Sleep Duration Time Research Articles

Efficiency and safety of continuous theta burst stimulation for primary insomnia: A randomized clinical trial

ObjectivesPrimary insomnia is a substantial public health burden, but current treatments for this disorder have limited effectiveness and adherence. Herein, we aimed to investigate the efficacy and safety of continuous theta burst stimulation (cTBS) for the treatment of primary insomnia. MethodsThis two-armed, randomized, sham-controlled trial was conducted at Peking University Sixth Hospital and local community clinics. A total of 46 patients with primary insomnia were recruited and randomly allocated to either the cTBS group or sham group. Forty-one patients completed 10 sessions of cTBS or sham intervention and follow-up assessments. ResultsAfter the intervention, the severity of insomnia was significantly lower in the cTBS group than in the sham group, with a large effect size (Cohen's d = −1.938). Additionally, 52.4 % of patients in the cTBS group achieved a response (Insomnia Severity Index score reduction ≥8), whereas only 4 % of patients in the sham group achieved a response. The duration of objective total sleep time and slow-wave sleep were higher in the cTBS group than in the sham group. The degree of anxiety was lower in the cTBS group than in the sham group. There were no significant differences in depression, sleepiness, or cognitive function between the cTBS and sham groups. During follow-up, the sleep quality of the cTBS group significantly improved and remained stable at the 6-month follow-up. ConclusionIn this randomized clinical trial, cTBS improved insomnia symptoms and was generally well tolerated, thus supporting the further development of cTBS for the treatment of primary insomnia.

Subjective and objective sleep quality assessment in adolescent patients with inflammatory bowel disease

ObjectivesThere is a link between inflammatory bowel disease (IBD) and poor sleep quality that is presumed to be multifactorial. The purpose of this study was to identify factors that impact sleep quality in this group including clinical disease activity, depression, anxiety, quality of life, and disordered social media use through questionnaires. MethodsThis prospective study analyzed sleep quality in adolescent patients ages 13 to 18 with a diagnosis of IBD using objective data from wrist actigraphy and subjective report from the Pittsburgh Sleep Quality Index (PSQI). Additional screeners including the Short Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module, Generalized Anxiety Disorder 7-item screener, Patient Health Questionnaire depression screener, and Social Media Disorder scale were also collected. ResultsTwenty-three subjects enrolled and 16 completed questionnaires. 62.5 % of participants were in clinical remission and the remaining 37.5 % had mild to severe clinical IBD activity. Poor subjective sleep quality was associated with a shorter duration of sleep time and an increased clinical disease activity score. Patients in clinical remission slept for a longer duration than those with mild IBD activity. ConclusionsThis study did not identify a significant relationship between sleep quality and psychosocial factors in the adolescent population with IBD, though their influence cannot be discounted. There was a connection between the presence of disease activity and shorter sleep duration. Similarly, PSQI scores correlated with sleep time but not sleep quality.

Sleep onset time as a mediator in the association between screen exposure and aging: a cross-sectional study.

Excessive screen exposure has become a significant health concern. This study investigates the impact of screen time on aging in middle-aged and elderly populations. Healthy working adults over 45years old in Shanghai, China, underwent general and ocular examinations. Questionnaires collected demographics, medical history, and screen exposure details. Aging was assessed using the retinal age gap, defined as the difference between the retinal age predicted by deep learning algorithms based on fundus images and chronological age. Pathway analysis tested the mediation effect of sleep duration and onset time on the relationship between screen usage and retinal age gap. The retinal age gap increased with longer screen exposure, from 0.49 ± 3.51years in the lowest tertile to 5.13 ± 4.96years in the highest tertile (Jonckheere-Terpstra test, p < 0.001). Each additional hour of screen exposure accelerated the retinal age gap by 0.087years (95% CI, 0.027, 0.148, p = 0.005) in the fully adjusted linear model. Sleep onset time mediated the impact of screen usage on the retinal age gap (indirect effect, β = 0.11; 95% CI 0.04-0.24). The impact of screen usage in a light-off environment on the retinal age gap was fully mediated by sleep onset time (indirect effect, β = 0.22; 95% CI 0.07-0.38), with the proportion being 100%. Our study identified a correlation between excessive screen time and a wider retinal age gap in middle-aged and elderly individuals, likely due to delayed sleep onset. To mitigate the adverse effects on the retina and aging, it is important to limit screen usage and avoid screens before bedtime.

