Insomnia Research Articles

How Should Clinicians Partner With Families to Promote Children's Sleep Health?

Short sleep duration, poor sleep quality, and irregular timing of sleep are prevalent sleep troubles for children, but fully assessing children's sleep environments and effectively promoting children's overall sleep health is nearly impossible during brief clinical encounters. This commentary on a case suggests strategies for navigating this problem with a patient- and family-centered approach that prioritizes identifying family sleep-related beliefs, values, and goals and maintaining flexibility when offering evidence-based recommendations to improve children's sleep.

Acute Augmented Effect of Virtual Reality (VR)-Integrated Relaxation and Mindfulness Exercising on Anxiety and Insomnia Symptoms: A Retrospective Analysis of 103 Anxiety Disorder Patients With Prominent Insomnia.

Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice. This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021. All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups. In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation." Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed.

Sleep In Europe: Changes In Prevalence Of Sleep Disturbances In Middle-aged And Older Europeans

Abstract Background We analysed the prevalence of sleep-related parameters in those aged ≥50 years in 28 countries participating in waves 8 (2019/2020) and 9 (2022) of the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods Overall and per country prevalence rates of subjective trouble sleeping, daytime napping/resting and use of medication to aid sleep were analysed. Survey-weighted generalised linear models were used to assess changes between waves 8 and 9. Results A total of 34,322 people were included from wave 8 (55% female; mean age 68.27) and 50,670 from wave 9 (55% female; mean age 68.77). There was no statistically significant difference in the overall prevalence of subjective trouble sleeping (both 35%), use of medication to aid sleep (both 7%) or daytime napping/resting (both 47%) between waves 8 and 9. For trouble sleeping, prevalence ranged from 20% (Greece) to 52% (Estonia) in wave 8 and from 16% (Greece) to 50% (Portugal) in wave 9. Statistically significant reductions were observed in Estonia (52% vs. 49%, p = 0.006), Poland (49% vs. 37%, p <0.001) and Slovenia (38 vs. 33%, p = 0.001). A statistically significant increase was observed in Spain (27% vs. 37%, p = 0.004). Similarly for sleep-related medication use, statistically significant reductions were again observed in Estonia (11% vs. 9%, p = 0.028) and Poland (10% vs. 6%, p <0.001) but not Slovenia (both 4%, p = 0.858). The prevalence of daytime napping/resting remained very similar between waves 8 and 9, with the only marginally significant difference being in France (38% vs. 35%, p = 0.033). Conclusion This analysis shows the prevalence of subjective trouble sleeping, use of medication to aid sleep, and daytime napping/resting among middle-aged and older adults across Europe. Trouble sleeping remains a prevalent symptom amongst middle-aged and older adults but varies significantly across countries.

Associations Between Sleep And Cognition Among Middle-Aged And Older Adults In Europe

Abstract Background The Survey of Health, Ageing and Retirement in Europe (SHARE) is a supranational longitudinal study of community-dwelling middle-aged and older adults involving 29 countries, including all continental members of the European Union. We analysed wave 8 of SHARE (2019/2020) for associations between sleep and cognition. Methods The previously validated SHARE Cognitive Instrument (SHARE-Cog), which includes 10-word registration, verbal fluency and 10-word recall, was used to assess cognition. Together with data on impairment in activities of daily living and subjective perception of cognition, participants were divided into four groups: dementia, mild cognitive impairment (MCI), subjective memory complaint (SMC), normal cognition (NC). Survey-weighted generalised linear regression models were used to compare groups. To analyse the association between sleep duration and cognition, total hours of sleep was plotted on the x-axis and mean SHARE-Cog score on the y-axis. Results 29,450 were included (55% female; mean age 68.27), categorised as: Dementia 4%, MCI 9%, SMC 14% and NC 73%. A characteristic ‘inverted U’ shaped association was observed between sleep duration and cognition. Compared to optimal sleep duration of seven hours, mean SHARE-Cog scores declined progressively with more or less sleep. Those with cognitive impairment were significantly more likely to report recent trouble sleeping: Dementia 47%; MCI 43%; SMC 46%; NC 30% (p <0.001). Cognitive impairment was also significantly associated with increased use of medication to aid sleep (Dementia 17%; MCI 13%; SMC 8%; NC 4%, p <0.001) and with daytime napping or resting (Dementia 72%; MCI 60%; SMC 45%; NC 41%, p <0.001). Conclusion This analysis of a large population-based study confirmed an ‘inverted-U’ shaped association between sleep duration and cognition. Cognitive impairment was also significantly associated with increased reports of recent trouble sleeping, increased use of medication to aid sleep, and increased daytime napping or resting.

