Relação entre apoio social e sono de pessoas idosas cuidadoras em vulnerabilidade social / Relationship between social support and sleep of elderly caregivers in social vulnerability / Relación entre apoyo social y sueño de adultos mayores cuidadores con vulnerabilidad social

Objetivo: analisar a relação entre apoio social e qualidade do sono de pessoas idosas que cuidam de outros idosos em ambiente de vulnerabilidade social. Método: estudo transversal realizado com 65 cuidadores entrevistados por meio de instrumento de caracterização, Índice de Katz, Escala de Lawton e Brody, Índice de Qualidade do Sono de Pittsburgh e Escala de Apoio Social do Medical Outcomes Study, com dados analisados com testes de comparação e de correlação. Resultados: a maioria eram mulheres, cônjuges do idoso cuidado e possuíam sono de má qualidade. Observou-se correlação fraca e inversa entre má qualidade do sono e a dimensão interação social positiva (Rho=-0,27; p=0,028). Identificou-se relação significativa entre: apoio material e disfunção diurna (p=0,034); apoio afetivo e eficiência do sono (p=0,026); interação social positiva e qualidade subjetiva do sono (p=0,001) e disfunção diurna (p=0,008). Conclusão: Quanto maior a interação social positiva, melhor é a qualidade do sono.

Objective: to analyze the relationship between social support and sleep quality of elderly individuals who care for other elderly individuals in a socially vulnerable environment. Method: a cross-sectional study conducted with 65 caregivers interviewed using a characterization instrument, Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, and Medical Outcomes Study Social Support Scale, with data analyzed using comparison and correlation tests. Results: the majority were women, spouses of the elderly being cared for, and had poor sleep quality. A weak and inverse correlation was observed between poor sleep quality and the positive social interaction dimension (Rho=-0.27; p=0.028). Significant relationships were identified between: material support and daytime dysfunction (p=0.034); emotional support and sleep efficiency (p=0.026); positive social interaction and subjective sleep quality (p=0.001), as well as daytime dysfunction (p=0.008). Conclusion: The higher the positive social interaction, the better the sleep quality.

Objetivo: analizar la relación entre el apoyo social y la calidad del sueño de personas mayores que cuidan de otras personas mayores en entornos socialmente vulnerables. Método: estudio transversal realizado con 65 cuidadores entrevistados mediante un instrumento de caracterización, Índice de Katz, Escala de Lawton y Brody, Índice de Calidad del Sueño de Pittsburgh y Escala de Apoyo Social del Medical Outcomes Study, los datos fueron analizados mediante pruebas de comparación y correlación. Resultados: la mayoría eran mujeres, cónyuges del adulto mayor que recibe el cuidado y tenían mala calidad del sueño. Se observó una correlación débil e inversa entre la mala calidad del sueño y la dimensión de interacción social positiva (Rho=-0,27; p=0,028). Se identificó que había relación significativa entre: apoyo material y disfunción diurna (p=0,034); apoyo afectivo y eficiencia del sueño (p=0,026); interacción social positiva y calidad subjetiva del sueño (p=0,001) y disfunción diurna (p=0,008). Conclusión: Cuanto mayor sea la interacción social positiva, mejor será la calidad del sueño.

The latest on positive airway pressure for pediatric obstructive sleep apnea.

INTRODUCTION: Obstructive sleep apnea (OSA) is an important and evolving area in the pediatric population, with significant sequelae when not adequately managed. The use of positive airway pressure (PAP) therapy is expanding rapidly and is being prescribed to patients with persistent OSA post adenotonsillectomy as well as those children who are not surgical candidates including those with medical complexity. AREAS DISCUSSED: This article provides a state-of-the-art review on the diagnosis of pediatric OSA and treatment with positive airway pressure (PAP). The initiation of PAP therapy, pediatric interface considerations, PAP mode selection, administration and potential complications of PAP therapy, factors influencing PAP adherence, the use of remote ventilation machine downloads, considerations surrounding follow-up of patients post PAP initiation and evaluation of weaning off PAP will be reviewed. The literature search was conducted via PubMed, Cochrane Library and Google Scholar databases through to March 2024. EXPERT OPINION: Further research is required to address barriers to adherence. Further innovation of home monitoring devices for both the diagnosis and assessment of OSA is required, given the limited pediatric sleep medicine resources in several countries worldwide.

