Exercise-with-melatonin therapy improves sleep disorder and motor dysfunction in a rat model of ischemic stroke

Exercise-with-melatonin therapy has complementary and synergistic effects on spinal cord injury and Alzheimer's disease,but its effect on stroke is still poorly understood.In this study,we established a rat model of ischemic stroke by occluding the middle cerebral artery for 60 minutes.We treated the rats with exercise and melatonin therapy for 7 consecutive days.Results showed that exercise-with-melatonin therapy significantly prolonged sleep duration in the model rats,increased delta power values,and regularized delta power rhythm.Additionally,exercise-with-melatonin therapy improved coordination,endurance,and grip strength,as well as learning and memory abilities.At the same time,it led to higher hippocampal CA1 neuron activity and postsynaptic density thickness and lower expression of glutamate receptor 2 than did exercise or melatonin therapy alone.These findings suggest that exercise-withmelatonin therapy can alleviate sleep disorder and motor dysfunction by increasing glutamate receptor 2 protein expression and regulating hippocampal CA1 synaptic plasticity.

Non-alcoholic fatty liver disease and sleep disorders

Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.

Lack of a causal relationship between tea intake and sleep disorders: a two-sample Mendelian randomization study

Background:The relationship between tea intake(TI)and sleep disorders(SDs)has been a topic of interest for some time,but there remains a lack of data showing a causal relationship.We aimed to use a two-sample Mendelian randomization study to determine whether there is a causal link between TI and SDs.Methods:We collected data regarding TI,with a focus on green tea intake(GTI),herbal tea intake(HTI),and rooibos tea intake(RTI);and data regarding SDs and insomnia from genome-wide association studies.We analyzed these data using an inverse variance-weighted two-sample Mendelian randomization study,by means of the TwoSampleMR package in R4.2.3 software.Results:We found no genetic causal relationships of TI,GTI,HTI,or RTI with insomnia.The odds ratios(ORs)for these relationships were as follows:TI:OR=0.61,95%confidence interval(CI):0.29–1.28;GTI:OR=1.04,95%CI:0.95–1.14;HTI:OR=0.98,95%CI:0.82–1.17;and RTI:OR=1.04,95%CI:0.99–1.09.In addition,there were no genetic causal relationships of TI,GTI,HTI,or RTI with SDs.The OR values for these relationships were as follows:TI:OR=0.6,95%CI:0.34–1.06;GTI:OR=1,95%CI:0.93–1.07;HTI:OR=0.89,95%CI:0.66–1.2;and RTI:OR=1.02,95%CI:0.98–1.06.Conclusion:We found no causal relationships of TI with SDs or insomnia,irrespective of the type of tea consumed.However,additional Mendelian randomization studies are required to further explore the relationships of the timing and quantity of tea consumption with SDs and insomnia.

Correlation between blepharospasm and psychological diseases:the anxiety,depression and sleep disorder study

AIM:To investigate the relationship between benign essential blepharospasm(BEB)symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin type A(BoNT/A)can impact psychological symptoms.METHODS:This prospective interventional case series recruited 61 adults with evidence of BEB.Patients were administered the Jankovic Rating Scale(JRS),the Blepharospasm Disability Index(BSDI),Personal Health Questionnaire Depression Scale(PHQ-8),Generalized Anxiety Disorder 7-item scale(GAD-7)and the Athens insomnia scale(AIS)to evaluate the severity of BEB symptoms,depression,anxiety and sleep disorder before and 1wk,1,3mo after the BoNTA treatment.Statistical analysis was performed to assess the relationships between changes in the survey scores.RESULTS:The mean score for JRS,BSDI,PHQ-8,and GAD-7 improved significantly(P<0.0001),respectively,compared to the initial visit at follow-up.At baseline,worse BSDI scores were correlated with worse GAD-7 and PHQ-8,but not with worse AIS.At 1mo follow-up visit,there was no correlation between change in BSDI and PHQ-8/AIS,the change in GAD-7 showed a mild association with change in BSDI.The change in BSDI was correlated with the change in both PHQ-8 and GAD-7 in the subgroup of patients without a prior diagnosis of depression or anxiety.Patient satisfaction with BoNT/A treatment reached the highest at 1mo of follow-up(83.6%,51/61).CONCLUSION:BEB may lead to psychological diseases.BoNT/A can significantly improve motor and non-motor symptoms of BEB,which emphasize the effectiveness of BoNT/A and therefore pave the way for its use in the field of psychiatry.However,further research is needed to confirm these findings and understand the underlying mechanisms.

