Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal b...Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.展开更多
Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complicati...Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes.This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth.Methods A total of 803 pregnant women were prospectively enrolled.The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded.The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination.Results Using multiple linear regression,a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference(HC)and third-trimester fetal biparietal diameter(BPD).Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated.A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed.Longitudinal analysis reported similar results for BPD and HC.Conclusions Overall,a negative association between sleep duration and fetal biometric measurements was observed.Long sleep durations in the second trimester might negatively impact fetal growth,particularly brain parameters,including BPD and HC.展开更多
Background: The study’s primary research suggests the relationship between high-school international students in China’s sleep quality and learning efficiency which is academic performance. Considering the effect of...Background: The study’s primary research suggests the relationship between high-school international students in China’s sleep quality and learning efficiency which is academic performance. Considering the effect of Chinese traditional cultural background, this study mainly investigates Chinese international high school students’ sleeping quality and patterns through the Pittsburgh Sleep Quality Index. Methods: A sample of 249 Chinese high school students in the Pearl River Region completed the questionnaire about their sleep quality using PSQI, their academic performance, and socio-demographic factors one month before the final exam in July 2023. Results: None of the students have good sleep quality, according to the PSQI;40.8% of students have poor sleep quality, and 59.2% have significant sleep disturbance. The results of ordinal logistic regression show that good sleep quality is positively associated with good academic performance. Conclusion: Our findings highlight the association between sleep and academic performance on the unique sleep patterns of Chinese international high school students, who often follow very different sleep patterns from other conventional students enrolled in the regular curriculum. High school students suffer from severe sleep deprivation and poor sleep quality. Under great academic stress, Chinese high school students should know the importance of sleep, balance sleep, and study.展开更多
Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and prematu...Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.展开更多
Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explo...Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.展开更多
BACKGROUND Sleep deprivation is a common problem in society,and bedtime procrastination(BtP)has become a significant cause of poor sleep among healthy individuals across various countries.AIM To study BtP,sleep behavi...BACKGROUND Sleep deprivation is a common problem in society,and bedtime procrastination(BtP)has become a significant cause of poor sleep among healthy individuals across various countries.AIM To study BtP,sleep behavior,and subjective well-being in the Indian population.METHODS This was a cross-sectional study.The recruited participants were evaluated using the BtP Scale,World Health Organzation-5 Well-Being index,Patient Health Ques-tionnaire-2,Generalized Anxiety Disorder 2-item,Munich Chronotype Questionnaire and Single-Item Sleep Quality Scale.RESULTS A total of 401 participants were recruited for the study.Symptoms of anxiety were higher in the female participants compared to males.Among females,there was a significant positive correlation between BtP score with symptoms of anxiety(r=0.23)and depression(r=0.15)and a negative correlation with subjective wellbeing(r=-0.23).A significant negative correlation was found between the ages of women and BtP score(r=-0.15).Among the male participants,there was a significant negative correlation of age with BtP score(r=-0.3)and anxiety(r=-0.19).Here,too,the BtP score was positively correlated with depression(r=0.18)and anxiety(r=0.35).CONCLUSION BtP worsens anxiety,depression,sleep quality,and subjective well-being.It needs to be targeted for the promotion and prevention of mental health.展开更多
BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also la...BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions.We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.AIM To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.METHODS This cross-sectional study enrolled 5136 older adults(≥60 years)recruited between April and June 2024.Sleep quality was evaluated using the Pittsburgh Sleep Quality Index,and depressive symptoms were assessed with the Patient Health Questionnaire-9.Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.RESULTS The prevalence of depressive symptoms was 19.5%,and the overall rate of sleep disorders was 40.13%.Among the rural elderly,six sleep dimensions were found to be statistically significantly associated with depressive symptoms(all P<0.05),with the following odds ratios(ORs)and 95%confidence intervals(CIs):Subjective sleep quality(OR=2.066,95%CI:1.709-2.497),sleep onset latency(OR=2.476,95%CI:2.062-2.972),sleep efficiency(OR=1.686,95%CI:1.369-2.076),sleep disturbances(OR=2.092,95%CI:1.566-2.795),daytime dysfunction(OR=3.378,95%CI:2.882-3.959),and use of hypnotic medications(OR=1.662,95%CI:1.093-2.525).CONCLUSION Poor subjective sleep quality,prolonged sleep onset latency,reduced sleep efficiency,sleep disturbances,daytime dysfunction,and use of hypnotic medications are associated with depressive symptoms in the elderly.Therefore,healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.展开更多
Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study wa...Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study was conducted at 13 tertiary hospitals across China,enrolling patients who experienced chronic pain between November 2023 and May 2024.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,Pittsburgh Sleep Quality Index,and TCM constitution categories were used to assess the patients.The association between the TCM constitution and the D/A/S ratio was analyzed using multivariable logistic regression.Results:A total of 1107 patients(63.2%women)were analyzed.Compared with those with a balanced constitution,patients who had qi-deficiency and yin-deficiency were at a higher risk of depression.Qideficiency and yin-deficiency were associated with anxiety.Sleep disturbances were common in patients with qi-deficiency constitution(odds ratio[OR]:2.32,95%confidence interval[CI]:1.42-3.81),yangdeficiency constitution(OR:1.94,95%CI:1.26-2.98),yin-deficiency constitution(OR:2.03,95%CI:1.24 -3.32),blood stasis constitution(OR:2.07,95%CI:1.01-4.22),and qi-stagnation constitution(OR:2.66,95%CI:1.35-5.25).Conclusion:In patients with chronic pain,specific TCM constitutions may be associated with D/A/S.Further longitudinal studies are needed to clarify the potential causal relationships between TCM constitution types and these conditions.展开更多
BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid a...BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid as mood stabilizers,their effects on sleep quality have not been examined in adequate detail.AIM To evaluate and compare the effects of lithium and valproic acid on sleep quality in BD patients under remission.METHODS A total of 130 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria for BD in remission were included in this crosssectional study.The participants were receiving either lithium(n=78),or valproic acid(n=52),for a minimum of six months either alone or in combination with antipsychotics.Sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI).Comparative analyses between the lithium and valproic acid groups were conducted using independent t-tests,χ^(2)tests,and ANCOVA,adjusting for key variables such as age,sex,and body mass index.RESULTS Both groups demonstrated poor sleep quality,with the mean PSQI scores above the clinical threshold of 5.Patients in the lithium group exhibited significantly better habitual sleep efficiency(lithium:0.47±0.65,valproic acid:0.78±0.87,P=0.009)and fewer sleep disturbances(lithium:1.26±0.57,valproic acid:1.61±0.84,P=0.005).Other sleep parameters,including total sleep duration(P=0.082)and sleep latency(P=0.625),did not differ significantly.CONCLUSION Patients in the lithium group showed significantly better habitual sleep efficiency and fewer sleep disturbances compared to those receiving valproic acid,although other sleep parameters did not differ.These findings suggest a potential advantage of lithium in certain aspects of sleep quality in BD patients under remission.Future studies using objective sleep measures and longitudinal designs are warranted to confirm these findings.展开更多
BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the corr...BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.展开更多
Objective:To explore the correlation between night ECG parameters and sleep quality in elderly patients with atrial premature beat(PAC).Methods:A total of 307 elderly patients with PAC were selected from March 2022 to...Objective:To explore the correlation between night ECG parameters and sleep quality in elderly patients with atrial premature beat(PAC).Methods:A total of 307 elderly patients with PAC were selected from March 2022 to March 2024.The parameters of room morning load and heart rate variability(HRV)at night(22:00-6:00)were collected by 24h holter electrocardiogram,and the sleep quality of PAC patients was evaluated by Pittsburgh Sleep Quality Index(PSQI).Multiple regression analysis was used to explore the correlation between night ECG parameters and sleep quality.Results:The incidence of sleep disorder in 307 elderly PAC patients was 62.54%.Univariate analysis showed that there were no statistically significant differences in gender,BMI and education level(P>0.05),but there were statistically significant differences in age,disease course,underlying diseases,atrial morning load,SDNN,RMSSD,LF,HF,LF/HF and TP(P<0.05).Multivariate Logistic regression analysis showed that atrial