Search Evidence
Melatonin reduces sleep onset latency by approximately 7 minutes in adults with primary sleep disorders
A comprehensive meta-analysis of 19 RCTs (1,683 participants) found melatonin reduces sleep latency by ~7 minutes and increases total sleep time by ~8 minutes. Effects are more pronounced in older adults and those with circadian rhythm disruptions.
Low-dose melatonin (0.5mg) effectively shifts circadian rhythm for jet lag, shift work, and delayed sleep phase syndrome
Melatonin is the most potent chronobiotic available. Administered 5 hours before dim-light melatonin onset (DLMO), even low doses (0.5mg) produce a 1-2 hour phase advance. This makes it effective for jet lag, shift work adaptation, and delayed sleep phase syndrome. Timing is more critical than dose.
Glycine reduces sleep latency in human RCTs
Glycine (3g before bed) significantly reduces sleep onset latency and improves subjective sleep quality in healthy adults. Evidence from 3 human RCTs shows consistent effects, with the mechanism involving NMDA receptor modulation and thermoregulation.
Moderate-intensity aerobic exercise (150 min/week) significantly improves sleep quality in adults with chronic insomnia
A 4-week RCT found 150 min/week of moderate aerobic exercise significantly improved PSQI scores and objective sleep measures in adults with chronic insomnia. Exercise is recommended as a first-line behavioral intervention for insomnia.
Glycine improves overall sleep quality and reduces daytime sleepiness
Beyond reducing sleep latency, glycine (3g before bed) improves PSG-measured sleep quality including increased REM sleep and reduced nocturnal awakenings. Daytime sleepiness and fatigue are also significantly reduced the following morning.
Ashwagandha root extract (300mg BID) significantly improves sleep quality and reduces sleep onset latency in adults with insomnia
A well-designed 8-week RCT (n=138) found ashwagandha root extract significantly improved PSQI scores, reduced sleep onset latency, and improved sleep efficiency. Benefits were most pronounced in adults with insomnia and anxiety.
Magnesium supplementation improves sleep quality, especially in deficient or elderly populations
Magnesium supplementation (500mg) for 8 weeks significantly improves sleep efficiency, total sleep time, and PSQI scores in elderly adults with primary insomnia. Effects are most pronounced in individuals with magnesium deficiency.
Magnesium supplementation increases slow-wave (deep) sleep and improves sleep architecture
Magnesium supplementation (500mg for 8 weeks) significantly increases slow-wave sleep duration and improves overall sleep architecture in elderly adults with insomnia. The effect is linked to NMDA antagonism and GABA potentiation, which promote deeper, more restorative sleep.
Tart cherry juice improves sleep duration and efficiency in older adults with insomnia
Tart cherry juice (240ml twice daily) increases total sleep time by approximately 84 minutes and improves sleep efficiency in older adults with insomnia. The effect is attributed to natural melatonin content and procyanidins.
L-theanine improves subjective sleep quality and reduces anxiety without causing drowsiness
L-theanine (200mg daily) improves subjective sleep quality and reduces anxiety in adults with high anxiety levels. Unlike many sleep aids, it does not cause daytime drowsiness and promotes relaxation via alpha-wave enhancement.
Combined endurance and resistance exercise training improves peak oxygen consumption, quality of life, and six-minute walk test performance in heart failure patients, but does not significantly affect sleep parameters or depression levels.
A meta-analysis of 9 studies found that combined endurance and resistance exercise training significantly improved peak oxygen consumption (MD=4.36, 95% CI: 1.68-7.04, P=0.001), quality of life (MD=-9.32, 95% CI: -16.92 to -1.71, P=0.02), and six-minute walk test performance (MD=53.76, 95% CI: 38.81-68.70, P<0.0001) in heart failure patients. However, no statistically significant effects were observed on sleep parameters or depression levels.
Intranasal dexmedetomidine improves postoperative sleep quality in adult surgical patients
Intranasal dexmedetomidine significantly improved subjective and objective postoperative sleep outcomes compared to placebo or other controls. Sleep efficiency and total sleep time increased, sleep latency reduced, and the risk of sleep disturbance decreased by 47% (RR=0.53).
Walking interventions increase total sleep time and reduce wake after sleep onset in middle-aged and older adults
A systematic review and meta-analysis of 8 RCTs with 683 participants found that walking interventions increased total sleep time by 34.23 minutes (95% CI: 24.72 to 43.74) and reduced wake after sleep onset by 11.58 minutes (95% CI: -18.50 to -4.66). No significant effects were observed for sleep efficiency, sleep latency, or PSQI total score.
Five-element music therapy reduces anxiety and depression and improves sleep quality in cancer patients undergoing chemotherapy
This meta-analysis of 20 RCTs (1588 patients) found that five-element music therapy (FEMT) significantly reduced anxiety (SAS MD=-7.16, 95% CI -9.56 to -4.67; HAMA MD=-5.19) and depression (SDS MD=-7.07; HAMD MD=-5.89) scores compared to control. FEMT also improved sleep quality as measured by PSQI (MD=-2.52, 95% CI -2.89 to -2.16). However, the certainty of evidence was low to very low due to methodological limitations.
Aerobic exercise improves sleep-related outcomes in children and adolescents
A meta-analysis of 14 randomized controlled trials found that aerobic exercise was associated with improved sleep-related outcomes in children and adolescents (SMD = 0.91, 95% CI: 0.40-1.43). However, considerable heterogeneity (IĀ² = 91.5%) and a prediction interval crossing the null (-0.98 to 2.80) indicate uncertainty in the magnitude and consistency of the benefit.
Mind-body exercise combined with aerobic exercise is most effective for sleep disorders in Chinese adolescents
A network meta-analysis of 14 RCTs with 1,375 participants found that the combination of aerobic and mind-body exercise (AE+ME) had the highest probability (SUCRA=87.1%) of being most effective for improving sleep disorders in Chinese adolescents. Mind-body exercise alone (ME) also showed strong effectiveness (SUCRA=71.3%). The optimal regimen was 40-60 min sessions, ā„5 times per week, for less than 8 weeks, with moderate certainty evidence.
Mind-body exercise at 500 METs-min/week may be the most effective exercise modality and dose for improving sleep quality in breast cancer survivors after primary treatment.
A systematic review and dose-response network meta-analysis of 24 studies with 1495 breast cancer survivors found an inverted U-shaped relationship between exercise dose and sleep quality, with an effective range of 0 to 1100 METs-min/week and peak effect at 780 METs-min/week (SMD=0.7, 95% CrI: 0.38-1.06). Stratified by modality, mind-body exercise at 500 METs-min/week showed the largest effect (SMD=1.06, 95% CrI: 0.3-1.83), while aerobic and combined aerobic-resistance training also significantly improved sleep quality but with smaller effects.
Apigenin, a flavonoid in chamomile, may promote sleep onset via benzodiazepine receptor binding
Apigenin binds to benzodiazepine receptors and enhances GABAergic activity, promoting sedation. While preclinical evidence is strong, human clinical trials are limited. Chamomile, a natural source, has shown modest sleep benefits.
Aerobic intradialytic exercise reduces general fatigue and improves health-related quality of life compared to resistance intradialytic exercise in hemodialysis patients.
In a randomized controlled trial of 35 hemodialysis patients, aerobic exercise during dialysis was significantly more effective than resistance exercise in reducing general fatigue (MD: 2.2; 95% CI: 0.4-4.0) and improving health-related quality of life utility (MD: -0.04; 95% CI: -0.10 to -0.04). No significant between-group differences were found for handgrip strength or other secondary outcomes.
Guided internet-delivered cognitive behavioral therapy for insomnia (i-Sleep Autism) reduces insomnia severity in autistic adults.
In a randomized controlled trial of 163 autistic adults with insomnia, i-Sleep Autism significantly reduced insomnia severity at mid-intervention and post-test compared to waitlist control (d = 1.02, 95% CI [0.65, 1.40]). At post-test, 37.8% of the intervention group versus 11.1% of the control group showed clinically meaningful improvement, and effects were maintained at 6-month follow-up.
Water immersion thermotherapy significantly increases total sleep time and improves sleep efficiency in healthy adults, but does not significantly affect subjective sleep quality.
This meta-analysis of 10 randomized controlled trials found that water immersion thermotherapy (WIT) significantly increased total sleep time (SMD = 0.63, P = 0.0438) and improved sleep efficiency (SMD = 0.64, P = 0.0419). However, no significant effects were observed on sleep latency or any PSQI subscale, indicating limited overall subjective sleep quality improvement.
Ecological momentary interventions increase daily moderate-to-vigorous physical activity in older adults
A systematic review and meta-analysis of 12 studies found that ecological momentary interventions significantly increased daily moderate-to-vigorous physical activity in older adults (SMD = 0.24, 95% CI 0.09 to 0.39, p = .002, IĀ² = 0%). Narrative analysis also suggested potential improvements in sleep quality and sleep efficiency, but no significant effects on sedentary behavior were observed.
Tai Chi reduces pain and improves functional disability in patients with chronic nonspecific low back pain, but does not significantly improve sleep quality.
A meta-analysis of 8 RCTs involving 526 patients found that Tai Chi significantly reduced pain (VAS: MD = -1.40, 95% CI: -2.41 to -0.40) and improved functional disability (RMDQ: MD = -1.67, 95% CI: -2.75 to -0.59). However, improvements in sleep quality measured by PSQI were not statistically significant (MD = -0.18, 95% CI: -1.82 to 1.45).
L-theanine supplementation improves subjective sleep quality, reduces sleep onset latency, and decreases daytime dysfunction.
A systematic review and meta-analysis of 19 RCTs (N=897 participants) found that L-theanine significantly improved subjective sleep onset latency (SMD=0.15, 95% CI [0.01, 0.29], p=0.04), subjective daytime dysfunction (SMD=0.33, 95% CI [0.16, 0.49], p<0.001), and overall subjective sleep quality score (SMD=0.43, 95% CI [0.04, 0.83], p=0.03). The findings suggest potential use for managing sleep disturbances, but further research is needed on pure L-theanine and optimal dosing.
L-theanine supplementation significantly improves subjective sleep quality, sleep onset latency, and daytime dysfunction.
This systematic review and meta-analysis of 19 RCTs (N=897) found that L-theanine significantly improved subjective sleep onset latency (SMD=0.15, 95% CI [0.01, 0.29], p=0.04), subjective daytime dysfunction (SMD=0.33, 95% CI [0.16, 0.49], p<0.001), and overall subjective sleep quality score (SMD=0.43, 95% CI [0.04, 0.83], p=0.03). The findings suggest potential use for managing sleep disturbances, but further research is needed on pure L-theanine and optimal dosing.
Mepolizumab and dupilumab show no significant difference in reducing exacerbations in COPD patients with eosinophilic phenotype
A matching-adjusted indirect comparison (MAIC) of three mepolizumab trials (METREX, METREO, MATINEE) and two dupilumab trials (BOREAS, NOTUS) found no statistically significant differences between the two biologics in reducing moderate/severe exacerbations or improving health-related quality of life (SGRQ-C) in COPD patients with eosinophilic phenotype. The rate ratio for annualized moderate/severe exacerbations was 0.91 (95% CI: 0.60-1.37) using investigator-assessed chronic bronchitis and 1.13 (95% CI: 0.80-1.58) using SGRQ-C definition, both non-significant.
Hyperbaric oxygen therapy improves cognitive function and sleep quality in traumatic brain injury patients
This meta-analysis of 8 RCTs with 570 participants found that HBOT significantly improved computerized cognitive performance (SMD=0.23, 95% CI: 0.07-0.40), executive function and processing speed (SMD=-0.59, 95% CI: -0.93 to -0.26), memory function (SMD=0.33, 95% CI: 0.03-0.63), and sleep quality (MD=1.98, 95% CI: 0.07-3.88). No significant benefits were found for Glasgow Outcome Scale, PTSD symptoms, neurobehavioral symptoms, or emotional distress.
Botulinum toxin treatment improves depression and anxiety but not sleep disturbance in cervical dystonia patients
This meta-analysis of 42 studies found that non-motor symptoms are highly prevalent in cervical dystonia, with sleep disturbance affecting 57.1% and fatigue 60.6% of patients. Botulinum toxin treatment produced modest improvements in depression (SMD = -0.31) and anxiety (SMD = -0.23), but no significant benefit for sleep disturbance.
A single bout of moderate-intensity aerobic exercise following acute sleep restriction enhances psychological aspects of daytime functioning but does not improve neurocognitive function.
In a randomized controlled trial, 56 adults who were sleep-restricted to 4 hours performed either moderate-intensity aerobic exercise or seated rest. The exercise group reported significantly increased energy (d=0.69) and arousal (d=0.94), and decreased fatigue (d=-0.79) and sleepiness (d=-0.95) compared to controls. No significant differences were found in neurocognitive measures (P3 amplitude, latency, accuracy, reaction time).
Ashwagandha root extract improves cognitive performance and sleep quality in children aged 6-12 years
An 8-week randomized, double-blind, placebo-controlled trial in 85 children (73 completers) found that Ashwagandha root extract (ARE) gummies (150 mg twice daily) significantly improved speed of information processing, delayed word recall, Stroop task accuracy, Corsi block span, and choice reaction time accuracy compared to placebo. Parent-reported sleep quality also improved on the Sleep Disturbance Scale for Children (SDSC), with no significant adverse events.
Probiotic supplementation (Cerebiome) improves depressive symptoms but not insomnia symptoms in adults with mild-to-moderate insomnia and work-related stress
In a 12-week randomized, placebo-controlled, double-blind trial, adults with mild-to-moderate insomnia and work-related stress received either Cerebiome probiotic or placebo. Both groups showed significant reductions in insomnia severity, but there was no significant between-group difference. The probiotic group showed a significant improvement in depressive symptoms (PHQ-9) compared to placebo.
High-flow nasal cannula reduces treatment failure risk compared to conventional oxygen therapy in pediatric acute respiratory failure
In children with acute respiratory failure, high-flow nasal cannula (HFNC) significantly lowers the risk of treatment failure compared to conventional oxygen therapy (OR: 0.509, 95% CI: 0.42-0.61). However, HFNC does not significantly differ from CPAP in intubation rates or hospital mortality, and may be associated with a non-significant increase in treatment failure versus CPAP.
Lifestyle interventions, primarily physical activity, produce a small reduction in depressive symptoms in informal caregivers of older adults
This meta-analysis of 21 randomized controlled trials (N=2,099) found that lifestyle interventions, mostly physical activity-based, led to a small but significant reduction in depressive symptoms (SMD = -0.34, 95% CI -0.47 to -0.20). However, no consistent effects were observed for physical activity, sleep quality, caregiving burden, stress, or self-rated health. Subgroup analyses indicated that only hybrid interventions combining in-person sessions with technology-supported monitoring showed significant reductions in depressive symptoms.
Montelukast combined with inhaled corticosteroids may increase the risk of neuropsychiatric adverse events in pediatric asthma patients compared to ICS monotherapy
A systematic review and meta-analysis of 6 studies (3 RCTs, 3 cohort studies) involving 559 pediatric patients found that the combination of montelukast with ICS was associated with a 12.1% incidence of neuropsychiatric adverse events versus 8.6% with ICS alone. The pooled risk ratio was 1.41 (95% CI: 0.89-2.22, P=0.14), with an absolute risk difference of 3.5%, translating to approximately 35 additional events per 1,000 children, though this result was not statistically significant.
Melatonin improves sleep quality in chronic non-cancer pain patients without increasing adverse events
Moderate-certainty evidence from a network meta-analysis of 98 RCTs (28,920 participants) showed that melatonin significantly improved subjective sleep quality compared to placebo (SMD = -0.60, 95%CI: -0.98, -0.22). Unlike other pharmacological agents, melatonin was not associated with an increased risk of adverse events (OR = 0.88, 95%CI: 0.19, 3.94).
Melatonin is not superior to placebo for reducing pain in chronic musculoskeletal pain but may provide modest benefits as an adjunct treatment
In a systematic review and meta-analysis of 23 studies (2028 participants), melatonin was not superior to placebo for reducing pain in chronic musculoskeletal pain (MD: -6.76/100, 95% CI: -15.89 to 2.36), but sensitivity analysis excluding high-risk studies showed a significant effect (MD: -10.04/100, 95% CI: -17.68 to -2.39). Melatonin improved sleep quality in chronic MSK pain but not in postoperative pain, and adverse events were mild and transient.
Withania somnifera improves anxiety symptoms in individuals with mental disorders
This systematic review and meta-analysis of 14 RCTs found that Withania somnifera significantly reduced anxiety symptoms compared to controls, with an outlier-corrected standardized mean difference of -1.13 (95% CI: -1.65 to -0.60). The effect was confirmed using Bayesian analysis for anxiety, but not for depression. The median dose was 600 mg/day over 8 weeks.
Lifestyle interventions improve 24-hour movement behaviors in preschool children
Lifestyle interventions were associated with increases in moderate-to-vigorous physical activity (MD 5.77 min/day) and sleep duration (MD 0.18 h/day), and reductions in sedentary behavior (MD -7.62 min/day) and screen time (MD -0.33 h/day) in preschool children aged 2-6 years. However, heterogeneity was substantial and the certainty of evidence was low.
Combination therapies (pharmacotherapy plus psychotherapy or acupoint stimulation) show greater efficacy than monotherapies for anxiety, depression, and panic disorder in perimenopausal women, but no single strategy is superior across all outcomes.
This network meta-analysis of 131 RCTs (11,457 perimenopausal women) found that drug_psych ranked highest for reducing HAMD (SUCRA=92.4%), KI (97.9%), SDS (94.5%), PSQI (98.1%), and FSH (96.1%), and for elevating E2 (SUCRA=0.1% for elevation). AcuStim_psych ranked highest for HAMA reduction (93.7%), psych for SAS reduction (98.9%), and drug_AcuStim for clinical efficacy (SUCRA=9.0% for inefficacy) and LH reduction (100%). Safety was highest for control (65.5%).
Acute caffeine supplementation improves sprint performance and passing accuracy while reducing rating of perceived exertion in rugby players
A systematic review and meta-analysis of 13 randomized placebo-controlled trials found that acute caffeine supplementation in rugby players was associated with small improvements in sprint performance (Hedges' g = -0.41, 95% CI: -0.73 to -0.08) and reduced rating of perceived exertion (Hedges' g = -0.40, 95% CI: -0.73 to -0.06). A large positive effect was observed for passing accuracy (Hedges' g = 1.65, 95% CI: 0.69 to 2.61), though with high heterogeneity. No significant effects were found for jumping, strength, or metabolic markers.
Withania somnifera (Ashwagandha) reduces perceived stress and improves sleep quality compared to placebo
The systematic review found that Withania somnifera (Ashwagandha) showed beneficial signals for stress and sleep outcomes based on controlled human studies. Meta-analysis was feasible for this node versus placebo on perceived stress and sleep quality, though confidence in effect magnitude is limited by heterogeneity and small-study effects.
Manual acupoint therapy improves sleep quality in chemotherapy patients
Manual acupoint therapy ranked highest for improving sleep quality among five TCM interventions, with a SUCRA of 91.9% and a large effect size compared to auricular therapy (SMD = -9.92; 95% CI, -14.83 to -5.01). This finding is based on a network meta-analysis of 35 RCTs involving 2025 cancer patients undergoing chemotherapy.
Exercise interventions improve sleep quality in patients with depression
This meta-analysis of 17 RCTs with 1,457 participants found that exercise interventions significantly improved sleep quality in patients with depression (SMD = -0.37, 95% CI: -0.48 to -0.27). Dose-response modeling suggested that exercise doses around 312.75 METĀ·min/week may yield greater improvements (Hedges' g = -0.51, 95% CI: -0.71 to -0.31).
Exercise plus cognitive behavioral therapy (EX + CBT) improves subjective sleep quality and sleep-continuity parameters in insomnia patients
In a network meta-analysis of 31 RCTs with 2,457 participants, exercise combined with cognitive behavioral therapy (EX + CBT) ranked highest for improving Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), and wake after sleep onset (WASO). Compared to conventional control, EX + CBT showed significant effects on PSQI, SOL, and WASO, but no intervention significantly increased total sleep time.
Melatonin provides modest pain relief in chronic musculoskeletal pain but effects are comparable to conventional analgesics and often below minimal clinically important difference thresholds
In a systematic review of 23 RCTs (2028 participants), melatonin was not superior to placebo for chronic MSK pain (MD: -6.76/100, 95% CI: -15.89 to 2.36) but was superior to active controls (MD: -11.21/100, 95% CI: -14.29 to -8.13). Sensitivity analysis limited to low-risk studies showed superiority over placebo (MD: -10.04, 95% CI: -17.68 to -2.39). Sleep quality improved in chronic MSK pain but not postoperative pain, and adverse events were mild and transient.
Baduanjin exercise improves sleep quality in older adults
A systematic review and meta-analysis of 18 randomized controlled trials with 1,527 participants found that Baduanjin significantly improved sleep quality (MD = -2.81, 95% CI: -3.38 to -2.24, p < 0.001). The intervention also reduced depressive symptoms and improved quality of life, body composition, and handgrip strength.
Lumbar surgery improves sleep quality in patients with degenerative lumbar disease
This Bayesian meta-analysis of 25 studies (3,546 patients) found that lumbar surgery for degenerative lumbar disease was associated with a significant improvement in sleep quality (SMD -1.36; 95% CrI -2.02 to -0.71; posterior probability 99%). Pain, disability, and quality of life also improved significantly.
Mind-body therapies significantly improve sleep quality in perinatal women
A meta-analysis of 13 randomized controlled trials involving 782 participants found that mind-body therapies (mindfulness, Pilates, yoga) significantly improved sleep quality in perinatal women compared to controls (MD = -2.63, 95% CI -3.36 to -1.90). However, substantial heterogeneity was observed (IĀ² = 89.0%), and the certainty of evidence was rated as low by GRADE.
Exercise plus cognitive behavioral therapy improves subjective sleep quality and sleep continuity in insomnia patients
In a network meta-analysis of 31 RCTs with 2,457 participants, exercise combined with cognitive behavioral therapy (EX + CBT) ranked highest for improving Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), and wake after sleep onset (WASO). Compared to conventional control, EX + CBT showed significant effects on PSQI, SOL, and WASO, but no intervention significantly increased total sleep time.
Structured exercise interventions improve overall sleep quality in university students as measured by the PSQI global score
A meta-analysis of 7 randomized controlled trials (701 participants) found that structured exercise significantly reduced the PSQI global score compared to non-exercise controls (MD = -2.43, 95% CI -3.72 to -1.14). However, the prediction interval included the null value, and certainty of evidence was very low, indicating substantial uncertainty in the effect.
Cognitive Behavioral Therapy reduces fatigue severity in post-stroke patients
A meta-analysis of 9 RCTs involving 778 participants found that Cognitive Behavioral Therapy (CBT) was associated with a significant reduction in fatigue severity (SMD = -0.72, 95% CI: -1.06 to -0.38, P < 0.0001). CBT also improved sleep quality (SMD = -1.07, P = 0.003) and overall quality of life (SMD = 0.67, P = 0.01), with interventions lasting more than six weeks showing greater efficacy.
Sleep disorders during pregnancy are associated with increased risk of hypertensive disorders of pregnancy
This meta-analysis of 19 cohort studies involving 9,460,018 pregnant women found that sleep disorders during pregnancy significantly increased the risk of gestational hypertension (OR=1.50), preeclampsia (OR=1.83), and hypertensive disorders of pregnancy overall (OR=1.56). Obstructive sleep apnea showed the strongest associations, with ORs of 1.60 for gestational hypertension and 2.13 for preeclampsia.
Transcutaneous auricular vagus nerve stimulation improves sleep quality and reduces sleep onset latency in patients with sleep disorders
A meta-analysis of 14 RCTs found that taVNS significantly improved sleep quality (SMD = -0.57, 95% CI [-0.86, -0.28], p < 0.0001) and reduced time to fall asleep (SMD = -0.44, 95% CI [-0.64, -0.23], p < 0.0001). The intervention also lowered depression and anxiety scores, with only mild side effects reported.
Shaoyao Gancao Decoction as an adjunct to conventional Western medicine improves pain relief and sleep quality in patients with postherpetic neuralgia
This meta-analysis of 15 RCTs (1,188 patients) found that adding Shaoyao Gancao Decoction (SGD) to conventional Western medicine significantly improved overall response rate (OR=5.42, 95% CI: 3.40-8.64), reduced VAS pain scores (MD=-1.33, 95% CI: -1.68 to -0.99), improved PSQI sleep scores (MD=-2.23, 95% CI: -2.85 to -1.62), and reduced adverse events (OR=0.34, 95% CI: 0.21-0.56) compared to Western medicine alone.
Narrative interventions improve sleep quality in patients with cancer
A systematic review and meta-analysis of 11 randomized controlled trials found that narrative interventions significantly improved sleep quality in cancer patients (Hedge's g = 1.292, 95% CI 0.53 to 2.04, p = 0.005). The evidence for this outcome was rated as low quality. The analysis included studies from China, the USA, and Spain conducted between 2011 and 2025.
Tai Chi/Qigong, yoga, and combined exercise improve sleep quality in individuals with breast cancer
A Bayesian network meta-analysis of 39 RCTs with 4066 participants found that Tai Chi/Qigong showed the largest sleep benefit (Hedges' g = -0.45, 95% CrI: -0.86 to -0.04), followed by yoga and combined exercise (both g = -0.30) compared to active controls. Dose-response analyses suggested optimal benefits at moderate doses around 4.5 METs, 281.3 METĀ·min/session, and 910 METĀ·min/week.
Mind-body therapies improve sleep quality in perinatal women
A systematic review and meta-analysis of 13 randomized controlled trials involving 782 participants found that mind-body therapies (mindfulness, Pilates, yoga) significantly improved sleep quality in perinatal women compared to controls (MD = -2.63, 95% CI -3.36 to -1.90). However, substantial heterogeneity was observed (IĀ² = 89.0%), and the certainty of evidence was rated as low by GRADE.
Ion channel modulators, particularly calcium channel blockers and sodium channel antagonists, reduce pain and improve sleep in patients with painful diabetic neuropathy
A meta-analysis of 36 RCTs with 6611 participants found that ion channel modulators, especially calcium channel blockers (mirogabalin, pregabalin, gabapentin, crisugabalin) and sodium channel antagonists (oxcarbazepine, lacosamide, lamotrigine, sodium valproate), significantly reduced pain scores, VAS scores, and sleep interference scores compared to placebo. TRPA1 and P2X3 antagonists showed no significant difference from control. Adverse events were mild to moderate, though mirogabalin and oxcarbazepine had higher discontinuation risk.
Tai Chi reduces depression, anxiety, stress, and improves sleep quality in college students
A meta-analysis of 12 RCTs involving 1,057 college students found that Tai Chi significantly reduced depression (SMD = -0.67), anxiety (SMD = -0.79), and stress (SMD = -0.40), and improved sleep quality (MD = -2.14). The evidence supports Tai Chi as an effective intervention for mental health in this population, though sleep quality findings showed substantial heterogeneity.
Herbal medicines improve sleep quality in postpartum mothers
A systematic review and meta-analysis of 7 randomized clinical trials found that herbal medicines significantly improved sleep quality in postpartum mothers. The mean overall sleep quality score was lower in the intervention group compared to controls (standard mean difference = -0.89, 95% CI: -1.61 to -1.18, P = 0.014).
Perioperative esketamine improves postoperative sleep quality in patients undergoing laparoscopic cholecystectomy
Esketamine significantly improved postoperative sleep quality compared to control regimens, with a mean difference of -5.78 (95% CI [-6.80 to -4.76]) on a sleep quality scale. This finding was based on a meta-analysis of six randomized controlled trials involving 569 patients.
Low-dose naltrexone improves fatigue, cognition, sleep, pain, and functioning in long COVID patients
A systematic review and meta-analysis of four observational pre-post studies (n=155) found that low-dose naltrexone (1-6 mg/day) was associated with moderate to large improvements in long COVID symptoms. Pooled effect sizes showed significant reductions in fatigue (Hedges' g=-0.74), brain fog (Hedges' g=-0.53), and sleep quality (Hedges' g=-0.60), as well as large effects for pain (Hedges' g=-0.93) and daily functioning (Hedges' g=-0.93). No serious adverse events were reported in the two studies that assessed safety.
Obstructive sleep apnea and mood disorders show a high prevalence of comorbidity, with age and body mass index as significant moderators
This meta-analysis of 23 studies found a significant prevalence of comorbidity between obstructive sleep apnea (OSA) and mood disorders (major depressive disorder and bipolar disorder), with 446,495 comorbid mood disorders among 2,380,986 OSA patients. Mean age (Ī²=0.18) and mean body mass index (Ī²=-0.18) were identified as significant moderators of OSA prevalence.
Progressive muscle relaxation improves subjective sleep quality in adults
A systematic review and meta-analysis of 14 randomized controlled trials (957 participants) found that progressive muscle relaxation significantly improved sleep quality (Hedges g = -1.24, 95% CI -1.71 to -0.77, p < 0.001). Improvements were seen in both cancer and non-cancer patients, but the effect was not significant in adults aged 55 years and older. The number of PMR sessions was not associated with sleep quality improvements.
Homeopathic interventions are not statistically significantly more effective than control conditions for improving insomnia in adults
A systematic review and meta-analysis of 9 studies (6 RCTs, 3 non-randomized) found a moderate but non-significant effect of homeopathy on sleep outcomes (SMD = 0.63, 95% CI [-0.13, 1.39], p = 0.1051) with substantial heterogeneity (IĀ² = 88.26%) and publication bias. Overall certainty of evidence was low, and most studies had high or critical risk of bias, leading to the conclusion that current evidence is insufficient to support homeopathy for insomnia.
Obstructive sleep apnea is associated with a significantly increased risk of periodontitis
This meta-analysis of 18 studies found that patients with obstructive sleep apnea have more than twice the odds of having periodontitis compared to those without OSA (OR = 2.22; 95% CI: 1.78-2.77). A moderate positive correlation was also found between OSA severity and periodontal disease severity (r = 0.39; 95% CI: 0.17-0.58).
Music therapy reduces delirium incidence in adult ICU patients
Music therapy significantly reduced the incidence of delirium in adult ICU patients (RR = 0.49; 95% CI: 0.40-0.60; p < 0.001). The meta-analysis of 15 RCTs involving 1,552 patients also showed improvements in sleep quality, anxiety, and depression.
Web-based cognitive behavioral therapy for insomnia (CBTi) is the most effective delivery format for improving sleep outcomes in adolescents with insomnia
In a network meta-analysis of 22 RCTs involving adolescents with insomnia, web-based CBTi consistently outperformed other delivery formats (face-to-face, group-based, mobile-app-based, self-help, brief CBTi, and sleep hygiene) across most sleep outcomes. Compared to usual care, web-based CBTi improved total sleep time by 33 minutes, reduced sleep onset latency by 23 minutes, increased sleep efficiency by 7%, and reduced insomnia severity by 5 points.
Non-pharmacological interventions improve sleep quality in informal caregivers of people with mild cognitive impairment or dementia
Non-pharmacological interventions (e.g., behavioral, psychoeducational) significantly reduced PSQI scores by a mean difference of -1.27 points compared to control conditions in a meta-analysis of 5 RCTs involving 334 caregivers. However, the certainty of evidence is very low due to high risk of bias across all included trials.
Daridorexant 25 mg improves objective and subjective sleep metrics in insomnia patients over 3 months
In a meta-analysis of 6 RCTs with 2905 insomnia patients, daridorexant 25 mg showed sustained efficacy in objective sleep measures (LPS, WASO) at 3 months and in subjective total sleep time (sTST) at 3 months (SMD 0.25 [0.14, 0.36], P < 0.0001). The 25 mg dose was associated with an increased risk of adverse events of special interest (AESIs) compared to placebo (RR 4.00 [1.64, 9.76], P = 0.002).
Poor subjective sleep quality is common in tension-type headache and associated with depressive symptoms
The pooled prevalence of poor sleep quality (PSQI >5) in adults with tension-type headache was 67% (95% CI 53-79%). The mean PSQI score was 9.48, significantly higher than controls (mean difference 3.77, 95% CI 2.32-5.22), and correlated robustly with depression (r=0.51).
Acute caffeine supplementation may slightly improve maximal strength and may benefit muscular endurance in some protocols in female participants, but certainty of evidence is low or very low for most outcomes.
A systematic review and three-level meta-analysis of 24 studies (23 in quantitative synthesis, 107 effect sizes) found a small mean effect of caffeine on maximal strength (g = 0.17, 95% CI 0.06 to 0.29; low GRADE) and a larger mean effect on muscular endurance (g = 0.54, 95% CI 0.06 to 1.02; low GRADE), but the latter had a wide prediction interval indicating low reproducibility. Movement speed showed a small, uncertain estimate (g = 0.13; CR2 p = 0.072; very low GRADE), and other domains were not pooled due to insufficient clusters.
The Glasgow Sleep Effort Scale (GSES) shows good overall internal consistency with a pooled Cronbach's alpha of 0.81
A reliability generalization meta-analysis of 34 articles (40 independent estimates, total N=16,022) found that the GSES has good internal consistency (pooled alpha = 0.81, 95% CI [0.79, 0.82]). Significant heterogeneity was observed (I2 ā 85%), and publication year moderated internal consistency estimates. Reliability induction (e.g., omitting reliability coefficients) was common in nearly 58% of initially retrieved studies.
Nabiximols improves sleep disruption in multiple sclerosis patients
A systematic review and meta-analysis of 25 studies (2949 patients) found that nabiximols significantly reduced sleep disruption in MS patients (MD = -15.75; 95% CI = (-22.02)-(-9.49)). The evidence certainty was low to very low, and findings are considered exploratory.
Hormone therapy and phytoestrogens alleviate psychological symptoms in menopausal women, particularly mood and anxiety.
This systematic review and meta-analysis of 51 RCTs (n=41,821) for hormone therapy and 16 RCTs (n=1,191) for phytoestrogens found that both interventions reduced psychological symptoms in menopausal women, especially mood and anxiety. Tibolone showed a significant improvement in depression (SMD 0.93, 95% CI 0.62-1.24). Post-menopausal women experienced greater benefits for sleep quality with hormone therapy and for depression and anxiety with phytoestrogens compared to perimenopausal women.
Dupilumab improves patient-reported sleep quality in patients with severe, uncontrolled CRSwNP
A systematic review of 7 studies (n=2164) found that dupilumab consistently improved sleep quality outcomes in CRSwNP patients, including SNOT-22 sleep domain (mean reduction up to -7.02 points at 24 weeks, p<0.001), PSQI, ESS, and ISI scores. One study reported a decrease in poor global sleep quality from 88.9% at baseline to 5.7% at 12 months. However, evidence is limited by lack of objective sleep measures and high risk of bias in observational studies.
Total sleep time and sleep efficiency are reduced in drug-free bipolar patients during both manic and depressive phases compared to healthy controls.
In a meta-analysis of 43 case-control studies involving 670 bipolar patients, 520 healthy controls, and 280 unipolar depressed patients, total sleep time and sleep efficiency were significantly reduced in drug-free bipolar patients during both manic and depressive episodes compared to healthy controls. Delta sleep was reduced only in depressive patients, while manic patients showed decreased REM latency and increased REM density.
Nurse-led interventions reduce depressive symptoms and improve health-related quality of life in post-stroke patients
This systematic review and meta-analysis of 18 studies found that nurse-led interventions significantly reduced depressive symptoms (SMD -1.17, 95% CI -1.65 to -0.70) and improved health-related quality of life (SMD 1.15, 95% CI 0.52-1.78) in adults with stroke. Sleep quality also improved modestly (SMD -0.27, 95% CI -0.50 to -0.03), but effects on anxiety and neurological recovery were not statistically significant.
Add-on oral H1 antihistamines produce clinically unimportant reductions in atopic dermatitis severity and itch severity in children and adults with moderate to severe eczema
A systematic review and network meta-analysis of 47 randomized trials (6230 participants) found that adding first- or second-generation H1 antihistamines to standard care likely reduces atopic dermatitis severity by a mean difference of -1.87 on the oSCORAD scale (95% CrI -3.47 to -0.27) and itch severity by -0.89 on a 0-10 scale (95% CrI -1.41 to -0.37). Both effects are statistically detectable but well below the minimal important differences of 8.2 and 3, respectively, indicating no clinically meaningful benefit.
Physical exercise improves sleep quality in patients with psychiatric disorders.
A systematic review and meta-analysis of 21 RCTs (1628 participants) found that physical exercise significantly improves sleep quality in patients with psychiatric disorders, with a moderate overall effect size (g = -0.57, 95% CI: -0.75 to -0.38, P < 0.001). Larger effects were observed for aerobic modalities (g = -0.69), low-to-moderate intensity (g = -0.70), and frequency of ā„3 sessions per week (g = -0.60).
Homeopathic interventions do not significantly improve insomnia compared to control conditions
A systematic review and meta-analysis of 9 studies (6 RCTs and 3 non-randomized) found a moderate but non-significant effect of homeopathy on sleep outcomes (SMD = 0.63, 95% CI [-0.13, 1.39], p = 0.1051) with substantial heterogeneity (IĀ² = 88.26%) and publication bias. The certainty of evidence was low, and most studies had high or critical risk of bias, leading to the conclusion that current evidence is insufficient to support homeopathy for insomnia.
Mindfulness-based exercise improves motor function and certain cognitive domains in Parkinson's disease patients
This meta-analysis of 28 studies found that mindfulness-based exercise (MBE) significantly improved motor function (UPDRS-III: MD -4.74, 95% CI [-6.78, -2.70]) and cognitive function (MoCA: MD 1.93, 95% CI [1.12, 2.74]; MMSE: MD 2.80, 95% CI [0.32, 5.29]) in Parkinson's disease patients. However, no significant improvements were observed for non-motor symptoms like depression, sleep, or quality of life.
Shared decision-making may increase lung cancer screening participation with acceptable information quality and does not increase decisional conflict/regret.
This systematic review of 31 US-based studies found that shared decision-making (SDM) for lung cancer screening may increase participation (low certainty of evidence) and does not increase decisional conflict or regret (high certainty of evidence). The choice of SDM tool (e.g., decision aid vs. education tool) may not affect uptake, though a decision aid may be superior to an education tool.
Esketamine demonstrates superior analgesic efficacy and has the higher probability of being the optimal treatment for reducing early postoperative sleep disturbance incidence compared to dexmedetomidine.
In a network meta-analysis of 10 RCTs (645 patients), esketamine significantly reduced VAS pain scores at rest and during movement at 24 and 48 hours postoperatively. Both esketamine and dexmedetomidine reduced the incidence of PSD on the first postoperative day, but esketamine showed a stronger effect (RR=0.655 vs RR=0.773). Esketamine also improved subjective sleep outcomes (AIS, NRS) more effectively, likely due to its superior analgesia.
Meditation-based interventions improve subjective sleep quality in older adults with mild cognitive impairment
A systematic review and meta-analysis of 7 studies (n=434) found that meditation-based interventions significantly improved sleep quality in adults aged ā„55 with mild cognitive impairment. The pooled effect size was large (Hedges' g = -0.75, 95% CI -1.23 to -0.28) with substantial heterogeneity (IĀ² = 77.9%). Five of seven studies showed significant improvements in subjective sleep quality, and one actigraphy-based study reported reduced daytime napping.
Digital cognitive behavioural therapy for insomnia reduces insomnia severity in Armed Forces and Veteran populations
A systematic review and meta-analysis of 5 RCTs (n=309 intervention, n=249 control) found that digital CBT-I produced a statistically significant moderate-to-large reduction in insomnia severity compared to minimum contact controls, with substantial heterogeneity (IĀ²=74%). Treatment gains were maintained up to 12 months, and three studies reported clinically meaningful ISI reductions of ā„6 points.
Post-stroke sleep disturbance/insomnia is associated with female sex, anxiety, depression, and heart disease in stroke survivors
This meta-analysis of 13 studies (6,109 stroke survivors) found that female patients and those with anxiety, depression, or heart disease had significantly higher odds of post-stroke sleep disturbance/insomnia. Sleep disturbance/insomnia was more pronounced during follow-up beyond 3 months post-stroke.
Commercial Chinese polyherbal preparations combined with conventional therapy improve sleep quality in elderly patients with insomnia
A network meta-analysis of 19 RCTs involving 1851 participants found that commercial Chinese polyherbal preparations combined with conventional therapy significantly reduced PSQI scores (MD = -2.53, 95% CI [-3.62, -1.44]) and increased clinical effective rate (OR = 6.08, 95% CI [3.21, 11.51]) compared to conventional therapy alone. The evidence for effects on serum IL-6 was exploratory and limited.
