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

Knee osteoarthritis (KOA) is a highly prevalent chronic condition that substantially impairs functional capacity and quality of life among middle-aged and older adults. Sensory loss, including hearing and vision loss, is another major health concern in aging populations. Dual sensory loss (DSL), the coexistence of visual and auditory impairment, leads to more severe clinical consequences than single sensory deficits, largely due to disrupted sensory integration and diminished neural compensatory mechanisms. Emerging evidence indicates that osteoarthritis is linked to progressive deterioration of auditory and visual function, highlighting the need for early identification of individuals at risk. Therefore, this study aimed to develop a machine learning-based time-to-event prediction model for DSL among middle-aged patients with symptomatic KOA and to externally validate its performance in an independent hospital-based cohort, then identify its risk factors through interpretable analysis, providing essential evidence to support early preventive interventions. Data from the China Health and Retirement Longitudinal Study (N = 605) were utilized in model development phase. After data preprocessing steps, we trained and tested four time-to-event ML algorithms. Model performance was evaluated in 10-fold cross-validation by using the concordance index (C-index), Brier scores and calibration plots. A sensitivity analysis was conducted by redefining DSL using a broader cutoff and re-training all models under the same cross-validation framework to assess the robustness and stability of the finding. An independent hospital-based cohort (N = 195) was used for preliminary external validation. The optimal model was further evaluated by the decision curve analysis (DCA) to assess its clinical utility and interpreted with SHapley Additive exPlanations (SHAP) to quantify feature contributions and directional effects. 15 variables with the highest predictive capacity were retained. The DeepSurv model demonstrated superior performance in both the construction and validation phase, achieving C-index exceeding 0.8, with a Brier score below 0.1. The sensitivity analyses results were largely consistent with our primary findings, supporting the robustness of the associations. SHAP analysis revealed self-rated health and sleep duration as the most important predictors, both negatively influencing DSL risk. The DeepSurv model effectively predicts time-to-event risk of DSL in KOA patients, highlighting subjective health perception and sleep duration as critical modifiable factors. These findings support the development of targeted early preventive strategies in clinical practice to preserve sensory function and reduce the long-term disease burden associated with KOA.

This study aimed to analyse the effect of sleep quality on cognitive function in elderly patients with Alzheimer's disease (AD). This retrospective study extracted clinical data from the hospital's electronic medical record system for elderly patients with AD admitted to the Departments of Neurology or Geriatrics between June 2022 and June 2024. Cognitive function was assessed using the MiniMental State Examination (MMSE), subjective sleep quality was evaluated with the Athens Insomnia Scale (AIS) and objective sleep architecture parameters were measured via overnight polysomnography (PSG). Participants were stratified into mild and moderate-to-severe cognitive impairment groups according to their MMSE scores. General characteristics and sleep-related indicators were compared between the two groups. A binary logistic regression model was employed to analyse independent factors influencing cognitive impairment severity. In this model, cognitive impairment severity served as the dependent variable, and PSG parameters and AIS score served as the core independent variables. Adjustments were made for potential confounding factors, including age, gender, years of education, disease duration, Hospital Anxiety and Depression Scale (HADS) scores and Instrumental Activities of Daily Living Scale (IADL) scores. The cohort comprised 61 (40.67%) moderate-to-severe and 89 (59.33%) mild impairment patients. Compared with the mild impairment group, the moderate-to-severe group showed significantly poorer subjective (higher AIS) and objective sleep profiles, including reduced total sleep time, efficiency, and N2/N3 sleep and increased N1 sleep, latency and awakenings (p < 0.05). Adjusted regression identified the N3 stage/total sleep time ratio as a protective factor (odds ratio [OR] = 0.720, 95% CI: 0.576-0.900, p = 0.004) and the AIS score (OR = 1.850, 95% CI: 1.405-2.434, p < 0.001) and number of awakenings (OR = 3.101, 95% CI: 1.879-5.116, p < 0.001) as independent risk factors. In elderly patients with AD, impaired objective sleep architecture and subjective insomnia are significantly associated with poor cognitive function. This study highlighted sleep parameters as potential indicators for cognitive status assessment.