Effects of serum inflammatory factors,health index and disease activity scores on ankylosing spondylitis patients with sleep disorder

BACKGROUND Patients with ankylosing spondylitis(AS)frequently suffer from comorbid sleep disorders,exacerbating the burden of the disease and affecting their quality of life.AIM To investigate the clinical significance of serum inflammatory factors,health index and disease activity scores in patients with AS complicated by sleep disorders.METHODS A total of 106 AS patients with comorbid sleep disorders were included in the study.The patients were grouped into the desirable and undesirable prognosis groups in accordance with their clinical outcomes.The serum levels of inflammatory factors,including C-reactive protein,erythrocyte sedimentation rate,interleukin(IL)-6,tumour necrosis factor-αand IL-1β,were measured.Disease activity scores,such as the Bath AS functional index,Bath AS disease activity index,Bath AS metrology index and AS disease activity score,were assessed.The health index was obtained through the Short Form-36 questionnaire.RESULTS The study found significant associations amongst serum inflammatory factors,health index and disease activity scores in AS patients with comorbid sleep disorders.Positive correlations were found between serum inflammatory factors and disease activity scores,indicating the influence of heightened systemic inflammation on disease severity and functional impairment.Conversely,negative correlations were found between disease activity scores and health index parameters,highlighting the effect of disease activity on various aspects of healthrelated quality of life.Logistic regression analysis further confirmed the predictive value of these factors on patient outcomes,underscoring their potential utility in risk assessment and prognostication.CONCLUSION The findings demonstrate the intricate interplay amongst disease activity,systemic inflammation and patientreported health outcomes in AS patients complicated by sleep disorders.The results emphasise the need for comprehensive care strategies that address the diverse needs and challenges faced by these patients and underscore the potential relevance of serum inflammatory factors,health index and disease activity scores as prognostic markers in this patient population.

Sleep disturbances and psychomotor retardation in the prediction of cognitive impairments in patients with major depressive disorder

BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR.

Sleep Disorders among Professional Oil Tanker Drivers in Ouagadougou Burkina Faso

Introduction: Sleep disorders among professional drivers are a major road safety problem. They cause fatigue and drowsiness at the wheel, which can lead to road traffic accidents and even accidents at work. The aim of this study was to assess sleep disorders among professional drivers of oil tankers in Ouagadougou, Burkina Faso. Methods: This was a descriptive and analytical cross-sectional study carried out from 11 April 2020 to 11 September 2020 in the national hydrocarbon company’s fuel depot. All the drivers present at the time were included and accomplished a questionnaire incorporating the commonly scales using to assess sleep disorders, sleep quality and sleep apnoea. Data analysis using R 3.6.1 software enabled to perform univariate and multivariate analyses to identify associated factors. Adjusted odd ratios were used to measure the strength of association. The significance level chosen was p ≤ 0.05. Results: All the 339 respondents were male. A proportion of 33.6% suffered from insomnia, including 12.7% with moderate to severe insomnia, and 18.58% were at risk of sleep apnoea. On the Epworth scale, 26.6% of drivers showed sleep debt and 4.1% excessive daytime sleepiness. The risk factors associated with insomnia were the use of psychostimulants. A history of diabetes and insomnia were risk factors associated with sleep apnoea syndrome. Conclusion: The prevalence of sleep disturbance and insomnia among the respondents were 52.2% and 33.6% respectively. Use of psychostimulants was the identified risk factor. The prevalence of SAS was 4.72%, with diabetes and insomnia as associated factors.

Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.