Emotional Freedom Techniques (EFT) reduces sleep disturbance in cancer patients
A meta-analysis of 9 RCTs (760 patients) found that EFT significantly reduced sleep disturbance as measured by the Pittsburgh Sleep Quality Index (PSQI), with a mean difference of -3.00 (95% CI: -4.39 to -1.61, P < 0.01). The effect was strongest in breast cancer patients and with 4-week protocols, sessions ā„30 minutes, and frequency ā„7 sessions/week. Narrative evidence also suggested benefits for pain and fatigue.
Meditation, yoga, tai chi, and qigong improve subjective sleep quality in older adults with sleep disturbance, with meditation showing the highest probability of being ranked best.
In a network meta-analysis of 45 studies with 3,568 participants, meditation (MD -3.49, 95% CrI -4.92 to -2.09), yoga (MD -2.40, 95% CrI -4.55 to -0.27), qigong (MD -2.21, 95% CrI -4.01 to -0.42), and tai chi (MD -1.87, 95% CrI -2.99 to -0.77) were associated with improvements in sleep quality compared to control. Meditation also showed superior efficacy compared to sleep hygiene education (MD -2.87, 95% CrI -4.45 to -1.30).
Physical activity interventions improve multiple developmental outcomes in children and adolescents with autism spectrum disorder, with an overall adjusted effect size of g=0.58.
This second-order meta-analysis of 34 first-order meta-analyses found that physical activity interventions yield significant positive effects across developmental domains in children and adolescents with ASD, with an overall adjusted effect size of g=0.58. The largest effects were observed for motor skills and sleep quality, while executive function and cognitive outcomes showed more modest effects. Outdoor activities and ball sports showed larger pooled effects than other intervention types.
Pain catastrophizing mediates the relationship between pain intensity and depressive symptoms in adults with chronic pain
This systematic review and meta-analysis identified pain catastrophizing as a mediator of the pain-depression relationship in adults with chronic pain. Pooled indirect effect for pain catastrophizing on the pain-to-depression pathway was Ī² = 0.150 (95% CI: 0.066, 0.233), but with substantial heterogeneity and high influence from a single study. Narrative synthesis also supported sleep quality, pain self-efficacy, and pain interference as preliminary mediators.
Traditional Chinese exercises, especially Tai Chi, improve physical function, pain, mental health, sleep quality, and bone mineral density in patients with musculoskeletal disorders.
This umbrella review of 92 meta-analyses (1744 RCTs) found high-certainty evidence that traditional Chinese exercises (TCEs) significantly improve physical function in knee osteoarthritis, mental health in knee osteoarthritis and neck pain, and sleep quality in fibromyalgia. Tai Chi significantly alleviated chronic MSD-related pain and stiffness and increased bone mineral density in osteopenia/osteoporosis. Longer duration, higher frequency, and moderate-to-high weekly volume were associated with greater clinical gains.
Emotional Freedom Techniques (EFT) reduce sleep disturbance in cancer patients
A meta-analysis of 9 RCTs (760 patients) found that EFT significantly reduced sleep disturbance as measured by the Pittsburgh Sleep Quality Index (PSQI), with a mean difference of -3.00 (95% CI: -4.39 to -1.61, P<0.01). Subgroup analyses showed stronger effects with 4-week protocols, sessions ā„30 minutes, and frequency ā„7 sessions per week. Benefits were significant in breast cancer patients but not in other cancer types.
Withania somnifera (Ashwagandha) improves anxiety symptoms in individuals with mental disorders
A systematic review and meta-analysis of 14 RCTs (360 treated, 353 controls) found that Withania somnifera significantly reduced anxiety symptoms (outlier-corrected SMD: -1.13, 95% CI: -1.65 to -0.60) compared to controls. The effect was confirmed using Bayesian analysis for anxiety but not for depression. No significant differences in safety or tolerability were found.
Acupuncture and related therapies improve post-stroke insomnia, with combined therapies showing the best outcomes.
This systematic review and network meta-analysis of 107 RCTs (8062 patients) found that acupuncture and related therapies were superior to western medicine and conventional rehabilitation for post-stroke insomnia, as measured by the Pittsburgh Sleep Quality Index. Combined therapy (acupuncture + auriculotherapy + electroacupuncture) had the best overall outcomes, while specific therapies were best for different symptoms (e.g., point embedding for subjective sleep quality, warm acupuncture for daily functional dysfunction).
Combined sleep-circadian interventions reduce depressive symptoms and improve sleep outcomes in adults with mental disorders
This meta-analysis of 11 RCTs found that non-pharmacological sleep-circadian interventions significantly reduced depressive symptom severity (SMD = -0.51, 95% CI: -0.72 to -0.30) and improved insomnia severity (MD = -5.23, 95% CI: -6.41 to -4.04) in adults with mental disorders. Treatment response was higher in intervention groups (RR = 1.68, 95% CI: 1.25 to 2.27), but evidence certainty ranged from very low to moderate.
Theanine plus caffeine improves cognitive and mood outcomes in healthy participants
This meta-analysis of 15 RCTs found small-to-moderate benefits of theanine plus caffeine over placebo on cognition and mood outcomes, including choice reaction time (SMD -0.48 at 1 hour) and digit vigilance task accuracy (SMD 0.20 at 2 hours). Theanine alone also showed a small-to-moderate benefit on choice reaction time (SMD -0.35 at 1 hour). However, confidence intervals were wide, indicating uncertainty in effect magnitude.
Cannabinoids reduce insomnia severity and improve sleep quality in adults with insomnia or poor sleep quality
This meta-analysis of 10 RCTs (2134 participants) found that cannabinoids significantly reduced insomnia severity (MD -3.73, 95% CI -5.04 to -2.42) and improved sleep quality (MD -3.94, 95% CI -5.47 to -2.40). Total sleep time increased by 33.99 minutes and sleep efficiency improved by 4.31%, with modest reductions in sleep onset latency. Adverse events were more frequent with cannabinoids (RR 3.96) but mostly mild and no serious harms were observed.
Transcranial magnetic stimulation reduces alcohol craving in patients with alcohol use disorder
A meta-analysis of 19 RCTs involving 942 patients with AUD found that TMS significantly reduced alcohol craving compared to sham stimulation. Subgroup analysis showed significant effects with cTBS, 10 or 15 sessions, 10 Hz frequency, and follow-up ā¤1 month or ā„3 months. TMS also improved abstinence days, reduced alcohol intake, alleviated depressive symptoms, and enhanced cognitive function.
Evening/nighttime exercise is associated with higher wake after sleep onset (WASO) compared to morning exercise, indicating a modest effect on sleep continuity.
A meta-analysis of 16 randomized controlled trials found that evening/nighttime exercise was associated with higher wake after sleep onset (WASO) compared to morning exercise (SMD = -0.51, 95% CI [-0.89, -0.12]), indicating a modest effect on sleep continuity. However, this finding should be interpreted with caution due to potential small-study effects. Overall, the evidence does not indicate a clear advantage of morning over evening exercise for most sleep outcomes.
Solriamfetol improves objective wakefulness and reduces subjective sleepiness in Chinese OSA patients with EDS across all disease severity levels.
In a post hoc analysis of a 12-week RCT, solriamfetol (up to 150 mg/day) significantly prolonged MWT sleep latency vs placebo in all AHI subgroups: AHI<5 (LS mean difference 12.13 min, p<0.0001), 5ā¤AHI<30 (12.68 min, p<0.0001), and AHIā„30 (10.94 min, p=0.0001). ESS scores significantly improved in the two milder subgroups but not in the severe OSA subgroup (p=0.2497).
Remote ischemic preconditioning training improves sleep quality in post-stroke insomnia patients
A 10-day remote ischemic preconditioning (RIPC) intervention significantly improved sleep quality (PSQI) and stroke-specific quality of life (SS-QOL) in post-stroke insomnia patients at 1 week and 3 months post-intervention, with no significant effect on anxiety (GAD-7). The intervention was well tolerated with no significant difference in adverse events compared to routine nursing.
Hypoxia exposure does not produce a statistically significant circadian phase advance in healthy adults
This exploratory crossover study compared the effects of normobaric hypoxia (12% inspired oxygen for 2 hours) with luminotherapy plus melatonin on circadian phase shifting in healthy adults. The hypoxia condition produced an average phase advance of approximately 35 minutes, which was not statistically significant, while the light and melatonin condition produced a significant phase advance of about 78 minutes. The findings do not support hypoxia as an effective intervention for circadian resynchronization.
Melatonin adjunctive to stable pharmacotherapy improves parent-reported sleep disturbances and Stroop Color-Word Test performance in pediatric ADHD over 6 weeks, though causal attribution is limited by the open-label single-arm design.
In 32 children and adolescents with ADHD and comorbid sleep disturbances on stable methylphenidate or atomoxetine, adjunctive melatonin (3-5 mg/day) for 6 weeks reduced Children's Sleep Habits Questionnaire (CSHQ) total scores from 50.25 Ā± 3.60 to 34.31 Ā± 2.69 (F=506.238, p < .001, partial Ī·Ā²=0.942). Stroop Color-Word Test scores showed large observed changes (d=1.12-1.19, all p < .001), but practice effects cannot be excluded without a control group.
Comprehensive nursing intervention improves sleep quality, psychological outcomes, pain, and coping in patients with comorbid depression and thoracolumbar compression fracture
A quasi-experimental study of 60 patients with comorbid depression and thoracolumbar compression fracture found that comprehensive nursing intervention (including psychological counseling, environmental optimization, individualized pain management, health education, structured rehabilitation, and daily living support) significantly improved sleep quality (PSQI: 7.83 vs. 12.47, p<0.001, d=1.70), depression (SDS: 56.83 vs. 70.17, p<0.001, d=1.64), anxiety (SAS: 54.30 vs. 67.50, p<0.001, d=1.69), and pain (VAS: 3.17 vs. 4.93, p<0.001, d=1.50) compared to conventional nursing.
A single session of resistance exercise does not markedly alter sleep architecture in young males, regardless of regimen type (maximum strength vs. hypertrophy training).
This study compared the effects of maximum strength training (MST) and hypertrophy training (HYP) on sleep quality in 11 young males. MST significantly reduced REM sleep time compared to a control condition, but no other sleep parameters (total sleep time, sleep efficiency, sleep onset latency, wake after sleep onset, non-REM sleep) differed significantly. The findings suggest that a single bout of resistance exercise, whether strength- or hypertrophy-focused, does not substantially change overall sleep architecture.
Add-on Limosilactobacillus reuteri probiotic does not improve depressive symptoms in overweight depressed patients with systemic low-grade inflammation
In an 8-week double-blind RCT, 75 overweight patients with major depressive disorder and systemic low-grade inflammation (hs-CRP ā„ 1 mg/L) received either L. reuteri probiotic or placebo added to stable treatment. No significant effects on depression outcomes (MADRS total score or inflammatory depressive symptoms) were found (all p > 0.25). Exploratory analyses suggested that lower baseline fecal formic acid and greater treatment-associated increase in formic acid were linked to MADRS improvement in the probiotic group (p < 0.01).
DISCOVER, a brief CBT-based self-referral workshop, improves depression and anxiety outcomes in adolescents with clinical-level depression at 12 and 18 months follow-up.
In a secondary analysis of the BESST cluster RCT, adolescents with clinical-level depression who received DISCOVER had significantly higher odds of achieving normal-range symptoms at 12 months (RRR=3.12, 95% CI: 1.48-15.97, p=0.006) and 18 months (RRR=2.63, 95% CI: 1.11-6.24, p=0.029) compared to treatment-as-usual. Small-to-moderate effects were maintained for depression (d=0.44 at 12 months, d=0.30 at 18 months) and anxiety (d=0.38 at 12 months, d=0.30 at 18 months).
Limosilactobacillus reuteri probiotic does not improve depressive symptoms in overweight depressed patients with systemic low-grade inflammation
In an 8-week double-blind RCT, add-on L. reuteri probiotic showed no significant effect on depressive symptoms (MADRS score) or inflammatory depressive symptoms compared to placebo in MDD patients with BMI ā„25 and hs-CRP ā„1 mg/L. However, lower baseline fecal formic acid and greater treatment-associated increase in fecal formic acid were significantly associated with MADRS reduction in the probiotic group (p<0.01).
Comprehensive nursing intervention improves psychological outcomes, sleep quality, pain, and coping in patients with comorbid depression and thoracolumbar compression fracture
A comprehensive nursing intervention including psychological counseling, environmental optimization, individualized pain management, health education, structured rehabilitation, and daily living support significantly reduced depression (SDS: 56.83 vs. 70.17, p<0.001, d=1.64), anxiety (SAS: 54.30 vs. 67.50, p<0.001, d=1.69), sleep disturbance (PSQI: 7.83 vs. 12.47, p<0.001, d=1.70), and pain (VAS: 3.17 vs. 4.93, p<0.001, d=1.50) compared to conventional nursing. Positive coping increased (21.53 vs. 16.07, d=1.35) and negative coping decreased (7.83 vs. 11.27, d=1.36).
Stellate ganglion block shows favorable trends in perioperative psychological symptoms and postoperative recovery quality in non-elderly patients undergoing total hip arthroplasty for osteonecrosis of the femoral head, but evidence is inconsistent and not robust to baseline adjustment.
In a randomized controlled trial of 94 non-elderly patients undergoing total hip arthroplasty for osteonecrosis of the femoral head, those receiving ultrasound-guided stellate ganglion block with 4 mL of 0.8% lidocaine showed improved GAD-7 scores and higher QoR-15 scores compared to placebo. However, the GAD-7 effect was not confirmed after adjusting for baseline scores, and HADS depression/anxiety scores did not reach statistical significance.
Global connectivity-based target selection for rTMS did not enhance analgesic efficacy in chronic pain patients compared to classic M1 stimulation
In a randomized, double-blind trial, 90 chronic pain patients received 12 sessions of rTMS over 8 weeks, comparing stimulation of the cortical site with lowest pre-therapy global connectivity, highest connectivity, or classic M1 stimulation. No significant between-group differences were found for the primary outcome (ā„30% pain reduction) or secondary outcomes (all p > 0.05). Exploratory analyses showed that lower local M1 connectivity was associated with greater pain reduction only in the Classic-M1 group (r = 0.50, p = 0.005).
Open-label placebos do not reduce cardiac anxiety, improve sleep quality, or enhance well-being in inpatients with cardiovascular disease undergoing cardiac rehabilitation.
In a randomized controlled trial of 122 inpatients with cardiovascular disease, open-label placebos (OLPs) added to treatment as usual and self-monitoring did not significantly improve cardiac anxiety, sleep quality, or well-being compared to control groups. All groups showed significant improvements over time, but no between-group differences were found for any primary outcome.
Personalized online counselling based on cognitive behavioral principles does not significantly improve sleep efficiency in shift workers compared to sleep diary completion alone.
In a randomized controlled trial of 66 German shift workers, both the intervention group receiving four personalized counselling messages and weekly sleep diaries and the control group completing only sleep diaries showed significant improvements in sleep efficiency, insomnia symptoms, and depression symptoms over four weeks. However, the improvements were not significantly greater in the intervention group than in the control group, failing to demonstrate superiority of the counselling intervention. Daytime sleepiness did not improve in either group.
Add-on Limosilactobacillus reuteri probiotic does not reduce depressive symptoms in overweight depressed patients with systemic low-grade inflammation
In an 8-week double-blind RCT, 75 patients with major depressive disorder, BMI ā„25 kg/m2, and hs-CRP ā„1 mg/L received either L. reuteri probiotic or placebo added to stable treatment. No significant effects were found on any primary or secondary outcomes (all p > 0.25). Lower baseline fecal formic acid and greater treatment-associated increase in fecal formic acid were significantly associated with MADRS score reduction in the probiotics group (p < 0.01).
Heartfulness meditation as adjunct to methotrexate does not significantly improve PASI 75 response in moderate to severe psoriasis
In a randomized controlled trial of 50 adults with moderate to severe psoriasis, adding heartfulness meditation to methotrexate resulted in PASI 75 achievement in 61.1% of the intervention group versus 52.38% in the control group, but this difference was not statistically significant (P = 0.548). Trends toward better improvements in BSA, DLQI, PSS, and PSQI were observed in the meditation group, but none reached significance. No adverse events related to meditation were reported.
Physical activity participation is associated with lower obesity risk in male Saudi adolescents
Physically active male Saudi adolescents had significantly lower BMI (23.64 vs. 30.28 kg/m2), waist circumference (85.46 vs. 97.35 cm), and waist-to-height ratio (0.488 vs. 0.562) compared to inactive peers. Obesity prevalence by IOTF criteria was 17.1% in active vs. 51.9% in inactive, and abdominal obesity was 31.4% vs. 72.2%.
Combined vitamin D and calcium supplementation improves sleep quality in individuals with prediabetes
In a 24-week RCT involving 212 Chinese adults with prediabetes, the vitamin D plus calcium group showed a significant reduction in total PSQI score compared to pre-intervention levels. Subgroup analyses also found improved sleep quality with calcium alone in women, those with low baseline 25(OH)D (<30 ng/mL), and menopausal individuals.
Transcranial alternating current stimulation (tACS) reduces pain intensity in adults with musculoskeletal pain but does not significantly improve sleep quality.
A meta-analysis of 6 RCTs (232 participants) found that tACS significantly reduced pain intensity compared to control (SMD = -0.355, 95% CI: -0.625 to -0.084, p = 0.010). However, no significant improvement was found for sleep quality (SMD = 0.004, 95% CI: -0.310 to 0.317, p = 0.982). The certainty of evidence was low for both outcomes.
Self-acupressure reduces pain and improves sleep quality in patients with osteoarthritis
A systematic review and meta-analysis of 23 studies (2639 participants) found that self-acupressure was associated with significant reductions in pain (VAS at week 1: SMD = -0.52; WOMAC pain at week 4: SMD = -0.39) and improved sleep quality (PSQI at week 8: SMD = -0.86). The intervention also improved health-related quality of life (SF-6D at week 8: SMD = 0.17). Adverse events were minor and transient, but evidence quality was low-to-moderate with heterogeneity and risk of bias concerns.
Once-daily sustained-release pregabalin (YHD1119) achieves quality of life outcomes comparable to twice-daily immediate-release pregabalin in patients with peripheral neuropathic pain
In a phase 3 randomized, double-blind, active-controlled trial, 296 Korean patients with peripheral neuropathic pain received either once-daily sustained-release pregabalin (YHD1119) or twice-daily immediate-release pregabalin for 12 weeks. Quality of life measures (SF-12, WSIS, PGIC, CGIC) showed no statistically significant differences between groups, with SF-12 Physical Component Summary changes of +2.50 vs +3.08 (p=0.5243) and WSIS improvements of -2.12 vs -2.19 (p=0.3691). The results support the new SR formulation as a practical alternative with comparable patient-reported benefit and once-daily dosing convenience.
Melatonin modestly improves sleep latency and duration in children with cerebral palsy compared with placebo
In a systematic review of 12 randomized controlled trials, melatonin was the only intervention showing modest improvement in sleep latency and duration compared with placebo in children with cerebral palsy. Other pharmacological and non-pharmacological interventions showed inconsistent or negligible effects. The overall certainty of evidence was low.
Adults with obstructive sleep apnea syndrome appear more likely to experience sleep bruxism, suggesting a potential bidirectional association
An umbrella review of eight systematic reviews found frequent coexistence of sleep bruxism and obstructive sleep apnea syndrome (OSAS) in adults, possibly due to shared mechanisms like micro-arousals and autonomic activation. Only one review included a meta-analysis, and most reviews had low or critically low methodological quality. The evidence is heterogeneous and limited, with causality remaining unclear.
Refugee and asylum-seeking populations exhibit clinically significant sleep disturbances, with high pooled prevalence of sleep adversities.
A systematic review and meta-analysis of 66 studies (n=42,956) found that refugees and asylum seekers have clinically significant sleep disturbances. The pooled mean Insomnia Severity Index (ISI) score was 13.76 (95% CI 10.39-17.13), bordering on moderate clinical insomnia, and the pooled mean Pittsburgh Sleep Quality Index (PSQI) score was 8.59 (95% CI 2.11-15.07), exceeding clinical thresholds for poor sleep. The pooled prevalence of sleep adversities was 43.2% in adults and 36.4% in children.
Meta-analyses of the same intervention can yield conflicting results due to differences in inclusion criteria, statistical methods, and outcome definitions.
This paper examines why meta-analyses on the same topic may disagree, highlighting that pooled estimates can vary based on methodological choices. It emphasizes the need to look beyond the summary effect to understand sources of heterogeneity.
Full Cognitive Behavioral Therapy for Insomnia (CBT-I) improves work productivity outcomes including absenteeism and presenteeism in adults with insomnia.
Moderate-quality evidence from 7 randomized controlled trials involving 4751 participants showed that Full CBT-I significantly improved absenteeism and presenteeism. Low-quality evidence supported its effect on work productivity loss and activity impairment.
Long-term use of dual orexin receptor antagonists improves subjective sleep outcomes in adults with chronic insomnia
A systematic review and meta-analysis of 6 randomized controlled trials with 3,546 participants found that DORAs (suvorexant, lemborexant, daridorexant) improved subjective sleep parameters at 6 and 12 months. Adverse events were similar to placebo at 6 months but higher at 12 months, with no significant difference in overall discontinuation due to adverse events, though higher doses increased discontinuation at 6 months.
Obstructive sleep apnea-hypopnea syndrome has a high prevalence in patients with cystic fibrosis, particularly in pediatric patients.
The pooled prevalence of OSAHS in patients with CF was 48% (IĀ² = 96.5%), with slightly higher rates in pediatric patients than adults. The mean AHI was 3.47 in pediatric and 6.19 in adult CF patients, and those with OSAHS had worse pulmonary function and oxygen saturation.
Non-motor outcomes are highly prevalent after stroke, with no significant differences between hospital and population settings except for bowel dysfunction.
A systematic review and meta-analysis of 357 prospective cohort studies (247,541 participants) found that adverse non-motor outcomes such as anxiety, depression, fatigue, and sleep disturbance are common after stroke. Pooled prevalence did not differ significantly between hospital-based and population-based studies, except for bowel dysfunction, which was higher in population-based studies (61% vs 47%). Use of non-validated outcome measures was associated with higher reported prevalence for several outcomes.
The pooled prevalence of PTSD among ICU nurses is approximately 32.78%
This systematic review and meta-analysis of 25 observational studies found that the prevalence of PTSD among ICU nurses ranges from 3.3% to 64%, with a pooled prevalence of 32.78% (95% CI: 31.6%ā33.9%). The high prevalence underscores the need for targeted interventions and support programs for this population.
Meditation and breathing exercises may improve quality of life in patients with eye diseases
A systematic review of seven studies (six RCTs and one single-arm trial) found preliminary evidence that meditation and breathing exercises improve quality of life, anxiety, depression, and sleep quality in patients with eye diseases. However, the evidence is limited by concerns with study quality and short follow-up durations.
The pooled prevalence of moderate-to-high risk of obstructive sleep apnea (OSA) in the Chilean population is 25%
A systematic review and meta-analysis of 15 studies involving 13,157 participants found that the pooled prevalence of moderate-to-high risk of OSA (defined by STOP-Bang score >3) in Chile is 25% (95% CI: 16-34%). The most frequently reported symptoms were snoring, excessive daytime sleepiness, and witnessed apneas. The findings are based mainly on screening questionnaires, with only three studies using respiratory polygraphy.
The prevalence of common mental disorders, anxiety, depression, burnout, insomnia, and stress among primary healthcare workers in Brazil is fragmented and requires systematic review and meta-analysis to consolidate estimates.
This protocol describes a systematic review and prevalence meta-analysis to consolidate prevalence estimates of mental health outcomes among primary healthcare workers in Brazil. The review will search multiple databases from inception to 16 September 2025, include quantitative observational studies, and pool prevalence using random-effects models. The study aims to synthesize associated sociodemographic, occupational, and organizational factors.
Cognitive-behavioral therapy reduces depression in people with Parkinson's disease
This systematic review of 54 studies found moderate-certainty evidence from multiple randomized controlled trials that cognitive-behavioral therapy (CBT) improves depression in people with Parkinson's disease. Evidence for anxiety and sleep disorders suggests potential benefit but with low certainty due to heterogeneity and small sample sizes.
Melatonin doses ā¤5 mg/day for at least four weeks reduce body weight in humans
This review found that sleep deprivation lowers melatonin levels, which impairs insulin sensitivity via IRS/PI3K/AKT and cAMP/PKA/CREB pathways. Intervention studies using melatonin doses of ā¤5 mg/day for at least four weeks showed potential for reducing body weight in humans, though findings on appetite-regulating neuropeptides were mixed.
Testosterone therapy randomized controlled trials exhibit suboptimal reporting of adverse events, including polycythemia, gynecomastia, major adverse cardiovascular events, and obstructive sleep apnea
A critical analysis of 30 testosterone therapy (TTh) randomized controlled trials found highly heterogeneous and suboptimal reporting of adverse events. Only 83% measured hematocrit levels, 23% reported baseline values, 17% reported gynecomastia, 20% reported MACE, and 33% mentioned OSA, with few reporting incidence rates. This underscores the need for standardization in TTh trials.
Mandatory naptime in childcare settings is associated with increased napping but may reduce nighttime sleep and total daily sleep duration in young children.
A systematic review of 6 studies found that mandatory naptime (tested in 4 studies) was associated with increased napping. One study reported that mandatory naptime was associated with reduced nighttime sleep and total daily sleep duration. Music and massage therapy (each tested in 1 study) were associated with reduced nap latency.
Nurses and midwives perceive poor sleep as an expected and inevitable part of the job, influenced by personal, work-related, and institutional factors, and employ various behaviours to manage sleep.
This systematic review of 33 qualitative studies synthesized 245 findings into 24 categories and 9 synthesised findings. It found that while nurses and midwives view sleep as important, they often accept poor sleep as an unavoidable aspect of their profession, with experiences shaped by personal circumstances, work factors, and institutional practices, and they use strategies like planning sleep time, sleep aids, and environmental modifications.
Clonazepam and melatonin remain principal treatments for RBD in synucleinopathies, but evidence is limited and inconsistent, with clonazepam raising safety concerns and melatonin showing inconsistent efficacy.
A systematic review of 18 studies evaluated pharmacological treatments for vPSG-confirmed RBD in synucleinopathies. Clonazepam showed possible benefit but raised safety concerns, while melatonin was better tolerated but had inconsistent efficacy. Evidence for other agents was preliminary, and larger randomized trials are needed.
Correction notice for the article on Baduanjin exercise effects on sleep quality, depressive symptoms, quality of life, and body composition in older adults.
This paper is a correction notice for a previously published systematic review and meta-analysis (DOI: 10.3389/fpubh.2026.1882039). It does not present new findings but corrects errors in the original article. The original article reported that Baduanjin exercise improved sleep quality, depressive symptoms, quality of life, and body composition in older adults.
Presleep whey protein ingestion improves sleep quality after resistance exercise compared with an isocaloric control in resistance-trained individuals
In a randomized, double-blind, crossover trial of nine resistance-trained young adults, consuming 40 g of whey protein 30 minutes before bed significantly improved sleep-onset latency (9.0 vs 19.0 min), sleep efficiency (96% vs 93%), total sleep time (400 vs 363 min), and subjective sleep rating (8.0 vs 6.0) compared with an isocaloric maltodextrin control. Whey also reduced delayed onset of muscle soreness at 12 and 24 hours post-training.
Baseline gut microbiota composition, particularly microbial hydrogen-producing capacity, may modify individual responses to hydrogen supplementation on sleep quality
In a randomized, double-blind, placebo-controlled trial of 44 healthy adults with poor sleep quality, hydrogen-rich jelly did not significantly improve sleep outcomes in the overall analysis. However, when participants were stratified by baseline abundance of hydrogen-producing bacteria (e.g., Bacteroides), those with lower abundance showed greater improvement in sleep quality and mental stress, suggesting a microbiome-dependent effect.
Ashwagandha root extract combined with melatonin improves sleep quality in adults with sleep disturbances.
In an 8-week RCT, 200 adults aged 18-50 with sleep disturbances received ARE (300 mg twice daily), MLT (3 mg/day), their combination, or placebo. The combination group showed the greatest reduction in sleep onset latency (p < 0.0001) and significant improvements in total sleep time, wake after sleep onset, and sleep efficiency (all p < 0.0001).
Strawberry leaf extract improves episodic memory and reduces perceived stress in older adults with self-reported memory complaints
In a 12-week randomized, double-blind, placebo-controlled trial, 109 older adults (60-80 years) with subjective memory complaints received either 300 mg/day strawberry leaf extract or placebo. Exploratory analyses showed significant improvements in episodic memory (reduced PAL total errors at Week 6 and Week 12) and reduced perceived stress at Week 6 in the SLE group compared to placebo.
HIRAID Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients
This protocol describes a stepped-wedge cluster RCT evaluating the HIRAID Inpatient framework across 35 wards in 10 hospitals with 1259 nurses and 4050 patients per month. The study aims to reduce preventable nurse-associated clinical deterioration and hospital-acquired complications by standardizing nursing assessment, decision-making, and communication.
Shatavari root extract combined with Ashwagandha improves sexual arousal, lubrication, orgasm, and total FSFI scores in women with sexual health concerns.
In an 8-week randomized controlled trial of 135 women, the combination of Shatavari and Ashwagandha root extracts (SHT-ARE) significantly improved Female Sexual Function Index (FSFI) scores for arousal (P=0.041), lubrication (P=0.027), orgasm (P=0.031), and total FSFI (P=0.005) compared to placebo. Shatavari alone improved only total FSFI (P=0.025) and satisfaction (P<0.0001). The SHT-ARE group also showed reduced sexual distress (FSDS, P<0.0001) and increased happiness (OHQ, P<0.0001).
Combined early in-bed cycling and intravenous amino acid supplementation does not improve 6-minute walk distance in patients with acute respiratory failure.
In a multicenter phase 2 RCT of 115 patients with acute respiratory failure, the intervention group received in-bed cycling (mean 40 min/d) and intravenous amino acid (total protein 1.9 g/kg/d) plus usual care, while controls received usual care alone (protein 0.9 g/kg/d). The median 6-minute walk distance at hospital discharge was similar between groups (108 m vs 95 m, P=0.51), and secondary outcomes also showed no significant differences.
High-intensity interval training-based virtual reality exergaming improves inhibitory control and inattention symptoms in adolescents with ADHD compared to an active, nonexercise VR control condition
This protocol describes an ongoing RCT testing whether HIIT-based VR exergaming (Move Sapiens) produces greater improvements in inhibitory control and inattention than an active VR control without vigorous exertion in 98 adolescents with ADHD. As of April 2026, 58 participants have been enrolled, with 79.3% completing the intervention. Results are expected by December 2026.
Balance-ACT may improve health-related quality of life in adults with post-COVID syndrome compared to treatment as usual, but efficacy is not yet established as this is a study protocol.
This protocol describes a randomised controlled trial evaluating Balance-ACT, a novel ACT-based intervention, for post-COVID syndrome (PCS). The trial will recruit 196 adults with PCS from NHS long COVID services and randomise them to Balance-ACT (10 sessions over 13 weeks) or treatment as usual (educational videos and self-help leaflet). The primary outcome is health-related quality of life measured by SF-36 Physical Component Score at 14 weeks post-randomisation, with secondary outcomes including sleep disturbance, fatigue, and cognitive function.
Ashwagandha root extract improves sleep quality in pregnant women
In a 12-week RCT, Ashwagandha root extract (ARE) 300 mg twice daily plus standard care significantly improved subjective sleep quality at all visits (p=0.036), sleep duration at weeks 8 and 12 (p<0.001), and sleep disturbances at week 12 (p=0.028) compared to standard care alone in pregnant women in their second trimester. No adverse events were reported.
Clay pot therapy combined with thunder-fire moxibustion improves sleep quality in orthopedic patients with chronic refractory wounds
In a randomized controlled trial of 60 orthopedic patients with chronic refractory wounds, those receiving clay pot therapy plus thunder-fire moxibustion (in addition to conventional treatment) showed significantly better Pittsburgh Sleep Quality Index scores (9.58 Ā± 1.56 vs 11.30 Ā± 2.15, P<0.05) compared to conventional treatment alone. The intervention also improved wound healing rates and reduced pain scores.
Neiyanggong reduces cancer-related fatigue and improves sleep quality in breast cancer patients undergoing chemotherapy.
A randomized controlled trial of 72 breast cancer patients undergoing chemotherapy found that a staged progressive dynamic-static Neiyanggong intervention significantly reduced cancer-related fatigue (PFS-R total score interaction effect F=94.810, P<0.001, Ī·Ā²=0.807) and improved sleep quality (PSQI total score interaction effect Wald ĻĀ²=292.975, P<0.001) compared to routine care. After three chemotherapy cycles, fatigue scores were significantly lower in the Neiyanggong group (P<0.05), and notable improvements were seen in sleep latency, sleep efficiency, and daytime dysfunction (P<0.001).
Adjunctive melatonin or digital cognitive behavioural therapy for insomnia (dCBT-I) may be more effective than pill placebo at reducing depressive symptoms in young adults with mood disorders
The MELODY trial is a phase 3 randomised controlled trial testing whether 12 weeks of adjunctive melatonin or dCBT-I are more effective than pill placebo at reducing depressive symptoms in 660 young people aged 18-30 years with major depressive disorder or bipolar II disorder and significant sleep complaints. The primary outcome is depressive symptoms at week 12, measured by the Quick Inventory of Depressive Symptomatology, Adolescent version. This is a study protocol, so no results are reported yet.
Multi-strain probiotics reduce hyperactivity and improve academic performance in adults with ADHD
A double-blind RCT found that daily multi-strain probiotic supplementation for three months significantly decreased hyperactivity, improved gastrointestinal symptoms, and enhanced academic performance in college students with ADHD. Younger participants showed greater overall benefits, and higher academic grades were associated with lower hyperactivity and impulsivity.
Melissa officinalis Phytosome (MOP) improves sleep quality in adults with mild insomnia
In a double-blind, placebo-controlled crossover study, MOP significantly reduced Insomnia Severity Index (ISI) scores by an average of 2.9 points compared to placebo (6.8 Ā± 4.1 vs 9.7 Ā± 3.7, p=0.003). Slow-wave sleep (SWS) duration increased by 15%, REM sleep decreased by 10%, and 87% of treated participants reported improved sleep quality versus 30% in the placebo group (ĻĀ²=21.01, p=0.0003).
Ashwagandha root extract sustained-release (AshwaSR) 150 mg and 300 mg capsules reduce perceived stress and improve sleep quality in healthy stressed adults.
In a randomized, double-blind, placebo-controlled trial, healthy adults with moderate stress (Perceived Stress Scale score 14-26) taking AshwaSR 150 mg or 300 mg daily for 60 days showed significant reductions in perceived stress (38.6% and 41.6% reduction, respectively) and significant improvements in sleep quality compared to placebo. Serum cortisol was significantly reduced only in the 300 mg group.
FMT-based treatment protocol improves sleep efficiency in chronic insomnia disorder
A randomized, double-blind, placebo-controlled trial found that a fecal microbiota transplantation (FMT)-based treatment protocol incorporating antibiotic pretreatment improved polysomnography-measured sleep efficiency by 13.9 percentage points (95% CI 7.29-20.41, p=0.003) compared to placebo in adults with chronic insomnia disorder. The intervention also reduced wake after sleep onset and showed sustained improvements in subjective insomnia scores from 2 to 6 months.
Lemborexant improves sleep quality in patients with cirrhosis
In a double-blind, placebo-controlled crossover trial, Lemborexant at 5 mg and 10 mg significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores in cirrhosis patients over 2 weeks. The 5 mg dose also improved cognitive function as measured by the EncephalApp Stroop Test, while the 10 mg dose showed a mild increase in reaction time. Liver function remained unchanged across groups.
Modified Sini Powder (MSNP) reduces depressive symptoms in postoperative non-small cell lung cancer patients with mild-to-moderate depression
This protocol describes a multicenter, randomized, double-blind, placebo-controlled trial evaluating MSNP for postoperative mild-to-moderate depression in NSCLC patients. The primary outcome is the total effective rate at 6 weeks, defined as a ā„25% reduction in the 17-item Hamilton Depression Rating Scale score from baseline. The study aims to provide robust clinical evidence and explore multi-omics mechanisms.
Melatonin impairs glucose tolerance and first-phase insulin secretion in MTNR1B diabetes risk variant carriers
In a randomized, double-blind, placebo-controlled crossover trial, 5 mg oral melatonin worsened glucose tolerance (11.7% increase) and reduced early C-peptide responses (19.2% decrease) in MTNR1B G-allele risk carriers, but not in noncarriers. The impairments were driven by a 40% suppression of glucose-stimulated first-phase Ī²-cell responsivity and dysregulated insulin negative feedback.
Walnut peptide and theanine combination (WPT) improves chronic stress-induced sleep disorders by restoring slow-wave sleep duration and quality in adults with poor sleep quality.
In an 8-week randomized, placebo-controlled human trial, WPT restored sleep duration and improved subjective sleep quality scores (PSQI ā„ 7). Mechanistically, WPT reduced serum corticosterone levels and increased GABA and tryptophan in CUMS mice, indicating HPA axis regulation and neurotransmitter modulation.
Baduanjin exercise alleviates anxiety, depressive symptoms, and improves sleep quality and quality of life in patients with primary glaucoma
An 8-week Baduanjin exercise intervention (5 sessions per week, 30 min each) significantly improved anxiety (HADS-A), depressive symptoms (HADS-D), and sleep quality (PSQI) compared to routine care in patients with primary glaucoma. Benefits were more pronounced in patients with higher baseline symptom levels. The intervention also improved domain-specific quality of life, particularly glare/dark adaptation and outdoor mobility.
Perioperative hydrogen gas inhalation improves postoperative recovery quality in day surgery patients
In a double-blind RCT of 150 day surgery patients (laparoscopic cholecystectomy or thyroidectomy), those inhaling a hydrogen-oxygen mixture (66.7% hydrogen) showed significantly better recovery quality than controls inhaling nitrogen-oxygen, with a smaller reduction in QoR-15 scores (9Ā±12 vs. 14Ā±13, p=0.008). Exploratory analyses suggested trends toward lower pain, greater physical independence, and improved sleep quality, along with reduced plasma IL-6 and IL-12 levels.
Preoperative transcutaneous electrical acupoint stimulation reduces postoperative pain and improves sleep quality in breast cancer patients with preoperative sleep disturbance
In breast cancer patients with preoperative sleep disturbance (PSQI ā„ 6), preoperative TEAS (2/100 Hz, 8-12 mA, 30 min at LI4, HT7, PC6) significantly reduced postoperative pain scores (NRS) at 4, 24, 48, and 72 hours and improved Athens Insomnia Scale scores on postoperative days 1-2 compared to the sleep disturbance control group. Intraoperative blood pressure variability was also lower in the TEAS group (sdSBP: 9.31 Ā± 2.73 vs 18.85 Ā± 6.74; cvSBP: 0.08 Ā± 0.02 vs 0.16 Ā± 0.05).
HMB + EPA/DHA supplementation increases postabsorptive net protein breakdown in COPD patients
In a 10-week RCT, HMB + EPA/DHA (but not EPA/DHA alone) significantly increased postabsorptive net protein breakdown (p=0.028) and whole body production of glutamine, taurine, and tyrosine in COPD patients. Both EPA/DHA and HMB + EPA/DHA increased lean soft tissue, but only HMB + EPA/DHA reduced whole body and extremity fat mass.
Probiotic effects on brain function, as measured by resting state functional connectivity, persist 4-6 weeks after discontinuation in healthy older adults.
This RCT found that some brain-related effects of probiotics, particularly changes in resting state functional connectivity between the left superior parietal lobule and right occipital/cuneal/intracalcarine/supracalcarine cortex, persisted 4-6 weeks after cessation of a 6-week supplementation period. Additionally, significant time*group interaction effects were observed for Hospital Anxiety and Depression Scale Total Score and Anxiety Subscore between weeks 10-12 and week 6, but not from baseline. The study involved 32 healthy older adults (mean age 68.0 years) and compared two probiotic formulations of Lacticaseibacillus rhamnosus HN001 against placebo.
Tirzepatide improves patient-reported outcomes and objective assessments in adults with moderate-to-severe OSA and obesity, with greater improvements in those with worse baseline fatigue, sleepiness, or sleep quality.
In two 52-week randomized placebo-controlled trials (SURMOUNT-OSA), tirzepatide (10/15 mg) led to greater improvements in patient-reported outcomes (e.g., fatigue, sleepiness, sleep quality) and objective measures (AHI, weight, OSA remission) compared to placebo. Participants with worse baseline symptoms showed larger improvements on related PROMs, while objective improvements were similar across severity subgroups.