Interaction between trouble sleeping and diabetes on metabolic dysfunction-associated fatty liver disease and liver fibrosis in adults results from the National Health and Nutrition Examination Survey 2017-2018.

Metabolic dysfunction-associated fatty liver disease (MAFLD), trouble sleeping, and diabetes, as major public health problems, were closely related. The study examined the interaction between trouble sleeping and diabetes on MAFLD and liver fibrosis in adults with MAFLD. The data were obtained from the National Health and Nutrition Examination Survey 2017-2018. Multivariate logistic regression model and subgroup analyses were conducted to assess the relationship between either trouble sleeping or diabetes on MAFLD and liver fibrosis. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were utilized to assess the additive interaction. Ultimately, 3747 participants were included, with 2229 known MAFLD subjects. Compared with participants without diabetes, those with diabetes had a higher risk of MAFLD [odds ratio (OR) = 5.55; 95% confidence interval (CI) = 4.07-7.56] and liver fibrosis risk (OR = 3.61; 95% CI = 2.67-4.89). We also found a significant association of trouble sleeping with an increased risk of MAFLD (OR = 1.54; 95% CI = 1.17-2.02) and liver fibrosis risk (OR = 1.51; 95% CI = 1.06-2.16), compared with those without trouble sleeping. Moreover, there was a significant interaction between diabetes and trouble sleeping on MAFLD [RERI = 1.76 (95% CI: -0.22 to 3.73), AP = 0.35 (95% CI: 0.08-0.63), S = 1.80 (95% CI: 1.02-3.16)] and liver fibrosis risk [RERI = 1.79 (95% CI: 0.37-3.21), AP = 0.44 (95% CI: 0.20-0.69), S = 2.44 (95% CI: 1.18-5.08)]. The findings highlight that trouble sleeping and diabetes had a synergistic effect on MAFLD and liver cirrhosis. The study highlights the importance of addressing both trouble sleeping and diabetes management in adults to mitigate the risk of MAFLD and liver fibrosis.

Characteristics of locus coeruleus functional connectivity network in patients with comorbid migraine and insomnia

BackgroundMigraine and insomnia are prevalent conditions that often co-occur, each exacerbating the other and substantially impacting the quality of life. The locus coeruleus (LC), a brainstem region responsible for norepinephrine synthesis, participates in pain modulation, sleep/wake cycles, and emotional regulation, rendering it a potential nexus in the comorbidity of migraine and insomnia. Disruptions in the LC-noradrenergic system have been hypothesized to contribute to the comorbidities of migraine and insomnia, although neuroimaging evidence in humans remains scarce. In this study, we aimed to investigate the intrinsic functional connectivity (FC) network of the LC in patients with comorbid migraine and subjective chronic insomnia and patients with migraine with no insomnia (MnI) using resting-state functional magnetic resonance imaging (rs-fMRI) and seed-based FC analyses.MethodsIn this cross-sectional study, 30 patients with comorbid migraine and chronic insomnia (MI), 30 patients with MnI, and 30 healthy controls (HCs) were enrolled. Participants underwent neuropsychological testing and rs-fMRI. The LC-FC network was constructed using seed-based voxel-wise FC analysis. To identify group differences in LC-FC networks, voxel-wise covariance analysis was conducted with sex and age as covariates. Subsequently, a partial correlation analysis was conducted to probe the clinical relevance of aberrant LC-FC in patients with MI and MnI.ResultsExcept for the insomnia score, no other significant difference was detected in demographic characteristics and behavioral performance between the MI and MnI groups. Compared with HCs, patients with MI exhibited altered LC-FC in several brain regions, including the dorsomedial prefrontal cortex (DMPFC), anterior cerebellum, dorsolateral prefrontal cortex (DLPFC), thalamus, and parahippocampal gyrus (PHG). Lower FC between the LC and DLPFC was associated with greater insomnia severity, whereas higher FC between the LC and DMPFC was linked to longer migraine attack duration in the MI group.ConclusionOur findings reveal the presence of aberrant LC-FC networks in patients with MI, providing neuroimaging evidence of the interplay between these conditions. The identified LC-FC alterations may serve as potential targets for therapeutic interventions and highlight the importance of considering the LC-noradrenergic system in the management of MI.

