Clocks & Sleep最新文献

The school and university periods represent a critical phase in individuals' cognitive, emotional, and behavioural development. Numerous lifestyle factors can influence executive functions and high-level cognitive processes crucial for learning and behavioural adaptation. Sleep and physical activity are two variables that influence executive functions and that could be modified through behavioural interventions. Numerous scientific studies suggest that adequate sleep quality and duration are linked to improved cognitive performance. Similarly, regular physical exercise correlates with neurocognitive benefits. However, these two aspects of lifestyle are often compromised in students, resulting in attention difficulties, reduced working memory, and difficulty in inhibitory control, all aspects of non-optimal executive functioning. Even though the scientific literature separately explores "sleep and executive functions" and "physical activity and executive functions", few studies have integrated the two factors to assess their combined effect on executive functioning, particularly within the student population. The present narrative review aims to outline an integrated theoretical framework of existing scientific literature and to identify any knowledge gaps that may guide future research. It could provide relevant insights for designing preventive or promotional interventions to enhance students' cognitive performance and mental well-being.

Concussions significantly impact sleep quality among adolescents. Despite increasing recognition of these effects, the complex relationship between adolescent concussions and sleep disturbances is still not fully understood and presents mixed findings. Here, we conducted a systematic review and meta-analysis to assess how concussions affect sleep-related symptoms in adolescents. We included papers presenting Pittsburgh Sleep Quality Index (PSQI) differences following concussion in high school and collegiate patients, with sleep measures recorded following concussion. Animal studies, research on participants with conditions other than concussion, non-English articles and papers failing to present PSQI data were excluded. We searched MEDLINE^®, Embase^®, CINAHL, Web of Science™, PsycINFO^®, Google Scholar, and Cochrane Central Register of Controlled Trials databases until 23 August 2024. In addition, we performed hand-searching of relevant reference lists and conference proceedings to identify further studies. Risk of bias was assessed using the Newcastle-Ottawa scale. In total, we considered 4477 studies, with nine meeting the inclusion criteria. Our analysis involved 796 participants, 340 of whom had experienced a concussion. Analysis was carried out using the meta and metafor packages in R (version 4.0.0). We showed a deterioration in sleep quality post-concussion, as evidenced by increased PSQI (standardised mean difference 0.84; 95% CI 0.53-1.16; p < 0.0001). Subgroup and quality assessments confirmed the consistency of these findings. Since poor sleep quality impacts daytime activities, we analysed the relationship between concussion and daytime dysfunction. We showed that concussion is associated with a significant worsening of the daytime dysfunction score by 0.55 (95% CI 0.24-0.70; p = 0.006). We conclude that concussions impair both sleep quality and daytime functioning in adolescents. Our research underscores the need for systematic inclusion of sleep quality assessments in post-concussion protocols and calls for targeted interventions to manage sleep disturbances post-concussion to mitigate their broader impacts on daily functioning.

The circadian rhythm of the central brain clock in the suprachiasmatic nucleus (SCN) is synchronized by light. White adipose tissue (WAT) is one of the metabolic endocrine organs containing a molecular clock, and it is synchronized by the SCN. Excess WAT is a risk factor for health issues including type 2 diabetes mellitus (DM2). We hypothesized that bright-light exposure would affect the human WAT transcriptome. Therefore, we analyzed WAT biopsies from two previously performed randomized cross-over trials (trial 1: n = 8 lean, healthy men, and trial 2: n = 8 men with obesity and DM2). From 7:30 h onwards, all the participants were exposed to either bright or dim light. Five hours later, we performed a subcutaneous abdominal WAT biopsy. RNA-sequencing results showed major group differences between men with obesity and DM2 and lean, healthy men as well as a differential effect of bright-light exposure. For example, gene sets encoding proteins involved in oxidative phosphorylation or respiratory chain complexes were down-regulated under bright-light conditions in lean, healthy men but up-regulated in men with obesity and DM2. In addition to evident group differences between men with obesity and DM2 and healthy lean subjects, autonomic or neuroendocrine signals resulting from bright-light exposure also differentially affect the WAT transcriptome.