Factors leading to excessive fatigue in nurses - a three-year follow-up study.

BACKGROUND: Global nursing shortages necessitate the identification of mitigatable factors that may reduce nursing absence and turnover. Fatigue has been shown to be associated with these issues. This study aimed to identify factors leading to development of or recovery from excessive fatigue in nurses as these can offer actionable avenues for protecting nurses against fatigue or supporting fatigue recovery. METHODS: A longitudinal study among nurses randomly sampled from the Norwegian Nurse's Organization. The Chalder Fatigue Questionnaire measured fatigue. Dichotomized scoring was used, with scores ≥ 4 considered excessive fatigue. The study included questions on shift work schedules, psychosocial work characteristics, sleep, body mass index, physical activity, caffeine, alcohol, mental health, etc. Two sets of logistic regression analysis were conducted (one for development of and one for recovery from excessive fatigue), evaluating how changes in work, lifestyle and health between baseline (2015) and follow-up (2018) affected first, odds of development of excessive fatigue and second, odds of recovery from excessive fatigue. RESULTS: Among 1,311 included nurses, 21.6% maintained, 13.3% developed, and 18.0% recovered from excessive fatigue (2015-2018). Within work characteristics, increased psychological work demands were associated with development of excessive fatigue OR = 1.77 (CI = 1.11-2.82). Several work characteristics were associated with recovery from excessive fatigue, including decreased decision latitude (OR = 0.39; CI = 0.19-0.82) and increased coworker support (OR = 1.90; CI = 1.11-3.24). Shift work variables were not associated with fatigue outcomes. Amongst lifestyle factors, changes in sleep duration, obesity, and exercise were significant. Notably, developing inappropriate sleep duration (OR = 2.84; CI = 1.47-5.48) increased odds of developing excessive fatigue, while maintaining inappropriate sleep duration (< 6 h or > 8 h) (OR = 0.19; CI = 0.54-0.65) decreased odds of recovering. All assessed health conditions (depression, anxiety, insomnia, and shift work disorder) were related to development of (ORs 2.10-8.07) or recovery from (ORs 0.10-0.50) excessive fatigue. Depression, for example, increased odds of development of (OR = 8.07; CI = 2.35-27.66) and decreased odds of recovery (OR = 0.10; CI = 0.04-0.26) from excessive fatigue. CONCLUSIONS: Changes in lifestyle factors, health conditions, and psychosocial work factors were associated with development of and recovery from excessive fatigue. Sleep and psychosocial work factors played important roles. We found no relationship with shift work schedules.

The Effect of Sleep Duration on Hypertension Risk in an Adult Asian Population: A Systematic Review and Meta-Analysis.

Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear. This meta-analysis aims to elucidate the impact of short sleep duration on hypertension risk within the adult Asian population. A systematic search of databases, including PubMed, Scopus, and ScienceDirect, was conducted to identify relevant studies published up to January 4, 2024. Eligible studies comprised observational cohort studies and cross-sectional studies that compared short sleep duration to normal sleep duration in relation to hypertension risk among Asian adults. The definitions for short and normal sleep durations were derived from the respective studies. The random effects model was utilized to pool effect estimates, and all statistical analyses were conducted using Review Manager 5.4 software (RevMan) (Cochrane Collaboration, Oxford, UK). Results from a systematic search obtained seven studies assessing sleep duration and hypertension risk in Asian populations. Based on a meta-analysis of six studies, short sleep duration is associated with a higher hypertension risk when compared to normal sleep duration (OR: 1.36; 95% CI: 1.13-1.64; p: 0.0010; I2: 75%). Subgroup analysis based on sex showed that the association is evident across males (OR: 1.12; 95% CI: 1.01-1.25; p: 0.03; I2: 64%) and females (OR: 1.22; 95% CI: 1.10-1.35; p: 0.0003; I2: 82%). In conclusion, based on the analyzed studies, short sleep duration is associated with a higher mild risk of hypertension, irrespective of sex. Thus, short sleep duration can be a modifiable risk factor that can be prevented to reduce the risk of hypertension. By incorporating sleep hygiene practices and promoting healthy sleep habits, significant improvement in cardiovascular health can be made, especially in hypertension risk at a population level. Further studies on the effect of sleep duration in different age populations should be conducted to confirm the impact of short sleep duration.