Download to Heal: Navigating the Pixelated Path of Digital Therapeutics in Psychiatric Care.

Digital therapeutics have evolved rapidly with technological advances in healthcare. Despite their increasing use, gaps remain in understanding their regulatory frameworks, integration, and efficacy for conditions like substance use disorder, insomnia, attention deficit hyperactivity disorder, and post-traumatic stress disorder. This study evaluates FDA-approved digital therapeutics and explores their potential to revolutionize psychiatric treatments amid ongoing technological and regulatory changes. We conducted a comprehensive review of major databases, focusing on articles published up to January 2024 on FDA-approved digital therapeutics. We excluded non-English articles and those lacking empirical data or focusing on non-FDA-approved therapeutics. Our analysis covered regulatory compliance, clinical outcomes, and integration with traditional treatments. The review of nine FDA-cleared digital therapeutics revealed benefits like improved treatment accessibility and potential reductions in healthcare costs. For example, Somryst, a cognitive-behavioral therapy-based treatment for insomnia, showed that over 40 percent of users overcame chronic insomnia, and 60 percent experienced improvements without adverse effects. However, challenges remain, including low provider adoption, inadequate insurance coverage, and high user dropout rates. While digital therapeutics enhance accessibility, they face regulatory challenges, reimbursement issues, and the need for robust clinical evidence. Success depends on collaboration among stakeholders to demonstrate value, ensure safety, and integrate them into existing healthcare systems.

Affective temperament, attachment style and life events related to abandonment in an Italian sample with somatic symptoms

ObjectiveThis study investigates the psychological factors influencing somatic symptoms following the end of a romantic relationship. We hypothesize that affective temperaments may predict attachment styles and depressive rumination components in individuals who have experienced abandonment. Furthermore, we postulate that gender differences exist in the variables under investigation. MethodsThe administered tests included: Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Attachment Style Questionnaire (ASQ) and Ruminative Response Scale (RRS). The differences between the groups were assessed using Student's t-test for independent samples. In addition, regression analysis, in which the RRS (Brooding, Reflection and Depression) and ASQ (Confidence, Discomfort with Closeness, Need for Approval, Preoccupation with Relationships, and Relationships as Secondary) variables were considered dependent variables and all the TEMPS-A factors were included in the equation. ResultsSubjects at the end of a love affair presented the following psychosomatic symptoms: difficulty breathing, chest pain, feeling faint, sweating, dizziness, fatigue, palpitations, air hunger, difficulty sleeping, and swollen legs and ankles. The Anxious and Hyperthymic temperaments were negative predictors of the ruminative depressive dimension, and of “Confidence” and “Discomfort with Closeness” in the ASQ. The Cyclothymic and Anxious temperaments were predictors of “Discomfort with Closeness”, “Need for Approval”, “Preoccupation with Relationships”, and “Relationships as Secondary”. ConclusionAffective temperaments play a crucial role in determining how an individual deals abandonment in a romantic relationship, significantly influencing attachment styles and the tendency towards depressive rumination.