morning load,SDNN,RMSSD,LF and LF/HF were independent influencing factors of sleep disorder in elderly PAC patients(P<0.05).Patients with sleep disorders were divided into mild group,moderate group and severe group according to PSQI score,and there were statistically significant differences in the indexes of atrial morning load,SDNN,LF,LF/HF and TP among the three groups(all P<0.05).Spearman correlation analysis showed that room morning load,LF,LF/HF and TP were positively correlated with the degree of sleep disorder,while SDNN parameters were negatively correlated with the degree of sleep disorder(all P<0.05).Conclusion:There is a significant correlation between night ECG parameters and sleep disorders in elderly patients with PAC.It is possible to prevent and treat sleep disorders by monitoring ECG abnormalities and improve the reliability of treatment.展开更多
Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retro...Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retrospective analysis was conducted on the diagnosis and treatment data of 104 children with ASD complicated with sleep disorder admitted to Xi’an Traditional Chinese Medicine(TCM)Encephalopathy Hospital from January 2022 to December 2024.Cross-pattern main acupoints were screened via frequency statistics,chi-square test,and factor analysis;pattern-specific auxiliary acupoints were extracted by combining multiple correspondence analysis,cluster analysis,and association rule mining.Results:Ten cross-pattern main acupoints(Baihui,Sishenzhen,Language Area 1,Language Area 2,Neiguan,Shenmen,Yongquan,Xuanzhong)were identified,and acupoint combination schemes for four major TCM patterns(Hyperactivity of Liver and Heart Fire,Deficiency of Kidney Essence,Deficiency of Both Heart and Spleen,Hyperactivity of Liver with Spleen Deficiency)were established.Conclusion:Acupuncture treatment should follow the principle of“regulating spirit and calming the brain as the root,and dredging collaterals based on pattern differentiation as the branch”.The synergy between main and auxiliary acupoints can accurately regulate the disease,providing a basis for precise clinical treatment.展开更多
Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD...Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.展开更多
Attention deficit hyperactivity disorder(ADHD),a prevalent neurodevelopmental disorder influenced by both genetic and environmental factors,remains poorly understood regarding how its polygenic risk score(PRS)impacts ...Attention deficit hyperactivity disorder(ADHD),a prevalent neurodevelopmental disorder influenced by both genetic and environmental factors,remains poorly understood regarding how its polygenic risk score(PRS)impacts functional networks and symptomology.This study capitalized on data from 11,430 children in the Adolescent Brain Cognitive Development study to explore the interplay between PRSADHD,brain function,and behavioral problems,along with their interactive effects.The results showed that children with a higher PRSADHD exhibited more severe attention deficits and rule-breaking problems,and experienced sleep disturbances,particularly in initiating and maintaining sleep.We also identified the central executive network,default mode network,and sensory-motor network as the functional networks most associated with PRS and symptoms in ADHD cases,with potential mediating roles.Particularly,the impact of PRSADHD was enhanced in children experiencing heightened sleep disturbances,emphasizing the need for early intervention in sleep issues to potentially mitigate subsequent ADHD symptoms.展开更多
Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patient...Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients.Methods:A total of 232 lung cancer patients treated in the oncology department from October 2024 to October 2025 were included and randomly divided into an experimental group and a control group,with 116 cases in each group.The control group received routine nursing care for lung cancer,while the experimental group received additional symptom management education intervention based on the KAP theory.Fatigue,pain,and sleep conditions were quantified at the 4th and 8th weeks after the intervention.Results:After 4 and 8 weeks of intervention,the RPFS scores,VAS scores,and PSQI scores in the experimental group were lower than those in the control group at the same time points(p<0.05);moreover,the scores in the experimental group at each time point were lower than those before the intervention(p<0.05).Conclusion:Symptom management education based on the KAP theory can effectively improve the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients,enhance their quality of life,and has clinical promotion value.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