The effect of sleep and its restriction on selected inflammatory parameters

Insufficient sleep duration may lead to a series of immune dysfunctions. One of the factors influencing this effect could be physical activity (PA). The study aimed to assess the impact of deprivation of sleep (DS) on selected inflammatory parameters. Seventy-seven participants completed the protocol consisting of polysomnography (PSG) conducted in a sleep laboratory and DS, monitored with an actigraph. PA was assessed with actigraphy, which categorized participants as active or inactive. White blood cells (WBC) values negatively correlated with sleep efficiency based on sleep diaries and PSG parameters (total sleep time, sleep efficiency, and REM duration), but regression analysis showed that WBC depends only on the sleep diary parameter. Granulocytes (GRA) positively correlated with REM latency, and negatively with sleep efficiency. After DS, all participants exhibited an elevated GRA count. The number of WBC and GRA increased also in the active group; inactive participants showed no changes in inflammatory parameters. The overall number of WBC depends primarily on the quality of sleep over a period of several days. Under the influence of sleep deprivation, the number of GRA increases, but the number of leukocytes depends on the level of physical activity during DS.

Prevalence and factors associated with the poor quality of sleep among Indian nurses.

Nursing health workers deal with a variety of issues that may have an unfavorable influence on their capability to peaceful sleep. The consequences of poor quality of the sleep can lead to increased fatigue, decreased concentration, and a higher risk of medical and nursing errors. The purpose of this research study was to determine in the occurrence and associated factors for poor quality of the sleep among Indian nurses. The participants in this cross-sectional study were selected by the use of a multi-stage sampling technique. A total of 25 hospitals (across 4 zones) were randomly sampled. A total of 850 (out of 1250) nurses participated in the study. To collect socio-demographic data, a self-administered questionnaire was employed. PSQI scale was implemented to assess quality of sleep, and the other scale of DASS-21 was used to assess mental well-being. The majority of nurses had mild (6-7 hours) as well as moderate (5-6 hours) levels of difficulty in the duration of sleep time. The occurrence of poor quality of the sleep in nursing professionals is high. 9.2% had depression, 13.7% had anxiety, and 18.9% faced, which appears to be linked to insufficient sleep in the adjusted model. In the univariate study, additional night shifts and additional shift hours were substantially related to insufficient sleep. Nurses' quality of sleep is substantially hampered due to various reasons, and nurse mangers should devise the framework to avoid its harmful effects and to provide desirable management and high-quality patient care.

The Effect of Two Health Education Packages on Nutritional Knowledge, Practices, and Physical Activity Levels Among School-Going Adolescents in Rishikesh: A Cluster Randomized Trial.

Introduction Adolescence is a critical period known for presenting specific challenges in disease treatment and health promotion. Studies have highlighted that increased nutritional awareness is associated with healthier eating habits, while regular physical activity aids in controlling and preventing non-communicable diseases. Equipping adolescents with health education in schools prepares them to adopt and maintain healthy lifestyles throughout their lives. To assess and compare the efficacy of health education packages targeting nutrition knowledge, practices, and physical activity levels, a cluster-randomized trial was conducted among school-going adolescents. Methodology Two distinct health education packages were developed for the two intervention groups. In group 1, a health talk supported by a flip chart was delivered, followed by pamphlet distribution. In contrast, in group 2, only information pamphlets were distributed. The study was conducted in government schools in Rishikesh, with four schools selected. Two schools were randomly allocated to each intervention arm. In each school, a questionnaire was administered to assess the students' nutrition knowledge, practicesand physical activity levels. This was followed by the intervention, and the students were reassessed for the same parameters after two weeks. Result The pre-intervention and post-intervention comparisons within the same group- the mean scores for nutrition knowledge, food practice, sleep duration, and recreational screen time were comparable in the intervention group 1 (p>0.05). There was a decrease in the mean physical activity score and screen time for studies in intervention group 1, and these differences were statistically significant (p<0.05). The mean scores for nutrition knowledge, physical activity, sleep duration, and screen time for studies were comparable in the intervention group 2 (p>0.05). There was an increase in the mean food practice score and a decrease in recreational screen time in intervention group 2, and these differences were statistically significant (p<0.05). On comparing the groups with each other, it was found thatGroup 2 exhibited a significantly higher mean food practice score compared to group 1 post-intervention. While there was a statistically significant decrease in the mean physical activity score in intervention group 1, this group still had higher physical activity levels than group 2.Post-intervention, group 2 exhibited a higher screen time for studies compared to group 1. Both groups had comparable sleep durations at baseline and post-intervention, with intervention group 1's mean sleep duration falling within the recommended range set by the American Academy of Sleep Medicine. Regression analysis provided valuable insights into the relationship between baseline values of various variables and their post-intervention values, aiding in understanding the impact of the health education packages. Conclusion The findings emphasize the significance of incorporating nutrition and physical activity education into the curriculum of students.

