Even with modern therapy, people living with HIV (PLWH) commonly experience fatigue and face increased risk of cardiovascular disease. Obstructive sleep apnea (OSA) is common in PLWH and might contribute to these symptoms, yet the impact of OSA treatment in this population is underinvestigated. Academic university-affiliated HIV and sleep medicine clinics. One hundred twenty PLWH underwent polysomnography and completed questionnaires measuring fatigue, daytime sleepiness, perception of cognitive functioning, and sleep quality. Those with OSA were offered positive airway pressure (PAP) therapy. All measurements were repeated after 12 weeks of treatment. Cardiovascular outcome markers included peripheral arterial tonometry (reactive hyperemia index), heart rate, and blood pressure. Seventy persons had OSA and 41 (59%) elected to use PAP. Participants demonstrated a mean (secure digital) age of 52.8 (8.8) years, 39 men, mean body mass index 28.2 (3.9) kg/m 2 , and apnea hypopnea index 4% 33.5 (26.1). PAP therapy was associated with statistically ( P < 0.05) and clinically significant improvements in fatigue [pre 39 (27 to 44) vs. post 42 (32 to 48)], reactive hyperemia index [1.6 (1.4 to 2.2) vs. 2.1 (1.7 to 2.7)], and heart rate [73 (64 to 80.50) vs. 68 (61 to 73) beats per minute]. Daytime sleepiness, sleep quality, and perception of cognitive functioning all showed improvement ( P < 0.05), although changes were clinically modest. Treatment of OSA in PLWH can improve fatigue and markers of cardiovascular health, consistent with PAP treatment of OSA in non-PLWH populations. Our findings support assessment and treatment of OSA in PLWH to address commonly experienced symptoms.

Mental health disorders and sleep disturbances are significant public health challenges, especially among the elderly. Dietary fat quality has emerged as a critical regulator of sleep and mental well-being. This study aimed to investigate the association between fat quality and sleep/mental health outcomes in elderly individuals, considering gender-specific interactions. This cross-sectional study included 398 Iranian elderly individuals aged 65-85 years with sleep disturbances and mental health concerns. Dietary intake was evaluated using a validated semi-quantitative Food Frequency Questionnaire (FFQ). Psychological health, sleep quality, and mood were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the Profile of Mood States (POMS) questionnaire, respectively. Fat quality was assessed using the Fat Quality Index (FQI), cholesterol/saturated-fat index (CSI) and Omega-3:6 ratio. The study population consisted of 217 women and 181 men with a mean age of 63.31 ± 3.62 years. In the fully adjusted model, higher FQI was associated with lower anxiety risk and higher depression risk. The higher omega-3 to omega-6 ratio was linked to better sleep quality and lower depression risk, but higher anxiety risk. Higher CSI was associated with better sleep quality, higher anxiety risk and higher stress. Gender interactions were evident across various outcomes and fat quality indicators with sleep quality influenced by the omega-3/omega-6 ratio and CSI; mood by FQI and CSI; depression by FQI and CSI; anxiety by the omega-3/omega-6 ratio, FQI, and CSI; and stress showed interactions with all three indicators. Fat quality indicators exhibit complex and gender-dependent associations with mental health and sleep outcomes in older adults. While higher FQI appears protective against anxiety, it may elevate depression risk. A favorable omega-3/omega-6 ratio supports sleep and reduces depression risk but may increase anxiety. Elevated CSI correlates with improved sleep yet heightened anxiety and stress. These findings underscore the nuanced role of dietary fat composition in psychological well-being and sleep, highlighting the importance of personalized nutritional strategies.

Effects of Transcutaneous Electrical Acupoint Stimulation on Preoperative Anxiety in Adults: A Meta-analysis.

This study seeks to better understand the impact of schedule change on physiological and self-report measures of stress and quality of life among career firefighters. This study examined the impact of a schedule change from 24/48 to a 24-hour on/72-hour off, 48-hour on/72-hour off (i.e., 1/3/2/3) shift rotation on markers of stress among career firefighters over a seven-month period. Physiological measures such as salivary biomarkers (cortisol, testosterone, testosterone-to-cortisol ratio, interleukin-6) and blood pressure as well as self-reported survey instruments for occupational stress and job satisfaction were assessed throughout the study. By the end of the study, participants demonstrated significantly lower salivary cortisol concentrations, improved quality of life, and better sleep quality. These findings suggest that transitioning to a 1/3/2/3 schedule may reduce physiological stress and improve quality of life among career firefighters.

