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European Journal of Sport Science Jun 2024The aim of this study was to investigate sleep-wake behavior and gain insights into perceived impairment (sleep, fatigue, and cognitive function) of athletes competing...
The aim of this study was to investigate sleep-wake behavior and gain insights into perceived impairment (sleep, fatigue, and cognitive function) of athletes competing in two international multi-day adventure races. Twenty-four athletes took part across two independent adventure races: Queensland, Australia and Alaska, USA. Individual sleep periods were determined via actigraphy, and racers self-reported their perceived sleep disturbances, sleep impairment, fatigue and cognitive function. Each of these indices was calculated for pre-, during- and post-race periods. Sleep was severely restricted during the race period compared to pre-race (Queensland, 7:46 [0:29] vs. 2:50 [1:01]; Alaska, 7:39 [0:58] vs. 2:45 [2:05]; mean [SD], hh:mm). As a result, there was a large cumulative sleep debt at race completion, which was not 'reversed' in the post-race period (up to 1 week). The deterioration in all four self-reported scales of perceived impairment during the race period was largely restored in the post-race period. This is the first study to document objective sleep-wake behaviors and subjective impairment of adventure racers, in the context of two geographically diverse, multi-day, international adventure races. Measures of sleep deprivation indicate that sleep debt was extreme and did not recover to pre-race levels within 1 week following each race. Despite this objective debt continuing, perceived impairment returned to pre-race levels quickly post-race. Therefore, further examination of actual and perceived sleep recovery is warranted. Adventure racing presents a unique scenario to examine sleep, performance and recovery.
PubMed: 38874812
DOI: 10.1002/ejsc.12143 -
Food Science & Nutrition Jun 2024Sleep is crucial for preserving both physical and mental health, including skin health. Presently, there is a burgeoning interest in the use of herbal and natural...
Sleep is crucial for preserving both physical and mental health, including skin health. Presently, there is a burgeoning interest in the use of herbal and natural ingredients to mitigate the adverse effects of sleep disorders. In this 4-week, randomized, double-blind, controlled trial, 70 subjects with sleep disorders were randomly assigned to receive either a placebo or a , , and GABA (PZG) supplement (10 mL per day). Total sleep duration was detected by wrist actigraphy, and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Skin conditions were evaluated based on assessments of skin hydration, glossiness elasticity, color, severity of wrinkles, and skin roughness. After 4 weeks, the total sleep duration significantly increased by 12.96% ( .006) and the PSQI score notably decreased by 59.94% ( .000) compared to the baseline. Notably, compared to the baseline conditions, skin hydration, radiance, elasticity, firmness, wrinkle severity, and roughness were significantly improved in the PZG group. In addition, the PZG group demonstrated significantly greater improvements than the placebo group in terms of changes from baseline in total sleep duration, PSQI score, skin hydration, wrinkle severity, and skin roughness. The present results demonstrated that the combined intake of herbs and GABA can improve sleep quality and enhance skin health without adverse effects.
PubMed: 38873452
DOI: 10.1002/fsn3.4048 -
BMC Geriatrics Jun 2024Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at... (Meta-Analysis)
Meta-Analysis
Effectiveness of pedometer-based walking programmes in improving some modifiable risk factors of stroke among community-dwelling older adults: a systematic review, theoretical synthesis and meta-analysis.
BACKGROUND
Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults?
METHOD
Eight databases were searched up to December 2, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects.
RESULTS
The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes.
CONCLUSION
Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals.
TRIAL REGISTRATION
Registration Number: INPLASY202230118.
Topics: Humans; Aged; Walking; Independent Living; Stroke; Risk Factors; Aged, 80 and over; Actigraphy; Health Promotion; Randomized Controlled Trials as Topic; Middle Aged
PubMed: 38872081
DOI: 10.1186/s12877-024-05069-z -
Scientific Reports Jun 2024Proper alignment of activity-rest and light-dark patterns allows for healthy bodily functions to occur at optimal times of the day. Disruptions to this alignment may...
