Treatment Of Sleep Disturbances Research Articles

Which Interventions Are Effective in Treating Sleep Disturbances After THA or TKA? A Systematic Review.

Poor sleep quality is a common complaint after total joint arthroplasty (TJA), and it is associated with reports of higher pain and worse functional outcomes. Several interventions have been investigated with the intent to reduce the incidence of postoperative sleep disturbance with varying effectiveness. An aggregate of the best available evidence, along with an evaluation of the quality of those studies, is needed to provide valuable perspective to physicians and to direct future research. In this systematic review, we asked: (1) What is the reported efficacy of the most commonly studied medications and nonpharmacologic approaches, and (2) what are their side effects and reported complications? This systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search using a combination of controlled vocabulary and keywords was performed utilizing Medline (Ovid), Embase (Ovid), Cochrane Central, and Web of Science databases from database inception to 2023, with the last search occurring October 24, 2023, to identify studies that evaluated a sleep intervention on the effect of patient-reported sleep quality after THA or TKA. Inclusion criteria were clinical trials, comparative studies, and observational studies on adult patients who underwent primary TKA or THA for osteoarthritis and who completed validated sleep questionnaires to assess sleep quality postoperatively. We excluded studies on patients younger than 18 years, patients with sleep apnea, TKA or THA because of trauma or conditions other than osteoarthritis, revision TJA, studies in languages other than English, and studies from nonindexed journals or preprint servers. Two investigators independently screened 1535 studies for inclusion and exclusion criteria and extracted data from the included studies. Ultimately, 14 studies were included in this systematic review, including 12 randomized controlled trials and 2 prospective comparative studies. A total of 2469 participants were included, with a mean ± SD age of 65 ± 7 years and 38% men in control groups and 65 ± 7 years and 39% men in intervention groups. Sleep quality questionnaires utilized included the Pittsburgh Sleep Quality Index, Self-Rating Scale of Sleep, 100-mm VAS - Sleep, Sleep Disturbance Numeric Rating Scale, Likert scales, and one institutionally designed questionnaire. Quality analysis was performed utilizing the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials, where higher scores of 13 indicated a more reliable study, and the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies, where higher scores of 9 indicated a more reliable study and scores < 5 represented a high risk of bias. Two of the randomized controlled trials scored a 12 of 13, and the remaining 10 met every criteria of the JBI checklist. Both comparative studies scored 5 of 9 possible points of the Newcastle-Ottawa Scale. Melatonin and selective cyclooxygenase-2 inhibitor rofecoxib were found to provide a clinically important benefit to sleep quality within the first postoperative week after TJA. However, rofecoxib was withdrawn from the market globally in 2004 over concerns about increased risk of cardiovascular events. Another cyclooxygenase-2 inhibitor, celecoxib, remains available. No other intervention demonstrated a clinical benefit. Side effects of melatonin include dizziness, headache, paresthesia, and nausea, and it is contraindicated in patients with liver failure, autoimmune conditions, or who are receiving warfarin. Long-term adverse effects of rofecoxib include hypertension, edema, and congestive heart failure, and it is contraindicated in patients with renal insufficiency or who are receiving warfarin. Melatonin is considered safe in older patients, but more caution should be taken with rofecoxib. Owing to limited evidence in support of most of the interventions we studied, none of these interventions can be recommended for routine use after TJA. Melatonin and rofecoxib may provide a benefit to sleep quality in some patients, but physicians need to understand the adverse effects and contraindications before recommending these interventions. Additionally, rofecoxib is no longer commercially available. Future investigation is warranted to evaluate the effectiveness of interventions with minimal side effect profiles for providers to be able to make an informed decision about interventions for sleep improvement after TJA. Level III, therapeutic study.