Technology has brought about a revolution in the management of type 1 diabetes (T1D). The adoption of continuous glucose monitoring (CGM) and insulin pump therapy in the everyday life of children and adolescents with T1D is a real innovation and the most promising choice for optimizing glycemic control in this population. The incorporation of an alarm system, including notifications, alerts and alarms and warning patients and their parents about glucose levels and upcoming events interfering with safety, is an invaluable additional tool for better targeting euglycemia. However, in parallel with the clinical benefits of alarm systems in ameliorating metabolic control parameters, alarm fatigue was recorded as a phenomenon, negatively affecting the everyday lives of patients and their caregivers, and as a cause for rejecting or abandoning CGM or pump therapy treatment. There are a few data concerning the frequency, consequences and methods of eliminating alarm fatigue among children. As a result, we have conducted a narrative review to briefly present the basic philosophy of the existing CGM alarm systems and their positive effect on glycemic management, and focus on alarm fatigue; definition, frequency, effect on quality of life and sleep, not only of T1D pediatric patients but also of their families, and methods of elimination. Efforts to achieve a more reliable and accurate alarm system and educate on adapting personalized limits and positively interpreting them may protect the T1D pediatric population from alarm fatigue and prevent rejection or incomplete use of CGM and insulin pump as the therapeutic choice, ensuring the best glycemic control.

Should Sleep Quality Improve in Patients Receiving Yoga for Other Conditions?

The community service partner is the elderly and families in Tambak Baru Ilir Village. Hypertension in the elderly is often accompanied by pain, either due to complications of hypertension or due to physical decline due to aging. Uncontrolled pain can lead to increased blood pressure, sleep disturbances, depression, and a reduced quality of life. In addition to pharmacological treatment, non-pharmacological approaches are needed to help reduce pain, one of which is Quranic recitation therapy. Recitation therapy has been shown to have a calming effect and can help reduce anxiety and stress levels, as well as improve sleep quality in the elderly, contributing to pain reduction and blood pressure stabilization. The result of this interventions, There was a decrease in pain levels in elderly people with hypertension after being given Murottal therapy in Tambak Baru Ilir Village. Murottal therapy activities can be given to elderly people with hypertension to reduce the level of pain they feel.

Background Sleep is a fundamental biological process, the duration and quality of which are of key importance for the proper development and health of the pediatric population. Understanding the complex relationship between sleep and the pathogenesis of diseases during childhood is essential for developing effective preventive and interventional strategies aimed at supporting the holistic health of the youngest patients. Aim This review aims to provide an analysis of available scientific evidence regarding the impact of insufficient sleep duration and poor sleep quality on a wide range of health indicators in children and adolescents. Special emphasis is placed on the consequences for mental health and eating disorders. Materials and methods This review synthesizes current evidence by examining literature available on PubMed, Google Scholar, and academic sources using keywords related to the sleep duration, sleep quality, pediatric population, mental health and eating disorders. Experimental, cohort, systematic reviews and clinical studies were evaluated. Results We highlight sex- and age-dependent vulnerabilities and discuss the multifactorial interplay between sleep behavior, lifestyle factors, and disease risk.Specifically, interventions aimed at improving sleep hygiene, reducing screen exposure before bedtime, and addressing sleep disorders such as obstructive sleep apnea show promise in mitigating risks associated with obesity, hypertension, emotional disorders, and chronic inflammation. Conclusion Sleep duration and sleep quality contributes to pediatric obesity, insulin resistance, cardiometabolic risk, mental health, inflammatory processes and headache disorders. Limitations in current research, including methodological heterogeneity and reliance on subjective sleep measures, underscore the need for prospective studies. We recommend future research focus on mechanistic pathways linking sleep disturbances to specific health outcomes.

The 36-item Short-Form Health Survey (SF-36) is widely used to assess health-related quality of life. However, only few studies have examined longitudinal SF-36 trajectories in general populations, and even fewer have explored their relationships with lifestyle factors, including sleep quality. We conducted a longitudinal analysis of SF-36 subscale trajectories among 910 Japanese individuals aged ≥ 60 years from 2007 to 2018 (4,799 records). Using latent class mixed models, we identified distinct trajectory patterns for each subscale. Notably, the role-physical (RP) and role-emotional (RE) subscales exhibited multiple patterns, including rapid decline and non-decline trajectories. We further examined predictors that differentiated between these two trajectory patterns-rapid decline and non-decline-with similar baseline scores. Consequently, poor performance on the open-eye one-leg standing test and higher depression scores on the Centre for Epidemiologic Studies Depression Scale predicted RP and RE declines, respectively. Importantly, poor sleep quality, as measured by the Pittsburgh Sleep Quality Index-particularly the total score and component 7 (daytime dysfunction)-was associated with subsequent RP and RE declines. In contrast, sleep timing variables (bedtime, sleep onset, and wake-up time) were not predictive. These findings suggest that preserving good sleep quality may help prevent future limitations in daily physical and emotional roles.