OBJECTIVE： Difficulty falling asleep （sleep latency） and staying asleep （sleep maintenance） are common problems for persons living with pain. Research demonstrates that sleep problems are, in turn, related to exa...OBJECTIVE： Difficulty falling asleep （sleep latency） and staying asleep （sleep maintenance） are common problems for persons living with pain. Research demonstrates that sleep problems are, in turn, related to exacerbation of chronic pain. There is a growing body of evidence for a range of pragmatic, non-pharmacological sleep interventions that can potentially be incorporated into pain management programs. This study looks at the outcome of teaching patients with musculoskeletal pain standardized pre-bedtime hand self-Shiatsu （HSS） to reduce sleep latency. METHODS： A case series design, with participants acting as their own controls, was selected to facilitate hypothesis generation for this novel, under-researched intervention. Sleep efficiency, latency and maintenance, sleep beliefs, pain intensity and basic participant demographics were collected at baseline with actigraphy and standardized self-report questionnaires. After one week of baseline data collection, the HSS intervention was taught to participants. Follow-up data were collected at 2 and 8 weeks post-intervention. RESULTS： Data collected at baseline and the two follow-up periods revealed no apparent changes in the objective actigraphy data. However a trend toward improved self-reported sleep latency （time to fall asleep） and sleep duration （time spent asleep） emerged. A number of participants reported they were more concerned with increasing their period of unbroken sleep as opposed to their total sleep time and it is possible that HSS may be useful to be applied during nighttime awakenings as well as before bed. None of the participants reported adverse effects of the intervention. CONCLUSION： These preliminary findings are promising and future studies exploring the mechanism of action and with stronger control of treatment fidelity are indicated.展开更多
AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of live...AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.展开更多
基金supported by grants from Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA22096018(to JY)Guangxi Key Research and Development Program,No.AB22080053(to DD)+6 种基金Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA23023004(to MZ)the National Natural Science Foundation of China,Nos.82260021(to MZ),82060315(to DD)the Natural Science Foundation of Guangxi Zhuang Autonomous Region,No.2021GXNSFBA220007(to GD)Clinical Research Center For Medical Imaging in Hunan Province,No.2020SK4001(to JL)Key Emergency Project of Pneumonia Epidemic of Novel Coronavirus Infection in Hunan Province,No.2020SK3006(to JL)Science and Technology Innovation Program of Hunan Province,No.2021RC4016(to JL)Key Project of the Natural Science Foundation of Hunan Province,No.2024JJ3041(to JL).
文摘Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.
基金supported by the National Natural Science Foundation of China(No.81873843)the National Science and Technology Pillar Program of China during the Twelfth Five-Year Plan Period(No.2014BAI05B05)the Fundamental Research Funds for the Central Universities(No.2017KFYXJJ102 and 2019KFYXKJC053).
文摘Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes.This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth.Methods A total of 803 pregnant women were prospectively enrolled.The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded.The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination.Results Using multiple linear regression,a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference(HC)and third-trimester fetal biparietal diameter(BPD).Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated.A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed.Longitudinal analysis reported similar results for BPD and HC.Conclusions Overall,a negative association between sleep duration and fetal biometric measurements was observed.Long sleep durations in the second trimester might negatively impact fetal growth,particularly brain parameters,including BPD and HC.
文摘Background: The study’s primary research suggests the relationship between high-school international students in China’s sleep quality and learning efficiency which is academic performance. Considering the effect of Chinese traditional cultural background, this study mainly investigates Chinese international high school students’ sleeping quality and patterns through the Pittsburgh Sleep Quality Index. Methods: A sample of 249 Chinese high school students in the Pearl River Region completed the questionnaire about their sleep quality using PSQI, their academic performance, and socio-demographic factors one month before the final exam in July 2023. Results: None of the students have good sleep quality, according to the PSQI;40.8% of students have poor sleep quality, and 59.2% have significant sleep disturbance. The results of ordinal logistic regression show that good sleep quality is positively associated with good academic performance. Conclusion: Our findings highlight the association between sleep and academic performance on the unique sleep patterns of Chinese international high school students, who often follow very different sleep patterns from other conventional students enrolled in the regular curriculum. High school students suffer from severe sleep deprivation and poor sleep quality. Under great academic stress, Chinese high school students should know the importance of sleep, balance sleep, and study.
文摘Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.
