Sleep Quality Research Articles

The effects of mindfulness therapy on infertile female patients: A meta-analysis.

About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4-6 couples. It is thus essential to find effective psychological treatment. To conduct a systematic review of previous meta-analyses on mindfulness-based therapy outcomes in infertile female patients and a meta-analysis of studies nested within these meta-analyses. Randomized controlled trials (RCTS) on the efficacy of mindset-based interventions in infertile female patients were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNI, VIP Database, and Wanfang Database until March 1, 2023. Two researchers screened the literature, extracted data according to inclusion and exclusion criteria, and conducted quality control according to Cochrane Handbook 5.1.0. When there was ambiguity, a third party determined it. The meta-analysis was performed using RevMan 5.3 software. 14 randomized controlled trials involving 1784 patients were included. Meta-analysis showed that compared with conventional care, mindfulness-based intervention can effectively relieve anxiety in female infertility patients [SMD =-2.25, 95% CI (-2.90, -1.60), P< 0.00001], depression [SMD =-2.25, 95% CI (-2.99, -1.52), P< 0.00001], perceived stress [SMD =-0.99, 95% CI (-1.27, -0.71), P< 0.00001], improved quality of life, physiological function [MD = 14.03, 95% CI (11.98, 16.07), P< 0.00001], Role limitations due to physical problems [MD = 11.30, 95% CI (5.71, 16.90), P< 0.0001], vitality [MD = 11.55, 95% CI (9.46, 13.65), P< 0.00001], mental health [MD = 17.32, 95% CI (15.29, 19.35), P< 0.00001]. Existing evidence shows that mindfulness therapy can effectively relieve the anxiety and depression of infertile women, reduce the level of stress, and improve the quality of life and sleep quality. However, due to the limited quantity and quality of the literature, multi-center, large-sample, and high-quality randomized controlled studies should be conducted in the future.

Association of family meals with sleep and quality of life in Japanese preschool and elementary school children: A cross-sectional study

ABSTRACT Sleep is crucial for children’s health and eating habits. The decline in family meals has raised concerns about its impact on children. Previous research indicated associations between family meals and psychological health and dietary habits, but their relationship with sleep behavior is less understood. This study examined the association between family meals (breakfast and dinner), sleep patterns, and quality of life among Japanese preschoolers and elementary school students (1st to 3rd grade). The cross-sectional study involved 6,177 children aged 3–8 years in Japan. Mothers completed an online survey on family meal habits, sleep patterns, and the KINDL-R questionnaire to assess quality of life. Results showed that family meals were associated with sleep behaviors and KINDL scores. Multiple regression analysis indicated that family breakfast was associated with earlier bedtime and wake-up time, shorter weekend sleep duration, reduced social jet lag, and a morning chronotype, as detected by the Munich ChronoType Questionnaire. Family dinners were linked to later sleep and wake-up times and an evening chronotype. Family breakfast and dinner were associated with higher KINDL scores, with dinner having a stronger positive impact. These findings underscore the significance of family meals in associating sleep patterns and quality of life among Japanese children.

Prospectively predicting 6-month risk for non-suicidal self-injury among adolescents after psychiatric hospitalization based on a predictive model

BackgroundIt is challenging to predict the occurrence of non-suicidal self-injury (NSSI) among adolescents over short periods. Moreover, the predictive value of indices for NSSI remains elusive. Thus, this study aimed to identify predictors of NSSI within 6 months among adolescents after psychiatric hospitalization by establishing a risk assessment model.MethodsA total of 632 high-risk participants were included in this study. The distribution characteristics of adolescent NSSI were initially assessed through a cross-sectional survey, following which risk factors were identified using logistic regression analysis. The risk score method was then used to construct a 6-month risk assessment model for NSSI. Lastly, the predictive effect of the model was evaluated by indicators such as the area under the receiver operating characteristic (ROC) curve and the positive predictive value.ResultsAfter 6 months, 412 cases of NSSI were identified. According to the logistic regression model, the frequency of relapses, medication status, and NSSI history were identified as influencing factors. Higher scores on the Impulsive Behavior Scale and Pittsburgh Sleep Quality Index were associated with a higher risk of NSSI. Conversely, higher scores on the Pain and Belief Perception Scale were correlated with a lower risk of NSSI. Moreover, the area under the ROC curve for the predictive model was 0.9989, with a 95% confidence interval of (0.9979, 0.9999), highlighting its high predictive ability and accuracy. The predictive model was validated using 78 patients, yielding an area under the ROC curve of 0.9703 and a 95% confidence interval of (0.9167, 0.9999), demonstrating outstanding predictability.ConclusionThese results collectively showed that the predictive model could accurately predict adolescent NSSI. Thus, the model’s primary variables may be applied to predict the risk of NSSI in the clinical setting.

