Sleep Wake Research Articles

Evaluation of the Garmin Vivofit 4 for assessing sleep in youth experiencing sleep disturbances.

Wearable monitors are increasingly used to assess sleep. However, validity is unknown for certain monitors and populations. We tested the Garmin Vivofit 4 in a pediatric clinical sample. Participants (n = 25) wore the monitor on their nondominant wrist during an overnight polysomnogram. Garmin and polysomnography were compared using 95% equivalence testing, mean absolute error, and Bland-Altman analysis. On average (mean ± SD), the Garmin predicted later sleep onset (by 0.84 ± 1.60 hours) and earlier sleep offset (by 0.34 ± 0.70 hours) than polysomnography. The resulting difference for total sleep time was -0.55 ± 1.21 hours. Sleep onset latency was higher for Garmin than polysomnography (77.4 ± 100.9 and 22.8 ± 20.0 minutes, respectively), while wake after sleep onset was lower (5.2 ± 9.3 and 43.2 ± 37.9 minutes, respectively). Garmin sleep efficiency averaged 3.3% ± 13.8% lower than polysomnography. Minutes in light sleep and deep sleep (the latter including rapid eye movement) were within ±3.3% of polysomnography (both SDs = 14.9%). No Garmin means were significantly equivalent with polysomnography (adjusted p > 0.99). Mean absolute errors were 0.47 to 0.95 hours for time-based variables (sleep onset, offset, and latency, plus total sleep time and wake after sleep onset), and 8.9% to 21.2% for percentage-based variables (sleep efficiency and sleep staging). Bland-Altman analysis showed systematic bias for wake after sleep onset, but not other variables. The Vivofit 4 showed consistently poor individual-level validity, while group-level validity was better for some variables (total sleep time and sleep efficiency) than others.

The association between timing of dietary macronutrient and sodium consumption and sleep duration and quality.

The objective of this study was to examine the association between the timing of dietary macronutrients and sodium intake and sleep quantity and quality. This was a cross-sectional study that included 34 adults between 21 and 50 years of age. The main outcome measures were objective sleep measures assessed from three nights of wrist actigraphy including sleep duration, fragmentation, and wake after sleep onset (WASO), and one night of polysomnography (PSG), including rapid eye movement (REM) sleep, non-REM stage 2 (N2), stage 3 (N3), and WASO. Multiple linear regression models and linear mixed models were used to estimate the associations between sleep measures and dietary measures (carbohydrates, fats, saturated fats, proteins, and sodium). Dietary timing was examined in two ways: (1) the average amount of each nutrient consumed within 3 hours of sleep start, and (2) the interval between the final intake of each nutrient and sleep. Average fat intake within 3 hours of sleep was associated with greater WASO from PSG (β = 4.48, p = 0.01). No other associations were found between the macronutrients or sodium intake (p > 0.05) within 3 hours of sleep and the sleep parameters from PSG or actigraphy. Similarly, no associations were found between any of the PSG or actigraphy sleep measures and the interval between final nutrient intakes and sleep with sleep duration. The study suggests that greater fat but not carbohydrate, protein, saturated fat, or sodium intake close to sleep may be associated with greater sleep disruption; however, no other associations were observed.

Did Perceived Stress Influence Possible Sleep Bruxism and Awake Bruxism in Dentistry Students During COVID-19 Pandemic? A Web-Based Cross-Sectional Study

Did Perceived Stress Influence Possible Sleep Bruxism and Awake Bruxism in Dentistry Students During COVID-19 Pandemic? A Web-Based Cross-Sectional Study

ПСИХОЛОГИЧЕСКИЕ ОСОБЕННОСТИ АДАПТАЦИИ ОРГАНИЗМА ЗДОРОВОГО ЧЕЛОВЕКА К МОДЕЛИРУЕМЫМ ФАКТОРАМ КОСМИЧЕСКОГО ПОЛЕТА В ЭКСПЕРИМЕНТЕ С 21-СУТОЧНОЙ «СУХОЙ» ИММЕРСИЕЙ

