Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a populat...Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.展开更多
BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The m...BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation.Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation.Nevertheless,there is a lack of clinical application and imaging evidence.METHODS We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023.They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep.Following the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores.Additionally,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring device.Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.RESULTS Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea event.The lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved.Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state.Conversely,during mid-frequency anti-snoring device treatment,these areas increased compared to snoring.CONCLUSION The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS,thereby improving their quality of life and reducing daytime sleepiness.These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.展开更多
BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effec...BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.展开更多
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 ...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.展开更多
Emerging evidence indicates that sleep deprivation(SD)can lead to Alzheimer’s disease(AD)-related pathological changes and cognitive decline.However,the underlying mechanisms remain obscure.In the present study,we id...Emerging evidence indicates that sleep deprivation(SD)can lead to Alzheimer’s disease(AD)-related pathological changes and cognitive decline.However,the underlying mechanisms remain obscure.In the present study,we identified the existence of a microbiota-gut-brain axis in cognitive deficits resulting from chronic SD and revealed a potential pathway by which gut microbiota affects cognitive functioning in chronic SD.Our findings demonstrated that chronic SD in mice not only led to cognitive decline but also induced gut microbiota dysbiosis,elevated NLRP3 inflammasome expression,GSK-3βactivation,autophagy dysfunction,and tau hyperphosphorylation in the hippocampus.Colonization with the“SD microbiota”replicated the pathological and behavioral abnormalities observed in chronic sleep-deprived mice.Remarkably,both the deletion of NLRP3 in NLRP3-/-mice and specific knockdown of NLRP3 in the hippocampus restored autophagic flux,suppressed tau hyperphosphorylation,and ameliorated cognitive deficits induced by chronic SD,while GSK-3βactivity was not regulated by the NLRP3 inflammasome in chronic SD.Notably,deletion of NLRP3 reversed NLRP3 inflammasome activation,autophagy deficits,and tau hyperphosphorylation induced by GSK-3βactivation in primary hippocampal neurons,suggesting that GSK-3β,as a regulator of NLRP3-mediated autophagy dysfunction,plays a significant role in promoting tau hyperphosphorylation.Thus,gut microbiota dysbiosis was identified as a contributor to chronic SD-induced tau pathology via NLRP3-mediated autophagy dysfunction,ultimately leading to cognitive deficits.Overall,these findings highlight GSK-3βas a regulator of NLRP3-mediated autophagy dysfunction,playing a critical role in promoting tau hyperphosphorylation.展开更多
BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic foundation.The immunological underpinnings of certai...BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic foundation.The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies(GWAS)and genotyping techniques using highdensity genetic markers(e.g.,SNP or CNVs).But this tactic hasn't yet been applied to OSAHS.Using a Mendelian randomization analysis,we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS.AIM To investigate the immune cells'association with OSAHS via genetic methods,guiding future clinical research.METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS.Summary statistics for each immune cell feature were obtained from the GWAS catalog.Information on 731 immune cell properties,such as morphologic parameters,median fluorescence intensity,absolute cellular,and relative cellular,was compiled using publicly available genetic databases.The results'robustness,heterogeneity,and horizontal pleiotropy were confirmed using extensive sensitivity examination.RESULTS Following false discovery rate(FDR)correction,no statistically significant effect of OSAHS on immunophenotypes was observed.However,two lymphocyte subsets were found to have a significant association with the risk of OSAHS:Basophil%CD33dim HLA DR-CD66b-(OR=1.03,95%CI=1.01-1.03,P<0.001);CD38 on IgD+CD24-B cell(OR=1.04,95%CI=1.02-1.04,P=0.019).CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach,thus offering direction for potential future medical research.展开更多
Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhan...Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.展开更多
Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and s...Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and staying asleep. Recent literature has identified an association between academic performance, negative mood state and low activity level in young adults with sleep disturbances. Young adulthood is a time for the installation of sleep health. Both individual and schedule impositions to the young adults’ sleep schedule are to be modified to obtain Sleep Health. Recent research has identified daytime light effects on sleep such as blue light from electronics as alerting and low level light for relaxation. The aim of this study was to identify sleep quality effects with varying light exposures. It was hypothesized that bright (>450 lux) light conditions would be considered focusing and low light (<220 lux) would be considered calming. We hypothesized that sleep quality would improve by 5% with the introduction of a calm light condition. Undergraduates from a small midwestern university were invited to participate in the study in exchange for a gift card. Six participants completed the study, two males, four females all between 21 - 24 years old. Both hypotheses were supported by qualitative analysis.展开更多
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 diso...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.展开更多
Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astroc...Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astrocytes are now recognized as playing a more complex role than mere bystanders in the central nervous system.However,their role in regulating the sleep neurocircuitry is not well understood.From this perspective,we highlight the role of astrocytes in sleep modulation,with a particular focus on regulatory mechanisms related to the ventrolateral preoptic nucleus(VLPO)of the hypothalamus.We briefly discuss recent literature reporting the role of VLPO astrocytes in regulating sleep-associated behaviors.展开更多
Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and q...Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and quality sleep are protective factors against cognitive decline and poor health and can improve coping with stressors. The “Active Feedback” intervention comprises a wearable activity and sleep tracker (Fitbit), access to Fitbit software healthy lifestyle software apps;one session with Memory Assessment Service (MAS) staff providing physical activity and sleep hygiene advice and two further engagement, discussion, and feedback sessions. Purpose/Aim: This study investigates the acceptability and feasibility of Active Feedback and the effect on stress, mental wellbeing, and sleep quality, and the links between these factors. Methods: An open-label patient cohort design with no control group was used. Pre-intervention, 4-week and 8-week intervention assessments were performed using participant self-report measures: Perceived Stress Scale (PSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Sleep Conditioning Index (SCI). Twenty-five participants completed an eight-week three-session intervention (18 males and 7 females), with the age range of 66 - 84 years old, and average age of 73.8 years (SD = 5.09). Fifteen participants had a diagnosis of MCI, ten participants did not. Results: There were non-significant improvements in SCI scores from 21.0 (SD = 8.84) to 21.6 (SD = 6.20) at 8 weeks, PSS scores from 17.5 (SD = 5.89) to 17.0 (SD = 6.20) at 8 weeks, and WEMWBS scores from 46.9 (SD = 9.23) to 48.8 (SD = 9.69) at 8 weeks. There were negative correlations between WEMWBS and PSS. Conclusion: Active Feedback intervention was found to be feasible and acceptable. Active Feedback could be enhanced to include motivational interviewing and goal setting.展开更多
Background: Many adolescents have a sleep debt. Individuals sleeping for their optimal sleep duration are expected to experience no sleepiness. Then, it is important to recognize one’s optimal sleep duration to reduc...Background: Many adolescents have a sleep debt. Individuals sleeping for their optimal sleep duration are expected to experience no sleepiness. Then, it is important to recognize one’s optimal sleep duration to reduce sleep debt. However, there is no simple method to determine this value. Since body mass index and sleep duration exhibit a U-shaped association, it is expected that a person taking optimal sleep duration would show no marked deviation from the mean body mass index value for the population evaluated. By using self-reported sleepiness and standardized body mass index, this study aimed to estimate individual optimal sleep duration. Methods: Data from 2540 grade 5 - 11 students were used. Students who declared no sleepiness during class and also had a gender- and grade-standardized body mass index of ±1.5 were termed ideal students. The average sleep durations of ideal students were compared with those of non-ideal students. The differences of sleep duration between ideal and no-ideal students were added to habitual sleep duration of each non-ideal student to obtain assumed optimal sleep duration. A multiple regression line to predict assumed optimal sleep duration was calculated using the least squares method. Results: The mean sleep duration of 666 ideal students exceeded the lower limit of daily sleep duration proposed as “may be appropriate” for children aged 6 - 17 years by National Sleep Foundation of the USA, being longer than those of non-ideal students. Significant regression formula for assumed optimal sleep duration was obtained (adjusted R2 = 0.996, p Conclusions: No contradiction was identified in the sleep duration obtained from ideal students as with optimal sleep duration. Although further studies to confirm the current estimation are needed, a simple formula to estimate individual optimal sleep duration through easily obtainable parameters was proposed.展开更多
