Sleep Debt Research Articles

Sex differences in sleep deficits in mice with an autism-linked Shank3 mutation

BackgroundInsomnia is more prevalent in individuals with Autism Spectrum Disorder (ASD), can worsen core-symptoms and reduces quality of life of both individuals and caregivers. Although ASD is four times more prevalent in males than females, less is known about sex specific sleep differences in autistic individuals. Recent ASD studies suggest that sleep problems may be more severe in females, which aligns with the sex bias seen in insomnia for the general population. We have previously shown that male mice with a mutation in the high confidence ASD gene Shank3, Shank3∆C, recapitulate most aspects of the ASD insomnia phenotype. The objective of the present study was to leverage the Shank3∆C model to investigate sex-specific effects in sleep using polysomnography.MethodsAdult male and female Shank3∆C and wildtype (WT) littermates were first recorded for 24 h of baseline recordings. Subsequently, they were sleep deprived (SD) for five hours via gentle handling and allowed 19 h of recovery sleep to characterize the homeostatic response to SD. Vigilance states (rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep and wake) were assigned by manual inspection using SleepSign. Data processing, statistical analysis and visualization were conducted using MATLAB.ResultsSex and genotype effects were found during baseline sleep and after SD. At baseline, male Shank3∆C mice sleep less during the dark period (active phase) while female Shank3∆C mice sleep less during the light period (rest phase) and sleep more during the dark period. Both male and female Shank3∆C mice show reduced spectral power in NREM sleep. We detect a significant effect of sex and genotype in sleep onset latency and homeostatic sleep pressure (sleepiness). In addition, while male Shank3∆C mice fail to increase sleep time following SD as seen in WT, female Shank3∆C mice decrease sleep time.ConclusionsOverall, our study demonstrates sex differences in sleep architecture and homeostatic response to SD in adult Shank3∆C mice. Thus, our study demonstrates an interaction between sex and genotype in Shank3∆C mice and supports the use of the Shank3∆C model to better understand mechanisms contributing to the sex differences in insomnia in ASD in clinical populations.

The Circadian Brain and Cognition.

Circadian rhythms are inherent to living organisms from single cells to humans and operate on a genetically determined cycle of approximately 24hours. These endogenous rhythms are aligned with the external light/dark cycle of the Earth's rotation and offer the advantage of anticipating environmental changes. Circadian rhythms act directly on human cognition and indirectly through their fundamental influence on sleep/wake cycles. The strength of the circadian regulation of performance depends on the accumulated sleep debt and the cognitive domain, and it has been suggested to involve the activation of ascending arousal systems and their interaction with attention and other cognitive processes. In addition, attention-related cortical responses show extensive circadian rhythms, the phases of which vary across brain regions. This review discusses the impact of the circadian system on sleep/wake regulation and cognitive performance. It further addresses the health implications of circadian disruption, particularly in relation to mental and neurological disorders.

The show must go on: fostering residents’ sustainable employability in medical education – a qualitative exploration of the Resident Leadership Program

BackgroundResidents’ sustainable employability (SE) is threatened by high burn-out rates, sleep deficits, and career dissatisfaction. Medical education may contribute to residents’ SE by providing them with opportunities to influence their employment contexts and to develop conscious self-regulation. This paper explores how residents, participating in the Resident Leadership Program (RLP), are enabled to work on, and learn about, their SE.MethodsThe RLP took place between February and July 2021 and consisted of lectures on, and practice in, quality improvement (QI) work. SE was the theme that governed residents’ QI projects. In this study, residents were interviewed individually before the program (n = 8), were observed while participating in the program (45 h) and were interviewed in three groups after the program (n = 8). The data were analysed in accordance with the ‘flexible-coding’ method.ResultsThe findings are presented in four ‘acts’ mirroring an unfolding play as a metaphor to show how residents’ understanding of context, self-regulations, and quality improvement work—relevant to their SE—changed in the RLP. The acts include ‘setting the stage’, describing how residents experienced the context of medicine; ‘acting the part’, depicting how residents managed their employment contexts using self-regulation; ‘changing the décor’, elaborating on residents’ QI projects; and ‘growing one’s role’, presenting residents’ take-aways from participating in the RLP that may benefit their SE. These take-aways encompassed awareness of the importance of SE, a reconsideration and/or adjustment of self-regulation, feeling better equipped to navigate employment contexts, and increased joy in work because of contributing to peers’ SE through QI work.ConclusionsOur results indicate that medical education is a fruitful environment for providing important lessons and tools for residents to work on and learn about their SE, likely benefiting their SE throughout their careers.

