Effect of pandemic outbreak on psychological levels and the predictors of mental health in health professionals.

Sleep duration is a well-established factor associated with all-cause mortality and cardiovascular mortality. Poor sleep quality was also suggested to affect all-cause mortality risk among adults. The Cardiovascular Occupational Risk Factor determination in Israel Study (CORDIS) is a prospective cohort study of industrial workers who entered the study during 1985-1990 and have been followed for 36 years. We examined the relationship between sleep duration, sleeping problems and difficulties, and all-cause mortality in the CORDIS cohort. Self-reported data, including sleep duration and sleeping problems, from 7287 participants were merged with data on all-cause mortality obtained from the National Death Registry and the Central Bureau of Statistics. Over the 36-year follow-up, 2159 participants died: 445 were < 45 years and 1714 were ≥ 45 years. Sleep duration of ≤ 5 h significantly increased mortality risk (hazard ratio [HR] = 1.30, p = 0.0032), with a more pronounced effect in those < 45 years (HR = 1.55, p = 0.0028). Sleeping problems also increased mortality risk (HR = 1.30, p = 0.0088), with a stronger association among younger individuals (HR = 1.63, p = 0.0399). Conversely, difficulty sleeping when anticipating something unpleasant was linked to increased mortality only in those aged ≥ 45 years (HR = 1.17, p = 0.0440). Our analysis showed that short sleep duration and sleeping problems are significant predictors for all-cause mortality, particularly in younger individuals (< 45 years). These results emphasize the importance of addressing sleep problems among different age groups to potentially reduce mortality risk.

To examine the associations of objectively measured sleep parameters (sleep duration, efficiency, and nocturnal oxygen desaturation) with retinal arterial structure assessed using optical coherence tomography (OCT). This cross-sectional study included 5991 adults from the community-based Nagahama Study in Japan (2012-2016). All participants underwent OCT and wrist actigraphy. Retinal arterial outer diameter (OD), inner diameter (ID), and wall thickness were measured from peripapillary OCT B-scans. Sleep period time (SPT) and sleep efficiency (defined as total sleep time divided by SPT) were derived from actigraphy. Nocturnal oxygen desaturation was evaluated using the 3% oxygen desaturation index (3%ODI) obtained from synchronized actigraphy and oximetry recordings. Associations between retinal arterial parameters and sleep/oxygenation metrics were evaluated using multivariable linear regression models adjusted for demographic, ocular, and systemic covariates. Among 5991 participants (mean age 57.6years; 30.6% male), shorter sleep duration was associated with narrower retinal arterial diameters (OD: β=0.399; 95% confidence interval [CI], 0.165-0.632; ID: β=0.402; 95% CI, 0.188-0.616). Higher 3%ODI were associated with thicker arterial walls (β=0.121; 95% CI, 0.050-0.192) and wider OD (β=0.431; 95% CI, 0.003-0.859). Sleep efficiency showed no significant associations with any vascular parameter. Sleep duration and nocturnal oxygen desaturation showed distinct associations with retinal arterial characteristics. OCT-based vascular metrics may serve as noninvasive indicators of sleep-related microvascular alterations.

This commentary summarizes the evidence base, equity implications, and implementation considerations for later school start times (SSTs) in Alabama. In Alabama, almost half of children report sleep durations below age-based recommendations. Of the 138 school districts in Alabama, few have middle and high schools adhering to the 8:30 am or later SSTs recommended by the American Academy of Sleep Medicine and the National Sleep Foundation. Historically designed to meet Industrial Revolution-era schooling needs, current SSTs are largely dictated by tradition and fail to promote the health and well-being of modern-day students. Adolescent chronotype shifts later, producing later sleep onset and wake time. Given their naturally delayed chronotype, early SSTs often lead to poor sleep quality and shorter total sleep duration in adolescents, which can negatively impact metabolic and cardiovascular health. Earlier SSTs negatively impact social development as well. Earlier SSTs can result in shorter sleep duration, which has been associated with adolescent suicidal behavior and substance use. Early SSTs are also correlated with poorer academic achievement. The literature provides substantial evidence supporting a relation between later SSTs and improved adolescent physical and mental health, social development, academic outcomes, and decreased motor vehicle accident incidence. Given prolific racial/ethnic and socioeconomic disparities in Alabama, later SSTs may offer a practical and sustainable pathway for addressing health inequities in Alabama. The prioritization of the health, well-being, and development of students warrants legislative discussion in Alabama regarding later start times for middle and high schools, along with strategic planning to overcome logistical challenges.

