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.

Clinical efficacy and mechanism study of mid-frequency anti-snoring device in treating moderate obstructive sleep apnea-hypopnea syndrome

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.

Relevance of sleep for wellness:New trends in using artificial intelligence and machine learning

Sleep and well-being have been intricately linked,and sleep hygiene is paramount for developing mental well-being and resilience.Although widespread,sleep disorders require elaborate polysomnography laboratory and patient-stay with sleep in unfamiliar environments.Current technologies have allowed various devices to diagnose sleep disorders at home.However,these devices are in various validation stages,with many already receiving approvals from competent authorities.This has captured vast patient-related physiologic data for advanced analytics using artificial intelligence through machine and deep learning applications.This is expected to be integrated with patients’Electronic Health Records and provide individualized prescriptive therapy for sleep disorders in the future.

Obstructive sleep apnea-hypopnea syndrome immunological relationship

Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a complex disorder cha-racterized by symptoms resulting from intermittent hypoxia and hypopnea,with research indicating a crucial role of immune system dysregulation and genetic variations in its pathogenesis.A recent Zhao et al study utilizes Mendelian ran-domization analysis to explore the causal relationship between immune cell characteristics and OSAHS.The study identifies specific lymphocyte subsets as-sociated with OSAHS,providing valuable insights into the disease's pathophy-siology and potential targets for therapeutic intervention.The findings underscore the significance of genetic and immunological factors in sleep disorders,offering a fresh perspective on OSAHS's complexities.Compared to existing literature,Zhao et al's study stands out for its focus on genetic markers and specific immune responses associated with OSAHS,expanding upon previous research primarily centered on systemic inflammation.In conclusion,the study represents a signi-ficant advancement in the field,shedding light on the causal role of immune cells in OSAHS and paving the way for future research and targeted treatments.

Wild Nutrition’s Food-Grown® Magnesium Supplementation Increases Sleep Quality and Sleep Duration and Reduces Stress in a Healthy Adult Population: A Double-Blind, Randomised, Placebo-Controlled Study

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.

SLEEP-MAD模式护理策略在结直肠癌病人术后护理中的应用

目的:探讨SLEEP-MAD模式护理策略在结直肠癌病人术后护理中的应用价值。方法:2022年5月—2023年5月选取医院收治的86例结直肠癌病人为研究对象,按照随机数字表法将病人分为观察组、对照组各43例,对照组行常规护理,观察组实施SLEEP-MAD模式护理策略,干预前后采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、视觉模拟疼痛评分表(VAS)、匹兹堡睡眠质量指数量表(PSQI)、癌因性疲乏评分及欧洲癌症研究与治疗组织生命质量量表(EORTC QLQ-C30)评价病人的不良情绪、疼痛感、癌因性疲乏、睡眠质量及生活质量。结果:干预后观察组病人HAMA、HAMD、VAS、PSQI及癌因性疲乏评分低于对照组(P<0.05);干预后观察组病人EORTC QLQ-C30评分高于对照组(P<0.05)。结论:SLEEP-MAD模式护理策略可有效减轻结直肠癌病人焦虑及抑郁情绪,减轻病人术后疼痛感及癌因性疲乏,改善病人睡眠质量及生活质量。

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.

Relationship between sleep quality and blood pressure level in nurses performing shift work

Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.

Astrocytic calcium waves:unveiling their roles in sleep and arousal modulation

Neuron-astrocyte interactions are vital for the brain’s connectome.Understanding astrocyte activities is crucial for comprehending the complex neural network,particularly the population-level functions of neurons in different cortical states and associated behaviors in mammals.Studies on animal sleep and wakefulness have revealed distinct cortical synchrony patterns between neurons.Astrocytes,outnumbering neurons by nearly fivefold,support and regulate neuronal and synaptic function.Recent research on astrocyte activation during cortical state transitions has emphasized the influence of norepinephrine as a neurotransmitter and calcium waves as key components of ion channel signaling.This summary focuses on a few recent studies investigating astrocyte-neuron interactions in mouse models during sleep,wakefulness,and arousal levels,exploring the involvement of noradrenaline signaling,ion channels,and glutamatergic signaling in different cortical states.These findings highlight the significant impact of astrocytes on large-scale neuronal networks,influencing brain activity and responsiveness.Targeting astrocytic signaling pathways shows promise for treating sleep disorders and arousal dysregulation.More research is needed to understand astrocytic calcium signaling in different brain regions and its implications for dysregulated brain states,requiring future human studies to comprehensively investigate neuron-astrocyte interactions and pave the way for therapeutic interventions in sleep-and arousal-related disorders.