Dietary Habits of Young Poles and Their Selected Determinants: A Review and Implications for Public Health.

This study investigates the dietary patterns, health behaviors, and related determinants among young people in Poland, amid increasing lifestyle-related health concerns like obesity and poor nutrition. Understanding the factors influencing these behaviors is crucial for crafting effective public health strategies. The objective was to analyze young Poles' eating habits, their perceptions of health, and the role of various determinants in shaping these behaviors. A survey was conducted among a representative sample of young Poles, gathering data on eating habits, health perceptions, and lifestyle choices. The survey focused on the respondents' understanding of healthy eating, sources of nutrition knowledge, and the influence of family, social media, and public health campaigns. Data were analyzed using descriptive statistics, and correlations between health behaviors and socio-demographic factors were examined. The study revealed that 88% of young respondents prioritize health, with 73% acknowledging a link between nutrition and health. While most participants accurately described healthy eating and reported adherence to dietary guidelines, 43% engaged in emotional eating, which often led to compulsive behaviors associated with obesity. Social media, internet articles, and family were primary sources of nutrition knowledge. Despite their knowledge, fruit and vegetable consumption was below recommended levels, and physical activity levels were insufficient in nearly half of the respondents. Only 36% regularly read food labels, with many choosing products containing additives. Appearance-related stress was prevalent among 52% of respondents, while sleep deficits and lack of sufficient physical activity were common. The findings suggest that while young Poles possess a high level of awareness regarding healthy eating, gaps remain in the application of this knowledge, particularly concerning emotional eating and inadequate fruit and vegetable consumption. Public health campaigns should be more effectively targeted to address these gaps and promote sustainable health behaviors from early childhood. Addressing emotional eating, enhancing physical activity, and improving nutrition education through effective channels like social media are key to improving public health outcomes.

Sleeping on the edge: Adolescents living at moderate altitude report greater sleep need

PurposeResearch in adults suggests that altitude impacts the restorative properties of sleep and increases risk for mental health concerns. The aim of this study was to extend this research to an adolescent sample to examine how living at altitude may be associated with greater sleep need and mental health symptoms during a period of the life-span when risk for insufficient sleep and mental health difficulties is high. MethodsData were collected from 105 adolescents aged 10–17 years residing at moderate-high altitudes. Parents reported on sociodemographics and adolescent depressive and anxiety symptoms, and adolescents reported on their subjective sleep need and sleep duration. Altitude was calculated using U.S. Geological Survey data. ResultsAdjusting for age, sex, socioeconomic status, rurality, and sleep duration, living at higher altitude was associated with reports of greater sleep need. Altitude was unrelated to mental health symptoms. DiscussionThe majority of adolescents do not obtain the recommended amount of sleep. These findings suggest that adolescents living at moderate-high altitudes may be at further risk due increased sleep need at higher elevations.