基金supported by Peking University,the National Natural Science Foundation of China,the National Institute on Aging and the World Bank。
文摘Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
文摘BACKGROUND Sleep deprivation is a common problem in society,and bedtime procrastination(BtP)has become a significant cause of poor sleep among healthy individuals across various countries.AIM To study BtP,sleep behavior,and subjective well-being in the Indian population.METHODS This was a cross-sectional study.The recruited participants were evaluated using the BtP Scale,World Health Organzation-5 Well-Being index,Patient Health Ques-tionnaire-2,Generalized Anxiety Disorder 2-item,Munich Chronotype Questionnaire and Single-Item Sleep Quality Scale.RESULTS A total of 401 participants were recruited for the study.Symptoms of anxiety were higher in the female participants compared to males.Among females,there was a significant positive correlation between BtP score with symptoms of anxiety(r=0.23)and depression(r=0.15)and a negative correlation with subjective wellbeing(r=-0.23).A significant negative correlation was found between the ages of women and BtP score(r=-0.15).Among the male participants,there was a significant negative correlation of age with BtP score(r=-0.3)and anxiety(r=-0.19).Here,too,the BtP score was positively correlated with depression(r=0.18)and anxiety(r=0.35).CONCLUSION BtP worsens anxiety,depression,sleep quality,and subjective well-being.It needs to be targeted for the promotion and prevention of mental health.
基金Supported by China Postdoctoral Science Foundation,No.2023M732119Natural Science Foundation of Shandong Province,No.ZR2024QG032。
文摘BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions.We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.AIM To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.METHODS This cross-sectional study enrolled 5136 older adults(≥60 years)recruited between April and June 2024.Sleep quality was evaluated using the Pittsburgh Sleep Quality Index,and depressive symptoms were assessed with the Patient Health Questionnaire-9.Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.RESULTS The prevalence of depressive symptoms was 19.5%,and the overall rate of sleep disorders was 40.13%.Among the rural elderly,six sleep dimensions were found to be statistically significantly associated with depressive symptoms(all P<0.05),with the following odds ratios(ORs)and 95%confidence intervals(CIs):Subjective sleep quality(OR=2.066,95%CI:1.709-2.497),sleep onset latency(OR=2.476,95%CI:2.062-2.972),sleep efficiency(OR=1.686,95%CI:1.369-2.076),sleep disturbances(OR=2.092,95%CI:1.566-2.795),daytime dysfunction(OR=3.378,95%CI:2.882-3.959),and use of hypnotic medications(OR=1.662,95%CI:1.093-2.525).CONCLUSION Poor subjective sleep quality,prolonged sleep onset latency,reduced sleep efficiency,sleep disturbances,daytime dysfunction,and use of hypnotic medications are associated with depressive symptoms in the elderly.Therefore,healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.
基金supported by the Fundamental Research Funds for the Central Universities(2022-JYB-JBZR-035,2023-JYB-KYPT-11)Qihuang Scholars Grant Project 2021.
文摘Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study was conducted at 13 tertiary hospitals across China,enrolling patients who experienced chronic pain between November 2023 and May 2024.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,Pittsburgh Sleep Quality Index,and TCM constitution categories were used to assess the patients.The association between the TCM constitution and the D/A/S ratio was analyzed using multivariable logistic regression.Results:A total of 1107 patients(63.2%women)were analyzed.Compared with those with a balanced constitution,patients who had qi-deficiency and yin-deficiency were at a higher risk of depression.Qideficiency and yin-deficiency were associated with anxiety.Sleep disturbances were common in patients with qi-deficiency constitution(odds ratio[OR]:2.32,95%confidence interval[CI]:1.42-3.81),yangdeficiency constitution(OR:1.94,95%CI:1.26-2.98),yin-deficiency constitution(OR:2.03,95%CI:1.24 -3.32),blood stasis constitution(OR:2.07,95%CI:1.01-4.22),and qi-stagnation constitution(OR:2.66,95%CI:1.35-5.25).Conclusion:In patients with chronic pain,specific TCM constitutions may be associated with D/A/S.Further longitudinal studies are needed to clarify the potential causal relationships between TCM constitution types and these conditions.