Sleep and bipolar disorder: Associations with delivery and neonatal outcomes.

Type 1 diabetes (T1D) is a complex autoimmune disorder heavily influenced by heritable traits. However, the interplay between modifiable lifestyle factors and genetic susceptibility remains insufficiently characterised. This study sought to elucidate how genetic background and lifestyle determinants jointly affect T1D liability. Utilising the UK Biobank cohort, we performed both cross-sectional and longitudinal assessments. A polygenic risk score (PRS) was computed to quantify genetic predisposition to T1D across 403,778 subjects. Concurrently, a composite lifestyle index was generated based on six domains: adiposity, smoking status, alcohol intake, physical exertion, diet quality, and sleep duration. We evaluated cross-sectional relationships using multivariable logistic regression and assessed longitudinal outcomes using Cox proportional hazard models. In a 15-year longitudinal study (median follow-up: 12.3years) of 402,005 participants, 1474 cases of T1D were identified. Stratified by genetic risk, participants in the intermediate (hazard ratio [HR]=1.17; 95% CI: 1.00-1.37) and highest (HR=2.89; 95% CI: 2.46-3.39) risk groups demonstrated significantly elevated risks of incident T1D compared to the lowest risk group, independent of lifestyle factors. Conversely, when categorised by lifestyle patterns, both intermediate (HR=0.61; 95% CI: 0.52-0.71) and healthy (HR=0.43; 95% CI: 0.37-0.52) lifestyle groups exhibited substantially reduced risks of T1D compared to the unhealthy lifestyle group, irrespective of genetic predisposition. A significant interaction between genetic risk and lifestyle on the risk of T1D was found in both cross-sectional and longitudinal analyses (p<0.001). The data reveal a robust inverse relationship between adherence to a healthy lifestyle and T1D incidence across all genetic strata, even among those with elevated hereditary risk. These results underscore the critical role of lifestyle modification in mitigating T1D susceptibility, distinct from genetic inheritance.

Relationship between cardiovascular health score trajectory and incident stroke in patients with hypertension.

Associations of modifiable lifestyle behaviors with cardiovascular-kidney-metabolic syndrome across risk categories: Findings from a U.S. national survey.

Ramadan fasting and seizure activity in adults with epilepsy: A systematic review and meta-analysis.

Healthy plant-based diet has been shown to benefit cardiovascular health and prevent coronary heart disease (CHD). However, association in combination with other ideal health behaviours on CHD prevention has been understudied. Furthermore, limited attention has been given to potential interactions with genetic CHD predisposition, which may add personalized health behaviour recommendations. We evaluated the association between healthy lifestyle and CHD incidence and investigated potential effect modification with genetically determined CHD risk. We analysed 7764 participants (mean age 63, 60.1% women) from the population-based Rotterdam Study. The degree of adherence to the healthy lifestyle was quantified by a healthy plant-based diet-lifestyle (hPDI-Lifestyle) score. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95%-confidence intervals (CIs) for CHD according to the hPDI-Lifestyle score, stratified by polygenic risk score of coronary artery disease. We documented 918 CHD cases during 116,324 person-years of follow-up. Ideal adherence to the hPDI-Lifestyle was associated with a 20% lower CHD risk among participants at low genetic risk (HR 0.80, 95% CI 0.71-0.90), and a 44% lower CHD risk among those at high genetic risk (HR 0.56, 95% CI 0.49-0.64) compared with participants at high genetic risk but with poor adherence to the hPDI-Lifestyle (p for interaction <0.001). Our findings support recommendations to adopt a healthful plant-based diet in combination with lifestyle (non-smoking, adequate physical activity and moderate sleep duration) for personalized CHD prevention. Potential differences by genetic predisposition of lifestyle on CHD prevention warrants further investigations. This work was supported by the Erasmus Medical Centre and Erasmus University, Rotterdam, Netherlands.