Esports training is typically self-directed and frequently scheduled late in the day, which may disrupt habitual sleep-wake patterns and contribute to poor sleep outcomes. Although previous esports research has identified delayed sleep timing and reduced sleep duration at the group level, less is known about how night-to-night fluctuations in sleep behaviour and stable individual characteristics jointly influence perceived sleep quality. Examining both intra-individual and inter-individual determinants may provide a more nuanced understanding of sleep health in esports athletes. Twenty-four esports athletes (male: n = 16, age M = 20.13 ± 2.42 years; female: n = 8, age M = 25.13 ± 4.02 years; range 18-33) from Brisbane, Australia, completed the study between October 2023 and March 2024. The protocol comprised baseline questionnaires assessing sleep hygiene, habitual sleep quality, chronotype, and daytime sleepiness, followed by approximately seven consecutive nights of wrist-worn actigraphy and daily sleep diaries (187 valid nights). Subjective sleep quality was rated each morning on a 5-point scale. Multilevel modelling was used to examine within-person associations between nightly deviations in sleep duration and bed/wake times, as well as the timing of esports gameplay relative to bedtime (no gameplay, < 1h, 1-2h, > 2h). Between-person predictors included sleep hygiene, habitual sleep timing and duration, and age. Participants averaged approximately 6h 42min (± 51min) of sleep per night and reported moderate subjective sleep quality. The intraclass correlation coefficient indicated that 20% of the variance in sleep quality was attributable to between-person differences, with the remaining 80% reflecting within-person variability. At the nightly level, longer-than-average sleep duration was associated with higher perceived sleep quality, whereas nightly bed and wake times were not significant predictors. Nights in which gameplay ended 1-2h before bedtime were associated with poorer sleep quality compared with nights without gameplay. At the between-person level, poorer sleep hygiene was associated with lower sleep quality, whereas later habitual bedtimes were associated with higher sleep quality ratings across the monitoring period. Subjective sleep quality in esports athletes is shaped by both nightly variability in sleep duration and stable behavioural characteristics. These findings highlight the importance of sleep regularity, behavioural routines, and training schedules in esports, and support the use of multilevel approaches to capture dynamic sleep processes in performance-based gaming contexts.

Objective Shift work disrupts circadian rhythms and is established as a risk factor for metabolic syndrome. While poor sleep quality is often hypothesized as the primary mediator linking shift work to dyslipidemia, the extent to which circadian misalignment affects lipid metabolism independently of sleep complaints remains unclear. This study aimed to investigate the independent and combined effects of shift work and sleep quality on serum lipid profiles in a cohort of male underground miners. Methods A cross-sectional analysis was conducted on 921 male miners from the Kailuan Group. Participants were categorized by work schedule into Night Shift (0:00–7:59, n = 326) and Day/Morning Shift (8:00–23:59, n = 595) groups to ensure distinct circadian exposure profiles. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a score &amp;gt;5 defining poor sleep. Fasting serum lipids—Total Cholesterol (TC), Triglycerides (TG), High-Density Lipoprotein Cholesterol (HDL-C), and Low-Density Lipoprotein Cholesterol (LDL-C)—were quantified. General Linear Models (GLM) and interaction analyses were employed to assess associations, adjusting for age, education, smoking, and alcohol consumption. Results Night shift workers exhibited significantly higher global PSQI scores compared to day workers (4.70 ± 3.06 vs. 3.59 ± 2.71, P &amp;lt; 0.001). While the overall prevalence of dyslipidemia did not significantly differ (32.52% vs. 27.57%, P = 0.114), night shift work was significantly associated with elevated mean TC levels (5.36 ± 2.83 vs. 5.09 ± 1.09 mmol/L, P = 0.039) independent of covariates and occupational factors. Surprisingly, subjective sleep quality (PSQI) showed no significant correlation with lipid parameters (All P &amp;gt; 0.05). In the stratified interaction analysis, the highest TC levels were observed in the “Night Shift + Good Sleep” subgroup (5.51 ± 3.43 mmol/L), significantly differing from the “Day Shift + Good Sleep” reference group (4.96 ± 1.06 mmol/L, P = 0.039). Conclusion Night shift work is associated with elevated total cholesterol in male miners, an effect that persists even among those reporting good sleep quality. This suggests that circadian misalignment governs lipid dysregulation via pathways distinct from subjective sleep disruption. Occupational health interventions should target circadian phase management beyond basic sleep hygiene education.