Sleep disturbance, suicidal ideation and psychosis-risk symptoms in individuals at clinical high risk for psychosis

Insomnia and suicidal ideation (SI) are common in schizophrenia, including in individuals at clinical high-risk for psychosis (CHR-P). Previous studies have found associations between sleep disturbance, SI, and psychopathology in schizophrenia. We explored these associations in a CHR-P cohort. We leveraged data from CHR-P individuals in the North American Prodrome Longitudinal Studies (NAPLS-3) (n = 688) cohort. We investigated relationships between sleep disturbance (Scale of Prodromal Symptoms [SOPS]; Calgary Depression Scale for Schizophrenia [CDSS], and the Pittsburgh Sleep Quality Index [PSQI]), suicidal ideation (CDSS), and psychosis-risk symptoms. The prevalence of terminal insomnia, sleep disturbance, and SI in NAPLS3 was 25 %, 69 %, and 29 %, respectively. After controlling for potential confounders, multiple indices of sleep disturbance (SOPS, PSQI: OR = 1.05–1.40) were significant indicators of concurrent SI. Terminal insomnia was not associated with conversion to psychosis. Multiple indices of sleep problems were associated with higher total and subscale psychosis-risk symptom scores (β = 0.09–0.39). Sleep problems are prevalent and associated with SI and more severe psychosis-risk symptoms in CHR-P individuals. These findings underscore the importance of designing longitudinal intervention studies to investigate whether the treatment of sleep disturbances may reduce suicidality and symptoms in this population.

Sleep Quality and Bariatric Surgery-Can We Treat Sleep Disturbances and Insomnia in Patients with Obesity with Laparoscopic Sleeve Gastrectomy?

Introduction: Bariatric surgery is the mainstay of treatment of obesity, with a proven, long-lasting effect on body weight reduction and remission of co-morbidities. Sleep disorders, including insomnia, and deteriorated sleep quality and duration are associated with obesity, and a reduction in body weight can be associated with a reduction in prevalence of sleep disorders. The purpose of this study was to assess the influence of laparoscopic sleeve gastrectomy (LSG) on the prevalence and intensity of different sleep disturbances. Methods: This observational prospective study included 80 patients qualified for bariatric surgery who filled in a questionnaire with a set of structured questions about different sleep disturbances, such as difficulties in falling asleep, night awakenings, early morning awakenings, snoring, and nightmares, as well as eating at night and daytime dysfunction, supplemented with Athens Insomnia Scale (AIS), before and 6 months after bariatric surgery. Results: There was a statistically significant reduction in incidence of night awakenings, with 40.00% of participants reporting night awakenings before surgery and, respectively, 25.00% after surgery. A significant reduction was also observed in the rate of patients who reported snoring, with 60.00% before the surgery and 38.75% after the surgery (p < 0.05). There was a correlation present between estimated weight loss % (EWL%) and reduction in snoring (p < 0.05). The mean total AIS score before surgery was 7.21 and 5.99 after surgery, and the change was statistically significant (p < 0.05). A total AIS score of 8 or more, the cutoff score for insomnia diagnosis according to the Polish validation of the Athens Insomnia Scale, was present in 44.16% of cases before surgery and in 38.00% after surgery (p = 0.52). There was a significant difference in the incidence of awakening during the night score before and after surgery (p < 0.05; CI 0.022-0.341), sleep quality (p < 0.05; CI 0.0105-0.4311), well-being during the day (p < 0.05; CI 0.0273-0.4143), and sleepiness during the day (p < 0.05; CI 0.101-0.444). Conclusions: LSG is observed to have a positive effect on selected sleep disturbances and insomnia remission in patients with obesity, measured by a significant reduction in Athens Insomnia Scale scores in follow-up 6 months after surgery. Additionally, patients after bariatric surgery reported less night awakenings and there was a lower rate of snoring. Therefore, LSG can be considered an effective therapeutic tool for insomnia in patients with obesity.

Effects of high-intensity interval training on sleep disturbances associated with posttraumatic stress disorder.