文摘BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid as mood stabilizers,their effects on sleep quality have not been examined in adequate detail.AIM To evaluate and compare the effects of lithium and valproic acid on sleep quality in BD patients under remission.METHODS A total of 130 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria for BD in remission were included in this crosssectional study.The participants were receiving either lithium(n=78),or valproic acid(n=52),for a minimum of six months either alone or in combination with antipsychotics.Sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI).Comparative analyses between the lithium and valproic acid groups were conducted using independent t-tests,χ^(2)tests,and ANCOVA,adjusting for key variables such as age,sex,and body mass index.RESULTS Both groups demonstrated poor sleep quality,with the mean PSQI scores above the clinical threshold of 5.Patients in the lithium group exhibited significantly better habitual sleep efficiency(lithium:0.47±0.65,valproic acid:0.78±0.87,P=0.009)and fewer sleep disturbances(lithium:1.26±0.57,valproic acid:1.61±0.84,P=0.005).Other sleep parameters,including total sleep duration(P=0.082)and sleep latency(P=0.625),did not differ significantly.CONCLUSION Patients in the lithium group showed significantly better habitual sleep efficiency and fewer sleep disturbances compared to those receiving valproic acid,although other sleep parameters did not differ.These findings suggest a potential advantage of lithium in certain aspects of sleep quality in BD patients under remission.Future studies using objective sleep measures and longitudinal designs are warranted to confirm these findings.
文摘BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.
文摘Objective:To explore the correlation between night ECG parameters and sleep quality in elderly patients with atrial premature beat(PAC).Methods:A total of 307 elderly patients with PAC were selected from March 2022 to March 2024.The parameters of room morning load and heart rate variability(HRV)at night(22:00-6:00)were collected by 24h holter electrocardiogram,and the sleep quality of PAC patients was evaluated by Pittsburgh Sleep Quality Index(PSQI).Multiple regression analysis was used to explore the correlation between night ECG parameters and sleep quality.Results:The incidence of sleep disorder in 307 elderly PAC patients was 62.54%.Univariate analysis showed that there were no statistically significant differences in gender,BMI and education level(P>0.05),but there were statistically significant differences in age,disease course,underlying diseases,atrial morning load,SDNN,RMSSD,LF,HF,LF/HF and TP(P<0.05).Multivariate Logistic regression analysis showed that atrial morning load,SDNN,RMSSD,LF and LF/HF were independent influencing factors of sleep disorder in elderly PAC patients(P<0.05).Patients with sleep disorders were divided into mild group,moderate group and severe group according to PSQI score,and there were statistically significant differences in the indexes of atrial morning load,SDNN,LF,LF/HF and TP among the three groups(all P<0.05).Spearman correlation analysis showed that room morning load,LF,LF/HF and TP were positively correlated with the degree of sleep disorder,while SDNN parameters were negatively correlated with the degree of sleep disorder(all P<0.05).Conclusion:There is a significant correlation between night ECG parameters and sleep disorders in elderly patients with PAC.It is possible to prevent and treat sleep disorders by monitoring ECG abnormalities and improve the reliability of treatment.
基金Song Hujie’s Inheritance Studio of National Renowned Traditional Chinese Medicine Experts.
文摘Objective:To explore the core acupuncture acupoints and pattern-adapted acupoint combination rules for autism spectrum disorder(ASD)complicated with sleep disorder using clinical data mining technology.Methods:A retrospective analysis was conducted on the diagnosis and treatment data of 104 children with ASD complicated with sleep disorder admitted to Xi’an Traditional Chinese Medicine(TCM)Encephalopathy Hospital from January 2022 to December 2024.Cross-pattern main acupoints were screened via frequency statistics,chi-square test,and factor analysis;pattern-specific auxiliary acupoints were extracted by combining multiple correspondence analysis,cluster analysis,and association rule mining.Results:Ten cross-pattern main acupoints(Baihui,Sishenzhen,Language Area 1,Language Area 2,Neiguan,Shenmen,Yongquan,Xuanzhong)were identified,and acupoint combination schemes for four major TCM patterns(Hyperactivity of Liver and Heart Fire,Deficiency of Kidney Essence,Deficiency of Both Heart and Spleen,Hyperactivity of Liver with Spleen Deficiency)were established.Conclusion:Acupuncture treatment should follow the principle of“regulating spirit and calming the brain as the root,and dredging collaterals based on pattern differentiation as the branch”.The synergy between main and auxiliary acupoints can accurately regulate the disease,providing a basis for precise clinical treatment.