A novel nutritional blend of tryptophan, glycine, magnesium, tart cherry powder, and l-theanine reduces sleep onset latency and increases total sleep time and efficiency in healthy adults.
In a randomized, double-blind crossover study with 16 healthy adults, a nutritional blend reduced sleep onset latency by 24 Ā± 25 minutes (P=0.002), increased total sleep time by 22 Ā± 32 minutes (P=0.01), and improved sleep efficiency by 2.4% Ā± 3.9% (P=0.03), while also reducing morning sleepiness (P=0.02). The effects may be mediated by upregulation of key metabolites like 6-sulfatoxymelatonin, D-serine, and L-glutamic acid.
Esketamine-adjuvanted stellate ganglion block reduces postoperative sleep disturbance after gynecological laparoscopic surgery
Adding an esketamine-adjuvanted stellate ganglion block to intraoperative esketamine and dexmedetomidine significantly reduced the incidence of postoperative sleep disturbance on day 1 (62.9% vs. 83.2%, p=0.002) and day 3 (25.8% vs. 42.1%, p=0.017) in patients undergoing gynecological laparoscopic surgery. The intervention also lowered early postoperative anxiety without increasing perioperative complications.
Perioperative sub-anesthetic esketamine reduces postoperative depression and anxiety and improves sleep quality in acoustic neuroma patients.
In a randomized clinical trial of 77 patients undergoing acoustic neuroma surgery, esketamine significantly reduced the incidence of depression on postoperative day 1 (7.7% vs 31.6%, RR 0.24, 95% CI 0.08-0.80, p=0.008) and day 3 (0.0% vs 15.8%, p=0.031) compared to placebo. Anxiety and sleep disturbances were also significantly reduced, but no significant effects on immune function or pain were observed.
Mild hyperbaric oxygen therapy improves sleep quality and cognitive performance in healthy young adults at high altitude
In a randomized controlled trial of 60 healthy young males residing at 4300 m for at least six months, 5 days of mild hyperbaric oxygen therapy (mHBOT) significantly reduced PSQI scores compared to control (adjusted mean difference = -1.08, 95% CI: -1.76 to -0.46, p = 0.003). The mHBOT group also showed significantly higher accuracy on a working memory task and altered brain activation patterns in the superior temporal gyrus, suggesting improved neurocognitive efficiency.
LLM-driven coaching prompts grounded in the Transtheoretical Model of Change increase daily step count compared to generic prompts in adults at risk for cardiovascular disease.
This study will test whether personalized text-based coaching prompts generated by a large language model (LLM) increase daily step count more than generic prompts. The primary endpoint is change in daily step count over each intervention week in a randomized crossover trial with 15,000 adults across the US and UK. Recruitment began in March 2026 and is ongoing.
A multispecies probiotic intervention improves sleep quality in individuals with self-reported sleep disturbances
In a randomized, double-blind, placebo-controlled trial, 94 participants with poor sleep quality (PSQI > 5) received either a multispecies probiotic (OMNiBiOTiCĀ® STRESS Repair) or placebo for 28 days. The probiotic group showed a significantly greater improvement in sleep quality (PSQI score 6.8 Ā± 2.9 vs. 7.7 Ā± 3.1; p = 0.036) compared to placebo, driven by improvements in sleep efficiency and latency.
Stapokibart improves quality of life, including sleep, in patients with chronic rhinosinusitis with nasal polyps
In a post hoc analysis of the phase 3 CROWNS-2 study, stapokibart significantly improved SNOT-22 domain scores for nasal, ear/facial, sleep, and emotion compared to placebo during the 24-week double-blind period. These improvements were maintained or further improved during the open-label extension and safety follow-up periods, indicating sustained clinical benefit.
PhYoMind intervention (physiotherapy-integrated yoga and mindfulness) plus home exercise improves disease impact and functional impairment in fibromyalgia syndrome compared to home exercise alone
This protocol describes an 8-week randomized controlled trial (n=40) comparing PhYoMind (physiotherapy, yoga, and mindfulness) plus home exercise versus home exercise alone in individuals with fibromyalgia syndrome. The primary outcome is the Fibromyalgia Impact Questionnaire total score, with secondary outcomes including sleep quality, pain, fatigue, and autonomic function. The study is powered at 80% with an effect size of Cohen's f=0.675.
Fenavari (combined standardized extract of fenugreek and shatavari) significantly reduces menopausal symptoms and improves sleep quality in women aged 40-60 years
In a randomized, double-blind, placebo-controlled trial, 138 women with menopausal symptoms received Fenavari 300 mg, Fenavari 500 mg, or placebo daily for 84 days. Both doses significantly reduced Menopause Rating Scale (MRS) total scores from Day 14 onward, with the 500 mg dose showing greater effects (MRS change: -10.40 vs -8.26 for 300 mg vs -4.09 for placebo). Significant improvements were also observed in sleep quality, anxiety, mood, and hormonal parameters (increased estradiol, decreased FSH).
Melatonin is more effective than olanzapine in improving sleep quality in cancer patients with insomnia, with a superior adverse effect profile.
In a prospective, double-blind, randomized trial of 60 advanced cancer patients with insomnia, both oral melatonin (3 mg/day) and oral olanzapine (5 mg/day) significantly improved sleep parameters over four weeks (p < 0.001). Melatonin showed statistically significant superiority over olanzapine in PSQI scores at week four and overall AIS scores across all time points, and had a more favorable adverse effect profile (olanzapine was associated with somnolence, akathisia, and weight gain).
Qigong (Baduanjin) intervention reduces cesarean section rate in pregnant women
This multicenter RCT protocol aims to evaluate whether adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the cesarean section rate compared to standard care alone. The study plans to enroll 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation across 11 centers in China.
WeChat public-account intervention based on the IMB model reduces internet addiction and increases sleep duration in college students
A 6-week WeChat-based IMB intervention significantly reduced internet addiction (adjusted mean change -4.531, 95% CI -7.281 to -1.781; P=.001) and increased sleep duration (odds ratio 2.186, 95% CI 1.142-4.183; P=.02) in college students aged 18-24 with internet addiction. The intervention also improved motivation and behavioral skills, with effects varying by addiction severity.
Intraoperative dexmedetomidine reduces postoperative sleep disturbance in older adults undergoing major abdominal surgery
In a randomized, double-blind, placebo-controlled trial of 203 older adults (median age 71 years) undergoing major abdominal surgery, intraoperative dexmedetomidine infusion significantly reduced the relative risk of first-night postoperative sleep disturbance by 70-80% compared to normal saline. The incidence of first-night PSD was 65.7% in the saline group, 20.6% in the low-dose group (RR 0.31, 95% CI 0.19-0.50, NNT 2.2), and 11.8% in the high-dose group (RR 0.18, 95% CI 0.09-0.34, NNT 1.8).
Adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the rate of caesarean section in pregnant women.
This multicenter RCT protocol aims to evaluate whether a pregnancy-adapted qigong (Baduanjin) program, added to routine lifestyle intervention, reduces the caesarean section rate. The study plans to enroll 1062 women with singleton pregnancies at 11-13+6 weeks gestation across 11 Chinese institutions. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, gestational weight gain, and mental health/sleep measures.
Early ultrasound-guided thoracic paravertebral block reduces postherpetic neuralgia incidence in acute herpes zoster patients
In a randomized clinical trial of 100 patients with acute thoracic herpes zoster, adding ultrasound-guided thoracic paravertebral block (TPVB) with bupivacaine and methylprednisolone to standard therapy significantly reduced the incidence of postherpetic neuralgia at 90 days (16% vs. 34%, P=0.037). The TPVB group also showed improved pain scores, quality of life, sleep quality, and functional disability at 3 and 6 months.
Early adenotonsillectomy increases clinically-meaningful benefit compared to watchful waiting in children with mild sleep-disordered breathing
In a secondary analysis of the PATS randomized trial, 65% of children who received early adenotonsillectomy (eAT) experienced clinically-meaningful improvement on at least 2 of 4 domains (behavior, quality of life, subjective sleepiness, blood pressure) versus 39% in the watchful waiting group (p<0.01). A high Mallampati score (III or IV) was the only predictor of benefit (OR 4.16, 95% CI [1.22, 15.6], p=0.027).
Combined vitamin D and calcium supplementation, or calcium alone, improves sleep quality in individuals with prediabetes
In a 24-week RCT of 212 Chinese adults with prediabetes, the vitamin D plus calcium group showed a significant reduction in total PSQI score compared to pre-intervention levels. Subgroup analyses indicated that calcium supplementation alone improved sleep quality in women, those with low baseline 25(OH)D (<30 ng/mL), and menopausal individuals.
Adding cervical vagus nerve block to thoracic paravertebral block reduces postoperative opioid consumption after thoracoscopic lung surgery
This randomized, double-blind, placebo-controlled trial will test whether adding an ultrasound-guided cervical vagus nerve block (CVNB) with 5 mL of 0.375% ropivacaine to standard thoracic paravertebral block (TPVB) reduces cumulative opioid consumption within 24 hours postoperatively in patients undergoing video-assisted thoracoscopic surgery (VATS) lung resection. The primary outcome is cumulative opioid consumption expressed as intravenous morphine milligram equivalents (MME). The study aims to enroll 110 adult patients to detect a clinically meaningful reduction in opioid use.
A psycho-behavioural intervention reduces cancer-related fatigue in post-treatment colorectal cancer patients
In a pilot RCT of 50 post-treatment colorectal cancer patients, a 6-week psycho-behavioural intervention significantly reduced cancer-related fatigue compared to usual care (F=6.49, p=0.014, Hedges' g=-0.71). The intervention also improved physical activity, dietary behaviours, and sleep disturbance, but not anxiety or depressive symptoms.
Digital cognitive behavioral therapy for insomnia (dCBT-I) improves sleep onset latency in chronic insomnia patients, with effects comparable to zolpidem at 5 weeks and sustained at 10 weeks.
In a small exploratory RCT, a 5-week dCBT-I app reduced subjective sleep onset latency (sSOL) by -20.65 min at Week 5, similar to zolpidem (-22.42 min, p=0.7729). At Week 10 follow-up, dCBT-I showed sustained improvement (-29.02 min) while zolpidem showed slight recurrence (-16.19 min). No treatment-related adverse events occurred in the dCBT-I group.
Acupuncture combined with estazolam improves sleep quality and clinical efficacy in hemodialysis patients with insomnia compared to estazolam alone
In a randomized controlled trial of 110 hemodialysis patients with insomnia, those receiving acupuncture plus 1 mg/d estazolam for 4 weeks had significantly lower PSQI, HAMA, and CMSSI scores at 2, 4, and 8 weeks compared to those receiving estazolam alone. The intervention group also showed a higher clinical effective rate (81.82% vs. 41.82%) and improved sleep structure parameters, with no major adverse events.
Early home-based pulmonary rehabilitation is feasible and safe for post-hospitalisation exertional hypoxaemia patients, but adding high-flow nasal oxygen reduces adherence.
This pilot feasibility trial found that a 3-week home-based pulmonary rehabilitation program for patients with exertional hypoxaemia after hospital discharge had 67% acceptance and 62% uptake. However, the addition of high-flow nasal oxygen during exercise training was associated with lower program completion (60% vs 89%) and reduced adherence to self-directed sessions.
A 20-min power nap reduces fatigue and daytime sleepiness in emergency doctors following night shifts
In a randomized controlled trial, 54 emergency doctors were assigned to either a 20-min EEG-verified power nap or a control group that stayed awake. The nap group showed a median 3-point reduction in Fatigue Assessment Scale (FAS) and a median 5-point reduction in Epworth Sleepiness Scale (ESS), while controls showed increases of 4 points on both scales. Between-group differences were significant (P<0.001) with large effect sizes (Cliff's delta = 0.71 for fatigue, 0.78 for sleepiness).
Ferula asafoetida oleo-gum resin improves sleep quality in individuals with functional dyspepsia symptoms
A 14-day randomized, double-blind, placebo-controlled trial found that 250 mg/day of Ferula asafoetida oleo-gum resin (ASF) significantly improved sleep quality as measured by the Bergen Insomnia Scale (BIS), with a mean change of 10.89 Ā± 3.23 points (P < .001) compared to placebo. The improvement was observed in 62 participants with functional dyspepsia symptoms.
The HIRAIDĀ® Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients.
This protocol describes a stepped-wedge cluster RCT evaluating the HIRAIDĀ® Inpatient framework across 35 wards in 10 hospitals with 1259 nurses and approximately 4050 patients per month. The study aims to improve quality and safety by reducing adverse events, improving patient experiences, and strengthening clinical communication.
Mindfulness-based stress reduction reduces nocturnal systolic blood pressure in patients with nocturnal hypertension
In a pilot RCT, MBSR significantly reduced nocturnal systolic BP by approximately 7 mmHg compared to usual care (121.9 vs. 128.6 mmHg, P < 0.001). The study demonstrated feasibility with high recruitment and retention rates, though no significant differences were found in other outcomes.
Perioperative dual-session transcutaneous auricular vagus nerve stimulation (taVNS) reduces the incidence of clinically significant postoperative sleep disturbance (POSD) after gynecologic laparoscopy compared with sham stimulation.
This protocol describes a randomized, double-blind, sham-controlled trial to test whether perioperative taVNS (two sessions: 30 min before anesthesia induction and 5 min after extubation) reduces the incidence of POSD (AIS score ā„6) on postoperative day 1. The trial plans to enroll 116 patients aged 18-65 undergoing elective gynecologic laparoscopy. The primary endpoint is the incidence of POSD on postoperative day 1, with secondary endpoints including sleep quality trajectory, anxiety/depression, recovery quality, and EEG spectral analyses.
Stapokibart improves sleep domain scores in patients with chronic rhinosinusitis with nasal polyps
In a post-hoc analysis of the phase 3 CROWNS-2 study, stapokibart significantly improved SNOT-22 Sleep domain scores compared to placebo during the 24-week double-blind period. These improvements were maintained or further improved during the 28-week open-label extension and 8-week safety follow-up.
Home-based, remotely monitored pulmonary rehabilitation increases moderate-to-vigorous physical activity in patients with idiopathic pulmonary fibrosis on antifibrotic therapy
In a randomized controlled trial of 29 patients with IPF, a 12-week home-based, remotely monitored exercise program increased daily moderate-to-vigorous physical activity (MVPA) by 28% in the intervention group, while the control group decreased by 35% (p=0.001 for group*time interaction). The intervention group's improvement of 49Ā±19 min/week was nearly double the minimal clinically important difference for IPF. The program was feasible with 100% completion, 92% adherence, and no adverse events.
Nine months of fluoxetine reduces post-traumatic stress symptoms and pain following traumatic musculoskeletal injury
In a non-blinded RCT, 33 patients receiving fluoxetine for 9 months after traumatic musculoskeletal injury showed a significant decrease in PTSD symptoms (estimate = -0.2, 95% CI: -0.4, -0.0) and pain (estimate = -0.1, 95% CI: -0.1, -0.0) over one year, while 35 patients receiving placebo (calcium) showed no significant change. No significant effects were found on depression, anxiety, or social isolation.
Evening high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) produce similar acute changes in circadian core body temperature mesor and phase in adults with obesity, with a borderline non-significant difference in amplitude change.
In a randomized crossover trial of 9 adult males with obesity, evening HIIT (~30 min at 90% HRR) and MIIT (~50 min at 60% HRR) both produced approximately one-hour phase advances in circadian core body temperature rhythm. The change in circadian temperature amplitude differed in direction between conditions (MIIT -0.01 Ā± 0.19 Ā°C; HIIT +0.12 Ā± 0.24 Ā°C) but did not reach statistical significance (p = 0.060, d_z = 0.73).
Automated IVR calls added to SMS reminders reduce missed appointments among high-risk patients
Adding automated interactive voice response (IVR) calls to existing text message reminders reduced no-show rates by 1.7 percentage points (from 11.3% to 9.6%) and increased appointment completion rates by 1.9 percentage points (from 75.9% to 77.8%) among high-risk patients. The intervention had the greatest effect on reducing no-shows in the highest risk quartile and improved equity by increasing completion rates most among Black patients.
Community health education lowers blood pressure and improves self-management in elderly hypertensive patients
In a randomized controlled trial of 200 elderly hypertensive patients, adding community health education to routine nursing significantly reduced systolic and diastolic blood pressure, improved self-care and self-management behaviors, reduced depression and anxiety, improved medication adherence, sleep quality, quality of life, and satisfaction compared to routine nursing alone after 6 months. Both groups improved, but the intervention group showed significantly better outcomes on all measures (p < 0.05).
Yoga Nidra and Music Therapy improve sleep quality and mental well-being in post-COVID-19 hospitalised patients compared to standard care alone
In a three-arm RCT of 90 post-COVID-19 hospitalised patients, both Yoga Nidra and Music Therapy (30 min daily for 30 days) significantly improved PSQI, PROMIS Global Health, and WHO-5 scores at day 15 and day 30 compared to standard care (p < .001). Large effect sizes were observed (partial Ī·Ā² = 0.195-0.795), with Yoga Nidra showing greater improvements in well-being and global health, while Music Therapy had stronger effects on sleep quality.
Adding supervised exercise to ergonomics training does not provide statistically significant additional benefit over ergonomics training alone for pain intensity in construction workers with work-related musculoskeletal disorders.
In a 12-week randomized controlled trial of 52 male construction workers with musculoskeletal complaints, both ergonomics training plus exercise and ergonomics training alone significantly improved pain, fatigue, sleep quality, and symptom burden from baseline. However, the between-group difference in pain intensity was not statistically significant (adjusted difference -0.34, 95% CI -0.99 to 0.32), and no significant incremental effect of added exercise was found on any secondary outcome.
Ashwagandha root extract improves ADHD symptoms and executive functioning in children and adolescents with mild ADHD
In a randomized, double-blind, placebo-controlled trial, 58 children and adolescents with mild ADHD received either 150 mg of ashwagandha root extract or placebo twice daily for 56 days. At Day 56, the ashwagandha group showed significantly lower ADHD-RS-IV total, inattention, and hyperactivity-impulsivity scores compared to placebo (P < 0.001), along with significant improvements in executive functioning (BRIEF-2) and patient-reported outcomes (PROMIS sleep disturbance and anxiety). No serious adverse events were reported.
A structured recreational exercise program reduces digital addiction and improves sleep quality in children aged 10-14
An 8-week recreational exercise program (3 sessions per week) significantly reduced digital addiction levels and improved sleep quality in 40 children aged 10-14, with large effect sizes. Improvements were maintained at a 6-week follow-up, while the control group showed no significant changes.
Evening endurance exercise performance is superior to morning performance, and circadian phenotype is associated with the magnitude of this diurnal variation.
In 24 healthy young adults, a 10-min cycling time trial showed significantly higher mean power, peak power, and distance covered in the evening (17:00-18:00) compared to morning (08:00-09:00). Chronotype and sleep midpoint accounted for 22% and 27% of the variance in the morning-evening performance difference, respectively.
Nature-based exercise therapies (surf or hike) reduce residual depression symptoms in service members with MDD, but sleep difficulties, low energy, and appetite changes commonly persist even among those who lose their diagnosis
In a secondary analysis of an RCT comparing weekly surf or hike therapy among 96 active duty service members with MDD, both interventions significantly improved depression symptoms. Among 88 completers, loss of MDD diagnosis reduced odds of most residual symptoms (ps ā¤ .039), but sleep difficulties (56%), low energy (38%), and appetite changes (22%) remained common at postprogram even in those who lost diagnosis. Exercise type did not affect residual symptom odds.
Intravenous lidocaine does not provide additional pain reduction beyond placebo in probable nociplastic chronic low back pain
In a randomized equivalence trial, 84 adults with probable nociplastic chronic non-specific low back pain received either intravenous lidocaine or saline placebo, both alongside multimodal pain management. At 3 months, the between-group difference in VAS pain was 0.24 (90% CI -0.33 to 0.81), within the prespecified equivalence margin of Ā±1.5, confirming therapeutic equivalence. Lidocaine did not improve pain but did improve sleep quality (mean difference in change score 1.81; 95% CI 0.49-3.14; p=0.027).
Tongyuan acupuncture reduces pain, improves sleep quality, and ameliorates emotional comorbidities in patients with postherpetic neuralgia.
In a randomized controlled trial of 106 PHN patients, Tongyuan electroacupuncture significantly reduced SF-MPQ pain scores (VAS, PPI, PRI) and PSQI sleep scores compared to conventional electroacupuncture after 4 weeks. The Tongyuan group had a total effective rate of 90.0% and a pain recurrence rate of 2.2% at 3-month follow-up, versus 74.5% and 17.1% in the control group.
Six weeks of exercise training improves parasympathetic heart rate variability in obese adults, but the effect on sympathetic HRV differs by obstructive sleep apnea severity
In obese adults, a six-week supervised exercise program improved cardiorespiratory fitness and parasympathetic HRV (VLF%, HF%) across the sample. However, an interaction effect showed that SDNN increased in those with no/mild OSA but decreased in those with moderate/severe OSA, suggesting insufficient sympathetic improvement in the latter group.
An interdisciplinary weight loss and lifestyle intervention increases circulating testosterone concentrations and improves scores on the intimate relationships and sexual activity subdomain of the FOSQ in men with obesity and obstructive sleep apnea.
In a randomized trial of 89 men with overweight/obesity and moderate to severe obstructive sleep apnea, an 8-week interdisciplinary weight loss and lifestyle intervention led to higher plasma testosterone at 8 weeks (between-group difference 77.6 ng/dL, p=0.042) and at 6 months (90.4 ng/dL, p=0.027) compared to usual care. FOSQ intimate relationships and sexual activity scores also improved at both time points (1.0 and 0.8 points, p<0.005). Changes correlated with favorable changes in sleep quality, body weight, and body composition.
Herbst appliance improves sleep quality in patients with mandibular retrognathia and obstructive sleep apnea
In a randomized clinical trial of 46 patients with mandibular retrognathia and OSA, the Herbst appliance significantly reduced AHI (mean change 1.08, p=0.031), supine AHI (mean change 3.29, p=0.001), and ODI (mean change 2.09, p=0.013) after an average 8-month follow-up. Twin Block appliance showed no significant changes in these sleep parameters. Both groups showed significant improvements in PSQI scores and skeletal sagittal measurements.
Transcranial direct current stimulation improves sleep quality and enhances offline consolidation of implicit sequence learning in individuals with insomnia
A randomized, double-blind, controlled trial assigned 42 individuals with insomnia to either active tDCS or sham stimulation for 7 consecutive days. The active stimulation group showed significantly lower PSQI scores and greater offline consolidation effects compared to sham, with significant Group x Time interactions for both sleep quality (F(1,40)=31.375, p<0.001, Ī·p2=0.440) and offline consolidation (F(1,40)=7.913, p=0.008, Ī·p2=0.165).
Mandala coloring reduces pain, perceived stress, and improves sleep quality in children hospitalized in a burn unit
In a randomized controlled trial of 40 children aged 7-12 in a burn unit, daily 30-minute mandala coloring sessions for seven days significantly reduced pain and perceived stress and improved sleep quality compared to routine care. Significant Group x Time interactions were found for pain (F(1,38)=38.329, p<.001, Ī·p2=0.508), perceived stress (F(1,38)=65.595, p<.001, Ī·p2=0.639), and sleep quality (F(1,38)=9.100, p=.005, Ī·p2=0.197), with large to very large effect sizes.
Nurse practitioner-led bundled care reduces postoperative delirium, pain, and sleep disturbances, and shortens hospital stay in cardiac surgery patients.
In a randomized controlled trial of 100 cardiac surgery patients, nurse practitioner-led bundled care significantly reduced postoperative delirium on Day 2 (6% vs 32%, p=0.001), improved pain scores across Days 1-3 (F=72.18, p<0.001), and improved sleep quality across Days 2-4 (F=233.35, p<0.001). Total hospital stay was shorter (median 8 vs 10 days, p<0.001).
Standardized saffron extract (UO SAF 02) improves mood and sleep quality in adults with low mood and subclinical to mild depressive symptoms
In a randomized, double-blind, placebo-controlled trial, 56 adults with low mood and BDI scores of 10-20 received 15 mg of standardized saffron extract (UO SAF 02) or placebo for 56 days. The saffron group showed significant improvements in mood (POMS score reduction of -48.46 vs -5.67, p < 0.0005), sleep quality (PSQI, p < 0.05), and reduced serum cortisol levels (p < 0.05) compared to placebo.
Home-based transcranial electric stimulation (tDCS over M1 or tACS over DLPFC) improves quality of life in chronic pain patients compared to sham stimulation
In a double-blind RCT with 120 chronic pain participants, both active tES modalities (M1-tDCS and DLPFC-tACS) significantly improved quality of life compared to sham, with mean differences of -7.7 and -7.8 respectively (p<.001). However, no differential effects were found for symptom-specific domains like mood, fatigue, or sleep, and all groups showed increased physical activity and physical function improvements.
Transcutaneous auricular vagus nerve stimulation (taVNS) reduces postpartum blues severity after cesarean delivery
A 5-day taVNS intervention significantly reduced postpartum blues severity on day 5, as measured by a visual analogue scale (median difference 4.13 cm; 95% CI, 3.39-4.93; p < 0.001). The active group also showed lower rates of Edinburgh Postnatal Depression Scale scores ā„13 at 1 month postpartum (4% vs. 26%; p = 0.003) and improved sleep quality on postoperative days 1-4.
Intraoperative esketamine infusion reduces early postoperative sleep disturbance in patients undergoing shoulder arthroscopy
In a randomized controlled trial of 80 patients with preoperative sleep disturbance undergoing shoulder arthroscopy, intraoperative esketamine infusion (0.3 mg/kg/h) significantly reduced the incidence of sleep disturbance on postoperative day 1 compared to placebo (5.0% vs. 27.5%; risk ratio 0.18, 95% CI 0.04-0.77). The esketamine group also showed longer device-estimated total sleep time on POD1 and lower Athens Insomnia Scale scores on POD1, POD3, and POD7, with improved PSQI scores at POD30.
The costoclavicular approach for infraclavicular perineural catheter placement is not superior to the paracoracoid approach for sensory blockade or analgesic effectiveness in ambulatory hand and wrist surgery.
In a randomized controlled trial of 139 adults undergoing ambulatory hand and wrist surgery, the costoclavicular (CC) approach resulted in successful sensory blockade at 48 hours in 42.6% of patients compared to 47.8% with the paracoracoid (PC) approach (adjusted risk difference -1.3%, 95% CI -17.5% to 15.0%). No clinically meaningful differences were observed in pain scores, opioid consumption, sleep quality, or patient satisfaction.
Niacin ingestion during exercise suppresses fatty acid availability and increases carbohydrate oxidation, but does not detectably influence post-exercise energy intake.
In a crossover study of 15 healthy participants (5 female), niacin ingestion during cycling suppressed plasma NEFA concentrations and total fat oxidation (mean difference vs fasted: -9Ā±5 g, p=0.001), similar to carbohydrate ingestion. Niacin increased plasma GLP-1 total concentrations compared to fasting, but ad libitum energy intake two hours post-exercise did not differ between conditions (FAST 833Ā±206 kcal, CARB 786Ā±219 kcal, NIACIN 780Ā±158 kcal, p=0.37).
REM-predominant OSA is associated with lower spontaneous resolution rates in children managed with watchful waiting, but adenotonsillectomy yields similar resolution rates regardless of OSA subtype.
In a secondary analysis of the Childhood Adenotonsillectomy Trial, children with REM-predominant OSA (REM-AHI/NREM-AHI ā„2) had lower odds of spontaneous resolution at 7 months under watchful waiting compared to non-REM-predominant OSA (aOR 0.52, 95% CI 0.28-0.97). However, adenotonsillectomy resulted in similar resolution rates between the two groups (aOR 0.75, 95% CI 0.34-1.66). REM-predominant OSA was also associated with greater daytime sleepiness and PSG severity but not with worse parent-reported symptom burden or quality of life.
Transvenous diaphragm neurostimulation reduces mechanical ventilation duration and increases weaning success, leading to cost savings and QALY gains in mechanically ventilated patients
Transvenous diaphragm neurostimulation (tDNS) was associated with a 2.8-day reduction in mechanical ventilation duration and a 10.5% increase in weaning success compared to standard of care. This led to projected acute care cost savings of $12,102 and long-term care savings of $11,999, with 0.10-0.68 QALYs gained over a patient's remaining lifetime.
Ashwagandha root extract and melatonin combination therapy improves sleep quality in adults with sleep disturbances
In a randomized, double-blind, placebo-controlled trial of 200 adults aged 18-50 years, an 8-week combination of Ashwagandha root extract (600 mg/day) and melatonin (3 mg/day) significantly reduced sleep onset latency (SOL) and improved total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE) compared to placebo (all p < 0.0001). Monotherapy with either Ashwagandha or melatonin produced moderate but comparable benefits.
Individualised homoeopathy reduces weekly bedwetting episodes in children with nocturnal enuresis.
A double-blind RCT in children with nocturnal enuresis found that individualised homoeopathy significantly reduced weekly bedwetting episodes compared to placebo, with a median reduction of -2.4 nights per week (p < 0.04). The study included 451 participants across five studies, but this specific finding comes from one RCT.
B. subtilis Rosell-179 probiotic supplementation enhances skin carotenoid status in healthy premenopausal women
A 10-week double-blind RCT in 37 premenopausal women found that daily supplementation with a mixed carotenoid supplement plus B. subtilis Rosell-179 probiotic led to a larger increase in skin carotenoid status (SCS) compared to carotenoid supplement plus placebo, with an estimated difference of 1.1 units at week 10 (p=0.056). Plasma carotenoids increased in both groups from baseline to week 5 but did not continue to increase, and no significant changes were observed in antioxidant capacity, inflammation, or skin health markers.
Proton pump inhibitor therapy improves nighttime heartburn relief and GERD-related sleep disturbances in adults with nocturnal GERD and sleep disturbances
A systematic review of 5 RCTs involving 1495 patients found that PPI therapy consistently improved nighttime heartburn relief and GERD-related sleep disturbances compared to placebo in three placebo-controlled trials. Subjective sleep quality and sleep-related daytime functioning also generally improved with PPI therapy, though findings were more heterogeneous across trials.
Andropause-related health education improves general health and sleep quality in retired men
A quasi-experimental study of 60 retired men at Neyshabur University of Medical Sciences, Iran, found that a four-week virtual andropause health education program via WhatsApp significantly improved general health (P < 0.001) and sleep quality (P = 0.002) in the intervention group compared to no change in the control group. Effect sizes were moderate, with partial eta-squared values of 0.226 for the time-by-group interaction on general health and 0.123 for group effects on sleep quality.
Opioid-free anesthesia reduces postoperative nausea and vomiting but does not improve overall postoperative recovery in elderly patients undergoing laparoscopic abdominal surgery
In a randomized controlled trial of 195 elderly patients undergoing laparoscopic abdominal surgery, opioid-free anesthesia (OFA) resulted in higher QoR-15 scores at 24h (110 vs 106, mean difference 4 points, 95% CI 2-8, p=0.002), but this difference was below the prespecified threshold for clinical significance and disappeared by 48h. OFA reduced PONV during the first 72h and modestly accelerated gastrointestinal recovery, but was associated with longer extubation times, prolonged PACU stay, and more intraoperative hypertension.
Saffron supplementation improves sleep quality and reduces daytime sleepiness and fatigue in patients with pulmonary sarcoidosis
In a single-blind RCT of 72 patients with pulmonary sarcoidosis, 60 days of saffron supplementation (30 mg twice daily) plus sleep-hygiene counseling significantly improved sleep quality (PSQI adjusted mean difference -2.21, p<0.001), reduced daytime sleepiness (ESS adjusted MD -2.46, p<0.001), and decreased fatigue (FAS adjusted MD -4.58, p<0.001) compared to counseling alone. Quality of life also improved as measured by PROMIS global physical health and SF-12 component scores.
PRF plus PRP improves pain, sleep quality, quality of life, and inflammation more than PRF alone or PRF plus ozone in postherpetic neuralgia patients at 90 days
In a single-center RCT of 122 adults aged 50-70 with single-segment PHN lasting >3 months, PRF plus PRP showed significantly greater improvement at 90 days compared to PRF alone and PRF plus ozone. VAS reduction was -2.49 (95% CI, -2.88 to -2.10) vs PRF alone and -1.43 (-1.80 to -1.05) vs PRF plus ozone; PSQI improved by -5.72 (-7.09 to -4.36) and -4.77 (-6.09 to -3.44), respectively; all adjusted P values <0.001.
Programmed manual reflexology therapy improves sleep quality, insomnia, and fatigue in adults with poor sleep quality via enhanced parasympathetic activity.
In a randomized crossover trial, 32 adults with poor sleep quality received 6 weeks of manual reflexology treatment (MRT) or foot massage equipment (FEM). MRT led to significantly greater reductions in PSQI global scores and all components, larger improvements in insomnia severity and both mental and physical fatigue, and immediate and sustained increases in HRV time-domain indices (SDNN, RMSSD, pNN50) with reduced LF/HF ratio, indicating enhanced parasympathetic modulation.
MOTIVATE increases device-measured moderate-to-vigorous physical activity (MVPA) at 3 and 6 months among community-dwelling stroke survivors compared with general PA information.
The MOTIVATE trial is a hybrid type 1 effectiveness-implementation randomized controlled trial testing a theory-informed, co-designed behavior change intervention to increase physical activity after stroke. The primary outcome is average daily minutes of moderate-to-vigorous physical activity (MVPA) measured by Fitbit Inspire 3 at 3 and 6 months. The trial aims to recruit 120 participants to detect a 10-minute/day difference in MVPA with 80% power, allowing for 20% attrition.
A 21-day total smartphone and social media detox improves sleep duration, daytime sleepiness, depressive symptoms, perceived stress, and working memory in adolescents, but effects are not maintained at 2-month follow-up.
In a pilot RCT with 82 adolescents aged 13-18, a 21-day total smartphone and social media detox (with or without a basic 'brick' phone) led to tentative improvements in sleep duration, daytime sleepiness, depressive symptoms, perceived stress, and working memory compared to controls. However, these improvements were not sustained at a 2-month follow-up. Retention was high with 13% attrition, and 83% of participants endorsed the need for government action on this issue.
Low-dose esketamine combined with pulsed radiofrequency reduces neuropathic pain and improves mood and sleep quality in herpes zoster patients with zoster-related neuralgia
In a randomized controlled trial of 60 patients with zoster-related neuralgia, continuous esketamine (0.02 mg/kg/h for 48 h) combined with pulsed radiofrequency (PRF) significantly reduced pain scores (NRS and ID-pain) at all post-treatment time points up to 3 months compared to PRF plus saline. Depression (HAMD-24) and sleep quality (PSQI) improved significantly from 48 hours through 12 weeks, while anxiety (HAMA) improved from 1 week onward. No significant differences in dissociative symptoms or adverse events were observed.
Anshen Buxin Liuwei Pill improves cardiac neurosis symptoms, anxiety, depression, and sleep quality in patients with heyisheng-type palpitation
In a randomized, double-blind, placebo-controlled trial, Anshen Buxin Liuwei Pill significantly improved cardiac neurosis symptoms (effective rate 83.00% vs 34.80% at week 8) and showed longer-term benefits in anxiety, depression, and sleep quality. The drug was safe and well-tolerated.
A 90-minute nap during Ramadan fasting improves time-motion metrics, reduces physiological strain, and enhances mood in professional soccer players during small-sided games.
A 90-minute nap (N90) during Ramadan fasting significantly increased total distance covered (p=0.011) and low/moderate-intensity running distances (p=0.005 and p=0.016) during small-sided games, while reducing resting heart rate (p=0.021), mean heart rate (p=0.006), and relative exercise heart rate (p=0.010). It also improved vigor (p<0.001), reduced fatigue (p=0.034), and lowered perceived exertion (p=0.010) compared to no nap.
A 20-min exercise session and a 90-min nap both preserve episodic memory encoding after 30 hours of sleep loss, with distinct neural mechanisms.
In a randomized controlled trial, both a 20-min exercise session and a 90-min nap improved episodic memory encoding after 30 hours of sleep deprivation by an average of 22% compared to a no-intervention control. EEG revealed that napping reduced neural fatigue and sleep pressure, while exercise enhanced episodic memory-related neural processing. These findings support the principle of neural degeneracy, where different interventions can achieve similar cognitive benefits through distinct brain mechanisms.
Early protocolized rehabilitation improves functional outcomes and quality of life in pediatric neurocritical patients at 24 weeks compared to usual care.
In a single-blind RCT of 196 pediatric neurocritical patients (aged 1-18 years), early protocolized rehabilitation initiated within 72 hours of mechanical ventilation significantly improved Pediatric Cerebral Performance Category scores at 24 weeks (mean difference 0.133, 95% CI 0.055-0.205, p<0.001). Significant improvements were also observed in behavior, adaptive function, sleep patterns, quality of life, and family functioning.
Mepilex Lite dressings combined with indomethacin suppositories may improve treatment efficiency of acute radiation dermatitis of the anal canal skin in rectal cancer patients undergoing radiotherapy.
This protocol describes an assessor-blinded RCT to evaluate the efficacy and safety of adding Mepilex Lite dressings to indomethacin suppositories for acute radiation dermatitis of the anal canal skin. The primary outcome is treatment efficiency at day 14 post-intervention, with secondary outcomes at days 7 and 21, plus pain, anxiety/depression, sleep quality, and quality of life. The study plans to enroll 274 patients, but results are not yet reported.
Parent-mediated screen time usage module reduces screen time and improves sleep quality in children with borderline IQ
A randomized controlled trial of 60 children with borderline IQ found that a parent-mediated screen time usage module (PM-STUM) significantly reduced screen time (Ī·Ā²p=0.4), improved sleep quality (Ī·Ā²p=0.3), increased physical activity (Ī·Ā²p=0.2), and reduced behavioral difficulties (Ī·Ā²p=0.2) compared to controls at 6 weeks postintervention.
Total physical activity moderates the effect of exercise type on high-altitude acclimatization among college students
In a cluster-randomized controlled trial, 295 college students at high altitude participated in either basketball or badminton for 18 weeks. The effect of exercise type on high-altitude acclimatization was significantly moderated by total physical activity (interaction B = -2.9965, p = 0.0056), with badminton showing better adaptation than basketball only at high activity levels. Sleep quality did not mediate this relationship.
Progressive relaxation exercises reduce postoperative pain and improve sleep quality in patients undergoing total knee replacement surgery
In a randomized controlled trial of 96 patients undergoing total knee replacement, progressive relaxation exercises led to significantly faster and greater reductions in postoperative pain (F=14.11, P=.000, Ī·Ā²=0.131) and significantly greater improvements in sleep quality (F=14.22, P<.001, Ī·Ā²=0.131) compared to control. Recovery index scores also improved more in the intervention group (F=6.531, P=.000, Ī·Ā²=0.065).
Elinzanetant reduces vasomotor symptom frequency and sleep disturbance in menopausal women across diverse populations
In the OASIS clinical trial program (OASIS-1-4), elinzanetant significantly reduced vasomotor symptom frequency vs placebo from as early as week 1 in OASIS-1 and -2, and by week 12 in all studies, with benefits maintained up to 50 weeks. Sleep disturbance, measured by PROMIS Sleep Disturbance Short Form 8b, improved across all trials as early as week 1, with significant reductions vs placebo at week 12 in OASIS-1, -2, and -4.
Caffeine expectancy does not improve interval running performance in trained runners
In a randomized controlled crossover trial, trained runners who believed they had consumed caffeine (placebo) showed no significant improvement in total session time for 5 x 1000-m interval running compared to a control condition (1021.50 Ā± 114.01 vs. 1017.23 Ā± 109.08 s, p = 0.270, ES = 0.31). No differences were found in pacing, heart rate, perceived exertion, or running kinematics, but participants reported increased feelings of activeness and some caffeine-related side effects (e.g., increased urine production, sleep disturbances) under the placebo condition.
Bilateral glossopharyngeal nerve block with 0.2% ropivacaine reduces postoperative pain and improves recovery outcomes in pediatric tonsillectomy compared to peritonsillar infiltration or sham control
In a double-blind RCT of 90 children (4-10 years) undergoing day-case tonsillectomy, bilateral glossopharyngeal nerve block (GNB) with 0.2% ropivacaine significantly prolonged time to first analgesic request (median 240 vs 120 min for control, P<0.001) and reduced pain at rest (2-12h) and during swallowing (2-24h) compared to sham control. GNB also reduced nausea (6.7% vs 20% RI and 33.3% control) and improved sleep quality and parental satisfaction, without increased sedation or major complications.