Sleep disturbances are common in individuals with posttraumatic stress disorder. Exercise interventions are a promising approach in the treatment of sleep disorders, but little is known about the efficacy of exercise interventions for sleep disturbances associated with posttraumatic stress disorder. A total of 40 individuals with posttraumatic stress disorder were randomized to six sessions of either high-intensity interval training or low-to-moderate-intensity training, administered within 12 days. Sleep quality was assessed over 24 days from baseline to post with the Pittsburgh Sleep Quality Index, a sleep log, and a waist-worn actigraphy. Analyses revealed that, regardless of group allocation, Pittsburgh Sleep Quality Index score improved significantly by 2.28 points for high-intensity interval training and 1.70 points for low-to-moderate-intensity training (d = 0.56 for high-intensity interval training; 0.49 for low-to-moderate-intensity training) over time, while there were no significant changes in any sleep log or actigraphy measure. Analysis of a subsample of those affected by clinically significant sleep disturbances (n = 24) revealed a significant time effect with no difference between exercise interventions: Pittsburgh Sleep Quality Index improved significantly by 2.65 points for high-intensity interval training and 2.89 points for low-to-moderate-intensity training (d = 0.53 for high-intensity interval training; 0.88 for low-to-moderate-intensity training), and actigraphy measure of wake after sleep onset was reduced significantly by 14.39 minutes for high-intensity interval training and 6.96 minutes for low-to-moderate-intensity training (d = 0.47 for high-intensity interval training; 0.11 for low-to-moderate-intensity training) from baseline to post. In our pilot study, we found an improvement in sleep quality from pre- to post-assessment. There were no significant differences between exercise groups. Further studies are needed to investigate whether the found time effects reflect the exercise intervention or unrelated factors.

Sleep and functional outcomes in children and adolescents with epilepsy: A scoping review

AimIn children and adolescents with epilepsy (CAWE), disturbed sleep and functional difficulties are frequently present, but their relationship is unclear. In this scoping review we aimed to explore associations between sleep and functional outcomes in CAWE. MethodWe registered the protocol with open science framework and conducted the review according to the PRISMA Extension for Scoping Reviews. We searched Medline, Embase, PsycINFO and PubMed for original studies reporting on relations between sleep and functional outcomes (adaptive/quality of life, behavioural/mood, cognitive & academic) in CAWE. To assess the quality of studies we used an extended version of the checklist employed by Winsor and colleagues [1]. ResultsWe identified 14 studies that included 1,785 CAWE and 1,260 control children, with a mean age of 9.94 and 10.13 years, respectively. The studies were highly heterogeneous with respect to samples, epilepsy variables, and methods used to assess sleep and functional outcomes. The quality of studies was medium. Associations between sleep and adaptive/quality of life, behavioural/mood, cognitive and academic outcomes were examined in 2, 10, 6, and 0 studies, respectively. Across studies, in CAWE, greater sleep disturbances were related to worse behavioural/mood outcomes, ranging from depression/anxiety to ADHD symptoms. Sleep disturbances did not consistently relate to cognitive outcomes, but they related to worse adaptive outcomes in both studies that examined their relationship. ConclusionsOur study provides evidence of relationship between disturbed sleep and behavioural/mood difficulties, which alerts to the need for careful evaluation and treatment of sleep disturbances in CAWE. Our study also highlights the need to examine relationships between sleep and other functional outcomes in CAWE, as studies conducted in the general population suggest that sleep disturbances may be modifiable and associated with improved functional outcomes.

Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder

BackgroundSleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study’s aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD.Study designA retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children’s Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization.ResultsOf the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01–2.95; and aOR = 2.71; 99%CI = 1.10–6.67, respectively).ConclusionsOur findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.

Evaluating possible ‘next day’ impairment in insomnia patients administered an oral medicinal cannabis product by night: a pilot randomized controlled trial