This study examined the effects of a personalized sleep or nutrition intervention on sleep in shift-workers. Fifty-seven healthy male workers on 12-hour shifts received the sleep intervention (n=25), nutrition intervention (n=22), or control (n=10). The sleep intervention aimed to improve sleep duration and quality through adjustments in sleep timing and sleep education. The nutrition intervention targeted circadian alignment by structuring meal timing and macronutrient distribution. Interventions were personalized using baseline sleep, diet, and physiological markers. Subjective sleep was assessed with the Insomnia Severity Index at baseline, last weeks of the intervention, and 8-month follow-up. Objective sleep outcomes (total sleep time, sleep efficiency, fragmentation index, and wake after sleep onset) were assessed through actigraphy at baseline, first and last weeks of the intervention. Mixed-effects models analyzed changes in subjective and objective sleep outcomes, adjusting for age, chronotype and household composition. The sleep intervention group had significantly higher insomnia scores at baseline, which improved to control levels post-intervention and remained so at follow-up. However, no significant changes in objective sleep were observed. The nutrition intervention group showed no significant effects on subjective or objective sleep outcomes. These findings suggest personalized sleep strategies may improve perceived sleep without detectable changes in objective measures.

Sleep disorders in addictions: State of the art and management.

The present study aimed to explore sleep diary-derived parameters and sleep measures as mediators of the effects of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) on psychological outcomes. A secondary analysis of a two-arm randomized controlled trial of a group-based TSC for major depressive disorder was conducted. The participants included 152 adults (mean age=34.0; 79.6% female) who were randomized into either the TSC or care-as-usual group. Mediation analysis indicated that reduction in insomnia symptom severity (standardized indirect effects: -0.06 to -0.17), sleep disturbance (-0.04 to -0.22), and sleep-related impairment (-0.04 to -0.17) was significantly mediated by sleep diary-derived sleep parameters. The treatment effects on depressive symptoms (standardized indirect effects: -0.05 to -0.10), anxiety symptoms (-0.04 to -0.07), fatigue (-0.05 to -0.09), functional impairment (-0.06 to -0.09), and quality of life (0.04 to 0.08) were sequentially mediated by sleep parameters and insomnia symptom severity. However, the severity of insomnia symptoms alone (magnitudes of standardized indirect effects: 0.09-0.17) but not sleep parameters alone (0.00-0.07) mediated the treatment effects on psychological outcomes, indicating that sleep parameters need to influence subjective sleep measures to sequentially affect psychological outcomes. These results underscore the critical roles of subjective sleep measures in clinical improvements within a sleep-targeted intervention.

Sleep quality is essential for maintaining physical health and psychological resilience. Because sleepwear remains in direct contact with the skin throughout the night, it may affect thermoregulation and comfort and, thereby, influence sleep. This randomized two-period, two-sequence crossover study investigated whether sleepwear infused with nanodiamond and nanoplatinum particles (DPV576) could improve sleep quality and promote fatigue recovery under free-living conditions. Fourteen healthy men (23.9 ± 1.7 years) wore DPV576 sleepwear and visually indistinguishable standard polyester sleepwear for one week each, separated by a one-week washout. Sleep was assessed using a wearable ECG-based actigraphy device; trained researchers additionally performed manual rescoring to verify automated outputs, including independent determination of sleep onset latency. Subjective sleep was assessed daily using the Sleep Quality Index of Daily Sleep and a visual analog scale; exploratory outcomes included voice-derived biomarkers and pre-/post-sleep grip strength. In manual rescoring, DPV576 was associated with higher sleep efficiency (93.0 ± 0.9% vs. 89.5 ± 1.5%, p < 0.05), fewer awakenings (8.4 ± 1.3 vs. 10.7 ± 1.4, p < 0.01), and shorter wake after sleep onset (30.4 ± 4.7 vs. 41.6 ± 6.0 min, p < 0.01), whereas total sleep time did not differ significantly (p = 0.096). These findings suggest that one-week use of DPV576 sleepwear may improve wearable ECG-derived sleep consolidation in young men, supporting a nonpharmacological wearable strategy to enhance sleep efficiency in everyday settings.