The role of circadian clock gene Arntl in the winter depression-like behavior in melatonin-proficient female CBA/N mice

Seasonal affective disorder (SAD), also known as winter depression, is a subtype of depression typically manifesting in winter. Typical symptoms of SAD, such as an increased need for sleep and carbohydrate cravings associated with increased appetite and weight, are distinct from those of major depression, and the underlying mechanisms of SAD remain unclear. Although laboratory mice are generally considered non-seasonal animals, we observed depression-like behaviors in melatonin-proficient female CBA/N mice maintained under winter-mimicking conditions. Transcriptome analysis of the brains of CBA/N mice maintained under winter- and summer-mimicking conditions revealed changes in the expression of circadian clock genes, including Arntl (also known as Bmal1). We generated Arntl-deficient, melatonin-proficient CBA/N mice using the speed congenic method to examine the role of Arntl in depressive behavior. The tail suspension test in these mice revealed a depressive phenotype. These results suggested that the circadian clock gene Arntl may be involved in winter depression-like behavior.

Sleep Habits and Disturbances in Healthcare Workers: A Cross-Sectional Survey in French Public Hospitals.

To describe the sleep habits (bedtime hours, waking hours, sleep duration) and to assess the prevalence of sleep disturbances (acute and chronic insomnia, insufficient sleep, perceived sleep debt) among French healthcare workers. Nurses and assistant nurses working in public hospitals from the Loire department at different work schedules (2x12h, 2x8h, fixed daytime, fixed nighttime) were asked about their socioprofessional and demographic information, their sleep habits and disturbances during night shifts, and the acceptability of a 20-min nap opportunity. A total of 297healthcare workers completed the survey with 76% reporting a sleep debt with a lower prevalence for fixed nighttime workers (62%) and a higher prevalence for 2x12h (84%) workers. The prevalence of acute insomnia was 76% with a significant difference between fixed nighttime (60%) and 2x12h (82%); whereas the prevalence of chronic insomnia was 35% without any significant difference between working schedules. Moreover, 18% of healthcare workers reported excessive daytime sleepiness, while 13% admitted to using sleep medication at least once a week. French healthcare workers reported poor sleep quality with a high prevalence of sleep debt, acute and chronic insomnia symptoms without an obvious impact of working schedules.

Sleepless nights and social plights: medial septum GABAergic hyperactivity in a neuroligin 3-deficient autism model.

Social deficits represent a core symptom domain of autism spectrum disorder (ASD), which is often comorbid with sleep disturbances. In this issue of the JCI, Sun et al. explored a medial septum (MS) circuit linking these behaviors in a neuroligin 3 conditional knockout model of autism. They identified GABAergic neuron hyperactivity following neuroligin 3 deletion in the MS. This hyperactivity resulted in the inhibition of the downstream preoptic area (POA) and hippocampal CA2 region, resulting in sleep loss and social memory deficits, respectively. Inactivating the hyperactive MS GABA neurons or activating the POA or CA2 rescued the behavioral deficits. Together, these findings deepen our understanding of neural circuits underlying social and sleep deficits in ASD.

Sleep as a social and cultural practice in Aotearoa: a scoping review

ABSTRACT Traditionally, sleep science is grounded in biology, physiology, and medicine. But socio-cultural considerations provide a crucial lens into sleep health. Exploring the sociology of sleep in Aotearoa New Zealand (AoNZ) could broaden our understandings and better represent sleep-related practices among our diverse communities. This scoping review represents the pre-existing literature concerning sleep as a social or cultural practice in AoNZ. The initial search (via Discover and Scopus) search yielded 2,442 results. Of these results, 113 manuscripts were characterised of interest, but only 20 were directly related and included in the review. This literature was presented in relation to Meadows’ (2005) modes of ‘sleep embodiment’ including sleep practice norms, the pragmatics of sleep and social roles, individual experiences and feelings related to sleep, and the visceral need for sleep. The findings highlight the progress of sleep literature in AoNZ. This covers diverse sleep practices, perspectives and experiences of sleep and sleeping, as well as the broader socio-cultural factors and unique AoNZ context that influence sleep. However, gaps in the field of local sleep research are also identified. Findings lay the foundation for further research in AoNZ to explore sleep-related discourses and practices that will ultimately broaden existing perspectives.