Objectives To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status.Furthermore,the study also aims to explore how inflammatory indicators may mediate...Objectives To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status.Furthermore,the study also aims to explore how inflammatory indicators may mediate the relationship.Methods The China Hainan Centenarians Cohort Study(CHCCS)collected baseline data on sleep status,inflammatory indicators,and blood pressure data.The study used a mediation model to investigate how inflammatory indicators mediate the relationship between sleep status and blood pressure status.Result In this study,a total of 967 centenarians were included.The prevalence of hypertension among the centenarians was 71.4%.The analysis showed that centenarians with poor sleep quality had a 43%higher risk of hypertension compared to those with normal sleep quality(OR=1.43,95%CI:1.03-1.97).Additionally,centenarians with nighttime sleep durations of≤6 h or>9 h had higher proportions of high pulse pressure(PP),with OR values of 1.76(95%CI:1.18-2.63)and 2.07(95%CI:1.34-3.19),respectively.Mediation analysis illustrated that complement C3 played a mediating role in the relationship between sleep quality and hypertension,with an effect ratio of 2.4%.Similarly,lymphocyte count,the neutrophil-to-lymphocyte ratio(NLR),and the systemic immune-inflammation index(SII)were identified as mediating factors in the association between nighttime sleep duration and high PP,with effect ratios of 91.22%,36.93%,and 0.20%,respectively.Conclusion In centenarians,poor sleep quality raises the risk of hypertension,with complement C3 as a mediator.Additionally,nighttime sleep durations of≤6 h or>9 h increases the risk of high PP,mediated by lymphocyte count,NLR,and SII.展开更多
Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the ca...Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.展开更多
Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial dire...Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,p<0.001)and N2(75.0(36.0-120.8)vs 30.0(1.3-59.3)min,F=12.55,p<0.001);the total sleep time on N1(506.0(408.0-561.0)vs 392.0(243.0-483.5)min,F=14.13,p<0.001)and N2(488.5(455.5-548.5)vs 346.0(286.5-517.5)min,F=7.36,p=0.007);the deep sleep time on N1(130.0(103.3-177.0)vs 42.5(9.8-100.8)min,F=24.4,p<0.001)and N2(103.5(46.0-154.8)vs 57.5(23.3-106.5)min,F=8.4,p=0.004);and the percentages of light sleep and REM sleep on N1 and N2(p<0.05 for each).The postoperative depression and anxiety scores did not differ significantly between the two groups.No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.展开更多
Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose...Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances.Methods Twenty-four patients with MDD and sleep disturbances(Pa_s),33 patients with MDD without sleep disturbances(Pa_ns)and 32 healthy controls(HCs)were recruited in this study.Resting-state functional imaging data were analysed using NH.Results Compared with Pa_ns and HCs,Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus.There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances(r=−0.42,p=0.001)as well as a positive correlation between NH in the right precuneus and sleep disturbances(r=0.41,p=0.002)in patients with MDD.Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN,which could differentiate pa_s from pa_ns.The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances.展开更多
To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individ...To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.展开更多
Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attentio...Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.展开更多
BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improvin...BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.展开更多
基金supported by the National Key R&D Program of China(2021YFC2501500)National Natural Science Foundation of China(82171476)。
文摘Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.
文摘BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation.Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation.Nevertheless,there is a lack of clinical application and imaging evidence.METHODS We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023.They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep.Following the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores.Additionally,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring device.Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.RESULTS Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea event.The lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved.Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state.Conversely,during mid-frequency anti-snoring device treatment,these areas increased compared to snoring.CONCLUSION The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS,thereby improving their quality of life and reducing daytime sleepiness.These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.
文摘BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.
基金supported by China Rehabilitation Research Center,No.2021zx-03the Special Fund for Joint Training of Doctoral Students between the University of Health and Rehabilitation Sciences and China Rehabilitation Research Center,No.2020 kfdx-008(both to TZ)。
文摘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.