Commercial Chinese polyherbal preparation Zao Ren An Shen prescription for primary insomnia: a systematic review with meta-analysis and trial sequential analysis.

Background: Natural products are widely used for primary insomnia (PI). This systematic review with trial sequential analysis (TSA) aimed to summarize evidence pertaining to the effectiveness and safety of Zao Ren An Shen (ZRAS) prescription, a commercial Chinese polyherbal preparation, for treating PI. Methods: Controlled clinical trials appraising ZRAS compared to controls or as an add-on treatment were systematically searched across seven databases until January 2024. Cochrane ROB 2.0 and ROBINS-I tools were adopted to determine risk of bias. Quality of evidence was assessed using the GRADE framework. Results: We analyzed 22 studies, involving 2,142 participants. The effect of ZRAS in reducing Pittsburgh Sleep Quality Index scores was found to be comparable to benzodiazepines [MD = 0.39, 95%CI (-0.12, 0.91), p = 0.13] and superior to Z-drugs [MD = -1.31, 95%CI (-2.37, -0.24), p = 0.02]. The addition of ZRAS to hypnotics more significantly reduced polysomnographically-recorded sleep onset latency [MD = -4.44 min, 95%CI (-7.98, -0.91), p = 0.01] and number of awakenings [MD = -0.89 times, 95%CI (-1.67, -0.10), p = 0.03], and increased total sleep time [MD = 40.72 min, 95%CI (25.14, 56.30), p < 0.01], with fewer adverse events than hypnotics alone. TSA validated the robustness of these quantitative synthesis results. However, the quality of evidence ranged from very low to low. The limited data available for follow-up did not support meta-synthesis. Conclusion: While ZRAS prescription shows promising effectiveness in treating PI, the overall quality of evidence is limited. Rigorously-designed randomized control trials are warranted to confirm the short-term efficacy of ZRAS and explore its medium-to-long-term efficacy. Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471497), identifier (CRD42023471497).

Dysrhythmic saliva microbiota in mobile phone addicts with sleep disorders and restored by acupuncture.

Background: Mobile phone addiction (MPA) greatly affects the biological clock and sleep quality and is emerging as a behavioral disorder. The saliva microbiota has been linked to circadian rhythms, and our previous research revealed dysrhythmic saliva metabolites in MPA subjects with sleep disorders (MPASD). In addition, acupuncture had positive effects. However, the dysbiotic saliva microbiota in MPASD patients and the restorative effects of acupuncture are unclear. Objectives: To probe the circadian dysrhythmic characteristics of the saliva microbiota and acupunctural restoration in MPASD patients. Methods: MPASD patients and healthy volunteers were recruited by the Mobile Phone Addiction Tendency Scale (MPATS) and the Pittsburgh Sleep Quality Index (PSQI). Saliva samples were collected every 4 h for 72 h. After saliva sampling, six MPDSD subjects (group M) were acupuncturally treated (group T), and subsequent saliva sampling was conducted posttreatment. Finally, all the samples were subjected to 16S rRNA gene sequencing and bioinformatic analysis. Results: Significantly increased MPATS and PSQI scores were observed in MPDSD patients (p< 0.01), but these scores decreased (p<0.001) after acupuncture intervention. Compared with those in healthy controls, the diversity and structure of the saliva microbiota in MPASD patients were markedly disrupted. Six genera with circadian rhythms were detected in all groups, including Sulfurovum, Peptostreptococcus, Porphyromonas and Prevotella. There were five genera with circadian rhythmicity in healthy people, of which the rhythmicities of the genera Rothia and Lautropia disappeared in MPASD patients but effectively resumed after acupuncture intervention. Conclusions: This work revealed dysrhythmic salivary microbes in MPASD patients, and acupuncture, as a potential intervention, could be effective in mitigating this ever-rising behavioral epidemic.

