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Processing in the non-dominant hand during sleep: in terms of early, middle-early and late brain responses 睡眠期间非惯用手的处理过程:早期、中期和晚期的大脑反应
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-02-12 DOI: 10.1007/s41105-024-00511-6
Gonca Inanc, Murat Ozgoren, Adile Oniz

The aim was to investigate brain responses to non-painful tactile stimuli applied to the non-dominant hand during sleep. 21 healthy subjects participated in the study (11 female, mean age ± SD: 20.67 ± 1.91 years). A 40-channel polysomnography system and a pneumatic tactile stimulator unit were used. Stimuli were applied to the participants’ non-dominant hand. Evoked potential components of the CZ electrode were examined in four sleep stages (N1, N2, N3, and REM). Repeated measures ANOVA was used in statistical analyses. Brain responses, categorized as early (P50, N100, and P200), mid-early (N300, P450, and N550), and late (P900 and Nlate), were detected all sleep stages. No notable variances were found in the amplitude and latency of early brain responses when analyzed across different sleep stages. Differences in both amplitude and latency were observed across different sleep stages for the N300, P450, P900, and Nlate response components. This study presents a pioneering exploration into the responses of the non-dominant hand throughout all sleep stages, encompassing eight distinct response components. This novel investigation contributes to the existing literature by shedding light on previously unexplored aspects. The observed early responses are identified as sensory, while middle to late responses align with cognitive processes within the realm of sleep research. Notably, N300, P450, P900, and Nlate components display variations across diverse sleep stages, marked by alterations in both amplitude and latency. These findings offer valuable insights into the dynamic nature of hand responses throughout the sleep continuum.

目的是研究睡眠时大脑对施加在非惯用手的非疼痛触觉刺激的反应。21 名健康受试者(11 名女性,平均年龄(± SD):20.67±1.91 岁)参加了研究。研究使用了 40 通道多导睡眠监测系统和气动触觉刺激装置。刺激物作用于受试者的非惯用手。在四个睡眠阶段(N1、N2、N3 和快速动眼期)检测 CZ 电极的诱发电位成分。统计分析采用重复测量方差分析。大脑反应分为早期(P50、N100 和 P200)、中早期(N300、P450 和 N550)和晚期(P900 和 Nlate),在所有睡眠阶段均可检测到。在对不同睡眠阶段的早期大脑反应的振幅和潜伏期进行分析时,没有发现明显的差异。在不同睡眠阶段,N300、P450、P900 和 Nlate 反应成分的振幅和潜伏期都存在差异。本研究开创性地探讨了非惯用手在所有睡眠阶段的反应,包括八个不同的反应成分。这项新颖的调查揭示了以前未曾探索过的方面,为现有文献做出了贡献。观察到的早期反应被确定为感官反应,而中后期反应则与睡眠研究领域的认知过程相一致。值得注意的是,N300、P450、P900 和 Nlate 成分在不同的睡眠阶段显示出不同的变化,以振幅和延迟的改变为标志。这些发现为了解手部反应在整个睡眠过程中的动态性质提供了宝贵的见解。
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引用次数: 0
Examining the structure validity of the Pittsburgh Sleep Quality Index among female workers during New Zealand’s initial COVID-19 lockdown 考察匹兹堡睡眠质量指数在新西兰 COVID-19 封锁初期女工中的结构有效性
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-19 DOI: 10.1007/s41105-023-00509-6
Margrethe Helles, Richard Fletcher, Mirjam Münch, Rosemary Gibson