Validity and reliability testing of the Shatri Sinulingga psychosomatic test (SSPT) questionnaire as a screening instrument for psychosomatic disorders in Indonesia

The incidence of psychosomatic disorders is increasing in Indonesia, and therefore screening instruments that are culturally appropriate for the Indonesian population are needed. The aim of this study was to assess the validity and reliability of the Shatri Sinulingga psychosomatic test (SSPT) questionnaire as a screening instrument for psychosomatic disorders in Indonesia. An analytic descriptive cross-sectional study divided into two stages (questionnaire formulation and distribution through the Psikosom.id application) was conducted in 2023. The validity test was carried out using the product moment technique, and Cronbach's alpha assessment was carried out to evaluate the reliability of the questionnaire. A total of 372 participants were included, with a mean age of 39.24 years old. The SSPT questionnaire scores had strong correlations with the scores of hospital anxiety and depression scale (HADS) (r=0.668; p&lt;0.001) and the Symptom Checklist-90 (SCL-90) (r=0.674; p&lt;0.001); and moderately correlated with the score of fatigue severity scale (FSS) (r=0.505; p&lt;0.001) and Pittsburgh Sleep Quality Index (PSQI) (r=0.492; p&lt;0.001). The correlation coefficient (r) value of each SSPT question ranged from 0.389–0.726, and all r higher than r table with an overall Cronbach’s alpha of 0.744. The SSPT questionnaire's strong predictive performance: had a sensitivity of 75.6% and specificity of 71.4% with an area under the curve (AUC) of 81% (95%CI: 76.6–85.4%; p&lt;0.001) to HADS; sensitivity of 80% and specificity of 58.6% with an AUC of 75.1% (95%CI: 70–80.2%; p&lt;0.001) to FSS; sensitivity of 64% and specificity of 67.5% with an AUC of 71.2% (95%CI: 65.4–77%; p&lt;0.001) to PSQI; and had sensitivity of 78% and specificity of 67.4% with an AUC of 80.9% (95%CI: 76.6–85.3%; p&lt;0.001) to SCL-90. The study highlights that the SSPT questionnaire is valid and reliable to be used as a screening instrument for psychosomatic disorders in Indonesia.

Clinical study of different frequency transcranial magnetic stimulation combined with paroxetine in the treatment of poststroke depression with insomnia.

Study the treatment of poststroke depression and insomnia using varied repetitive transcranial magnetic stimulation (rTMS) frequencies alongside paroxetine. Aim to enhance rTMS effectiveness for depression, insomnia, neurological impairment, and daily living skills. Ninety poststroke depression (PSD) patients were randomly divided into a low-frequency group (low-frequency rTMS + enteric-coated paroxetine), a high-frequency group (high-frequency rTMS + enteric-coated paroxetine), and a control group (sham stimulation + enteric-coated paroxetine). The treatment was administered 5 times a week for a total of 2 weeks. Before treatment, at the end of the 2-week treatment, and at the end of the 6-week follow-up, the 3 groups of patients were assessed using the Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), National Institutes of Health Stroke Scale (NIHSS), and Modified Barthel Index (MBI). The mean differences of scores measured at different frequencies and at different times were analyzed by repeated measure one-way analysis of variance. The interaction between different frequency and score before and after treatment was significant. HAMD, PSQI, and NIHSS scores of the 3 groups after 2 weeks of treatment and 6 weeks of follow-up were significantly lower than before treatment, while MBI scores were opposite. The main effect of treatment scores in different frequency groups showed that HAMD, NIHSS, and MBI scores were not significantly different among the 3 groups before treatment. The HAMD, PSQI, and NIHSS scores of the low frequency group and the high frequency group were significantly lower than those of the control group after treatment, and the MBI scores were the opposite, except that there was no significant difference in HAMD-17 scores among the 3 groups at the 6-week follow-up. Among them, HAMD score in high-frequency group was significantly lower than that in low-frequency group, and PSQI score was significantly higher than that in low-frequency group. Low-frequency rTMS combined with medication has a better therapeutic effect on the insomnia symptoms of PSD, while high-frequency rTMS combined with medication has a more pronounced therapeutic effect on the depressive symptoms of PSD. Both high-frequency and low-frequency rTMS have an improving effect on neurofunctional deficits and activities of daily living.