Symptoms Six Weeks After COVID-19 Are Reduced Among US Health Care Personnel Receiving Additional Vaccine Doses During the Omicron Period, December 2021-April 2022.

The objective of this study was to test the hypothesis that subsequent doses of the coronavirus disease 2019 (COVID-19) vaccine are associated with lower incidence of COVID-19-like symptoms at 6 weeks after infection. This study was a case-control analysis of health care personnel in an ongoing multicenter COVID-19 vaccine effectiveness study. We enrolled participants at the time of COVID-19-like symptoms between December 19, 2021, and April 27, 2022, which corresponded to the early Omicron-predominant period after original monovalent severe acute respiratory syndrome coronavirus 2 additional vaccination doses became available. Our outcome was self-reported symptoms completed 6 weeks after the onset of symptoms. We enrolled 2478 participants, of whom 1422 (57%) had COVID-19. The prevalence of symptoms at 6 weeks was 26% (n = 373) in those with COVID-19 and 18% (n = 195) in those without COVID-19. Fatigue (11%) and difficulty sleeping (7%) were most strongly associated with COVID-19. A total of 1643 (66%) participants received a subsequent vaccine dose (after the primary series). Participants with COVID-19 who had received a subsequent vaccination had lower odds of symptoms at 6 weeks (adjusted odds ratio [aOR], 0.55; 95% CI, 0.43-0.70), but this relationship was not observed in those without COVID-19 (aOR, 0.87; 95% CI, 0.59-1.29). Health care personnel who received subsequent doses of original monovalent COVID-19 vaccine had a lower prevalence of symptoms at 6 weeks than those that did not.

Little grinder, big concern - a questionnaire survey

Background: Bruxism in paediatric dentistry refers to the habitual grinding or clenching of teeth in children. This condition can manifest during the day or night and may have various underlying causes. Bruxism has multifactorial etiology including disturbed sleep cycle and excessive gadget use in children. Present study aimed to evaluate the knowledge and awareness of parents about bruxism in children who visited the department. Bruxism is a common concern in paediatric dentistry, presenting challenges for dental professionals and parents alike in managing and addressing its effects on a child's oral health. Methods: The study was conducted among the parents visiting the Department with their children for the treatment. A self-administered questionnaire about knowledge and awareness regarding bruxism habit, sleep cycle, and gadget use in children was made. It was shared with parents using E-methods. Data was collected and statistical analysis was done. Results: In this study, parents stated that 74.1% of children grind their teeth, and 63% of children did so while using the device. Children most frequently utilized mobile devices (51.9%), then TV (13%), electronic toys and video games (11.10%), laptops/PCs and tablets (6.50%). Before falling asleep, 81.50% of the kids used their gadgets, and after using them, 60.20% of the kids reported having trouble sleeping. Conclusions: According to this study, children who clench their teeth have disrupted sleep, and clenching of teeth is more common in children who experience stress as a result of prolonged use of gadgets. Thus, a significant relationship was seen between children's use of gadgets, sleep disruption, and bruxism.

Assessment of the use of Caffeinated Products among Students in Madonna University, Nigeria

Objective This study explores the diverse patterns of caffeine consumption among Madonna University students, with emphasis on motivations, effects, and perceptions. It also investigates the potential influence of sociodemographic factors on caffeine consumption. Methods A cross-sectional survey was conducted among Madonna University students to collect data on caffeine consumption patterns, motivations, experiences, and sociodemographic characteristics. Chi-square tests were employed to assess the independence of sociodemographic factors from caffeine consumption. Results The study found that students consumed caffeine for various reasons, including increased alertness, taste enjoyment, and social interactions. Side effects, such as nervousness and difficulty sleeping, were reported alongside positive effects like improved concentration. A significant proportion of students believed that caffeine negatively affected their physical and mental health. Sociodemographic factors, including gender, age, academic level, and faculty choice, were not significantly associated with caffeine consumption. Conclusion This study underscores the multifaceted nature of caffeine consumption among university students, emphasizing the need for comprehensive educational programs to promote responsible caffeine consumption and awareness of potential side effects. The findings also suggest that interventions to moderate caffeine use should be broad-based and target the entire student population, as sociodemographic factors do not significantly influence caffeine consumption. Acknowledging the limitations, this research contributes to our understanding of caffeine use among young adults and informs initiatives aimed at promoting balanced and mindful caffeine consumption in university settings.