Actigraphy-based sleep outcomes in substance use disorders: A systematic review and meta-analysis.

Objectively measured sleep duration often diverges from the subjectively perceived sleep duration in patients with insomnia. Although depression is known to affect sleep, little is known about its influence on the discrepancy between subjective and objective sleep measures, which we sought to clarify in this study. We analyzed medical records from 229 patients with insomnia, including anamnestic data, Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI) scores, and polysomnography and actigraphy measurements. Patients were compared according to their anamnesis of depressive disorder and BDI scores. Group differences were evaluated using Wilcoxon rank-sum tests and multivariate linear regression with log-transformed outcomes to control for relevant confounders. Patients with insomnia (mean PSQI score 12.4) and comorbid depression (as a trait) showed significantly higher sleep-onset latency, lower sleep efficiency, and longer total sleep time, as assessed by actimetry. Patients with insomnia and relevant depressive symptoms (BDI score ≥14 points) did not differ from those without relevant depression in objective sleep measurements. However, they presented significantly higher scores on subjective measurements of overall sleep quality, sleep latency, sleep disturbances, and daytime disturbances. In patients with insomnia, current depressive symptoms have an impact only on the subjective perception of sleep, whereas comorbid depressive disorder also influences objective sleep measurements. A clearer understanding of the discrepancy between subjective and objective sleep measures across different patient cohorts will enhance personalized treatment in patients with insomnia.

The effect of Dual Orexin Receptor Antagonists on sleep: a systematic review and pairwise meta-analysis.

Effects of bright light and near-infrared light on insomnia symptoms in community-dwelling older adults: a randomized clinical trial.

The effect of postoperative back massage on pain, sleep outcomes and serum cortisol after open-heart surgery: A randomized controlled trial.

We investigated the effects of Lactobacillus paragasseri OLL2716 on sleep under psychological stress. In this randomized, double-blind, placebo-controlled trial, 78 healthy Japanese students in the fourth year of medical school were exposed to 2 consecutive academic exam stressors. They were randomly assigned to the OLL2716 or placebo group, and each group consumed 85 g of yogurt containing L. paragasseri OLL2716 or placebo yogurt daily for 8 wk. Two examinations were performed after 4 and 7 wk of intake. The State-Trait Anxiety Inventory (STAI) was used to assess anxiety level. As the primary endpoint, subjective sleep was evaluated using the Ogri-Shirakawa-Azumi sleep inventory MA version (OSA-MA) and the Pittsburgh Sleep Quality Index. Objective sleep was assessed using Fitbit sleep-monitoring devices. Saliva was collected for 2 min between 1600 and 1800 h. Salivary cortisol and chromogranin A levels were measured to assess physiological stress response. These data were obtained at baseline (0 wk) and during the intake periods (2, 4, 5, 7, and 8 wk after intake). The STAI data showed that anxiety levels were similar in both groups. The OSA-MA data showed that the changes in "sleepiness on rising" score at 2 and 4 wk and "dreaming" score at 8 wk were significantly improved, and the changes in objective sleep length at 2, 4, and 7 wk were significantly increased in the OLL2716 group compared with those in the placebo group. Additionally, the salivary chromogranin A secretion rate at 4 wk and salivary cortisol secretion rate at 5 wk were significantly decreased in the OLL2716 group compared with those in the placebo group. These results suggest that the intake of L. paragasseri OLL2716 improves stress-induced sleep deprivation, maintains sleep homeostasis, and moderates the stress response. Therefore, L. paragasseri OLL2716 is a potential strategy for reduced daytime performance associated with sleep dissatisfaction among individuals living in the modern stressful society.