The 21-d dry immersion study with participation of 8 male volunteers at the age of 25 to 33 years included investigations of the psychological aspects of adaptation to simulated spaceflight factors. Psychological testing 14 days prior to DI and on day 21 of the study was performed using the multilevel adaptivity inventory (А.G. Maklakova and S.V. Chermianina), the inventory of mental activity, interests, affective tone, strain and comfort (L.A. Kurgansky and Т.А. Nemchina), well-being in extreme conditions inventory (А. Volkova and N.E. Vodopianova) and situation-adaptable subjective vitality scale (R. Rayan and S. Frederick, apecialized by L.A. Aleksandrova). Participants in the study adapted successfully to the conditions as could be deduced from stability of their personal adaptation potential. At the end of the study the participants were noted to be more neurotic, demonstrated symptoms of autonomic regulation imbalance, disorders in the sleep wakefulness cycles, psychological discomfort and reduction of the energy potential. These changes witnessed to a moderate stress reaction to the DI conditions.

A descriptive study of sleep patterns and knowledge among department of juvenile services staff

Abstract Study Objectives Little is known about sleep health among staff in the US juvenile justice system. Poor sleep health is associated with negative mental and physical health, which may impact daily interactions and treatment of detained youth. The current study explored sleep–wake patterns and sleep health knowledge of Department of Juvenile Services (DJS) staff in Maryland (MD). Methods DJS Staff (N = 218) were invited to complete a survey that queried staff on their own sleep–wake patterns, job role and schedule, and knowledge of youth sleep needs. Descriptive analyses and multivariate analyses of variance (MANCOVA) were conducted to summarize workers’ sleep–wake patterns and examine differences by staff position and schedule. Results Fifty-one percent of staff served as RAs who directly supervise the youth. Just over half (55%) worked in detention and 45% in treatment facilities. Staff reported sleeping 7.24 hours (SD = 4.10) on workdays and 8.59 hours (SD = 2.69) on non-workdays. RA staff working night/rotating versus day shifts reported the most sleep irregularity with larger weekend oversleep times. A little more than half of the staff (53.9%) were knowledgeable regarding youth sleep health with differences by position type. Conclusions Findings show that DJS staff are meeting recommended sleep duration guidelines but are still experiencing sleep schedule and time in bed irregularity. Knowledge variability of youth sleep health across staff may necessitate focused educational programming. Overall, this study may inform future development and prioritization of sleep and circadian health interventions and educational campaigns for staff who work with detained juveniles. This paper is part of the Sleep and Circadian Health in the Justice System Collection.

Sleep Quality and its Predictors among Undergraduate Medical Students of a Teaching Institute in Telangana, South India: A Cross-sectional Study

Abstract Background: Medical students are vulnerable to sleep disturbances as they navigate life through academic stress, long on-call duties, emotional challenges, and exhaustion. Insufficient sleep negatively affects cognitive functions and fine motor skills, leading to deficiencies in attention, increased drowsiness while driving, propensity for risk-taking behavior, heightened risk of depression, impaired interpersonal relationships, and the potential to impact learning technical aspects of curriculum as well as delivering quality patient care. Objectives: The objective of this study was to measure the sleep quality and its determining factors among undergraduate medical students of a teaching institute in Telangana, South India. Methodology: A cross-sectional study was conducted among 401 undergraduate medical students. A semi-structured questionnaire including the sociodemographic details, medical history, and screen time, followed by the Pittsburgh Sleep Quality Index (PSQI) which assesses the time of quality sleep, frequency of troubled sleep, etc., over the last 1 month was used. The quality of sleep score of >5 indicates poor sleep quality. Results: The mean age was 20.41 years (standard deviation [SD] =2.08). Known comorbidities were present among 17 (4.2%), and 13 (3.2%) had psychiatric conditions. Poor sleep quality was present among 70% of medical undergraduates. The mean global PSQI score was 6.22 (SD = 2.9). The factors found significantly associated with poor sleep quality were academic stress (P = 0.009; odds ratio [OR] = 2.154 [CI = 1.250–3.713]), headache and self-medication (P = 0.008; OR = 1.868 [CI = 1.178–2.964]), and nighttime screen use (P < 0.001; OR = 18.12 [CI = 5.48–59.87]). Conclusion: Sleep deprivation and poor sleep quality is a major concern among medical undergraduates. It is important to have a proper sleep–wake routine and maintain good sleep hygiene. This includes reducing the use of screens before bedtime and addressing any underlying health conditions, including mental health issues, to improve sleep quality and overall well-being.