Pre-bedtime music maintains global subjective sleep quality in family caregivers of patients with advanced cancer
In a randomized controlled trial, 76 family caregivers of advanced cancer patients were assigned to listen to individually chosen music for 30 minutes before bedtime for 7 days or to a control group listening to pre-recorded basic nursing education messages. The music group showed a significantly smaller decline in global sleep quality (PSQI Global Score change +0.60 vs +2.05 points, p=0.006), indicating that music helped maintain sleep quality. Exploratory findings also suggested improvements in subjective sleep duration (+0.55 h) and daytime sleepiness (ESS -2.74 points).
Online laughter yoga improves sleep quality and reduces burnout symptoms in nurses
In a pilot randomized trial with 47 nurses, online laughter yoga significantly improved sleep quality (p=0.009), emotional exhaustion (p=0.006), and personal accomplishment (p=0.006) with large effect sizes, while face-to-face and control groups showed no significant changes. No significant differences in perceived stress were observed across groups.
Lactiplantibacillus plantarum Probio87 supplementation improves functional constipation and associated psychological well-being in adults
In a randomized, double-blind, placebo-controlled trial, 104 adults with functional constipation (Rome IV criteria) received either L. plantarum Probio87 or placebo for 8 weeks, with a 4-week follow-up. Probio87 significantly increased weekly complete spontaneous bowel movements at Week 8 and Week 12 compared to placebo, and improved Rome IV symptom scores, constipation-related quality of life, and HAMD-24 domains (anxiety, sleep, retardation). Exploratory gene-expression analysis showed increased BDNF and reduced IL-1Ī², CD117, CXCR5, IDO1, DBH, and MLNR expression in the probiotic group.
Fenugreek oral capsule improves self-reported sleep quality in primiparous postpartum women
In a triple-blind RCT of 60 primiparous women, fenugreek seed extract (700 mg daily) significantly improved PSQI scores compared to placebo at postpartum days 30 and 60 (p<0.001). At day 60, mean PSQI scores were 5.1Ā±1.4 in the fenugreek group vs 8.9Ā±1.5 in the placebo group, after adjusting for baseline differences.
Ashwagandha root extract improves sleep quality and reduces perceived stress in pregnant women
In a 12-week RCT of 70 pregnant women in their second trimester, Ashwagandha root extract (ARE) 300 mg twice daily plus standard care significantly improved subjective sleep quality at all visits (p=0.036), sleep duration at weeks 8 and 12 (p<0.001), and sleep disturbances at week 12 (p=0.028) compared to standard care alone. Perceived stress was also significantly reduced with ARE (-10.50 vs. -5.35; p<0.001).
Elinzanetant reduces wakefulness after sleep onset in postmenopausal women with sleep disturbance
Elinzanetant 120 mg reduced polysomnography-measured wakefulness after sleep onset (WASO) by an estimated 22.5 minutes more than placebo at Week 4 (90% CI: -35.47, -9.52). Post hoc analysis across 12 weeks suggested improvements in sleep continuity, supported by subjective and objective multimodal measures.
Golimumab reduces disease activity and improves quality of life in patients with axial spondyloarthritis
Golimumab, an anti-TNF-alpha antibody, is effective in reducing disease activity, back pain, sleep disruption, and fatigue in axial spondyloarthritis, while improving quality of life and work productivity. Real-world studies and post hoc analyses support these benefits, with a favorable safety profile consistent with other TNF inhibitors.
Cetaphil Restoraderm Eczema Soothing Moisturizer and Eczema Rapid Relief Cream provide rapid and sustained itch relief in eczema-prone individuals
In a randomized, blinded, split-body study of 33 participants with eczema-prone skin and mild-to-moderate itch, both the eczema moisturizer and eczema cream provided rapid itch relief after a single application, with mean times to relief of 38 seconds and 43 seconds, respectively. Both treatments significantly reduced itch severity from baseline by 98% to 99% at 24 hours (mean NRS 0.03 and 0.09, both P<0.0001).
Home-based remotely supervised high intensity interval training (HIIT) improves aerobic fitness and reduces fat mass in older adults
In older adults (61-74 years), 8 weeks of home-based remotely supervised HIIT on an all-extremity non-weight-bearing ergometer increased maximal oxygen consumption by 4.5 mlĀ·kgā»Ā¹Ā·minā»Ā¹ and decreased fat mass by 1.4 kg, while no adverse events occurred and 96% of sessions were completed. Aerobic fitness declined during the control period but improved significantly after HIIT.
A four-week VR-based mindfulness intervention reduces ADHD symptoms and improves related psychosocial outcomes in college students compared to a video-based mindfulness control.
In a randomized controlled trial, 58 college students with ADHD symptoms were assigned to either a VR-based mindfulness intervention (Headspace on Meta Quest Pro) or a video-based mindfulness control. The VR group showed significantly greater reductions in ADHD symptom severity (ASRS score -5.8 vs -2.3 points, p<0.001) and improvements in depression, anxiety, sleep quality, and academic engagement (p<0.01 for all). The effect on cognitive-motor reaction time was not significant after correction for multiple comparisons.
Blue light therapy delivered through LED-integrated glasses improves sleep quality and reduces daytime sleepiness in Parkinson's disease
In a randomized, placebo-controlled pilot study, Parkinson's disease patients using blue light glasses for 2 weeks showed significantly better Pittsburgh Sleep Quality Index scores compared to red light placebo at 5 weeks (p=0.029, effect size=0.896). Clinically significant daytime sleepiness dropped from 50% to 6.7% in the blue light group.
Ferula asafoetida oleo-gum resin (ASF) improves sleep quality in individuals with functional dyspepsia symptoms
In a randomized, double-blind, placebo-controlled trial, 62 participants with functional dyspepsia symptoms received 250 mg/day of ASF or placebo for 14 days. ASF treatment significantly improved sleep quality as measured by the Bergen Insomnia Scale, with a mean change of 10.89 Ā± 3.23 points (P < .001) on day 14.
Combining sleep report feedback with telephone-based health guidance may improve subjective sleep status in community-dwelling older adults.
In a three-arm randomized controlled trial of 229 community-dwelling older adults (mean age 78.5 years), participants receiving sleep report feedback plus telephone-based health guidance for either 3 or 6 months showed significant within-group improvements in Athens Insomnia Scale (AIS) scores at 3 months, while those receiving feedback alone showed no significant change. Between-group comparison at 3 months showed that the group receiving feedback plus guidance for the first 3 months had significantly lower AIS scores than the control group (feedback alone).
Acupuncture improves insomnia severity and sleep quality in breast cancer patients with post-chemotherapy insomnia, but the effect may not be clinically meaningful.
In a randomized sham-controlled trial of 76 breast cancer patients with post-chemotherapy insomnia, acupuncture significantly reduced Insomnia Severity Index (ISI) scores compared to sham at post-treatment (mean difference -1.61, 95% CI -2.71 to -0.50) and at 1-month follow-up (-1.77, 95% CI -3.22 to -0.32). However, the between-group difference did not reach the minimal clinically important difference, so a clinically meaningful advantage over sham cannot be concluded.
Guided digital cognitive-behavioral therapy for insomnia (CBT-I) reduces insomnia severity in adults with insomnia and co-occurring anxiety, PTSD, or BPD symptoms
In a randomized controlled trial, guided digital CBT-I produced large reductions in insomnia severity compared to a sleep diary control at posttreatment (d = -1.04) and at 8-month follow-up (d = -0.98). Small effects were observed on anxiety and BPD symptoms at posttreatment, but not on PTSD symptoms, and these effects were not sustained at follow-up.
Organic selenium supplementation improves glycemic control and insulin sensitivity in patients with type 2 diabetes and diabetic peripheral neuropathy
In a triple-blind, randomized, placebo-controlled trial, 50 patients with T2DM and DPN received 200 Ī¼g/day organic selenium or placebo for 8 weeks. Selenium significantly reduced fasting blood sugar (mean difference -33.95 mg/dL), HbA1c (-1.20%), and HOMA-IR (-1.57), while increasing QUICKI (0.02). No significant between-group improvements were seen in overall quality of life or sleep quality, except for daytime dysfunction.
Nurse-led algorithm-based early mobilization protocol reduces post-intensive care syndrome in cardiac surgery ICU patients
In a randomized controlled trial of 38 cardiac surgery ICU patients, a nurse-led algorithm-based early mobilization protocol significantly reduced PICS scores (Z = -3.83, P < .001), anxiety and depression (Z = -3.52, P < .001), and improved sleep quality (Z = -3.83, P < .001) compared to usual care. No mobilization-related adverse events occurred.
Survodutide reduces body weight in Chinese adults with overweight or obesity
This phase 3 randomized controlled trial is designed to evaluate the efficacy, safety, and tolerability of survodutide (3.6 mg or 4.8 mg once weekly) versus placebo in Chinese adults with overweight or obesity. The primary endpoints are percentage change in body weight and achievement of ā„5% body weight reduction from baseline to week 52. Baseline characteristics show a mean BMI of 33.2 kg/mĀ² and a high prevalence of obesity-related complications.
Mediterranean diet is associated with a shift toward a more morning-oriented chronotype in female patients with relapsing-remitting multiple sclerosis
In a 12-week randomized pilot trial, 34 female patients with relapsing-remitting MS were assigned to either a Mediterranean diet (MedDiet) or time-restricted eating (TRE). MEQ scores increased only in the MedDiet group (p = 0.035), suggesting a shift toward morningness, while PSQI scores improved over time in both groups without a diet-specific effect. No significant changes were observed in appetite-related hormones (leptin, ghrelin).
Unsaturated fatty acids (oleic acid and alpha-linolenic acid) enhance metabolic flexibility by accelerating time-based respiratory quotient dynamics compared to palmitic acid in healthy young men
In a randomized crossover trial, meals enriched with unsaturated fatty acids (oleic acid or alpha-linolenic acid) led to faster time-to-peak RQ and time-to-FQ compared to palmitic acid-rich meals, indicating more efficient postprandial substrate switching. The oleic acid trial also showed higher serum C2-acylcarnitine-to-free carnitine ratios and urinary C2-acylcarnitine concentrations, which were associated with faster time-to-FQ.
Daily Lactococcus cremoris YRC3780 intake for 8 weeks improves subjective sleep quality and alleviates daytime sleepiness and difficulty falling asleep in healthy Japanese adults with sleep complaints.
In a randomized, double-blind, placebo-controlled trial of 105 healthy Japanese adults with Athens Insomnia Scale (AIS) scores ā„6, daily intake of Lactococcus cremoris YRC3780 for 8 weeks significantly improved AIS scores and change from baseline compared to placebo. Significant improvements were also seen in specific AIS items for sleep induction at 4 weeks and daytime functioning at 8 weeks, as well as in subjective measures of falling asleep quickly and sleepiness while watching TV.
PeptiSleepā¢ improves getting to sleep and quality of sleep in adults with sleep impairment
In a randomized, placebo-controlled pilot study, PeptiSleepā¢, a rice protein hydrolysate, showed nominally significant improvements in getting to sleep (p=0.050) and quality of sleep (p=0.036) as measured by the Leeds Sleep Evaluation Questionnaire. The study was exploratory with a small sample size (n=26) and no adjustments for multiple comparisons.
Adding a floss-band procedure with active shoulder movement to conventional physiotherapy improves shoulder pain and sleep quality in chronic hemiplegic shoulder pain patients.
In a randomized controlled trial of 40 adults with chronic hemiplegic shoulder pain, adding a floss-band procedure with active shoulder movement to conventional physiotherapy significantly improved SPADI scores (by 20.87-28.34 points) and PSQI scores (by 2.48-3.87 points) compared to physiotherapy alone. Secondary outcomes including VAS pain and shoulder range of motion also favored the experimental group. All results remained significant after Holm correction.
Immersive virtual reality (IVR) reduces negative affect in college students with mild-to-moderate depressive symptoms
This pilot RCT with 70 college students found that a standardized IVR game intervention, added to routine psychological guidance, significantly reduced negative affect (NA) over time compared to control (group-by-time interaction p < 0.001). Sustained reductions in NA were observed starting at T3 in the intervention group. No significant improvements were found in core depression severity (HAMD-17) or in sleep quality after correction, though sleep quality showed a trend toward improvement.
A fixed 1-month course of oral oxycodone after total knee arthroplasty produces small improvements in day 1 pain and length of hospital stay that are statistically significant but below clinically meaningful thresholds.
In a triple-blind randomized controlled trial, 190 adults undergoing primary total knee arthroplasty received either immediate-release oral oxycodone (5 mg twice daily) or placebo for 1 month, in addition to a standardized multimodal nonopioid regimen. Oxycodone reduced day 1 pain by 0.48 cm on a 10-cm VAS (P=0.015) and length of stay by 0.2 days (P=0.047), but these differences did not reach the minimal clinically important difference (MCID) of 1.0 cm for pain. No significant differences were observed for pain at day 7 or 30, or for functional outcomes, sleep quality, or satisfaction.
Online Mindfulness-Based Stress Reduction (MBSR) improves sleep quality in mothers of children with autism spectrum disorder
In a randomized controlled trial of 72 mothers of children with ASD, an online MBSR program (eight 90-minute sessions twice a week) significantly improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) immediately after and one month post-intervention compared to a control group. The intervention group showed significant improvement over time (F=107.004, P<0.001), while the control group showed no significant change (F=1.292, P>0.05).
Ayurvedic nutritional supplements and yoga protocol reduce the incidence and severity of acute mountain sickness in healthy personnel at high altitudes
This RCT protocol aims to assess the effectiveness of Ayurvedic nutritional supplements (Ayur-nutri kit and cardiac care tea) combined with a daily yoga protocol in reducing AMS incidence and severity among 1660 healthy personnel stationed at high altitudes (9,000ā15,000 feet) in the western Himalayas. The primary outcome is AMS incidence measured by Lake Louise Scoring System ā„6 during the first 7 days. Data collection is complete, but analysis is ongoing; results are expected by December 2026.
Almond consumption improves subjective sleep quality in adults with poor sleep
In a 5-month randomized controlled trial, adults with poor sleep quality who consumed whole almonds showed significantly greater improvements in subjective sleep efficiency compared to controls (mean change 9.7 vs. 5.4, p=0.021). The almond group also had lower global PSQI scores (3.94 vs. 4.79, p=0.013), higher subjective sleep efficiency (94.45% vs. 91.85%, p=0.012), and shorter subjective sleep latency (18.46 vs. 26.29 min, p=0.016) after adjustment. Endline melatonin concentrations were significantly higher in the almond group (250.63 vs. 206.19 pg/mL, p=0.050).
Continuous intraoperative esketamine infusion reduces the incidence of postoperative sleep disorders and improves sleep quality in parturients undergoing cesarean section under general anesthesia.
In a randomized, double-blind, placebo-controlled trial, 140 parturients undergoing elective cesarean delivery under general anesthesia received either continuous esketamine (0.3 mg/kg/h) or saline after delivery. At 3 and 7 days post-surgery, the esketamine group had significantly lower PSQI scores, lower sleep NRS scores, and lower incidence of PSD and postpartum depression compared to controls. The intervention also reduced pain scores and rescue analgesia use within 72 hours.
VR-integrated MBCT may improve functional disability and pain bothersomeness in patients with chronic non-specific low back pain (CNLBP) compared to usual care alone.
This protocol describes a randomized controlled trial to evaluate the efficacy and safety of an 8-week VR-integrated mindfulness-based cognitive therapy (VR-MBCT) as an adjunct to usual care in 214 patients with CNLBP. Primary outcomes are the proportions of patients achieving at least 30% improvement in functional disability (Oswestry Disability Index) and pain bothersomeness (0-10 scale) at week 8. The trial is open-label and will analyze data using intention-to-treat generalized estimating equations.
Daily vitamin D3 supplementation improves overall sleep quality more than weekly supplementation in vitamin D3-deficient adults
In a randomized controlled trial of 87 vitamin D3-deficient adults, daily supplementation (6000 IU/day for 8 weeks) significantly improved PSQI total score compared to weekly supplementation (60,000 IU/week) (8.46 vs 9.93, P=0.024). Daily dosing also improved sleep duration (0.93 vs 1.55, P=0.002) and daytime dysfunction (0.67 vs 1.11, P=0.007), while weekly dosing was better for reducing need for sleep medication (0.13 vs 0.37, P=0.034).
Aromatherapy with chamomile-lavender blend or vetiver oil reduces fatigue and improves sleep quality in intensive care nurses
In a randomized placebo-controlled trial, 96 intensive care nurses with fatigue and sleep disturbances received either chamomile-lavender essential oil blend, vetiver oil, or placebo (jojoba oil) via aromatherapy massage once daily before bedtime for 4 weeks. Both active aromatherapy groups showed significant reductions in fatigue (VAS and Piper Fatigue Scale) and improvements in sleep quality (PSQI) compared to placebo, with PSQI scores decreasing from ~10.4 to ~4.6 in active groups versus ~10.8 to 6.8 in placebo. The study reported a large effect size (f=0.462) and high statistical power (0.984).
Shatavari root extract combined with Ashwagandha improves female sexual function, mood, and happiness in women with sexual health concerns.
In an 8-week RCT with 135 women, the combination of Shatavari and Ashwagandha (SHT-ARE) significantly improved total FSFI scores (P=0.005), arousal (P=0.041), lubrication (P=0.027), and orgasm (P=0.031) compared to placebo. The SHT-ARE group also showed reduced sexual distress (FSDS, P<0.0001), improved happiness (OHQ, P<0.0001), and reduced mood disturbances (POMS, P<0.0001).
Chamomile and L-theanine beverage reduces menstrual pain and improves mood and sleep quality in young women with primary dysmenorrhea
A randomized, double-blind, placebo-controlled study found that daily consumption of a chamomile and L-theanine beverage (CTT) for five days around menstruation significantly reduced pain intensity by 57.17% (VAS) and 55.46% (NRS) compared to baseline. The intervention also significantly decreased severity of lower abdominal pain, back pain, depression, irritability, and daytime dysfunction by 31-56% in young women with primary dysmenorrhea.
Dietary nitrate supplementation preserves peak oxygen uptake during Ramadan fasting in healthy adults
In a randomized controlled trial, healthy adults who consumed beetroot juice (providing ~6.45 mmol nitrate) twice daily for 10 days during Ramadan fasting maintained their absolute and relative peak oxygen uptake, while the control group experienced significant declines. Absolute VO2peak decreased by -155 mL/min in controls but increased by +67 mL/min in the nitrate group (P<0.01). Relative VO2peak changed by -2.4 mL/kg/min in controls versus +0.3 mL/kg/min in the nitrate group (P=0.02).
Digitally delivered interdisciplinary care (ADCompanion) is noninferior to routine care in reducing disease severity in patients with atopic dermatitis
This protocol describes a multicenter randomized noninferiority trial comparing a digital interdisciplinary care concept (ADCompanion) to routine care for atopic dermatitis. The primary endpoint is physician-assessed disease severity (SCORAD) at 6 months, with 603 participants recruited across 7 centers in Germany. Final results are expected in 2026, and the claim of noninferiority is not yet established.
Intranasal dexmedetomidine on the night before surgery reduces postoperative delirium incidence in older patients undergoing total hip or knee arthroplasty
In a randomized, double-blind, placebo-controlled trial, 232 older patients (ā„60 years) undergoing total hip or knee arthroplasty received either intranasal dexmedetomidine (100 Ī¼g total dose) or normal saline at 21:00 the night before surgery. The incidence of postoperative delirium within 3 days was 10.3% in the dexmedetomidine group versus 20.7% in the placebo group (relative risk = 0.50; 95% CI = 0.26-0.95; P = 0.030). The intervention also improved perioperative sleep quality and reduced anxiety and pain, with no severe adverse events.
Alixorexton, a selective orexin 2 receptor agonist, improves wakefulness in narcolepsy type 1
In a phase 2 randomized controlled trial, alixorexton (4, 6, or 8 mg once daily) significantly increased mean sleep latency on the Maintenance of Wakefulness Test compared to placebo at 6 weeks. Placebo-corrected improvements were 22.2, 24.1, and 26.0 minutes for the 4, 6, and 8 mg doses, respectively. The drug was generally well tolerated, with adverse events consistent with on-target OX2R agonism.
Reorganizing nighttime medical routines significantly improves objective and subjective sleep quality in hospitalized adults
In a randomized controlled trial, an intervention protocol that rescheduled non-essential nocturnal procedures (vital sign checks, medication administration, laboratory sampling) led to longer total sleep time (geometric mean 398 vs. 301 min, p=.015) and longer REM sleep duration (79.2 vs. 58.0 min, p=.010) compared to standard care. Subjective sleep quality also improved, with lower PSQI scores at study completion (4.6 vs. 8.7, p=.040).
Daily slow diaphragmatic breathing for 15 minutes reduces pain by up to 37% in patients with complex chronic non-cancer pain conditions
This systematic review of 10 RCTs (n=638) found that breathing therapy significantly improved pain and/or health-related quality of life in six studies. Two RCTs with low risk of bias demonstrated that daily slow diaphragmatic breathing for 15 minutes reduced pain by up to 37% in patients with chronic neck pain, chronic low back pain, fibromyalgia, or tension-type headache.
Heat exposure induces diurnal differences in renal responses, with daytime heat affecting glomerular filtration markers and nighttime heat elevating early kidney stress biomarkers.
In a randomized crossover trial, 41 healthy adults exposed to 8 hours of heat showed distinct renal biomarker changes depending on time of day. Daytime heat increased serum creatinine by 7.67% and cystatin C by 3.05%, while nighttime heat increased urinary IGFBP-7 by 58.40%, KIM-1 by 47.25%, and TIMP-2 by 51.88%. Sleep-related parameters partially mediated nighttime heat effects on renal responses.
Delayed estimated circadian phase is associated with greater restless legs syndrome symptom severity
In an exploratory pilot study of 21 patients with idiopathic RLS and 21 matched insomnia controls, patients with RLS showed a non-significant trend toward delayed estimated dim light melatonin onset (eDLMO) compared to controls (10:01 PM vs 9:33 PM, p=0.069, d=0.58). Within the RLS group, later eDLMO was modestly associated with higher RLS symptom severity scores (Ī²=0.0726, p=0.038) after adjusting for age and depressive symptoms.
Stapokibart improves sleep quality in patients with chronic rhinosinusitis with nasal polyps
In a post hoc analysis of the phase 3 CROWNS-2 study, stapokibart significantly improved SNOT-22 Sleep domain scores compared with placebo during the 24-week double-blind period. These improvements were maintained and further progressed during the open-label extension and safety follow-up periods, indicating sustained benefit for sleep quality.
Binaural beats combined with pure music reduces perceived stress in college students with poor sleep quality
A 4-week bedtime audio intervention combining binaural beats with pure music significantly reduced perceived stress (PSS scores) compared to a control group in college students with poor sleep quality (PSQI > 7). The binaural beats group was more effective at reducing stress than pink noise plus pure music, but no significant group differences were found for morning salivary cortisol levels.
Multi-herb formula (VL-G-A57) and ashwagandha (VL-G-E12) improve sleep quality in stressed adults
In a 60-day RCT, both VL-G-A57 (Rhodiola, holy basil, Schisandra chinensis) and VL-G-E12 (full-spectrum ashwagandha) significantly improved sleep quality as measured by PSQI compared to placebo (VL-G-A57: p=0.0008; VL-G-E12: p<0.0001). Restorative sleep also improved significantly in both groups (p<0.0001).
An exercise oncology program improves sleep quality in head and neck cancer patients undergoing chemo-radiation therapy
A randomized controlled trial of 70 head and neck cancer patients found that a 7-week exercise oncology program (15-20 minutes of brisk walking and resistance training) significantly improved Pittsburgh Sleep Quality Index scores from 13.97 to 7.09, while the control group's scores worsened from 13.06 to 14.14 (both p < 0.001). Urinary melatonin levels increased in the exercise group but the between-group difference was not significant after adjusting for baseline values (p = 0.372).
Multi-herb formula (VL-G-A57) and full-spectrum ashwagandha (VL-G-E12) improve sleep quality in stressed adults
In a 60-day randomized, double-blind, placebo-controlled trial, both VL-G-A57 (Rhodiola, holy basil, Schisandra chinensis) and VL-G-E12 (ashwagandha) significantly improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) compared to placebo. VL-G-A57 showed p=0.0008 and VL-G-E12 showed p<0.0001 for PSQI improvement, with corresponding improvements in restorative sleep (RSQ-W, p<0.0001 for both).
Tart cherry juice may improve sleep quantity and quality in older adults with self-reported insomnia
This protocol describes a randomized, double-blind, placebo-controlled, cross-over pilot study testing 16 oz. of tart cherry juice daily for 4 weeks in 20 older adults with self-reported insomnia. The study aims to evaluate feasibility and collect preliminary data on sleep quantity/quality and biomarkers related to melatonin, cortisol, serotonin, and inflammation.
Electroacupuncture reduces migraine days and attacks in menstrual-related migraine compared to sham electroacupuncture
This protocol describes a multicenter single-blinded RCT evaluating electroacupuncture for menstrual-related migraine. 120 participants will be randomized to electroacupuncture or sham electroacupuncture, receiving 18 sessions over 12 weeks. The primary outcome is change in migraine days and attacks during weeks 9-12 versus baseline.
Early time-restricted eating and daytime bright light therapy may improve glycemic control in adults with type 2 diabetes
This protocol describes a 4-arm randomized controlled trial testing the independent and combined effects of early time-restricted eating (eTRE) and daytime bright light therapy (BLT) on glycemic control and other health outcomes in adults with type 2 diabetes. The trial will randomize 344 participants to one of four groups: control, eTRE, BLT, or eTRE+BLT, with an intensive 16-week intervention and follow-up at 1 year. The primary outcome is glycemic control measured by HbA1c and 24-hour glucose.
Adding HMB to EPA/DHA supplementation for 10 weeks increases postabsorptive net protein breakdown in COPD patients
In a randomized double-blind placebo-controlled trial, 46 patients with COPD received daily EPA/DHA, EPA/DHA plus HMB, or placebo for 10 weeks. The HMB plus EPA/DHA group showed a significant increase in postabsorptive net protein breakdown (p=0.028), while EPA/DHA alone did not, suggesting enhanced protein turnover cycling associated with lean soft tissue gain.
Ashwagandha root extract improves sleep quality in children aged 6-12 years
In a randomized, double-blind, placebo-controlled trial, 73 children aged 6-12 years completed an 8-week supplementation with Ashwagandha root extract (ARE) gummies (150 mg twice daily) or placebo. Parent-reported sleep quality, measured by the Sleep Disturbance Scale for Children (SDSC), significantly improved in the ARE group (p = 0.035).
L-theanine improves sleep quality and reduces stress markers in individuals with mild to moderate sleep disturbances
This study protocol describes a randomized, double-blind, placebo-controlled trial evaluating the effects of L-theanine (100mg, 200mg, 400mg) on sleep and stress markers in 60 healthy adults aged 18-65 with mild to moderate sleep disturbances. The primary outcomes are changes in objective and subjective sleep quality parameters and secondary outcomes include biochemical, physiological, and subjective stress markers after a 14-day intervention. The trial aims to determine the optimal dose of L-theanine for improving sleep and stress.
Sotatercept improves hemodynamics, right heart function, and reduces the risk of adverse clinical outcomes in PAH patients not achieving low risk on background therapy
In recent randomized trials, add-on therapy with sotatercept led to improvements in hemodynamics and right heart function, and reduced the risk of adverse clinical outcomes in patients with pulmonary arterial hypertension who were not achieving low risk on maximal background therapy. This represents the first antiremodeling therapy approved for PAH, targeting dysregulation of the activin arm of the TGF-Ī² pathway.
Tart cherry juice may increase sleep quantity in older adults with insomnia
Two small pilot studies reported that 2 weeks of daily tart cherry juice consumption (half dose morning, half at night) may increase sleep quantity in older adults with insomnia, as assessed by sleep diary or one night of polysomnography. The proposed protocol aims to test a longer duration (4 weeks) with doses closer to bedtime and daily objective monitoring via a wearable device.
Perioperative music therapy improves sleep quality in patients aged 50-70 years undergoing total knee arthroplasty
This randomized controlled trial found that perioperative music therapy significantly enhanced sleep quality in patients aged 50-70 years undergoing total knee arthroplasty. The intervention was delivered during the perioperative period, and sleep quality was measured using validated instruments. Key numerical results were not specified in the abstract.
The Good Nights Sleep Program improves child sleep duration and parent sleep latency and consistency in low-income families
A pilot randomized clinical trial of the Good Nights Sleep Program, combining education with behavior change strategies, showed that children receiving the intervention had longer actigraphy-derived sleep hours compared to waitlist controls, and parents reported shorter sleep latency and more consistent actigraphic wake times. The study enrolled 75% Black and 25% White parent-child dyads with a mean family income-to-needs ratio of 1.68.
Green tea and its bioactive compounds (EGCG, L-theanine) may improve mood disorder symptomology, particularly symptoms of depression, but no evidence supports effects on BDNF.
A systematic review of 13 RCTs found that green tea, green tea extract, L-theanine, or EGCG improved depressive symptoms in 4 studies, anxiety in 6, stress in 5, and sleep in 1. No studies reported statistically significant effects on brain-derived neurotrophic factor (BDNF).
GBP supplementation improves delayed verbal memory and reaction time in healthy adults and those with moderate stress
Two exploratory RCTs found that 480 mg/day of a standardized Ginkgo biloba extract with phosphatidylserine (GBP) for 4 weeks improved delayed verbal memory and reaction time versus placebo in healthy volunteers. A second trial in adults with moderate stress showed mood benefits and a trend toward faster reaction times at both 240 mg and 480 mg doses. Effects on cognitive models in the second study were more modest than expected.
Cheek acupuncture may improve postoperative recovery after endoscopic sinus surgery
This pilot randomized controlled trial will assess whether cheek acupuncture, administered within 30 minutes before anesthesia induction, improves postoperative recovery in 90 adults undergoing endoscopic sinus surgery. The primary outcome is the Quality of Recovery-15 score at 24 hours postoperatively, with secondary outcomes including sleep disturbance, pain, and inflammatory biomarkers.
LLM-driven text-based coaching grounded in the Transtheoretical Model of Change increases daily step count compared to generic prompts in adults at risk for cardiovascular disease.
This study will test whether personalized coaching prompts generated by a large language model (LLM) can increase daily step count more than generic prompts in a fully digital, randomized crossover trial. The primary endpoint is change in daily step count, with a target enrollment of 15,000 adults across the US and UK. Recruitment began in March 2026 and is ongoing.
Bilateral transcutaneous auricular vagus nerve stimulation reduces excessive daytime sleepiness in patients with narcolepsy type 1 compared to sham stimulation
This study protocol describes a randomized, double-blind, sham-controlled trial (TARGET-2) evaluating the efficacy and safety of bilateral taVNS versus unilateral taVNS and sham stimulation in 153 patients with narcolepsy type 1. The primary outcome is the change in Epworth Sleepiness Scale (ESS) score from baseline to 12 weeks. The trial is ongoing, with anticipated completion by March 2027.
Bezisterim (NE3107) improves cognition, fatigue, sleep, and post-exertional malaise in adults with long COVID
This phase 2, triple-blind, placebo-controlled RCT will evaluate bezisterim (20 mg twice daily for 12 weeks) in 208 adults aged 18-69 with long COVID symptoms lasting at least 3 months. Outcomes include cognition, fatigue, sleep, post-exertional malaise, and quality of life measured via Cogstate Battery and PROMIS scales.
Integrating cognitive behavioral therapy for insomnia (CBTi) into best-practice care (BPC) for knee osteoarthritis (KOA) patients with insomnia may reduce pain severity more than BPC alone with lifestyle education.
This randomized controlled trial protocol aims to test whether adding 6 sessions of CBTi to 12 sessions of physical therapist-led best-practice KOA care reduces pain severity more than best-practice care plus 6 general lifestyle education sessions in 128 patients with KOA and insomnia. The primary outcome is between-group difference in change in pain severity at 6 months post-intervention.
Outdoor aerobic exercise may provide greater therapeutic advantages than indoor aerobic exercise for adolescents with subthreshold depression
This randomized controlled trial protocol aims to compare the psychological effects of indoor versus outdoor aerobic exercise in adolescents with subthreshold depression. The study will recruit adolescents meeting standardized subthreshold depression screening criteria and randomly assign them to an indoor or outdoor aerobic exercise group for an 8-week program (2-3 sessions per week, 40 minutes per session at moderate intensity). Depressive symptoms, anxiety, and sleep quality will be assessed at baseline, mid-intervention, and post-intervention.
Progressive relaxation exercises administered via telenursing improve sleep quality in nursing students after an earthquake
A randomized controlled trial with 86 nursing students from two universities in eastern Turkey found that 20 minutes of nightly progressive relaxation exercises via video call for 4 weeks significantly improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). The post-test PSQI scores showed a significant difference between the experimental and control groups (P < 0.005), while pre-test scores were not significantly different (P > 0.05).
Foot reflexology massage using aromatic oils improves sleep quality in individuals with poor sleep quality
A single-blind RCT found that 20 minutes of daily foot reflexology massage with aromatic oils for 21 days significantly improved sleep quality in adults with poor sleep (PSQI >5). The intervention group's mean PSQI score dropped from 14.25 to 10.30 (p<0.001), while the control group showed minimal change (14.10 to 14.15, p=0.34).
Shatavari root extract combined with Ashwagandha root extract improves sexual arousal, lubrication, orgasm, and total Female Sexual Function Index scores in women.
In an 8-week randomized, double-blind, placebo-controlled trial with 135 women, the combination of Shatavari and Ashwagandha root extracts (SHT-ARE) significantly improved FSFI Arousal (P = 0.041), Lubrication (P = 0.027), Orgasm (P = 0.031), and Total FSFI (P = 0.005) scores compared to placebo. The SHT-ARE group also showed reduced sexual distress (FSDS, P < 0.0001), increased happiness (OHQ, P < 0.0001), and improved mood (POMS, P < 0.0001) versus placebo.
Nucleotides supplementation may improve sleep quality in older adults aged 60-70 years
The TALENTs trial is a randomized, double-blinded, placebo-controlled study evaluating nucleotides as an anti-aging supplement in 122 older adults (mean age 65.65 years, 67.21% female). Baseline data showed that nearly half of participants had room for improvement in sleep quality, and sleep quality was measured as a secondary outcome at 2 and 4 months.
Caffeine supplementation in athletes may impair sleep quality and duration, particularly when consumed close to bedtime or in high doses.
This systematic review of nine randomized controlled trials found that caffeine supplementation can have detrimental effects on sleep parameters in athletes, including reduced sleep quality, quantity, and efficiency, as well as increased sleep onset latency and number of awakenings. The effects vary based on timing of consumption, habitual caffeine use, and dose.
Medicinal cannabis improves quality of life and symptom control in advanced cancer patients
This Phase I/II double-blind, randomized controlled trial evaluates the safety, tolerability, and impact of medicinal cannabis on quality of life and symptom control in advanced cancer patients. The Phase II component specifically measures outcomes including pain, anorexia, anxiety, sleep, nausea, treatment satisfaction, toxicity, and caregiver burden using validated instruments.
High-intensity interval training improves sleep quality in obese female college students
A 12-week HIIT intervention (3 sessions/week, 30 min/session) significantly improved sleep quality in obese female college students, as measured by lower PSQI scores compared to a control group receiving only health education (P < 0.05). The study also found improvements in body morphology, mental health, physical fitness, and quality of life.
A 4-week bedtime audio intervention combining binaural beats with pure music reduces perceived stress in college students with poor sleep quality
In a three-group randomized controlled trial of 66 college students with poor sleep quality (PSQI > 7), a 30-minute audio intervention combining binaural beats with pure music at bedtime for 4 weeks (5 nights/week) significantly reduced perceived stress as measured by the PSS, with significant time, group, and time-by-group interaction effects (p < 0.05). The binaural beats + pure music group was more effective at reducing stress than pink noise + pure music or control. However, no significant group differences were found in morning salivary cortisol levels, which showed only a main effect of time.
Inhalation of 2.5% CO2 increases arterial oxygen partial pressure and exercise performance at high altitude in healthy lowlanders
In a double-blind pilot study at 4505 m, inhalation of 2.5% CO2 significantly increased PaO2 (42.3 vs. 34.9 mmHg) and PaCO2 (33.5 vs. 31.4 mmHg) compared to ambient air. Endurance shuttle walk test distance was also significantly longer with CO2 inhalation (960.0 m vs. 677.0 m).
Standardized lime peel supplement reduces sleep latency and improves sleep efficiency in adults with sleep disturbance
In a randomized, double-blind, placebo-controlled trial, 80 adults with sleep disturbances received either 300 mg/day of standardized lime peel supplement (SLPS) or placebo for 2 weeks. SLPS significantly improved polysomnographic outcomes including reduced sleep latency, wake after sleep onset, and total wake time, as well as enhanced sleep efficiency, total sleep time, and stage 2 sleep. Daytime sleepiness measured by the Epworth Sleepiness Scale was also decreased, with no serious adverse effects reported.
Individualized music therapy (IMT) improves response rates in adults with major depressive disorder, generalized anxiety disorder, and primary insomnia compared to nonindividualized music therapy.
This protocol describes a multistage study evaluating individualized music therapy (IMT) versus nonindividualized music therapy in adults aged 18-60 with mild-to-moderate major depressive disorder, generalized anxiety disorder, or primary insomnia. The primary outcome is response rate at 8 weeks, defined as ā„50% reduction in MADRS, HAMA, or PSQI scores. The study includes a pilot randomized clinical trial (n=300) comparing the two interventions.
Standardized lime peel supplement (SLPS) reduces sleep latency and improves sleep efficiency in adults with sleep disturbance
In a randomized, double-blind, placebo-controlled trial, 80 adults with sleep disturbances received 300 mg/day of SLPS or placebo for 2 weeks. SLPS significantly improved polysomnographic outcomes, including reduced sleep latency, wake after sleep onset, and total wake time, as well as enhanced sleep efficiency, total sleep time, and stage 2 sleep. Daytime sleepiness was also decreased, with no serious adverse effects reported.
Six months of multimodal exercise in individuals on the Alzheimer's disease continuum is associated with short-term preservation of hippocampal and amygdala subfield volumes and increased hippocampus-amygdala connectivity, which are linked to sleep and activity parameters.
In the MOVE study, 46 individuals on the AD continuum were randomized to 6 months of multimodal exercise or psychoeducation. The exercise group showed increased hippocampus-amygdala connectivity and attenuated subfield atrophy after the intervention, but both groups progressed in cognitive decline and hippocampal atrophy one year later. Hippocampal and amygdalar volumes and connectivity were associated with sleep parameters, suggesting a link between exercise, sleep, and brain structure.
An app-based REHEAT intervention reduces adverse effects of heatwaves among Swiss home care workers
This protocol describes a randomized controlled trial testing the REHEAT app intervention to protect home care workers from heat-related health risks. The study involves 350 participants randomized 1:1 to intervention or control, with outcomes including strain accumulation, cognitive performance, emotional distress, sleep, night recovery, and mental and physical health. No outcome data have been analyzed yet as the study is ongoing.
A 12-week yogic breathing and relaxation programme reduces blood pressure and improves sleep quality in adults with hypertension.
In a randomized controlled trial of 66 adults with Stage 1 hypertension or elevated blood pressure, a 12-week structured yogic breathing and relaxation programme significantly reduced systolic blood pressure from 132.42 to 124.06 mmHg (p < 0.001) and diastolic blood pressure from 84.42 to 78.61 mmHg (p < 0.01), and significantly improved sleep quality (p = 0.019) compared to standard lifestyle interventions.
Nurse-led family intervention (SCCIP-N) may reduce post-traumatic stress symptoms in families of children with cancer in China
This protocol describes a multicentre randomised controlled trial evaluating a nurse-led family-based psychosocial intervention (SCCIP-N) to reduce post-traumatic stress symptoms (PTSS) in families of paediatric cancer patients. The trial will enrol 110 families across Hunan and Xinjiang, with assessments at baseline and 1, 4, and 8 weeks post-intervention. Primary outcomes are PTSS in children and caregivers, with secondary outcomes including sleep quality and physiological measures.
Multidomain lifestyle interventions combined with pharmacological or nutraceutical approaches may improve cognition in individuals across the Alzheimer's disease continuum.