Research progress on melatonin, 5-HT, and orexin in sleep disorders of children with autism spectrum disorder.

Sleep disorders are among the common comorbidities of autism spectrum disorder (ASD), which not only affect the daily life and learning ability of children but may also exacerbate other symptoms of ASD, seriously impacting the quality of life of children and their families. Given this, understanding the neurobiological mechanisms of sleep disorders in children with ASD has significant research value for developing effective intervention strategies. Melatonin, 5-HT, and orexin are key neurotransmitters that regulate the sleep-wake cycle. Through in-depth analysis of the biological functions and regulatory pathways of these neurotransmitters, new perspectives may be provided for personalized treatment of sleep disorders in children with ASD. This article reviews the research progress on melatonin, 5-HT, and orexin in sleep disorders among children with autism spectrum disorder, focusing on exploring the mechanisms of these key neurotransmitters in sleep disorders of children with ASD and how they affect the sleep-wake cycle, providing a theoretical basis for improving the sleep quality of children with ASD.

Quality of life as a reflection of metabolic indicators in patients undergoing programmed hemodialysis

Metabolic disorders associated with chronic kidney disease (CKD) can lead to a decrease in the quality of life of patients on hemodialysis. The aim of this study is to analyze the correlation between quality of life (QOL) in patients receiving treatment with PHD and clinical and laboratory indicators. Material and methods. 251 patients with stage 5 CKD were included in the study. There were 108 men and 143 women. The mean age was 54.4 ± 9.9 years. All participants completed a specific quality of life questionnaire KDQOL-SF. Results. The interviewed patients reported more concern about symptoms such as weakness, dizziness, and muscle pain (U = 765, p &lt; 0.001), which was correlated with albumin levels (R = 0.5, p &lt; 0.01) and calcium-phosphorus product levels (R = –0.48, p &lt; 0.05). They also expressed concern about the inability to travel or follow a special diet (U = 553, p &lt; 0.005), which correlated with heart rate levels (R = –0.51, P &lt; 0.1) and serum potassium levels (R = –0.6, P &lt; 0.1). Additionally, the burden of CKD correlated with triglycerides (R = 0.36, p = 0,01).Work capacity is associated with age (R = –0.54; p &lt; 0.001), eKT/V (R = 0.47; p &lt; 0.01). Indicators of cognitive function correlate with blood pressure (BP) (R = –0.51, p &lt; 0,001) and pulse pressure (P = –0,55, p &lt; 0,01). Sexual functions are associated with BP (R = –0,64, p &lt; 0,05), calcium levels (R = 0,76, p &gt; 0.80), iron (0,42, p = 0,90), transferrin saturation coefficient (0.5, p = 0.91). Sleep quality correlates with calcium-phosphate production (0.3, p &gt; 0.15). The feeling of social support correlates with magnesium (0,3, P &gt; 0,8), calcium (0.2, P &gt; 0,1). Conclusions. Correlations between quality of life, blood pressure, albumin, and calcium phosphate metabolism, iron, were found.

Canonical correlation-based relationships between social support and sleep quality in a hospital psychiatric outpatient population with examining the mediating roles of anxiety and depressive symptoms