The recognition of poor sleep quality is a significant health issue since there is a paucity of comprehensive data on sleep quality in women and the previous studies that have no providing a holistic understanding of the issue across different stages of women's lives. Therefore, conducting a systematic review and meta-analysis of poor sleep quality and associated factors among women in Ethiopia is an essential to provide actionable insights for healthcare providers and policymakers. A systematic review and meta-analysis of 11 studies among 6038 women of the exact heterogeneity of (I² = 99%) with a comprehensive search using electronic databases (PubMed, Cochrane Library, Google Scholar, and African Journal Online) was performed covering articles indexed through June 2000 to 1,August 2025. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Epidemiological Data Research Institute Critical Appraisal Checklist which studies scoring above 75% were considered for inclusion in the meta-analysis. The inter-rater reliability between the two reviewers for the JBI quality assessment was substantial (Cohen's κ = 0.82; 95% CI: 0.73-0.91), indicating good consistency in scoring across studies. The I2 test statistics were used to examine the heterogeneity of the studies. A random-effects meta-analysis was performed to estimate the prevalence of the poor sleep quality, and the results are reported in a forest plot. The pooled prevalence of poor sleep quality among 6038 women was 42.25% (95 CI: 30.80, 53.7). In this review, having depressed (AOR = 3.7, 95%CI: 2.82, 4.8), substance use (AOR = 2.00, 95%CI: 1.6, 2.6), Intimate Partners Violence (IPV) (AOR = 3.20, 95%CI: 1.95, 5.3), stress 2.50, 95%CI: 1.82, 3.43), and low social support (AOR = 4.2, 95%CI: 2.700, 6.60) were significantly associated with poor sleep quality. Poor sleep quality is affecting over 40% of women in Ethiopia. Depression, substance use, intimate partner violence, stress, and low social support are statistically associated with poor sleep quality. Therefore, targeting mental health and social support, alongside public education and policy integration, are essential to improve sleep quality.

This study explores the therapeutic value of nature-based intervention methods in psychiatry through an assessment of their practical applications, action mechanisms, and conceptual development. The conceptual framework is based on discussions of emerging psychological constructs such as eco-anxiety, ecological grief, and solastalgia, which have arisen as a result of climate change. The study reviews the psychiatric effects of horticultural therapy, forest bathing, community gardening, and mindfulness-based nature practices. The findings indicate that horticultural therapy helps patients with depression and anxiety and improves their attention, forest bathing decreases cortisol levels and boosts immunity and sleep quality, community gardening reduces social isolation and creates feelings of belonging, and mindfulness-based nature practices help people manage stress and develop self-awareness. They further demonstrate that nature-based practices support both personal mental health and the creation of enduring mental health policies. However, evidence on the long-term effects of these interventions and their adaptability to different cultural contexts is limited. Standardized assessment tools are lacking in this field, which creates challenges for the comparison of different research findings. To integrate nature-based interventions into clinical practice, structural policy changes and professional development training are both needed, together with the establishment of ecologically sensitive protocols and policy arrangements that encourage interdisciplinary collaboration.

Academic stress and online learning engagement in medical students: the parallel mediating roles of sleep quality and positive academic emotions.

To explore the longitudinal associations between maternal sleep, anxiety, depression across pregnancy trimesters and adverse pregnancy outcomes. A prospective cohort study was conducted in a maternal and child health hospitals in China from September 2018 to March 2021. Totally of 3147 pregnant women completely participated in this study, who were with complete data available. Measures included Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale and pregnancy outcomes to estimate the sleep quality, anxiety, and depression, respectively. Sleep quality of pregnant women in the first trimester pregnancy had not significant association with adverse pregnancy outcomes (p-value > 0.05). However, compared with pregnant women with good sleep quality, women with poor sleep quality in the second trimester pregnancy was associated with 1.421 times risk of adverse pregnancy outcomes (95% CI: 1.037-1.947, p-value < 0.05). In addition, in the second trimester pregnancy, anxiety was associated with a significantly reduced risk of adverse pregnancy outcomes (OR = 0.632, 95% CI: 0.42-0.95, p-value < 0.05), while depression in the second trimester pregnancy was not significantly associated with adverse pregnancy outcomes (p-value > 0.05). Moreover, both anxiety and depression of pregnant women in the third trimester pregnancy were not significantly associated with adverse pregnancy outcomes (p-value > 0.05). Longitudinal associations between sleep, anxiety, depression and pregnancy outcomes across pregnancy trimesters indicated that maternal health care workers should focus on changes of the sleep quality, anxiety and depression across pregnancy trimesters, and its effects on pregnancy adverse outcomes.