Sleep is important for good physical and mental health. The COVID-19 pandemic lockdown created a unique context that impacted psychological and social drivers for sleeping well. The Pittsburgh Sleep Quality Index (PSQI) is a widely used measurement tool assessing subjective sleep quality. The traditional model of the PSQI (a one-factor model), whilst validated and used across different populations, has also been questioned with regards to data fit and representativeness of its global score in different social and work-related circumstances. Examination of the structure validity of the PSQI in the unique context of the pandemic has been scarce. This study determined the PSQI structure validity amongst employed women considered to experience increased stressors during the pandemic lockdown. The subjectively reported PSQI data from 498 female workers (mean age 44.6 years) collected during New Zealand’s first national COVID-19 lockdown (April, 2020) was used. Confirmatory factor analyses compared the original one-factor model of the PSQI with the two- and three-factor models used by Jia et al. (2019) within this pandemic context. Results showed that the two-factor model provided a superior fit of the PSQI data compared to the original one-factor or a three-factor model. These findings suggest that a sub-score of the PSQI with two factors appears to be better at describing the sleep quality of healthy working women during the constrained situation of the pandemic lockdown compared to a single global sleep quality score. This indicates the importance of considering the validity of subjective sleep measures when used within unique social contexts and stressors.

睡眠对身心健康非常重要。COVID-19 大流行的封锁创造了一个独特的环境,影响了良好睡眠的心理和社会驱动因素。匹兹堡睡眠质量指数(PSQI)是一种广泛使用的评估主观睡眠质量的测量工具。尽管匹兹堡睡眠质量指数的传统模型(单因素模型)已在不同人群中得到验证和使用,但其在不同社会和工作环境下的数据拟合度和总体得分代表性也受到了质疑。在大流行病的独特背景下,对 PSQI 结构有效性的研究还很少。本研究确定了被认为在大流行病封锁期间会承受更多压力的就业妇女的 PSQI 结构有效性。研究使用了在新西兰第一次全国性 COVID-19 封锁期间(2020 年 4 月)收集的 498 名女工(平均年龄 44.6 岁)主观报告的 PSQI 数据。确认性因素分析比较了 PSQI 的原始单因素模型和 Jia 等人(2019 年)在这一流行病背景下使用的双因素和三因素模型。结果显示,与最初的单因素或三因素模型相比,双因素模型对 PSQI 数据的拟合效果更好。这些结果表明,与单一的总体睡眠质量评分相比,包含两个因子的 PSQI 子评分似乎更能描述健康职业女性在大流行病封锁的限制条件下的睡眠质量。这表明,在独特的社会环境和压力下使用主观睡眠测量时,考虑其有效性非常重要。
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引用次数: 0
Demographic predictors of bedtime procrastination in the Japanese population 日本人睡前拖延症的人口学预测因素
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-18 DOI: 10.1007/s41105-023-00508-7

Abstract

Bedtime procrastination (BP) is prevalent and problematic, with no previous study conducted in Japan. This study developed the Japanese version of the Bedtime Procrastination Scale (BPS), assessed its validity, and investigated the relationship between BP, demographic features, and sleep outcomes. Participants were divided into two samples (N = 252 and N = 630). Sample 1 involved a longitudinal study to confirm test–retest reliability of the BPS. Sample 2 involved a cross-sectional study to assess confirmatory factor analysis, criterion-related validity, construct validity, and determine the internal consistency of the BPS. The relationship between BP and demographic features (gender, age, and employment status) and sleep outcomes (Athens Insomnia Scale, sleep hours, sleep onset latency, and sleep efficiency) was investigated using Sample 2. The BPS showed good internal consistency (Cronbach’s α coefficients = .90–91), test–retest reliability (ICC = .86), and one factor model was valid; CFI = .95, TLI = .94, RMSEA = .10, and SRMR = .04. The BPS had a moderate positive association with general procrastination, moderate negative associations with self-control, sleep quality, and sleep duration on weekdays, and those who answered “yes” to the item “Do you have trouble with bedtime procrastination?” had higher BPS scores. BPS scores were moderately higher for younger participants (≤ 40 years), slightly higher for females, and non-significantly different between employment statuses. The BPS showed a significant positive correlation with insomnia symptoms, weak positive association with sleep efficiency on weekdays and holidays, and no significant association with sleep onset latencies on holidays and weekdays. This study provides new data on demographic predictors of BP in Japan. No clear effects of gender and employment status were found, but age was a strong predictor of BP, where younger age groups had a higher BP risk.