Cannabis and its major constituents, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are being widely used to treat sleep disturbances. However, THC can cause acute cognitive and psychomotor impairment and there are concerns that driving and workplace safety might be compromised the day after evening use. Here, we examined possible ‘next day’ impairment following evening administration of a typical medicinal cannabis oil in adults with insomnia disorder, compared to matched placebo. This paper describes the secondary outcomes of a larger study investigating the effects of THC/CBD on insomnia disorder. Twenty adults [16 female; mean (SD) age, 46.1 (8.6) y] with physician-diagnosed insomnia who infrequently use cannabis completed two 24 h in-laboratory visits involving acute oral administration of combined 10 mg THC and 200 mg CBD (‘THC/CBD’) or placebo in a randomised, double-blind, crossover trial design. Outcome measures included ‘next day’ (≥9 h post-treatment) performance on cognitive and psychomotor function tasks, simulated driving performance, subjective drug effects, and mood. We found no differences in ‘next day’ performance on 27 out of 28 tests of cognitive and psychomotor function and simulated driving performance relative to placebo. THC/CBD produced a small decrease (-1.4%, p=.016, d=-0.6) in accuracy on the Stroop-Colour Task (easy/congruent) but not the Stroop-Word Task (hard/incongruent). THC/CBD also produced a small increase (+8.6, p=.042, d=0.3) in self-ratings of Sedated at 10 h post-treatment, but with no accompanying changes in subjective ratings of Alert or Sleepy (p’s>0.05). In conclusion, we found a lack of notable ‘next day’ impairment to cognitive and psychomotor function and simulated driving performance following evening use of 10 mg oral THC, in combination with 200 mg CBD, in an insomnia population who infrequently use cannabis.

Cyclic Meditation and Sleep Quality: A Review

Abstract Objectives Insufficient sleep leads to several short- and long-term physical and mental consequences. Yoga is a popularly known complementary health approach that maintains physical and mental health through asanas, meditation, and breathing techniques. Cyclic meditation (CM), derived from one of the Upanishads, is practiced by combining physical postures (asanas) with relaxation techniques. Recent findings emphasize the significance of CM as a means to enhance sleep quality. The current review aims to find the effects of CM on sleep quality through the available scientific data. Methods The current review includes research articles evaluating CM's effect on sleep quality from various databases such as PubMed, Cochrane, Embase, and Google Scholar up to January 22, 2023. We conducted a literature search using keywords related to CM and sleep quality, and search results were restricted to studies published in the English language. Results There were 5 articles with 277 participants meeting inclusion criteria, all conducted in India. Of those, 2 were randomized controlled trials and 3 were single-group or two-group pre-post and crossover studies. Participants ranged from healthy volunteers, type-2 diabetic patients, alcohol dependents, and caregivers for special needs children. Based on the available scientific evidence, CM has been found to be effective (d = 0.56–4.90) in enhancing the quality of sleep. Conclusion The CM technique could be tentatively considered as a beneficial practice to improve sleep. However, further, adequately powered, and randomized controlled studies with various other parameters of sleep are required to strongly recommend CM as a stand-alone yogic intervention for sleep disturbance.

Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions: A Retrospective Analysis of Overall Outcomes for 26 Cases

Abstract Objectives Sleep difficulties are highly prevalent among children with rare genetic neurodevelopmental conditions (RGNC) such as Angelman and Smith-Magenis syndromes. Behavioral interventions are commonly used in the treatment of sleep difficulties in children; however, research is limited in children with RGNC. This study evaluated the overall effectiveness and acceptability of function-based behavioral sleep interventions for children with RGNC. Methods Data was collated from a series of experimental single-case research studies with 26 children (18 months to 19 years of age) with a range of RGNC, who received a behavioral sleep intervention. Intervention strategies included circadian (e.g., sleep/wake rescheduling), antecedent (e.g., sleep hygiene), and/or consequence (e.g., positive reinforcement of sleep-conducive behavior and modified extinction) modifications implemented by parents. Clinicians provided support for parents mostly via telehealth methods. Overall outcomes were examined using modified Brinley plots and effect size estimates. The effect of age, gender, and a range of psychological variables on intervention response was also examined. Results Improvements in sleep problem severity were observed for 24/26 participants, and gains were maintained at long-term follow-up for 13/16. Interestingly, 50% of the children achieved clinically significant change with less restrictive strategies (e.g., circadian, antecedent and positive reinforcement strategies), suggesting extinction procedures may be used as the last option in a sequence of interventions. Parents generally perceived interventions to be acceptable. There was minimal evidence of any differential response to intervention as a function of age, gender, or psychological variables. Conclusions Results suggest function-based behavioral interventions offer an effective and socially valid method for treating sleep disturbance in children with RGNC.