An integrative analysis of cell-specific transcriptomics and nuclear proteomics of sleep-deprived mouse cerebral cortex.

Sleep regulation follows a homeostatic pattern. The mammalian cerebral cortex is the repository of homeostatic sleep drive and neurons and astrocytes of the cortex are principal responders of sleep need. The molecular mechanisms by which these two cell types respond to sleep loss are not yet clearly understood. By combining cell-type specific transcriptomics and nuclear proteomics we investigated how sleep loss affects the cellular composition and molecular profiles of these two cell types in a focused approach. The results indicate that sleep deprivation regulates gene expression and nuclear protein abundance in a cell-type-specific manner. Our integrated multi-omics analysis suggests that this distinction arises because neurons and astrocytes employ different gene regulatory strategies under accumulated sleep pressure. These findings provide a comprehensive view of the effects of sleep deprivation on gene regulation in neurons and astrocytes.

Sleep duration and sleep loss during pregnancy: a longitudinal FinnBrain birth cohort study.

To investigate sleep duration and sleep loss during antenatal period and assess associative factors, including maternal characteristic and mood symptoms. A cohort of 3038 women was enrolled. Self-reported sleep duration and sleep loss, the latter being calculated from preferred sleep need and actual sleep duration, were measured in early, mid- and late pregnancy, and at delivery. The associations with age, BMI, parity, education, smoking, napping, and depressive and anxiety symptoms were evaluated. Sleep duration was longest in early pregnancy and shortest at delivery (7.93h-7.76h, p < 0.001). The proportion of short sleepers (< 6h) increased from 1.4% to 5.9% throughout the studied period (p < 0.001). Mean sleep loss remained stable in early- and mid-pregnancy, lowering in late pregnancy (p < 0.001) and increasing again until delivery (p = 0.003). The number of women with notable sleep loss (> 2h) was similar during the first three measurement points (9.4%, 8.9% and 9.5%), but increased until delivery (14.1%, p < 0.001). Older, multiparous, and more-depressive women slept less (p < 0.001, p < 0.001, p = 0.017). Women with higher BMI were more likely to sleep < 6h in late pregnancy (p = 0.012). Multiparous, more-depressive, and higher-BMI women reported more sleep loss (p < 0.001, p < 0.001, p = 0.049). We confirmed earlier reported decrease in sleep duration at the end of pregnancy. As a novel finding, we showed a notable increase in sleep loss during the last month of pregnancy. Various factors were associated with both short sleep and sleep loss, especially multiparity, napping and depressive symptoms.

A spectrum of altered non-rapid eye movement sleep in schizophrenia.

Multiple facets of sleep neurophysiology, including electroencephalography (EEG) metrics such as non-rapid eye movement (NREM) spindles and slow oscillations, are altered in individuals with schizophrenia (SCZ). However, beyond group-level analyses, the extent to which NREM deficits vary among patients is unclear, as are their relationships to other sources of heterogeneity including clinical factors, ageing, cognitive profiles and medication regimens. Using newly collected high-density sleep EEG data on 103 individuals with SCZ and 68 controls, we first sought to replicate our previously reported group-level differences between patients and controls (original N=130) during N2 stage. Then in the combined sample (N=301 including 175 patients), we characterized patient-to-patient variability. We replicated all group-level mean differences and confirmed the high accuracy of our predictive model (AUC=0.93 for diagnosis). Compared to controls, patients showed significantly increased between-individual variability across many (26%) sleep metrics. Although multiple clinical and cognitive factors were associated with NREM metrics, collectively they did not account for much of the general increase in patient-to-patient variability. Medication regimen was a greater contributor to variability. Some sleep metrics including fast spindle density showed exaggerated age-related effects in SCZ, and patients exhibited older predicted biological ages based on the sleep EEG; further, among patients, certain medications exacerbated these effects, in particular olanzapine. Collectively, our results point to a spectrum of N2 sleep deficits among SCZ patients that can be measured objectively and at scale, with relevance to both the etiological heterogeneity of SCZ as well as potential iatrogenic effects of antipsychotic medication.

