Sleep Time Research Articles

Application of Music Therapy in Improving the Sleep Quality and Mental Health of Nurses with Circadian Rhythm Sleep Disorders Caused by Work Shifts.

To analyze the impact of using music therapy to improve the sleep quality and mental health of nurses who suffer from circadian rhythm sleep disorders. Our retrospective analysis included 360 nurses with circadian rhythm sleep disorders from 20 different departments who worked in Wuhan Third Hospital for more than 1 year from May 2022 to May 2023. A total of 180 nurses with circadian rhythm sleep disorders were classified as the control group (received melatonin receptor agonist Melatonin Receptor Type 2 [MT2]). The other 180 cases were classified into the observation group (received melatonin receptor agonist MT2 + music therapy). After six courses of treatment, the clinical efficacy, Self-Assessment Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index Scale (PSQI) score of the two groups of nurses were compared. Before treatment, no statistically significant differences in baseline treatment and SAS, SDS, and PSQI scores were found between the two groups. After treatment, the total effective rate of treatment in the observation group was 85.56%, which was significantly higher than the 50.56% in the control group (P < 0.001). After treatment, the SAS, SDS and PSQI scores of the observation group were lower than those of the control group (P < 0.05). The SAS, SDS and PSQI scores of both groups were lower after treatment than they were before treatment (P < 0.05). Implementing music therapy for nurses with circadian rhythm sleep disorders caused by shifts can improve sleep quality and reduce negative emotions. It is a clinical strategy with clinical application value and a certain promotion value.

Habitual Nocturnal Sleep, Napping Behavior, and Recovery Following Training and Competition in Elite Water Polo: Sex-Related Effects.

To examine nocturnal sleep patterns, napping behaviors, and subjective wellness responses of elite water polo players within an in-season week and to identify whether sleeping patterns differ between men and women. Sleep characteristics of 10 male and 17 female professional water polo players were objectively assessed during 1week of the in-season period, including 5 training days, 1 match day, and 1day of rest. Internal load (rating of perceived exertion × duration of training or match) was assessed 30 minutes posttraining or postmatch, and the total quality of recovery was recorded every morning. A series of multilevel models were used to analyze the data. Time in bed and wake-up time were earlier on both training (P < .001) and rest days (P < .001) than on the day of the match. Internal workload did not predict any of the players' sleeping patterns. Midday naps predicted less time in bed (P = .03) and likely less sleep time (P = .08). The total quality of recovery was predicted only by the total sleep time (P < .01). Women exhibited higher sleep efficiency (P < .001), less waking after sleep onset (P = .01), and a lower number of awakenings (P = .02) than men. The current results indicate that the nocturnal sleep patterns of elite water polo players are not associated with internal load and that women display better nocturnal sleep quality compared with men. As long naps interfere with nocturnal sleep, and total nocturnal sleep time predicts total quality of recovery, we suggest that athletes follow hygiene sleep strategies to facilitate adequate nocturnal sleep and next-day recovery.

Exploring the interplay between circadian rhythms and prostate cancer: insights into androgen receptor signaling and therapeutic opportunities.

Circadian rhythm disruption is closely related to increased incidence of prostate cancer. Incorporating circadian rhythms into the study of prostate cancer pathogenesis can provide a more comprehensive understanding of the causes of cancer and offer new options for precise treatment. Therefore, this article comprehensively summarizes the epidemiology of prostate cancer, expounds the contradictory relationship between circadian rhythm disorders and prostate cancer risk, and elucidates the relationship between circadian rhythm regulators and the incidence of prostate cancer. Importantly, this article also focuses on the correlation between circadian rhythms and androgen receptor signaling pathways, as well as the applicability of time therapy in prostate cancer. This may prove significant in enhancing the clinical treatment of prostate cancer.