摘要 睡前拖延症(BP)是一种普遍存在的问题,以前在日本没有进行过研究。本研究开发了日语版睡前拖延量表(BPS),评估了其有效性,并调查了BP、人口统计学特征和睡眠结果之间的关系。参与者被分为两个样本(N = 252 和 N = 630)。样本 1 是一项纵向研究,目的是确认 BPS 的重测可靠性。样本 2 是一项横断面研究,旨在评估确认性因子分析、标准相关有效性、构建有效性,并确定 BPS 的内部一致性。样本 2 调查了血压与人口统计学特征(性别、年龄和就业状况)和睡眠结果(雅典失眠量表、睡眠时间、睡眠开始潜伏期和睡眠效率)之间的关系。BPS显示出良好的内部一致性(Cronbach's α系数=.90-91)和测试-再测可靠性(ICC=.86),单因素模型有效;CFI=.95,TLI=.94,RMSEA=.10,SRMR=.04。BPS与一般拖延症呈中度正相关,与自控力、睡眠质量和平日睡眠时间呈中度负相关,对 "你是否有睡前拖延症 "项目回答 "是 "的人BPS得分较高。年轻参与者(≤ 40 岁)的 BPS 得分略高,女性略高,不同就业状况者的 BPS 得分差异不显著。BPS与失眠症状呈显著正相关,与平日和节假日的睡眠效率呈微弱正相关,与节假日和平日的睡眠开始潜伏期无显著相关。这项研究提供了有关日本血压人口学预测因素的新数据。研究没有发现性别和就业状况对血压有明显影响,但年龄对血压有很强的预测作用,年龄越小血压风险越高。
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引用次数: 0
Association between sleep quality and living environment among Chinese older persons: a cross-sectional study 中国老年人睡眠质量与居住环境的关系:一项横断面研究
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-17 DOI: 10.1007/s41105-023-00510-z
Yan Wang, Mengjie Guo, Jianan Li, Yan Zhang, Jing Cheng, Linhai Zhao, Lidan Wang, Guixia Fang, Guimei Chen, Zhongliang Bai, Han Liang, Ren Chen, Li Wang

Sleep quality significantly affects the quality of life of older persons. Therefore, this study explored the relationship between sleep quality and living environment of older persons in China to provide a theoretical basis for therapies to alleviate sleep disorders in older persons. A total of 6211 subjects > 60 years of age in Anhui Province, China, were evaluated using the Pittsburgh Sleep Quality Index and a self-reported questionnaire. Multivariate logistic regression analysis revealed that living alone (OR = 1.26, 95% CI 1.09–1.46) and living in a rural area (OR = 1.19, 95% CI 1.06–1.34) were significantly associated with a high incidence of sleep disorders in older persons. Living near a park or foot paths suitable for exercise or walking was significantly associated with a lower incidence of sleep disorders in older persons (OR = 0.87, 95% CI 0.77–0.96). Individual factors such as female sex (OR = 1.30, 95% CI 1.14–1.48) and depression (OR = 2.80, 95% CI 2.47–3.19) were also associated with sleep quality in older persons. These data indicate a correlation exists between living environment and sleep quality.

睡眠质量严重影响老年人的生活质量。因此,本研究探讨了中国老年人睡眠质量与生活环境之间的关系,为缓解老年人睡眠障碍的疗法提供理论依据。本研究使用匹兹堡睡眠质量指数和自我报告问卷对中国安徽省 6211 名 60 岁以上的受试者进行了评估。多变量逻辑回归分析表明,独居(OR = 1.26,95% CI 1.09-1.46)和居住在农村地区(OR = 1.19,95% CI 1.06-1.34)与老年人睡眠障碍的高发显著相关。而居住在公园或适合锻炼或散步的人行道附近则与老年人睡眠障碍发生率较低明显相关(OR = 0.87,95% CI 0.77-0.96)。女性性别(OR = 1.30,95% CI 1.14-1.48)和抑郁(OR = 2.80,95% CI 2.47-3.19)等个体因素也与老年人的睡眠质量有关。这些数据表明,生活环境与睡眠质量之间存在相关性。
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引用次数: 0
The effects of an exercise program on inflammation in adults who differ according to obstructive sleep apnea severity 运动计划对阻塞性睡眠呼吸暂停严重程度不同的成年人炎症的影响
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-30 DOI: 10.1007/s41105-023-00505-w
Devon A. Dobrosielski, Karla A. Kubitz, Mary F. Walter, Hyunjeong Park, Christopher Papandreou, Susheel P. Patil

