disorders and cognitive functions compared to the norms. Patients of the FM group noted a lower QoL (according to EQ-5D, p=0.041) then in RA+FM group, despite the comparable severity of FM and the intensity of the PS in both groups. FM in patients with RA develops at a later age compared to «pure» FM. The clinical picture of FM with and without RA does not differ in the main manifestations, however, the QoL of patients with «pure» FM is lower. Accounting for fibromyalgia in the treatment of rheumatoid diseases can significantly improve the QoL of patients.

An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study

BackgroundAccording to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies. ObjectiveMETA analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting. ResultsA total of seven papers were included. Meta-analysis showed that tai chi exercise was more effective in improving sleep problems in elderly patients with sleep disorders compared to the control group, and the difference was significant. This was demonstrated by a decrease in the global Pittsburgh Sleep Quality Index (PSQI) score [SMD = −0.66, 95 % CI (−0.91, −0.41), P < 0.00001], as well as its subdomains of subjective sleep quality [SMD = −0.79, 95 % CI (−1.06, −0.52), P < 0.00001], sleep latency [SMD = −0.80, 95 % CI (−1.21, −0.40), P < 0.00001], sleep duration [SMD = −0.38, 95 % CI (−0.72, −0.04), P = 0.03], habitual sleep efficiency [SMD = −0.58, 95 % CI (−0.84, −0.31), P < 0.0001], sleep disturbance [SMD = −0.51, 95 % CI (−0.78, −0.25), P = 0.00001] and daytime dysfunction [SMD = −0.33, 95 % CI (−0.59, −0.07), P = 0.01]. Improvement was also observed in the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index Scale (ISI). The results showed that the optimal duration and frequency of Tai Chi exercise therapy for improving moderately severe elderly patients with sleep disorders was long-term. ConclusionThis study systematically assessed the efficacy of Tai Chi exercise therapy for elderly patients with moderate-to-severe sleep disorders. Through a meta-analysis of relevant randomized controlled trials (RCTs), it aims to determine the effectiveness of Tai Chi exercise in improving sleep quality in elderly patients with moderate-to-severe sleep disorders, as well as to compare its effects with those of traditional treatments; to analyze the safety of Tai Chi exercise for this patient population and assess its feasibility as a non-pharmacological therapy; and to fill the research gaps and provide more comprehensive and systematic evidence support. This study provides a practical approach to reducing the risk of medication side effects in older adults with sleep disorders and offers a potentially effective non-pharmacological treatment option, especially for those who are unable or unwilling to use medication. Tai chi exercise may not only improve sleep, but also improve coordination, muscle strength, balance, and reduce stress and anxiety in older adults. It also helps older adults socialize and enhances their social connections and emotional support. This study suggests that community centers or activity centers for the elderly can organize tai chi classes to promote the participation of older adults, and can be used as a scientific exercise rehabilitation tool in clinical treatment, incorporating tai chi practice into daily life, such as tai chi practice at a fixed time every day or every week, which not only helps to improve the sleep disorders of older adults, but also improves their overall quality of life.

A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland.

Objective: This study investigated the prevalence of the most common mental health symptoms in a large primary care patient population and characterized their determinants. Methods: Data came from a 2015-16 cross-sectional study of a primary care population in Switzerland. An investigator presented the study to patients in waiting rooms, and 1,103 completed a tablet-based questionnaire measuring stress in daily life, sleep disorders and anxiety and depressive symptoms. Diagnoses and treatments were recorded. Results: Moderate-to-high anxiety and depressive symptoms concerned 7.7% of patients; 27.6% felt stressed at least once a week; 17.2% had severe sleep disorders. Sociodemographic determinants were associated with psychiatric symptoms: female sex, young age, and frequency of consultations with a GP. Participants taking psychotropics had high levels of mental distress. Conclusion: Even though most patients were regularly monitored by their GP, a significant number of mental health problems were found. GPs should be provided with concrete tools to manage these patients better. Collaboration with mental health specialists should be encouraged in primary care settings.

Influence of endotracheal tube and laryngeal mask airway for general anesthesia on perioperative adverse events in patients undergoing laparoscopic hysterectomy: A propensity score-matched analysis.