A systematic review of 12 randomized controlled trials found that combining multidomain lifestyle interventions (2-7 domains including physical exercise, cognitive training, dietary guidance, social activities, sleep hygiene, cardiovascular/metabolic risk management, psychoeducation or stress management) with pharmacological components (e.g., Omega-3, Tramiprosate, vitamin D, BBH-1001, epigallocatechin gallate, Souvenaid, metformin) may effectively improve cognition. Seven trials targeted participants with prodromal AD, MCI, or early dementia, while five focused on at-risk individuals or those with subjective cognitive decline, with two studies enriching populations for APOE-Īµ4 carriers.
Integrating cognitive behavioral therapy for insomnia into best-practice care reduces pain severity in patients with knee osteoarthritis and insomnia
This protocol describes a randomized controlled trial testing whether adding 6 sessions of CBTi to 12 sessions of physical therapist-led best-practice care (BPC) reduces pain severity more than BPC plus 6 general lifestyle education sessions in 128 patients with knee osteoarthritis and insomnia. The primary outcome is between-group difference in pain severity change at 6 months post-intervention. Secondary outcomes include sleep, mood, function, inflammation biomarkers, and cost-effectiveness.
Qigong (Baduanjin) intervention reduces caesarean section rate in pregnant women
This multicenter RCT protocol aims to evaluate whether adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the caesarean section rate compared to standard care alone. The study plans to enroll 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation across 11 institutions in China. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, gestational weight gain, and mental health/sleep outcomes.
Nucleotides (NTs) as an anti-aging supplement may improve sleep quality in older adults, but efficacy is not yet established.
The TALENTs trial enrolled 122 adults aged 60-70 years to evaluate nucleotides as an anti-aging supplement. Baseline data showed nearly half of participants had room for improvement in sleep quality, but results on NT effects are pending.
The REHEAT app-based intervention reduces adverse effects of heatwaves among Swiss home care workers.
This protocol describes a randomized controlled trial evaluating the REHEAT app intervention for 350 Swiss home care workers. The study aims to causally assess the intervention's effectiveness in reducing strain accumulation, cognitive decline, emotional distress, sleep disruption, and impaired night recovery during heatwaves. No outcome data have been analyzed yet, as the trial is ongoing.
Exogenous nucleotides may improve sleep quality in older adults
In a randomized controlled trial of 122 adults aged 60-70, nearly half of participants had room for improvement in sleep quality at baseline. The study will evaluate changes in sleep quality from baseline to 4 months as part of a comprehensive geriatric health assessment, but results are not yet reported.
Clay pot combined with thunder-fire moxibustion improves sleep quality and wound healing in orthopedic patients with chronic refractory wounds
In a randomized controlled trial of 60 orthopedic patients with chronic refractory wounds, those receiving clay pot therapy plus thunder-fire moxibustion (in addition to conventional treatment) showed significantly better Pittsburgh Sleep Quality Index scores (9.58 vs 11.30) and higher wound cure rates (26.67% vs 3.33%) compared to conventional treatment alone. The intervention also reduced local symptom scores and pain scores.
Adenotonsillectomy improves quality of life and behavior in children with obstructive sleep apnea
The CHAT study showed that surgical intervention (adenotonsillectomy) significantly improves quality of life and behavior in pediatric obstructive sleep apnea patients. This supports adenotonsillectomy as the gold standard treatment for OSA in children.
Nucleotide supplementation may improve sleep quality in older adults aged 60-70 years
This randomized controlled trial (TALENTs) enrolled 122 community-dwelling adults aged 60-70 years, with nearly half having room for improvement in sleep quality at baseline. The study will evaluate changes in sleep quality from baseline to 4 months as part of a comprehensive geriatric health assessment, comparing a nucleotide intervention group to a placebo control group.
Caffeine supplementation may have a detrimental effect on sleep and recovery in athletes
This systematic review of nine randomized controlled trials found that caffeine supplementation can adversely affect sleep parameters in athletes, including sleep quality, quantity, efficiency, number of awakenings, and sleep onset latency. The effects vary based on timing of consumption, habitual caffeine use, and dose.
Acupotomy at spinal acupoints improves therapeutic effectiveness in patients with primary insomnia
In a comparative study of 185 primary insomnia patients, acupotomy at spinal acupoints (95 cases) resulted in a significantly higher overall response rate than Zolpidem Tartrate Tablets (90 cases). The acupotomy group also showed significantly greater improvements in sleep quality (PSQI, ISI), hyperarousal (PSAS, HAS), sleep latency, actual sleep duration, number of awakenings, anxiety (SAS), depression (BDI), and serum neurotransmitters (GA, GABA), with a lower total adverse reaction rate.
Lavender scent improves sleep quality and physical balance in elderly individuals
In a randomized controlled trial of 90 elderly participants, those who slept with lavender pouches for one month showed significant improvements in sleep quality (PSQI total score decreased from 6.11Ā±2.86 to 4.33Ā±2.07, p<0.05) and physical balance (BBS score increased from 38.31Ā±11.84 to 41.48Ā±10.82, p<0.05). Sleep latency also decreased significantly.
Modified Sini Powder reduces depressive symptoms in postoperative NSCLC patients with mild-to-moderate depression
This protocol describes a multicenter, randomized, double-blind, placebo-controlled trial evaluating Modified Sini Powder (MSNP) for postoperative mild-to-moderate depression in 468 NSCLC patients. The primary outcome is the total effective rate at 6 weeks, defined as a ā„25% reduction in the 17-item Hamilton Depression Rating Scale score from baseline.
Acupuncture improves sleep quality in patients with chronic insomnia and mild cognitive impairment
This protocol describes a sham-controlled randomized trial testing acupuncture for chronic insomnia with mild cognitive impairment. Eighty-two participants will receive 10 sessions of real or sham acupuncture over 4 weeks, with the primary outcome being change in PSQI total score from baseline to week 4. The study aims to provide evidence for acupuncture as a non-pharmacological intervention in this comorbid population.
A qigong (Baduanjin) intervention program reduces the rate of caesarean section in pregnant women when added to routine lifestyle intervention.
This multicenter RCT protocol aims to evaluate the additive effect of a qigong intervention program (modified seated Baduanjin) compared to routine lifestyle intervention alone on reducing caesarean section rate in 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, maternal gestational weight gain, and mental health and sleep-related outcomes.
An app-based intervention (REHEAT strategy) reduces adverse effects of heatwaves among Swiss home care workers
This protocol describes a randomized controlled trial testing the REHEAT app intervention to protect home care workers from heat-related health risks. The study aims to evaluate the effectiveness of the app in reducing strain accumulation, improving cognitive performance, emotional distress, sleep, night recovery, and mental and physical health during summer months. The trial involves 350 participants from Northern and Southern Switzerland, with data collection ongoing and no results yet available.
HD-tDCS over the dorsal medial prefrontal cortex reduces insomnia severity and improves sleep onset latency and sleep efficiency in chronic insomnia patients
A 10-day regimen of active high-definition transcranial direct current stimulation (HD-tDCS) targeting the bilateral dorsal medial prefrontal cortex significantly decreased Pittsburgh Sleep Quality Index (PSQI) scores compared to sham stimulation in chronic insomnia patients. Exploratory polysomnography findings also showed improvements in sleep onset latency and sleep efficiency after active treatment.
Caffeine supplementation may impair sleep quality and increase insomnia risk in athletes
This systematic review of 9 randomized controlled trials found that caffeine supplementation can have detrimental effects on sleep parameters such as sleep quality, duration, efficiency, and onset latency in athletes. The effects varied based on timing of consumption, dose, and habitual caffeine use.
Probiotics reduce hyperactivity and improve academic performance in adults with ADHD
A double-blind RCT found that a multi-strain probiotic supplement taken daily for three months significantly decreased hyperactivity, improved gastrointestinal symptoms, and enhanced academic performance in college students with ADHD. Younger participants experienced greater overall benefits, and higher academic grades were associated with lower hyperactivity and impulsivity.
Ultrasound-guided stellate ganglion acupuncture combined with conventional acupuncture may provide additional benefit over conventional acupuncture alone for chronic insomnia disorder.
This randomized controlled trial will enroll 80 patients with chronic insomnia disorder to compare ultrasound-guided stellate ganglion acupuncture plus conventional acupuncture versus conventional acupuncture alone over 12 sessions in 4 weeks. Primary outcomes include the Insomnia Severity Index and functional near-infrared spectroscopy measures of brain function, with follow-up at week 8.
Hot water immersion improves sleep quality in athletes
Hot water immersion (HWI) significantly improved sleep quality in athletes compared to control conditions, while cold water immersion (CWI) did not show consistent benefits for sleep. The review included eight studies and found HWI also enhanced acute anaerobic power, whereas CWI impaired immediate power output.
Preoperative ultrasound-guided stellate ganglion block reduces the incidence and severity of postoperative sore throat after thoracic surgery with double-lumen endobronchial tubes
This study protocol describes a double-blind RCT testing whether preoperative ultrasound-guided SGB with 0.25% ropivacaine 4mL reduces POST incidence at 6 hours postoperatively compared to saline placebo in 132 patients undergoing thoracoscopic resection with DLTs. Secondary outcomes include POST severity at multiple time points, pain scores, nausea/vomiting, hoarseness, recovery quality, sleep quality, and analgesic consumption.
LLM-driven text-based coaching prompts grounded in the Transtheoretical Model of Change increase daily step count compared to generic prompts in adults at risk for cardiovascular disease.
The My Heart Counts study is a prospective observational cohort with an embedded randomized crossover trial (N=15,000) evaluating personalized LLM-generated coaching prompts versus generic prompts. The primary endpoint is change in daily step count, analyzed using mixed-effects models.
Modified Sini Powder (MSNP) improves depressive symptoms in postoperative NSCLC patients with mild-to-moderate depression
This protocol describes a multicenter, randomized, double-blind, placebo-controlled trial evaluating MSNP for postoperative depression in NSCLC patients. The primary outcome is a ā„25% reduction in the 17-item Hamilton Depression Rating Scale score after 6 weeks of treatment. The trial aims to provide robust clinical evidence and explore multi-omics mechanisms.
HD-tDCS over the dorsal medial prefrontal cortex reduces PSQI scores and improves sleep onset latency and sleep efficiency in chronic insomnia patients
A 10-day regimen of active high-definition transcranial direct current stimulation (HD-tDCS) targeting the bilateral DMPFC significantly decreased Pittsburgh Sleep Quality Index (PSQI) scores compared to sham stimulation in chronic insomnia patients. Exploratory polysomnography findings also showed improvements in sleep onset latency (SOL) and sleep efficiency (SE) after active treatment.
Ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, tart cherries, turmeric, and valerian root may improve mental energy outcomes in adults without severe disease.
This scoping review of 101 randomized controlled trials evaluated 16 dietary ingredients for effects on mental energy. Eleven ingredients showed promising directional benefits (ā„20% of outcomes improved) across cognition, mood, and sleep domains, with dark chocolate, ginseng, ashwagandha, and lion's mane mushroom being most promising for cognition.
The ALMA multidimensional group intervention improves cognitive function in women with breast cancer undergoing active oncological treatment.
This protocol describes a randomized controlled trial evaluating the ALMA intervention (two 120 min face-to-face sessions/week for four months) in 63 women with breast cancer. The primary outcome is objective global cognitive performance measured by the Montreal Cognitive Assessment, with secondary outcomes including perceived cognitive function, sleep quality, and functional autonomy.
Computerized cognitive behavioral therapy for insomnia reduces subjective overreporting of sleep onset latency in veterans with moderate-to-severe traumatic brain injury
In 36 veterans with insomnia and moderate-to-severe TBI, cCBT-I (SleepEZ program) decreased the discrepancy between subjective and objective sleep onset latency, driven by improvements in subjective but not objective sleep measures. Sleep efficiency discrepancies grew larger post-intervention due to subjective improvements without corresponding objective changes.
Lutein and zeaxanthin supplementation increases macular pigment optical density and improves attention and processing speed in healthy teenagers
In a 6-month randomized, double-blind, placebo-controlled trial, 82 teenagers aged 13-18 with high screen use and low fruit/vegetable intake received either 10 mg lutein and 2 mg zeaxanthin or a placebo daily. Compared to placebo, LZ supplementation significantly increased macular pigment optical density in both eyes (left: P=0.010; right: P=0.004) and improved tests of attention (P=0.026) and processing speed (P=0.034), but did not affect visual reasoning, nonverbal memory, or self-reported sleep and attention.
Electrical dry needling combined with therapeutic exercise is not yet proven to be more effective than therapeutic exercise alone in patients with chronic nonspecific neck pain, as the trial is ongoing and results are pending.
This protocol describes a randomized controlled trial comparing electrical dry needling (EDN) combined with therapeutic exercise versus therapeutic exercise alone in 70 participants with chronic nonspecific neck pain. The trial is ongoing, with recruitment partially completed (35 of 70 as of January 2026), and results are expected to be published in late 2026. No efficacy results are available yet.
Skin temperature monitoring shows promising feasibility for in-field circadian rhythm estimation after only three days, with cosinor models fitting better on skin temperature than activity-based data.
In a randomized crossover field study with 17 healthy participants (19-32 years), skin temperature monitoring (distal, proximal, distal-proximal gradient) provided better cosinor model fit for circadian rhythm estimation than actimetry after three nights of manipulated sleep (8h vs 4h time-in-bed). Sleep restriction reduced distal temperature amplitude but did not significantly moderate other skin temperature rhythm parameters, whereas activity rhythms showed reduced amplitude, delayed acrophase, and increased mesor.
Home-based OSA screening does not improve quality of life in patients with atrial fibrillation compared to standard care
The VIR-SAAF trial is a national, decentralised RCT investigating whether home-based OSA screening and referral for potential treatment improves quality of life, physical activity, and AF-related outcomes compared with standard care in adults with paroxysmal or persistent AF. The primary outcome is the between-group difference in change from baseline to 18 weeks in quality of life using the Atrial Fibrillation Effect on QualiTy-of-life questionnaire. As a protocol paper, no results are reported yet.
A hybrid factorial SMART-MRT intervention combining human and app-based coaching reduces caregiver stress in family caregivers of people with dementia.
This protocol describes a trial testing a BPSD management intervention with 550 family caregivers randomized to five conditions including human and app-based coaching. The primary outcome is caregiver stress, with secondary outcomes including sleep quality and psychological well-being. The study uses adaptive trial designs and machine learning to personalize just-in-time support.
Adding liposomal bupivacaine to bupivacaine hydrochloride for serratus anterior plane block improves pain-related and early recovery outcomes after modified radical mastectomy compared with bupivacaine hydrochloride alone.
This randomized, double-blind trial compares liposomal bupivacaine plus bupivacaine HCl versus bupivacaine HCl alone for serratus anterior plane block in 76 patients undergoing modified radical mastectomy. The primary outcome is the Quality of Recovery-15 score at 24 hours postoperatively, with secondary outcomes including pain intensity up to 72 hours, opioid use, and sleep quality. Results are pending as this is a protocol paper.
Melatonin improves sleep quality in patients with primary breast cancer undergoing adjuvant chemotherapy
In a randomized, double-blind, placebo-controlled trial, 40 patients with stage I-III breast cancer receiving adjuvant chemotherapy were given 6 mg/day melatonin for 6 months. Melatonin significantly improved sleep latency (from 1.50 to 1.00, P=0.001), sleep efficiency (from 1.11 to 0.56, P=0.003), and total PSQI scores (from 8.39 to 6.50, P=0.003) compared to placebo across the three phases of chemotherapy. No significant differences were observed during the Adriamycin phase, but during the Taxol phase, melatonin showed significant improvement in anxiety (P=0.077) and overall PSQI scores (P=0.015).
Dexmedetomidine-flurbiprofen axetil-based opioid-free analgesia improves postoperative sleep quality and attenuates melatonin suppression after thyroidectomy
In a randomized controlled trial of 96 patients undergoing thyroidectomy, an opioid-free PCIA regimen (dexmedetomidine, flurbiprofen axetil, ondansetron) significantly improved sleep quality (RCSQ scores, P<0.001) and preserved nocturnal melatonin secretion (urinary 6-SMT, P<0.001) compared to opioid-based PCIA (sufentanil, ondansetron). The opioid-free group also showed shorter sleep latency, fewer nocturnal awakenings, longer total sleep time, lower anxiety, and reduced opioid-related adverse events.
Iron supplementation reduces restless legs syndrome severity and sleep disturbances in individuals with iron deficiency anemia
Iron deficiency anemia is consistently linked to decreased sleep quality, reduced sleep duration, and increased restless legs syndrome (RLS). Iron supplementation, whether oral or intravenous, significantly decreases RLS severity scores and sleep disturbances in most assessed randomized controlled trials, with moderate-certainty evidence.
Repeated-sprint exercise in hypoxia does not alter sleep quality in young male adults
In a crossover trial, ten healthy young men performed repeated-sprint exercise in hypoxia (FiO2 14.5%), normoxia (FiO2 20.9%), or no exercise (REST). Sleep quality measures (total sleep time, sleep efficiency, sleep latency, sleep stages) did not differ significantly among conditions, but heart rate was higher and HRV-derived pNN50 was lower during the first 90 minutes of sleep after exercise compared to REST.
Sleep intervention shows effects in human trials
Hunger, satiety, and eating behavior after craniopharyngioma - narrative review on current management and future therapeutic perspectives.. Published in Frontiers in endocrinology (2026). PMID: 42626294.
Weekend recovery sleep does not fully compensate for the cardiometabolic effects of partial sleep restriction
In a randomized crossover trial of 10 healthy adults, 5 days of sleep restriction (reduced by 102 min/night) followed by 2 days of ad libitum recovery sleep led to worsened sleep quality, higher triglyceride levels, and higher blood pressure compared to adequate habitual sleep. These findings suggest that weekend recovery sleep fails to fully reverse the adverse metabolic and cardiovascular effects of weekday sleep restriction.
Intraoperative low-dose remimazolam maintenance reduces the incidence of emergence agitation without prolonging emergence time in patients undergoing oral surgery
This protocol describes a randomized controlled trial testing whether low-dose remimazolam maintenance during oral surgery reduces emergence agitation (EA) incidence without prolonging emergence time. The trial will enroll 388 patients, with primary outcome being EA incidence (tested for superiority) and key secondary outcome being emergence time (tested for non-inferiority).
Two-week high-frequency aerobic exercise reduces depressive symptoms and improves frontal function in subthreshold depression
A two-week high-frequency aerobic exercise (6-7 sessions/week) significantly decreased BDI-II and PHQ-9 scores in female participants with subthreshold depression, while increasing response and remission rates. The intervention also reduced activation in the dorsolateral prefrontal cortex, frontal eye field, and premotor and supplementary motor areas, and improved functional connectivity and network efficiency.
Home-based phase-targeted auditory stimulation enhances slow wave activity and improves patient-reported outcomes in Parkinson's disease
This two-week at-home intervention with phase-targeted auditory stimulation (PTAS) of slow waves in Parkinson's disease reproduced previously reported enhancement of slow wave activity and confirmed indications of improved patient-reported outcomes. High adherence and data quality suggest home-based PTAS is feasible for long-term therapeutic investigation.
Remotely delivered gamified exercise intervention shows feasibility and preliminary efficacy for preventing Parkinson's disease in prodromal subgroups
The Slow-SPEED trials are the first non-pharmacological Parkinson's disease prevention trials worldwide, testing a gamified, remotely administered exercise intervention versus active control over 18-36 months in three complementary prodromal subgroups: iRBD (n=110, Netherlands), hyposmia (n=110, UK), and LRRK2/GBA1 mutation carriers (n=600, US). The trials aim to provide unique insights for large-scale Parkinson's prevention studies.
Benson relaxation exercise reduces anxiety levels and improves sleep quality in adolescents receiving inpatient psychiatric treatment
In a randomized controlled trial of 60 adolescents in a psychiatric clinic, those performing Benson relaxation exercise five times had significantly lower state anxiety and better sleep quality at post-test (Day 6) and follow-up (Day 10) compared to the control group. The intervention group showed sustained improvements over the 10-day study period.
Auditory neuromodulation-based PDT (BELL-001) reduces insomnia severity in adults with insomnia disorder
The SERENE trial is a multicenter, randomized, double-blind, sham-controlled superiority trial evaluating BELL-001, an auditory neuromodulation-based prescription digital therapeutic, in adults with insomnia. The primary endpoint is change in Insomnia Severity Index (ISI) score from baseline to 4 weeks, with a minimum of 114 participants enrolled. The study aims to determine if this biosignal-responsive acoustic feedback intervention can provide clinically meaningful improvements in insomnia.
Additional postoperative dexmedetomidine hydrochloride nasal spray improves objective sleep structure and reduces subjective sleep deterioration in patients undergoing gynecological laparoscopic surgery
In a single-blind RCT of 80 patients, those receiving an additional 75 Ī¼g dexmedetomidine nasal spray on the night of surgery had longer total sleep time (P=0.030), higher proportion of deep sleep (P=0.040), fewer awakenings (P=0.020), and a higher proportion without subjective sleep deterioration (25.0% vs 5.0%, P=0.012) compared to controls. No significant difference was found in total Athens Insomnia Scale score (P=0.771).
Yifei Sanjie Pill reduces the 2-year progression rate of high-risk pulmonary nodules in adults with mixed ground-glass nodules ā¤8 mm.
This multicenter RCT protocol evaluates YFSJ versus placebo for preventing progression of high-risk pulmonary nodules over 2 years. The primary outcome is progression rate defined by ā„2 mm increase in diameter, ā„1 mm increase in solid component, or new solid component. The study enrolled 589 participants and will analyze results using Kaplan-Meier and Cox regression.
Short-term intake of Montmorency tart cherry juice improves sleep quality in elite female field hockey players after intermittent exhaustion exercise
A randomized controlled trial with 19 elite female field hockey players found that short-term consumption of tart cherry juice over 48 hours significantly improved sleep quality variables, including total time in bed (TTB, p=0.015), wake after sleep onset (WASO, p=0.044), and movement index (MI, p=0.031), compared to a placebo. However, no significant changes were observed in melatonin or cortisol levels.
Transcutaneous auricular vagus nerve stimulation reduces acute mountain sickness severity in patients with AMS
This protocol describes a double-blind, randomized, sham-controlled trial evaluating the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) for acute mountain sickness (AMS). The primary outcome is the change in the 2018 Lake Louise AMS Score at 24 hours, with at least 158 participants receiving either active or sham taVNS for five consecutive days.
Culturally adapted patient navigation improves lung cancer screening uptake in American Indian/Alaska Native adults
This study protocol describes a type 1 hybrid implementation-effectiveness randomized controlled trial testing a culturally adapted patient navigation intervention to increase lung cancer screening (LCS) completion in American Indian/Alaska Native (AI/AN) adults. Two hundred eligible participants across 5 Tribal clinics in Washington state will be randomized 1:1 to patient navigation or enhanced usual care, with the primary outcome being completion of a chest CT within 6 months of randomization. The study also includes a 15-month implementation evaluation to assess sustainability of the intervention in Tribal clinic settings.
Standardized lime peel supplement (SLPS) improves sleep quality in adults with sleep disturbance
In a randomized, double-blind, placebo-controlled trial, 80 adults with sleep disturbances received either 300 mg/day of SLPS or placebo for 2 weeks. SLPS significantly improved polysomnographic outcomes including reduced sleep latency, wake after sleep onset, and total wake time, as well as enhanced sleep efficiency, total sleep time, and stage 2 sleep. Daytime sleepiness measured by the Epworth Sleepiness Scale was also decreased, with no serious adverse effects reported.
Walnut peptide and theanine combination (WPT) improves sleep disorders in adults with poor sleep quality
In an 8-week randomized, placebo-controlled human trial, WPT restored sleep duration and improved subjective sleep quality scores as assessed by the Pittsburgh Sleep Quality Index (PSQI) in adults with PSQI ā„ 7. The intervention also reduced waking activity in zebrafish and restored slow-wave sleep duration and delta wave power density in CUMS mice, while lowering serum corticosterone and increasing GABA and tryptophan levels.
Time-restricted eating (16:8) may improve circadian rhythm gene expression (BMAL-1, miRNA-let-7f-1-3p), circadian rhythm status, and sleep quality in obese women compared to an energy-restricted diet
This randomized controlled trial protocol aims to compare the effects of a 16:8 time-restricted eating diet (fasting from 8 PM to 12 PM the next day) versus an energy-restricted diet (55% carbohydrate, 30% fat, 15% protein) over 12 weeks in 42 obese women. Outcomes include expression of BMAL-1 and miRNA-let-7f-1-3p genes, circadian rhythm status, sleep quality, anthropometric measurements, and metabolic markers. The study hypothesizes that TRE can positively affect circadian rhythm-related gene expression and sleep quality.
Foot reflexology improves sleep quality and reduces restless legs syndrome in female patients with multiple sclerosis
In a randomized, double-blind clinical trial of 64 female MS patients, foot reflexology performed for 4 weeks (3 times/week, 26 min/session) significantly improved sleep quality (p < 0.001) and reduced restless legs syndrome (p < 0.001) compared to a sham group. The sham group showed no significant change in sleep quality (p = 0.30) and an increase in restless legs syndrome (p < 0.001). Between-group differences were significant at both immediate and 1-month follow-ups (p < 0.0001).
Acute sleep fragmentation decreases skeletal muscle blood flow during exercise
In a randomized crossover study of 20 adults, one night of fragmented sleep (induced by audio alarms every 30 minutes) significantly reduced brachial artery dilation and forearm blood flow during rhythmic handgrip exercise compared to habitual sleep. Peak and total hyperemic responses to single contractions were not affected, and endothelial sensitivity to shear rate was similar between conditions.
Baseline gut microbial characteristics may serve as potential biomarkers of heterogeneous treatment response in young adults with irritable bowel syndrome, distinguishing distinct multidimensional response phenotypes.
In a secondary analysis of a randomized controlled trial (NCT03332537) with 62 participants, two distinct symptom-trajectory phenotypes were identified: a Constrained Response Phenotype (n=35) and an Adaptive Multidomain Response Phenotype (n=27). Baseline gut microbiota taxa and predicted functional pathways differed between phenotypes and predicted treatment response to pain self-management interventions, with phenotype-specific predictors such as Alistipes and Sutterella for Phenotype A and Phascolarctobacterium, Collinsella, and Parabacteroides for Phenotype B.
TCM directional drug penetration therapy accelerates gastrointestinal function recovery, modulates gut microbiota, and improves sleep quality in postoperative ovarian cancer patients.
In a randomized controlled trial of 112 postoperative ovarian cancer patients, those receiving TCM directional drug penetration therapy in addition to conventional rehabilitation showed significantly shorter recovery times to first bowel sounds, anal flatus, and defecation compared to controls (P < 0.05). The therapy also led to significantly lower total PSQI scores, sleep duration, sleep efficiency, and sleep disturbance scores (P < 0.05), indicating improved sleep quality. Gut microbiota analysis revealed different dominant bacteria and lower abundance of the phosphotransferase system pathway in the treatment group.
Exercise affects sleep outcomes in human trials
Transcranial electric stimulation in chronic pain: Effects on quality of life, physical function, activity and clinical status.. Published in Journal of neuropsychology (2026). PMID: 42490298.
HD-tDCS over the DMPFC reduces PSQI scores and improves sleep onset latency and sleep efficiency in chronic insomnia patients
A 10-day course of active high-definition transcranial direct current stimulation (HD-tDCS) targeting the dorsal medial prefrontal cortex significantly decreased Pittsburgh Sleep Quality Index (PSQI) scores compared to sham stimulation in chronic insomnia patients. Exploratory polysomnography measures also showed improvements in sleep onset latency and sleep efficiency after active treatment.
MBSR program improves quality of life, life satisfaction, sleep quality, and mental well-being in menopausal women
An 8-week MBSR program significantly improved quality of life, life satisfaction, and mental well-being, and reduced sleep disturbances in menopausal women compared to a control group (p < 0.001). Within-group analyses showed significant improvements across all outcomes in the intervention group (p < 0.001), while no significant changes were observed in the control group (p > 0.05).
Evening high-intensity swimming exercise impairs REM sleep and increases wake after sleep onset in male swimmers
In a crossover trial, 12 competitive male swimmers completed high-intensity evening swimming (6:30-8:30 pm) and a no-exercise control condition. The exercise condition significantly reduced REM sleep duration (81.4 vs 107.6 min) and increased wake after sleep onset (23.5 vs 3.4 min) compared to control, while other sleep variables were unaffected. Core body temperature was higher during exercise but returned to baseline by bedtime.
Late-night eating is linked to circadian rhythm disruption, metabolic conditions, sleep disturbances, and mood disorders
The abstract reports that late-night eating is associated with circadian rhythm disruption, metabolic conditions such as metabolic syndrome, obesity, and type 2 diabetes, as well as sleep disturbances and mood disorders including depression and anxiety. However, the true magnitude of this effect remains unclear, and no systematic review has specifically evaluated the effects of dinner timing and energy intake on these outcomes.
Auricular acupressure improves sleep quality in pregnant women with insomnia
In a randomized, double-blind trial of 86 pregnant women (ā„28 weeks' gestation) with insomnia, auricular acupressure (AA) significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores by 3.51 points (p < 0.01) and increased nightly sleep duration (p < 0.01) compared to sham AA. No adverse events occurred, indicating AA is a safe and effective non-invasive intervention for insomnia during pregnancy.
Transcutaneous electrical nerve stimulation (TENS) reduces moderate-to-severe itching after burns on limbs
This protocol describes a multicentre, randomised, placebo-controlled trial testing TENS for post-burn itch. The primary outcome is the proportion of patients achieving ā„50% reduction in Worst Itch Numeric Rating Scale (WINRS) score after 7 days of daily 30-minute TENS sessions. The study aims to recruit 382 patients with moderate-to-severe itching (WINRS ā„4) from multiple burn centres in China.
Brief behavioral intervention for insomnia delivered via teleconsultation improves insomnia, anxiety, depression, and quality of life in COVID-19 survivors
In a randomized pilot trial, both teleconsultation and in-person brief behavioral interventions for insomnia significantly reduced insomnia severity (ISI from 14.57 to 5.57), anxiety (GAD-7 from 13.00 to 5.29), depression (PHQ-9 from 15.86 to 5.00), and improved quality of life (SF-36 from 30.00 to 77.14) at post-treatment and 3-month follow-up. The study concluded that teleconsultation is a viable treatment option for insomnia and mental health comorbidities.
Both written and verbal sleep hygiene strategy interventions modestly improve sleep-related behaviors in track and field athletes, particularly by encouraging earlier bedtimes and slightly extending total sleep duration.
In a three-arm randomized controlled trial with 66 track and field athletes, both written and verbal sleep hygiene strategy groups showed significant improvements in Sleep Hygiene Index scores from baseline to intervention, compared to a control group. Although no significant differences were found in objective sleep parameters, there was a non-significant trend toward increased total sleep time, primarily due to earlier bedtimes.
MAIC training reduces psychological stress and improves subjective sleep quality in elite swimmers
An 8-week Mindfulness-Acceptance-Insight-Commitment (MAIC) program embedded in routine high-load training significantly reduced athlete-specific psychological stress and salivary cortisol, and improved subjective sleep quality (PSQI) and mindfulness in elite swimmers compared to usual-practice controls. Improvements in psychological stress and mindfulness persisted at three-month follow-up, while lower cortisol and better sleep quality remained relative to controls.
Harmonizing mind acupuncture combined with nicotine replacement therapy reduces nicotine craving and increases abstinence in tobacco use disorder
This pragmatic randomized controlled trial will evaluate whether adding harmonizing mind acupuncture (HMA) to nicotine replacement therapy (NRT) improves outcomes in tobacco use disorder. The co-primary outcomes are change in nicotine craving (VAS) from baseline to week 6 and biochemically verified 7-day point prevalence abstinence at week 6. The trial will enroll 220 participants and follow them for 24 weeks.
Multi-strain Lactobacillus and Bifidobacterium probiotic formulations improve sleep quality in elite athletes
Probiotic interventions with multi-strain Lactobacillus and Bifidobacterium formulations enhanced sleep quality in elite athletes, as reported in small-scale randomized controlled trials and a controlled non-randomized study. The evidence is preliminary, with improvements noted in self-reported sleep quality.
Regular kangaroo care improves sleep-wake cycle regulation and physiological stability in premature infants
In a randomized controlled trial of 36 premature infants, regular kangaroo care (KC) for three consecutive days (twice daily, 60 minutes per session) significantly improved Bispectral Index (BIS) values, heart rate, respiratory rate, oxygen saturation, and body temperature compared to control. No significant effects were observed on infant body weight or maternal breast milk cortisol and melatonin levels.
MobACT, a guided internet-based Acceptance and Commitment Therapy programme, may improve pain acceptance in Italian adults with chronic pain.
This study protocol describes a two-arm randomized controlled trial evaluating the effectiveness and cost-effectiveness of MobACT, a guided internet-based ACT intervention, for Italian adults with medically verified chronic pain. The primary outcome is pain acceptance measured by the Chronic Pain Acceptance Questionnaire at post-intervention (T1), with secondary outcomes including pain intensity, pain interference, sleep quality, and psychological flexibility. The trial compares immediate MobACT to a waitlist control, with a 6-month follow-up in the intervention group only.
Quercetin improves night-time sleep in patients with type 2 diabetes mellitus
In a randomized controlled trial, 500 mg quercetin daily for 12 weeks (with a washout and second supplementation period) significantly improved night-time sleep by 11.6% compared to a 7.3% worsening in the control group (p < 0.001). The study included 88 patients with T2DM completing the trial.
Serratus posterior superior intercostal plane block (SPSIPB) reduces perioperative pain and improves postoperative sleep quality in patients undergoing cardiac implantable electronic device implantation.
In a double-blind RCT of 60 patients, SPSIPB significantly reduced pain scores at all time points compared to sham control (p < 0.001), with clinically significant intraoperative pain (VAS ā„ 4) occurring in 83.3% of controls versus none in the SPSIPB group. Postoperative sleep quality was also improved, with median SQ-NRS scores of 2 in the SPSIPB group versus 7 in controls (p < 0.001), and 80.0% of controls reporting poor sleep quality versus none in the SPSIPB group.
Exercise combined with ergonomics training improves sleep quality in automotive workers with non-specific chronic low back pain
A randomized controlled trial compared ergonomics training plus exercise to ergonomics training alone in 56 automotive workers with low back pain. After 12 weeks, the intervention group showed significantly greater improvements in sleep quality (p<0.05) compared to the control group, with no significant between-group difference in fatigue severity.
Home-based tailored light therapy improves memory, sleep efficiency, and circadian stimulus in mild cognitive impairment
In a 24-week randomized placebo-controlled trial, active light therapy significantly improved ADAS-Cog memory scores (p=0.035) and morning circadian stimulus AUC (0.021 vs -0.030, p=0.025) compared to placebo. Sleep percent also improved (-0.21 vs -1.29, p=0.042) and wake after sleep onset decreased (2.19 vs 8.23 min, p=0.031) in the active group.
Adding aerobic exercise to physical therapy reduces pain and central sensitization-related symptoms in temporomandibular disorder patients with nociplastic pain
In a randomized-controlled trial of 43 TMD patients with nociplastic pain, adding high-intensity interval aerobic exercise (stationary bike) to physical therapy significantly reduced central sensitization symptoms (-9.5; p=0.04), pain intensity (-23.2; p=0.04), kinesiophobia (-4.1; p=0.04), and sleep impairment (-3.8; p=0.01) at 6 weeks. Pain reductions persisted at 12-week follow-up (VAS -26.2; p=0.04). Strength training only reduced kinesiophobia at follow-up.
An online intervention based on self-efficacy theory improves maternal sleep quality and reduces anxiety in mothers of infants aged 10 to 24 months.
In a randomized clinical trial with 104 mothers of infants aged 10-24 months, an online intervention involving two virtual meetings on sleep, relaxation, and anxiety management plus motivational messages significantly improved sleep quality (PSQI from 10.4 to 4.9) and reduced both trait-anxiety (38.2 to 33.5) and state-anxiety (36.4 to 33.8) after 30 days, compared to a control group that received only monitoring. All improvements were statistically significant (p<0.05).
HRV biofeedback may enhance HRV during stress recovery but does not improve resting HRV, emotional health, or cognition in older adults
In a randomized sham-controlled trial, 53 healthy older adults received either active HRV biofeedback or sham for 5 weeks. The active group showed a significant increase in low-frequency HRV during recovery from a stressor, but no group differences were found for resting HRV, emotional functioning, or cognitive performance. Both groups reported improved sleep quality, suggesting a possible placebo effect.
Cognitive behavioral therapy reduces sedentary time and increases sleep duration in adults with major depressive disorder
In a secondary analysis of the CBT+ trial, adults with major depressive disorder who underwent 8 weeks of cognitive behavioral therapy (CBT) showed a significant average within-person decrease of 47.2 minutes/day of sedentary time (95% CI: -82.0 to -14.4; p = .007) and a significant increase of 36.5 minutes/day in sleep duration (time in bed; 95% CI: 4.2 to 68.8; p = .028). Total physical activity increased by a non-significant 12.3 minutes/day (95% CI: -34.5 to 59.1; p = .589).
Rural home hospital care provides positive patient experiences across perceived quality, comfort, and technology, with some opportunity for improvement in technology interfaces for select patients.
In a qualitative evaluation of a randomized controlled trial, 38 acutely ill rural patients receiving home hospital care reported high satisfaction, driven by strong rapport with the care team and safe, effective medical care in their homes. Patients perceived comfort from familiar surroundings, improved social support, nutrition, and sleep, while technology facilitated care but presented a learning curve and occasional barriers. Overall, the rural home hospital model was positively received, with minor technological challenges.
rs-fcMRI-guided rTMS is feasible and safe in adolescents with MDD, with preliminary clinical efficacy signals
This pilot trial will randomize 45 adolescents with MDD to conventional left DLPFC rTMS, rs-fcMRI-guided rTMS, or sham stimulation over 4 weeks. Primary outcomes include feasibility, adherence, retention, preliminary efficacy (CDRS-R response/remission), and safety. The study aims to provide preliminary evidence on feasibility and early efficacy of individualized circuit-informed rTMS.
Tart Montmorency cherry supplementation improves sustained attention, alertness, and reduces mental fatigue in middle-aged adults
In a 3-month double-blind RCT, 30 ml of Montmorency cherry concentrate twice daily improved digit vigilance accuracy by 3.3% (95% CI: 0.2, 6.4%) and reduced false alarms by 1.2 (95% CI: -2.0, -0.4) compared to placebo. Alertness increased by 5.9% (95% CI: 1.3, 10.5%) and mental fatigue decreased by 9.5% (95% CI: -16.5, -2.5%).
MOMENT-V, a telehealth-plus-mHealth intervention, is feasible for young adults with cannabis use disorder in primary care
This pilot randomized controlled trial protocol evaluates the feasibility of MOMENT-V, a fully remote brief intervention combining telehealth motivational enhancement therapy with mobile health ecological momentary intervention, versus enhanced usual care in 60 young adults with cannabis use disorder. Primary outcomes include intervention and trial feasibility measures (completion, engagement, acceptability, screening, eligibility, enrollment, retention) against a priori benchmarks. The study is ongoing, with recruitment from August 2025 to January 2027 and data collection projected to end in July 2027.
GBP (Ginkgo biloba extract with phosphatidylserine) improves delayed verbal memory and reaction time in healthy adults and those with moderate stress.
Two exploratory RCTs found that 480 mg/day of GBP for 4 weeks improved delayed verbal memory and reaction time versus placebo in healthy volunteers. A second study in adults with moderate stress showed mood benefits and a trend toward faster reaction times at both 240 mg and 480 mg doses.
ETAS reduces wake time after sleep onset in healthy adults dissatisfied with their sleep
In a randomized, placebo-controlled, double-blind crossover study, 14-day intake of ETAS (300 mg/day as ETAS50) did not significantly change the proportion of N3 sleep but significantly reduced wake time after sleep onset (WASO) and total time of N1 sleep. It also improved AIS scores for total score, awakenings during the night, and daytime functioning. Post-hoc analysis showed significant reductions in WASO for those with high baseline WASO and improved sleep efficiency in those with low baseline sleep efficiency.
A single session of intermittent hypoxia acutely reduces cortisol and leptin while increasing adiponectin levels in people with Parkinson's disease, without disrupting sleep behavior.
In a randomized, double-blind, crossover trial, 15 people with Parkinson's disease (pwPD) and 15 healthy controls underwent one session of intermittent hypoxia (IH) or normoxia. IH acutely decreased cortisol and leptin and increased adiponectin in pwPD, with no significant changes in BDNF, IL-6, or iron. No effects on sleep parameters were observed immediately post-IH, but total sleep time decreased 24 hours after IH versus the immediate post-session measurement in pwPD.