Cognitive Behavioural Therapy for insomnia decreases the discrepancy between objective and subjective measures of sleep.

INTRODUCTION: Individuals with insomnia disorder often exhibit differences between reported experiences of sleep and objectively measured sleep parameters; however, the implications of this subjective-objective sleep discrepancy during treatment remains unclear. OBJECTIVE: The aim of this study was to investigate the impact of cognitive behavioural therapy for insomnia (CBT-I) on the discrepancy between objective and subjective measures of sleep, and to assess whether changes in clinical variables such as depression, anxiety, fatigue, and beliefs about sleep, were related to changes in discrepancy. METHODS: Twenty-five participants with insomnia disorder were enrolled in group CBT-I. Sleep measures were continually sampled from baseline until 2 weeks post-treatment with both objective (i.e., actigraphy) and subjective (i.e., sleep diary) methods. RESULTS: The subjective-objective discrepancy significantly decreased from baseline early on in treatment (following the second session) and were maintained at post-treatment for sleep onset latency, wake after sleep onset (WASO) and sleep efficiency (SE). Total sleep time (TST) discrepancy and misperception decreased from baseline to post-treatment. Improvement in depression symptoms, fatigue symptoms, and negative beliefs about sleep were significantly correlated with the decrease in the discrepancy for WASO and SE. CONCLUSION: These findings suggest that CBT-I resolves the mismatch between objective and subjective sleep parameters early in treatment for adults with insomnia. Sleep misperception improved from underestimating to accurately estimating TST. Improvement of psychological symptoms were related to decrease in sleep discrepancies across treatment. Future research is needed to explore how feedback on objective and subjective sleep discrepancy may impact sleep perception across treatment with CBT-I.

Predicting long-term sleep deprivation using wearable sensors and health surveys.

Sufficient sleep is essential for individual well-being. Inadequate sleep has been shown to have significant negative impacts on our attention, cognition, and mood. The measurement of sleep from in-bed physiological signals has progressed to where commercial devices already incorporate this functionality. However, the prediction of sleep duration from previous awake activity is less studied. Previous studies have used daily exercise summaries, actigraph data, and pedometer data to predict sleep during individual nights. Building upon these, this article demonstrates how to predict a person's long-term average sleep length over the course of 30 days from Fitbit-recorded physical activity data alongside self-report surveys. Recursive Feature Elimination with Random Forest (RFE-RF) is used to extract the feature sets used by the machine learning models, and sex differences in the feature sets and performances of different machine learning models are then examined. The feature selection process demonstrates that previous sleep patterns and physical exercise are the most relevant kind of features for predicting sleep. Personality and depression metrics were also found to be relevant. When attempting to classify individuals as being long-term sleep-deprived, good performance was achieved across both the male, female, and combined data sets, with the highest-performing model achieving an AUC of 0.9762. The best-performing regression model for predicting the average nightly sleep time achieved an R-squared of 0.6861, with other models achieving similar results. When attempting to predict if a person who previously was obtaining sufficient sleep would become sleep-deprived, the best-performing model obtained an AUC of 0.9448.

Acute sleep deprivation (ASD) and cardioprotection: Impact of ASD on oxytocin-mediated sympathetic nervous activation preceding myocardial infarction.