Sleep, Sleep Disorders, and Mental Health: A Narrative Review

Abstract Evidence suggests that sleep is a vital component of physical and health well-being. However, while sleep problems are present in individuals with mental health problems such as depression, it has not been clear whether these conditions are independent or whether they might be causally related. Indeed, if sleep or sleep disorders predispose or modify onset and outcomes of mental health issues, treatment of these factors could be explored as new mental health prevention or treatment options. The aim of this review was to examine in detail the bidirectional relationship between sleep, sleep disorders, and mental and physical health and well-being. It has considered the evidence that sleep architecture disruption, occurring through both quantity, quality, and timing of sleep as well as through the presence of sleep disorders may both influence mental health and well-being as well as be disrupted by both physical and mental health conditions. Also, the review has explored the effects of sleep disruption on mental health and performance through fatigue, mood, and vigilance. The review has considered the bidirectionality between sleep, sleep disorders, and mental health to examine how these may lead to or exacerbate mental health disorders such as affective, anxiety, autism, depressive and schizophrenia disorders but also considers how these conditions can affect sleep. The review highlights that poor sleep or the presence of a sleep disorder can increase the risks from mental health conditions such as suicidality. Furthermore, mental health conditions such as anxiety and worry can cause racing or repetitive thoughts that can keep an individual awake, leading to shortened sleep. It is important that sleep and sleep disorders are considered potential modifiable factors that could improve mental health outcomes. The important interconnect between both physical and mental health and sleep, in patient evaluations, also needs to be considered as these may affect treatment pathways and patient outcomes. Further, more robust and perspective research is required to establish the triad relationship of physical, mental health, and sleep.

Lifestyle Practices of Adolescents in a Tertiary Care Centre in India

Introduction: Adolescents are individuals in the 10–19year age group; there are 253 million adolescents in India. Growth and development are predominant during adolescence, a relatively healthy time. Good diet, physical activity, sleep, and screen time are pillars of good health. Aims &amp; Objectives: To identify lifestyle practices such as diet, physical activity, sleep, and screen time among adolescents in the outpatient and inpatient services, Departments of Paediatrics and Paediatric Surgery, Christian Medical College, Vellore. Methods: A descriptive study design employing a non-probability purposive sampling technique was used to recruit 1420 adolescents. Written consent and assent were obtained, demographic and clinical variables were collected using interviews, and the lifestyle practice was assessed using a modified YRBS questionnaire. Results: 70.8% of the adolescents were in the age group of 10-14 years; males and females were almost equal (46.2 and 53.8%), 73.6% lived in nuclear families, and 19.4% had a BMI of 23 adult equivalent. Regarding diet in the past 7 days, 41.3% did not consume green/vegetable salads, and 89.7% of the adolescents ate breakfast daily, but the meals of 81.4% did not contain 25% carbohydrates. 42.2% did not meet the recommended 60 minutes of daily physical activity, and 51% were not a part of any sports team in the past year. Most (33.8%) of the adolescents slept for about 8 hours during the school days, but 68% reported difficulty falling asleep. Most participants (58.7% and 59.2%) stopped screentime just before sleep on weekdays and weekends. Conclusion: Adolescence is when lifestyle behaviours that affect present and future health begin. Therefore, helping adolescents establish healthy lifestyles and avoid developing health risk behaviours is crucial and should be started before these behaviours are firmly established. Keywords: Adolescents, Lifestyle, Diet, Physical Activity, Sleep, Screen time.

An exploration into the sleep of workers on block-calving, pasture-based dairy farms

The benefits of sufficient and high-quality sleep for people are well documented. Insufficient sleep increases the risk of accidents, injuries, and negative health implications for people. This is especially relevant for farmers, as they work with large animals and machinery. Dairy farming often requires early start times and long days, particularly over the high workload calving period in block calving, pasture-based systems. However, there is little published data quantifying the sleep quantity and quality of farmers over this period. In this study, the sleep patterns of workers (n = 33) on 10 New Zealand dairy farms was measured for 90 d over the spring calving period using a sleep measuring device (OuraTM ring, Oura Health Ltd., Oulu, Finland). Total sleep time (TST) averaged 6 h 15 min, lower than the required 7 to 9 h for optimal wellbeing and cognitive functioning. TST decreased over the calving period and was significantly correlated with both sleep start and wake times. Factors such as work start time, farm location, and role on farm influenced sleep quantity and quality; indicating adjusting these on-farm factors could positively impact TST. Further research is required to better understand sleep and its effect on dairy farmers, over both the calving period and the remaining months of the year.