0385 Hypnosis Intervention for Sleep Disturbances in Individuals with Mild Cognitive Impairment

0385 Hypnosis Intervention for Sleep Disturbances in Individuals with Mild Cognitive Impairment

Overcoming Sleep Disorders with Complementary Therapy for Patients Undergoing Hemodialisis

This study aims to collect relevant information on the effectiveness of complementary therapies in treating sleep disturbances in patients undergoing routine hemodialysis. The method used in this study is a literature study by collecting and reviewing several published articles regarding the role, use, and effect of complementary therapy in patients on routine hemodialysis with sleep disturbance problems. The results showed the effectiveness of complementary therapies such as music therapy, acupressure, and Benson's relaxation in overcoming sleep disturbances and improving patients' sleep quality. In conclusion, the three complementary therapies can overcome sleep disturbances and improve hemodialysis patients' sleep quality. However, of the three therapies, the authors concluded that Benson's relaxation intervention was an intervention that had better effectiveness than other complementary therapies. Keywords: Complementary Therapy, Hemodialysis, Sleep Disorders

Assessment and Management of Sleep Disturbance in Palliative Care Settings.

Background: Sleep disturbances, including insomnia, sleep-disordered breathing, and circadian rhythm disorders with potential consequences including excessive daytime somnolence and worsening fatigue, are prevalent yet largely under-measured and therefore under-managed problems in people receiving palliative care. This has the potential to negatively affect the person's functioning and quality of life. Objectives: We aimed to review the current practice of assessment and management of sleep disturbances in people with life-limiting illnesses in Australian and New Zealand palliative care settings, and to define areas for improvement in assessment and management of sleep disturbances and further research. Design: A cross-sectional, online survey was conducted with palliative care health professionals (PCHPs) to explore current approaches to routine assessment of sleep disturbances and PCHPs' awareness of, and perceived access to, evidence-based resources for assessing and managing sleep disturbances in their local settings. Results: Fifty-four PCHPs responded to the survey, including allied health professionals (44%), palliative care nurses (26%), and physicians (19%). Over 70% of PCHPs endorsed routine verbal screening of sleep symptoms, and >90% recommended management with basic behavioral strategies. However, none of PCHPs used validated patient-reported outcome measures for sleep, and <10% of PCHPs demonstrated awareness or use of sleep-specific interventions (including medications). Only 40% reported they had access to sleep specialist services for patients. Conclusion: Our findings provide a useful snapshot of current approaches to managing sleep disturbances in palliative care. Gaps in current practice are highlighted, including the lack of structured, clinical assessment, referral pathways, and PCHPs' perceived lack of access to targeted interventions for sleep disturbances.

Maternal Sleeping Problems Before and After Childbirth - A Systematic Review.

The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women's sleep quality but also for their mental well-being.

Non-pharmacological interventions for sleep disruptions and fatigue after traumatic brain injury: a scoping review.

The aim of this study was to conduct a scoping review to determine the nature, variety, and volume of empirical evidence on nonpharmacological interventions for sleep disturbances with potential implications for fatigue in adults sustaining a traumatic brain injury (TBI). A systematic literature search was conducted across four databases to identify primary studies testing a single non-pharmacological intervention or a combination of non-pharmacological interventions for sleep disturbances and fatigue in community-dwelling adults with TBI. Sixteen studies were reviewed addressing six non-pharmacological interventions for sleep disruptions and fatigue after TBI including light therapy, cognitive-behavioral therapy, warm footbath application, shiatsu, and sleep hygiene protocol. Non-pharmacological interventions involving light or cognitive-behavioral therapy were reported in 75% of the studies. Actigraphy-based estimation of total sleep time and subjective level of fatigue were frequent outcomes. While this scoping review has utility in describing existing non-pharmacological approaches to manage sleep and fatigue after TBI, the findings suggest that interventions are often developed without considering TBI individuals' source of motivation and the need for support in self-administration. Future studies may achieve greater sustainability by considering the evolving needs of TBI patients and their families and the drivers and barriers that might influence non-pharmacological intervention use at home.