Attention should be paid to sleep disorders in critically ill patients and its recognition and intervention

The sleep deficiency and sleep disturbance of critically ill patients may result in adverse outcomes, negative effects on early rehabilitation, and may persist well beyond the intensive care unit (ICU). It has been paid more and more attention in clinical practice. The sleep problems of critically ill patients are associated with suffered critical illness, ICU environments, and coexisting sleep disorders before critical illness. Poor sleep quality, insufficient sleep duration, severe sleep fragmentation and irregular circadian rhythms during critical care illness have been extensively described. In addition, ICU patients have been specifically shown to experience atypical sleep and pathologic wakefulness. So the sleep in critical ill patients should be evaluated. Sleep can be evaluated by both subjective assessment and objective measurements, including polysomnography and actigraphy. According to individual situation, comprehensive, interdisciplinary, and personalized interventions, which include treating critical illness, improving ICU environment to reduce interference to sleep, nonpharmacological treatment to relax and stabilize sleep, and treating coexisting sleep disorders, should be taken to improve the patient's sleep and then to promote the early rehabilitation of critically ill patients.

Mechanism of Schisandra chinensis in Treatment of Insomnia by Sleep–Wake Cycle Based on Network Pharmacology

Background Schisandra chinensis (SC) is the dried fruit of SC of Magnoliaceae, which has been used to treat many diseases, such as asthma, cough, insomnia, spontaneous sweating, and so on, for more than 2000 years. Lignans are important active ingredients of SC for improving insomnia, but it is not clear the exact material basis and mechanism of action. Objectives This study aimed to discover the mechanism by which SC treats insomnia through network pharmacology. Materials and Methods It was used to study the chemical constituents of SC by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS). The SC–Insomnia network and the protein–protein interaction (PPI) network were set up using network pharmacology to research the mechanisms by which SC treats insomnia. The targets found in network pharmacology were proven by enzyme-linked immunosorbent assays (ELISA) and real-time polymerase chain reactions (RT-PCR). Results It identified 26 monomer compounds, all of which were lignans. From the SC–Insomnia and PPI networks, seven main active lignans were discovered, which could play an important part in treating insomnia, along with 11 targets that play an important part in the sleep−wake cycle. It was verified by the expression of GABA with ELISA and GABRA1 with RT-PCR. Conclusion Based on network pharmacology, the mechanism by which SC treats insomnia is through the sleep–wake cycle. It was a foundation to rationally apply SC for treating insomnia in the clinic.

Accelerometer-assessed sleep and decline in physical function in older men

Assess the prospective association of actigraphically measured sleep with self-report and objective measures of physical function among community-dwelling older men. Participants were (n=1496) men aged ≥65 years from the Osteoporotic Fractures in Men Studyand ancillary sleep study who were followed up at 4 years for physical function outcomes. Sleep predictors included baseline total sleep time (<6, 6-8hours [reference], >8hours), sleep efficiency (<80% or ≥80% [reference]), wake after sleep onset (<90 [reference] or ≥90minutes), and sleep onset latency (<30 [reference] or ≥30minutes), measured by wrist actigraphy. Outcomes included self-reported difficulties in mobility and instrumental activities of daily livingand objective measures of physical performance (time to complete chair stands, gait speed, grip strength, best narrow walk pace). Multivariable regression models estimated associations between the sleep predictors and change in physical function at follow-up, adjusting for demographic and health-related variables. Participants with short average baseline total sleep time (<6hours) had significantly greater slowing in their walking speed from baseline to follow-up. Participants with long baseline sleep onset latency (≥30minutes) had significant increases in mobility difficulties and time to complete chair stands. Sleep efficiency and wake after sleep onset were not significantly associated with any outcomes. No sleep predictors were associated with change in instrumental activities of daily living. These findings add to the body of evidence showing links between poor sleep and subsequent declines in physical function. Further experimental research is needed to understand the mechanisms at play.