Patient activation enhances self-management of chronic illnesses, and sleep quality is vital for health. The link between activation and sleep quality and the mediating role of chronic diseases remain underexplored. This study examined the association between patient activation and sleep quality, variations across chronic disease groups, and whether chronic diseases mediate this relationship. A population-based cross-sectional survey in South Tyrol (Italy) included 2090 adults (55.0% response rate). Patient activation was measured using the Patient Activation Measure (PAM-10), and sleep quality was measured using the Brief Pittsburgh Sleep Quality Index (B-PSQI). The presence and number of chronic diseases were self-reported. Bivariate analyses, multiple linear regression, and mediation analyses (PROCESS) were performed. Among the participants, 918 (44%) reported at least one chronic disease. These individuals had poorer sleep (B-PSQI mean: 5.05 ± 3.26 vs. 3.66 ± 2.65; p < 0.001) and lower patient activation (PAM-10: 54.4 ± 12.7 vs. 57.2 ± 12.5; p < 0.001) than those without. A negative correlation between PAM-10 and B-PSQI was observed (r = -0.12, p < 0.001), with stronger associations in patients with hypertension and mental illness. In adjusted regressions, chronic disease, female sex, and older age predicted poorer sleep, whereas higher PAM-10 scores predicted better sleep. Mediation analyses showed that chronic disease partially mediated the relationship between patient activation and sleep quality, accounting for 4.7% to 6.3% of the total effect. Conclusions: Higher patient activation correlates with better sleep quality, although this relationship is partly mediated by the chronic disease burden. Sleep disturbances persist across chronic conditions, despite good self-management. These findings highlight the importance of adopting strategies to manage chronic diseases and sleep disturbances, acknowledging that while patient activation is statistically associated with sleep quality, the strength of this relationship is limited.

Hypersomnia may be classified as primary or secondary, with secondary hypersomnia arising from a variety of underlying causes. Thus, according to ICSD3-TR classification, the diagnosis of idiopathic hypersomnia (IH) is established based on (1) excessive daytime sleepiness (EDS); (2) electrophysiological findings including either a mean sleep latency of less than 8 min on the Multiple Sleep Latency Test (MSLT) or increased total sleep (≥11 h) on 24 h polysomnography; and (3) systematic elimination of other potential etiologies, including sleep deprivation, substances, and medical, psychiatric (notably mood disorders), or sleep disorders. Nevertheless, the clinical heterogeneity observed in IH fuels an ongoing debate, reflecting the limited understanding of its underlying pathophysiological mechanisms. This report describes the case of a patient presenting with a clinical and polysomnographic phenotype of IH (MSLT < 8 min). A comprehensive psychopathological evaluation was performed to explore the possibility of secondary hypersomnia, which revealed features consistent with complex post-traumatic stress disorder (c-PTSD). Psychotherapy focused on c-PTSD was administered with positive and objective results in hypersomnolence/EDS. This clinical improvement suggests a potential relationship between psychological trauma and hypersomnia, a connection that is rarely described in the literature and warrants further investigation. This case highlights the need for a comprehensive assessment of secondary factors, particularly complex trauma, even in the presence of a clinical and polysomnographic phenotype consistent with IH.

This study described and analyzed the results of cardiorespiratory polygraphic studies in infants under three months who were hospitalized and monitored due to suspected apneas.

Methods: Cross-sectional study. Patients aged <3 months hospitalized from 2011 to 2023 were included. All were referred for suspected apneas, and cardiorespiratory polygraphies (PG) were conducted simultaneous to non-invasive monitoring. Demographic, PG, and diagnostic variables were recorded. PG values were obtained and compared between diagnostic groups. Association was evaluated according to diagnosis, prematurity, presence, and alteration type with Kruskal-Wallis, Wilcoxon, and Fisher tests. Association between quantitative variables was assessed with Spearman's rho and the presence of alteration with binomial logistic regression. Analysis was performed with Jamovi v.2.3, and statistical significance was defined as p < 0.05.

Results: A total of 155 studies were included. Median age was 41.0 days (IQR 22.0-59.0), median gestational age was 38 weeks (IQR 32.0-42.0), and 52.3% were premature.

Diagnosis: brief resolved unexplained events (BRUE) (58.1%), apnea of prematurity (27.1%), hypotonic syndrome (7.1%), laryngomalacia (LGM) (3.9%), and craniofacial alterations (CFA) (3.9%). Altered results in 21.9% polygraphies: 44.1% with AHI ≧ 5/h and 20.6% with SpO₂ ≦ 90% in >5% of the record. CFA and LGM patients had a higher risk of an altered polygraph than those with apnea of prematurity (OR 21.3/8.5) and BRUE (OR 35.9/14.3), respectively.

Conclusions: Infants under three months of age referred for apnea showed often abnormal polygraphic indices, showing significant differences between diagnostic groups. Performance of sleep studies in these groups was feasible and allowed to confirm the presence of apneas and their level of severity. Particular attention should be considered in children with CFA and LMG, since their risk is significantly higher. Age-specific apnea patterns seem to be of interest, as this may possibly lead to future consequences.