Hubungan Dukungan Suami, Peran Bidan Dan Pengetahuan Ibu Terhadap Kejadian Baby Blues Pada Ibu Nifas Di BPM Bidan Lena Jakarta

Introduction: Based on a preliminary study on secondary data at BPM Midwife Lena Jakarta in 2021 112 post-partum mothers gave birth at the BPM. From 112 post-partum mothers; based on secondary data from Lena's BPM in 2021, 15 post-partum mothers did not receive the support of their husbands, such as husbands never helping mothers with homework and husbands sometimes getting angry when the baby cries. Of the 112 post-partum mothers; 19 post-partum mothers felt anxious and worried that their babies would cry a lot and mothers felt that their sleep time was reduced. Of 112 post-partum mothers; 3 post-partum mothers felt uncomfortable with their current physical condition. Methods: This study aims to determine the relationship between the husband's support, the midwife's role, and the mother's knowledge of post-partum mother's baby blues. This type of research is Analytical and Descriptive with a cross-sectional approach. Results: there is a significant relationship between the husband's support and the incidence of baby blues in post-partum mothers with a p-value of 0,029 which is smaller than the alpha value of 0,029 &lt;0,05. there is a significant relationship between the role of the midwife and the incidence of baby blues in post-partum mothers with a p-value of 0,030; the p-value is smaller than the alpha value 0,030 &lt; 0,05. there is a significant relationship between mothers' knowledge of the incidence of baby blues in post-partum mothers with a p-value of 0,023; the p-value is smaller than the alpha value 0,023 &lt; 0,05. Discussion: It is known that from a total of 37 respondents; the number of post-partum mothers who experienced symptoms of baby blues was 24 respondents (64,9%) which means that the variables of husband's support, the midwife's role, and a mother's knowledge played a big role in triggering the occurrence of baby blues in post-partum mothers.

The therapeutic potential of hemp seed oil as Nasya in the management of insomnia: a literature review

Abstract The significance of getting sufficient sleep for maintaining good health and wellbeing is widely known. The American Psychiatric Association classifies insomnia as the most common sleep–wake disorder characterized by difficulty with sleep quality, timing, and quantity. The residual effects and the social stigma associated with the use of sedative drugs incline patients toward seeking alternative therapy. Ayurveda presents an exhaustive elucidation of the etiology, manifestations, and therapeutic modalities concerning insomnia. Among the extensively prescribed Panchakarma (the five-fold bio-purification process) interventions for insomnia management, Nasya (instillation of oils, powders, or juices through the nasal route) holds a significant position. Nasya is considered an effective way to directly deliver medicines to the brain by bypassing the blood–brain barrier through olfactory and trigeminal nerve pathways. Anandkand, an important book on Indian alchemy, mentions various formulations of hemp, including the use of hemp seed oil (Vijaya Beej Tail) for Nasya. A narrative analysis of hemp seed oil Nasya for insomnia was conducted using Ayurvedic texts and electronic databases. Although valued for its nutraceutical properties, there is limited clinical data on its effectiveness in treating insomnia. No relevant clinical studies were found for its use in treatment of insomnia, but some preclinical and clinical studies exist for other conditions. The presence of a perfect proportion of omega-3 to omega-6 fatty acids, coupled with its antioxidant properties and the existence of preclinical findings suggesting the sedative and anti-anxiety effects of hemp seed extracts by influencing the benzodiazepine receivers linked to gamma-aminobutyric acid, makes it a choice for Nasya therapy in clinically managing insomnia. A significant enhancement in scientific research efforts is imperative to maximize its potential utilization.

Relationship Between Sleep Quality and Quality of Life: Analysis of Hepatocellular Carcinoma Survivors.