Proper alignment of activity-rest and light-dark patterns allows for healthy bodily functions to occur at optimal times of the day. Disruptions to this alignment may cause poor sleep as well as physical, mental, and cognitive problems. The purpose of this cross-sectional study was to determine if poorer circadian alignment was associated with decreased cognitive functioning among older (> 60 years) participants in the National Health and Nutrition Examination Survey. We utilized actigraphy-based rest-activity and dark-light measurements to calculate phasor magnitude (strength of circadian alignment coupling) and phasor angle (phase difference between activity-rest and light-dark cycles). Multiple linear regression models were used to determine associations of phasor magnitude and angle with performance in various cognitive tests, including Digit Symbol Substitution Test score (DSSS), CERAD Savings Percentage (CSP), and Animal Fluency Test (AFT) score. The results showed that a lower phasor magnitude (which indicates decreased strength of alignment coupling between rest-activity and dark-light cycles) was significantly associated with decreased DSSS (indicating slower processing speed and poorer working memory) when controlling for many important sociodemographic factors. However, this association became non-significant when accounting for sleep duration and total physical activity. Phasor angle did not have a significant association with any of the cognitive scores. Overall, we provided evidence indicating that circadian alignment may be a predictor of cognitive performance. Future studies should investigate whether improving circadian alignment may improve cognitive function and prevent cognitive decline.
Topics: Humans; Female; Male; Aged; Circadian Rhythm; Cognition; Cross-Sectional Studies; Middle Aged; Actigraphy; Aged, 80 and over; Sleep; Nutrition Surveys
PubMed: 38866912
DOI: 10.1038/s41598-024-64309-9 -
BMJ Open Jun 2024Insomnia is a common symptom among patients with schizophrenia and schizoaffective disorder, negatively impacting symptom severity, functioning and well-being; however,...
INTRODUCTION
Insomnia is a common symptom among patients with schizophrenia and schizoaffective disorder, negatively impacting symptom severity, functioning and well-being; however, it is rarely the direct focus of treatment. The main recommended treatment for insomnia is cognitive behavioural therapy (CBT-I). There is some evidence that CBT-I can also be used to treat insomnia in patients with schizophrenia, but only a few randomised controlled trials (RCTs) have been published. The aim of this ongoing RCT is to determine whether we can alleviate symptoms of insomnia and improve the quality of life in patients with schizophrenia and schizoaffective disorder through CBT-I delivered via the internet or in a group mode.
METHODS AND ANALYSES
The aim of this study is to recruit 84-120 outpatients from the Psychosis Clinics of Helsinki University Hospital and the City of Helsinki Health Services. The main inclusion criteria are a diagnosis of schizophrenia or schizoaffective disorder and self-reported sleep problems. The study will be performed on a cyclic basis, with a target of 12-24 patients per cycle. Participants are randomly assigned into three groups: (1) a group receiving only treatment as usual (TAU), (2) internet-based individual therapy for insomnia (iCBT-I)+TAU or (3) group therapy for insomnia (GCBT-I) conducted via a virtual platform+TAU. The primary outcome measures are quantitative changes in the Insomnia Severity Index score and/or changes in health-related quality of life using the 15D quality of life measure. Secondary outcomes include self-reported variables for sleep, health, stress and the severity of psychotic and depressive symptoms; objective outcomes include actigraphy and bed sensor data to evaluate circadian rhythms and motor activity. Outcome measures are assessed at baseline and after the treatment period at weeks 12, 24 and 36.
ETHICS AND DISSEMINATION
The Coordinating Ethics Committee of the Hospital District of Helsinki and Uusimaa, Finland, approved the study protocol. The results will be published in peer-reviewed journals.
TRIAL REGISTRATION NUMBER
NCT04144231.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Cognitive Behavioral Therapy; Schizophrenia; Psychotic Disorders; Quality of Life; Randomized Controlled Trials as Topic; Adult; Female; Male; Finland
PubMed: 38866575
DOI: 10.1136/bmjopen-2023-076129 -
Nature and Science of Sleep 2024Body-worn accelerometers are commonly used to estimate sleep duration in population-based studies. However, since accelerometry-based sleep/wake-scoring relies on...
PURPOSE
Body-worn accelerometers are commonly used to estimate sleep duration in population-based studies. However, since accelerometry-based sleep/wake-scoring relies on detecting body movements, the prediction of sleep duration remains a challenge. The aim was to develop and evaluate the performance of a machine learning (ML) model to predict accelerometry-based sleep duration and to explore if this prediction can be improved by adding skin temperature data, circadian rhythm based on the estimated midpoint of sleep, and cyclic time features to the model.