基金supported by the National Key R&D Pro-gram of China(No.2021YFC2501500)the National Natural Science Foundation of China(Nos.82271525 and 82071488)the Nanfang Hospital Clinical Research Project of Southern Medical University(No.2021CR009),China。
文摘Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
基金supported by the National Natural Science Foundation of China(62373062,82022035,and 82001450)the Scientific and Technological Innovation 2030-The Major Project of the Brain Science and Brain-Inspired Intelligence Technology(2021ZD0200500)the Startup Funds for Talents at Beijing Normal University,and the China Postdoctoral Science Foundation(2022M710434).
文摘Attention deficit hyperactivity disorder(ADHD),a prevalent neurodevelopmental disorder influenced by both genetic and environmental factors,remains poorly understood regarding how its polygenic risk score(PRS)impacts functional networks and symptomology.This study capitalized on data from 11,430 children in the Adolescent Brain Cognitive Development study to explore the interplay between PRSADHD,brain function,and behavioral problems,along with their interactive effects.The results showed that children with a higher PRSADHD exhibited more severe attention deficits and rule-breaking problems,and experienced sleep disturbances,particularly in initiating and maintaining sleep.We also identified the central executive network,default mode network,and sensory-motor network as the functional networks most associated with PRS and symptoms in ADHD cases,with potential mediating roles.Particularly,the impact of PRSADHD was enhanced in children experiencing heightened sleep disturbances,emphasizing the need for early intervention in sleep issues to potentially mitigate subsequent ADHD symptoms.
文摘Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients.Methods:A total of 232 lung cancer patients treated in the oncology department from October 2024 to October 2025 were included and randomly divided into an experimental group and a control group,with 116 cases in each group.The control group received routine nursing care for lung cancer,while the experimental group received additional symptom management education intervention based on the KAP theory.Fatigue,pain,and sleep conditions were quantified at the 4th and 8th weeks after the intervention.Results:After 4 and 8 weeks of intervention,the RPFS scores,VAS scores,and PSQI scores in the experimental group were lower than those in the control group at the same time points(p<0.05);moreover,the scores in the experimental group at each time point were lower than those before the intervention(p<0.05).Conclusion:Symptom management education based on the KAP theory can effectively improve the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients,enhance their quality of life,and has clinical promotion value.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金the support of the Canadian CAM Research Fund (CCRF)–Canadian Interdisciplinary Network for Complementary & Alternative Research (INCAM)
文摘OBJECTIVE： Difficulty falling asleep （sleep latency） and staying asleep （sleep maintenance） are common problems for persons living with pain. Research demonstrates that sleep problems are, in turn, related to exacerbation of chronic pain. There is a growing body of evidence for a range of pragmatic, non-pharmacological sleep interventions that can potentially be incorporated into pain management programs. This study looks at the outcome of teaching patients with musculoskeletal pain standardized pre-bedtime hand self-Shiatsu （HSS） to reduce sleep latency. METHODS： A case series design, with participants acting as their own controls, was selected to facilitate hypothesis generation for this novel, under-researched intervention. Sleep efficiency, latency and maintenance, sleep beliefs, pain intensity and basic participant demographics were collected at baseline with actigraphy and standardized self-report questionnaires. After one week of baseline data collection, the HSS intervention was taught to participants. Follow-up data were collected at 2 and 8 weeks post-intervention. RESULTS： Data collected at baseline and the two follow-up periods revealed no apparent changes in the objective actigraphy data. However a trend toward improved self-reported sleep latency （time to fall asleep） and sleep duration （time spent asleep） emerged. A number of participants reported they were more concerned with increasing their period of unbroken sleep as opposed to their total sleep time and it is possible that HSS may be useful to be applied during nighttime awakenings as well as before bed. None of the participants reported adverse effects of the intervention. CONCLUSION： These preliminary findings are promising and future studies exploring the mechanism of action and with stronger control of treatment fidelity are indicated.
基金Supported by Grants from the Associao Fundo de Incentivo a Pesquisa and FAPESP-CEPID-Proc. 95/14303-3
文摘AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