ASSOCIATIONS OF NIGHT AND DAY SLEEP WITH COGNITIVE PERFORMANCE IN SHIFT WORKERS: PRELIMINARY RESULTS

Abstract Emerging evidence suggests that night shift workers are at higher risk of severe cognitive impairment, mainly because of the repeated disruption of the sleep–wake schedule and the resulting poor sleep (e.g., less deep sleep or shorter sleep time). However, questions remain about how daytime and nighttime sleep characteristics correlate with cognitive performance in shift workers. The purpose of this study is to examine the association of objective sleep quality, measured on workdays and days off, with cognitive performance, determined by the psychomotor vigilance task (PVT), in shift workers compared to day workers. We included eight night shift and ten day shift workers from an ongoing pilot study in this analysis. Participants undergo multiple home sleep studies with electroencephalograms on their workdays or days off. Sleep quality measures include total sleep time (TST), percentage of deep sleep stage in TST, and wake time after sleep onset (WASO). Night shift workers showed longer TST and shorter WASO during their nighttime sleep on days off compared to day shift workers. In night shift workers, longer deep sleep on days off was significantly correlated with faster mean reaction time to a visual stimulus (better cognitive performance) on the PVT (r = -.944, p = .016), after controlling for age. However, longer deep sleep during their daytime sleep was associated with slower reaction time (r = .756, p = .049). Further studies are necessary to elucidate differential impacts of daytime and nighttime sleep on the risk of future cognitive impairment in night shift workers.

Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment

ObjectivesWhile the association between insomnia and traumatic brain injury (TBI) is well established, TBI rehabilitation programs that focus on sleep as a primary target are limited. Cognitive behavioral therapy for insomnia (CBTi) is an effective treatment for insomnia, however; its use within TBI clinics is relatively unknown. Therefore, our aim was to evaluate the implementation of CBTi, used in conjunction with a smartphone app for insomnia, within a US military TBI program to improve care within this setting.SettingA TBI clinic at a US military installation.MethodsMHS beneficiaries underwent 6 sessions of CBTi and a 1-month post-treatment follow up session. Data was collected at each treatment session as part of routine clinical care.ResultsA total of 69 US MHS beneficiaries seen at a TBI clinic with a diagnosis of insomnia began CBTi. Attrition rate at the end of the CBTi program and 1-month posttreatment session was 35% and 48%, respectively. Results demonstrated that sleep onset latency (SOL) and wake after sleep onset (WASO) decreased during treatment (p's &amp;lt; 0.001). Further, symptoms reported on the Insomnia Severity Index (ISI) improved during CBTi (p &amp;lt; 0.001).ConclusionFindings demonstrate how CBTi used in conjunction with a CBTi smartphone application can be used to effectively treat insomnia for MHS beneficiaries seeking care for TBIs. This evaluation provides the basis for further research on how CBTi may improve care within TBI programs.

Sleep and rest-activity rhythms for women at different menopausal statuses: the role of mental health.

To examine how mental health interplays with menopausal status in relation to sleep patterns and rest-activity rhythms (RARs) among middle-aged women. This cross-sectional study recruited 87 women aged 45 to 60 years from community and a gynecology clinic in Taiwan. Participants wore actigraphy devices for 7 days and were also assessed with self-reported questionnaires. Hierarchical regression was used to examine the effects of menopausal status and mental health on sleep and RARs. Perimenopausal and postmenopausal women had higher relative amplitude and interdaily stability of RARs than premenopausal women. There were no differences in actigraphy-based sleep parameters across menopausal statuses. There was no difference in depressive symptoms or loneliness across menopausal statuses. Higher levels of depressive symptoms were significantly associated with longer sleep latency ( β = 0.26, P = 0.022) and wake after sleep onset ( β = 0.28, P = 0.012), and lower sleep efficiency ( β = -0.30, P = 0.008) after adjusting for menopausal status and age. In addition, there was marginal significance of the positive association between loneliness and interdaily stability ( β = 0.18, P = 0.079). A moderating effect ( βmenopausal status*loneliness = -0.40, P = 0.025) showed that lonelier premenopausal women exhibited greater relative amplitude (RA) of rest-activity rhythms, but lonelier menopausal women had lower RA of RAR. Mental health plays an important role for middle-aged women with different menopausal statuses in relation to sleep patterns and RARs.