We analyzed the correlation between the Pittsburgh Sleep Quality Index (PSQI) subcategories (sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, sleep medications, and daytime dysfunction) and a comprehensive measure of quality of life (QOL), the 36-Item Short Form Survey (SF-36) items, in patients with hepatocellular carcinoma (HCC) to determine the components that require intervention to improve QOL. A total of 75 patients with recurrent HCC admitted to our hospital between May 2021 and May 2023 were included in this study. The QOL score was used for the SF-36 items, and the sleep disorder score was used for PSQI questionnaires. Correlations were found between sleep quality, sleep disturbance, and SF-36 for all QOL items and between sleep onset time and SF-36 for six QOL items: bodily pain, mental health, physical functioning, role-emotional, role-physical, and vitality. Correlations between daytime dysfunction and SF-36 were found for all QOL items, except for physical functioning. No correlation was found between sleep duration, sleep efficiency, sleep medications, and SF-36 for any QOL item. Sleep duration, sleep efficiency, and sleep medications may not contribute to QOL improvement in patients with HCC and sleep disturbances. Factors that improve sleep quality and sleep difficulty may contribute to QOL improvement. Therapeutic interventions aimed at improving general health and social functioning for sleep latency and physical functioning for daytime arousal difficulty are required.

Associations between Sleep and Physical Activity Behavior Clusters and Epigenetic Age Acceleration in Mexican Adolescents.

Epigenetic aging, a marker of biological aging measured by DNA methylation, may be affected by behaviors, including sleep and physical activity. However, investigations of physical activity and sleep with epigenetic aging among pediatric populations are scant and have not accounted for correlated behaviors. The study population included 472 Mexico City adolescents (52% female). Blood collection and 7-day wrist actigraphy (Actigraph GTX-BT) occurred during a follow-up visit when participants were 14.5 (2.09) years. Leukocyte DNA methylation was measured with the Infinium MethylationEPIC array after bisulfite conversion, and 9 epigenetic clocks were calculated. Sleep vs wake time was identified through a pruned dynamic programing algorithm, and physical activity was processed with Chandler cut-offs. Kmeans clustering was used to select actigraphy-assessed physical activity and sleep behavior clusters. Linear regression analyses were used to evaluate adjusted associations between the clusters and epigenetic aging. There were 3 unique clusters: "Short sleep/high sedentary behavior", "Adequate sleep duration and late timing/low moderate or vigorous physical activity (MVPA)", and "Adequate sleep duration/high MVPA". Compared to the "Adequate duration/high MVPA", adolescents with "Adequate duration and late sleep timing/low MVPA" had more accelerated aging for the GrimAge clock (β = 0.63;95% CI 0.07, 1.19). In pubertal-stratified analyses, more mature adolescents in the "Adequate duration and late sleep timing/low MVPA group" had accelerated epigenetic aging. In contrast, females in the "Short sleep/high sedentary" group had decelerated epigenetic aging for the Wu pediatric clock. Associations between behavior clusters and epigenetic aging varied by pubertal status and sex. Contrary results in the Wu clock suggest the need for future research on pediatric-specific clocks.

Propofol improves sleep deprivation-induced sleep structural and cognitive deficits via upregulating the BMAL1 expression and suppressing microglial M1 polarization.