Wake up to gastro-oesophageal reflux disease: The interplay between arousal and night-time reflux.

This review examines the temporal association between nocturnal gastro-oesophageal reflux and sleep-arousal cycles. Most nocturnal gastro-oesophageal reflux events occur during the awake cycle, and arousals precede most nocturnal gastro-oesophageal reflux events, indicating that arousal from sleep predisposes to nocturnal gastro-oesophageal reflux. This sheds light on the complex relationship between nocturnal gastro-oesophageal reflux and sleep, and has implications for managing nocturnal gastro-oesophageal reflux symptoms. The appearance of symptoms and the pathophysiology of nocturnal gastro-oesophageal reflux are influenced by sleep hygiene, sleep disturbances and the misalignment of circadian rhythms. Nocturnal gastro-oesophageal reflux and its related sleep disorders are prevalent and negatively impact the quality of life. There is conflicting evidence on whether nocturnal gastro-oesophageal reflux and sleep disturbances are causally linked, and whether sleep disturbances drive nocturnal gastro-oesophageal reflux. Poor sleep quality increases oesophageal hypersensitivity and overall acid exposure. The nocturnal gastro-oesophageal reflux is linked to the more severe forms of gastro-oesophageal reflux disease, especially with atypical/extra-oesophageal manifestations and complications of mucosal damage such as oesophagitis and stricture, Barret's oesophagus, and oesophageal adenocarcinoma. This review highlights the role of sleep problems in presenting nocturnal gastro-oesophageal reflux, and the potential benefits of treating sleep disturbances in enhancing patient care and quality of life.

Sleep disturbance and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis

IntroductionGlobally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia.MethodsThis systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger’s test and funnel plot. Cochran’s chi-squared test and I2 values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis.ResultsIn this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI: 39.34–61.52). Third trimester pregnancy AOR = 4.03; 95% CI: 2.84,5.71), multigravidity (AOR = 1.99; 95% CI: 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI: 1.52,4.31), depression (AOR = 3.57; 95% CI: 2.04, 6.27), stress (AOR = 2.77; 95% CI: 1.57, 4.88), anxiety (AOR = 3.69; 95% CI: 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI: 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women.ConclusionThis review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.

Impact of subjective sleep quality on objective measures of neurocognitive dysfunction in patients with major depressive disorder

Background: Sleep disturbances are prevalent in major depressive disorder (MDD). MDD and sleep disturbances are both linked to cognitive impairments. Studies exploring the mechanisms and impact of sleep disturbances on neurocognitive functioning in depressed patients are lacking and proper assessment and therapeutic interventions for sleep disturbances are not part of clinical management of MDD. Aim: We investigated the association between subjective sleep quality and neurocognitive dysfunction in patients with MDD. Materials and Methods: Patients with moderate MDD episode were matched and assigned to two groups with poor and good sleep quality. We used Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. To measure frontotemporally mediated cognitive functioning, following tests were administered: Wisconsin Card Sorting Test (WCST) and degraded continuous performance test (CPT-DS). Two-tailed independent samples t tests or Mann–Whitney U tests and Pearson’s correlation coefficient were performed for the statistical analysis of sleep latency, sleep duration, overall sleep quality, CPT d’ value, WCST correct answers, errors, and perseverative errors. Results: Participants with MDD and poor sleep quality performed worse on cognitive tests compared to patients with MDD and good sleep quality. Scores of subjective sleep on PSQI positively correlated with WCST errors (r (60) =0.8883 P = .001) and negatively correlated with WCST correct answers (r (60) = -.869 P = .001) and measures of CPT-DS d’ value (r (60) = -.9355 P = .001). Conclusions: Poor sleep quality, notably sleep duration and sleep latency, worsens the neurocognitive impairments of MDD patients. As these impairments are found to be associated with treatment outcomes, sleep disturbances should be additionally assessed and treated in MDD episode.