DLPFC-targeted rTMS reduces phantom limb pain and improves psychological comorbidities in traumatic amputees
In a pilot randomized controlled trial, 27 traumatic amputees with phantom limb pain received either real or sham rTMS applied to the dorsolateral prefrontal cortex (DLPFC) for 10 sessions over 2 weeks. Real rTMS was associated with improvements in pain intensity, anxiety, depression, and quality of life compared to sham, suggesting potential as an adjunctive therapy.
Virtual tourism multisensory stimulation improves cognitive function, neuropsychiatric symptoms, quality of life, and sleep in older adults with mild cognitive impairment
In a randomized controlled trial, 66 older adults with mild cognitive impairment received either 8 weeks of virtual tourism multisensory stimulation or waitlist control. The intervention group showed significant improvements in cognitive function, neuropsychiatric symptoms, quality of life, and sleep, with benefits sustained up to 16 weeks. Attrition was 6.06% and activity attendance was 81.25%.
Withania somnifera and Rhodiola rosea improve sleep quality in healthy individuals and patients with stress-related disorders
A systematic review of 24 RCTs (19 on W. somnifera, 5 on R. rosea) found that supplementation with standardized extracts improved sleep quality. Doses ranged from 120-1000 mg/day for W. somnifera and 290-1500 mg/day for R. rosea, with treatment lasting 3-16 weeks.
High-dose L-theanine-caffeine combination improves selective attention in acutely sleep-deprived young adults
A double-blind, placebo-controlled crossover trial found that a combination of 200 mg L-theanine and 160 mg caffeine significantly improved hit rate (P=0.02) and target-distractor discriminability (P=0.047) in a visual selective attention task compared to placebo. The combination also produced a significantly greater pre-post-dose reaction time improvement (38.1 ms, P=0.003) and enhanced P3b ERP amplitudes with reduced latencies.
Ashwagandha root extract sustained-release (AshwaSR) reduces perceived stress and improves sleep quality in healthy stressed adults
In a randomized, double-blind, placebo-controlled trial, AshwaSR 150 mg and 300 mg capsules significantly reduced Perceived Stress Scale scores by 38.6% and 41.6% respectively from baseline to day 60 (P < .001). Both doses also significantly improved sleep quality, psychological well-being, and eating behavior compared to placebo, with the 300 mg dose additionally reducing serum cortisol levels (P < .05).
Both VL-G-A57 (Rhodiola, holy basil, Schisandra chinensis) and VL-G-E12 (full-spectrum ashwagandha) improve sleep quality in individuals with high stress
In a 60-day randomized, double-blind, placebo-controlled trial involving 186 participants with high stress, both VL-G-A57 and VL-G-E12 significantly improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) compared to placebo (VL-G-A57: p=0.0008, VL-G-E12: p<0.0001). Restorative Sleep Questionnaire-Weekly (RSQ-W) results also showed significant improvements in both active groups versus placebo (p<0.0001).
Tart cherry juice consumption may increase sleep quantity in older adults with insomnia
Two preliminary pilot studies suggest that 2 weeks of daily tart cherry juice consumption (half dose morning, half at night) may increase sleep quantity in older adults with insomnia, as assessed by sleep diary or one night of polysomnography. The proposed protocol aims to evaluate feasibility of a longer 4-week intervention with doses closer to bedtime and daily objective sleep monitoring via wearable devices.
A hybrid digital intervention combining continuous monitoring with embedded RCTs is feasible for promoting healthy movement behaviors in university students.
This pilot study protocol describes a five-month hybrid design using Apple Watches and iPhones to monitor sleep, physical activity, and screen time in first-year university students, with three embedded RCTs testing ecological momentary interventions. Feasibility outcomes include recruitment, engagement, and user experience, with preliminary effectiveness explored for each movement behavior.
Green tea and its bioactive compounds may improve mood disorder symptomology, particularly symptoms of depression, but no evidence to date reports effects on BDNF.
A systematic review of 13 RCTs found that green tea, green tea extract, L-theanine, and EGCG improved depressive symptoms in 4 studies, anxiety in 6, stress in 5, and sleep in 1. No studies found a statistically significant effect on brain-derived neurotrophic factor (BDNF).
HMB added to EPA/DHA supplementation increases postabsorptive net protein breakdown in COPD patients
In a 10-week RCT, COPD patients receiving HMB + EPA/DHA showed a significant increase in postabsorptive net protein breakdown (p=0.028), while EPA/DHA alone did not. Both interventions increased lean soft tissue, but only HMB + EPA/DHA reduced whole body and extremity fat mass.
Blueberry juice improves total and LDL cholesterol and psychological wellbeing in adults
In a 20-day randomized controlled trial, 60 mL/day of blueberry juice significantly reduced total cholesterol from 4.36 to 3.79 mmol/L and LDL cholesterol from 2.71 to 2.23 mmol/L compared to placebo, which showed increases. Psychological wellbeing indices (Beck Depression Inventory, State Trait Anxiety Inventory, COOP WONCA) also improved significantly in the blueberry group.
Probiotic supplementation reduces hyperactivity and improves academic performance in adults with ADHD
A double-blind RCT found that a multi-strain probiotic supplement taken daily for three months significantly decreased hyperactivity, improved gastrointestinal symptoms, and enhanced academic performance in college students with ADHD. Age was a significant predictor, with younger participants showing greater overall benefits.
Montmorency tart cherry and blueberry juice consumption may improve cardiometabolic outcomes including systolic blood pressure, sleep efficacy, and other indices in healthy individuals.
This protocol describes a 20-day, single-blind, randomized placebo-controlled trial testing the effects of 60 mL/day of Montmorency tart cherry juice or blueberry juice versus a flavored placebo on cardiometabolic outcomes in 45 healthy individuals. Primary outcome is between-group difference in systolic blood pressure from baseline to post-intervention; secondary outcomes include sleep efficacy indices, anthropometric measures, energy expenditure, and psychological wellbeing. The study is registered and approved but results are not yet reported.
NNZ-2591 improves sleep in children and adolescents with Phelan-McDermid syndrome
In an open-label phase 2 trial, NNZ-2591 was associated with significant improvements in sleep assessments among 18 children and adolescents with Phelan-McDermid syndrome after 13 weeks of treatment. Sleep was one of 14 secondary efficacy endpoints, with significant improvement from baseline observed at week 13.
PPG-based wearable devices show varying heart rate measurement accuracy across exercise intensities, with Apple Watch SE and Polar Verity Sense demonstrating highest agreement with ECG reference
In 37 healthy young adults, heart rate accuracy of four PPG-based wearables was compared to ECG across exercise intensities. The Apple Watch SE and Polar Verity Sense had significantly lower mean absolute error (MAE) and higher concordance correlation coefficients (CCC) than Polar Pacer Pro and Galaxy Watch 6, with MAE decreasing as intensity increased.
Nighttime fasting intervals are not significantly associated with depressive symptoms during the perinatal period in women with overweight or obesity
In a secondary analysis of 232 pregnant individuals with pre-pregnancy BMI ā„25 kg/mĀ², nighttime fasting intervals (NFIs) remained stable across early pregnancy, mid-pregnancy, and 6 months postpartum (mean 12.7 hours). NFIs were not significantly associated with depressive symptoms overall, but at mid-pregnancy, long NFIs showed a geometric mean ratio of 0.84 (95% CI: 0.64-1.11) relative to middle NFIs, suggesting a potential but non-significant trend. After adjusting for sleep quality, longer NFIs were significantly associated with lower depressive symptoms in mid-pregnancy.
Objective sleep parameters are associated with cognitive performance in euthymic bipolar disorder
In 40 euthymic individuals with bipolar disorder, longer assumed sleep duration was negatively associated with overall cognitive performance (Ī² = -0.38, p = 0.011). Longer sleep onset latency was negatively associated with working memory (Ī² = -0.41, p = 0.014) and processing speed (Ī² = -0.38, p = 0.002), while greater wake time after sleep onset was negatively associated with verbal fluency (Ī² = -0.39, p = 0.016).
CGM-guided dietary titration improves Time in Range in GSD patients
In interventional settings, CGM-guided dietary titration improved Time in Range from 72% to 86% in gene therapy trials, and reduced serum triglycerides and liver size. CGM consistently identified asymptomatic hypoglycemia, with adult cohorts spending up to 12% of time below range despite normal spot checks.
Association rules derived from multimodal sleep data reveal significant co-occurrences between lifestyle interventions and sleep patterns in adults with mild-to-moderate OSA using a digital therapeutics application.
The study analyzed a 12-week digital intervention for 192 adults with mild-to-moderate OSA, combining sleep diary, smartwatch, and app engagement data. Using the Apriori algorithm, association rules with lift and confidence scores significantly higher than random chance were generated, showing co-occurrences between lifestyle missions and sleep diary or watch measurements.
A four-week combined respiratory muscle training and breathing exercise program improves sleep quality and reduces perceived stress in healthy university students.
A 4-week intervention combining diaphragmatic breathing, pursed-lip breathing, and threshold-loaded inspiratory/expiratory muscle training (40-60% maximal inspiratory pressure, 5 days/week) was associated with a 26% improvement in sleep quality (PSQI) and a 19% reduction in perceived stress (PSS) in 40 healthy university students (median age 22, BMI 23.14 Ā± 4.05 kg/mĀ²). Breath-holding time increased by 132% (p < 0.001, r = 0.87), and functional performance improved significantly (TUG decreased 9%, d_z = 1.01; STS improved 12%, d_z = 1.12).
Physical exercise is associated with better sleep quality in university students, mediated by reduced mobile phone addiction and rumination
A cross-sectional study of 1,300 university students found that physical exercise negatively predicted PSQI scores (Ī² = -0.022, p < 0.01), indicating better sleep quality. This association was mediated by a chain pathway through reduced mobile phone addiction and rumination.
Cheers Restore use is associated with improved next-day subjective well-being after alcohol consumption in healthy adults
In a decentralized observational cohort study of 90 adults, use of the dietary supplement Cheers Restore was associated with statistically significant improvements in next-day mental clarity, physical well-being, energy, and sleep quality compared to alcohol-only nights. Effect sizes were small (Cohen's d = 0.20-0.32). The study was observational and not designed to establish causality.
Metformin may improve sleep outcomes in older adults with type 2 diabetes, particularly those with poor baseline sleep quality.
This narrative review suggests that metformin use in older adults with T2DM is associated with modest improvements in sleep-related outcomes, especially among patients with Pittsburgh Sleep Quality Index scores above 5. The evidence is based on observational studies and mechanistic plausibility, with no dedicated randomized controlled trials available.
High-dose melatonin (30 mg/day) is safe and feasible but does not accelerate early biochemical or radiographic bone healing after tibial fracture fixation within 49 days
In a prospective controlled study, 25 adults with closed tibial shaft fractures received either 30 mg/day melatonin for 49 days post-surgery or standard care. Both groups showed significant increases in ALP and RUST scores over time, but no significant between-group differences were found for ALP (p=0.324) or RUST (p=0.261). The intervention was well tolerated with high adherence (91.7%) and no serious adverse events.
Prenatal PFOA exposure is associated with modestly higher sleep problem scores in early childhood
In a cohort of 2,836 mother-child pairs, higher prenatal PFOA concentrations were associated with higher CBCL Sleep Problems T-scores in children aged 1-5 years (Ī²=0.13; 95% CI: 0.05, 0.21). Associations for PFOS, PFNA, and PFHxS were small and not statistically significant.
Low-sodium oxybate reduces daytime sleepiness and improves nighttime sleep in participants with narcolepsy
In a phase 4 open-label study of 34 participants with narcolepsy (type 1 or 2), low-sodium oxybate (LXB) significantly reduced daytime sleepiness, with a least-squares mean change in Epworth Sleepiness Scale score of -7.7 (P < 0.0001). Nighttime sleep improvements included a 45-minute increase in deep sleep (N3 duration), a reduction in transitions to lighter sleep stages by 13.1, and 3.2 fewer nocturnal awakenings.
Adherence to two or more 24-h movement behavior guidelines reduces hypertension risk in adolescents
Adolescents who adhered to two or more movement behavior recommendations (physical activity, screen time, sleep) had a reduced risk of hypertension (RR=0.31; 95% CI: 0.09-0.98) compared to those meeting fewer guidelines. This association was not modified by social determinants of health.
Indirect antibiotic exposure during delivery is associated with a higher daytime-to-nighttime sleep ratio and fewer nighttime awakenings in infants at 2 and 6 months.
In a prospective birth cohort study of 192 infants, maternal antibiotic use during delivery was associated with a higher daytime-to-nighttime sleep ratio and fewer nighttime awakenings at 2 and 6 months of age. Effect sizes were small to moderate, indicating subtle alterations in sleep behavior rather than overt sleep disturbance.
Poor sleep is an independent predictor of musculoskeletal pain prevalence and burden in university students
A cross-sectional study of 9,122 university students found that poor sleep was the strongest independent predictor of both MSP prevalence (OR=2.81, 95% CI: 2.26-3.49) and pain burden (OR=3.72, 95% CI: 2.86-4.83). MSP prevalence was 58.7%, with neck, back, and shoulders most affected.
Nearly all patients with chronic pain experience sleep-wake disturbances, with none achieving 85% sleep efficiency.
In a cohort of 100 patients with chronic pain, 95% had poor sleep quality based on PSQI scores, 67% had clinical insomnia (ISI ā„ 15), and average sleep efficiency was 64% (range 28-81%). A significant correlation was found between sleep efficiency and physical activity level (rs=0.31, 95% CI 0.10-0.50).
Children with autism spectrum disorder and comorbid sleep disorder exhibit impaired perivascular neuroclearance linked to systemic iron deficiency.
In a study of 230 children with ASD (114 with sleep disorder, 116 without) and 110 typically developing controls, those with ASD and sleep disorder showed significantly reduced ALPS indices and elevated free water fraction, indicating impaired neuroclearance. Serum iron was markedly lower in this group, and mediation analysis supported a pathway from iron deficiency to cerebral edema to impaired neuroclearance.
Adherence to the Canadian 24-Hour Movement Guidelines is associated with lower all-cause mortality in adults with chronic kidney disease.
Among 5578 adults with CKD, meeting the MVPA or sedentary behavior recommendations individually was associated with lower all-cause mortality (MVPA: HR=0.48; SB: HR=0.75), while sleep alone was not significant. Combined adherence to all three components showed a strong protective effect (HR=0.45), particularly in adults aged ā„65 years.
A wearable-supported digital health intervention with personalized feedback and light incentives improves attitudes toward sleep and physical activity but shows limited behavioral change in a community setting
This proof-of-concept study tested a wearable device (Oura Ring or Fitbit) integrated with the Welloop app and light incentives in 130 participants (median age 49, 83% women) in Kobe, Japan. Attitudinal outcomes showed significant or near-significant improvements in perceived enjoyment and necessity of physical activity and a significant shift in dietary stage of change, while objective behavioral changes were modest (small improvements in exercise duration, walking time, reduced sleep procrastination) and mostly not statistically significant.
Sleep duration of approximately 7 hours on weekdays and at least moderate-intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- to high-intensity physical activity was associated with significantly lower fasting blood glucose and glycated hemoglobin, and may partially offset adverse glycemic effects of insufficient sleep.
Long-term melatonin therapy (ā„1 year) is associated with increased risk of new onset heart failure, heart failure requiring hospitalization, and all-cause mortality in adult insomnia patients
A single unpublished conference abstract reported a statistically significant increased risk of new onset heart failure, heart failure requiring hospitalization, and all-cause mortality associated with long-term melatonin therapy (one year or longer) in adult patients with insomnia. This observation has not undergone peer review or independent validation and is considered hypothesis-generating.
Blue-filtering lenses do not provide clinically meaningful improvements in sleep-related outcomes
The review found that blue-filtering lenses show small and inconsistent effects on sleep-related outcomes. Current evidence does not support the routine use of blue-blocking glasses for sleep improvement.
Lower serum ferritin levels within the normal range are strongly correlated with greater RLS symptom severity in drug-naive patients
In 113 drug-naive idiopathic RLS patients with serum ferritin within the laboratory reference range (22-322 Ī¼g/L), multiple regression analysis showed ferritin level (p < 0.001) and age (p = 0.001) were independent predictors of symptom severity. The median ferritin was 51.4 Ī¼g/L, and a very strong negative correlation was found between ferritin and RLS severity scores.
Disruptive mealtime behaviors, dietary supplements, and hyperactivity/noncompliance predict clinically significant insomnia symptoms in young children with autism spectrum disorder.
In a sample of 103 children with autism (mean age 5.8 years, 77.7% male), 33% had clinically significant insomnia symptoms (PAIRS ā„ 22). After adjusting for confounders, disruptive mealtime behaviors, parent health-related quality of life and family functioning, ABC subscales, and dietary supplements were significantly associated with insomnia symptoms; best subset modeling identified ABC hyperactivity/noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (ROC = 0.842).
Sleep quality improves across a competitive season in collegiate female rowers
This prospective observational study of 12 collegiate female rowers found that sleep quality significantly improved from early to late season (p = 0.009), with small-to-moderate effect sizes. Fatigue, confusion, and total mood disturbance also decreased significantly, while sleep quantity remained unchanged.
Depressive symptoms are negatively associated with both physical and mental health-related quality of life among physical education teacher education students
In a cross-sectional study of 168 physically active physical education teacher education students in Chile, depressive symptoms were negatively associated with both the physical component summary (PCS) and mental component summary (MCS) of HRQoL, with stronger associations for MCS. The model explained 61% of variance in MCS but only 6% in PCS, indicating mental health symptoms are more strongly linked to HRQoL than physical activity in this sample.
Children with autism and comorbid sleep disorder exhibit neuroclearance dysfunction linked to systemic iron deficiency
In a study of 230 children with ASD (114 with sleep disorder, 116 without) and 110 typically developing controls, those with ASD and sleep disorder showed significantly reduced ALPS indices and elevated free water fraction, indicating impaired perivascular clearance. Serum iron was markedly lower in the ASD-sleep disorder group, and mediation analysis supported a pathway from iron deficiency to cerebral edema to impaired neuroclearance.
Blue-blocking glasses do not provide clinically meaningful improvements in sleep-related outcomes
This narrative review found that blue-filtering lenses show small and inconsistent effects on sleep-related outcomes. Under typical viewing conditions, screen light exposure remains well below levels associated with photochemical retinal damage in experimental models. The review concludes that current evidence does not support the routine preventive or therapeutic use of blue-blocking glasses.
Prescribed sleep medication use is prevalent (20.9%) among children and young people experiencing mental health crises, and is associated with longer length of stay, trauma-related psychiatric conditions, and polypharmacy.
In a cross-sectional study of 201 children and young people (CYP) attending a mental health crisis service in Sydney, 20.9% were prescribed sleep medications (e.g., melatonin, benzodiazepines). Multivariate regression showed that longer length of stay (AOR=3.61), trauma-related psychiatric conditions (AOR=2.81), and polypharmacy (AOR=11.36) were significantly associated with increased prescribed sleep medication use.
Elevated VE/VCO2 slope predicts higher mortality in hypersensitivity pneumonitis
In patients with hypersensitivity pneumonitis, an elevated VE/VCO2 slope (ā„42) was associated with a higher risk of 5-year mortality (HR 3.65; 95% CI 1.04 to 12.80). Restricting analysis to HP patients showed a similar hazard ratio of 5.49 (95% CI 1.19 to 33.54).
Initiating novel hypnotics in BZRA users reduces BZRA use, but success declines with longer prior BZRA use
In a retrospective cohort study of 190 patients on BZRA hypnotics who initiated novel hypnotics, 46% achieved BZRA reduction at 1 year. Success rates were significantly higher in patients with less than 1 year of prior BZRA use (69%) compared to those with 1 year or more (36%).
Smartphone addiction and sedentary time are associated with poorer sleep quality and more frequent neck/shoulder symptoms in university students
In a cross-sectional study of 585 university students, higher smartphone addiction and longer sedentary time were associated with higher PSQI scores, a higher prevalence of poor sleep (43.8%), and a higher prevalence of neck/shoulder symptoms (46.2%). Meeting physical activity recommendations was associated with lower PSQI scores and lower prevalence of poor sleep but not with neck/shoulder symptoms.
Circadian rhythm sleep disorder is associated with an increased risk of open-angle glaucoma, and melatonin use may reduce this risk.
In a retrospective cohort study of 24,730 matched pairs, patients with circadian rhythm sleep disorder had a significantly higher risk of open-angle glaucoma at 5 years (0.27% vs. 0.08%; aHR 2.88, 95% CI 1.78-4.66). Among melatonin users, the risk was not significantly different from controls, suggesting a potential protective effect of melatonin.
Organized sports participation is associated with higher physical activity levels and lower BMI in Saudi male adolescents, but also with shorter sleep duration.
Among 124 Saudi male adolescents (70 athletes, 54 non-athletes), athletes had significantly higher physical activity levels (98.6% vs 55.6% meeting guidelines) and lower BMI (23.64 vs 29.69 kg/m2). However, athletes reported shorter average sleep duration (9.06 vs 11.28 hours per day), though both groups exceeded 8 hours. No significant difference was found in daily screen time.
A remote physical activity intervention improves physical activity and quality of life but has limited effects on sleep quality and musculoskeletal symptoms in Brazilian education professionals.
A 12-week remote physical activity intervention using motivational messages delivered via digital platforms significantly increased light, moderate, vigorous, and total physical activity in education professionals. Quality of life improved in physical, psychological, and environmental domains, but overall sleep quality did not change significantly, while sleep duration worsened slightly. Upper back pain decreased significantly, but other musculoskeletal symptoms showed no significant improvement.
Good sleep quality increases live birth probability by 12% in IVF-ET patients
The review found a significant positive correlation between sleep quality and pregnancy outcomes in IVF-ET patients. Women with good sleep quality had a 12% higher probability of live birth compared to those with poor sleep quality. Poor sleep quality was identified as an independent risk factor for pregnancy failure in females and reduced semen quality in males.
Serum magnesium level is associated with cognitive function in Palestinian elderly
In a cross-sectional study of 200 older adults (mean age 64.6 years), serum magnesium levels showed a substantial correlation with cognitive function as measured by the MoCA score. The mean MoCA score was 24.5 Ā± 3.66, and magnesium levels were also associated with smoking status and instrumental activities of daily living (IADL), but not with activities of daily living (ADL) or other factors like sleep quality.
Physical exercise reduces bedtime procrastination in college students through a chain mediation of self-control and time management tendencies
A survey of 1,069 college students found that physical exercise negatively predicted bedtime procrastination (Ī² = -0.158, p < 0.01). Self-control and time management tendencies mediated this relationship in a chain pathway: physical exercise ā self-control ā time management tendency ā bedtime procrastination.
Higher magnesium intake is associated with lower odds of insomnia symptoms in adults without diabetes
In Puerto Rican adults without diabetes, higher total magnesium intake (per 100 mg/d) was associated with 58% lower odds of insomnia symptoms (OR 0.42, 95% CI 0.23-0.79), and magnesium supplement users had 63% lower odds compared to nonusers (OR 0.37, 95% CI 0.17-0.81). This association was not observed in participants with diabetes (P-interaction < 0.05).
Epilepsy is associated with reduced REM sleep in children, with the effect strongest under age 6 and amplified by antiseizure medications
In a propensity score-matched cross-sectional study of 560 children with epilepsy and 560 non-epilepsy clinical comparators, children with epilepsy had significantly reduced REM sleep (median 18.2% vs 20.9%, g=-0.32, FDR p<0.001). The REM deficit was amplified by antiseizure medication use (15.8% vs 19.8%, g=-0.48, p<0.001) and followed a developmental gradient, being strongest in children under 6 years (g=-0.38) and not detected in those over 12 years (g=-0.07, p=0.953).
Semaglutide 2.4 mg reduces the incidence of obesity-related complications and is cost-effective in Japan under retreatment scenarios.
In a lifetime economic model from a Japanese public payer perspective, semaglutide 2.4 mg plus diet and exercise reduced the incidence of obesity-related complications such as type 2 diabetes, cardiovascular events, obstructive sleep apnea, and gout compared to diet and exercise alone. The incremental cost-effectiveness ratio was Ā„5,300,580/QALY for patients without type 2 diabetes and Ā„7,077,984/QALY for those with type 2 diabetes, with retreatment improving QALY gains.
Meal enjoyment, social interaction, and outing frequency are associated with handgrip strength in older women after adjusting for age
In a cross-sectional study of 2206 community-dwelling older women, higher handgrip strength was associated with younger age and more favorable lifestyle behaviors. After adjusting for age, meal enjoyment (p=0.024), social interaction (p=0.001), and outing frequency (p=0.017) remained significantly associated with handgrip strength, while sleep quality (p=0.073) and exercise frequency (p=0.060) did not. Higher lifestyle scores were significantly associated with higher handgrip strength.
Asthma predicts higher risk of depression, anxiety, and their comorbidity in Australian men
In a retrospective cohort study of 16,021 Australian men followed from 2014 to 2022, self-reported asthma was associated with significantly higher risks of depression (RR=1.23), anxiety (RR=1.12), and comorbid depression with anxiety (RR=1.27). The highest prevalence of comorbid depression and anxiety was observed in 2020.
THC/CBD combination reduces Restless Legs Syndrome severity in patients with multiple sclerosis and idiopathic RLS
In an exploratory open-label trial, 2.7 mg THC/2.5 mg CBD significantly improved IRLS scores after 1 and 3 months (p<0.001), with sustained improvement at 1 year in 66.66% of patients. Wake after sleep onset was also significantly reduced (p=0.015).
Walking habit reduces colorectal cancer risk in adults in Hunan, China
In a case-control study of colorectal cancer (CRC) patients and matched controls in Hunan, China, participants with a walking habit had a significantly lower risk of CRC compared to those without (OR=0.533, 95% CI: 0.392-0.725, P<0.001). This protective effect was observed after adjusting for gender and age.
Financial strain is associated with poorer sleep outcomes, with stronger associations among Asian individuals, particularly Pakistani individuals, compared to White individuals.
This longitudinal study of 36,544 individuals (114,164 person-years) from the UK Household Longitudinal Study found that financial strain was associated with poorer sleep quality, sleep disturbance, daytime dysfunction, sleep latency, and sleep medication use. The association was stronger among Asian individuals compared to White individuals, with the effect most pronounced in Pakistani individuals.
Sleep-timing mismatch (MSFsc-lights-off interval) predicts poorer objective sleep initiation, continuity, and REM architecture in a clinical population under a fixed laboratory schedule
In 645 clinically referred adults undergoing polysomnography under a fixed schedule (lights-off 21:30, lights-on 06:00), a greater mismatch between individual sleep midpoint (MSFsc) and lights-off time was independently associated with longer sleep onset latency, lower sleep efficiency, higher N1 sleep, and lower REM percentage. These associations were most pronounced in patients with later MSFsc and remained significant after adjusting for age, sex, BMI, AHI, and insomnia severity.
SGLT2 inhibitors reduce acute kidney injury incidence in patients with diabetes mellitus receiving cisplatin chemotherapy
In a retrospective study of 288 patients with diabetes mellitus receiving cisplatin, those taking SGLT2 inhibitors had a significantly lower incidence of acute kidney injury (13.9% vs 28.5%, OR 0.42, 95% CI 0.23-0.76). The SGLT2 inhibitor group also showed higher eGFR at 3 months and lower rates of hypomagnesemia and anemia.
Sleep duration of approximately 7 hours on workdays and at least moderate-intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- to high-intensity physical activity was associated with significantly lower fasting blood glucose and glycated hemoglobin, and could partially offset the adverse glycemic effects of insufficient sleep.
Moderate-to-vigorous physical activity combined with optimal sleep duration (6-8 h/night) is associated with the lowest risk of falls in Chinese older adults
Among 10,232 Chinese adults aged 60+, moderate-to-vigorous physical activity (MVPA) was associated with 15.8% lower odds of falls (OR=0.842, 95% CI: 0.745-0.952) compared to low physical activity. The combination of MVPA and optimal sleep (6-8 h) was associated with the lowest fall risk (OR=0.524, 95% CI: 0.440-0.626) relative to the reference group.
Advanced age, prolonged hypertension duration, severe hypertension, sedentary lifestyle, and frequent pre-bedtime electronic device use are independently associated with sleep disorders in elderly hypertensive patients.
In a cross-sectional study of 528 elderly hypertensive patients, the prevalence of sleep disorders was 39.02%. Multivariate logistic regression identified advanced age (ā„70 years), prolonged hypertension course (ā„10 years), high hypertension grade (grade 2-3), lack of regular exercise, and frequent pre-bedtime electronic device use (ā„3 times/week) as independent factors associated with sleep disorders (all P < 0.001).
Longer nocturnal sleep duration is associated with higher personal-social development and communication scores in 12-month-old Iranian infants
In a sample of 646 Iranian infants, longer nocturnal sleep duration was significantly associated with higher personal-social development scores (Ī²=0.52, p=0.03) and better communication scores (Ī²=0.42, p=0.05). Increased night waking duration was negatively associated with personal-social (Ī²=-0.92, p<0.001) and total ASQ scores (Ī²=-2.01, p=0.004).
High parental perceived stress is associated with increased obesity risk in Spanish children and adolescents
Children of parents with high perceived stress had a higher prevalence of obesity (4.0% vs 1.6%) compared to those with low-stress parents, with an adjusted odds ratio of 2.76 (95% CI, 1.08-7.06; P = .03). The study also found positive linear associations between parental stress and children's BMI z-score and waist-to-height ratio.
Long sleep duration is associated with sarcopenia in community-dwelling older adults, with a stronger association in those with lower physical activity
In a cross-sectional study of 2855 older adults (mean age 75.6 years), those sleeping ā„9 hours had higher odds of sarcopenia (OR 2.09, 95% CI 1.01-4.29) after adjusting for covariates. The association was stronger in participants with lower moderate-to-vigorous physical activity (OR 3.34, 95% CI 1.21-9.21) and not significant in those with higher activity (OR 1.37, 95% CI 0.47-3.99).
Both regular exercise and weekend warrior activity patterns are associated with better physical health in adolescents compared to insufficient activity, with no significant difference between the two patterns.
In a cross-sectional study of 1,070 Tibetan and Han adolescents aged 12-18, both regular exercise (ā„60 min/day of MVPA on most days) and weekend warrior patterns (ā„60 min/day on fewer days) were associated with better physical health scores compared to insufficient activity. The odds ratios were 2.193 (95% CI: 1.324-3.633) for regular activity and 3.278 (95% CI: 1.386-7.749) for weekend warrior pattern, with no significant difference between them (p=0.417).
Hericium erinaceus supplementation improves symptoms of sleep disorders
A systematic review of five RCTs and three pilot clinical trials found that Hericium erinaceus (Lion's Mane mushroom) reduced symptoms of sleep disorders. The review also reported cognitive improvements, with a combined weighted mean increase of 1.17 on the Mini-Mental State Examination in intervention groups.
Higher dietary intake of lignans and hydroxycinnamic acids is associated with better sleep quality in Italian adults
In a cohort of 1936 Italian adults, higher dietary intake of lignans and hydroxycinnamic acids was significantly associated with lower odds of inadequate sleep quality, as measured by the Pittsburgh Sleep Quality Index. Specific compounds naringenin, apigenin, and matairesinol also showed inverse associations. The association was stronger in normal-weight individuals, while no significant associations were found in overweight/obese individuals.
Circadian rhythm sleep disorder increases risk of open-angle glaucoma, but melatonin use may reduce this risk
In a retrospective cohort study of 24,730 matched pairs, patients with circadian rhythm sleep disorder (CRSD) had a significantly higher risk of open-angle glaucoma (OAG) at 1 year (0.14% vs. 0.04%; aHR 2.67), 3 years (0.25% vs. 0.07%; aHR 3.02), and 5 years (0.27% vs. 0.08%; aHR 2.88). Among CRSD patients using melatonin, the risk of OAG was not significantly different from controls, suggesting a potential protective effect of melatonin.
Poorer sleep quality and lower quality of work life are independently associated with greater missed perioperative nursing care among operating room technologists.
In a cross-sectional study of 332 operating room technologists, poorer sleep quality (B=0.85, Ī²=0.14, p=0.012) and lower quality of work life (B=-0.12, Ī²=-0.15, p=0.021) were independently associated with greater missed perioperative nursing care. The final regression model explained 33.8% of the variance in missed care.
Higher educational attainment is associated with better cardiometabolic markers and health behaviors in a large Japanese population.
In a cross-sectional study of 61,684 Japanese adults, higher education levels were generally associated with better cardiometabolic markers (e.g., lower waist circumference, BMI, blood pressure) and healthier behaviors (e.g., less smoking, more exercise), though also linked with higher LDL cholesterol. Associations were stronger in women and middle-aged participants (39-64 years).
Eating jetlag is not associated with adiposity in preschool children overall, but among those with high social jetlag, greater morning latency jetlag is associated with higher BMI z-score and waist-to-height ratio.
In a cross-sectional study of 639 Finnish preschoolers (3-6 years), eating jetlag indicators were not associated with adiposity in the full sample. However, among children with high social jetlag (median 62 min), greater morning latency jetlag was associated with higher BMI z-score (Ī²=0.83, 95% CI: 0.19 to 1.46) and higher waist-to-height ratio (Ī²=0.035, 95% CI: 0.013 to 0.058).
Fatigue in children with ESR-JIA is associated with lower muscle mass, weaker ankle plantarflexor strength, higher pain intensity, depression-related cognitive changes, and poorer sleep efficiency.
In a cross-sectional study of 77 children with enthesitis/spondylitis-related juvenile idiopathic arthritis (ESR-JIA), fatigue severity was independently associated with pain intensity, depression-related cognitive changes, ankle plantarflexion strength, and sleep efficiency. These factors collectively explained 33.6% of the variance in fatigue scores measured by the PedsQL-MFS.
Eating jetlag is associated with adiposity in preschool children only when social jetlag is high, with direction varying by indicator
In a cross-sectional study of 639 Finnish preschoolers (3-6 years), eating jetlag indicators were not associated with BMI z-score or waist-to-height ratio in the full sample. However, among children with high social jetlag (median 62 min), greater eating midpoint jetlag was associated with lower BMI z-score (Ī²: -0.65, 95% CI: -1.21 to -0.10), while greater morning latency jetlag was associated with higher BMI z-score (Ī²: 0.83, 95% CI: 0.19 to 1.46) and higher waist-to-height ratio (Ī²: 0.035, 95% CI: 0.013 to 0.058).
Probable respiratory sarcopenia is independently associated with reduced exercise capacity in elderly smokers
In a COPD-enriched smoking cohort, probable respiratory sarcopenia (defined as respiratory muscle weakness plus low muscle mass) was identified in 12% of participants. This group showed significantly impaired physical performance, including reduced gait speed, 6-minute walking distance (6MWD), and knee extension strength, with probable respiratory sarcopenia independently associated with lower 6MWD (Ī² = -0.24; p = 0.02) after adjusting for confounders.
Bilingual health education improves dietary behavior and metabolic indicators in obese Mongolian adolescents
A 6-month Mongolian-Chinese bilingual health education intervention for 111 obese adolescents (from 2,210 screened) significantly improved dietary choices, exercise habits, sleep patterns, and metabolic profiles. Fasting blood glucose, total cholesterol, and LDL-C levels were significantly reduced, with abnormal LDL-C and total cholesterol prevalence dropping to 0% at 6-month follow-up.
Easier access to biologics is associated with a greater likelihood of achieving clinical remission and other favorable outcomes in severe asthma
This ecological study of 9,183 severe asthma patients from 21 countries found that countries with easier access to biologics (higher Biologic Accessibility Score, BACS) had higher proportions of patients achieving clinical remission (pā¤0.001), no exacerbations (p<0.001), well- or partly controlled asthma (p=0.047), ppFEV1 or ppPEFR ā„80% (p=0.004), and no long-term oral corticosteroid use (p=0.045) one year after biologic initiation. The findings suggest that reducing barriers to biologic access may improve outcomes, but causality requires further confirmation.
Physical activity is associated with better sleep quality in adolescents, mediated by psychological resilience and academic stress, and moderated by peer support.
In a cross-sectional study of 1,347 high school students in Shanghai, physical activity was negatively associated with PSQI scores (indicating better sleep quality), with a direct association (Ī² = -0.202, 61.3% of total effect) and indirect associations through psychological resilience (Ī² = -0.053, 16.0%), academic stress (Ī² = -0.040, 12.1%), and the serial pathway of resilience and academic stress (Ī² = -0.035, 10.6%). Peer support weakened the positive association between academic stress and PSQI scores.
Reallocating 30 minutes of sedentary behavior to sleep or physical activity is associated with reduced depressive and anxiety symptoms in Chinese adolescents, particularly among those with insufficient sleep.
In a cross-sectional study of 7,767 Chinese adolescents, replacing 30 minutes of sedentary behavior with sleep was associated with lower depression (B = -0.47) and anxiety (B = -0.31) scores. Replacing sedentary behavior with physical activity also reduced symptoms (depression B = -0.12, anxiety B = -0.07). Associations were stronger in adolescents with insufficient sleep.
Suboptimal sleep duration and inadequate physical activity are associated with increased waist circumference and central obesity risk in Chinese adults
In a large Chinese cohort (106,518 participants), both short (<7 h/day) and long (ā„9 h/day) sleep durations were associated with higher waist circumference and increased risk of central obesity compared to optimal sleep (7-<9 h/day). Joint analyses showed that individuals with inadequate physical activity and short sleep had the highest waist circumference and central obesity risk.
Perinatal antibiotic exposure during delivery is associated with altered sleep behavior in infants at 2 and 6 months of age.
In a prospective birth cohort study of 192 infants, indirect antibiotic exposure during delivery was associated with a higher daytime-to-nighttime sleep ratio and fewer nighttime awakenings at 2 and 6 months. Effect sizes were small to moderate, suggesting subtle alterations in sleep behavior rather than overt sleep disturbance.
Brief bedside PPG-HRV, particularly HF-related indices such as lnHF and HFnorm, provides auxiliary physiological information related to pain, sleep disturbance, and depressive symptoms in hospitalized adults with chronic pain.
In a cross-sectional study of 172 inpatients with chronic pain, lnHF was significantly associated with pain, sleep disturbance, and depression. Random-forest models showed the strongest predictive performance for sleep disturbance (RĀ²_CV = 0.844), followed by depression (RĀ²_CV = 0.696) and pain-related burden (RĀ²_CV = 0.506).
Higher apnoea-hypopnoea index is associated with reduced exercise capacity and increased all-cause mortality in a general population
In a population-based study of 1001 participants, a higher AHI was inversely associated with peak oxygen uptake (V'O2 peak) and significantly associated with all-cause mortality over a median 10.3-year follow-up (hazard ratio 1.31-1.72). Mediation analysis suggested a possible but non-significant indirect effect via reduced exercise capacity.
Psychological resilience and job satisfaction are protective factors, while nursing stress, night shift frequency, and poor sleep quality are risk factors for burnout among ICU nurses.
A machine learning model using nine predictors identified burnout in ICU nurses with an AUC of 0.983 and Brier score of 0.054. Psychological resilience (SHAP value 0.197) and job satisfaction (0.152) were primary protective factors, while nursing stress (0.059), night shift frequency (0.016), and poor sleep quality (0.015) were key risk factors.
Post-concussion clinical insomnia is associated with prolonged recovery time in children and adolescents with persistent post-concussion symptoms
In a prospective longitudinal study of 20 children and adolescents with persistent post-concussion symptoms, 45% also had post-concussion clinical insomnia (PCCI). Recovery time was three times longer for those with PCCI (median 150 days) compared to those without (median 47 days), and mood disturbance significantly predicted sleep disturbance at 4-week follow-up.
Asthma predicts increased risk of depression, anxiety, and their comorbidity in Australian men
In a retrospective cohort study of 16,021 Australian men followed from 2014 to 2022, self-reported asthma was associated with a 23% higher risk of depression (RR=1.23, 95% CI: 1.16-1.30), a 12% higher risk of anxiety (RR=1.12, 95% CI: 1.05-1.18), and a 27% higher risk of comorbid depression with anxiety (RR=1.27, 95% CI: 1.17-1.38). The highest prevalence of comorbid depression and anxiety was observed in 2020.
Participation in Japanese croquet and strength exercise is associated with a lower risk of developing dementia in older Japanese community-dwelling adults
In a prospective cohort of 5074 older Japanese adults, participation in Japanese croquet (adjusted HR 0.68, 95% CI 0.46-0.99) and strength exercise (adjusted HR 0.26, 95% CI 0.08-0.81) was significantly associated with a reduced risk of developing dementia over a 4-year follow-up, compared to non-exercisers. Other exercise types (calisthenics, walking, golf) did not show significant associations.