Sleep restriction and age effects on distinct aspects of cognition in adolescents.

Insufficient sleep negatively impacts scholastic performance in children and adolescents. Here we use a dose response time in bed (TIB) restriction study to evaluate associations between sleep loss and multiple aspects of cognition. We evaluated changes in cognitive measures across ages 10 to 23 years and determined whether the effects of sleep loss changed across this age range. A younger cohort (n=77, age range 9.9 to 16.2 years) was studied annually for 3 years. An older cohort study (n=82, age range 15 to 22.8 years) was interrupted by the COVID pandemic with 25 participants completing multiple years. Annually participants completed each of three TIB conditions: four consecutive nights with 7, 8.5, or 10h in bed. A day of cognitive testing followed the fourth night. Restricting TIB to 7h was associated with impaired top-down attentional control and cognitive flexibility, but performance did not differ between the 8.5 and 10h TIB conditions. Psychomotor vigilance test performance decreased as TIB was restricted from 10 to 8.5h and decreased further with restriction to 7h. Sternberg test measures of working memory were not significantly affected by TIB restriction. The effects of sleep loss on these cognitive measures did not change significantly with age, but age-related improvement in many of the measures may compensate for some sleep loss effects. The findings here do not indicate an adolescent decrease in sleep need; however, the minimal duration of sleep needed for optimal performance appears to differ depending on the cognitive measure.

Association of sleep patterns and disorders with metabolic dysfunction-associated steatotic liver disease and liver fibrosis in contemporary American adults

Introduction and ObjectivesThe impact of sleep on metabolic dysfunction-associated steatotic liver disease (MASLD) in American adults remains unclear. This study aimed to address the relationship of sleep patterns and disorders with MASLD and liver fibrosis comprehensively. Materials and MethodsThis cross-sectional study included adult participants from the National Health and Nutrition Examination Survey 2017-2020. Multivariate adjusted regression analysis were used to examine the association of sleep with MASLD and liver fibrosis. We further addressed these associations using restricted cubic splines, mediation analysis, stratified analysis and multiple sensitivity analysis. ResultsWe enrolled 5368 participants. Certain sleep disorders, sleep duration, high sleep debt and specific sleep-wake time were associated with MASLD. Late workday sleep was a shared risk factor for MASLD and liver fibrosis. Short sleep on workdays and free days favored MASLD, whereas average weekly long sleep protected against MASLD. Workday, free day and average weekly optimal sleep duration was 7.5 h, 8 h and 7.78 h, respectively. Mediation analysis suggested that fasting glucose and high-density lipoprotein cholesterol indirectly mediated the relationship between sleep duration and MASLD, whereas stratified analysis showed that sex influenced the relationship, and that the correlation was only observed in women and specific age groups. ConclusionsSleep duration independently affected MASLD but only in women and specific age groups. Moreover, late sleep on workdays was a shared risk factor for MASLD and liver fibrosis. These results suggest targeting sleep behaviors for MASLD prevention and developing age- and sex-specific strategies.

SP5.6 - Sleep Quality and Barriers to Sleep on a Postoperative Surgical Ward

Abstract Aim Sleep is an essential part of recovery post-operatively and poor sleep quality has been linked to increased patient pain, increased rates of post-operative complications such as delirium and to longer hospital stays. It is widely accepted that adults need at least seven hours of sleep at night. Surgery can induce a degree of insomnia and thus we sought to identify quality of sleep on a postoperative general surgical ward and to identify common barriers to sleep and reasons patients experience interruptions to sleep. Methods Using patient questionnaires, we investigated quality of sleep and explored factors, both intrinsic and extrinsic, which influenced patients both falling asleep and being woken throughout the night. Results Average age of participants was 73yrs. Average length of sleep was only 5.4 hours. 89% patients reported having sleep interrupted throughout the night and on average patients were awoken 2.4 times throughout the night. Only 11% reported feeling refreshed in the morning after sleep. Noise and pain were the most common barriers identified to falling asleep affecting 73% of patients. The predominant reasons for being awoken from sleep were noise (94%), interruptions for observations/bloods (67%) and thirst (33%). Conclusions This study has identified a high prevalence of poor sleep quality in postoperative surgical patients. Common factors influencing this are noise, pain and interruptions by medical staff. Many of these can be addressed through simple interventions to promote better recovery of patients by recognising and supporting the need for high quality sleep.