Chronic short sleep duration lengthens reaction time, but the deficit is not associated with motor preparation.

The purpose of this study was to investigate the association between chronic sleep duration and reaction time performance and motor preparation during a simple reaction time task with a startling acoustic stimulus in adults. This cross-sectional study included self-reported short sleepers (n = 25, ≤ 6 hr per night) and adequate sleepers (n = 25, ≥ 7.5 hr per night) who performed a simple reaction time task requiring a targeted ballistic wrist extension in response to either a control-tone (80 dB) or a startling acoustic stimulus (120 dB). Outcome measures included reaction times for each stimulus (overall and for each trial block), lapses, and proportion of startle responses. Chronic short sleepers slept on average 5.7 hr per night in the previous month, which was 2.8 hr per night less than the adequate sleepers. Results revealed an interaction between sleep duration group and stimulus type; the short sleepers had significantly slower control-tone reaction times compared with adequate sleepers, but there was no significant difference in reaction time between groups for the startling acoustic stimulus. Further investigation showed that chronic short sleepers had significantly slower control-tone reaction times after two blocks of trials lasting about 5 min, until the end of the task. Lapses were not significantly different between groups. Chronic short sleep duration was associated with poorer performance; however, these reaction time deficits cannot be attributed to motor preparation, as startling acoustic stimulus reaction times were not different between sleep duration groups. While time-on-task performance decrements were associated with chronic sleep duration, alertness was not. Sleeping less than the recommended sleep duration on a regular basis is associated with poorer cognitive performance, which becomes evident after 5 min.

Poor healthy lifestyle and life's essential 8 are associated with higher risk of new-onset migraine: a prospective cohort study.

Lifestyle are closely related to migraine. However, there is a lack of studies investigating the association between Healthy lifestyle or Life's Essential 8 (LE8) and the risk of migraine. The objective of this research was to investigate the relationship between Healthy lifestyle scores and Life's essential 8 scores, and migraine. 332,895 UK Biobank participants without migraine were included. Healthy lifestyle were assessed using seven lifestyle factors, and categorized as poor, intermediate, or ideal. LE8, based on the American Heart Association (AHA) Guidelines for Cardiovascular Health (CVH), consist of eight indicators classified as low, moderate, or high CVH. The Cox proportional hazard model was employed to examine the association between Healthy lifestyle scores, LE8 scores, and migraine, with calculations for population-attributable fraction (PAF) and cumulative incidence. During a median follow-up of 13.58 years, participants in intermediate (HR: 0.91; 95% CI: 0.85, 0.99) or ideal category of Healthy lifestyle (HR: 0.81; 95% CI: 0.73, 0.91) significantly reduced migraine risk compared to the poor category. Similarly, high CVH (HR: 0.73; 95% CI: 0.58, 0.92) also lowered migraine risk, while moderate CVH (HR: 0.93; 95% CI: 0.85, 1.02) did not show a difference compared to low CVH. If all individuals adhered to higher categories of Healthy lifestyle and LE8, approximately 11.38% and 22.05% of migraine cases could be prevented. Among individual lifestyle factors, maintaining an ideal body mass index (BMI), physical activity, sleep duration, sleep pattern, and sedentary time were associated with substantial reductions in migraine risk, by 5.65%, 0.81%, 10.16%, 16.39%, and 6.57%, respectively. Our study provides evidence that poor Healthy lifestyle and Life's Essential 8 are associated with higher risk of new-onset migraine.

Shorter night-time sleep duration and later sleep timing from infancy to adolescence.