Objective: This study aims to examine the associations between various dimensions of social support and sleep quality in a hospital psychiatric outpatient population using canonical correlation analysis, while also investigating the potential mediating roles of anxiety and depressive symptoms. Methods: Employing a cross-sectional design, survey data were collected from 10,071 individuals visiting Hangzhou Seventh People’s Hospital between October 2020 and October 2023. After excluding invalid cases, a total of 10,063 participants were included for analysis. The survey encompassed gathering basic demographic information as well as administering the Social Support Rating Scale, Self-rating Depression Scale, Self-rating Anxiety Scale, and Pittsburgh Sleep Quality Index Scale. Data analysis was conducted using SPSS 27.0 statistical software with canonical correlation analysis employed to examine the relationships. Additionally, the mediating effects of anxiety and depression symptoms were examined using the SPSS PROCESS macro. Results: Canonical correlation analysis reveals a significant positive correlation between social support dimensions and various aspects of sleep quality. The first pair of canonical variables (r = 0.586, p < 0.001) accounts for an impressive 97% of the cumulative contribution. It is found that this pair of canonical variables explains 68.9% of the variance in social support and 49.0% in sleep quality. Mediation analysis revealed that anxiety and depressive symptoms significantly mediated the relationship between social support and sleep quality, accounting for 88% of the total effect. Specifically, anxiety accounted for 47% mediation while depression accounted for 41%. Conclusion: The study findings revealed a significant positive correlation between social support and sleep quality dimensions, indicating a robust association between increased social support and enhanced individual sleep quality. Furthermore, the results indicated that anxiety and depression partially mediated the relationship between social support and sleep quality, offering novel insights into the intricate connection between mental health and sleep quality.

Sleep quality, daytime sleepiness, and risk of falling: results from an exploratory cross-sectional study.

There is growing recognition of the importance of managing sleep disorders in the elderly, particularly given their complexity within a multidimensional framework. The aim of the present study is to investigate whether sleep quality and daytime sleepiness are associated with the risk of falls in older adults. This study included patients aged 75years or older who were consecutively evaluated at the Geriatric Service, University Hospital of Monserrato, Cagliari, Italy. Participants underwent geriatric assessment, including sleep analysis using the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS), as well as an assessment of risk of falls with Performance Oriented Mobility Assessment (POMA). The study included 206 subjects, of whom 70.4% were women, with a median age of 83years. A total of 141 participants (68.4%) had poor sleep quality, and 43 (20.9%) had excessive daytime sleepiness (EDS). Among people at high risk of falls, 85 participants had bad sleep quality, and 24 a satisfying one (χ2: 8.23, p = 0.0029); additionally, 77 participants did not exhibit daytime sleepiness, while 32 did (χ2: 9.03, p = 0.0027). To further explore these results, we designed logistic regressions, considering dichotomized PSQI and dichotomized ESS as independent variables, and dichotomized POMA as the dependent variable, and finally adjusted them for confounders. The adjusted model for PSQI yielded OR: 2.04 (95%CI 1.02-4.10), and the adjusted model for ESS yielded OR: 2.56 (95%CI 1.17-5.91). Our study demonstrated that an increased estimated risk of falling is associated with poor sleep quality and EDS in older adults, independently of the confounders.

Social Pain Minimization Mediates Discrimination’s Effect on Sleep Health

ABSTRACT Objective Discrimination disrupts sleep and contributes to race-based health inequities for Black Americans, but less is known about the psychological mechanisms underlying this relation. The current work tests whether emotion invalidation, termed Social Pain Minimization (SPM), mediates discrimination’s negative effects on sleep quality. We focus on the experiences of Black Americans because of racism’s disproportionate effect on the health outcomes of Black individuals in the U.S. Methods Four studies with cross-sectional (Studies 1a-1b) and cross-lagged panel designs (Studies 2–3; N total = 1,176) were used. Discrimination and SPM were assessed with established measures and self-reported sleep quality was assessed with three different operationalizations including the short form Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep-Related Impairment (SRI) subscale and composites of the Insomnia Severity Index (ISI). Results Cross-sectional (Studies 1a-1b) and longitudinal mediation analyses (Studies 2–3) indicated discrimination’s negative effect on sleep quality partially operated through SPM (Study 1a, 95% CI = [−.24, −.016]); Study 1b, 95% CI = [−.22, −.03]; Study 2, 95% CI = [−.268, −.007]]; Study 3, 95% CI = [−0.043, −.002]). Conclusion Beyond its direct negative effect on sleep, discrimination also operates through SPM to reduce sleep quality. Emotion invalidation stemming from discrimination damages sleep.

Efficacy of Static Magnetic Field Therapy on Pain Intensity, Functional Disability, Sleep Quality and Depressive Symptoms in Patients with Mechanical Neck and Low Back Pain.