To compare perioperative adverse events between general anesthesia with endotracheal tube (ETT) and general anesthesia with laryngeal mask airway (LMA) in patients undergoing laparoscopic hysterectomy. This was a large sample retrospective, propensity score-matched (PSM) study. We collected the data of 6739 female patients who underwent laparoscopic hysterectomy between January 2016 and June 2021 in our hospital, China. Patients were divided into two groups (ETT group and LMA group) according to different airway management modes. Data on all perioperative adverse events were collected. PSM analysis was performed to control confounding factors and differences in baseline values between the two groups. Finally, 4150 female patients were recruited after PSM. The total number of patients taking intraoperative vasoactive drugs during surgery was higher in the ETT group than in the LMA group (P = 0.04). The LMA group had a higher incidence of vomiting (51 [2.46%]) and somnolence (165 [7.95]) in the postanesthesia care unit (PACU) than the ETT group (71 [3.42%] and 102 [4.92%], respectively) (P = 0.02 and P < 0.001). Hypothermia was significantly higher in the LMA group (183 [10.36%]) than in the ETT group (173 [8.34%]) in the PACU (P = 0.03). The number of patients with sore throat was significantly higher in the ETT group (434 [20.02%]) than in the LMA group (299 [14.41%]) in the ward (P < 0.001). Other variables such as hypoxemia, moderate to severe pain, abdominal distension, diarrhea, sleep disorders, wound bleeding, and skin itch were not significantly different between the two groups (P > 0.05). The ETT group had more incidences of vomiting, sore throat, and cough complications and needed more drug treatment than the LMA group. LMA is a better airway management mode and LMA general anesthesia can be safely used in patients undergoing laparoscopic nonemergency hysterectomy.

16 The Multicultural Neuropsychological Scale (MUNS): The New Attention Subtest, Preliminary Cross-Cultural Data

Objective:The MUNS is a screening scale developed in Cordoba, Argentina (2018). It is devised with multicultural stimuli that are easily translated into different languages. The scale consists of seven subtests evaluating five cognitive domains: attention, memory, executive functioning, constructional praxis, and language. Previous cross-cultural studies with this scale found significant differences in performance on the attention subtest. The authors have developed a new attention subtest called “Arrows Cancellation”, a short cancellation test designed to overcome its predecessor’s shortcomings. The minimum score of this subtest is 0, and the maximum score is 160. It takes between 3 to 5 minutes to administer. A pilot study of this subtest was performed in Argentina in 2021 (n=62, M=105.61 ± 15.06). The aim of this study is to present the first cross-cultural comparison for the Arrows Cancellation subtest of the MUNS.Participants and Methods:Argentinian (n=25, 84% female) and U.S.A. (n=39, 87% female) samples were administered the Arrows Cancellation subtest. In both cases, individuals gave their consent to participate voluntarily in this study. Participants’ health backgrounds, explored through a set of questions, determined their inclusion in the study. Participants with any of the following diagnoses were excluded from this sample: stroke, loss of consciousness (at least 20 minutes), traumatic head injury, central nervous system disease, chronic renal insufficiency, hepatic encephalopathy, non-treated thyroid disease, epilepsy, non-treated high blood pressure, severe cardiac failure, severe sleep disorders, coma, diagnosed psychiatric disease, or illegal drug consumption. Argentinians were given the instructions in Spanish whilst Americans were instructed in English. The mean age for the Argentinian sample was 21.24 ± 2.44, and for the American sample it was 20.18 ± 1.89. The mean years of education was 13.44 ± 0.96 for the Argentinian group and 13.6 ± 1.55 for the American group. A t-test showed that there were no significant differences in age (p=.06), years of schooling (p=.67) between both samples.Results:The mean score of the Arrows Cancellation subtest for the Argentinian sample was 107.30 ± 14.51 and 108.95 ± 14.12 for the American sample. A t-test did not show significant differences in the Arrows Cancellation subtest score between samples (p=.65). In addition, there were no significant differences between males and females (p=.43).Conclusions:The results of this study show that the new attention subtest of the MUNS did not show significant differences between two different cultural samples. Further studies are needed to confirm its utility in other cultural settings. Among the limitations of this study are the sample sizes and the restricted ranges of age and years of schooling.

The prevalence of alcohol and pre-workout caffeine consumption and their effect on injuries and sleep disorders in young elite soccer players

Aim: to study the prevalence of alcohol and pre-workout caffeine use and their impact on sleep quality and injury among the young soccer players.Methods: this study examined the prevalence of alcoholic beverages and pre-workout caffeine consumption in young soccer players, as well as the effect of these substances on sleep disorders and injuries among 236 elite athletes aged 11–21 years.Results: 16.5 % of soccer players use pre-workout caffeine. Most often 1–2 times per week. Caffeine consumption is weakly positively correlated with age (p &lt; 0,001, R = 0,41.) and is most common in the age group of 19–21 years with consumption rates at 58.8 %. 17.3 % of young soccer players consume alcohol moderately and its consumption significantly correlates with age. Most often alcohol was consumed at the age of 19–21 years. Alcohol and caffeine consumption are significantly, but weakly correlated with the risk of severe sleep disorders on the Athlete Sleep Behavior Questionnaire (ASBQ). However, injuries during matches and training sessions did not depend on alcohol (p = 0.076) or caffeine (p = 0.14) consumption according to the Kraskal — Wallis test. At the same time, sleep disorders on the ASBQ significantly correlated with injury.Conclusion: the widespread use of alcohol and caffeine, and their negative impact on sleep among soccer players aged 11–21 years were revealed, but there was no connection between the use of these substances and injuries.