Here, we (a) examined the trajectories of night-time sleep duration, bedtime and midpoint of night-time sleep (MPS) from infancy to adolescence, and (b) explored perinatal risk factors for persistent poor sleep health. This study used data from 12,962 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Parent or self-reported night-time sleep duration, bedtime and wake-up time were collected from questionnaires at 6, 18 and 30 months, and at 3.5, 4-5, 5-6, 6-7, 9, 11 and 15-16 years. Child's sex, birth weight, gestational age, health and temperament, together with mother's family adversity index (FAI), age at birth, prenatal socioeconomic status and postnatal anxiety and depression, were included as risk factors for persistent poor sleep health. Latent class growth analyses were applied first to detect trajectories of night-time sleep duration, bedtime and MPS, and we then applied logistic regressions for the longitudinal associations between risk factors and persistent poor sleep health domains. We obtained four trajectories for each of the three sleep domains. In particular, we identified a trajectory characterized by persistent shorter sleep, a trajectory of persistent later bedtime and a trajectory of persistent later MPS. Two risk factors were associated with the three poor sleep health domains: higher FAI with increased risk of persistent shorter sleep (OR = 1.20, 95% CI = 1.11-1.30, p < .001), persistent later bedtime (OR = 1.28, 95% CI = 1.19-1.39, p < .001) and persistent later MPS (OR = 1.30, 95% CI = 1.22-1.38, p < .001); and higher maternal socioeconomic status with reduced risk of persistent shorter sleep (OR = 0.99, 95% CI = 0.98-1.00, p = .048), persistent later bedtime (OR = 0.98, 95% CI = 0.97-0.99, p < .001) and persistent later MPS (OR = 0.99, 95% CI = 0.98-0.99, p < .001). We detected trajectories of persistent poor sleep health (i.e. shorter sleep duration, later bedtime and later MPS) from infancy to adolescence, and specific perinatal risk factors linked to persistent poor sleep health domains.

Baseline coronary artery stenosis severity is an independent predictor of subsequent poor sleep quality in patients with acute coronary syndrome.

To investigate the relationship between coronary artery lesion severity determined using the baseline SYNTAX score and sleep problems that might occur after discharge determined using the Pittsburgh Sleep Quality Index (PSQI). This prospective study included patients with first acute coronary syndrome (ACS) who underwent percutaneous coronary angiography between February 2019 and August 2019. The severity of coronary artery stenosis was classified according to coronary angiography and SYNTAX scores. Patients were grouped as those with a SYNTAX score of ≤22 and >22. Sleep quality after discharge was classified according to the PSQI. PSQI ≤5 represented good sleep quality, and PSQI >5 represented poor sleep quality. Univariate and multivariate logistic regression was used to investigate the relationship between sleep quality and coronary artery stenosis severity. A total of 424 patients were included in the study. Of these, 294 (69.34%) had a SYNTAX score of ≤22 and 130 (30.66%) had a SYNTAX score of >22. The mean age of all patients was 60.37 ± 12.23 years, 59.69 ± 11.85 years in the SYNTAX ≤22 groups and 61.90 ± 12.98 years in the SYNTAX >22 group (P = 0.086). The majority (78.54%) of the patients were male and there was no significant difference between the SYNTAX ≤22 group and the SYNTAX >22 group in terms of sex distribution (P = 0.383). According to the univariate logistic regression analysis, age (P = 0.014), diabetes (P = 0.027), left ventricular ejection fraction (P = 0.001), estimated glomerular filtration rate (P = 0.039), creatine kinase MB (P = 0.040) and SYNTAX scores (P < 0.001) were significantly associated with high PSQI global scores (>5). However, according to the multivariate logistic regression analysis results, high (>22) SYNTAX scores were the only factor independently associated with the high (>5) PSQI global scores [odds ratio, 3.477; 95% confidence interval (CI), (2.190-5.522); P < 0.001]. Complete revascularization group had significantly higher sleep latency and sleep duration time, sleep efficiency and the percentage of patients with PSQI global score of ≤5 than the incomplete revascularization group (P < 0.001 for all). Among patients with ACS, those with high SYNTAX scores should be monitored more carefully for sleep disorders that may occur later.

Sleep duration time and human papillomavirus infection risk: The U-shaped relationship revealed by NHANES data.