Mechanical neck pain (MNP) and mechanical low back pain (MLBP) can have a negative impact on the quality of life of patients and may be associated with high levels of disability. Magnetic field therapy has been using in the treatment of various diseases. This study was conducted to assess the effects of Static Magnetic Field (SMF) therapy generated by neodymium magnets in patients with MNP and MLBP. In this randomized, double-blind, sham-controlled, crossover study, patients with MNP and MLBP were randomly assigned to either the magnetic band or sham band treatment groups. After the initial 2-week phase (with participants randomly assigned to either treatment or sham-control), both groups underwent a 1-week washout period. Subsequently, the groups were swapped and proceeded with a second 2-week phase. Visual Analogue Scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODI), Neck Disability Index (NDI), Insomnia Severity Index (ISI), and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the patients' pain severity, functional disability, sleep quality, and levels of depressive symptoms, respectively. Of the 30 subjects, 17 (56.7%) had MLBP, whereas 13 (43.3%) had MNP. Magnetic band treatment (MBT) resulted in a significant decrease in the VAS score (p < 0.001) in all patients. MBT led to a significant decrease in the ODI score (p = 0.009) in patients with MLBP. A significant decrease in the NDI score was found in MBT (p < 0.001) in patients with MNP. The improvement in ISI and PHQ-9 scores was also significantly higher in MBT (p < 0.001). For patients with MNP and MLBP who have not experienced sufficient benefits from conventional treatments, neodymium magnets can be considered as an alternative treatment option due to their significant properties.

Addressing treatment hurdles in adults with late-onset attention-deficit/hyperactivity disorder: a detailed case report

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum.Case presentationA 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions.ConclusionThis case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies.

Relationship between sexual dysfunction and burnout among physicians in primary hospital: a cross-sectional study.

The relationship between sexual dysfunction and burnout among physicians remains unclear. To investigate the frequency of sexual dysfunction among physicians in primary hospital and explore the association between sexual dysfunction and burnout. This study was a cross-sectional survey conducted through a questionnaire. We used the Arizona Sexual Experience Scale and the Chinese version of the Maslach Burnout Inventory-Human Service Survey to assess sexual function and burnout among physicians in primary hospital. Considering the working environment of physicians, we also evaluated the doctor-patient relationship and sleep quality. Over one-third of physicians experience sexual dysfunction. Burnout is a significant factor to sexual dysfunction among medical professionals. A total of 382 doctors participated in this survey, and the prevalence of sexual dysfunction was 33.51%. Sexual arousal and orgasm were the main sexual dysfunctions faced by male and female doctors, respectively. The prevalence of burnout among physicians was 43.72%. The prevalence of sexual dysfunction among physicians experiencing burnout (45.51%) was higher than that observed in physicians without burnout (24.19%). Physicians with burnout exhibited significantly higher total and individual scores on the Arizona Sexual Experience Scale as compared with physicians without burnout (all P values <.05). There was a significant positive correlation between depersonalization and sexual drive (r = 0.508, P < .001), sexual arousal (r = 0.521, P < .001), lubrication (r = 0.432, P < .001), orgasm/erection (r = 0.420, P < .001), and sexual satisfaction (r = 0.434, P < .001). Logistic regression analysis confirmed that-in addition to burnout-older age, dissatisfaction with income, a poor doctor-patient relationship, and poor sleep were significant contributors to sexual dysfunction among physicians in primary hospitals. Sexual health is an integral aspect of well-being. Prioritizing the sexual health of medical professionals can significantly contribute to improving their productivity. First, our sample size was small, and the impact of different specialties on sexual functioning was somewhat overlooked. Second, we lacked laboratory data (eg, testosterone and prolactin levels) that could provide substantial support to sexual identification. Finally, although we used logistic regression to establish causality, the relationship between sexual dysfunction and certain factors may be bidirectional. The issue of sexual dysfunction among doctors needs more attention. We should make targeted efforts to improve the quality of physicians' sexual lives.

When fatigue and cognitive impairment persist- a neurological follow-up-study in patients with Post-COVID syndrome

Considering the relevance for patients, economics and public health data about the course of the neurological Post-COVID Syndrome (PCS) are urgently needed. In this study 94 PCS patients (73% female, age in median 49 years) were examined in median 9.4 (T1) and for a second time 14 months (T2) after mild to moderate SARS-CoV-2 infection. Mood, sleep quality and health related quality of life (QoL) were evaluated via structured anamnesis and self-report questionnaires; attention, concentration and memory via psychometric tests. 47% of the patients reported an improvement of their symptoms over time, but only 12% full recovery. 4% noticed deterioration and 49% no change. Main disturbances at both time points were fatigue, deficits in concentration and memory. In patients with perceived improvement QoL significantly increased between T1 and T2, although their test performance as well as the fatigue score remained unchanged. In patients with persisting impairment QoL, fatigue scores and psychometric test results did not change significantly. Abnormal psychometric tests were more frequent at both time points in the group without improvement. But, significant fatigue and cognitive impairment persisted for more than 1 year after SARS-CoV-2 infection in both groups.