基金National Natural Science Foundation of China(81870850)Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX23_0322)。
文摘Emerging evidence indicates that sleep deprivation(SD)can lead to Alzheimer’s disease(AD)-related pathological changes and cognitive decline.However,the underlying mechanisms remain obscure.In the present study,we identified the existence of a microbiota-gut-brain axis in cognitive deficits resulting from chronic SD and revealed a potential pathway by which gut microbiota affects cognitive functioning in chronic SD.Our findings demonstrated that chronic SD in mice not only led to cognitive decline but also induced gut microbiota dysbiosis,elevated NLRP3 inflammasome expression,GSK-3βactivation,autophagy dysfunction,and tau hyperphosphorylation in the hippocampus.Colonization with the“SD microbiota”replicated the pathological and behavioral abnormalities observed in chronic sleep-deprived mice.Remarkably,both the deletion of NLRP3 in NLRP3-/-mice and specific knockdown of NLRP3 in the hippocampus restored autophagic flux,suppressed tau hyperphosphorylation,and ameliorated cognitive deficits induced by chronic SD,while GSK-3βactivity was not regulated by the NLRP3 inflammasome in chronic SD.Notably,deletion of NLRP3 reversed NLRP3 inflammasome activation,autophagy deficits,and tau hyperphosphorylation induced by GSK-3βactivation in primary hippocampal neurons,suggesting that GSK-3β,as a regulator of NLRP3-mediated autophagy dysfunction,plays a significant role in promoting tau hyperphosphorylation.Thus,gut microbiota dysbiosis was identified as a contributor to chronic SD-induced tau pathology via NLRP3-mediated autophagy dysfunction,ultimately leading to cognitive deficits.Overall,these findings highlight GSK-3βas a regulator of NLRP3-mediated autophagy dysfunction,playing a critical role in promoting tau hyperphosphorylation.
基金Supported by Doctoral Research Fund Project of Henan Provincial Hospital of Traditional Chinese Medicine,No.2022BSJJ10.
文摘BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic foundation.The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies(GWAS)and genotyping techniques using highdensity genetic markers(e.g.,SNP or CNVs).But this tactic hasn't yet been applied to OSAHS.Using a Mendelian randomization analysis,we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS.AIM To investigate the immune cells'association with OSAHS via genetic methods,guiding future clinical research.METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS.Summary statistics for each immune cell feature were obtained from the GWAS catalog.Information on 731 immune cell properties,such as morphologic parameters,median fluorescence intensity,absolute cellular,and relative cellular,was compiled using publicly available genetic databases.The results'robustness,heterogeneity,and horizontal pleiotropy were confirmed using extensive sensitivity examination.RESULTS Following false discovery rate(FDR)correction,no statistically significant effect of OSAHS on immunophenotypes was observed.However,two lymphocyte subsets were found to have a significant association with the risk of OSAHS:Basophil%CD33dim HLA DR-CD66b-(OR=1.03,95%CI=1.01-1.03,P<0.001);CD38 on IgD+CD24-B cell(OR=1.04,95%CI=1.02-1.04,P=0.019).CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach,thus offering direction for potential future medical research.
文摘Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.
文摘Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and staying asleep. Recent literature has identified an association between academic performance, negative mood state and low activity level in young adults with sleep disturbances. Young adulthood is a time for the installation of sleep health. Both individual and schedule impositions to the young adults’ sleep schedule are to be modified to obtain Sleep Health. Recent research has identified daytime light effects on sleep such as blue light from electronics as alerting and low level light for relaxation. The aim of this study was to identify sleep quality effects with varying light exposures. It was hypothesized that bright (>450 lux) light conditions would be considered focusing and low light (<220 lux) would be considered calming. We hypothesized that sleep quality would improve by 5% with the introduction of a calm light condition. Undergraduates from a small midwestern university were invited to participate in the study in exchange for a gift card. Six participants completed the study, two males, four females all between 21 - 24 years old. Both hypotheses were supported by qualitative analysis.
基金Supported by National Natural Science Foundation of China,No.82360880,and 82060661Jiangxi Provincial Natural Science Foundation of China,No.20232ACB206057+3 种基金Key project of Jiangxi Provincial Department of Education,No.GJJ218104Teaching reform research project of Jiangxi Province of China,No.JXJG-22-130-1National Natural Science Foundation of China,No.81660151Jiangxi Provincial Natural Science Foundation of China,No.20212BAB206092.