Stroke patients often experience reduced sleep quality, and sleep disturbances not only impair the rehabilitation process but may also increase the risk of frailty. Meanwhile, anxiety and depression are highly prevalent in this population and may mediate the relationship between sleep and frailty. However, research on the potential heterogeneity of sleep quality and its association with frailty in older stroke patients remains limited, and the mechanisms underlying the role of psychological factors are still unclear. Therefore, this study aimed to identify the potential subtypes of sleep quality in older stroke patients, examine their associations with frailty, and further analyze the mediating roles of anxiety and depression, providing evidence for precise assessment and intervention of frailty in this population. A total of 310 older stroke patients hospitalized in the neurology department of a tertiary hospital in Shandong Province from November 2024 to June 2025 were recruited using convenience sampling. General demographic and clinical data were collected, and patients were assessed using the Tilburg Frailty Indicator, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Latent profile analysis of sleep quality was performed using Mplus, and mediation analyses were conducted using SPSS. Two latent profiles of sleep quality were identified: relatively good sleep group (76.7%) and inefficient sleep with daytime dysfunction group (23.2%). Significant differences were observed in total frailty scores and all dimensions across the different sleep quality profiles ( p < 0.001). Bootstrap mediation analysis indicated that anxiety and depression significantly mediated the association between sleep quality profiles and frailty, accounting for 30.7% and 34.6% of the total effect, respectively. Sleep quality among older stroke patients demonstrated heterogeneity, with those in the inefficient sleep with daytime dysfunction group exhibiting significantly higher frailty levels than those in the good sleep group. Furthermore, anxiety and depression played mediating roles in the relationship between sleep quality profiles and frailty.

Understanding the impact of training sessions on physiological, psychological, and immunological responses is crucial for adequate training periodization and preventing negative influences on health, training, and performance. To characterize the responses of heart rate variability (HRV), sleep time and quality, motivation, dry-land strength, and swimming performance to an overload period of three consecutive 7-day cycles (cycles 1, 2, and 3) with different training intensity and volume dynamics. Secondly, to test the capability of HRV to assess daily variation in training loads on the basis of explainable artificial intelligence (XAI)models. A total of 14 high-level swimmers (4 males and 10 females, aged 17.5 ± 1.5years) were monitored via an orthostatic test, Hooper index, sleep questionnaires, and rating of perceived exertion (RPE) of each training session. The self-reported and prescribed training loads were compared. At the beginning of each cycle and at the end of cycle 3, swimmers completed anthropometric testing, countermovement jumps, hand-grip strength tests, and a 5 × 200m incremental protocol. High-level swimmers accurately perceived their daily training loads. However, differences between the training and RPE loads emerged on weekends, indicating that physiological and psychological loads have different influences and should be considered simultaneously when characterizing training loads. The overload period was characterized by an increase in both training (27%) and RPE (20%) loads without eliciting a negative effect on sleep quantity and quality. During the overload period, supine (F2.18 = 3.448, η2 = 0.28; p = 0.05) and standing (F2.18 = 3.809, η2 = 0.30; p = 0.04) mean heart rate (HR) increased and supine log root mean square of the successive differences (LnRMSSD; F2.18 = 4.379, η2 = 0.33; p = 0.028) and maximal blood lactate (F3.27 = 3.441, η2 = 0.28; p = 0.03) decreased during and after cycle 3 (respectively). Dry-land and swimming performances were maintained, indicating that the autonomic nervous system appears to be more sensitive (XAI models r2=0.91 and 0.9)to changes in acute/short-term training load. HRV indices, particularly supine RMSSD and mean HR, were the most sensitive markers of training load variation, while sleep, strength and power, and swimming performance remained stable. HRV can be employed as a practical tool for monitoring training responses and managing training loads in competitive swimmers.