Frailty and Its Associated Factors in Patients With Atrial Fibrillation: A Cross-Sectional Study.

This study aimed to investigate the prevalence of frailty and its predictors among Taiwanese patients with atrial fibrillation (AF). A cross-sectional study was conducted, enrolling 188 AF patients aged over 20 years from a medical center in northern Taiwan. Participants were recruited from September 1 to December 30, 2022. Structured questionnaires were used to gather data on demographics, disease characteristics, Study of Osteoporotic Fractures Index, Short Portable Mental Status Questionnaire, Mini Nutritional Assessment Short-Form, Chinese Version Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Among Taiwanese AF patients, over two-thirds were at risk of frailty, with susceptibility increasing with age. Key potential predictors included sex, cognitive function, nutritional status, sleep quality, and depression, jointly explaining 47.6% of the variation, with nutritional status being the most significant. These findings underscore the importance of comprehensive assessment and management strategies to address frailty in AF patients and improve overall health outcomes.

Ashwagandha and stress

Ashwagandha, also known as Withania somnifera, is an adaptogen gaining popularity as a natural stress reducer. Stress is a common phenomenon caused by factors such as lifestyle, work pressure or social conflict, and has a negative impact on both mental and physical health. In response to these challenges, more and more people are looking for natural solutions, and adaptogens such as ashwagandha offer support in dealing with stress without significant side effects. Scientific research shows that ashwagandha can lower levels of the stress hormone cortisol and improve results on tests assessing stress, anxiety and depression. Numerous studies conducted on both animals and humans confirm its beneficial effects on mental and physical health, including improvement of cognitive functions, sleep quality and emotional well-being. The mechanism of action of ashwagandha includes regulation of the HPA axis, reduction of glucocorticoids and modulation of the immune system. Despite promising results, further research is needed to fully understand its mechanism of action, assess long-term effects, and investigate possible interactions with other drugs. Ashwagandha seems to be a safe and effective agent in the fight against stress, but it is recommended to consult a doctor before starting supplementation.

Recurrent Aphthous Stomatitis and Sleep Quality Factors: A Comprehensive Analysis.

Due to the unclear etiology of recurrent aphthous stomatitis (RAS), a painful and distressing condition with a high prevalence, the researchers have hypothesized a connection between sleep quality and RAS. The cross-sectional study enrolled 10,138 Fasa Cohort Study participants aged 35-70 years. Various sleep quality factors were calculated and categorized based on the Pittsburgh Sleep Questionnaire. Among 9030 subjects finally included with RAS prevalence of 20.2%, adjusted logistic regression showed significant odds ratios (ORs) in subjects who sleep < 5 h (OR = 1.44, 95%CI 1.25, 1.66), have sleep latencies of more than 60 min (OR = 1.37, 95%CI 1.11, 1.69), have sleep efficiencies of 65%-75% (OR = 1.55, 95%CI 1.21, 1.98), or regularly go to bed after 11 p.m. (OR = 1.23, 95%CI 1.11, 1.37). Subgroup analyses indicated no significant associations between RAS and various sleep factors in individuals who worked night shifts, and stronger associations were observed in men than women. The study found a significant positive association between RAS and sleep quality factors such as shorter duration, lower efficiency, longer latency, later bedtime, and regular sleeping pill use. Establishing early and sufficient sleep and addressing sleep onset disturbances by adhering to sleep hygiene principles should be prioritized in individuals with RAS.