Exercise improves chronic inflammation and is recommended as a first-line medical or behavioral treatment for OSA with obesity. We examined whether the effects of an exercise program on inflammatory blood markers differed according to severity of OSA among obese adults. Overweight (BMI > 27 kg/m2) adults were evaluated for OSA using overnight polysomnography and subsequently classified as exhibiting no-to-mild OSA (AHI < 15 events/hour) or moderate-to-severe OSA (AHI ≥ 15 events/hour). Cardiorespiratory fitness, body composition assessed by DXA, fasting metabolic parameters and adipokines (i.e., glucose, insulin, leptin and adioponectin), and multiple markers of inflammation (i.e., CRP, IL-4, IL-8 and TNF-α) were measured at baseline (Pre) and following a 6-week (3 days per week) comprehensive exercise program (Post). Ten adults (Age: 48 ± 8 years; W:6; M:4) with no/mild OSA and 12 adults (Age: 54 ± 8 years; W:5; M:7) with moderate/severe OSA completed all aspects of the trial. No significant differences in age, cardiorespiratory fitness, body composition, fasting metabolic parameters and most inflammatory markers were observed between groups at baseline. Exercise training decreased total fat mass (Pre: 41,167 ± 13,315 g; Post: 40,311 ± 12,657 g; p = 0.008), leptin (Pre: 26.7 ± 29.6 pg/ml; Post: 22.7 ± 19.4 pg/ml; p = 0.028) and adiponectin (Pre: 16.6 ± 10.9 µg/ml; Post: 11.0 ± 10.6 µg/ml; p = 0.004) in those with moderate/severe OSA. Among those with no/mild OSA, exercise training resulted in a decrease in total fat mass (Pre = 37,332 ± 20,258 g; Post: 37,068 ± 18,268 g, p = 0.037). These data suggest that while 6 weeks of exercise reduced adipokines in those with moderate-to-severe OSA, it was not sufficient to improve common markers of inflammation among overweight adults with OSA.

运动可改善慢性炎症,被推荐为治疗肥胖性 OSA 的一线药物或行为疗法。我们研究了运动项目对炎症血液标志物的影响是否会因肥胖成人 OSA 的严重程度而有所不同。对体重超重(体重指数为 27 千克/平方米)的成年人使用夜间多导睡眠图进行了 OSA 评估,随后将其分为无至轻度 OSA(AHI 为 15 次/小时)或中至重度 OSA(AHI ≥ 15 次/小时)。在基线(前)和为期 6 周(每周 3 天)的综合锻炼计划(后)之后,分别测量了心肺功能、通过 DXA 评估的身体成分、空腹代谢参数和脂肪因子(即葡萄糖、胰岛素、瘦素和厌氧连蛋白)以及多种炎症指标(即 CRP、IL-4、IL-8 和 TNF-α)。10 名无/轻度 OSA 成人(年龄:48 ± 8 岁;女:6;男:4)和 12 名中度/重度 OSA 成人(年龄:54 ± 8 岁;女:5;男:7)完成了试验的所有环节。各组之间在年龄、心肺功能、身体成分、空腹代谢指标和大多数炎症标志物方面没有明显的基线差异。在中度/重度 OSA 患者中,瘦素(事前:26.7 ± 29.6 pg/ml;事后:22.7 ± 19.4 pg/ml;p = 0.028)和脂肪连通素(事前:16.6 ± 10.9 µg/ml;事后:11.0 ± 10.6 µg/ml;p = 0.004)的变化幅度更大。在无/轻度 OSA 患者中,运动训练导致总脂肪量减少(前:37,332 ± 20,258 g;后:37,068 ± 18,268 g,p = 0.037)。这些数据表明,虽然 6 周的运动能降低中度至重度 OSA 患者的脂肪因子,但不足以改善 OSA 超重成人的常见炎症指标。
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引用次数: 0
Unintended consequences: college students’ melatonin usage, sleep disturbance, and depressive symptoms 意外后果:大学生使用褪黑激素、睡眠障碍和抑郁症状
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-22 DOI: 10.1007/s41105-023-00506-9
Jack S. Peltz, Ronald Rogge