INTRODUCTION: This study explored how acute sleep deprivation (ASD) before myocardial ischemia influences oxytocin release from paraventricular (PVN) neurons and its correlation with sympathetic nervous system (SNS) activity post-acute sleep loss, impacting subsequent left ventricular (LV) remodeling following myocardial infarction (MI). METHODS: The study was conducted in two phases: induction of ASD, inducing MI, blood sampling, euthanizing animals and collecting their heart and brain for histological and gene expression evaluations. The animals in first and second phase were euthanized 24 h and 14 days after MI, respectively. RESULTS: Pre-MI ASD, accompanied by increased serum epinephrine levels within 24 h of MI, upregulated oxytocin and cFos expression in the PVN. Also, pre-MI ASD resulted in decreased serum PAB levels 14 days post-MI (P < 0.001). While notable echocardiographic changes were seen in MI versus sham groups, ASD demonstrated protective effects. This was evidenced by reduced infarct size, elevated TIMP1, MMP2, and MMP9 in the LV of SD + MI animals versus MI alone (P < 0.05). Additionally, histological analysis showed reduced LV fibrosis in pre-MI ASD subjects (P < 0.05). CONCLUSION: Our study supports the notion that activation of oxytocin neurons within the PVN subsequent to ASD interacts with autonomic centers in the central nervous system. This enhanced sympathetic outflow to the heart prior to MI triggers a preconditioning response, thereby mediating cardioprotection through decreased oxidative stress biomarkers and regulated extracellular matrix (ECM) turnover.

Sleep quality in eating disorders: A systematic review and meta-analysis.

Eating disorders (ED) are psychological disorders characterized by dangerous eating behaviours, including protracted fasting and binge eating. Mental disorders comorbidities (e.g., anxiety and depression), as well as sleep difficulties, are common and might interfere with treatment response. This work investigated sleep quality, circadian preferences, and sleep disorders in ED patients compared to healthy controls (HC) and the impact of ED treatment on patients' sleep. A literature search on Pubmed, Web of Science, Medline, and PsychInfo included 27 studies. Random effect analyses were performed (sample eating disorders = 711; sample healthy controls = 653) and subgroup analyses were calculated based on the ED subgroups: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder. Whole sample analyses showed poorer physiological and subjective sleep quality in patients. Subgroup analyses showed that poorer physiological sleep was present only in anorexia nervosa. Two studies reporting circadian preferences and sleep disorders showed higher evening preference in patients and no differences in apnea prevalence between patients and healthy controls, respectively. Some studies suggested that specialized eating disorder treatments (e.g., Cognitive Behavioural Therapy for ED) can improve sleep quality in patients. Although these findings highlight poorer sleep in patients with ED compared to healthy controls, the mechanisms underlying sleep alterations in eating disorders remain to be identified.

High bioavailable testosterone levels increase the incidence of isolated REM sleep behavior disorder: Results from multivariable and network Mendelian randomization analysis.

OBJECTIVES: To explore the causal relationships between sex hormone levels and incidence of isolated REM sleep behavior disorder (iRBD). METHODS: In our study, we utilized Genome-Wide Association Studies (GWAS) data for iRBD, including 9447 samples with 1061 cases of iRBD provided by the International RBD Study Group. Initially, we conducted a two-sample univariate MR analysis to explore the impact of sex hormone-related indicators on iRBD. This was followed by the application of multivariable MR methods to adjust for other hormone levels and potential confounders. Finally, we undertook a network MR analysis, employing brain structure Magnetic Resonance Imaging (MRI) characteristics as potential mediators, to examine whether sex hormones could indirectly influence the incidence of iRBD by affecting brain structure. RESULTS: Bioavailable testosterone (BioT) is an independent risk factor for iRBD (Odds Ratio [95 % Confidence Interval] = 2.437 [1.308, 4.539], P = 0.005, corrected-P = 0.020), a finding that remained consistent even after adjusting for other sex hormone levels and potential confounders. Additionally, BioT appears to indirectly increase the risk of iRBD by reducing axial diffusivity and increasing the orientation dispersion index in the left cingulum and cingulate gyrus. CONCLUSIONS: Our research reveals that elevated levels of BioT contribute to the development of iRBD. However, the specific impact of BioT on different sexes remains unclear. Furthermore, high BioT may indirectly lead to iRBD by impairing normal pathways in the left cingulum and cingulate gyrus and fostering abnormal pathway formation.

The relationship between internet addiction, sleep quality, and psycho-social problems among secondary school students in Erbil, 2023-2024.