This meta-analysis examines the bidirectional within-person association between sleep and affect using data from 118 studies. Focusing on intensive longitudinal designs such as daily diaries and ecological momentary assessments, this meta-analysis examines how daily variations in sleep, measured via subjective and objective methods, are associated with fluctuations in positive and negative affect. Results show small-to-moderate within-person correlations, with better subjective sleep quality and longer sleep duration predicting improved next-day affect. Conversely, more positive affect and less negative affect during the day were modestly associated with better subjective sleep quality but not total sleep time. The within-person correlations were generally stronger when aspects of sleep were self-reported rather than objectively measured, highlighting the importance of perceived sleep experiences. These findings were largely consistent across age groups and health status, suggesting that the relationship between sleep and affect may be universal. Overall, this study underscores the psychological significance of everyday sleep-affect dynamics.

Sleep health in the family Context: Predictors and qualitative exploration of parentally perceived early childhood insomnia.

The relationship between sleep quality, clinical decision-making and the tendency to make medical errors in nurses.

Anxiety is common during the perinatal period and is associated with adverse maternal and infant outcomes, highlighting a need to identify predictors of perinatal anxiety. Accumulating research implicates sleep disruption in perinatal anxiety and related symptoms, including obsessive-compulsive symptoms. We examined the associations among insomnia symptoms and sleep duration with perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms and the moderating role of coping from pregnancy through postpartum. A sample of 231 women (agemean = 32.97 ± 4.36 years; 74% white) completed interview and self-report measures of sleep, coping, perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms in early and late pregnancy, 6 weeks postpartum, and 6 months postpartum. Multilevel models were used for data analysis. Shorter sleep duration predicted increases in subsequent perinatal anxiety (B = -.63, p < .05) and obsessive beliefs (B = -2.17, p < .05), whereas perinatal anxiety and related symptoms did not predict subsequent sleep disruption (p's > .05). Those who reported higher insomnia symptoms and shorter sleep duration reported higher perinatal anxiety (B = 1.19, p < .001; B = -3.18, p < .001), obsessive beliefs (B = 3.42, p < .001; B = -11.57, p < .001), and obsessive-compulsive symptoms (B = .69, p < .001; B = -1.94, p < .001) on average. The relation between insomnia symptoms and perinatal anxiety was moderated by coping (B = -.18, p < .01). These findings suggest that sleep disruption is a modifiable risk factor for perinatal anxiety and related symptoms.

ABSTRACTBackgroundAlthough caffeine is widely used in athletes due to its ergogenic effects, the effects of its main metabolite, paraxanthine, on performance and sleep have not been adequately investigated.PurposeThis study aimed to comparatively investigate the effects of caffeine and its main metabolite paraxanthine on rowing performance and sleep quality.MethodsThe study was designed as a randomized, double-blind, crossover study and included 14 male university-level rowers (21.6 ± 1.9 age; 2.2 ± 1 years of rowing experience). The participants participated in 2000-m rowing ergometer time trials under four different supplementation conditions (caffeine + paraxanthine, caffeine + placebo, paraxanthine + placebo, and placebo with 200 mg each). Performance data (completion time, mean power, and heart rate), sleep quality, and daytime sleepiness were assessed by subjective scales. The data were analyzed by repeated-measures analysis of variance (ANOVA) and Bonferroni post-hoc tests.ResultsCompared with the placebo, the combined caffeine + paraxanthine condition was associated with faster 2000-m performance and higher mean power output (p = 0.044; Cohen's d = 0.30). Caffeine alone and paraxanthine alone did not show clear evidence of performance improvement in this sample, although estimates favored both conditions versus placebo. Conditions containing caffeine were associated with poorer subjective sleep quality, whereas paraxanthine alone showed more favorable sleep-related outcomes.ConclusionThese results indicate that the combined ingestion of caffeine and paraxanthine elicited the most pronounced performance benefits, while paraxanthine alone did not demonstrate clear standalone ergogenic efficacy at the administered dose. However, paraxanthine was associated with better subjective sleep outcomes compared to caffeine, suggesting that its potential value may be related more to tolerability rather than superior performance enhancement, particularly for athletes training in the evening. Study limitations, including the small sample size and lack of objective sleep measures, should be considered when interpreting the results.Practical applicationsParaxanthine may represent a practical option for athletes who prioritize sleep quality or experience sensitivity to caffeine-related sleep disturbances, although further dose‒response studies are required to clarify its ergogenic potential.