Deterioration Patterns in Patients Admitted for Severe COPD Exacerbation

Background: Chronic obstructive pulmonary disease (COPD) exacerbations represent significant clinical events marked by worsening respiratory symptoms, often necessitating changes in medication or hospitalization. Identifying patterns of exacerbation and understanding their clinical implications are critical for improving patient outcomes. This study aimed to identify exacerbation patterns in COPD patients using variations in the COPD Assessment Test (CAT) scores and compare clinical characteristics and comorbidities among patients with different exacerbation patterns. Methods: An observational study was conducted involving COPD patients admitted for severe exacerbations. The administered CAT questionnaire referred to two periods: 1) the period during hospital admission and 2) the stable period two months prior to admission. Results: Fifty patients (60% male, mean age 70.5 years, standard deviation [SD] 9.6) were included; of these, eight (16%) were active smokers. Significant worsening in CAT scores during the exacerbation compared to the stable period was observed (25 vs. 13.5, p &lt; 0.001). Three exacerbation patterns were identified: increased cough and sputum (cluster 1); increased dyspnea and activity limitation (cluster 2); and poorer sleep quality and lower energy (cluster 3). No significant differences were found regarding demographics and lung function. Conclusions: Three distinct exacerbation patterns were identified in COPD patients based on CAT score variations, suggesting that exacerbations are heterogeneous events. Future studies with larger sample sizes and prospective follow-up are necessary to validate these findings and explore their clinical and prognostic implications.

Neurofeedback to enhance sleep quality and insomnia: a systematic review and meta-analysis of randomized clinical trials

ObjectiveThis systematic review and meta-analysis of randomized-clinical trials aims to analyze the effect of interventions incorporating surface neurofeedback techniques on self-perceived sleep quality and insomnia in patients with or without sleep disturbances.MethodsThe review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was deposited in the Prospero international prospective registry of systematic reviews (CRD42024528401). Seven clinical trials with different main outcomes but with pre-post intervention records of self-perceived sleep quality or insomnia symptoms assessed by questionnaires met our inclusion criteria, including a publication date within the last 10 years. Five trials investigated sleep quality through scores on the Pittsburgh sleep quality Index (PSQI) and three trials signs of insomnia severity assessed with validated scales. The methodological quality of the included studies was assessed using the Cochrane Collaboration’s tool for assessing the risk of bias and showed a high quality of them.ResultsA total of 5 studies that evaluated sleep quality with the PSQI total score were included in the meta-analysis. The results revealed that control conditions succeeded in improving PSQI-assessed sleep quality more than the analyzed Neurofeedback interventions (PSQI total score 0.57; 95% CI 0.13 to 1.01; p = 0.01). On the other hand, a total of 3 studies that evaluated insomnia severity with various insomnia scales were included in the meta-analysis The results revealed that neither the NF interventions nor the control conditions show a favorable outcome relative to each other (−0.13; 95% CI −0.44 to 0.18; p = 0.41).ConclusionThe interventions studied mostly apply a neurofeedback training protocol based on maintaining alpha waves in a range between 8 and 12 Hz, with electrode positioning in the frontal area or in the sensorimotor cortex and with a number of neurofeedback sessions ranging from 8 to 20 sessions. The meta-analysis showed that interventions incorporating surface neurofeedback do not produce additional benefits in self-perception of sleep quality or insomnia compared to a wide variety of control conditions including cognitive behavioral treatment or other biofeedback modalities.Systematic review registrationPROSPERO – International prospective register of systematic reviews – CRD42024528401 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=528401.

The Relationship between Chronotype and Academic Achievement among Slovene University Students: The Mediating Role of Trait Self-Control and Sleep Quality

Several studies have identified a relationship between an individual’s chronotype and academic performance. Specifically, individuals with a morning preference often outperform those with an evening preference. Our research explored whether trait self-control and sleep quality mediate this association. We conducted an online survey completed by Slovenian university students. Chronotype, trait self-control, and sleep quality were measured using the Morningness-Eveningness Questionnaire, the Brief Self-Control Scale, and the Pittsburgh Sleep Quality Index. Additionally, the participants’ academic achievement was assessed using an objective measure (the average grade for the winter 2022/2023 exam period) and a subjective measure (students’ own assessment of their performance compared to their peers). The results show that all researched concepts are positively correlated. Additionally, mediation analyses revealed that trait self-control significantly mediated the relationship between chronotype and both measures of academic achievement. Conversely, while sleep quality did not mediate the relationship between chronotype and objective academic achievement, it did partially mediate the relationship between chronotype and the subjective achievement measure. These insights provide a novel comprehension of the intrinsic modalities that might link chronotype and academic performance.