Caffeine use disorder has a direct effect on sleep problems and an indirect effect through depressive symptoms among university students
In a cross-sectional study of 530 Bangladeshi university students, nearly 72% reported caffeine consumption. Structural equation modeling showed that caffeine use disorder (CUD) had a significant direct effect on sleep problems and an indirect effect through depressive symptoms, while caffeine use motives did not directly affect sleep disturbance.
Sleep duration of approximately 7 hours on weekdays and moderate-to-high intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- and high-intensity physical activity were significantly associated with lower fasting blood glucose (Ī² = -2.76 and -3.22) and glycated hemoglobin (Ī² = -1.50 and -2.01) compared to low activity. Combined analysis showed that 'moderate sleep & high physical activity' on weekdays (Ī² = -3.57) and 'long sleep & high physical activity' on weekends (Ī² = -4.25) provided notable glycemic control benefits.
Hericium erinaceus reduces symptoms of sleep disorders
A systematic review of five RCTs and three pilot clinical trials found that Hericium erinaceus supplementation improved symptoms of sleep disorders, alongside benefits for depression, anxiety, and binge eating. The review included studies on participants with and without dementia, with cognitive improvements measured by a combined weighted mean increase of 1.17 on the Mini-Mental State Examination.
Healthy lifestyle is associated with higher life satisfaction among new university students
A cross-sectional study of 419 new undergraduate students at Tehran University of Medical Sciences found that those with healthy lifestyles had significantly higher odds of good life satisfaction (aOR = 1.91; 95% CI: 1.10, 3.35; p = 0.02). Each one-unit increase in lifestyle score was associated with a 28% increase in the odds of good life satisfaction (aOR = 1.28; 95% CI: 1.05, 1.57; p = 0.02).
Nocturnal sleep disturbances are associated with the severity of objective excessive daytime sleepiness in children and adolescents with narcolepsy type 1.
In a cross-sectional study of 114 children and adolescents with NT1, those with more severe daytime sleepiness (shorter mean sleep latency on MSLT) had progressively shorter nocturnal sleep latency, higher N1 sleep proportion, lower nocturnal oxygen saturation, and shorter mean REM sleep latency. Generalized linear models identified shorter nocturnal sleep latency, longer N1 sleep duration, higher arousal index, and higher periodic limb movements index as factors associated with shorter MSL.
Longer objective sleep duration is associated with worse cognitive performance in euthymic bipolar disorder
In 40 euthymic individuals with bipolar disorder, longer assumed sleep duration measured by actigraphy was negatively associated with overall cognitive performance (SCIP total score, Ī² = -0.38, p = 0.011), and longer total sleep time was negatively associated with delayed verbal learning (Ī² = -0.48, p = 0.003). Longer sleep onset latency was linked to worse working memory and processing speed, and more wake after sleep onset was linked to worse verbal fluency.
Healthy dietary practices, adequate sleep duration, and regular physical activity are associated with lower BMI, body fat percentage, and visceral fat levels in nursing intern students.
In a cross-sectional study of 801 nursing intern students, healthy lifestyle patterns including adequate sleep, regular physical activity, and healthy diet were significantly associated with lower BMI, body fat percentage, and visceral fat. Physical activity showed the strongest inverse association with BMI (r = -0.447, Ī² = -0.389), and the regression model explained 52% of BMI variance (RĀ² = 0.52, F = 48.72, p < 0.001).
Sleep physiology features from digital trackers predict next-day physical fatigue in healthy adults with moderate accuracy
This exploratory study found that sleep tracker-derived features, particularly respiratory rate and REM sleep duration, could predict next-day physical fatigue in healthy adults with an AUC of 0.75. Predictive performance was lower in neurodegenerative disease (AUC=0.62) and immune-mediated inflammatory disease cohorts, indicating limited generalizability to chronic disease populations.
Positional obstructive sleep apnea (POSA) is highly prevalent and characterized by lower BMI and a more favorable sleep and oxygenation profile independent of AHI.
In a retrospective analysis of 12,036 OSA patients, 66.3% had POSA and 27.8% had supine-exclusive POSA. Compared to non-POSA, POSA patients had lower AHI (24.1 vs. 44.4 events/h), lower BMI (29.2 vs. 31.4 kg/mĀ²), and after adjustment for AHI, showed shorter sleep latency, higher sleep efficiency, greater N3 proportion, improved oxygenation, and lower arousal index, with differences more pronounced at lower AHI levels.
Replacing 15 minutes of sleep or sedentary behavior with moving at any intensity reduces the risk of physical activity-related cancer in UK adults.
In a prospective analysis of 59,218 UK Biobank participants, replacing 15 minutes of sleep or sedentary behavior with moving at any intensity was associated with a 2% lower risk of PA-related cancer (HR 0.98, 95%CI 0.97-0.99). Greater moderate-to-vigorous physical activity, particularly vigorous activity, showed the most robust risk reduction.
Sleep disturbances and sleep latency are associated with metabolic syndrome in male Taiwanese workers
In a cross-sectional study of 348 Taiwanese workers, sleep disturbances and sleep latency were significant predictors of metabolic syndrome in men, while shift work and BMI were associated in women. The overall prevalence of metabolic syndrome was 26.4%, with higher rates in men (33.3%) than women (19.3%).
THC/CBD combination reduces RLS severity in patients with multiple sclerosis and idiopathic RLS
In an open-label trial, 2.7 mg THC/2.5 mg CBD significantly improved International Restless Legs Syndrome Rating Scale (IRLS) scores after 1 and 3 months (p < 0.001). Wake after sleep onset (WASO) also significantly decreased (p = 0.015), while sleep latency and sleep efficiency did not change significantly. After 1 year, 66.66% of patients remained on treatment with sustained IRLS improvement (p = 0.000).
Sleep physiology features from wearable trackers predict next-day physical fatigue in healthy adults with moderate discriminative capacity
The study evaluated the feasibility of using consumer- and research-grade sleep trackers to predict next-day fatigue and sleepiness in individuals with neurodegenerative and immune-mediated inflammatory diseases. In healthy adults, machine learning models achieved an AUC of 0.75 for predicting next-day physical fatigue, with respiratory rate and REM sleep duration as key features. Predictive performance was lower in chronic disease cohorts (AUC 0.62 for physical fatigue in NDD).
Objective sleep parameters are associated with distinct cognitive domains in euthymic bipolar disorder
In 40 euthymic individuals with bipolar disorder, actigraphy-measured sleep parameters were associated with cognitive performance. Longer assumed sleep duration was negatively associated with overall cognitive score (Ī² = -0.38, p = 0.011), longer sleep onset latency was negatively associated with working memory (Ī² = -0.41, p = 0.014) and processing speed (Ī² = -0.38, p = 0.002), and greater wake after sleep onset was negatively associated with verbal fluency (Ī² = -0.39, p = 0.016).
Intrahippocampal ripple propagation (RonO) is proportionally greater in less-irritative non-seizure onset zone hippocampus than in epileptogenic hippocampus.
In a study of 49 patients with hippocampal contacts, intrahippocampal propagation of ripples on oscillations (RonO, 80-250 Hz) was highest in less-irritative non-SOZ tissue (with <6 IED/min) compared to more-irritative non-SOZ (>6 IED/min) and SOZ tissue (p<0.05 and p<0.001, respectively). This suggests that RonO propagation may serve as a metric to quantify hippocampal epileptogenicity along a continuous spectrum.
Intrahippocampal ripple propagation proportion is highest in less-irritative non-seizure onset zone hippocampus compared to epileptogenic hippocampus
In a study of 49 patients (68 hemispheres) with hippocampal contacts, intrahippocampal propagation of ripples on oscillations (RonO, 80-250 Hz) was proportionally greater in less-irritative non-SOZ tissue (<6 IED/min) than in more-irritative non-SOZ (>6 IED/min) and seizure onset zone (SOZ) tissue. This suggests RonO propagation may serve as a metric to quantify hippocampal epileptogenicity along a continuous spectrum.
Higher dietary quality and physical activity are associated with better glycemic control in hospitalized patients with type 2 diabetes, with trait mindfulness (Act with Awareness) moderating these associations.
In a cross-sectional study of 400 hospitalized patients with T2DM, higher dietary scores were associated with lower HbA1c (Ī² = -0.019, 95% CI: -0.032 to -0.005) and fasting blood glucose (Ī² = -0.023, 95% CI: -0.042 to -0.003). Physical activity was negatively associated with HbA1c (Ī² = -0.002, 95% CI: -0.004 to 0.000) but not with FBG. Significant interactions with Act with Awareness were found for both outcomes.
Intrahippocampal ripple on oscillation (RonO) propagation is proportionally greater in less-irritative non-seizure onset zone tissue than in epileptogenic hippocampus
In 49 patients with hippocampal contacts, intrahippocampal RonO (80-250 Hz) propagation proportion was highest in less-irritative non-SOZ (low interictal epileptiform discharge rate) compared to more-irritative non-SOZ (p<0.05) and SOZ (p<0.001). This suggests RonO propagation may serve as a metric to quantify hippocampal epileptogenicity along a continuous spectrum.
Post COVID-19 condition is associated with lower health-related quality of life, more frequent fatigue, anxiety/depression, stress, loneliness, lower subjective cognitive functioning, and poorer sleep quality compared to non-PCC individuals.
In a cross-sectional study of 139 participants (87 with PCC, 52 without PCC), individuals with PCC reported significantly lower HRQoL (EQ-5D: p=0.005; VAS: p<0.001) and more frequent fatigue, anxiety/depression, stress, loneliness, lower subjective cognitive functioning, and poorer sleep quality (p<0.05). Objectively measured pulmonary function, metabolic health, and cognitive tests did not differ between groups, indicating a discordance between subjective burden and objective assessments.
Fatigue and pruritus in patients with primary biliary cholangitis are associated with increased comorbidities, healthcare resource use, and costs.
This US matched case-control study found that PBC patients with fatigue or pruritus had significantly more comorbidities (e.g., anxiety, depression, sleep disorders) at 1, 3, and 5 years post-index compared to those without these symptoms. They also had 1.6 to 6.1 times more healthcare visits and total healthcare costs were over $40,000 higher per patient per year.
Resistance exercise training improves vascular and autonomic function in individuals with chronic anxiety and high sleep irregularity
A retrospective analysis of 20 young adults with chronic anxiety who completed 10 weeks of resistance exercise training found that those with high total sleep time irregularity (ā„67.67 minutes) showed significant improvements in flow-mediated dilation (p < 0.01) and cardiovagal baroreflex sensitivity (p = 0.04), while those with low irregularity showed no significant changes. This suggests resistance exercise training may be particularly effective for higher-risk anxiety phenotypes with sleep irregularity.
Asthma is associated with increased risk of depression, anxiety, and their comorbidity in Australian men
In a retrospective cohort study of 16,021 Australian men followed from 2014 to 2022, self-reported asthma was significantly associated with higher risks of depression (RR=1.23), anxiety (RR=1.12), and comorbid depression with anxiety (RR=1.27). The highest prevalence of comorbid depression and anxiety (28%) was reported in 2020.
Electronic device use, sleep habits, and commuting patterns are associated with neck pain in Chinese adults
This multicentre cross-sectional study of 6,969 Chinese adults found that computer use for work ā„2 hours/day (OR=1.39), smartphone use for work ā„3 hours/day (OR=1.21), smartphone screen below eye level (OR=1.16), and firm mattress (OR=1.19) were associated with increased odds of neck pain. Sleeping ā„7 hours/day (OR=0.79), supine sleeping (OR=0.87), and walking as primary transportation (OR=0.80) were associated with decreased odds.
Cannabis-based medicinal products improve sleep quality in autistic adults over 18 months
In an observational case series of 130 autistic adults from the UK Medical Cannabis Registry, sleep quality as measured by the SQS improved significantly from baseline to 18 months (p < 0.001). The study also found improvements in anxiety and health-related quality of life, but these are associations due to the lack of a control group.
Intrahippocampal ripple propagation is proportionally greater in less-irritative non-seizure onset zone tissue than in epileptogenic hippocampus.
In a study of 49 patients with hippocampal contacts, intrahippocampal propagation of ripples on oscillations (RonO, 80-250 Hz) was highest in less-irritative non-SOZ tissue (less than 6 IED/min) compared to more-irritative non-SOZ (p<0.05) and seizure onset zone (p<0.001). This suggests RonO propagation may serve as a metric for hippocampal epileptogenicity along a continuous spectrum.
Duloxetine treatment improves sleep quality and reduces serum pro-inflammatory cytokine levels in patients with major depressive disorder
After 4 weeks of duloxetine treatment (40-60 mg/day), patients with MDD showed significant improvements in sleep parameters including increased total sleep time (TST) and sleep efficiency (SE), and decreased wake after sleep onset (WASO). Serum levels of pro-inflammatory cytokines IL-1Ī², IL-8, IL-12, and IFN-Ī³ were significantly reduced. Baseline correlations and concurrent changes in sleep and cytokine levels suggest a link between sleep improvement and inflammatory regulation during duloxetine intervention.
The GLIDE-C digital therapeutic program integrating CGM with personalized lifestyle coaching reduces HbA1c in adults with mildly uncontrolled type 2 diabetes.
In a prospective observational cohort study of 18 adults with T2DM (baseline HbA1c 7.5%-9.5%), the GLIDE-C app-based intervention combining CGM with diet, exercise, and cognitive behavioral therapy led to a mean HbA1c reduction of 0.59% (P=.05) over 60 days. Postprandial glucose decreased by 25.42 mg/dL (P=.06), and time in range increased by 9.98%, with improvements in sleep quality (P=.04).
Nocturnal sleep disturbances, including shorter sleep latency, longer N1 sleep duration, higher arousal index, and higher periodic limb movements index, are associated with greater objective daytime sleepiness severity in children and adolescents with narcolepsy type 1.
In a cross-sectional study of 114 children and adolescents with NT1, those with more severe objective daytime sleepiness (shorter mean sleep latency on MSLT) had significantly shorter nocturnal sleep latency, higher N1 sleep proportion, lower nocturnal oxygen saturation, and more frequent REM-related abnormalities. Generalized linear models identified shorter nocturnal sleep latency, longer N1 sleep duration, higher arousal index, and higher periodic limb movements index as independent factors associated with shorter MSL.
Sleep physiology features from wearable trackers can predict next-day physical fatigue in healthy adults with moderate accuracy.
In a feasibility study of 134 participants (42 healthy, 39 NDD, 53 IMID) across 3,062 nights, machine learning models using sleep tracker data achieved an AUC of 0.75 for predicting next-day physical fatigue in healthy adults, with respiratory rate and REM sleep duration as key predictors. Predictive performance was lower in neurodegenerative disease (AUC=0.62) and immune-mediated inflammatory disease cohorts, indicating limited generalizability to chronic disease populations.
Liposuction for lipedema reduces benzodiazepine dependence in women with lipedema
In a prospective cohort study of 100 women with Stage I-III lipedema on stable benzodiazepine therapy, liposuction led to 77% of patients reducing or discontinuing benzodiazepine use at six months, with 32% stopping entirely. Average daily dosage decreased from 3.2 mg to 1.4 mg (p < 0.001), and significant improvements were seen in anxiety, pain, sleep quality, and body image.
Physical exercise is associated with reduced cognitive frailty in community-dwelling older adults, partially mediated by self-efficacy
In a cross-sectional study of 563 community-dwelling older adults in China, the prevalence of cognitive frailty was 21.3%. Physical exercise was directly associated with cognitive frailty and indirectly through self-efficacy, with the mediation effect accounting for 35.17% of the total effect.
Greater morning latency jetlag is associated with higher BMI z-score and waist-to-height ratio in preschool children with high social jetlag
In a cross-sectional study of 639 Finnish preschoolers (3-6 years), eating jetlag indicators were not associated with adiposity in the full sample. However, among children with high social jetlag (median 62 min, IQR 17), greater morning latency jetlag was associated with higher BMI z-score (Ī²: 0.83, 95% CI: 0.19 to 1.46) and higher waist-to-height ratio (Ī²: 0.035, 95% CI: 0.013 to 0.058).
Larger time zone changes, eastward travel, and evening arrivals are associated with poorer fatigue, sleep, and wellness in female national team footballers, but travel variables explain limited variance.
This observational study of 45 female national team footballers over 3 years (342 flights) found that larger time zone shifts, eastward travel, and evening arrivals were associated with increased fatigue, poorer sleep, and worse total wellness scores (P < .001 for time zone; P = .003 for fatigue direction; P = .001 for sleep direction; P = .026 for wellness direction). However, effect sizes were mostly small or trivial, and travel variables explained only 0.1% to 10% of variance in wellness ratings.
Mean apnea-hypopnea duration is an independent marker of oxygen desaturation and sleep disruption in OSA patients, beyond the Apnea-Hypopnea Index
In a study of 136 OSA patients, longer mean apnea-hypopnea duration (MAD) was associated with poorer oxygenation, lower average saturation, shorter sleep latency, less NREM3, more NREM1, and higher arousal index. After adjusting for AHI, MAD remained significantly associated with Epworth Sleepiness Scale, sleep latency, NREM1/3, arousal index, and all oxygen metrics, with stronger effects in severe OSA (n=90).
Poor sleep quality (PSQI > 9.5) is associated with increased odds of fall history in older adults with type 2 diabetes
In a cross-sectional study of 60 participants (30 with T2DM, 30 controls), PSQI was the only variable significantly associated with fall status within the T2DM group (OR = 1.239, 95% CI: 1.033ā1.488). ROC analysis showed PSQI had acceptable discriminative ability (AUC = 0.785, p = 0.010) with an optimal cut-off of 9.5, yielding 72.7% sensitivity and 84.2% specificity.
Poorer subjective sleep quality and greater pain interference are associated with intention to initiate medical cannabis among older adults with chronic pain
In a prospective cohort of 218 older adults with chronic non-cancer pain, 45% intended to start medical cannabis. Lower subjective sleep quality and higher pain interference were the strongest correlates of intention, with each unit decrease in sleep quality associated with a 69% increase in odds (ORa=1.69, CI [1.125, 2.604]) and each 10-unit increase in pain interference associated with a 13% increase in odds (ORa=1.13, CI [1.001, 1.283]).
Higher physical activity scores and healthier nutrition-related behaviors are associated with lower odds of insomnia among female nurses
In a cross-sectional study of 328 female nurses in Taiwan, higher physical activity scores (AOR=0.92, 95% CI: 0.85-0.99) and healthier nutrition-related behaviors (AOR=0.91, 95% CI: 0.84-0.98) were associated with lower odds of insomnia. Working 10-12 hours per day was associated with higher odds of insomnia (AOR=2.21, 95% CI: 1.20-4.07).
A logistic regression-based risk classification model can predict insomnia symptoms in community residents with satisfactory performance.
A machine learning model using logistic regression achieved AUC values of 0.812 in internal validation and 0.795 in external validation for classifying insomnia symptom risk. The top five contributing factors were sleep time, sleep latency, bedtime, health status, and age.
Evening chronotype is associated with greater social jetlag and higher obsessive-compulsive symptom scores in healthy adults.
In a cross-sectional study of 95 healthy adults, evening chronotypes had significantly longer social jetlag than morning or intermediate types (F=16.70, p<.001). Evening chronotype was also linked to higher obsessive-compulsive symptom scores (p=.027), though overall psychiatric distress did not differ across chronotypes.
Sleep medication use during ICU stay is strongly associated with continued prescription at hospital discharge in critically ill patients in Japan
Among 1,595,351 ICU patients, 30.8% received sleep medications during their ICU stay. Sleep medication use during ICU stay was strongly associated with sleep medication prescription at hospital discharge (odds ratio: 6.90; 95% CI: 6.59-7.23), with 47.0% of users versus 11.3% of nonusers receiving prescriptions at discharge.
Longer nocturnal sleep duration in infants is associated with higher personal-social and communication development scores at 12 months
In a cohort of 646 Iranian infants, longer nocturnal sleep duration was significantly associated with higher personal-social development scores (Ī²=0.52, p=0.03) and better communication scores (Ī²=0.42, p=0.05). Increased night waking duration was negatively associated with personal-social and total ASQ scores, while more frequent night wakings were linked to lower problem-solving scores.
Tonic motor activation (TOMAC) reduces periodic leg movements during sleep and improves sleep reinitiation in adults with medication-refractory restless legs syndrome.
In 20 adults with medication-refractory RLS, 30-minute mid-sleep TOMAC sessions led to rapid sleep reinitiation (median 6.7 minutes) in 82.8% of sessions, with a 47.9% reduction in PLMS/hour and a 70.8% reduction in PLMS associated with arousal/hour. EEG power analysis showed a transition towards deeper sleep during stimulation.
Pediatric hypnotic prescribing in Japan increased over the past decade, with a significant acceleration after the April 2020 COVID-19 state of emergency.
The proportion of children and adolescents prescribed hypnotics in Japan rose from 0.4% in 2014 to 1.0% in 2023. Interrupted time-series analysis showed a significant post-emergency slope increase of 3.64 prescriptions per 100,000 population per month (95% CI, 2.69 to 4.58; P < 0.001), though pre-existing trends were already evident.
THC/CBD reduces RLS severity in patients with multiple sclerosis and idiopathic RLS
Treatment with 2.7 mg THC/2.5 mg CBD significantly improved International Restless Legs Syndrome Rating Scale (IRLS) scores after 1 and 3 months (p < 0.001), with sustained improvement at 1 year (p = 0.000) in patients who continued therapy. Wake after sleep onset (WASO) was also significantly reduced (p = 0.015).
Melatonin amplitude is positively associated with sleep efficiency in Arctic residents
In 15 Arctic residents, melatonin amplitude showed a significant positive association with sleep efficiency (Ī² = 0.317, p < 0.037, Ī·Ā² = 0.10) after adjusting for photoperiod, while melatonin phase parameters (acrophase or DLMO) had no significant relationship. No seasonal variations in sleep efficiency were observed across winter solstice, spring equinox, and summer solstice.
Anticipatory financial strain is associated with sleep problems, partially mediated by loneliness
This longitudinal study found that worrying about future finances (anticipatory financial strain) was associated with higher loneliness and worse sleep quality and greater sleep disturbance in a large UK sample. Loneliness partially mediated the relationship between financial worry and these sleep outcomes. The study used fixed-effects regression models on 20,355 individuals over two waves (2018-2020 and 2021-2023).
Satisfactory sleep quality is associated with a lower risk of adolescent idiopathic scoliosis in Shanghai school students.
In a cross-sectional study of 5,026 students aged 9-15 in Shanghai, satisfactory sleep quality showed a protective association against screening-detected adolescent idiopathic scoliosis (AIS). The IPW-adjusted estimated population prevalence of AIS was 3.8%, with 162 confirmed cases. Multivariable logistic regression identified sleep quality as one of several modifiable factors associated with AIS.
Wearable sleep trackers show feasibility for predicting next-day physical fatigue in healthy adults using sleep physiology features.
This exploratory study found that machine learning models using sleep tracker data achieved an AUC of 0.75 for predicting next-day physical fatigue in healthy adults, with respiratory rate and REM sleep duration as key features. Predictive performance was lower in neurodegenerative disease (AUC=0.62) and immune-mediated inflammatory disease cohorts. The findings are preliminary and limited by outcome binarisation and small sample sizes.
Inpatient environmental noise management combined with mindful breathing regulation improves nocturnal blood pressure and sleep quality in patients with post-stroke sequelae of liver-yang hyperactivity type.
This retrospective cohort study of 200 patients found that adding noise management and mindful breathing regulation to conventional nursing significantly reduced nocturnal systolic and diastolic blood pressure and improved Pittsburgh Sleep Quality Index scores compared to conventional nursing alone after 4 weeks. The combined group also showed better emotional regulation, psychological stability, and environmental satisfaction.
Elite academy soccer players exhibit compromised sleep quality through fragmentation despite adequate sleep duration
This study of 13 elite U15 academy soccer players found that while total sleep time (431-541 min) and sleep efficiency (84.4%) met age-specific recommendations, wake after sleep onset (53.3 min) and number of awakenings (39.8) substantially exceeded thresholds for good sleep quality. Training days yielded significantly lower total sleep time (431 min) and time in bed (478 min) compared to non-training days (541 min and 596 min, respectively).
Greater variability of post-respiratory delta-band activity is associated with neurocognitive dysfunction in obstructive sleep apnea
In a secondary analysis of 1077 adults with OSA from the APPLES study, greater variability (instability) of post-respiratory delta-band EEG activity was independently associated with poorer global cognitive performance (Ī² = -1.50, 95% CI -2.30 to -0.71; p = 0.001) and reduced objective wakefulness (Ī² = -0.38, 95% CI -0.64 to -0.11; p = 0.005), after adjusting for AHI and other confounders. This suggests delta instability may be a marker of impaired cortical resilience to respiratory stress.
Sleep disturbances prospectively predict suicidal ideation in adults
In a prospective cohort study of 652 adults, sleep disturbance (PSQI ā„ 6) was associated with a nearly 4-fold increased odds of future suicidal ideation (OR = 3.97). This association remained significant after adjusting for depressive symptoms (OR = 1.59). Bidirectional associations were also observed.
Ticagrelor is associated with a greater than 7-fold increased risk of periodic breathing during exercise in coronary patients undergoing cardiac rehabilitation.
In a retrospective observational study of 84 coronary patients, ticagrelor was independently associated with a >7-fold increased risk of exercise-induced periodic breathing compared to thienopyridines (OR=7.17, 95% CI [2.31-25.19], p<0.001). Despite this ventilatory disturbance, ticagrelor did not impair gas exchange or aerobic capacity, and patients on ticagrelor had significantly higher peak VO2.
Negative illness perception is associated with increased insomnia in maintenance hemodialysis patients, partially mediated by fear of progression and moderated by self-compassion.
In a cross-sectional study of 332 maintenance hemodialysis patients in China, 55.72% reported insomnia. Illness perception was positively correlated with insomnia (r=0.629, p<0.01), and fear of progression mediated 17.5% of this relationship. Self-compassion moderated the effect, with higher self-compassion weakening the link between illness perception and fear of progression.
Daily social media use duration does not impact sleep outcomes in university students, but specific platforms like TikTok and Snapchat may influence bedtime and sleep onset latency.
In a 14-day longitudinal study of 62 university students, objective measures of social media use and sleep (via accelerometers and smartphone data) found no within- or between-participant effects of total daily social media duration on sleep duration, onset latency, efficiency, or bedtime. However, TikTok use was associated with later bedtime (positive between-participants effect), and Snapchat use was associated with shorter sleep onset latency (negative between-participants effect).
School connectedness is inversely associated with sleep disorders in adolescents, mediated by physical exercise and anxiety.
Among 519 adolescents aged 11-15 from northwestern Hunan, China, higher school connectedness was significantly correlated with fewer sleep disorders. This relationship was mediated by increased physical exercise and reduced anxiety, forming a chain mediation pathway.
Physical activity habit automaticity is prospectively associated with higher quality of life through lower psychological distress, moderated by exercise identity
In a three-wave longitudinal study of 1024 Chinese university students, higher physical activity habit automaticity at baseline was associated with lower psychological distress at the second wave (B = -0.503, p < 0.001), which in turn was associated with higher quality of life at the third wave (B = -0.086, p < 0.001). The indirect effect was significant (effect = 0.043, 95% CI [0.028, 0.059]), with a mediated proportion of 30.9%, and this indirect pathway was stronger among students with higher exercise identity.
Older age, female sex, smoking, and comorbidity are associated with lower accelerometer-measured physical activity in adults with cardiovascular diseases.
In a cross-sectional study of 1,484 Swedish adults aged 50-64 with cardiovascular diseases, being in the oldest age group (OR=0.59), female sex (OR=0.73), regular/occasional smoking (OR=0.37), and having one (OR=0.61) or more comorbidities (OR=0.45) were significantly associated with lower odds of higher moderate-to-vigorous physical activity levels. A healthy diet was associated with higher physical activity (OR=1.84).
Limited screen time is associated with the strongest improvement in physical fitness among children, followed by healthy eating, regular physical activity, and sufficient sleep.
In a nationwide cross-sectional study of 60,177 children in China, a higher Health Lifestyle Score (HLS) was significantly associated with better general physical fitness. Among individual lifestyle factors, limited screen time showed the strongest positive correlation (Ī²=1.34; 95% CI, 1.24 to 1.45), followed by healthy eating (Ī²=0.49; 95% CI, 0.39 to 0.59), regular physical activity (Ī²=0.40; 95% CI, 0.34 to 0.46), and sufficient sleep (Ī²=0.12; 95% CI, 0.04 to 0.20).
Longer sleep onset latency is significantly correlated with lower time in range in adults with cystic fibrosis-related diabetes
In a remote pilot study of 30 adults with CFRD, longer sleep onset latency measured by actigraphy was significantly correlated with lower time in range (TIR), indicating worse glycemic control. The study found that 76.7% of participants reported poor sleep quality, with 46.7% endorsing clinically significant insomnia symptoms.
Additive effects of lifestyle behaviors, rather than interactions, primarily drive type 2 diabetes onset, with each additional recommendation met progressively extending diabetes-free survival.
In 259,448 UK Biobank adults followed for up to 16 years, additive effects of fruit/vegetable intake, physical activity, sleep duration, alcohol consumption, and smoking explained about 93% of between-strata variance in T2D onset. Never smoking and meeting physical activity guidelines consistently characterized longer survival, and each additional recommendation met progressively extended T2D-free survival.
Probiotics containing L. brevis KABP052 increase circulating estrogens in postmenopausal women
A 12-week intervention with probiotics containing L. brevis KABP052 increased circulating estrogen levels by up to 26% in postmenopausal women, suggesting gut microbiome modulation can enhance endogenous estrogen activity. This provides a non-pharmacological strategy for managing estrogen decline.
Outpatient melatonin use is associated with a small reduction in REM sleep percentage in children
In a propensity score-matched cross-sectional study of 684 children, melatonin users had a lower median percentage of REM sleep than nonusers (16.7% vs 19.0%, Hedges g = -0.22, FDR-corrected P = .003). No significant differences were found in total sleep time, non-REM sleep stages, respiratory indices, arousal index, periodic limb movements, or oxygen desaturation index.
Higher maternal physical fitness is associated with a more favorable 24-hour movement behavior profile in preschool children, including greater sleep duration, higher physical activity, and lower sedentary time.
In a cross-sectional study of 161 preschool children aged 4-6 years, maternal physical fitness (moderate vs. low) was associated with increased child sleep duration (Ī²=0.41 h/night), higher total physical activity (Ī²=60.70 min/day), higher light physical activity (Ī²=32.80 min/day), higher moderate-to-vigorous physical activity (Ī²=27.88 min/day), and lower sedentary time (Ī²=-52.70 min/day). No significant associations were found for paternal physical fitness or parental moderate-to-vigorous physical activity with child anthropometry, motor competence, or physical fitness.
Multi-level factors across the Health Ecological Model are independently associated with subjective cognitive decline among hypertensive patients in rural China
In a cross-sectional study of 860 hypertensive patients in rural Shanxi, China, 80.58% met criteria for subjective cognitive decline (SCD). Factors associated with higher odds of SCD included advanced age (OR=1.042), family history of hypertension (OR=2.352), hypertensive complications (OR=3.049), moderate hypertension risk (OR=1.847), lack of physical exercise (OR=1.611), fairly good or fairly poor sleep quality (OR=1.644 and 1.939), lower household income (OR=3.282), utilization of county-level hospitals (OR=1.697), and mild depression (OR=2.068). Former drinker status was associated with lower odds of SCD (OR=0.294) but may reflect residual confounding.
Depressive symptoms scores are positively associated with incident spinal pain risk in middle-aged and elderly populations
A prospective cohort study using 9-year CHARLS data found that each 1-point increase in depressive symptoms score (CESD-10) was associated with an 8% higher risk of incident spinal pain (OR=1.08, 95% CI:1.05-1.11). The highest quartile had a 2.58-fold higher risk compared to the lowest, with a linear dose-response relationship and a critical threshold of approximately 2.1.
Poor sleep quality is associated with increased fall risk in older adults
In a cross-sectional study of 67 older adults, fall occurrence was associated with poorer sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) (Ļ = 0.243; p = 0.047). Participants in a community-based physical activity program (G60UP) had better sleep quality (lower PSQI scores) and reported fewer falls (0.26 Ā± 0.51 vs. 0.78 Ā± 0.83; p = 0.005) compared to sedentary older adults.
Smoking and alcohol experimentation and less structured eating timing at ages 10-12 are shared determinants of shorter sleep and higher BMI percentile at age 14 in adolescents.
In a Scottish birth cohort (n=4157), having tried smoking or alcohol at age 12 and being allowed to eat whenever the child wanted at age 10 were meaningfully associated with both shorter sleep duration and higher BMI percentile at age 14. These associations were independent of other covariates, suggesting shared modifiable determinants for sleep and weight outcomes.
Disruptive mealtime behaviors, parent health-related quality of life and family functioning, ABC subscales, and dietary supplements are significantly associated with insomnia symptoms in young children with autism spectrum disorder.
In a sample of 103 children with autism (mean age 5.8 years, 77.7% male), 33% scored ā„22 on the Pediatric Autism Insomnia Rating Scale (PAIRS). After adjusting for confounders, disruptive mealtime behaviors, parent health-related quality of life and family functioning, ABC subscales (especially hyperactivity/noncompliance), and dietary supplements were significantly associated with elevated insomnia symptoms.
Adequate functional health literacy is associated with better sleep quality and longer sleep duration in patients with type 2 diabetes in Bangladesh
In a cross-sectional study of 401 patients with type 2 diabetes in Dhaka, only 27.3% had adequate functional health literacy (FHL). Adequate FHL was significantly associated with higher sleep metrics, with longer sleep duration (AOR = 9.17) and higher quality sleep (AOR = 5.67) increasing the likelihood of adequate FHL.
Higher baseline ultra-processed food consumption predicts lower adherence to 24-hour movement guidelines in children at 2-year follow-up
Children aged 4-5 years with the highest tertile of ultra-processed food consumption had a 27% higher risk of not meeting 24-hour movement guidelines after 2 years compared to the lowest tertile (RR 1.27, 95% CI 1.04-1.55). The association was primarily driven by increased recreational screen time, with the highest UPF tertile showing 1.82 times the risk of not meeting screen time recommendations.
Rotating shift work is associated with higher odds of irregular menstrual cycles and dysmenorrhea among female nurses
A cross-sectional study of 3,544 female nurses in China found that a history of rotating shift work was associated with higher odds of irregular menstrual cycles (OR=1.31, 95% CI: 1.03-1.65) and dysmenorrhea (OR=1.71, 95% CI: 1.42-2.06). Long-term cumulative exposure (ā„12 years) to rotating shift work and night shifts was linked to elevated likelihood of menorrhagia.
Company cafeteria use, regular exercise, and breakfast consumption are associated with reduced hyperuricemia risk, while smoking and breakfast skipping increase risk among male manufacturing workers
In a cross-sectional study of 613 male manufacturing workers in Japan, 20.6% had high uric acid (ā„7.0 mg/dL). Multivariable logistic regression identified smoking (OR=1.861), skipping breakfast ā„3 times/week (OR=1.684), and higher ALT (OR=1.035) as risk factors, while company cafeteria use (OR=0.528), regular exercise (OR=0.501), older age (OR=0.952), and higher eGFR (OR=0.969) were protective.
Vigorous-intensity work is associated with increased odds of cough or expectoration in individuals with mild to moderate COPD
In a cross-sectional study of 723 participants with mild-to-moderate COPD from NHANES 2007-2012, self-reported vigorous-intensity work was associated with higher odds of cough or expectoration (OR = 2.43, 95% CI: 1.41-4.22, P = 0.002) after full adjustment. A dose-response relationship was observed between longer duration of vigorous work and increased symptoms.
Favorable sleep health is positively associated with employee engagement in Japanese companies
In a cross-sectional analysis of 2,502 Japanese companies, favorable sleep health (as part of health-appropriate lifestyle factors) was positively associated with employee engagement (adjusted odds ratio [aOR] 1.03, 95% CI 1.02-1.04). High engagement was strongly linked to higher revenue (aOR 1.65, 95% CI 1.31-2.07) and operating profit (aOR 1.40, 95% CI 1.13-1.74).
COMISA patients exhibit a more vulnerable body composition profile characterized by lower skeletal muscle mass and higher visceral fat area compared to OSA-only patients
In a cross-sectional study of 2915 patients with moderate-to-severe OSA, 29.7% were classified as COMISA. COMISA patients had lower skeletal muscle mass (SMM) and higher visceral fat area (VFA), with the SMM/VFA ratio inversely associated with insomnia severity (Ī² = -0.08, p = 0.001) and COMISA status (OR = 0.29, p = 0.004), particularly in males.
Lansoprazole may trigger or exacerbate restless legs syndrome and periodic limb movement disorder in hemodialysis patients
A 76-year-old hemodialysis patient developed dopaminergic-refractory RLS/PLMD after starting lansoprazole 15 mg/day. Symptoms nearly completely resolved within 14 days of lansoprazole withdrawal, with RLS-6 score dropping from 28 to 4, and a Naranjo score of 5 indicating a probable adverse drug reaction.
The 3-flap technique improves sleep quality in female patients with biopolymer disease in the gluteal and lumbar regions
A retrospective cohort study of 199 female patients undergoing the 3-flap technique for biopolymer removal reported statistically significant improvements in well-being indicators, including sleep quality. The study found that postoperative symptom resolution included reductions in myalgia (OR 0.15), asthenia (OR 0.03), and anxiety (OR 0.08), with sleep quality also improving as a secondary outcome.
Sleep disorder is associated with any-domain intrinsic capacity impairment in community-dwelling older adults with chronic diseases
In a cross-sectional study of 1063 community-dwelling older adults with chronic diseases in Nanjing, China, sleep disorder was significantly associated with any-domain intrinsic capacity impairment (OR 2.94, 95% CI 2.12 to 4.07). The prevalence of any-domain intrinsic capacity impairment was 70.18%, with sensory impairment being the most common domain deficit.
Persistent cognitive dysfunction in POTS is associated with abnormal cerebral blood flow and may persist despite conventional cardiovascular-centered treatments.
This scoping review of 18 studies found that abnormal cerebral blood flow was reported in 61% of 56 POTS patients with cognitive dysfunction. Sustained cognitive stress induced a greater reduction in cerebral blood flow velocity in POTS patients (approximately 7.8%) compared to controls (1.8%), suggesting a hemodynamic mechanism for brain fog and other cognitive symptoms.
Sleep disorders precede and increase the risk of sepsis-associated delirium, with melatonin dysregulation mediating this relationship
In a prospective cohort of 99 ICU patients with sepsis, sleep disorders preceded SAD onset with a duration-dependent effect and were associated with a 1.45-7.69-fold higher risk of delirium across multiple analyses. Lower melatonin concentrations correlated with worse multidimensional sleep impairment, and mediation analysis showed that melatonin reduction occurring alongside sleep disturbances was associated with SAD development (ACME = -0.110, P = 0.024).
Wearable single-channel EEG-derived sleep metrics are associated with physical and behavioral health outcomes in adolescents
In a community sample of 85 adolescents (ages 11-17), at-home single-channel sleep-EEG metrics were linked to physical and behavioral health. Greater REM duration and percentage were associated with decreased odds of overweight/obesity, while more N3 sleep was associated with decreased odds of hypertension. Sleep efficiency, sleep onset latency, and N3 decline were also associated with ADHD and internalizing disorder diagnoses.
Exercise duration during a brief pre-transplant step test independently predicts overall survival, ICU admission, and invasive mechanical ventilation after hematopoietic cell transplantation.
In a single-center retrospective cohort of 3,458 adult HCT recipients, each additional minute of exercise during a 3-minute step test was associated with lower mortality (HR 0.90, 95% CI 0.82-0.99), lower odds of ICU admission (OR 0.80, 95% CI 0.69-0.92), and lower odds of invasive mechanical ventilation (OR 0.70, 95% CI 0.55-0.89) after full adjustment. Oxygen desaturation did not predict any outcome after hemoglobin adjustment.
Baseline insomnia severity modifies the association between sleep efficiency and next-day daytime HRV (RMSSD) in a predominantly healthy cohort
In a wearable-based dataset of 49 participants over 4 weeks, the interaction between CSD-style sleep efficiency and baseline Insomnia Severity Index (ISI) was positively associated with next-day daytime RMSSD (Ī²=0.0060; 95% CI, 0.0023 to 0.0097; P=0.002). This suggests that individuals with higher baseline insomnia symptoms show a stronger positive coupling between sleep efficiency and next-day heart rate variability.