Microplastic exposure disturbs sleep structure,reduces lifespan,and decreases ovary size in Drosophila melanogaster

The organ-specific toxicity resulting from microplastic(MP)exposure has been extensively explored,particularly concerning the gut,liver,testis,and lung.However,under natural conditions,these effects are not restricted to specific organs or tissues.Investigating whether MP exposure presents a systemic threat to an entire organism,impacting factors such as lifespan,sleep,and fecundity,is essential.In this study,we investigated the effects of dietary exposure to two different doses of MPs(1–5μm)using the terrestrial model organism Drosophila melanogaster.Results indicated that the particles caused gut damage and remained within the digestive system.Continuous MP exposure significantly shortened the lifespan of adult flies.Even short-term exposure disrupted sleep patterns,increasing the length of daytime sleep episodes.Additionally,one week of MP exposure reduced ovary size,with a trend towards decreased egg-laying in mated females.Although MPs did not penetrate the brain or ovaries,transcriptome analysis revealed altered gene expression in these tissues.In the ovary,Gene Ontology(GO)analysis indicated genotoxic effects impacting inflammation,circadian regulation,and metabolic processes,with significant impacts on extracellular structure-related pathways.In the brain,GO analysis identified changes in pathways associated with proteolysis and carbohydrate metabolism.Overall,this study provides compelling evidence of the systemic negative effects of MP exposure,highlighting the urgent need to address and mitigate environmental MP pollution.

Probiotics administration alleviates cognitive impairment and circadian rhythm disturbance induced by sleep deprivation

Gut microbiome is indispensable for maintaining normal brain function.Specifically,gut microbiota plays a causal role in sleep deprivation(SD)-induced cognitive impairment.In this study,neurobehavioral effects of the Bifidobacterium breve strain(CCFM1025)were assessed in sleep-deprived mice.CCFM1025 improved the body weight and food and water intake of the mice.It also alleviated SD-induced cognitive behavioural abnormalities(in the novel object recognition test),but did not show beneficial effects on mood-and spatial memory-related behaviours.CCFM1025 significantly altered the gut microbial composition and genome function.Key microbial metabolites that may regulate sleep function were also identified,such as isovaleric acid andγ-aminobutyric acid in the gut and purine metabolites in the serum.Those metabolites may participate in gutbrain communication by acting on the striatal melatonin system,for example to increase melatonin levels,and by regulating the expression of circadian clock genes such as those encoding the adenosine A2A receptor and period circadian regulator 1.Collectively,administration of probiotics alleviated cognitive impairment and circadian rhythm disturbance induced by SD via modulation of gut microbiome and its metabolites.These findings may help guide the treatment of insomnia or other sleep disorders via dietary strategies.

Regulation of sleep by astrocytes in the hypothalamic ventrolateral preoptic nucleus

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.

Decoding the nexus:branched-chain amino acids and their connection with sleep,circadian rhythms,and cardiometabolic health