Role of the autonomic nervous system in young, middle-aged, and older individuals with essential hypertension and sleep-related changes in neurocardiac regulation

Essential hypertension involves complex cardiovascular regulation. The autonomic nervous system function fluctuates throughout the sleep–wake cycle and changes with advancing age. However, the precise role of the autonomic nervous system in the development of hypertension during aging remains unclear. In this study, we characterized autonomic function during the sleep–wake cycle in different age groups with essential hypertension. This study included 97 men (53 with and 44 without hypertension) aged 30–79 years. They were stratified by age into young (< 40 years), middle-aged (40–59 years), and older (60–79 years) groups. Polysomnography and blood pressure data were recorded for 2 min before and during an hour-long nap. Autonomic function was assessed by measuring heart rate variability and blood pressure variability. Data were analyzed using t tests, correlation analyses, and two-way analysis of variance. During nonrapid eye movement (nREM), a main effect of age was observed on cardiac parasympathetic measures and baroreflex sensitivity (BRS), with the highest and lowest levels noted in the younger and older groups, respectively. The coefficients of the correlations between these measures and age were lower in patients with hypertension than in normotensive controls. The BRS of young patients with hypertension was similar to that of their middle-aged and older counterparts. However, cardiac sympathetic activity was significantly higher (p = 0.023) and BRS was significantly lower (p = 0.022) in the hypertension group than in the control group. During wakefulness, the results were similar although some of the above findings were absent. Autonomic imbalance, particularly impaired baroreflex, plays a more significant role in younger patients with hypertension. The nREM stage may be suitable for gaining insights into the relevant mechanisms.

Effects of a family judo program on sleep quality in youth with Autism Spectrum Disorder

ObjectiveThe purpose of this study was to examine the effects of a family-based judo program on sleep quality in youth diagnosed with Autism Spectrum Disorder (ASD). Methods: Eighteen youth (13.17 years ± 3.76, 78% male) diagnosed with ASD participated in a 14-week family judo program. Sleep quality was assessed using the Actigraph GT9X accelerometer pre- and post-judo intervention. Non-parametric paired t-tests were conducted to examine changes in sleep quality variables. Results: There was a significant increase in sleep efficiency (p = .05), and a significant decrease in both sleep latency (p = .001) and wake after sleep onset (p = .02) following participation in the judo program. There were no changes in sleep duration observed in this sample (p = .83). Conclusion: Participation in a family judo program may improve sleep quality in youth with ASD. More research is necessary to understand the mechanisms by which judo may improve sleep quality in youth with ASD.

Circadian rhythms in older adults are associated with sleep quality, cognitive function, and ß‐amyloid burden: an accelerometry analysis of the Lifestyle Enriching Activities for Research in Neuroscience Intervention Trial ‐ LEARNit

AbstractBackgroundSeveral studies demonstrate circadian rhythm disturbances in patients with Alzheimer’s disease. However, less is known about circadian rhythms in older adults with early mild cognitive impairment. Wrist‐worn accelerometers provide continuous, objective, high resolution quantification of 24‐hour rest activity rhythms. This study examines the relationship between circadian rhythms and sleep, cognition, and ß‐amyloid (Aß) burden.MethodThis study examines baseline data from the “Lifestyle Enriching Activities for Research in Neuroscience Intervention Trial” (LEARNit). Sixty‐six older adults ages 55‐80 experiencing early cognitive changes wore a GENEActiv accelerometer for approximately 30 consecutive days. Accelerometer data was analyzed using the R package GGIR (version 2.8‐1), and circadian rhythm measures were extracted using the GGIR secondary package ActCR (version 0.3.0). Circadian rhythm variables include intradaily variability (fragmentation), interdaily stability (rhythm synchronization to light‐dark cycle), acrotime (peak activity time), and Midline Estimated Statistics of Rhythm or MESOR (mean activity level). Up‐MESOR and Down‐MESOR represent the timing of activity increasing above or decreasing below MESOR, respectively—lower values of each indicate a phase advance (shift towards morning), whereas higher values indicate a phase delay (shift towards evening). Sleep was assessed as mean sleep efficiency and Wake After Sleep Onset, or WASO (accumulated wakefulness after sleep onset). Cognitive tests include the Montreal Cognitive Assessment (MoCA) for global cognition and attention/processing speed (Digit Symbol Task). Aß burden was measured by positron emission tomography standard uptake value ratio for fifty‐six participants. Age‐adjusted linear regression models were used to test associations between circadian rhythms and sleep, cognition, and Aß.ResultParticipant characteristics are summarized in Table 1 and results are summarized in Figure 1. Intradaily variability (b = ‐0.095, p = 0.03) and interdaily stability (b = 0.34, p = 0.01) were both associated with mean sleep efficiency. Intradaily variability (b = 1.41, p&lt;0.001) and interdaily stability (b = ‐4.45, p&lt;0.001) were associated with WASO. Up‐MESOR was associated with MoCA total score (b = ‐0.41, p = 0.03). Up‐MESOR (b = ‐2.12, p = 0.006), Down‐MESOR (b = ‐1.99, p = 0.02), and acrotime (b = ‐4.20, p&lt;0.001) were associated with Digit Symbol score. Down‐MESOR was significantly associated with Aß (b = ‐0.029, p = 0.02).ConclusionCircadian rhythm robustness is positively associated with better sleep quality. Participants with dynamic circadian rhythm phases demonstrated poorer cognition and higher Aß burden.