This study aims to investigate the relationship between sleep factors (sleep duration time [SDT] and obstructive sleep apnea [OSA]) and human papillomavirus (HPV)/high-risk HPV(HR-HPV) infection, utilizing data from the National Health and Nutrition Examination Survey (NHANES). We conducted a cross-sectional analysis using NHANES data, focusing on SDT and OSA's association with HPV/HR-HPV infection. The primary statistical methods included weighted multivariate linear regression and logistic regression to assess the association between SDT, OSA, and HPV/HR-HPV infection. The study employed restricted cubic splines (RCS) for evaluating potential non-linear relationships between SDT and HPV/HR-HPV infection. Subgroup analyses were conducted. Interaction terms were used to examine the heterogeneity in associations across different subgroups. The study identified a U-shaped relationship between SDT and HPV infection. Specifically, 7 hours of sleep was associated with the lowest risk of HPV infection. In comparison, SDT less than 7 hours resulted in a 26.3% higher risk of HPV infection (Odds Ratio [OR] = 1.26, 95% Confidence Interval [CI]: 1.029, 1.549), and more than 9 hours of sleep showed a 57.4% increased risk (OR = 1.574, 95% CI: 1.116, 2.220). The relationship between SDT and HR-HPV infection was significant in the first two models, but not in the fully adjusted model. No significant interaction was found between sleep duration and other covariates. There was no association between OSA and HPV/HR-HPV infection. The study underscores the complex relationship between sleep duration and HPV infection risk, suggesting both very short and very long sleep durations may increase HPV infection likelihood. The findings highlight the need for further research to explore the biological mechanisms underpinning this association and to consider broader population groups and more precise sleep assessment methods in future studies.

Impact of COVID-19 pandemic on 24-hour movement behaviors among preschoolers from Brazil

Healthy habits during early childhood are essential for a healthy adolescence and adulthood. Before the COVID-19 pandemic, the number of children who met the 24-h movement behavior (physical activity [PA], sedentary behavior, and sleep) guidelines was low worldwide. Despite a lack of evidence, the restriction measures imposed during the COVID-19 pandemic are claimed to have further reduced the number, especially among preschoolers. Thus, this study was designed to compare the time spent on movement behaviors before and during the COVID-19 pandemic in low-income preschoolers from the Northeast Region of Brazil. Forty mothers provided data on their preschoolers&amp;rsquo; sleep, sedentary behavior, and outdoor and indoor PA. To compare indoor and outdoor PA, sleep duration, and sedentary time during the weekdays and weekends, before and during the pandemic, generalized estimation equations were used. During the weekdays, a significant increase in sleep duration (553.7 vs. 627.0; p &lt; 0.01) and sedentary times (225.0 vs. 409.5; p &lt; 0.01) were observed. Further, an increase in the sedentary time during the weekend (319.5 vs. 406.5; p &lt; 0.01) and the total time between the pre-pandemic and pandemic periods (249.0 vs. 409.5; p &lt; 0.01) was observed. Our findings also unveiled that preschoolers were seven times more likely to be active outdoors for an hour or more before than during the pandemic (OR = 6.55; 95% CI = 2.07 &amp;ndash; 20.73). In summary, the pandemic has altered preschoolers&amp;rsquo; routines, leading to changes in their health behaviors over time.

Abstract P528: Associations Between Sleep Duration and Sedentary Behavior Among Racial/Ethnic Minorities: Analysis of NHANES 2011-2018

Underlying mechanisms linking sleep to cardiovascular disease (CVD) risk are unclear, though they may be partially explained by movement behavior (e.g., sedentary time, moderate-vigorous physical activity [MVPA]). However, large-scale studies among racial/ethnic minorities are scant, which is important to address, given existing racial/ethnic disparities in CVD risk. National Health and Nutrition Examination Survey (NHANES) data was used to address these gaps. Adults 20-80 years from NHANES 2011-2018 were included in this cross-sectional study. After excluding those &lt; 20 years, those with depression, and those with missing data on sleep duration, sedentary time or MVPA, or putative confounders, 13,024 participants were included in the analysis. Sleep duration (hr./night), sedentary time (hr./day), and MVPA (hr./day) were self-reported, with sedentary time and MVPA obtained from the validated Global Physical Activity Questionnaire (GPAQ). Multivariate linear regression was used to evaluate the association between sleep duration and sedentary time, adjusted for MVPA, age, gender, race/ethnicity, body mass index, smoking history, education, and poverty income ratio. Additionally, we examined if associations between sleep duration and sedentary time varied by MVPA. Finally, we used stratification to assess whether the association between sleep duration and sedentary time varied by race/ethnicity. Median (Q1, Q3) age was 45.2 (31.1, 58.9) years and 52.3% of the sample were male. Median (Q1, Q3) sleep duration, sedentary time, and MVPA were 7.0 (6.1, 7.8) hr./night, 5.6 (3.8, 7.8) hr./day, and 2.9 (1.0, 6.1) hr./day), respectively. In the full sample, sleep duration was inversely associated with sedentary time (β = -5.5 min [95% CI: -9.3, -1.8] p = .0047), with each additional hr. of sleep duration associated with a 5.5-min decrease in sedentary time. MVPA did not change the association between sleep duration and sedentary time. After stratifying by race/ethnicity, differences in the sleep duration-sedentary time association were observed. Among multi-racial participants, every 1-hr. increase in sleep duration was associated with a 21.0-min. decrease in sedentary time (β = -21.0 min. [95% CI: -35.6, -6.5] p = .0053), a similar pattern was observed among Non-Hispanic (NH)-Asian participants (β = -12.6 min. [95% CI: -21.1, -4.0] p = .0047) and participants that identified as Mexican American or other Hispanic (β = -6.8 min. [95% CI: -11.2, -2.4] p = .0029). Associations between sleep and sedentary behavior may differ according to race/ethnicity. Findings indicate that researchers designing physical activity and sedentary behavior reduction interventions for racial/ethnic minorities should consider how sleep health may be affected. However, prospective studies with repeated measures are needed to confirm the temporality of these associations.