An anterior-posterior gradient in hippocampal subfield volumes linking sleep health to cognition in young adults.

To investigate alterations in functional connectivity of the mediodorsal thalamic nucleus (MD) in Chronic Insomnia Disorder (CID) patients and their correlations with clinical neuropsychological characteristics. The study enrolled individuals who met the International Classification of Sleep Disorders -Third Edition (ICSD-3) criteria for CID, with the addition of age- and sex-matched healthy controls (HC). Using bilateral Mediodorsal medial magnocellular (MDm) and Mediodorsal lateral parvocellular (MDl) as seeds, whole-brain resting-state functional connectivity (RSFC) was analyzed. Group RSFC differences between CID and HC were compared, followed by correlations with Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scales (SAS) and Self-Rating Depression Scales (SDS) in CID patients. Mediation analyses were conducted to investigate whether RSFC alterations serve as a mediator associated with symptoms of anxiety or depression in CID patients. The study included 50 CID patients and 42 HCs. Patients showed reduced RSFC of the MD with the other subregions of the thalamus, middle frontal gyrus (MFG), lingual gyrus (LING), caudate nucleus (CAU), and cerebellum. The left MDl-right LING connectivity showed a significant negative correlation with SAS scores, and this connectivity significantly mediated the relationship between sleep quality and anxiety in CID patients. Our findings demonstrate that the MD may serves as a critical hub in both sleep-wake regulation and emotional processing networks in CID patients, positioning it as a promising target for personalized neuromodulation therapies aimed at treating CID and its comorbid anxiety.

Objective: To examine the association between Fear of Missing Out (FoMO) and dimensions of sleep health. Methods: We searched PubMed, PsycINFO, and Web of Science from inception to March 2025. Primary inclusion criteria were original studies reporting associations between FoMO and any sleep health dimension. Risk of bias in included studies was assessed independently by two reviewers using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Correlations between FoMO and sleep health dimensions were synthesized using random-effects meta-analytic models. Results: Twenty-two studies (25 independent samples; N = 12,191 participants) were included. Most used survey methods and assessed FoMO with the Fear of Missing Out Scale. Meta-analytic random-effects models were conducted for each sleep health dimension with at least 3 independent results. Twelve studies showed a positive correlation between FoMO and Sleep Quality (Fisher's Z = 0.265; p < 0.05), four studies showed a positive correlation between FoMO and Bedtime Procrastination (Fisher's Z = 0.231; p < .001), and five studies showed a positive correlation between FoMO and worse Sleep Hygiene (Fisher's Z = 0.268; p < .001). Two or fewer independent samples showed positive significant relations between FoMO and insomnia, later lights out time, problematic sleep, sleep deprivation, sleep onset latency, and sleep duration. Discussion: Preliminary evidence suggests FoMO is associated with multiple dimensions of sleep health. Further longitudinal studies using multidimensional sleep assessments are needed. PROSPERO registration: CRD42023446430.

Running Under Conditions of Extreme Sleep Deprivation and Exhaustion: An Analysis of Performance and Satisfaction of 200+ Mile (322+ Kilometer) Ultramarathon Runners.

BackgroundMild-to-moderate depression is an increasing public health problem worldwide, which is more prevalent than major depression but has received less attention Currently, no existing highly effective pharmacological treatments with minimal adverse reactions are available for this condition. Jin’s Three-Needle Acupuncture (JTN) may be an alternative treatment option for mild-to-moderate depression patients.MethodsThis is a prospective, parallel-arm, single-blind, randomized controlled trial. We plan to enroll 106 participants with mild-to-moderate depression, randomly assigning them to receive either JTN or sham acupuncture (SA) in a 1:1 ratio. All participants will receive the JTN treatment or SA treatment for 8 weeks (3 per week). The primary outcome will be assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17). Secondary outcomes will include the Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), and the Traditional Chinese Medicine Syndrome Score Scale (TCMSS). Evaluations will be performed at baseline and at weeks 4, 6, and 8 after treatment initiation. Statistical analyses will be conducted on both the intention-to-treat (ITT) and per-protocol (PP) datasets.DiscussionThis study aims to provide high-quality evidence regarding the efficacy and safety of JTN as a treatment for mild-to-moderate depression. Additionally, the mechanisms underlying the effects of JTN in treating mild-to-moderate depression will be explored.Trial registrationThe trial registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2024000872). URL: https://www.itmctr.ccebtcm.org.cn