Re-Evaluating Recommended Optimal Sleep Duration: A Perspective on Sleep Literacy.

A significant number of adolescents experience sleepiness, primarily due to sleep deprivation. The detrimental effects of inadequate sleep on both physical and mental health are well documented, particularly during adolescence-a critical developmental stage that has far-reaching implications for later life outcomes. The International Classification of Diseases 11th Revision recently introduced the disorder termed 'insufficient sleep syndrome,' characterized by a persistent reduction in sleep quantity. However, diagnosing this condition based solely on sleep duration is challenging due to significant individual variation in what constitutes optimal sleep. Despite this, managing sleep debt remains difficult without a clear understanding of individual optimal sleep needs. This review aims to reassess recommended sleep durations, with a focus on enhancing sleep literacy. Beginning with an exploration of insufficient sleep syndrome, this review delves into research on optimal sleep duration and examines foundational studies on sleep debt's impact on the developing brain. Finally, it addresses the challenges inherent in sleep education programs from the perspective of sleep literacy. By doing so, this review seeks to contribute to a deeper understanding of the chronic sleep debt issues faced by adolescents, particularly those affected by insufficient sleep syndrome.

Improving sleep health in paramedics through an app-based intervention: a randomised waitlist control pilot trial

BackgroundDue to work commitments, shiftworkers often obtain inadequate sleep, consequently experiencing negative health, wellbeing, and safety outcomes. Given shiftworkers may have limited control over their work commitments, lifestyle and environmental factors within their control may present an intervention opportunity. However, such interventions require tailoring to ensure applicability for this sleep-vulnerable population.MethodsA randomised waitlist control pilot trial investigated the effectiveness of mobile health application Sleepfit, which delivered a tailored sleep health intervention aimed at improving sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. Outcome measures of self-reported sleep health (sleep need, duration, and quality, fatigue, Insomnia Severity Index, Fatigue Severity Scale, and Epworth Sleepiness Scale scores) and sleep hygiene (Sleep Hygiene Index score) were collected at baseline, post-intervention, and 3-month follow-up.ResultsFifty-eight paramedics (aged 33.4 ± 8.0 years; 50% male) were recruited, and trialed Sleepfit for a 14-day intervention period between August 2021–January 2022. For all participants, there was a significant reduction in Insomnia Severity Index and Sleep Hygiene index scores after intervention engagement. Regression models demonstrated no significant intervention effect on sleep health or sleep hygiene outcomes (intervention versus waitlist control group). A high study drop-out rate (91.4%) prevented assessment of outcomes at 3-month follow-up.ConclusionsPilot trial findings demonstrate that Sleepfit may elicit improvements in sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. However, low enrolment and retention means that findings should be interpreted with caution, further highlighting potential engagement challenges, especially among paramedics who are particularly in need of support for improved sleep.Trial registrationProspectively registered with the Australian New Zealand Clinical Trial Registry 24/01/2020 (reference no. ACTRN12620000059965).

Novel murine closed-loop auditory stimulation paradigm elicits macrostructural sleep benefits in neurodegeneration.