Abstract P540: Sleep Duration, Rapid Eye Movement Sleep, and Subclinical Myocardial Damage

Introduction: Sleep is strongly linked to clinical cardiovascular disease and was added in 2022 to the AHA’s Life’s Essential 8. Optimizing sleep duration and quality may reduce the risk of cardiovascular disease. Few studies have examined self-reported sleep duration and percent time in rapid eye movement (REM) sleep measured by single night in-home polysomnography with high sensitivity cardiac troponin T (hs-troponin T), a biomarker of subclinical cardiovascular disease. Methods: We conducted a cross-sectional study of adults without a history of cardiovascular disease who participated in both the Atherosclerosis Risk in Communities (ARIC) Study and the Sleep Heart Health Study (SHHS) in 1995-1998. We used linear regression with sleep duration and percentage time of REM sleep modeled as predictors with restricted cubic splines and examined associations with the outcome, hs-troponin T. We adjusted for age, sex, body mass index, waist-to-hip ratio, alcohol intake, smoking status, systolic blood pressure, hypertension medication use, diabetes, HDL- and LDL-cholesterol, and cholesterol-lowering medication use. Results: Among 1,587 participants (mean age 63, 54% female), the mean sleep duration was 7.3 hours, and mean % REM time was 20.7. Sleep duration was not associated with hs-troponin T ( Figure, Panel A ). However, percentage REM sleep was negatively associated with hs-troponin T, but with a threshold effect; there was a negative linear association of hs-troponin T with % REM sleep but only at values &lt;15% ( Figure, Panel B ). Conclusion: While self-reported sleep duration was not associated with TnT levels, there was evidence that low % REM sleep, a specific neurophysiological sleep state, was associated with subclinical cardiovascular disease. These findings suggest that multiple sleep dimensions should be considered in efforts to optimize cardiovascular health.

Examining the relationship between meeting 24-hour movement behaviour guidelines and mental health in Chinese preschool children.

Limited research has explored the relationship between adhering to 24-h Movement Behaviour guidelines and mental health in Chinese preschool children. The objectives of this study encompassed two primary goals: (1) to investigate the adherence of preschool children in China to the 24-h Movement Behaviour guidelines; and (2) to analyze the relationship between fulfilling various combinations of these guidelines and mental health, identifying the most advantageous combination. Utilizing a convenience sampling approach, this study included 205 preschool children (117 boys and 88 girls, average age 4.8 ± 0.51 years) from five kindergartens in Hengyang, Hunan Province. The physical activity (PA) and sedentary behaviour of preschool children were objectively assessed using waist-worn accelerometers, while sleep duration and screen time were reported by the children's parents. To evaluate mental health, the parent version of the internationally validated Strength and Difficulties Questionnaire (SDQ) was employed, which measures externalizing problems, internalizing problems, and prosocial behaviour. Employing Mplus 8.0 for Structural Equation Modeling analysis, while controlling for demographic variables, the study explored the connection between preschool children's mental health and their adherence to the 24-h Movement Behaviour guidelines. Worryingly, merely 14.6% of preschoolers met the recommended guidelines for all three aspects (PA, sleep duration, and screen time). Positive correlations were identified between meeting PA guidelines and displaying prosocial behaviour (β = 0.184; p < 0.05), while screen time adherence exhibited a negative correlation with externalizing problems (β = -0.207; p < 0.05). Similarly, there was a negative association between sleep duration adherence and externalizing problems (β = -0.191; p < 0.05). Meeting all three recommended guidelines was notably linked to enhanced prosocial behaviour (β = 0.464; p < 0.05), while following the screen time and sleep duration guidelines was negatively associated with externalizing problems (β = -0.246; p < 0.05). This study underscores the limited adherence of Chinese preschoolers to the comprehensive 24-h Movement Behaviour guidelines. Noteworthy findings include the positive influence of PA on prosocial behaviour, alongside the significant roles that sleep duration and screen time play in mitigating externalizing problems within this age group. Alignment with the 24-h Movement Behaviour guidelines is associated with more favorable mental health indicators in preschoolers.