PATIENTS AND METHODS
Twenty-nine adults (17 females), mean (SD) age 40.2 (15.0) years (range 17-70) participated in the study. Overnight polysomnography (PSG) was recorded in a sleep laboratory or at home along with body movement by two accelerometers with an embedded skin temperature sensor (AX3, Axivity, UK) positioned at the low back and thigh. The PSG scoring of sleep/wake was used as ground truth for training the ML model.
RESULTS
Based on pure accelerometer data input to the ML model, the specificity and sensitivity for predicting sleep/wake was 0.52 (SD 0.24) and 0.95 (SD 0.03), respectively. Adding skin temperature data and contextual information to the ML model improved the specificity to 0.72 (SD 0.20), while sensitivity remained unchanged at 0.95 (SD 0.05). Correspondingly, sleep overestimation was reduced from 54 min (228 min, limits of agreement range [LoAR]) to 19 min (154 min LoAR).
CONCLUSION
An ML model can predict sleep/wake periods with excellent sensitivity and moderate specificity based on a dual-accelerometer set-up when adding skin temperature data and contextual information to the model.
PubMed: 38863481
DOI: 10.2147/NSS.S452799 -
BMC Psychology Jun 2024Sleep is vital for maintaining individuals' physical and mental health and is particularly challenged during pregnancy. More than 70% of women during the gestational... (Randomized Controlled Trial)
Randomized Controlled Trial
Promoting sleep health during pregnancy for enhancing women's health: a longitudinal randomized controlled trial combining biological, physiological and psychological measures, Maternal Outcome after THERapy for Sleep (MOTHERS).
BACKGROUND
Sleep is vital for maintaining individuals' physical and mental health and is particularly challenged during pregnancy. More than 70% of women during the gestational period report insomnia symptoms. Sleep dysfunction in the peripartum increases the risk for a cascade of negative health outcomes during late pregnancy, birth, and postpartum. While psychological interventions are considered the first line treatment for sleep difficulties, they are still scarcely offered during pregnancy and there is a lack of longitudinal research combining psychological and physiological indices.
METHODS
The present protocol outlines a randomized controlled trial aimed at testing the long-term effectiveness of an automatized digitalized psychoeducational intervention for insomnia for expectant mothers complaining insomnia symptoms without comorbidity. Outcomes include physiological, hormonal, and subjective indices of maternal psychopathology, stress, and emotional processes, and sleep and wellbeing of the family system. The trial is part of a longitudinal study evaluating expectant mothers from early pregnancy (within the 15th gestational week) to 6-months postpartum through 6 observational phases: baseline (BSL), 6- and 12-weeks from BSL (FU1-FU2), 2-to-4 weeks after delivery (FU3), and 3- and 6-months after delivery (FU4-5). We plan to recruit 38 women without sleep difficulties (Group A) and 76 women with sleep difficulties (Group B). Group B will be randomly assigned to digital psychological control intervention (B1) or experimental psychoeducational intervention targeting insomnia (B2). At 3 time points, an ecological-momentary-assessment (EMA) design will be used to collect data on sleep and emotions (diaries), sleep-wake parameters (actigraphy) and stress reactivity (salivary cortisol). We will also test the DNA methylation of genes involved in the stress response as biomarkers of prenatal poor sleep. Information on partner's insomnia symptoms and new-borns' sleep will be collected at each stage.
DISCUSSION
The proposed protocol aims at testing an easily accessible evidence-based psychoeducational intervention for expectant mothers to help them improving sleep, health, and wellbeing in the peripartum. The results could improve the understanding and management of sleep difficulties and peripartum depression.
TRIAL REGISTRATION
The study protocol has been registered on 22 April 2024 with ClinicalTrials.gov Protocol Registration and Results System (PRS), ID: NCT06379074.
PROTOCOL VERSION
April 23, 2024.
Topics: Humans; Female; Pregnancy; Sleep Initiation and Maintenance Disorders; Longitudinal Studies; Adult; Mothers; Pregnancy Complications; Women's Health; Postpartum Period
PubMed: 38858743
DOI: 10.1186/s40359-024-01827-1 -
MedRxiv : the Preprint Server For... May 2024Sleep-wake disturbances frequently present in Veterans with mild traumatic brain injury (mTBI). These TBI-related sleep impairments confer significant burden and...
