Sleep and Vigilance最新文献

Purpose: COVID-19 forced the shutdown of colleges and socialization around the world including India and prolonged lockdown could have a significant impact on sleep, mood, emotion and anxiety in students. Here, we designed a survey to assess the effect of lockdown on sleep-wake, self-esteem, depression and anxiety via the survey on 321 Indian college-going students.

Methods: We assessed the effect of lockdown on sleep-wake (wake up, get up, bed and sleep timing, total time in bed and sleep duration) and self-esteem and depression on students via various questions.

Results: We found that students delayed sleep timing by 1 h in lockdown than pre-lockdown days. Specifically, urban male populations were late sleeper than any other group. However, total sleep duration did not differ between groups. In self-esteem questions, most students agreed that they were of no good, felt nervous, displeased, and frustrated about performance in lockdown. Depression and anxiety questionnaire gave more significant results related to mood and mental health. More than 50% of students agreed that they faced a lack of concentration, had been feeling irritated and angry, felt fatigued and tired, and everything had been a failure during lockdown days.

Conclusion: Overall, the survey suggests that lack of social life and prolonged lockdown affect the sleep-wake cycle, self-esteem, anxiety and depression of Indian students.

Supplementary information: The online version contains supplementary material available at 10.1007/s41782-022-00200-9.

Introduction/background: The nationwide lockdown enforced due to the spread of coronavirus disease-2019 had a definite impact on sleep.

Objective: To observe any changes in the duration, pattern and quality of sleep among pharmacy students due to the lockdown.

Methods: A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the ethical committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analyzed using STATA version 16.0.

Results and discussion: Out of 310 participants, the study revealed an increase in the time needed to fall asleep (p value < 0.001) and in the total duration of sleep (p value < 0.001). A delay in the time of sleep in the morning (p value < 0.001) and at night (p value < 0.001) was also one among the many significant results. The incidences of jerky leg movements (p value < 0.001), snoring (p value < 0.001), frequent nightmares (p value < 0.001) and anxiety (p value < 0.001) were also increased as a direct effect of the lockdown.

Conclusion: The study has confirmed the detrimental impact of the lockdown on sleep among pharmacy students. All attributes of sleep duration and sleep quality have achieved statistical significance signifying the need to develop cognitive behavioral interventions and prevent the worsening of mental health amidst the COVID-19 era.

Purpose: Post-menopausal life is fairly long period of life that is marked by poor health and sleep. Fatigue amidst extraordinary pandemic stress had taken a toll on the sleep quality and overall wellbeing. Yogic sleep can be instrumental in relaxing the brain and help in achieving self-control of mind and body in the post-menopausal life. This can be a non-pharmacological intervention to improve the wellbeing of women.

Methods: Effect of 24 weeks of yoga-nidra practice and exercise module was tested in a post-menopausal subject after taking baseline of 4 weeks on parameters like sleep latency, total sleep time, mood on waking and during day, BMI, and activity rhythm of body using 24 h actigraphy and sleep diary.

Results: After administering the dual protocol, there was remarkable elevation in mood both on waking up and entire day from 5th week onwards. Mood shifted toward a happier state. Latency to sleep decreased after 4 weeks, while total sleep time improved only after 16 weeks of dual management strategy. The BMI was also reduced to 28.4 from initial value of 30.3. Morning awakening patterns did not change, but it was not accompanied by pain or headache.

Conclusion: The results indicated the therapeutic potential of yoga-nidra and exercise package in this actigraphy-based longitudinal pilot study. Yoga-nidra can be easily practiced at home, and thus, it is a promising non-pharmacological strategy for aging population in improving their wellbeing.

Purpose: Insomnia is a highly prevalent disorder that is seen across all age groups causing significant morbidity to the patients. Its prevalence has further risen during COVID-19 pandemic. It is widely acknowledged that untreated insomnia can lead to significant health risks and socio-occupational dysfunction.

Methods: A narrative review was conducted following focused search of databases.

Results: Available guidelines mention two different approaches for the management of insomnia-pharmacological and non-pharmacological. Non-pharmacological therapies like multicomponent cognitive behavior therapy for insomnia (CBT-I) have been advocated for the management of acute as well as chronic insomnia in the literature as it has been found efficacious and useful. Multiple variants of CBT-I, e.g., digitally delivered CBT-I, brief CBT-I have been tested during pandemic owing to closure of clinics. However, there are certain issues to be considered while choosing CBT-I as therapy. For example, like other forms of psychotherapies, is there a need for assessing the candidature of patient before administering CBT-I; is CBT-I free of adverse effects as commonly thought; is CBT-I more efficacious than hypnotics; and at last, how to manage cases that are not candidate for CBT-I.

Conclusion: This narrative review addresses the scientific robustness of evidence for issues related to adherence, efficacy and adverse effects of non-pharmacological therapies. Available literature suggests that data related to adherence and efficacy of CBT-I suffer from methodological shortcomings and careful selection of patient is important for the successful therapy. At the same time, attempts have been made to shed light to the areas where CBT-I can be helpful in the management of insomnia.

With the emergence of new SARS-CoV-2 variants, a close analysis of factors that affect the efficacy of the vaccine in different groups is a must. It is important to elucidate the role of clinical, behavioral and host factors on modulation of immunogenicity of the SARS-CoV-2 vaccine. Data from other vaccines have shown that duration and efficiency of sleep affect the immunogenicity of the vaccine. There is a need for identification of circadian influence and sleep on SARS-CoV-2 vaccine using validated immune correlates of protection. We propose that sleep acts as a natural adjuvant by promoting the immunological synapse formation between the antigen presenting cells and CD4⁺ T cells thereby leading to activation of cellular and humoral immunity in SARS-CoV-2 infection. Thus, apart from the titer of neutralizing antibodies, the cellular immunity including CD4⁺ T cells and memory T cells must be assessed to clearly demarcate the long-term effect of sleep duration and efficiency on vaccine immunogenicity.