Sedative and hypnotic effects of the saponins from a traditional edible plant Liriope spicata Lour. in PCPA-induced insomnia mice

Ethnopharmacological relevanceLiriope spicata Lour., a species listed in the catalogue of ‘Medicinal and Edible Homologous Species’, is traditionally used for the treatment of fatigue, restlessness, insomnia and constipation. Aim of the studyThis study is aimed to evaluate the sedative and hypnotic effect of the saponins from a natural plant L. spicata Lour. in vivo. Materials and methodsThe total saponin (LSTS) and purified saponin (LSPS) were extracted from L. spicata, followed by a thorough analysis of their major components using the HPLC-MS. Subsequently, the therapeutic efficacy of LSTS and LSPS was evaluated by the improvement of anxiety and depression behaviors of the PCPA-induced mice. ResultsLSTS and LSPS exhibited similar saponin compositions but differ in their composition ratios, with liriopesides-type saponins accounting for a larger proportion in LSTS. Studies demonstrated that both LSTS and LSPS can extend sleep duration and immobility time, while reducing sleep latency in PCPA-induced mice. However, there was no significant difference in weight change among the various mice groups. Elisa results indicated that the LSTS and LSPS could decrease levels of NE, DA, IL-6, and elevate the levels of 5-HT, NO, PGD2 and TNF-α in mice plasma. LSTS enhanced the expression of neurotransmitter receptors, while LSPS exhibited a more pronounced effect in regulating the expression of inflammatory factors. In conclusion, the saponins derived from L. spicata might hold promise as ingredients for developing health foods with sedative and hypnotic effects, potentially related to the modulation of serotonergic and GABAAergic neuron expression, as well as immunomodulatory process.

Shared genetic architecture and causal relationship between sleep behaviors and lifespan

Poor sleep health is associated with a wide array of increased risk for cardiovascular, metabolic and mental health problems as well as all-cause mortality in observational studies, suggesting potential links between sleep health and lifespan. However, it has yet to be determined whether sleep health is genetically or/and causally associated with lifespan. In this study, we firstly studied the genome-wide genetic association between four sleep behaviors (short sleep duration, long sleep duration, insomnia, and sleep chronotype) and lifespan using GWAS summary statistics, and both sleep duration time and insomnia were negatively correlated with lifespan. Then, two-sample Mendelian randomization (MR) and multivariable MR analyses were applied to explore the causal effects between sleep behaviors and lifespan. We found that genetically predicted short sleep duration was causally and negatively associated with lifespan in univariable and multivariable MR analyses, and this effect was partially mediated by coronary artery disease (CAD), type 2 diabetes (T2D) and depression. In contrast, we found that insomnia had no causal effects on lifespan. Our results further confirmed the negative effects of short sleep duration on lifespan and suggested that extension of sleep may benefit the physical health of individuals with sleep loss. Further attention should be given to such public health issues.

Sleep duration and screen time in children and adolescents: Simultaneous moderation role in the relationship between waist circumference and cardiometabolic risk according to physical activity

AbstractTo evaluate the simultaneous moderating role of sleep duration and screen time in the relationship between waist circumference (WC) and clustered cardiometabolic risk score (cMetS) according to children and adolescents' physical activity. A cross‐sectional study was conducted on 3072 children and adolescents (aged 6–17 years, 57.5% girls). Physical activity, sleep duration, and screen time were assessed through a self‐report questionnaire. The cMetS was determined by averaging the z‐scores of risk factors and dividing it by four. Moderation analyses were tested through multiple linear regression models. Among physically active individuals, sleep duration (p = 0.85) and screen time (p = 0.96) had no influence on the relationship between WC and cMetS. However, a positive interaction between WC x screen time and cMetS (p = 0.04) was observed for physically inactive participants. Concerning sleep duration, there was no interaction with WC. Participants who spent 60 min of screen time presented lower cMetS, even presenting high WC, compared to the higher tertiles of screen time (180 and 360 min). However, although the interaction between sleep duration and WC was not significant, it was observed that the lowest tertile of sleep duration (482 min) combined with 60 min of screen time presented lower cMetS even with the presence of high WC. Our findings encourage compliance with physical activity guidelines associated with the adoption of adequate screen time to minimize the influence of waist circumference on cMetS.