观察重症肺炎伴睡眠障碍患者SLEEP-MAD模式干预对睡眠质量的影响

目的:研究重症肺炎睡眠障碍患者实施SLEEP-MAD模式干预的效果。方法:选取2022年1月至2022年12月福建医科大学附属泉州市第一医院收治的重症监护室(ICU)重症肺炎伴睡眠障碍患者40例作为研究对象,按照随机数字表法分为对照组和观察组,每组20例。观察组实施SLEEP-MAD模式干预,对照组实施常规护理。采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)比较2组患者干预前后焦虑、抑郁的变化情况,并比较2组患者的失眠发生率及护理满意度。结果:干预后,观察组PSQI评分、HAMA评分、HAMD评分显著低于对照组,观察组满意度显著高于对照组,观察组失眠发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:给予ICU重症肺炎睡眠障碍患者SLEEP-MAD模式干预,实施效果相对较好,患者满意度较高,失眠发生率显著降低,患者的负性情绪得到改善,睡眠质量随之提高,值得临床推广应用。

SLEEP-MAD护理模式对ICU重症肺炎睡眠障碍患者睡眠改善的效果

目的:分析SLEEP-MAD护理模式对ICU重症肺炎睡眠障碍患者睡眠的改善效果。方法:选取2021年11月至2023年11月厦门大学附属第一医院收治的ICU重症肺炎睡眠障碍患者86例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组43例。对照组采用常规护理模式,观察组采用SLEEP-MAD护理模式。对比2组的睡眠质量、心理弹性及自我负担。结果:在睡眠质量各维度评分方面,观察组均低于对照组(P<0.05);观察组较对照组,心理弹性评分更高,自我负担评分更低(P<0.05)。结论:SLEEP-MAD护理模式有利于改善ICU重症肺炎睡眠障碍患者的睡眠质量,减轻自我负担,临床可进一步推广应用。

Puerarin alleviates sleep disorders in aged mice related to repairing intestinal mucosal barrier

More and more evidence suggests that puerarin,a potential remedy for gut inflammation,may have an ameliorative effect on sleep disturbances.However,the relationship between puerarin and sleep disruption has not been extensively researched.This study aims to explore the role and mechanisms of puerarin in improving sleep disorders.We established a light-induced sleep disorder model in mice and assessed the effects of puerarin on cognitive behavior using open field and water maze tests.Pathological detection demonstrated that sleep disturbances resulted in observable damage to the liver,lung,and kidney.Puerarin reversed multi-organ damage and inflammation.Further,puerarin activated paneth cells,resulting in increased lysozyme and TGF-βproduction,and stimulating intestinal stem cell proliferation.Puerarin also effectively inhibited the expression of F4/80,iNOS,TNF-α,and IL-1βin the small intestine,while it increased Chil3,CD206,and Arg-1 levels.Moreover,puerarin treatment significantly decreased P-P65,TLR4,Bcl-xl,and cleaved caspase-3 protein levels while increasing barrier protein levels,including ZO-1,Occludin,Claudin 1 and E-cadherin suggesting a reduction in inflammation and apoptosis in the gut.Overall,puerarin diminished systemic inflammation,particularly intestinal inflammation,and enhanced intestinal barrier integrity in mice with sleep disorders.Our findings suggest a potential new therapeutic pathway for sleep disorders.

Psycho-cognitive behavioral problems in sleep disordered children

Sleep disturbances are common in childhood and adolescence. Sleep problems in early infants tend to be persistent and prominent in preschool and school-aged children. Chronic sleep disorders, especially in young children may lead to neurobehavioral problems and psycho-cognitive impairment. Sleep difficulties may be the result of underlying medical conditions, （breathing disorders） or psychological problems. Research studies have shown the association between sleep disorders and day time cognitive impairment, behavioral problems, poor school performance and inattention in children. Appropriate diagnosis and early management of sleep disorders in children lead to improvement of neurocognitive function and behavioral problems in these children.

Stroke and sleep-disordered breathing: A relationship under construction

The association between sleep-disordered breathing(SDB) and cardiovascular risk has been the focus of attention in recent years.Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke,including transient ischemic attack,ischemic cerebral infarction and intracerebral haemorrhage.It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB.Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB.Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.

Relationship between acute stress and sleep disorder in grass-root military personnel:Mediating effect of social support

Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P【0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P【0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.