Feasibility and acceptability for LION, a fully remote, randomized clinical trial within the VA for light therapy to improve sleep in Veterans with and without TBI: An MTBI sponsored protocol: LION: A remote RCT protocol within VA.
Sleep-wake disturbances frequently present in Veterans with mild traumatic brain injury (mTBI). These TBI-related sleep impairments confer significant burden and commonly exacerbate other functional impairments. Therapies to improve sleep following mTBI are limited and studies in Veterans are even more scarce. In our previous pilot work, morning bright light therapy (MBLT) was found to be a feasible behavioral sleep intervention in Veterans with a history of mTBI; however, this was single-arm, open-label, and non-randomized, and therefore was not intended to establish efficacy. The present study, LION (light vs ion therapy) extends this preliminary work as a fully powered, sham-controlled, participant-masked randomized controlled trial (NCT03968874), implemented as fully remote within the VA (target n=120 complete). Randomization at 2:1 allocation ratio to: 1) active: MBLT (n=80), and 2) sham: deactivated negative ion generator (n=40); each with identical engagement parameters (60-min duration; within 2-hrs of waking; daily over 28-day duration). Participant masking via deception balanced expectancy assumptions across arms. Outcome measures were assessed following a 14-day baseline (pre-intervention), following 28-days of device engagement (post-intervention), and 28-days after the post-intervention assessment (follow-up). Primary outcomes were sleep measures, including continuous wrist-based actigraphy, self-report, and daily sleep dairy entries. Secondary/exploratory outcomes included cognition, mood, quality of life, circadian rhythm via dim light melatonin onset, and biofluid-based biomarkers. Participant drop out occurred in <10% of those enrolled, incomplete/missing data was present in <15% of key outcome variables, and overall fidelity adherence to the intervention was >85%, collectively establishing feasibility and acceptability for MBLT in Veterans with mTBI.
PubMed: 38853958
DOI: 10.1101/2024.05.30.24308195 -
The International Journal of Behavioral... Jun 2024
PubMed: 38851707
DOI: 10.1186/s12966-024-01608-4 -
Frontiers in Psychiatry 2024Insomnia is one of the most common symptoms among breast cancer patients, which can be present throughout all stages of breast cancer. As a non-pharmacological...
BACKGROUND
Insomnia is one of the most common symptoms among breast cancer patients, which can be present throughout all stages of breast cancer. As a non-pharmacological alternative treatment, acupuncture has been suggested to improve sleep situations in patients with cancer suffering from insomnia. However, there is a lack of well-designed, high-quality clinical evidence regarding the efficacy of acupuncture in the treatment of breast cancer-related insomnia. This study is conducted to evaluate the efficacy and safety of acupuncture treatment for breast cancer-related insomnia.
METHODS
This study was designed as a multicenter, randomized, sham-controlled clinical trial. A total of 264 eligible patients with breast cancer-related insomnia will be randomized into an acupuncture group and a sham acupuncture group in a 1:1 ratio. In the trial, patients in the acupuncture and sham acupuncture groups will receive 12 sessions over a consecutive 4-week period. The primary outcome will be the treatment response rate of Insomnia Severity Index (ISI) at week 4; secondary outcomes include treatment remission rate of ISI, Sleep Efficiency (SE) obtained by the use of Sleep diary, treatment response rate of ISI at 8th and 16th weeks of follow-up, the mean changes of ISI, Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Quality of Life Questionnaire - Core 30 (QLQ-C30), sleep parameters recorded in Actigraphy and weekly usage of remedial drugs. Adverse events will be recorded throughout the study. All analyses will be based on the ITT principle and performed with SAS 9.4 statistical software.
DISCUSSION
This trial will evaluate the clinical efficacy and safety of acupuncture for breast cancer-related insomnia. If proven effective, acupuncture will provide an effective option for patients with breast cancer-related insomnia, which will play a positive role in helping patients reduce their use of sleeping medications.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier NCT05510700.
PubMed: 38846918
DOI: 10.3389/fpsyt.2024.1301338