Harnessing the Power of Integrated Behavioral Health to Enhance Insomnia Intervention in Primary Care.

Insomnia is prevalent in primary care and associated with co-morbid physical and mental health conditions and poor health outcomes. While there are effective treatments for insomnia in specialty mental health care, many patients have difficulty accessing these interventions. To begin, patients do not always report their sleep challenges to physicians; meanwhile, primary care providers often do not screen for insomnia symptoms. Furthermore, patients may experience several barriers to accessing specialty care for insomnia treatment, such as a limited number of available providers, financial burden, lack of transportation, and low perceptions of treatment effectiveness. Primary care behavioral health (PCBH) is well-equipped to address the challenges of accessing evidence-based care for insomnia through (1) identifying sleep issues, (2) providing psychoeducation on the possible treatments for insomnia, (3) intervening with poor sleep habits and acute insomnia early to prevent chronic insomnia, and (4) delivering appropriate evidence-based interventions for chronic insomnia. Primary care clinics should leverage behavioral health providers to increase screening and embed interventions into routine care for the benefit of improved outcomes for patients with insomnia and other sleep challenges.

Napping during cognitive behavioural therapy for insomnia: Friends or foes?

SummaryCognitive and Behavioural Therapy for Insomnia (CBT‐I) is the gold standard treatment for chronic insomnia, with one crucial step being the restriction of time spent in bed. This restriction often intensifies early afternoon sleepiness, leading to a natural gateway for a short recuperative nap, which might foster adherence to CBT‐I over time. In practice, mental health professionals providing CBT‐I lack consensus on whether or not to tolerate short naps during the CBT‐I period for requesting patients. In this pilot study, we examined the effects of authorised napping on CBT‐I efficiency in patients with insomnia (a napping group was compared with a matched non‐napping group, n = 108). We report that napping enhanced early afternoon alertness and importantly did not affect CBT‐I‐mediated improvements in the Insomnia Severity Index and Beck Depression Inventory‐2 and in self‐reported sleep efficiency, latency, and wake after sleep onset (assessed by the sleep diaries). Further investigations using objective methods of sleep assessments are now needed to confirm that napping behaviour does not compromise the improvements enabled by CBT‐I and may even strengthen adherence to the treatment.

Cortical activation and functional connectivity during a verbal fluency task in patients with chronic insomnia: A multi-channel NIRS study

BackgroundPatients with chronic insomnia exhibit varying degrees of cognitive dysfunction. Functional connectivity of different brain regions contributes to the understanding of underlying cognitive processes in the cerebral cortex. However, this has not yet been studied in patients with chronic insomnia. This study aimed to elucidate the differences between brain activity patterns in patients with chronic insomnia and healthy controls (HCs) using a verbal fluency task (VFT). MethodsWe recruited 84 patients with chronic insomnia and 81 HCs. Oxy-haemoglobin (Oxy-Hb) concentrations in the brains of the participants were monitored using functional near-infrared spectroscopy (fNIRS) while performing the VFT. ResultsDuring the task period, no significant difference was observed between the VFT results of the two groups; patients with chronic insomnia showed significantly less cortical activation in haemodynamic responses of oxy-Hb at channels and brain regions mainly located in the prefrontal cortex compared to HCs (FDR-corrected p < 0.05). Moreover, the average channel-to-channel connectivity strength of patients in the chronic insomnia group was lower than that of those in the HC group (t = −6.717, p < 0.001). ConclusionOur study provides neurological evidence for the dynamic detection of executive function in patients with chronic insomnia. Compared to HCs, patients with chronic insomnia exhibit weaker levels of brain activity and reduced task-related functional connectivity.