Sleep deprivation (SD) is a growing global health problem with many deleterious effects, such as cognitive impairment. Microglia activation-induced neuroinflammation may be an essential factor in this. Propofol has been shown to clear sleep debt after SD in rats. This study aims to evaluate the effects of propofol-induced sleep on ameliorating sleep quality impairment and cognitive decline after 48 h SD. Almost 8-12-week-old rats were placed in the SD system for 48 h of natural sleep or continuous SD. Afterwards, rats received propofol (20 mg·kg-1·h-1, 6 h) via the tail or slept naturally. The Morris water maze (MWM) and Y-maze test assessed spatial learning and memory abilities. Rat EEG/EMG monitored sleep. The expression of brain and muscle Arnt-like protein 1 (BMAL1), brain-derived neurotrophic factor (BDNF) in the hippocampus and BMAL1 in the hypothalamus were assessed by western blot. Enzyme-linked immunosorbent assay detected IL-6, IL-1β, arginase 1 (Arg1), and IL-10 levels in the hippocampus. Immunofluorescence was used to determine microglia expression as well as morphological changes. Compared to the control group, the sleep-deprived rats showed poor cognitive performance on both the MWM test and the Y-maze test, accompanied by disturbances in sleep structure, including increased total sleep time, and increased time spent and delta power in non-rapid eye movement sleep. In addition, SD induces abnormal expression of the circadian rhythm protein BMAL1, activates microglia, and causes neuroinflammation and nerve damage. Propofol reversed these changes and saved sleep and cognitive impairment. Furthermore, propofol treatment significantly reduced hippocampal IL-1β and IL-6 levels, increased BDNF, Arg1, and IL-10 levels, and switched microglia surface markers from the inflammatory M1 type to the anti-inflammatory M2 type. Propofol reduces SD-induced cognitive impairment and circadian rhythm disruption, possibly by lowering neuronal inflammation and switching the microglia phenotype from an M1 to an M2 activated state, thus exerting neuroprotective effects.

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.

Restoration of sleep-wake behavior following short photoperiod exposure in ventral subicular lesioned male Wistar rats: A 24-h sleep-wake electroencephalographical study.

The ventral subiculum regulates emotion, stress responses, and spatial and social cognition. In our previous studies, we have demonstrated anxiety- and depression-like symptoms, deficits in spatial and social cognition in ventral subicular lesioned (VSL) rats, and restoration of affective and cognitive behaviors following photoperiod manipulation (short photoperiod regime, SPR; 6:18 LD cycle). In the present study, we have studied the impact of VSL on sleep-wake behavioral patterns and the effect of SPR on sleep-wakefulness behavior. Adult male Wistar rats subjected to VSL demonstrated decreased wake duration and enhanced total sleep time due to increased non-rapid eye movement sleep (NREMS) and rapid eye movement sleep (REMS). Power spectral analysis indicated increased delta activity during NREMS and decreased sigma band power during all vigilance states. Light is one of the strongest entrainers of the circadian rhythm, and its manipulation may have various physiological and functional consequences. We investigated the effect of 21-day exposure to SPR on sleep-wakefulness (S-W) behavior in VSL rats. We observed that SPR exposure restored S-W behavior in VSL rats, resulting in an increase in wake duration and a significant increase in theta power during wake and REMS. This study highlights the crucial role of the ventral subiculum in maintaining normal sleep-wakefulness patterns and highlights the effectiveness of photoperiod manipulation as a non-pharmacological treatment for reversing sleep disturbances reported in mood and neuropsychiatric disorders like Alzheimer's disease, bipolar disorder, and major depressive disorder, which also involve alterations in circadian rhythm.

DPoSEB: Delegated Proof of Stake with Exponential Backoff Consensus Algorithm for Ethereum Blockchain

Blockchain is a technology that is rapidly gaining prominence and finding applications in various sectors such as banking, supply chain, healthcare, and e-governance. The consensus algorithm employed in a blockchain network is crucial as it directly impacts the network's performance and security. Different consensus techniques exist, including Proof of Work (PoW), Proof of Stake (PoS), Robust Proof of Stake (RPoS), and Delegate Proof of Stake (DPoS), each with its own set of advantages and disadvantages. In this work, we propose a new consensus algorithm called Delegated Proof of Stake with Exponential Back-off (DPoSEB). DPoSEB utilizes a stake-based selection of delegates and employs an exponential back-off technique to mitigate collisions among nodes within the network. Each delegate is assigned a random sleep time, and the node with the shortest wake-up time is chosen to mine the block for that particular round. However, collisions among nodes can still occur. To provide a fair chance for each delegate node, collided nodes are assigned an exponential back-off time. We implement our proposed algorithm on an Ethereum-based private blockchain network. To evaluate the effectiveness of our proposed work, we compare it with existing consensus mechanisms such as PoS (version 2) and Delegated RPOS with downgrading (DDRPOS) using different scenarios in terms of transaction latency, waiting time, and fairness as evaluation metrics. The results reveal that DPoSEB performs better than POS and DDRPOS.