Cardiovascular health, sleeping duration, and risk of mortality in current and former smokers

Background and aimsTo investigate the associations of ideal cardiovascular health metrics (ICVHMs) with all-cause mortality among former and current smokers compared with never smokers. Methods and resultsA total of 378,147 participants [mean age (SD) years: 56.3 (8.1); 47.2 % men] were included from the UK Biobank cohort. The ICVHMs were combined Life's simple 7 from the American Heart Association and sleep duration time. The association was explored using COX regression models. During a median follow-up of 13.3 years, we documented 24,594 deaths. Compared with never smokers, among former smokers, the multivariable-adjusted hazard ratio (HR) for all-cause mortality was 1.82 (95%CI 1.71–1.92) for participants who had ≤2 ICVHMs and 1.03 (0.97–1.10) for participants who had ≥6 ICVHMs; among current smokers, the HRs for mortality were 2.74 (2.60–2.89) and 2.18 (1.78–2.67). The phenomenon was more pronounced among participants younger than 60 years [HR (95%CI), 1.82 (1.71–1.95) for ≤2 ICVHMs vs 1.04 (0.96–1.12) for ≥6 ICVHMs with age ≥60 years and 1.83 (1.62–2.06) vs 0.98 (0.88–1.11) with age <60 years among former smokers; 2.66 (2.49–2.85) vs 2.44 (1.84–3.24) with age ≥60 years and 2.85 (2.62–3.10) vs 1.96 (1.47–2.61) with age <60 years among current smokers]. In addition, the HR for mortality of each 1-number increment in ICVHMs was 0.87 (0.86–0.89) among former smokers and 0.91 (0.89–0.94) among current smokers. ConclusionOur findings indicated the importance of adherence to have more ICVHMs in the mortality risk among former smokers, and priority of smoking cessation in current smokers. ImplicationsStudies have found that former smokers still have higher risks of lung cancer and all-cause mortality than never-smokers. The next question is whether the effects of previous or current smoking could be ameliorated by eight ideal cardiovascular health metrics (ICVHMs). We aim to explore whether ICVHMs may counteract the risk of all-cause mortality among former and current smokers. The results showed that only former smokers with ≥6 ICVHMs exhibited a comparable risk of all-cause mortality with never smokers. Furthermore, current smokers even having ≥6 ICVHMs still exhibited a higher risk of all-cause mortality compared with never smokers.

Nomogram for Predicting the Risk Factors for Falls in Older People: A Secondary Data Analysis Based on the 2021 Community Health Survey.

This study aimed to identify the risk factors for falls among older individuals living at home in a community and develop a nomogram to predict falls. This study included 74 492 people aged 65 years or older who participated in the 2021 Community Health Survey conducted in Korea. The data analysis methods used included the Rao-Scott χ2 test, a complex sample t-test, and complex binary logistic regression using SPSS 26.0. Using logistic regression analysis, a fall-risk prediction nomogram was created based on regression coefficients, and the reliability of the nomogram was calculated using a receiver operating characteristic (ROC) curve and values of the area under the curve (AUC). The fall incidence rate among older adults was 16.4%. Factors affecting the subject's fall experience included being more than 85 years old (OR = 1.40); living alone (OR = 1.13); receiving basic welfare (OR = 1.18); subjective health status (OR = 1.72); number of days spent walking (OR = 0.98); obesity (OR = 1.08); severe depression (OR = 2.84); sleep duration time (OR = 1.11); experiencing cognitive decline (OR = 1.34); and diabetes (OR = 1.12). In the nomogram, the depression score exhibited the greatest discriminatory power, followed by subjective health status, gender, experience of cognitive decline, age, basic livelihood security, adequacy of sleep, living alone, diabetes, and number of days of walking. The AUC value was 0.66. An intervention plan that comprehensively considers physical, psychological, and social factors is required to prevent falls in older adults. The nomogram developed in this study will help local health institutions assess all these risk factors for falling and create and implement systematic education and intervention programs to prevent falls and fall-related injuries among older individuals.