Pharmacological Management of Acute and Chronic Insomnia: A Cross-Sectional Study

Objective Insomnia is a frequent and difficult disease to treat. The objective was to determine the pharmacological management of a group of patients diagnosed with acute and chronic insomnia. Methods This is a cross-sectional study that identified patterns of prescription of drugs for outpatient use in patients with insomnia from a population database of 8.5 million individuals in the Health System of Colombia. Sociodemographic and pharmacological variables were considered. Results A total of 5825 patients with insomnia were identified. Acute insomnia was the most frequent complaint (85.2%). A total of 76.9% received pharmacological treatment, mainly through off-label drugs (70.7%), such as trazodone (20.2%), quetiapine (12.3%), and clonazepam (11.1%). The approved drugs were used in 9.9% of the patients, especially eszopiclone (4.7%) and zopiclone (3.6%). Benzodiazepines and Z compounds predominated in the elderly and individuals with chronic insomnia. Conclusions The pharmacological treatment of insomnia in this group of patients is heterogeneous, and medications not approved for this indication are very frequently used.

Epidemiology and burden of chronic insomnia disorder in Europe: an analysis of the 2020 National Health and Wellness Survey

Introduction Chronic insomnia disorder (CID) is considered a significant worldwide public health concern; however, its exact burden is unknown. We estimate its prevalence across France, Germany, Italy, Spain, and the United Kingdom, and assess the economic and humanistic burden for a broader insomnia population. Methods This retrospective, cross-sectional, observational study used 2020 National Health and Wellness Survey (NHWS) data. Patients reporting insomnia were characterized to define CID. Health-related quality of life (HRQoL), work productivity, and healthcare resource use (HCRU) outcomes were assessed in four cohorts according to insomnia diagnosis and treatment status and examined using multivariable analyses according to Insomnia Severity Index categories. Results Among 62,319 respondents, 9,035 (21.2%) reported experiencing insomnia over the previous 12 months. CID prevalence rates were 5.5% to 6.7% across the five countries and 6.0% overall. HRQoL outcomes were persistently poorer in cohorts of patients diagnosed with insomnia than those with undiagnosed insomnia. Undiagnosed and treated insomnia patients reported the highest work presenteeism and total work productivity impairment and the highest number of emergency room and hospitalization visits than patients with insomnia (either treated or untreated). After adjusting for covariates, patients with severe insomnia reported significantly worse EQ-5D-5L utility scores, higher absenteeism and presenteeism rates, and more healthcare provider visits over the past 6 months than patients without insomnia (all p < 0.01). Conclusions Our prevalence rates for CID align with published literature. A diagnosis of insomnia, use of sleep medications, and severity of insomnia are associated with poor quality of life, loss of work productivity, and higher HCRU, confirming the high unmet need and substantial humanistic and economic burden of CID.

A Clinical Study on The Efficacy of Homoeopathic Medicines in The Treatment of Primary Insomnia – A Pilot Study

A Clinical Study on The Efficacy of Homoeopathic Medicines in The Treatment of Primary Insomnia – A Pilot Study

Static and temporal dynamic alterations of local functional connectivity in chronic insomnia.

Several studies have revealed altered intrinsic neural activity in chronic insomnia (CI). However, the temporal variability of intrinsic neural activity in CI is rarely mentioned. This study aimed to explore static and temporal dynamic alterations of regional homogeneity (ReHo) in CI and excavate the potential associations between these changes and clinical characteristics.Eighty-seven patients with CI and seventy-eight healthy controls (HCs) were included. Resting-state functional magnetic resonance imaging was performed on all subjects and both static and dynamic ReHo were used to detect local functional connectivity. We then tested the relationship between altered brain regions, disease duration, and clinical scales. The receiver operating characteristic curve analysis was used to reveal the potential capability of these indicators to screen CI patients from HCs.CI showed increased dynamic ReHo in the right precuneus and decreased static ReHo in the right cerebellum_6. The dynamic ReHo values of the right precuneus were negatively correlated with the self-rating depression score and the static ReHo values of the right cerebellum_6 were positively correlated with the Montreal Cognitive Assessment-Naming score. In addition, the combination of the two metrics showed a potential capacity to distinguish CI patients from HCs, which was better than a single metric alone.The present study has revealed the altered local functional connectivity under static and temporal dynamic conditions in patients with CI, and found the relationships between these changes, mood-related scales, and cognitive-related scales. These may be useful in elucidating the neurological mechanisms of CI and accompanying symptoms.