Effects of mindfulness-based intervention programs on sleep among people with common mental disorders:A systematic review and meta-analysis

BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder.Although mindfulness has been suggested as an important component in alleviating insomnia,no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention(MBI)programs on sleep among people with depression or anxiety disorder.AIM To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder.METHODS Related publications in Embase,Medline,PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials.Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder.The fixed-effects model was used when heterogeneity was negligible,and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences(SMDs)and 95%confidence intervals(CIs).RESULTS We identified 397 articles,of which 10 randomised controlled trials,involving a total of 541 participants,were included in the meta-analysis.Studies of internet mindfulness meditation intervention(IMMI),mindfulness meditation(MM),mindfulness-based cognitive therapy(MBCT),mindfulness-based stress reduction(MBSR)and mindfulness-based touch therapy(MBTT)met the inclusion criteria.The greatest effect sizes are reported in favour of MBTT,with SMDs of-1.138(95%CI:-1.937 to-0.340;P=0.005),followed by-1.003(95%CI:-1.645 to-0.360;P=0.002)for MBCT.SMDs of-0.618(95%CI:-0.980 to-0.257;P=0.001)and-0.551(95%CI:-0.842 to-0.260;P<0.0001)were reported for IMMI and MBSR in the pooling trials,respectively.Significant effects on sleep problem improvement are shown in all reviewed MBI programs,except MM,for which the effect size was shown to be nonsignificant.CONCLUSION All MBI programs(MBTT,MBCT,IMMI and MBSR),except MM,are effective options to improve sleep problems among people with depression or anxiety disorder.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.METHODSIn this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.RESULTSAmong the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).CONCLUSIONPhysicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Dementia in military and veteran populations:a review of risk factors—traumatic brain injury,post-traumatic stress disorder,deployment,and sleep

The military population face a unique set of risk factors that may increase the risk of being diagnosed with dementia.Traumatic brain injury(TBI)and post-traumatic stress disorder(PTSD)have a higher prevalence in this group in comparison to the civilian population.By delving into the individual relationships between TBI and dementia,and PTSD and dementia,we are able to better explore dementia in the military and veteran populations.While there are some inconsistencies in results,the TBI-dementia association has become more widely accepted.Moderate-tosevere TBI has been found to increase the risk of being diagnosed with Alzheimer’s disease.A correlation between PTSD and dementia has been established,however,whether or not it is a causal relationship remains unclear.Factors such as blast,combat and chemical exposure may occur during a deployment,along with TBI and/or PTSD diagnosis,and can impact the risk of dementia.However,there is a lack of literature exploring the direct effects of deployment on dementia risk.Sleep problems have been observed to occur in those following TBI,PTSD and deployment.Poor sleep has been associated with possible dementia risk.Although limited studies have focused on the link between sleep and dementia in military and veteran populations,sleep is a valuable factor to study due to its association and interconnection with other military/veteran factors.This review aims to inform of various risk factors to the cognitive health of military members and veterans:TBI,PTSD,deployment,and sleep.

Gender Differences in Rapid Eye Movement-Related Sleep Disordered Breathing

Sleep disordered breathing (SDB) is an independent risk factor for cardiovascular disease. It is known to be associated more frequently with men than women, particularly in the premenopausal age range. The goal of this study is to evaluate gender differences among Korean patients diagnosed with SBD. This study included 309 patients who visited our Sleep Clinic due to sleep-related symptoms and were diagnosed with SDB by overnight polysomnography (PSG). We analyzed age, gender, body mass index, various PSG indices including sleep stages, apnea-hypopnea index (AHI) and AHI ratio in rapid eye movement (REM) versus non-REM (NREM) sleep stages (R:N ratio). Of those 309 patients diagnosed with obstructive sleep apnea, 217 (70.2%) were men (mean age 51.05 ± 12.64 years) and 92 (29.8%) were women (mean age 64.53 ± 10.43 years). The mean AHI during total sleep time was 30.34 ± 21.17 in men and 21.47 ± 17.14 in women (P P P = 0.402). REM SDB with R:N ratio higher than 2.0 was more frequently observed in women than in men, 34.8% (32/92) of women, compared with 11.9% (26/217) in men (P 60 years old. These findings suggest the possibility of different pathophysiologic mechanisms of SDB between genders and also between NREM versus REM sleep, which can be partly explained by the influence of female sex hormones.

Sleep-associated movement disorders and the risk of cardiovascular disease: A systematic review and metaanalysis

AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.