Sleep deprivation drives hepatic steatosis via sympathetic sprouting-induced ER stress in young male mice.

Prevalence of sleep problems and influencing factors among Chinese women aged 35-60years.

Deep learning for depression prediction in older adults: A retrospective cohort study from CHARLS (2011-2020) with independent cohort validation in CLHLS (2008-2018).

Circadian disruption has been linked to adverse metabolic health. Adolescents are particularly susceptible to circadian disruptors, such as delayed sleep onset and social jetlag, which may have sex-specific effects. However, evidence linking these disruptors with circadian gene expression and subsequent cardiometabolic risk remains limited. Our study included 203 adolescents (53% females, median age 13.6 years) from the ELEMENT cohort in Mexico City. Sleep was assessed via 7-day wrist actigraphy. A fasting venipuncture blood sample was collected between 8:00 a.m. and 12:00 p.m. RNA was isolated from blood leukocytes and sequenced to determine the relative expression of genes. We conducted differential gene expression analysis for 12 core clock genes in relation to sleep midpoint and social jetlag, adjusting for sleep duration and other potential confounders. We further evaluated how circadian gene expression associated with changes in adiposity, glucose metabolism, blood pressure, and lipid profiles over two years using linear regression. Later sleep midpoint (per 1-h increase) was associated with reduced mid-morning expression of four circadian genes: RORA (log2 fold change [LFC]: -0.190; P value: 0.001), RORC (LFC: -0.147; P value: 0.039), CLOCK (LFC: -0.141; P value: 0.019), and NR1D2 (LFC: -0.093; P value: 0.029). Additionally, expression levels of several clock genes (CRY1, NR1D2, BMAL1, and PER1-3) were associated with changes in metabolic biomarkers over two years in sex-specific patterns. For instance, NR1D2 showed a negative association with fasting glucose among females (β: -0.0012; P value: 0.020), while demonstrating positive associations with LDL cholesterol (β: 0.0023; P value: 0.002) and total cholesterol (β: 0.0016; P value: 0.028) among males. Expression of core clock genes was linked to circadian disruption and changes in cardiometabolic risk factors in a sex-specific manner among adolescents. Our findings provide novel insights into potential biological mechanisms underlying associations of circadian disruption with cardiometabolic health.

Patients with Parkinson's disease (PD) suffer from interrelated motor and non-motor symptoms. While most research focuses on motor improvement, this study investigated whether targeting mood via sequential bilateral dorsolateral prefrontal cortex (DLPFC) tDCS could favorably affect motor function in patients maintaining a stable medication 'ON' state. Additionally, we employed wearable smart devices to objectively evaluate real-world changes in daily activity and sleep patterns, complementing traditional clinician-rated scales. PD patients with mild-to-moderate depressive symptoms were enrolled. All participants completed a 7-day baseline monitoring period using a smart band. Participants received ten sessions of bilateral tDCS targeting the DLPFC (anode F3, cathode F4) at 2 mA for 30 minutes, three times a week. Clinical assessments and smart band monitoring were repeated during the final week of treatment. Pre-post changes and correlations were analyzed while controlling for potential confounders. Following tDCS, it was significant improvements in K-MADRS, STAI, AS, UPDRS part III, and PDQ-39. Smart device data showed a significant increase in daily step counts after treatment, while changes in physical activity time and sleep duration were not significant. Changes in step count were strongly correlated with improvements in apathy, and this relationship remained significant after confounding variables (rho = -0.76, p < 0.001). Bilateral DLPFC tDCS significantly improved mood and motor function in patients with PD. Smart band data further showed an increase in daily step counts after the intervention, with reductions in apathy. These findings suggest that tDCS may enhance goal-directed behavior by modulating mood-related pathways, highlighting apathy as an important therapeutic target in PD.