文摘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.
基金supported by a National Research Foundation of Korea(NRF)grant funded by the Korean government(2017R1A5A2015391 and 2020M3E5D9079764)(to KS).
文摘Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astrocytes are now recognized as playing a more complex role than mere bystanders in the central nervous system.However,their role in regulating the sleep neurocircuitry is not well understood.From this perspective,we highlight the role of astrocytes in sleep modulation,with a particular focus on regulatory mechanisms related to the ventrolateral preoptic nucleus(VLPO)of the hypothalamus.We briefly discuss recent literature reporting the role of VLPO astrocytes in regulating sleep-associated behaviors.
文摘Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and quality sleep are protective factors against cognitive decline and poor health and can improve coping with stressors. The “Active Feedback” intervention comprises a wearable activity and sleep tracker (Fitbit), access to Fitbit software healthy lifestyle software apps;one session with Memory Assessment Service (MAS) staff providing physical activity and sleep hygiene advice and two further engagement, discussion, and feedback sessions. Purpose/Aim: This study investigates the acceptability and feasibility of Active Feedback and the effect on stress, mental wellbeing, and sleep quality, and the links between these factors. Methods: An open-label patient cohort design with no control group was used. Pre-intervention, 4-week and 8-week intervention assessments were performed using participant self-report measures: Perceived Stress Scale (PSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Sleep Conditioning Index (SCI). Twenty-five participants completed an eight-week three-session intervention (18 males and 7 females), with the age range of 66 - 84 years old, and average age of 73.8 years (SD = 5.09). Fifteen participants had a diagnosis of MCI, ten participants did not. Results: There were non-significant improvements in SCI scores from 21.0 (SD = 8.84) to 21.6 (SD = 6.20) at 8 weeks, PSS scores from 17.5 (SD = 5.89) to 17.0 (SD = 6.20) at 8 weeks, and WEMWBS scores from 46.9 (SD = 9.23) to 48.8 (SD = 9.69) at 8 weeks. There were negative correlations between WEMWBS and PSS. Conclusion: Active Feedback intervention was found to be feasible and acceptable. Active Feedback could be enhanced to include motivational interviewing and goal setting.
文摘Background: Many adolescents have a sleep debt. Individuals sleeping for their optimal sleep duration are expected to experience no sleepiness. Then, it is important to recognize one’s optimal sleep duration to reduce sleep debt. However, there is no simple method to determine this value. Since body mass index and sleep duration exhibit a U-shaped association, it is expected that a person taking optimal sleep duration would show no marked deviation from the mean body mass index value for the population evaluated. By using self-reported sleepiness and standardized body mass index, this study aimed to estimate individual optimal sleep duration. Methods: Data from 2540 grade 5 - 11 students were used. Students who declared no sleepiness during class and also had a gender- and grade-standardized body mass index of ±1.5 were termed ideal students. The average sleep durations of ideal students were compared with those of non-ideal students. The differences of sleep duration between ideal and no-ideal students were added to habitual sleep duration of each non-ideal student to obtain assumed optimal sleep duration. A multiple regression line to predict assumed optimal sleep duration was calculated using the least squares method. Results: The mean sleep duration of 666 ideal students exceeded the lower limit of daily sleep duration proposed as “may be appropriate” for children aged 6 - 17 years by National Sleep Foundation of the USA, being longer than those of non-ideal students. Significant regression formula for assumed optimal sleep duration was obtained (adjusted R2 = 0.996, p Conclusions: No contradiction was identified in the sleep duration obtained from ideal students as with optimal sleep duration. Although further studies to confirm the current estimation are needed, a simple formula to estimate individual optimal sleep duration through easily obtainable parameters was proposed.