With such high rates of undergraduate sleep problems, students have chosen to take melatonin, an over-the-counter supplement that can facilitate sleep. Questions remain as to the effectiveness of melatonin for sleep problems, and questions have emerged about its impact on mental health. Accordingly, the current study examined how ongoing melatonin usage might impact relative changes in college students’ sleep disturbance and ultimately their depressive symptoms. The two-wave (baseline and 2-month follow-up), online sample consisted of 331 undergraduates (86% female; Mage = 21.3, SD = 2.4), who reported on melatonin usage, sleep disturbance, and depressive symptoms. Controlling for sleep hygiene, socio-economic status, and gender, our model demonstrated a significant indirect effect from ongoing melatonin usage to depressive symptoms. Specifically, melatonin consumption predicted relative increases in sleep disturbance, which, in turn, predicted corresponding increases in students’ depressive symptoms. Given the increasing prevalence of melatonin usage, the potential for unforeseen consequences remains high. Results suggest that the negative consequences of melatonin use can include both college students’ mental health and their sleep. Given the efficacy of addressing sleep problems with cognitive or behavioral strategies, it is essential that student support services highlight alternatives to melatonin and the potential problems associated with its use.

由于大学生睡眠问题的发生率如此之高,学生们选择服用褪黑素,这是一种可以促进睡眠的非处方补充剂。但褪黑素对睡眠问题的疗效仍存在疑问,其对心理健康的影响也出现了问题。因此,本研究探讨了持续服用褪黑素会如何影响大学生睡眠障碍的相对变化,并最终影响他们的抑郁症状。两波(基线和两个月的随访)在线样本包括 331 名大学生(86% 为女性;年龄 = 21.3,标准差 = 2.4),他们报告了褪黑激素的使用情况、睡眠障碍和抑郁症状。在对睡眠卫生、社会经济地位和性别进行控制后,我们的模型显示,褪黑激素的持续使用对抑郁症状有显著的间接影响。具体来说,褪黑激素的使用会导致睡眠障碍的相对增加,而睡眠障碍的增加又会导致学生抑郁症状的相应增加。鉴于褪黑素的使用越来越普遍,出现意外后果的可能性仍然很大。研究结果表明,使用褪黑素的负面影响可能包括大学生的心理健康和睡眠。考虑到通过认知或行为策略解决睡眠问题的效果,学生支持服务部门有必要强调褪黑素的替代品以及使用褪黑素可能带来的问题。
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引用次数: 0
Quetiapine improves sensorimotor gating deficit in a sleep deprivation-induced rat model 喹硫平可改善睡眠剥夺诱导大鼠模型中的感觉运动门控缺陷
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-14 DOI: 10.1007/s41105-023-00504-x
Öznur Özge Özcan, Burcu Çevreli, Arzu Temizyürek, Mesut Karahan, Muhsin Konuk

Background

Sleep deprivation (SD) impairs pre-stimulus inhibition, but the effect of quetiapine (QET) remains largely unknown.

Objective

This study aimed to investigate the behavioral and cognitive effects of QET in both naïve and sleep-deprived rats.

Materials and methods

Seven groups (n = 49) of male Wistar Albino rats were used in this study. SD was performed using the modified multiple platform technique in a water tank for 72 h. Our study consists of two experiments investigating the effect of QET on pre-pulse inhibition (PPI) of the acoustic startle reflex. The first experiment tested the effect of short- and long-term administration of QET on PPI response in non-sleeping (NSD) rats. The second experiment used 72 h REM sleep deprivation as a model for SD-induced impairment of the PPI response. Here, we tested the effect of QET on the % PPI of SD rats by short- and long-term intraperitoneal injection at the last 90 min of sleep SD and immediately subsequently tested for PPI.