Sleep health and subjective cognitive decline in the Vanderbilt Memory and Aging Project

AbstractBackgroundIdentifying modifiable risk factors for Alzheimer’s disease (AD) and related dementias (ADRD) may reveal critical evidence for early prevention. It is commonly believed that poor sleep is an early symptom of neurodegeneration and ADRD. However, distinct neurobiological processes occur during sleep, and dysfunction of these processes may also contribute to AD pathogenesis. Less is known about poor sleep and associations with subjective cognitive decline (SCD), a clinical symptom occurring before overt cognitive impairment due to early pathological AD. This study investigated associations between objective and self‐reported measures of sleep health and SCD in a community‐based cohort of older adults.MethodParticipants from the Vanderbilt Memory and Aging Project (n = 220; 74±7 years; 34% female) completed 7‐days of wrist actigraphy and self‐report measures for SCD [Everyday Cognition Scale (ECog)] and sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Actigraphy data was processed to estimate average nightly sleep duration, sleep efficiency, and wake after sleep onset. Linear regressions related objective and self‐report sleep health measures with total ECog score adjusting for age, sex, race/ethnicity, education, body mass index, depressive symptoms, Framingham cardiovascular risk score, and apolipoprotein E‐e4 carrier status.ResultIn main effect models, longer sleep duration was associated with greater SCD (b = 0.05, p&lt;0.01). In models adjusted for age, sex, race/ethnicity, and education, higher PSQI (indicative of poorer sleep quality) was associated with greater SCD (b = 1.06, p = 0.01); however, the association was no longer statistically significant in the fully adjusted model. No associations were observed between sleep efficiency or wake after sleep onset and SCD.ConclusionIn this community cohort of older adults, longer nightly sleep duration and self‐reported poor sleep quality were linked with higher SCD. Findings could suggest that abnormal sleep duration and poor sleep quality increase the earliest clinical symptoms of AD. Further investigations are needed to evaluate the potential pathways connecting sleep health to ADRD development.

Role of New Drug Delivery System in Brain Disorder: Narcolepsy

Narcolepsy is a chronic neurological disorder that involves a decreased ability to regulate sleep wake cycles. In this review authors highlighted various types of narcolepsy, the most common symptoms of the narcolepsy, symptoms of the narcolepsy in children, various causes of narcolepsy, how it effects, how common is narcolepsy, stages of narcolepsy, diagnosis of narcolepsy, its treatment and cure, complications associated with its treatment. The brain is shielded with blood brain barrier system and the methods that can enhance drug delivery to the brain are of great interest in treatment of various brain related problems. Novel drug delivery specially targeted drug delivery is a method by which localizing and maximizing drugs at their desired site of action to reduce toxicity and increase treatment efficiency. This review intends to detail new drug delivery system over conventional drug delivery system, brain targeted drug delivery, challenges faced while making targeted drug delivery system for brain, various strategies and advances in targeted drug delivery for the treatment of narcolepsy.