Hypnosis Intervention for Sleep Disturbances in Individuals with Mild Cognitive Impairment: A Randomized Pilot Study

ABSTRACT Poor sleep quality is highly prevalent among individuals with mild cognitive impairment (MCI). Further, poor sleep quality is associated with reduced quality of life, increased stress response, memory impairments, and progression to dementia among individuals with MCI. Pharmacological treatments for sleep have mixed efficacy and can lead to dependency. Therefore, alternatives to pharmacological treatments for improving sleep among individuals with MCI are needed. The present study reports on the feasibility of a non-pharmacological self-administered hypnosis intervention focused on sleep quality in adults with MCI. It was hypothesized that the hypnosis intervention program would be feasible and have acceptable levels of adherence to daily hypnosis practice. A two-armed randomized controlled pilot trial was conducted using a sample of 21 adults with MCI. Eligible participants were randomly assigned to listen to either hypnosis audio recordings or sham hypnosis recordings for five weeks. Program feasibility, program adherence, pain intensity, stress, and sleep quality were measured using a daily home practice log, questionnaires, and wrist actigraphy. The results found mid or higher levels of treatment satisfaction, ease of use, and perceived effectiveness at one-week follow-up, with participants in the hypnosis arm reporting greater perceived benefit. Adherence to assigned audio recordings and meetings were likewise within acceptable margins in both groups. No intervention-related adverse events were reported in either treatment condition. Significant improvements in sleep quality, sleep duration, and daytime sleepiness were found for the hypnosis intervention. The results of this study can be used to inform future research on the effects of hypnosis on sleep quality in adults with MCI.

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

ImportanceSleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified.ObjectiveTo examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs).Design, Setting, and ParticipantsThis cohort study used data from the Shanghai Children’s Health, Education and Lifestyle Evaluation–Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023.ExposuresSleep disturbances were assessed using the Children’s Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire.Main Outcomes and MeasuresOccurrence of incident and resolved EBDs at the 2-year follow-up.ResultsThe cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P &amp;amp;lt; .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P &amp;amp;lt; .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P &amp;amp;lt; .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P &amp;amp;lt; .001) were higher than among the group with no sleep disturbances.Conclusions and RelevanceIn this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

Longitudinal sleep, pain interference, and depressive symptoms in cognitively impaired older adults

AbstractBackgroundPoor sleep, pain, and depression are interrelated factors in older adulthood that may impair cognition. Few studies have examined associations among sleep, pain interference (i.e., how pain interferes with daily living), and depression with cognitive status. Therefore, we investigated these associations in verbally communicative older adults with and without cognitive impairment (CI). We hypothesized that individuals with CI will be more impacted by all variables in relation to the control group.MethodSleep (Neuro‐QoL Sleep), pain interference (Brief Pain Inventory‐Short Form), depression (15‐item Geriatric Depression Scale), and cognitive function (Telephone Interview for Cognitive Status) were investigated in older adults (ages ≥ 65) with CI (N = 16) compared to age‐ and sex‐matched controls (N = 28). Sleep, pain, and depression data were collected weekly over six weeks to allow for a detailed assessment of potential changes in symptoms. Data analyses were conducted in R using linear mixed effects models and conditional growth curve analysis.ResultAcross our sample, we found that more sleep disturbances were associated with more severe depression (p&lt;0.001), greater pain interference was associated with more severe depression (p&lt;0.001), and more sleep disturbances were associated with greater pain interference (p&lt;0.001). There was a significant interaction between cognitive status and sleep disturbances on depression (p = 0.0005), such that the CI group had a stronger positive relationship between sleep disturbances with depression severity. Similarly, there was a significant interaction between cognitive status and pain interference on depression (p&lt;0.001), such that the CI group had a stronger positive relationship between pain interference and depression severity.ConclusionThe findings demonstrate that the relationship among sleep, pain, and depression remain a concern in older adults with CI. As sleep worsened, depression tended to increase across both groups, yet in those with CI, this finding was stronger. Similarly, as pain interference worsened, depression tended to worsen in both groups, but this association was stronger in those with CI. Additional attention to the assessment, prevention, and treatment of sleep disturbance, pain, and depression in people living with and without CI is warranted, especially as individuals with CI may have difficulties communicating these problems.