Results

72 h SD impaired PPI, reduced startle amplitude, and attenuated the PPI% at + 4 dB, + 8 dB, and + 16 dB prepulse intensities. 10 mg/kg short and long-term QET administration completely improved sensorimotor gating deficit, increased startle amplitude, and restored the impaired PPI% at + 4 dB, + 8 dB, and + 16 dB after 72 h SD in rats.

Conclusion

Our results showed short- and long-term administration of QET improved sensorimotor gating deficit in 72 h SD. Further research is required for the etiology of insomnia and the dose-related behavioral effects of QET.

背景睡眠剥夺(SD)会损害刺激前抑制,但是喹硫平(QET)的影响在很大程度上仍不为人所知。我们的研究包括两个实验,调查 QET 对声惊反射前脉冲抑制 (PPI) 的影响。第一个实验测试了短期和长期服用 QET 对非睡眠(NSD)大鼠 PPI 反应的影响。第二个实验使用 72 小时快速眼动睡眠剥夺作为 SD 引起的 PPI 反应受损模型。在此,我们测试了 QET 对 SD 大鼠 PPI 百分比的影响,方法是在 SD 睡眠的最后 90 分钟进行短期和长期腹腔注射,随后立即进行 PPI 测试。10 mg/kg 短期和长期 QET 给药可完全改善大鼠的感觉运动门控缺陷,增加惊跳振幅,并恢复大鼠在 + 4 dB、+ 8 dB 和 + 16 dB 预脉冲强度下受损的 PPI%。关于失眠的病因和 QET 的剂量相关行为效应,还需要进一步研究。
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引用次数: 0
Correction to: Effect of physical activity on sleep problems in sedentary adults: a scoping systematic review 更正为体育锻炼对久坐成年人睡眠问题的影响:范围界定系统综述
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-12 DOI: 10.1007/s41105-023-00507-8
Anushree Rai, Mosab M. Aldabbas, Zubia Veqar
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引用次数: 0
Urbanisation negatively impacts sleep health and mood in adolescents: a comparative study of female students from city and rural schools of North India 城市化对青少年睡眠健康和情绪的负面影响:对印度北部城市和农村学校女生的比较研究
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-11 DOI: 10.1007/s41105-023-00503-y
Nisha Singh, Neelu Anand Jha, Vinod Kumar

This study investigated the impact of social settings on sleep, physical and mental health in female adolescents of North India (latitude 29.5 oN; longitude 77.5 oE). Using a battery of questionnaires, we compared the chronotype, sleep–wake pattern, sleep health (e.g. sleep quality, daytime sleepiness and fatigue) and mood (via depression, anxiety and stress symptoms) in female students (age 14–18 years) from rural (N = 719) and urban (N = 1033) schools separated by about 35 km, but families had almost similar socio-demographic details. The morning type was prevalent amongst rural, whilst the evening type was prevalent amongst urban students who also had access to smart phones, suggesting a possible greater use of the internet. There were greater negative sleep effects, daytime sleepiness, overall poor sleep quality, higher fatigue and anxiety levels in urban than the rural cohort. Interestingly, these measures also differed between school days and free days, suggesting an impact of the conflict between internal biological and social timings (= social jet lag). We also found a significant relationship between chronotype, internet addiction, mood-related parameters and measures of sleep health. Overall, these results suggest a possible impact of social settings on sleep health and mood-related behaviours in female adolescents.

本研究调查了社会环境对北印度(北纬 29.5 度;东经 77.5 度)女性青少年睡眠、身心健康的影响。通过一系列调查问卷,我们比较了农村学校(719 人)和城市学校(1033 人)女生(14-18 岁)的时间型、睡眠-觉醒模式、睡眠健康(如睡眠质量、白天嗜睡和疲劳)和情绪(通过抑郁、焦虑和压力症状),这两所学校相距约 35 公里,但家庭的社会人口详情几乎相似。农村学生多在早上出现睡眠障碍,而城市学生则多在晚上出现睡眠障碍,而且他们还能使用智能手机,这表明他们可能更多地使用互联网。与农村学生相比,城市学生在睡眠负面影响、白天嗜睡、总体睡眠质量差、疲劳和焦虑程度方面的表现更为突出。有趣的是,这些指标在上学日和放学日之间也存在差异,这表明内部生物时间和社会时间之间的冲突(=社会时差)产生了影响。我们还发现,时序型、网络成瘾、情绪相关参数和睡眠健康指标之间存在着重要关系。总之,这些结果表明,社会环境可能会对女性青少年的睡眠健康和情绪相关行为产生影响。
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引用次数: 0
Efficacy of cognitive behavioral therapy for insomnia in the perinatal period: a meta-analysis of randomized controlled trials 认知行为疗法对围产期失眠症的疗效:随机对照试验荟萃分析
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-10 DOI: 10.1007/s41105-023-00502-z
Shuya Feng, Bingqin Dai, Huawei Li, Huili Fu, Yunping Zhou