Association between sleep duration and sleep quality with pre-sarcopenia in the 20–59-year-old population: evidence from the National Health and Nutrition Examination Surveys 2005–2014

BackgroundSarcopenia is a musculoskeletal disease characterized by a significant reduction in muscle mass, strength, and performance. As it mostly affects older adults, it is often recognized as a disease of old age. However, sleep is also closely related to its development. Hence, it becomes critical to explore the relationship between sleep and sarcopenia in populations under 60 years of age to develop strategies for preventing sarcopenia. We here aim to explore the specific association between sleep duration and sleep quality with pre-sarcopenia in the non-elderly population using large population samples.MethodsThis study involved 7,187 participants aged 20–59 years from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2014. Pre-sarcopenia is defined based on the appendicular skeletal muscle mass (ASM) adjusted for body mass index (BMI). Self-reported sleep duration was categorized into three groups: <6 h (short sleep), 6–8 h (normal sleep), and > 8 h (long sleep). Sleep quality was assessed based on the Sleep Disorder and Trouble Sleeping Questionnaire. Univariate analysis and multivariate logistic regression were used to examine the relationship between sleep duration and sleep quality with pre-sarcopenia.ResultsSleep quality was significantly linked with the risk of pre-sarcopenia (OR 1.72, 95% CI 1.36–2.18, P < 0.01). Longer or shorter sleep duration did not affect the risk of pre-sarcopenia, in contrast to normal sleep duration. Subgroup analysis demonstrated a more pronounced association in individuals who are > 40 years old (P < 0.01), non-Hispanic (P ≤ 0.01), overweight (P < 0.01), have a higher income (P < 0.01), and are more educated (P ≤ 0.01). Moreover, this association was noted in populations with or without smoking (P < 0.01) and alcohol consumption (P < 0.01), hypertension (P < 0.01) and diabetes (P ≤ 0.02).ConclusionSleep quality is associated with an increased risk of pre-sarcopenia, while sleep duration is not in the population aged 20–59 years. Further prospective cohort studies with a large sample size are needed to determine causality and develop effective interventions for preventing sarcopenia in the population aged 20–59 years.

Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort

ObjectiveComorbidities between internalizing disorders (IDs) and functional disorders (FDs) are well-documented, indicating shared pathways. However, their symptom-level relationships have been largely unexplored. This exploratory study employs a network approach to investigate symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) to identify bridge symptoms explaining comorbidity between the two domains. MethodsWe used cross-sectional data on 72,919 adult subjects from the Lifelines Cohort Study, a Dutch general population sample. A total of 38 symptoms representing diagnostic criteria of IDs and FDs were assessed with validated questionnaires. Network models were estimated using eLasso, based on the Ising model, to identify bridge symptoms. The Network Comparison Test (NCT) was used to test whether there were differences in network structure and strength across sex and age. ResultsSymptoms were moderately connected, with a network density of 52.7%. ID and FD symptoms clustered in their respective domains, but were connected through the bridge symptoms, fatigue, difficulty concentrating, trouble sleeping, and unrefreshing sleep. Fatigue and difficulty concentrating had the most connections, associated with 86.6% and 78.9% of the other symptoms, respectively. NCTs indicated no differences in network connectivity between females versus males or younger versus older adults (>50 years). ConclusionsID and FD symptoms are moderately interconnected. Bridge symptoms displaying strong connections to multiple disorders may play a central role in the mechanisms underpinning the comorbidity between IDs and FDs.