Background: Advanced glycation end products (AGEs) accumulate in tissues with age and are associated with the risk of chronic diseases. However, evidence regarding lifestyle factors related to AGE accumulation in healthy adolescents is limited. The aim of this study was to explore dietary and lifestyle factors that may attenuate tissue AGE accumulation, using skin autofluorescence (SAF) as a noninvasive proxy marker, in healthy Japanese early adolescent girls. Methods: This cross-sectional study included 315 first-year junior high school girls aged 12–13 years from a private school in Japan. SAF was measured on the volar forearm using an AGE Reader MU. Dietary intake was assessed using a validated brief diet history questionnaire (BDHQ-15y). Lifestyle factors, including weekday sleep duration, were assessed using a self-administered questionnaire. Health-related variables (including weight-loss dieting) were also collected. Associations between SAF and each factor were analyzed using generalized linear models and nonparametric tests, with multivariable adjustment for potential confounders. Results: The mean SAF was 1.06 ± 0.13 arbitrary units. No significant associations were observed between SAF and health-related characteristics, nutrient intakes, or major food-group intakes. Longer weekday sleep duration was significantly associated with lower SAF (p for trend = 0.019) and remained significant after multivariable adjustment (p for trend = 0.018). A similar association was observed for better perceived restorative sleep (p for trend = 0.033; adjusted p for trend = 0.048). Conclusions: In healthy early adolescent girls, longer weekday sleep duration and better perceived restorative sleep were associated with lower SAF, whereas dietary intake was not. Given the largely irreversible age-related accumulation of AGEs, promoting healthy sleep during adolescence may help attenuate AGE accumulation early in life and reduce long-term AGE-related disease risk. Prospective studies with more detailed dietary assessments are needed to clarify dietary influences and confirm temporality.

Although prior research links first-time grandparenthood to changes in well-being in mid- and later life, little is known about how sleep duration and timing change across this transition. Guided by a life-course perspective, we examine within-individual changes in sleep duration, sleep onset timing, and nap duration around entry into grandparenthood among women and men. Using six waves of longitudinal data from the China Family Panel Studies (CFPS, 2010-2022), we estimate fixed-effects models with event-time indicators to trace sleep trajectories before and after the transition. Nighttime sleep duration declines after the transition to grandparenthood, with more sustained reductions among men than women. Among men, sleep duration decreases from the birth year and remains lower for up to nine years. Among women, declines are smaller and limited to specific post-transition years. We find little evidence of changes before the transition. Sleep onset timing and nap duration remain stable. Stratified analyses show differences by grandparental sex and parental lineage. Reductions are concentrated in the maternal lineage, particularly among non-employed maternal grandmothers and non-coresiding maternal grandfathers. Maternal grandfathers show declines shortly after the transition, regardless of employment status. Employment status and living arrangement otherwise show limited moderating effects. The transition to grandparenthood is associated with differentiated changes in sleep duration, showcasing the value of an intersectional life-course approach for understanding sleep in middle and later adulthood.