Pharmacological Treatments of Sleep–Wake Disorders: Update 2023

Biological, environmental, behavioral, and social factors can influence sleep and lead to sleep disorders or diseases. Sleep disorders are common, numerous, and heterogeneous in terms of their etiology, pathogenesis, and symptomatology. The management of sleep–wake circadian disorders (SWCDs) includes education on sleep hygiene, behavioral strategies, psychotherapy (cognitive behavioral therapy (CBT), particularly), instrument-based treatments (i.e., positive airway pressure therapy, hypoglossal nerve stimulation), and pharmacotherapy. Depending on the disease, therapy varies and is executed sequentially or can be a combination of several forms of therapy. Drugs used for SWCDs include traditional sleep- or wake-promoting agents and chronotherapeutic agents. Recently, novel medications, which more precisely act on specific neurochemical systems (i.e., the orexin system) important for sleep and waking, are also increasingly being used. In this review, the pharmacotherapy of common sleep disorders (insomnia, sleep-related breathing disorder, central disorders of hypersomnolence, circadian rhythm sleep–wake disorders, parasomnias, and sleep-related movement disorders) embedded in the overall therapeutic concept of each disorder is presented. There is also an outlook on possible future pharmacotherapies.

Association between sleep quality and nocturnal erection monitor by RigiScan in erectile dysfunction patients: a prospective study using fitbit charge 2

Background Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality and nocturnal erection monitor when conducting nocturnal erection monitor. All erectile dysfunction (ED) patients underwent sleep monitors using Fitbit Charge 2™ (Fitbit Inc.) and nocturnal penile tumescence and rigidity (NPTR) monitors using RigiScan® (GOTOP medical, Inc., USA) for two nights. Subsequently, the patients were divided into two groups: Group A included patients who experienced effective erections only on the second night, while Group B included patients who had effective erections on both nights. To explore the associations between NPTR parameters and sleep parameters, a comparative analysis was performed between Group A and Group B for both nights.ResultsFinally, our study included 103 participants, with 47 patients in Group A and 56 patients in Group B. Notably, the Group A patients showed significant improvements in NPTR parameters on the second night compared to the first night. Conversely, the NPTR parameters on Group B of the second night did not demonstrate a superior outcome when compared to the second night of Group A. Interestingly, it was found that only the disparities in sleep parameters accounted for the variation in NPTR parameters between the two groups on the first night. After correlation and ROC analysis, we identified the rapid eye movement (REM) sleep time and wake after sleep onset (WASO) time monitoring by the Fitbit Charge 2 as the primary parameters for predicting abnormal NPTR results in the first night.ConclusionsTherefore, our study strongly suggests a close association between sleep parameters and NPTR parameters. It emphasizes the importance of incorporating sleep monitoring alongside nocturnal erection monitoring to enhance the reliability of the NPTR results.

In vivo marker of brainstem myelin is associated to quantitative sleep parameters in healthy young men

The regional integrity of brain subcortical structures has been implicated in sleep–wake regulation, however, their associations with sleep parameters remain largely unexplored. Here, we assessed association between quantitative Magnetic Resonance Imaging (qMRI)-derived marker of the myelin content of the brainstem and the variability in the sleep electrophysiology in a large sample of 18-to-31 years healthy young men (N = 321; ~ 22 years). Separate Generalized Additive Model for Location, Scale and Shape (GAMLSS) revealed that sleep onset latency and slow wave energy were significantly associated with MTsat estimates in the brainstem (pcorrected ≤ 0.03), with overall higher MTsat value associated with values reflecting better sleep quality. The association changed with age, however (MTsat-by-age interaction—pcorrected ≤ 0.03), with higher MTsat value linked to better values in the two sleep metrics in the younger individuals of our sample aged ~ 18 to 20 years. Similar associations were detected across different parts of the brainstem (pcorrected ≤ 0.03), suggesting that the overall maturation and integrity of the brainstem was associated with both sleep metrics. Our results suggest that myelination of the brainstem nuclei essential to regulation of sleep is associated with inter-individual differences in sleep characteristics during early adulthood. They may have implications for sleep disorders or neurological diseases related to myelin.