文摘Objectives To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status.Furthermore,the study also aims to explore how inflammatory indicators may mediate the relationship.Methods The China Hainan Centenarians Cohort Study(CHCCS)collected baseline data on sleep status,inflammatory indicators,and blood pressure data.The study used a mediation model to investigate how inflammatory indicators mediate the relationship between sleep status and blood pressure status.Result In this study,a total of 967 centenarians were included.The prevalence of hypertension among the centenarians was 71.4%.The analysis showed that centenarians with poor sleep quality had a 43%higher risk of hypertension compared to those with normal sleep quality(OR=1.43,95%CI:1.03-1.97).Additionally,centenarians with nighttime sleep durations of≤6 h or>9 h had higher proportions of high pulse pressure(PP),with OR values of 1.76(95%CI:1.18-2.63)and 2.07(95%CI:1.34-3.19),respectively.Mediation analysis illustrated that complement C3 played a mediating role in the relationship between sleep quality and hypertension,with an effect ratio of 2.4%.Similarly,lymphocyte count,the neutrophil-to-lymphocyte ratio(NLR),and the systemic immune-inflammation index(SII)were identified as mediating factors in the association between nighttime sleep duration and high PP,with effect ratios of 91.22%,36.93%,and 0.20%,respectively.Conclusion In centenarians,poor sleep quality raises the risk of hypertension,with complement C3 as a mediator.Additionally,nighttime sleep durations of≤6 h or>9 h increases the risk of high PP,mediated by lymphocyte count,NLR,and SII.
基金supported by a Clinical Research Award from the Fonds de recherche du Québec.
文摘Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.
基金This study was supported in part by grants from the National Key R&D Program of China(2021ZD0203100 to JC)National Natural Science Foundation of China(NSFC81720108013,NSFC31771161 and NSFC81230025 to JC,NSFC81300957 and NSFC82171227 to HL,NSFC81771453 and NSFC31970937 to HZ)+6 种基金Jiangsu Provincial Special Program of Medical Science(BL2014029 to JC)Basic and Clinical Research Center in Anesthesiology of Jiangsu Provincial'Science and Education for Health'Project(JC),Zhejiang Provincial Natural Science Foundation(LY22H090019 to HL)Jiangsu Provincial Natural Science Foundation(BK20190047 to HZ)the Priority Academic Program Development of Jiangsu Higher Education Institutions(19KJA610005 to HZ)Distinguished Professor Program of Jiangsu(HZ),Jiangsu Province Innovative and Entrepreneurial Talent Program and Jiangsu Province Innovative and Entrepreneurial Team Program(HZ),Xuzhou Medical University start-up grant for excellent scientist(D2018010 and D2019025D to HZ)the Natural Science Foundation of Shanghai(21ZR1411300 to YH)Shenkang Clinical Study Foundation of Shanghai(SHDC2020CR4061 to YH).
文摘Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,p<0.001)and N2(75.0(36.0-120.8)vs 30.0(1.3-59.3)min,F=12.55,p<0.001);the total sleep time on N1(506.0(408.0-561.0)vs 392.0(243.0-483.5)min,F=14.13,p<0.001)and N2(488.5(455.5-548.5)vs 346.0(286.5-517.5)min,F=7.36,p=0.007);the deep sleep time on N1(130.0(103.3-177.0)vs 42.5(9.8-100.8)min,F=24.4,p<0.001)and N2(103.5(46.0-154.8)vs 57.5(23.3-106.5)min,F=8.4,p=0.004);and the percentages of light sleep and REM sleep on N1 and N2(p<0.05 for each).The postoperative depression and anxiety scores did not differ significantly between the two groups.No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.
基金This study was supported by grants from the National Natural Science Foundation of China(Grant numbers:82171508 and 82071507).
文摘Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances.Methods Twenty-four patients with MDD and sleep disturbances(Pa_s),33 patients with MDD without sleep disturbances(Pa_ns)and 32 healthy controls(HCs)were recruited in this study.Resting-state functional imaging data were analysed using NH.Results Compared with Pa_ns and HCs,Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus.There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances(r=−0.42,p=0.001)as well as a positive correlation between NH in the right precuneus and sleep disturbances(r=0.41,p=0.002)in patients with MDD.Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN,which could differentiate pa_s from pa_ns.The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances.
基金This work is supported by the National Natural Science Foundation of China(grant/award numbers:81871430,81871426,U22A20303,82260359)Hebei Provincial Natural Science Foundation(grant/award numbers:H2020206263,H2020206625)STI2030-Major Projects Program(grant/award number:2022ZD0214500).
文摘To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.
文摘Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.
文摘BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.