New-Onset Postoperative Atrial Fibrillation and Preoperative Sleep in Cardiac Surgical Patients

BackgroundNew-onset postoperative atrial fibrillation is associated with adverse clinical outcomes in older adults. Poor preoperative sleep quality is a putative modifiable risk factor. The relationships between new-onset postoperative atrial fibrillation and preoperative sleep structure in older adults undergoing elective cardiac surgery were investigated at a single center. MethodsThis was a prespecified substudy within a prospective observational study of perioperative electroencephalographic markers (ClinicalTrials.gov; NCT03291626). We analyzed preoperative sleep recordings from 71 cardiac surgical patients aged ≥60 years without a prior history of atrial fibrillation. Overnight recordings were acquired using a consumer-grade headband and underwent manual sleep staging. Electroencephalographic slow wave activity (power in the 0.5-4 Hz frequency band) was computed in 1-minute intervals for non-rapid eye movement sleep stages. Associations between new-onset postoperative atrial fibrillation incidence and sleep measures were evaluated using univariate logistic regression models and multivariate logistic regression models including age and sex. ResultsNew-onset postoperative atrial fibrillation was present in 22 of 71 (31%) patients. A higher preoperative percentage of total sleep time in non-rapid eye movement stage 1 was associated with new-onset postoperative atrial fibrillation (median difference of 5.4%, P = .0002, Mann-Whitney U-test), independent of age and sex. No associations were observed between new-onset postoperative atrial fibrillation and other sleep metrics, including slow wave activity (all P > .05, Mann-Whitney U-test). ConclusionsExcess preoperative non-rapid eye movement stage 1 sleep, consistent with greater sleep fragmentation, is a potential modifiable target for mitigating new-onset postoperative atrial fibrillation risk in older adults undergoing elective cardiac surgery requiring cardiopulmonary bypass.

Low-dose exogenous melatonin plus evening dim light and time in bed scheduling advances circadian phase irrespective of measured or estimated dim light melatonin onset time: preliminary findings.

The purpose of the present study was to preliminarily evaluate whether knowing the dim light melatonin onset (DLMO) time is advantageous when treating delayed sleep-wake phase disorder with low-dose melatonin treatment plus behavioral interventions (ie, evening dim light and time in bed scheduling). In this randomized, controlled, double-blind trial, 40 adults with delayed sleep-wake phase disorder were randomly assigned to 4 weeks of 0.5 mg timed to be administered either 3 hours before the DLMO (measured DLMO group, n = 20) or 5 hours before sleep-onset time per actigraphy (estimated DLMO group, n = 20), in conjunction with behavioral interventions. The primary outcome was change in the DLMO (measured in-home). Secondary outcomes included sleep parameters per diary and actigraphy (sleep-onset and -offset times and total sleep time), Morningness-Eveningness Questionnaire, Multidimensional Fatigue Inventory, PROMIS-Sleep Disturbance, PROMIS-Sleep Related Impairment, and Pittsburgh Sleep Quality Index. Mixed-effects models tested for group differences in these outcome. After applying the Bonferroni correction for multiple comparisons (significant P value set at < .004), there were significant main effects for visit on all outcomes except for the Pittsburgh Sleep Quality Index and total sleep time per wrist actigraphy and diary. There were no group-by-visit interactions for any of the outcomes (P > .004). Scheduled low-dose melatonin plus behavioral interventions may improve many circadian and sleep parameters regardless of whether melatonin administration is scheduled based on estimated or measured DLMO. A larger-scale trial is needed to confirm these preliminary findings. Registry: ClinicalTrials.gov; Name: The Clinical Utility of Measuring the Circadian Clock in Treatment of Delayed Sleep-Wake Phase Disorder; URL: https://clinicaltrials.gov/study/NCT03715465; Identifier: NCT03715465. Swanson LM, de Sibour T, DuBuc K, etal. Low-dose exogenous melatonin plus evening dim light and time in bed scheduling advances circadian phase irrespective of measured or estimated dim light melatonin onset time: preliminary findings. J Clin Sleep Med. 2024;20(7):1131-1140.