The sleep-wake cycle stands as an integrative process essential for sustaining optimal brain function and,either directly or indirectly,overall body health,encompassing metabolic and cardiovascular well-being.Given the heightened metabolic activity of the brain,there exists a considerable demand for nutrients in comparison to other organs.Among these,the branched-chain amino acids,comprising leucine,isoleucine,and valine,display distinctive significance,from their contribution to protein structure to their involvement in overall metabolism,especially in cerebral processes.Among the first amino acids that are released into circulation post-food intake,branched-chain amino acids assume a pivotal role in the regulation of protein synthesis,modulating insulin secretion and the amino acid sensing pathway of target of rapamycin.Branched-chain amino acids are key players in influencing the brain's uptake of monoamine precursors,competing for a shared transporter.Beyond their involvement in protein synthesis,these amino acids contribute to the metabolic cycles ofγ-aminobutyric acid and glutamate,as well as energy metabolism.Notably,they impact GABAergic neurons and the excitation/inhibition balance.The rhythmicity of branchedchain amino acids in plasma concentrations,observed over a 24-hour cycle and conserved in rodent models,is under circadian clock control.The mechanisms underlying those rhythms and the physiological consequences of their disruption are not fully understood.Disturbed sleep,obesity,diabetes,and cardiovascular diseases can elevate branched-chain amino acid concentrations or modify their oscillatory dynamics.The mechanisms driving these effects are currently the focal point of ongoing research efforts,since normalizing branched-chain amino acid levels has the ability to alleviate the severity of these pathologies.In this context,the Drosophila model,though underutilized,holds promise in shedding new light on these mechanisms.Initial findings indicate its potential to introduce novel concepts,particularly in elucidating the intricate connections between the circadian clock,sleep/wake,and metabolism.Consequently,the use and transport of branched-chain amino acids emerge as critical components and orchestrators in the web of interactions across multiple organs throughout the sleep/wake cycle.They could represent one of the so far elusive mechanisms connecting sleep patterns to metabolic and cardiovascular health,paving the way for potential therapeutic interventions.

Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

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.

Sleep quality and characteristics of older adults with acute cardiovascular disease

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.

Sleep Posture Classification Using RGB and Thermal Cameras Based on Deep Learning Model

Sleep posture surveillance is crucial for patient comfort,yet current systems face difficulties in providing compre-hensive studies due to the obstruction caused by blankets.Precise posture assessment remains challenging because of the complex nature of the human body and variations in sleep patterns.Consequently,this study introduces an innovative method utilizing RGB and thermal cameras for comprehensive posture classification,thereby enhancing the analysis of body position and comfort.This method begins by capturing a dataset of sleep postures in the form of videos using RGB and thermal cameras,which depict six commonly adopted postures:supine,left log,right log,prone head,prone left,and prone right.The study involves 10 participants under two conditions:with and without blankets.Initially,the database is normalized into a video frame.The subsequent step entails training a fine-tuned,pretrained Visual Geometry Group(VGG16)and ResNet50 model.In the third phase,the extracted features are utilized for classification.The fourth step of the proposed approach employs a serial fusion technique based on the normal distribution to merge the vectors derived from both the RGB and thermal datasets.Finally,the fused vectors are passed to machine learning classifiers for final classification.The dataset,which includes human sleep postures used in this study’s experiments,achieved a 96.7%accuracy rate using the Quadratic Support Vector Machine(QSVM)without the blanket.Moreover,the Linear SVM,when utilized with a blanket,attained an accuracy of 96%.When normal distribution serial fusion was applied to the blanket features,it resulted in a remarkable average accuracy of 99%.

NLRP3-mediated autophagy dysfunction links gut microbiota dysbiosis to tau pathology in chronic sleep deprivation

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.

Comparison of vergence mechanisms between university students with good and poor sleep quality

AIM:To compare the vergence mechanisms between good and poor sleepers in university students.METHODS:A total of 64 university students were recruited in this study.The validated Malay version of Pittsburgh Sleep Quality Index questionnaire(PSQI-M)was used to measure the participants’sleep quality over the past month.Participants were categorized as good sleepers(n=32)and poor sleepers(n=32)based on the PSQI-M scores.Heterophoria and fusional vergences were measured at distance and near.Mann-Whitney U test was used to compare heterophoria,negative fusional vergence(NFV),and positive fusional vergence(PFV)at distance and near between good and poor sleepers.Spearman correlation analysis was used to study the relationship between PSQI-M score and PFV at distance.RESULTS:Both distance and near heterophorias were not significantly different between good and poor sleepers(P>0.05).There was a difference in distance PFV(P<0.05)between good and poor sleepers,but not in distance NFV,near NFV,and near PFV(P>0.05).Distance PFV was negatively correlated with PSQI-M score(rs=-0.33,P<0.05).CONCLUSION:University students with poor sleep quality demonstrates a reduced ability to maintain fusion with increasing convergence demand at distance.Sleep quality assessment during binocular vision examination in university students is recommended.

Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty:a prospective,double-blind,pilot,randomised controlled trial

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.