OBJECTIVE: This study aimed to show the association between internet addiction (IA), sleep quality, and psycho-social problems among secondary school students DESIGN: A cross-sectional, descriptive, and correlational study design was used. SAMPLE: A total of 557 students from four secondary schools in Erbil were selected using multistage cluster sampling MEASUREMENTS: The questionnaires of this research contained socio-demographic data, Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Symptom Checklist-Y (PSC-Y) questionnaire. RESULTS: Findings indicated that students displayed a mild IA, averaging a score of 42.9 ± 19.18. Furthermore, the average sleep quality (PSQI) score was 8.95 ± 2.75, indicating moderate sleep disturbance, and the average score for psycho-social problems was 27.78 ± 13.29. Importantly, there was a strong and positive association between IA and psycho-social issues, as shown by a correlation coefficient of 0.31 (p < .001). Sleep quality was correlated with IA and psychosocial issues (p < .001, correlation values: .23 and .27, respectively) CONCLUSIONS: The study highlights the urgent need for health policymakers and nursing managers in Erbil to develop targeted interventions, such as awareness campaigns and digital well-being programs in school curricula, to mitigate the interlinked issues of IA, sleep quality, and psycho-social problems among students.

Work addiction risk, stress and well-being at work: testing the mediating role of sleep quality.

Introduction: Attention to work addiction risk is growing; however, more studies are needed to explore the possible impact of work addiction risk on various aspects of employees' work and life domains. Although several studies have considered the antecedents or consequences of work addiction risk, this study particularly focuses on sleep quality as a potential explanatory underlying mechanism in the relation between work addition risk and three outcome variables including stress at home, stress at work and well-being. Method: The data was collected using an online platform and participants consisted of 188 French employees who were selected using simple random sampling method. Participants responded to the survey including the Work Addiction Risk Test (WART), stress at work, well-being, and sleep quality. The data was analyzed using JASP and SPSS-26 programs. Results: The results revealed that there are significant positive relationships between work addiction risk and both stress at home and at work and negative relationships between work addiction risk and both sleep quality and well-being. In addition, the analyses of the mediation paths suggest the significant mediation role of sleep quality for the link between work addition risk and stress at work as well as the link between work addiction risk and well-being. Discussion: Given the verified mediating role of sleep quality in the relationship between work addiction, stress and wellbeing, it is recommended that organizations and companies pay particular attention to their employees' sleep quality.

Causal relationships between height, screen time, physical activity, sleep and myopia: univariable and multivariable Mendelian randomization.

Background: This study aims to investigate the independent causal relation between height, screen time, physical activity, sleep and myopia. Methods: Instrumental variables (IVs) for exposures and outcome were obtained from the largest publicly available genome-wide association studies (GWAS) databases. First, we performed a bidirectional univariate MR analysis using primarily the inverse variance weighted method (IVW) with height, screen time, physical activity and sleep as the exposure and myopia as the outcome to investigate the causal relationship between exposures and myopia. Sensitivity analysis was used to demonstrate its robustness. Then the multivariable MR (MVMR) and MR-based mediation approach was further used to estimate the mediating effect of potential confounders (education and time outdoors) on causality. Results: The results of univariate MR analysis showed that taller height (OR = 1.009, 95% CI = 1.005-1.012, p = 3.71 × 10-7), longer time on computer (OR = 1.048, 95% CI = 1.029-1.047, p = 3.87 × 10-7) and less moderate physical activity (OR = 0.976, 95% CI = 0.96-0.991 p = 2.37 × 10-3) had a total effect on the increased risk of developing myopia. Meanwhile our results did not have sufficient evidence to support the causal relationship between chronotype (p = 0.637), sleep duration (p = 0.952) and myopia. After adjusting for education, only taller height remains an independent risk factor for myopia. After adjusting for education, the causal relationship between height, screen and myopia still had statistical significance. A reverse causal relationship was not found in our study. Most of the sensitivity analyses showed consistent results with those of the IVW method. Conclusion: Our MR study revealed that genetically predicted taller height, longer time on computer, less moderate physical activity increased the risk of myopia. After full adjustment for confounders, only height remained independently associated with myopia. As a complement to observational studies, the results of our analysis provide strong evidence for the improvement of myopia risk factors and provide a theoretical basis for future measures to prevent and control myopia in adolescents.