Psychological Impact of COVID 19 Pandemic on Mental Health of Children Admitted to a Tertiary Care Centre

Background To prevent the COVID 19 transmission and reduce the burden on health systems, schools were closed and classes shifted to home-based distance learning models with online learning activities. Being quarantined in homes caused great psychological burden to children. This study was done to study the impact of COVID 19 on mental health of children and their screen and sleep behaviour before and during the pandemic.MethodsAdmitted children aged between 4-14 years and their siblings of same age group were enrolled after getting informed consent from their parents. The information regarding their socio-demographic factors, screen time, sleep time, physical activity and psychological problems were assessed using Paediatric symptom checklist Questionnaire. Outcome was measured by the scores obtained according to their age. Screen time and sleep behaviour was assessed using the guidelines proposed by American Academy of Paediatrics.ResultsTwenty-seven (15.81%) of 171 children had psychological impairment. The 11–14-year-olds and children living in urban area were more affected. All participants had abnormal screen time with respect to their age during COVID 19 pandemic and 99.4 % had increased screen time compared to pre COVID era. Abnormal sleep pattern was seen in 26.9 % and compared with pre-Covid times 73.6 % of the participants had less physical activity. Conclusions Implementation of psychosocial intervention and lifestyle modification strategies at community level is the need of the hour. Post Covid era remnant and sequalae of psychological impairment needs to be assessed.

Lifestyle Clusters of Diet Quality, Sleep, and Screen Time and Associations with Weight Status in Children from Madrid City: ENPIMAD Study.

Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

Readjustment of circadian clocks by exercise intervention is a potential therapeutic target for sleep disorders: a narrative review.

Circadian clocks are evolved endogenous biological systems that communicate with environmental cues to optimize physiological processes, such as the sleep-wake cycle, which is nearly related to quality of life. Sleep disorders can be treated using pharmacological strategies targeting melatonin, orexin, or core clock genes. Exercise has been widely explored as a behavioral treatment because it challenges homeostasis in the human body and affects the regulation of core clock genes. Exercise intervention at the appropriate time of the day can induce a phase shift in internal clocks. Although exercise is a strong external time cue for resetting the circadian clock, exercise therapy for sleep disorders remains poorly understood. This review focused on exercise as a potential treatment for sleep disorders by tuning the internal circadian clock. We used scientific paper depositories, including Google Scholar, PubMed, and the Cochrane Library, to identify previous studies that investigated the effects of exercise on circadian clocks and sleep disorders. The exercise-induced adjustment of the circadian clock phase depended on exercise timing and individual chronotypes. Adjustment of circadian clocks through scheduled morning exercises can be appropriately prescribed for individuals with delayed sleep phase disorders. Individuals with advanced sleep phase disorders can synchronize their internal clocks with their living environment by performing evening exercises. Exercise-induced physiological responses are affected by age, sex, and current fitness conditions. Personalized approaches are necessary when implementing exercise interventions for sleep disorders.

Multifaceted Roles of Melatonin in Sleep Disorders

Hormone protein melatonin helps regulate the sleep–wake cycle or circadian rhythm, making it a critical substance in sleep regulation. Melatonin synthesis mainly occurs in the epiphysis of the pineal gland, although extra-pineal melatonin has been observed in other sites of the body, such as salivary glands, the gastrointestinal tract, the placenta and breast milk. Over the years, research into melatonin has shown that it has multiple roles in sleep disorders, revealing its mechanisms of action, clinical implications and therapeutic performance. In this paper, we review recent findings on the role of melatonin in sleep disorders which include insomnia, delayed sleep phase disorder (DSPD), jet lag, and shift work sleep disorder (SWSD). In addition, we report results where melatonin agonists and novel therapeutic targets have been designed and utilized to manipulate the melatonin receptors. This paper helps delineate melatonin’s role in sleep disorders from the literature, and clarify new perspectives for prevention and treatment of human health.