Abstract Sleep is fundamental to children’s development, yet many children experience insufficient sleep, with digital media use identified as a key contributing factor. While previous research has examined the relationship between digital screen time and sleep patterns, most studies have not investigated how different types of digital media use relate to distinct sleep trajectories, particularly in the context of widespread smartphone adoption among children. This study aimed to identify distinct patterns of sleep duration trajectories and examine how different types of digital screen time, especially smartphone use, relate to these patterns. Using data from the Korea Children and Youth Panel Survey ( N = 2607), we conducted latent class growth analysis to identify sleep duration trajectories among children from fourth to eighth grade (2018–2022). Multinomial logistic regression analyses examined how digital screen time and other factors were associated with trajectory membership. Three distinct sleep trajectory patterns emerged: high-decreasing (16.7%), mid-decreasing (78.2%), and low-decreasing (5.1%). All groups showed decreasing trajectories over time, but from different starting points and at different rates. Smartphone use showed the strongest association with trajectory membership, whereas television viewing and computer use showed relatively weaker associations. Female students and those reporting higher smartphone use were more likely to belong to groups with shorter sleep duration. Academic factors, particularly private tutoring time, were also significantly associated with membership in shorter sleep duration groups. These findings highlight a shift in how different types of digital media affect children’s sleep, with smartphone use now showing a stronger influence than traditional screen time activities. Our results provide crucial insights for parents, educators, and policymakers in promoting healthy sleep patterns among children in an increasingly digital world.

Background and Aim. Non-invasive transcutaneous vagus nerve stimulation (tVNS) is increasingly investigated as a neuromodulation approach for improving sleep and autonomic regulation. Randomised trials have shown beneficial effects of tVNS on insomnia symptoms and sleep quality, although results vary depending on stimulation site and device type. Most previous studies used auricular stimulation, while wearable devices delivering stimulation in the cervical region have recently become available for consumer use. Pulsetto is a commercially available wearable non-invasive tVNS device delivering bilateral cervical stimulation through the skin. Real-world longitudinal data on sleep outcomes associated with consumer-grade VNS devices remain limited. The aim of this study was to evaluate changes in wearable-derived sleep parameters associated with regular use of this device in everyday conditions among users in the United States. Methods. This retrospective longitudinal observational study analysed sleep data linked to regular use of the Pulsetto device. Sleep outcomes were obtained from commercially available wearable devices (Garmin, Apple Watch, Oura). For each night, the stimulation session closest to bedtime was retained. Data were aligned to each user’s first recorded session and restricted to the first six weeks of use. Total sleep time was the primary outcome. Changes over time were evaluated using linear mixed-effects models with participant as a random effect. Results. After filtering, the dataset included 36 users and 969 nightly observations. Total sleep time increased across six weeks, with an estimated change of ~0.12 h/week (p &lt; 0.05), corresponding to ~35–40 min increase from Week 1 to Week 6. Secondary outcomes showed high variability due to differences in wearable devices, repeated sessions, and limited overlap of physiological metrics. Conclusions. In real-world conditions, regular use of a wearable bilateral cervical tVNS device was associated with a modest increase in sleep duration over six weeks. Variability typical of consumer-generated data limits causal interpretation, but results support feasibility of real-world monitoring and the need for controlled prospective studies. Keywords: Vagus nerve stimulation; sleep; wearable devices; real-world data; longitudinal study

Researchers have long speculated that sleep quality is tied to academic performance. This paper examines this relationship through a meta-analysis using the PRISMA 2020 guidelines. To clarify the relationship between sleep quality and academic performance, this study examined data from 72 independent effect sizes extracted from 59 articles involving 163,357 participants. The results indicate a modest positive correlation between sleep quality and academic performance (r = 0.17). Factors such as social jetlag significantly but negatively moderated the relationship between sleep quality and academic performance (r = −0.104), while sleep duration showed a significant positive correlation (r = 0.132). The school subject (Q = 14.986), age of participants (Q = 8.606), and culture (Q = 4.585) were significant moderators. Furthermore, while the research method did not significantly moderate the relationship between sleep quality and academic performance, the positive and significant association is robust across self-reported, objectively measured, and other-reported sleep quality, despite descriptive differences in effect-size magnitude. Given that sleep is an important physiological process associated with learning and development, students’ sleep quality warrants careful attention.