Improving OSAHS Prevention Based on Multidimensional Feature Analysis of Snoring

Obstructive Sleep Apnea–Hypopnea Syndrome (OSAHS), a severe respiratory sleep disorder, presents a significant threat to human health and even endangers life. As snoring is the most noticeable symptom of OSAHS, identifying OSAHS via snoring sound analysis is vital. This study aims to analyze the time-domain and frequency-domain characteristics of snoring sounds to detect OSAHS and its severity. The snoring sounds are extracted and scrutinized from nighttime acoustic signals, with spectral energy ratio features being applied, calculated via the snore detection frequency division method. A variety of time and frequency-domain features are derived from the snoring sounds. A novel Snore Detection Cepstral Coefficient (SDCC) is proposed, based on Mel Frequency Cepstral Coefficients (MFCCs) and snore detection frequency division. Relief-F feature screening is then applied to SDCC and MFCC. Canonical Correlation Analysis (CCA) is utilized on the fusion features obtained as a result, and the results indicate the highest accuracy (97.8%) with Subspace KNN. The optimal classifier with feature combination is used for the snore model of OSASH early warnings all night, effectively recognizing and assessing OSAHS and reflecting the severity of its disease. This result, achieving high accuracy and low computational complexity, shows that the proposed method holds significant promise for developing portable sleep health detection devices.

Summary of drug therapy to treat cognitive impairment-induced obstructive sleep apnea.

Obstructive sleep apnea (OSA) is a severe sleep disorder associated with intermittent hypoxia and sleep fragmentation. Cognitive impairment is a signifi- cant and common OSA complication often described in such patients. The most commonly utilized methods in clinical OSA treatment are oral appliances and continuous positive airway pressure (CPAP). However, the current therapeutic methods for improving cognitive function could not achieve the expected efficacy in same patients. Therefore, further understanding the molecular mechanism behind cognitive dysfunction in OSA disease will provide new treatment methods and targets. This review briefly summarized the clinical manifestations of cognitive impairment in OSA disease. Moreover, the pathophysiological molecular mechanism of OSA was outlined. Our study concluded that both SF and IH could induce cognitive impairment by multiple signaling pathways, such as oxidative stress activation, inflammation, and apoptosis. However, there is a lack of effective drug therapy for cognitive impairment in OSA. Finally, the therapeutic potential of some novel compounds and herbal medicine was evaluated on attenuating cognitive impairment based on certain preclinical studies.

The Effect of Sleep Disorders on Blood Sugar in Children With Type 1 Diabetes Mellitus

Background: Diabetes mellitus (DM) is a common metabolic disorder. The hemoglobin A1c (HbA1c) test is a simple laboratory test that shows the average amount of blood sugar in the last 3 months. Studies have shown that sleep is important in controlling blood sugar levels, so that sleep deprivation can reduce glucose tolerance. Lack of sleep and sleep disorders are also predictors of DM. Objectives: Given the contradictory information about the effect of sleep on blood sugar, the impact of various factors in the process of DM, including the lifestyle of patients, and the limited number of studies in this field in Iran, we decided to investigate the effect of sleep disorders on blood sugar control in people with type 1 DM. Methods: This cross-sectional descriptive-analytical study was performed on children with type 1 DM referred to the diabetes clinic. Their HbA1c levels were recorded in a checklist from the patient’s last test recorded in their files, and the standard Pittsburg sleep quality index (PSQI) was completed to assess their sleep disorders with the help of the child’s parents. Achieving a score higher than 5 in the whole questionnaire means poor sleep quality. After collecting data, they were analyzed in SPSS software, version 21. Results: A total of 200 children with type 1 DM were studied, of whom 119(59.5%) were boys, 81(40.5%) were girls. Also, 79 children (39.5%) were less than 1 year old, 67(33.5%) were 1 to 2 years old and 54 were more than 3 years old. Also, 104 children (52.6%) had no sleep disorders, while 69(32.1%) had moderate, 20(11.6%) had severe, and 7(3.7%) had very severe sleep disorders. Their Mean±SD age was 10.86±4.68 years, and HbA1c level was 9.64±3.35 mmol/mol. Conclusions: This study showed that the prevalence of sleep disorders based on the PSQI was approximately 50%. There was a significant relationship between elevated HbA1c and the prevalence of sleep disorders.