Obstructive Sleep Apnea Among Patients with Mild Cognitive Impairment.

Background: Obstructive sleep apnea (OSA) is associated with cognitive disorders, but little is known about prevalence of co-occurring OSA and mild cognitive impairment (MCI) as well as about co-occurring OSA and Alzheimer's disease (AD). Pathophysiological models integrating OSA, cognitive deficits and neurodegeneration remain speculative. Findings in this area could contribute to the knowledge about pathophysiological processes in cognitive disorders and neurodegenerative processes, be helpful for the diagnosis of cognitive disorders and provide approaches for the treatment of cognitive disorders. Objective: Examining the prevalence of OSA and patterns of cognitive deficits as well as AD biomarker profiles associated with OSA in a cohort of 104 MCI patients. Methods: Assessments used include: respiratory polygraphy, The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD NB), Tau, phosphoTau181, amyloid-ß-1-42/1-40, 18F-fluorodeoxyglucose positron emission tomography (F18-FDG-PET). Results: Prevalence of OSA of any severity: 58,7% (Apnea Hypopnea Index (AHI)≥5/h), OSA in a moderate-to-severe extent (AHI≥15/h): 25%. Only 13.1% of MCI patients with OSA reported daytime sleepiness. MCI-OSA patients showed no specific neuropsychological pattern. Presence of OSA was not associated with specific AD biomarker profiles in the whole study group besides a positive association between AD positivity in an AD biomarker sub cohort. Conclusions: OSA is highly prevalent in patients with MCI. It might often remain undiagnosed as only a small number of MCI-OSA patients report daytime sleepiness. OSA could contribute to MCI symptoms and even to AD pathology. Further research is needed to validate these findings and to investigate possible pathophysiological relationships between OSA and MCI as well as between OSA and AD.

Body image, self-efficacy, and sleep quality among patients with breast cancer: A latent profile and mediation analysis.

PURPOSE: As a sign of femininity, impaired breast after surgery causes particularly confusion for patients with breast cancer resulting in increased body image distress, which has negative impacts on sleep quality. And self-efficacy enables patients to use positive and effective coping strategies to maintain a favorable night's sleep. Therefore, our study is to explore the heterogeneity in body image experienced by patients with breast cancer and to examine the mediation effects of self-efficacy between body image and sleep quality. METHOD: Between July 2023 and October 2023, 251 patients with breast cancer were recruited for the Be Resilient to Breast Cancer program. They responded to the General Perceived Self-Efficacy Scale, Body Image Scale, and Pittsburgh Sleep Quality Index Scale. Data were analyzed using a latent profile analysis (LPA) and mediation analysis. RESULTS: Results of the LPA indicated that body image could be classified into three subgroups as follows: low (43.0%), moderate (45.5%), and high (11.5%). Furthermore, the mediation analysis demonstrated two partially mediated effects upon comparing the low and moderate (standard error, SE = 0.548, 95% confidence interval, CI = 0.009, 0.366) and the high and low (SE = 0.848, 95% CI = 0.570, 3.909) body image groups. CONCLUSION: Heterogeneity exists in body image, and self-efficacy mediates the relationship between body image and sleep quality. Hence, promoting self-efficacy can buffer the negative impacts of body image on sleep quality in patients with breast cancer, and self-efficacy-orientated interventions should also receive more attention in clinic.

Impact of spa therapy on physical activity, sleep and heart rate variability among individuals with fibromyalgia: Results of an ancillary study.