Boosting slow-wave activity (SWA) by modulating slow waves through closed-loop auditory stimulation (CLAS) might provide a powerful non-pharmacological tool to investigate the link between sleep and neurodegeneration. Here, we established mouse CLAS (mCLAS)-mediated SWA enhancement and explored its effects on sleep deficits in neurodegeneration, by targeting the up-phase of slow waves in mouse models of Alzheimer's disease (AD, Tg2576) and Parkinson's disease (PD, M83). We found that tracking a 2 Hz component of slow waves leads to highest precision of non-rapid eye movement (NREM) sleep detection in mice, and that its combination with a 30° up-phase target produces a significant 15-30% SWA increase from baseline in wild-type (WTAD)and transgenic (TGAD) mice versus a mock stimulation group. Conversely, combining 2 Hz with a 40° phase target yields a significant increase ranging 30-35% in WTPD and TGPD mice. Interestingly, these phase-target-triggered SWA increases are not genotype dependent but strain specific. Sleep alterations that may contribute to disease progression and burden were described in AD and PD lines. Notably, pathological sleep traits were rescued by mCLAS, which elicited a 14% decrease of pathologically heightened NREM sleep fragmentation in TGAD mice, accompanied by a steep decrease in microarousal events during both light and dark periods. Overall, our results indicate that model-tailored phase targeting is key to modulate SWA through mCLAS, prompting the acute alleviation of key neurodegeneration-associated sleep phenotypes and potentiating sleep regulation and consolidation. Further experiments assessing the long-term effect of mCLAS in neurodegeneration may majorly impact the establishment of sleep-based therapies.

Sleep Quality is Poor in Rheumatoid Arthritis Patients and Correlates with Anxiety, Depression, and Poor Quality of Life.

Sleep quality is poor in most rheumatoid arthritis (RA) patients. We planned this study to see the association of sleep quality with anxiety, depression, and quality of life (QOL) in Indian RA patients. One hundred twelve RA patients and 93 controls were included in this cross-sectional study. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Quality of life was assessed using the World Health Organisation Quality of Life (WHOQOL-BREF). Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS). The disease activity was measured by Disease Activity Score for 28 joints with 3 variables. Functional disability was measured by using the Indian version of the Health Assessment Questionnaire (HAQ). Poor sleep quality was seen in 103(92%) of the patients and 26(28%) controls (p<0.0001). RA patients had significantly higher PSQI scores as compared to the control group (10.8±3.7 vs.3.9±1.2, P<0.0001). Poor sleepers were more likely to be females (90% vs.0%, p = 0.02), and had longer disease duration (5.2±4.8 years vs. 2.8±2 years, p=0.01). Poor sleepers had more pain (VAS 42.2±23.6 mm vs.16.2±11.6 mm, p<0.001) and poor functional status (HAQ 1.2±0.5 vs. 0.6±0.4, p<0.01). There was a significant effect of the physical domain of WHOQOL-BREF, anxiety, and age on poor sleep quality. Poor sleep quality is seen in a majority of RA patients and correlates with anxiety, depression, and poor QOL. RA patients need to be routinely assessed for sleep quality and factors affecting poor sleep quality need to be addressed.

The Impact of Competitive Sports on the Mental Health of Young People

Introduction Mental health is a crucial component of overall well-being for everyone, and it becomes particularly important in the context of young student-athletes who must simultaneously meet educational and athletic challenges. Athletes, like their peers, struggle with various mental health issues such as anxiety, depression, suicidal thoughts, eating disorders, sleep deficits, burnout, and overtraining. The additional activity of engaging in competitive sports, compared to those who do not, can exacerbate these symptoms. The aim of study Identify and analyze specific sources of stress and mental health issues among young student-athletes and young individuals. Compare different research groups. Conclusion Student-athletes face the unique challenge of balancing intense training and sports competitions with educational demands. The constant pursuit of peak performance and coping with high expectations can lead to significant psychological stress. Factors such as injuries, overtraining, social identity issues, and sleep problems further impact their mental health, often leading to the development or worsening of existing mental health issues. It is important to note that professional psychological care is essential in managing the training schedule of a young athlete. For their development to be balanced across various dimensions such as proper physical growth, well-being, and mental wellness, this support is crucial.