In humans, the master circadian clock, present in the suprachiasmatic nucleus, plays an important role in controlling life-sustaining functions. The development of the circadian clock begins in the fetal period and is almost completed during infancy to early childhood, based on the developmental program that is influenced by the mother's daily rhythms and, after birth, with the addition of information from the daily life environment. It is known that circadian rhythms are deeply related not only to the balance of a child's mental and physical development but also to maintaining mental and physical health throughout one's life. However, it has been suggested that various health problems in the future at any age may be caused by the occurrence of circadian disturbances transmitted by the mother during the fetal period. This phenomenon can be said to support the so-called DOHaD theory, and the involvement of the mother in the maturation of appropriate and stable circadian rhythms cannot be ignored. We consider the problems and countermeasures during the fetal and infant periods, which are important for the formation of circadian clocks.

This study examined data from participants who completed the SLeep Education for Everyone Program (SLEEP) to explore how various demographic variables affected sleep outcomes and to determine which participant characteristics predicted success. A total of 104 individuals participated. The Sleep Hygiene Index (SHI) measured undesirable sleep behaviors; the Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality and self-reported sleep duration. Participant demographic information was collected at baseline. A mixed ANOVA evaluated group differences, and a multiple linear regression model identified predictors of sleep improvements. Change in SHI scores from pre- to post-intervention demonstrated a significant time × group interaction between Black and white participants (p = 0.024); further analysis indicated Black participants improved more. Better baseline scores predicted more favorable post-intervention outcomes for SHI, PSQI, and sleep duration. Fewer chronic conditions predicted better post-intervention SHI and PSQI scores. Older age also predicted better SHI scores. More favorable initial scores, fewer chronic conditions, and older age were the strongest predictors of positive outcomes following SLEEP. Improved sleep hygiene, sleep quality, and sleep duration were observed over time within subjects across all groups. In summary, SLEEP appears to be effective. Further work exploring challenges experienced by younger participants or those with multiple co-morbidities is warranted.

Background: Uvulopalatopharyngoplasty (UPPP) and expansion sphincter pharyngoplasty (ESP) are two standard surgical procedures for the treatment of snoring and obstructive sleep apnea. In a retrospective clinical trial, we compared the two surgical techniques regarding objective sleep parameters and patients' reported outcomes.

Materials and methods: Patients treated with UPPP or ESP between January 2016 and February 2020 were included in this retrospective clinical trial. Pre- and postoperative AHI, BMI, and smoking habits were recorded. Subjective improvement was assessed by the ESS score and symptom relief reported by patients and their bed partners.

Results: Between 2016 and 2020, 114 patients were included in the study, 74 patients suffered from OSA, and 30 patients had non-apnoeic snoring (AHI < 5/h). No preoperative sleeping studies were available in 10 patients (10/114; 9%). Based on the findings during drug-induced sedation endoscopy, most patients received an ESP (71/114, 62%), and 43 patients received a UPPP (43/114, 38%). Additionally, in 52/114 (46%), radio frequency ablation of the tongue base was performed if DISE revealed retrolingual collapse. ESP reduced AHI from 21.1 ± 10.8/h to 13.3 ± 12.1/h (p = 0.04), whereas UPPP caused a non-significant decrease in the AHI from 25.0 ± 13.8/h to 18.2 ± 14.6/h (p = 0.6). A minor secondary bleeding was observed in 32 patients, which was effectively treated with electrocautery or conservative therapy (32/114). This was more common in the ESP group (22/71; 31%) than in the UPPP group (10/43; 23%). Postoperative need for analgesics was higher in the ESP group than in the UPPP group. The ESS score showed no significant improvement after UPPP or ESP (p = 0.3), but subjective improvement in snoring was reported by 87/114 (76%) patients.

Conclusion: AHI reduction was significantly higher in the ESP patient group than in the UPPP group. ESP patients had a slightly higher rate of minor secondary bleeding and postoperative need for analgesics than UPPP patients.

Short sleep has been linked to overweight, possibly via alterations in appetite-regulating hormones, but findings are inconsistent. Sex differences may contribute to this variability. This systematic review examines whether sex modifies the hormonal response to sleep curtailment. PubMed, Embase, Cochrane, CINAHL, and PsycINFO were searched for English-language experimental studies published before December 2024. Included studies assessed at least one appetite-regulating hormone and presented sex-specific analyses. Studies involving health conditions affecting sleep, circadian misalignment, or additional interventions were excluded. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). Eight studies (n = 302 participants) met inclusion criteria. A narrative synthesis of the findings was conducted for each hormone separately to explore potential differences in their response to sleep restriction. Some sex-related variations in hormonal response to sleep restriction have been observed for leptin (four studies, n = 232), insulin (three studies, n = 56), glucagon-like peptide-1 (one study, n = 27), ghrelin (three studies, n = 87), adiponectin (two studies, n = 71) and thyroxine (two studies, n = 41). However, findings were inconsistent with no clear patterns. No sex-related differences were found for glucagon or PYY, though data were limited. Findings suggest sex may influence hormonal responses to sleep restriction, but inconsistencies highlight the need to consider factors such as BMI and energy balance. Well-controlled, adequately powered studies are needed to clarify these effects.