Spa therapy is recommended to manage symptoms of fibromyalgia, but the physiological mechanisms underlying this improvement have been poorly studied. In an original study, we explored the effect of a 3-week rheumatology spa treatment for fibromyalgia patients on quality of life and with a symptom severity questionnaire. We present here the results of an ancillary study which explored three secondary criteria using objective measurement methods: diurnal actimetry for physical activity analysis, nocturnal actimetry for sleep analysis and heart rate variability. Eighty-three fibromyalgia patients were randomized to participate in an immediate 3-week rheumatological spa therapy, either a start within 6 weeks after inclusion (interventional group, n = 39) or a delayed, start 6 months after inclusion (control group, n = 44). Patients were asked to wear an actimeter (n = 56) to assess diurnal physical activity and sleep quality and a 24-h Holter ECG (n = 60) to assess nocturnal heart rate variability at baseline, 3 months and 6 months after inclusion. Time spent in sedentary and light physical activity was reduced to ∼30 min at 6 months in the interventional group (P = 0.027). Sleep quality and heart rate variability were not improved. Spa therapy made it possible to reduce sedentary activities in patients' daily life for up to 6 months afterwards, concomitant with the improvement in quality of life, pain and fatigue as highlighted in the original Thermalgi study.

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

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

Sleep and long COVID: Preexisting sleep issues and the risk of PASC in a large general population using 3 different model definitions.

Study Objectives: Insomnia, poor sleep quality and extremes of sleep duration are associated with COVID-19 infection. This study assessed whether these factors are related to Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Methods: Cross-sectional survey of a general population of 24,803 U.S. adults to determine the association of insomnia, poor sleep quality and sleep duration with PASC. Results: Prevalence rates of PASC among previously COVID-19 infected participants for three definitions of PASC were COPE (21.9%), NICE (38.9%) and RECOVER PASC Score (15.3%). PASC was associated with insomnia in all 3 models in fully adjusted models with adjusted odds ratios (aORs) and 95% confidence intervals (CI) ranging from 1.30 (95% CI: 1.11-1.52, p≤0.05, PASC Score) to 1.52 (95% CI: 1.34-1.71, p≤0.001, (NICE). Poor sleep quality was related to PASC in all models with aORs ranging from 1.77 (95% CI: 1.60-1.97, p≤0.001, NICE) to 2.00 (95% CI: 1.77-2.26, p≤0.001, COPE). Sleep <6 hours was associated with PASC with aORs between 1.59 (95% CI: 1.40-1.80, p≤0.001, PASC Score) to 1.70 (95% CI: 1.53-1.89, p≤0.001, COPE). Sleep ≥ 9 hours was not associated with PASC in any model. Although vaccination with COVID-19 booster decreased the likelihood of developing PASC, it did not attenuate associations between insomnia, poor sleep quality and short sleep duration with PASC in any of the models. Conclusions: Insomnia, poor sleep quality and short sleep duration are potential risk factors for PASC. Interventions to improve sleep may decrease the development of PASC.

Anxiety and sleep quality in patients receiving maintenance hemodialysis: multiple mediating roles of hope and family function.

The objective of this cross-sectional study was to examine the extent of sleep quality among individuals undergoing maintenance hemodialysis (MHD) and to scrutinize whether hope and family function serve as mediators in the association between anxiety and sleep quality in this cohort. A convenience sampling method was used to recruit 227 patients receiving maintenance hemodialysis from two tertiary hospitals in Wuhan. Participants completed several self-report questionnaires, including the Sociodemographic questionnaire, Hospital Anxiety and Depression Scale, Athens Insomnia Scale, Herth Hope Index, and Family APGAR Index. As per the findings of the chain mediation analysis, it was observed that the sleep quality scores were directly predicted by anxiety. Moreover, anxiety positively predicted sleep quality scores through hope and family function as mediators. The observed types of mediation were partial mediation. The total indirect effect value was 0.354, indicating the mediating effect of hope and family function, while the total effect value was 0.481, representing the overall effect of anxiety on sleep quality. The total effect size was 73.60% (0.354/0.481), indicating that the mediation accounted for a significant portion of the relationship. This study established the chain mediating effect of hope and family function between anxiety and sleep quality in patients receiving maintenance hemodialysis. The findings highlight the importance of addressing anxiety and promoting hope and family function to improve sleep quality in this population. The findings suggest that healthcare professionals should be attentive to the anxiety levels of these patients and implement targeted interventions to help alleviate anxiety, enhance hope, and improve family functioning, with the ultimate goal of improving sleep quality in this population.