The meta-analysis aims to explore the effect of cognitive behavioral therapy for insomnia (CBT-I) in the perinatal period. Randomized controlled trials (RCTs) assessed the effects of CBT-I in perinatal women with insomnia, published in English, were eligible. Electronic searches were performed using PubMed, Embase (Elsevier), PsycINFO (Ebsco), and Web of Science (Clarivate Analytics). Insomnia Severity Index (ISI) as the primary outcome was used to estimate the pooled effects and durable efficacy of CBT-I. The secondary outcome measures were Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Of 46 studies reviewed, seven studies met the inclusion criteria. The meta-analysis indicated significant improvement in insomnia as measured with the ISI (standardized mean difference (SMD) = − 0.62, 95% confidence intervals (CI) − 0.77, − 0.47, I2 = 28%). At the follow-up time point, the meta-analysis indicated the durable efficacy of CBT-I (SMD = − 0.47, 95% CI − 0.90, − 0.03, I2 = 73%). Definite improvement of CBT-I on EPDS (SMD = -0.31, 95% CI − 0.55, − 0.06, I2 = 33%) and PSQI (SMD = − 0.82, 95% CI − 1.27, − 0.38, I2 = 68%) score change post-intervention were found. In sub-analyses, CBT-I had similar effect sizes, independent of possible modifiers (study population, comparison group, delivery format, etc.). This meta-analysis demonstrates that CBT-I is effective in alleviating insomnia, depression, and sleep quality among perinatal women. It is equally important to find that CBT-I has a durable efficacy on insomnia in the perinatal period. However, it is necessary to include larger samples and conduct rigorous RCTs to further explore this issue.

荟萃分析旨在探讨围产期失眠认知行为疗法(CBT-I)的效果。符合条件的随机对照试验(RCT)评估了 CBT-I 对围产期妇女失眠症的影响,这些试验均以英语发表。使用 PubMed、Embase(Elsevier)、PsycINFO(Ebsco)和 Web of Science(Clarivate Analytics)进行电子检索。失眠严重程度指数(ISI)作为主要结果,用于估算 CBT-I 的综合效果和持久疗效。次要结果指标为爱丁堡产后抑郁量表(EPDS)和匹兹堡睡眠质量指数(PSQI)。在所审查的 46 项研究中,有 7 项符合纳入标准。荟萃分析表明,用 ISI 测量的失眠情况有明显改善(标准化平均差 (SMD) = - 0.62,95% 置信区间 (CI) - 0.77, - 0.47,I2 = 28%)。在随访时间点,荟萃分析表明 CBT-I 具有持久疗效(SMD = - 0.47,95% CI - 0.90,- 0.03,I2 = 73%)。CBT-I对干预后EPDS(SMD = -0.31,95% CI -0.55,-0.06,I2 = 33%)和PSQI(SMD = -0.82,95% CI -1.27,-0.38,I2 = 68%)得分变化的改善是肯定的。在子分析中,CBT-I 具有相似的效应大小,不受可能的调节因素(研究人群、对比组、授课形式等)的影响。这项荟萃分析表明,CBT-I 能有效缓解围产期妇女的失眠、抑郁和睡眠质量。同样重要的是,CBT-I 对围产期失眠症具有持久疗效。然而,有必要纳入更多的样本并进行严格的 RCT 研究来进一步探讨这一问题。
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Sleep and Biological Rhythms
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