Physical activity is associated with white matter integrity in a nonlinear, age- and region-specific manner, with greatest benefits in sedentary and older individuals
In a cross-sectional analysis of 4188 participants (mean age 55.4 years), higher energy expenditure was associated with lower orientation dispersion, with the effect leveling off at higher activity levels (standardized Ī²linear = -0.153, Ī²quadratic = 0.034). Physical activity was linked to lower neurite density in motor tracts, but with advancing age, it became more strongly associated with higher neurite density and lower mean diffusivity of supratentorial fibers. Body weight, cardiometabolic, and inflammatory factors partly mediated these effects.
Poor sleep quality is associated with increased resignation intention among Chinese anesthesiologists
A nationwide cross-sectional survey of 30,255 Chinese anesthesiologists found that sleep quality was significantly associated with resignation intention. The study identified sleep quality as one of several factors linked to intention to leave the profession, alongside service years, weekly work hours, daily anesthesia caseload, annual income, smoking, alcohol, and exercise frequency.
Nurse-driven sleep interventions improve subjective sleep quality and patient satisfaction in hospitalized medical-surgical patients
This study compared nurse-driven and combined nurse-physician sleep interventions against standard care in 92 medical-surgical inpatients. Both intervention groups reported significantly deeper sleep, shorter sleep latency, fewer awakenings, faster return to sleep, and better overall sleep quality compared to controls (all p < 0.05). The nurse-driven intervention also led to an 8.47% increase in patient satisfaction with nighttime quietness and $21,351.68 in cost savings from reduced sitter hours.
Exercise reduces the risk of hepatic steatosis, fibrosis, and hepatocellular carcinoma in a dose-dependent manner in individuals with MASLD.
The paper reports that exercise is associated with a dose-dependent reduction in the risk of hepatic steatosis, fibrosis, and hepatocellular carcinoma in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). This effect is partly independent of weight loss, and lifestyle interventions including exercise improve cardiometabolic health beyond the liver.
Later first and last caloric intake timing is independently associated with lower Morningness-Eveningness Questionnaire (MEQ) scores in physically active university students.
In a cross-sectional study of 200 physically active university students, later first and last caloric intake were independently associated with lower MEQ scores (Ī² = -0.435 and -0.422, respectively; both p < 0.001), indicating greater eveningness. The model explained 51.1% of the variance in MEQ scores. Evening-type participants had poorer sleep behaviors, longer sleep latency, lower sleep efficiency, more nocturnal awakenings, and poorer subjective sleep quality compared to morning-type participants.
Older age and less frequent endurance training habits predict the likelihood of illness during Arctic military training
Survival analysis showed that older age and less frequent endurance training habits significantly predicted the likelihood of viral illness among cadets during a 2-week near-Arctic winter training. The study included 49 cadets, with a naturalistic viral infection outbreak in first-year cadets providing the experimental context.
Restorative sleep is associated with subjective well-being, self-rated health, and positive lifestyle factors in adults and older adults, with age-specific patterns.
In a cross-sectional survey of Japanese adults (20-64 years) and older adults (ā„65 years), restorative sleep was significantly associated with subjective well-being (AOR=1.92, 95% CI: 1.35-2.73) and self-rated health (AOR=2.27, 95% CI: 1.63-3.15) in adults, and with self-rated health (AOR=2.12, 95% CI: 1.19-3.77) and availability of a confidant (AOR=2.62, 95% CI: 1.44-4.78) in older adults. Getting up at a fixed time every morning and avoiding worries while in bed were related to restorative sleep in both groups.
Actigraphy-derived sleep measures are strongly associated with total WEMWBS and global PSQI, providing complementary information to PROMs in a 50+ year old workforce.
The study of 45 participants aged 50-66 over one year found that actigraphy-derived sleep measures (e.g., disturbances, awakenings) are strongly associated with mental wellbeing (WEMWBS) and sleep quality (PSQI), complementing self-reported data. Very strong associations (>|0.5|) were found between work-related stress items (BJSQ) and both wellbeing and sleep quality.
Frequent night shifts (ā„2 per week) are associated with increased risk of PMDD symptoms in Chinese female nurses
A cross-sectional study of 1,031 Chinese female nurses found that those working ā„2 night shifts per week had significantly higher risk of PMDD symptoms (p < .001). The prevalence of PMDD symptoms in this population was 42.4%, with night shift frequency identified as a significant predictor in multivariate regression.
Higher overall pre-sleep artificial light at night intensity is associated with shorter total sleep time in shift-working nurses and daytime office workers
This observational study of 136 shift nurses and 66 daytime office workers found that higher overall pre-sleep light intensity (Light PC1) measured by wrist actigraphy was strongly associated with shorter total sleep time (Ī²=-0.59, SE=0.08, p<0.001). Bedroom light intensity showed a weaker but significant association with shorter total sleep time (Ī²=-0.21, SE=0.09, p=0.028). Temporal patterns of light exposure (Light PC2) were not significantly associated with any sleep outcomes.
Greater sleep latency is associated with worse inhibitory control in pediatric ALL survivors
In a pilot study of 23 children aged 8-12 who were >6 months post-treatment for acute lymphoblastic leukemia, greater objectively measured sleep latency was associated with worse inhibitory control (r = -0.42, p = 0.046). Total sleep time was positively associated with inhibitory control and attention. The study demonstrated feasibility and acceptability of home EEG-based sleep monitoring in this population.
Short sleep duration (<6 h) is associated with increased odds of hypertension in Chinese older adults
In a cross-sectional study of 15,650 Chinese adults aged 65 and older, self-reported short sleep duration (<6 h) was associated with a 1.30-fold higher odds of hypertension compared with sleeping 6-9 h (adjusted OR 1.30; 95% CI 1.17, 1.44). Long sleep duration (ā„9 h) showed no significant association after full adjustment (OR 1.04; 95% CI 0.97, 1.12). The relationship followed a non-linear J-shaped curve.
Cohabitating and non-cohabitating caregivers of people with dementia have significantly poorer sleep quality compared to non-dementia caregivers.
This nationwide cross-sectional study of 230,900 adults from the 2024 Korean Community Health Survey found that both cohabitating caregivers (OR 1.17, 95% CI 1.13-1.20) and non-cohabitating caregivers (OR 1.12, 95% CI 1.04-1.20) of people with dementia had significantly higher odds of poor sleep quality (PSQI ā„ 6) compared to non-dementia caregivers. The association was stronger for cohabitating caregivers, with the largest effects on sleep medication use (OR 1.61) and daytime dysfunction (OR 1.41).
Eating behavior latent profiles are associated with body composition indices in Spanish preschoolers, with sex-specific differences for the controlled eater profile and fat-free mass index.
In a cross-sectional analysis of 1208 Spanish children aged 3-6 years, four eating behavior profiles (controlled, avid, typical, avoidant) were identified. Food approach subscales and the avid eater profile were positively associated with body composition indices, while food avoidance subscales and avoidant/controlled profiles showed inverse associations. The controlled eater profile showed opposite associations with fat-free mass index by sex: positive in boys (Ī²=0.42, 95% CI: 0.21, 0.62) but negative in girls (Ī²=-0.55, 95% CI: -0.77, -0.32).
Higher proportions of moderate-to-vigorous physical activity (MVPA) relative to other 24-hour movement behaviors are associated with greater bone strength in older women.
In a cross-sectional study of 296 older adults (mean age 76.3 years), compositional data analysis showed that higher proportions of MVPA within the 24-hour movement composition were associated with higher distal radius and tibia estimated failure load in women. Hypothetically displacing 10-60 minutes of inactivity with MVPA resulted in more favorable bone microarchitecture and strength parameters.
Health behaviors account for approximately half of the rural-urban gap in life satisfaction among graduate students at an elite Chinese university
In a cross-sectional survey of 497 graduate students at a Double First-Class university in China, rural-origin students scored 1.95 points lower on the Satisfaction with Life Scale (SWLS) than urban-origin peers after adjusting for sociodemographic covariates (p=0.003). Adding health behaviors (sleep, physical activity, insomnia) to the model reduced this gap by roughly half (p=0.088), with insomnia, physical activity, and sleep duration independently associated with life satisfaction.
Regular moderate-to-vigorous exercise is associated with better sleep quality and quality of life in perimenopausal women, partly explained by less severe menopausal symptoms.
In a cross-sectional study of 457 Chinese perimenopausal women, those who exercised regularly (ā„3 times/week, ā„30 min/session) had significantly lower (better) PSQI and MENQOL scores. The association between regular exercise and better sleep quality was independent of other factors, but effect sizes were small (|r|<0.2) and causality cannot be inferred.
Meeting all three 24-Hour Movement Guideline components (MVPA, sleep duration, sedentary behavior) is associated with lower odds and hazard of frailty in two nationally representative populations.
In cross-sectional analyses, meeting all three components was associated with lower odds of frailty in NHANES (OR=0.21; 95% CI, 0.14-0.32) and CHARLS (OR=0.29; 95% CI, 0.16-0.46). In longitudinal CHARLS analyses over a median follow-up of 7.0 years, meeting all three components was associated with a lower hazard of incident frailty (HR=0.33; 95% CI, 0.27-0.41) compared to meeting none.
Higher physical activity levels and less sedentary time are associated with more robust diurnal cortisol rhythms in colorectal cancer survivors up to 12 months post-treatment.
In 74 colorectal cancer survivors, more total sedentary time (per 2 hours/day) was associated with a flatter cortisol slope (Ī²=0.19; 95%CI=0.06,0.33) and higher cortisol awakening response (Ī²=0.14; 95%CI=0.01,0.27). More total physical activity (per 1 hour/day) was associated with higher relative amplitude of cortisol (Ī²=0.23; 95%CI=0.03,0.43), indicating more robust diurnal rhythms.
Morning melatonin profiles are highly variable in preschool-aged children, limiting the reliable calculation of dim-light melatonin offset (DLMOff).
In a study of 20 healthy preschoolers (mean age 4.31 years, 45% female), evening melatonin profiles consistently allowed calculation of DLMO in all participants, but morning melatonin levels were highly variable, enabling DLMOff calculation in only 8 participants. Among those 8, later DLMOff was strongly associated with later chronotype (r=0.81), sleep offset (r=0.84), and midsleep (r=0.80).
Vasomotor and depressive symptoms are primary correlates of poor sleep quality in postmenopausal women, regardless of breast cancer history
In a cross-sectional study of 102 postmenopausal women (64 with breast cancer, 38 without), global PSQI scores were similar between groups, and 34.3% were classified as poor sleepers. Vasomotor symptoms (Ī²=0.22, P=.004) and depressive symptoms (Ī²=0.45, P<.001) were significant correlates of sleep quality, together with employment and smoking, explaining 54% of variance. Breast cancer survivorship was not associated with sleep quality.
Probiotic supplementation with Lactobacillus rhamnosus CRL1505 and Bifidobacterium breve M-16V reduces respiratory tract infection burden and improves quality of life in children
In a prospective, multicenter, community-based study without a placebo control, 236 children aged 0-14 years with a recent history of RTIs received a 4-week probiotic course. Caregiver-reported outcomes showed that 95.34% reported reduced cold frequency, 94.49% observed fewer medical visits, and 97.88% reported improved quality of life. The study suggests that probiotics may be beneficial in real-world community settings, complementing prior RCTs.
Obesity is strongly associated with cardiomyopathy in UK Biobank participants
In a UK Biobank analysis of 442 individuals with cardiomyopathy and 173,429 matched controls, obesity was strongly associated with cardiomyopathy (OR 3.7, 95% CI 2.88 to 4.76, p<0.0001). The study also found that males had higher odds of cardiomyopathy than females (OR 2.5, 95% CI 2.04 to 3.05, p<0.0001).
Longer moderate-to-vigorous physical activity duration is associated with better macular choroidal circulation in older adults with primary open-angle glaucoma
In a cross-sectional study of older adults with POAG, longer MVPA duration was independently associated with greater choroidal vascular volume (Ī² = 0.04, P = 0.021) and higher choriocapillaris flow density (Ī² = 0.06, P = 0.004). Patients with POAG had lower PA levels and reduced choroidal circulation compared to age-matched controls.
An evening activity breaks intervention increases activity breaks and improves sleep quality in free-living adults
This pilot study tested a theory-informed intervention to increase evening activity breaks in free-living adults. Participants self-reported completing 3.6 activity breaks per evening, and there was a small reduction in sleep disturbances (PSQI score change -0.35, 95% CI -0.6 to -0.1), while objective measures of sedentary time, sleep, physical activity, and glycaemic outcomes showed little change.
Shifting physical training from morning to afternoon improves sleep health and morale in soldiers
In a study of 37 active-duty soldiers, shifting physical training from 6:30 AM to 2:00 PM for approximately 30 days did not change total sleep duration per 24 hours (t28 = -0.31, P = .38) but significantly improved sleep quality (PSQI; t33 = 2.60, P < .01), daytime sleepiness (Epworth; t33 = 2.88, P < .01), and insomnia symptoms (ISI; t33 = 2.14, P = .02). Morale also significantly improved (t34 = -2.04, P = .03), while stress and anxiety remained similar.
The COVID-19 pandemic was associated with a marked increase in central precocious puberty (CPP), particularly among girls, with higher odds during pandemic than pre-pandemic periods.
Pooled estimates show higher odds of central precocious puberty (CPP) during the COVID-19 pandemic compared to pre-pandemic periods, especially in girls. The evidence supports a reproducible epidemiological signal but does not establish a single causal mechanism.
Structured sleep hygiene training programs improve sleep quality and duration in physically and operationally demanding occupations
A systematic review of 10 studies (8 RCTs, 2 NRCTs) found that structured training programs for sleep hygiene led to moderate improvements in sleep quality and small-to-moderate effects on sleep duration in workers in physically and operationally demanding occupations. Phone assistance programs had minimal effects, and single lecture interventions had negligible impact. Evidence certainty was low due to imprecision, risk of bias, and indirectness.
Adherence to 24-h movement guidelines, particularly including the sleep guideline, is associated with lower odds of non-suicidal self-injury in adolescents, with mediation by psychological health and moderation by sex.
In a cross-sectional study of 4,205 Chinese adolescents, meeting more 24-h movement guidelines was associated with progressively lower odds of NSSI (1 vs 0: OR=0.72; 2 vs 0: OR=0.44; 3 vs 0: OR=0.31). Combinations including the sleep guideline were associated with lower NSSI than those without, and the association was stronger in girls. Psychological health significantly mediated the relationship.
Increased frequency of vigorous physical activity is associated with reduced difficulty falling asleep
In a cross-sectional analysis of 3960 participants from the Adventist Health Study-2, each unit increase in frequency of vigorous physical activity was associated with 3% lower odds of difficulty falling asleep (OR = 0.97; 95% CI = 0.94-0.98; P = 0.03). No significant association was found between vigorous activity and waking during the night.
COVID-19 stay-at-home orders reduced physical activity in older African Americans
In a subset of older African American participants with valid actigraphy data, mean daily step count decreased significantly by 20.1% from 1646 to 1315 steps after the COVID-19 stay-at-home order. Nightly sleep duration decreased but not significantly from 7.1 to 6.9 hours.
Unbalanced 24h movement behavior trajectories after acute stroke are associated with increased risk of poor functional recovery at 12 months
In a prospective longitudinal study of 298 stroke survivors, four distinct 24h movement behavior trajectories were identified. Compared to a balanced trajectory, the imbalance group (OR=5.237, 95%CI: 1.848-14.835) and the long-sleep, increased-sedentary, decreased-physical-activity group (OR=4.160, 95%CI: 1.589-10.891) had significantly higher odds of poor functional recovery at 12 months, after adjusting for multiple confounders.
Poor sleep quality is associated with higher odds of cognitive impairment in adult hyperthyroid patients
In a cross-sectional study of 406 hyperthyroid patients in Southeast Ethiopia, the prevalence of cognitive impairment was 29.06% (95% CI: 24.84-33.68). Poor sleep quality was significantly associated with increased odds of cognitive impairment (AOR = 2.24), indicating that hyperthyroid patients with poor sleep quality are more than twice as likely to have cognitive impairment compared to those with better sleep quality.
Afternoon exercise was associated with greater fat loss than morning exercise in overweight/obese adults with the PER3 rs228697 CC genotype
In an 8-week supervised moderate-intensity continuous training (MICT) intervention, overweight/obese university students with the PER3 rs228697 CC genotype who exercised in the afternoon (16:00-19:00) showed descriptively larger reductions in body weight, BMI, waist circumference, body fat percentage, and total fat mass compared to those who exercised in the morning (7:00-10:00). However, the between-group differences were modest and imprecise, and the study was exploratory, so strong conclusions cannot be drawn.
Work-influenced circadian disruption is associated with cardiometabolic disease risk indicators but not microbiome composition in nurses
In a cohort of 75 Philadelphia nurses, circadian rhythm disruption (CRD) was associated with higher cardiometabolic risk indicators such as hs-CRP, triglycerides, and blood pressure, and with unfavorable work environment factors (e.g., less break time, fewer staff/resources). However, CRD variables were not significantly associated with gut microbiome profiles. Lower exercise, higher exhaustion, less mealtime, and night shifts were specific CRD-related factors linked to elevated risk markers.
Postoperative sleep disturbance is highly prevalent (89.5%) and is associated with increased opioid consumption and prolonged hospital length of stay.
In a prospective cohort of 143 adult surgical patients, 89.5% experienced poor sleep quality on the first postoperative morning. Poor sleepers had significantly higher 24-hour opioid consumption (r=0.41, P<0.001) and longer median hospital stay (4 days vs 3 days, P=0.018).
Cannabis-based medicinal products are associated with sustained improvements in pain, health-related quality of life, sleep, and anxiety in patients with endometriosis at 24 months
In a 2-year prospective observational study of 101 patients with endometriosis, cannabis-based medicinal products (CBMPs) were associated with significant improvements in pain severity, pain interference, quality of life, sleep, and anxiety at all follow-up points (1, 3, 6, 12, 18, 24 months; p<0.001). Mean prescribed oral morphine equivalents decreased from 19.9 mg/day at baseline to 14.8 mg/day at 24 months. Adverse events were mostly mild, with fatigue (15.8%), lethargy (14.9%), and headache (12.9%) being most common.
Place-based ecological restoration improves self-rated health in Chinese residents
China's national ecological restoration pilot was associated with a 0.1697-point increase in self-rated health on a five-point scale, compared to non-exposed areas. The effect was robust across multiple sensitivity analyses and operated through environmental, economic, and psychosocial pathways.
Longer social media use duration is associated with increased depressive and anxiety symptoms in adolescents
This retrospective study of 156 adolescents found significant positive correlations between average daily social media use duration and PHQ-9 scores (r = 0.352, p < 0.001) and GAD-7 scores (r = 0.308, p < 0.001). Multivariate logistic regression identified longer social media use as an independent risk factor for positive depressive symptoms (OR = 1.794, 95% CI: 1.261-2.547) and positive anxiety symptoms (OR = 1.624, 95% CI: 1.169-2.267).
A nomogram integrating HbA1c, sleep quality, social support, and vision-related quality of life predicts depression risk in patients with type 2 diabetic retinopathy
This cross-sectional study of 490 diabetic retinopathy patients found that a nomogram combining four predictors (HbA1c, PSQI score, SSRS score, and VRQoL score) achieved excellent discrimination for depression risk (AUC=0.918 in training, 0.867 in internal validation, 0.875 in temporal validation). The prevalence of depressive symptoms was 29.18%. The nomogram can aid early screening of high-risk individuals.
A healthy lifestyle, particularly regular physical activity and low sedentary behavior, is associated with reduced all-cause and cardiovascular disease mortality in individuals with cardiovascular-kidney-metabolic syndrome.
In two prospective cohorts (UK Biobank and NHANES), higher healthy lifestyle scores were associated with significantly lower risks of all-cause and CVD mortality. For example, in UK Biobank, each unit increase in lifestyle score was linked to a 19% lower all-cause mortality risk (HR 0.81) and an 18% lower CVD mortality risk (HR 0.82). The associations were stronger in early stages of CKM syndrome.
Better sleep is associated with reduced post-concussion symptoms in children and adolescents
In a prospective longitudinal cohort of 2,991 children with concussion, sleep quality improved significantly over 12 weeks (mean sleep score from 76.3 at week 1 to 89 at week 12). Better sleep was significantly associated with reduced global and physical symptoms early in recovery, and with reduced cognitive and emotional symptoms throughout recovery.
Short sleep and physical inactivity are independently and jointly associated with prevalent cardiovascular disease in US adults
In a cross-sectional study of 1,577,591 US adults, short sleep (OR 1.26, 95% CI 1.22-1.30) and long sleep (OR 1.17, 95% CI 1.13-1.21) were independently associated with prevalent cardiovascular disease, as was physical inactivity (OR 1.11, 95% CI 1.09-1.14). The joint effect of short sleep and inactivity conferred the highest risk (OR 1.38, 95% CI 1.31-1.44), with no significant additive interaction (RERI -0.03, 95% CI -0.11 to 0.06), suggesting independent, additive risks.
Advanced CKM stage is associated with worse cardiovascular health and early arterial injury in young adults
In the FF-CHAYA study of 1283 young adults (mean age 22.9 years), more advanced CKM stages (1-3) were associated with significantly lower Life's Essential 8 scores and higher carotid intima-media thickness (a marker of early arterial injury) compared to Stage 0. For example, mean-maximum carotid intima-media thickness was 0.014 mm higher for Stage 1, 0.020 mm higher for Stage 2, and 0.100 mm higher for Stage 3 compared to Stage 0.
Seed cycling capsules with chasteberry reduce PMS symptom severity and frequency over two menstrual cycles
In a single-arm trial, 40 women using Two Moons Seed Cycling Capsules (ZEST and ZEN) showed significant improvements in Menstrual Symptom Questionnaire (MSQ) scores, Numerical Pain Rating Scale (NPRS) scores for cramping, and a 73.86% decrease in sick days due to menstrual issues by the end of Cycle 2. All nine PMS-related symptom parameters improved, including digestive upset, breast tenderness, and productivity interference. Participant satisfaction was high, with 71.79% reporting improved premenstrual/menstrual pain.
Higher sleep variability is associated with poorer memory trajectories over time in middle-aged and older adults
In the ALBION study of 184 adults (mean age 65, 65% women), time-varying analyses showed that sleep variability had robust non-linear associations with poorer memory trajectories over a 1.5-year follow-up, remaining significant after FDR correction. Cross-sectionally, more nightly awakenings were associated with poor memory and attention speed. The findings suggest that objective indicators of sleep continuity, particularly sleep variability, are most consistently related to domain-specific cognitive outcomes, with strongest evidence for memory decline over time.
Early glucose peak time during OGTT is a stronger biomarker of metabolic health than glucose curve morphology in normoglycemic adults
In normoglycemic adults, an early glucose peak (ā¤30 min) during a 3-hour OGTT was associated with lower post-prandial glucose, lower 3-hour insulin AUC, lower 2-hour FFA AUC, lower respiratory quotient, lower body fat, and higher energy expenditure compared to a late peak (>30 min). Biphasic glucose curves showed lower post-prandial glucose but no differences in insulin sensitivity or other metabolic measures versus monophasic curves. Glucose peak time demonstrated a stronger discriminative index of metabolic health than curve morphology.
Advanced age, living alone, unemployment, depression, and physical frailty are associated with social frailty in older adults with type 2 diabetes.
In a cross-sectional study of 334 older adults with type 2 diabetes, the prevalence of social frailty was 26.3%. Logistic regression identified age 70-79 years, age ā„80 years, living alone, unemployment, physical frailty, and depression as statistically significant factors associated with social frailty.
Work-family conflict, occupational burnout, occupational stress, nursing practice environment, and sleep disorders are associated with workplace violence among emergency department nurses.
In a study of 1540 emergency department nurses in China, 85.0% reported experiencing workplace violence in the past year. Machine learning models identified work-family conflict, occupational burnout, and occupational stress as significant factors across all models, while sleep disorders and nursing practice environment were significant in random forest and decision tree models. Random forest achieved the highest sensitivity (0.916) and accuracy (0.859), while logistic regression had the highest specificity (0.667).
SGLT2 inhibitors reduce acute kidney injury risk in patients with diabetes mellitus receiving cisplatin chemotherapy
In a retrospective study of 288 patients with diabetes mellitus receiving cisplatin, those taking SGLT2 inhibitors had a 13.9% incidence of acute kidney injury compared to 28.5% in controls (OR: 0.42; 95% CI: 0.23-0.76). The SGLT2i group also showed higher eGFR at 3 months and lower rates of hypomagnesemia and anemia.
Accelerated metabolic age is associated with increased risk of atherosclerotic cardiovascular disease and major adverse events in adults aged 65 years and older.
In a cohort of 1,218 participants (mean age 59.1 years), a metabolic age (metAge) derived from 987 plasma metabolites was associated with cardiovascular risk. Among adults aged 65 years and older, each one-year increase in accelerated metAge was associated with a 12% higher risk of ASCVD (HR=1.12, 95% CI: 1.00-1.26, two-sided p=0.059) and a 10% higher risk of major adverse events (HR=1.10, 95% CI: 1.01-1.18, two-sided p=0.028).
Zinc intake is positively associated with deep sleep duration in night-shift medical residents
In a cross-sectional study of 50 medical residents, zinc intake was positively correlated with deep sleep duration (r = 0.434, p = 0.010). This suggests that higher zinc consumption may be linked to increased deep sleep in this population.
Home-based anodal tDCS targeting the left DLPFC reduces cognitive fatigue in a patient with refractory post-mTBI fatigue
A single patient with chronic post-mild traumatic brain injury (mTBI) cognitive fatigue received 14 days of home-based anodal tDCS (2 mA, 20 min daily) over the left DLPFC, guided by FDG-PET/MRI findings. Fatigue severity (FSS-7) improved from 5.4 to 3.7, exceeding the minimal clinically important difference, and cognitive performance improved (SDMT: 46 to 58; MoCA: 26 to 29). No serious adverse events were reported.
Higher magnesium depletion score is associated with increased risk of circadian syndrome, partially mediated by body mass index
In a cross-sectional study of 12,328 U.S. adults from NHANES 2005-2018, higher magnesium depletion score (MDS) was significantly associated with increased risk of circadian syndrome (OR = 1.193, 95% CI: 1.099-1.295, P < 0.001). Body mass index mediated 21% (95% CI: 12.98-34%) of this association.
Patients with group 1 pulmonary hypertension and high HFpEF probability have a unique metabolome overlapping with clinical HFpEF, characterized by enhanced tryptophan-kynurenine pathway breakdown, lower serotonin, and decreased nitric oxide precursors.
This study stratified group 1 pulmonary hypertension (PH) patients by HFpEF probability and found that those with high probability (n=131) had significant metabolomic changes compared to low probability (n=62), including increased kynurenine metabolites and decreased serotonin, linoleate, arginine, and homoarginine. These changes overlapped with clinical HFpEF (n=240) and were abnormal relative to controls (n=85), suggesting biological overlap between the two conditions.
A high periodic limb movement index (PLMI) and high arousal index OSA phenotype is associated with increased cardiovascular risk in patients undergoing coronary artery bypass grafting.
In a case-comparison study, patients with coronary artery disease (CAD) undergoing CABG had significantly higher rates of abnormal PLMI, arousal index, and AHI compared to non-CAD controls (p=0.0002, p=0.002, p=0.015, respectively). Multivariable regression identified high PLMI and arousal index as the strongest associations with CAD, suggesting that this OSA phenotype may increase cardiovascular risk.
Preexisting neurodevelopmental, psychological, or mental health conditions and concussion history increase baseline concussion symptom burden and symptom reporting in UK university student-athletes.
Among 404 UK university student-athletes, those with preexisting NP/MH conditions reported higher overall symptom burden than those without. NP/MH diagnosis explained 12% of variance in symptom count and 16% in symptom severity, with previous concussion and depression/anxiety adding significant incremental variance. Student-athletes with both NP/MH and concussion history were more likely to report at least one symptom.
Egg and breakfast consumption are associated with some measures of muscular endurance, whereas sugary beverage consumption shows associations with several fitness indicators, particularly among girls, in children aged 10-12 years in Ningxia, China.
This repeated cross-sectional study of 3,970 children aged 10-12 in Ningxia, China, found that from 2019 to 2024, both boys and girls improved in lung capacity, muscular endurance, and speed-agility, alongside increases in BMI. Adjusted analyses showed modest associations between dietary behaviors and specific fitness outcomes: egg and breakfast consumption were linked to some muscular endurance measures, while sugary beverage consumption was associated with several fitness indicators, especially in girls.
Short sleep duration (<6 hours) is associated with higher odds of hypertension in Chinese older adults
In a cross-sectional study of 15,650 Chinese adults aged 65 and older, self-reported short sleep duration (<6 hours) was associated with a 1.30-fold higher odds of hypertension compared with sleeping 6-9 hours (adjusted OR 1.30; 95% CI 1.17, 1.44). Long sleep duration (ā„9 hours) showed no significant association after full adjustment (OR 1.04; 95% CI 0.97, 1.12). The relationship was non-linear (J-shaped), with the effect of short sleep more pronounced in adults without limitations in activities of daily living.
EEG-based measures (MMN, P300, 40-Hz ASSR, resting PSD) show good to excellent test-retest reliability in clinical high-risk for psychosis and control participants, supporting their use in CHR studies.
In an interim analysis of 654 CHR and 87 control participants, EEG measures demonstrated good to excellent test-retest reliability (mean G-coefficient 0.72 for CHR, 0.71 for controls). Small but significant decreases in measure magnitudes over sessions were observed, consistent with habituation, but reliability remained sufficient for use as predictors or outcome measures.
E-cigarette use is associated with higher odds of insufficient sleep among adolescents and young adults
This structured narrative review of six empirical studies and one narrative review found that exclusive e-cigarette use was consistently associated with 30-80% higher odds of insufficient sleep among adolescents and young adults. Dual users of combustible and electronic cigarettes showed the strongest associations, being up to three times more likely to report inadequate sleep, and also exhibited increased sleep latency.
Children with autism and sleep disorder exhibit impaired neuroclearance linked to systemic iron deficiency
In a study of 230 children with ASD (114 with sleep disorder, ASD-SD; 116 without, ASD-nSD) and 110 typically developing controls, ASD-SD children showed significantly reduced ALPS indices and elevated free water fraction, indicating impaired perivascular clearance. Serum iron was markedly lower in ASD-SD, and mediation analysis supported a pathway from iron deficiency to cerebral edema to impaired neuroclearance.
Engaging in multiple healthy lifestyle behaviors is associated with better health outcomes than focusing on a single domain
In a cross-sectional study of 510 adults, four multibehavioral clusters were identified: unhealthy behavior, mixed behavior-healthy diet, mixed behavior-stable good mood, and healthy behavior. Compared to the unhealthy behavior cluster, the mixed behavior-stable good mood and healthy behavior clusters had significantly higher mental health-related quality of life (Ī²=6.32, 95% CI 3.73-8.91 and Ī²=5.61, 95% CI 2.47-8.75, respectively) and well-being (Ī²=11.62, 95% CI 7.86-15.38 and Ī²=9.63, 95% CI 5.17-14.10, respectively). Participants in these clusters and those in the mixed behavior-healthy diet cluster also reported better perceived health (OR 3.19, 95% CI 1.20-8.49; OR 9.85, 95% CI 3.54-27.40; OR 12.18, 95% CI 4.04-36.71, respectively).
Muscular endurance and strength are lower in lymphangioleiomyomatosis (LAM) patients compared to matched healthy controls, coincident with greater self-reported fatigue.
In a cross-sectional study of 15 LAM patients and 15 matched controls, LAM patients exhibited significantly lower muscular force (by 220Ā±89 N), power (by 312Ā±129 W), endurance (by 4674Ā±1974 N*sec), and worse fatigue survey scores (p=0.02 to 0.0004). Poorer muscular endurance in LAM was associated with shorter 6-minute walk distance (r=0.68), lower VO2max (r=0.58), and worse fatigue (r=0.56). No differences in fiber type distribution were found.
Low-sodium oxybate reduces excessive daytime sleepiness and improves nighttime sleep quality in participants with narcolepsy
In a phase 4 open-label study of 34 participants with narcolepsy (NT1 or NT2), low-sodium oxybate (LXB) significantly reduced daytime sleepiness, with a least-squares mean change in Epworth Sleepiness Scale score of -7.7 (SE 0.9, P<0.0001). LXB also decreased transitions to lighter sleep stages by 13.1 (SE 2.9, P<0.0001), increased N3 (deep sleep) duration by 45.0 minutes (SE 8.8, P<0.0001), and reduced nocturnal awakenings by 3.2 (SE 0.9, P=0.0013). Most participants reported improved sleep quality and overall disease severity.
Evening chronotype is associated with unhealthy eating behaviors including meal skipping, delayed meal timings, unhealthy snacking, and lower intake of fiber and key micronutrients among Pakistani university students.
In a cross-sectional study of 345 Pakistani university students, evening chronotypes (16.5% of sample) exhibited significantly more unhealthy eating behaviors such as meal skipping, delayed meal timings, and unhealthy snacking, along with lower breakfast energy and reduced intake of fiber, magnesium, iron, zinc, and phosphorus compared to morning chronotypes. However, no significant association was found between chronotype and overall nutritional status (BMI or anthropometric measures).
Preoperative vitamin D deficiency is associated with a substantially increased risk of postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery
In a single-center retrospective study of 320 pediatric patients undergoing laparoscopic surgery under general anesthesia, the incidence of postoperative delirium (POD) was 80.3% (257/320) based on CAPD score ā„9. Patients with POD had significantly lower preoperative serum 25(OH)D3 levels, and multivariable analysis showed that vitamin D deficiency (<30 ng/mL) was independently associated with a higher risk of POD (adjusted OR=14.25; 95% CI: 3.33-61.0; P<0.001). The association remained robust after adjusting for postoperative sleep quality (OR=8.15; 95% CI: 1.88-35.3; P=0.005).
Gut microbiota taxa are causally associated with insomnia risk in European ancestry individuals
A Mendelian randomization study identified that Enterorhabdus, Family XIII AD3011 group, Paraprevotella, and Lachnospiraceae UCG004 increase insomnia risk, while Coprococcus1, Coprobacter, Desulfovibrio, Flavonifractor, Olsenella, Odoribacter, and Oscillibacter decrease risk. For specific insomnia phenotypes, Eisenbergiella increased risk of trouble falling asleep, while Haemophilus and Eubacterium brachy group reduced it; Family XIII UCG001, Lachnospiraceae FCS020 group, and Olsenella increased risk of waking too early, while Eubacterium brachy group and Victivallis reduced it.
Occupational and environmental exposure to inorganic dust during military service is associated with increased risk of sarcoidosis among U.S. Veterans.
In a retrospective nested case-control study of 3,019,636 U.S. Veterans with at least one military occupational code, inorganic dust exposure was associated with a modestly increased risk of sarcoidosis (conditional odds ratio [cOR] 1.08; 95% CI 1.003-1.170). The attributable fraction among the exposed was 7.6%, and the association was stronger when using a modified job exposure matrix (cOR 1.15; 95% CI 1.05-1.27) and when restricted to post-9/11 Veterans (cOR 1.25; 95% CI 1.07-1.47).
Higher body mass index, waist circumference, and body fat percentage are associated with greater somatic symptom severity in perimenopausal women
In a cross-sectional study of 112 Irish perimenopausal women, higher BMI, waist circumference, and body fat percentage were significantly correlated with overall menopausal symptom severity, but after adjusting for confounders, these body composition measures predicted only somatic symptoms (e.g., hot flushes, sleep problems, joint pain). No significant associations were found with psychological or urogenital symptoms. Median BMI was 28.3 kg/mĀ², mean body fat percentage was 34.9%, and median MRS score was 15.0.
Lower serum ferritin levels are strongly correlated with greater RLS severity in drug-naive patients with idiopathic RLS, even when ferritin is within the normal laboratory range.
In a cross-sectional study of 113 drug-naive idiopathic RLS patients with serum ferritin levels within the normal range (22-322 Ī¼g/L), multiple regression analysis identified serum ferritin (p < 0.001) and age (p = 0.001) as independent predictors of symptom severity. A very strong negative correlation was found between ferritin level and RLS severity, suggesting ferritin should be evaluated as a continuous parameter rather than a threshold.
Later eating timing is associated with lower diet quality in preschool children, with chronotype as an effect modifier
In 656 Finnish preschool children, longer morning latency, later eating midpoint, and later last eating occasion were associated with lower diet quality scores. Chronotype-stratified analyses showed that longer evening latency was inversely associated with diet quality only in early chronotypes, while later eating midpoint and last eating occasion were inversely associated in intermediate and late chronotypes, but not early.
Elevated fasting plasma succinate is associated with higher resting heart rate in young sedentary adults
In a cross-sectional analysis of 85 young sedentary adults, higher fasting plasma succinate concentrations were modestly associated with increased resting heart rate (Ī²=0.213, RĀ²=0.074, P=0.046), independent of sex and BMI. Participants with succinate above the cohort median had a resting heart rate about 4 bpm higher than those below the median (95% CI: +0.1 to +8.3, P=0.045). No significant associations were found with heart rate variability parameters.
Physical exercise is associated with better sleep quality among college students, mediated by mobile phone addiction tendency and moderated by psychological resilience.
In a sample of 1,583 college students, physical exercise was significantly negatively associated with sleep quality (Ī² = -0.19, p < 0.001), indicating better sleep quality with more exercise. The relationship was partially mediated by mobile phone addiction tendency (indirect effect = -0.03, 95% CI [-0.04, -0.02]), and psychological resilience moderated the first stage of this mediation, with exercise linked to reduced mobile phone addiction only among students with moderate to high resilience.
An actigraphy-based nap detection algorithm reliably identifies nap-based phenotypes that differentiate individuals with narcolepsy type 1 from healthy controls, and demonstrates that an orexin receptor 2-selective agonist reduces napping to normative levels.
The study developed and validated an actigraphy-based nap detection algorithm with high specificity (93.2%) and accuracy (F1 Area: 83.9%). Applying the algorithm, participants with narcolepsy type 1 had 12.8 fewer nap-free days over 28 days and slept 34 minutes more during the day than controls; treatment with oveporexton (TAK-861) increased nap-free days by 6.1-11.9 and reduced daytime sleep by 12-33 minutes versus baseline.
Physical activity improves executive function in college students through sequential reduction of anxiety and improvement of sleep quality
In a cross-sectional study of 2,033 Chinese college students, physical activity positively predicted executive function, with a direct effect accounting for 49.53% of the total variance. Three mediating pathways were identified: anxiety reduction (31.78%), sleep quality enhancement (14.02%), and a sequential chain of anxiety reduction leading to better sleep quality (4.67%). All mediating effects were statistically significant based on bootstrap confidence intervals.
Melatonin (1 mg/day) improves sleep quality and reduces overeating and weight gain in an obese school-aged boy with prenatal diabetes exposure
An 11-year-old boy with obesity born to a mother with type 2 diabetes and severe sleep disturbances was treated with 1 mg/day melatonin. After treatment, parental reports indicated marked improvements in sleep posture and nighttime awakenings, along with reduced overeating episodes and gradual weight reduction, without adverse events. The case suggests melatonin may be a useful adjunct in managing pediatric obesity by optimizing sleep behavior.
Probiotics may improve subjective sleep outcomes in individuals with insomnia and sleep disturbances via gut-brain axis modulation
This narrative review synthesizes mechanistic and clinical evidence suggesting probiotics can regulate sleep through gut-brain axis pathways, including immune-inflammatory modulation, HPA axis regulation, neuroactive metabolites, and vagal signaling. Clinical studies show small and diverse impacts on sleep outcomes, with improvements more frequently reported in subjective sleep assessments than objective tests. The review does not identify specific strains or dosages due to heterogeneity in included studies.
In-school learning is associated with higher psychological distress and depressive symptoms compared to home-based online learning in adolescents, and poorer sleep quality is independently associated with worse mental health.
A cross-sectional study of 5,787 Chinese adolescents (grades 7-12) found that in-school learning was associated with significantly higher psychological distress and depressive symptoms compared to home-based online learning (p<0.001). Poorer subjective sleep quality, longer sleep latency, and shorter sleep duration were independently associated with worse mental health, with subjective sleep quality showing the strongest association (Ī²=0.333, p<0.001). 23.4% of students had moderate to severe depressive symptoms.
Structured nursing care pathway integrated with standard pharmacological management improves postoperative biophysiological and psychological outcomes in patients undergoing spinal anesthesia
In a pilot quasi-experimental study of 20 patients undergoing spinal anesthesia, those receiving a structured nursing care pathway plus standard pharmacological therapy showed significant improvements in wound healing, pain, gastric motility, anxiety, and sleep quality compared to controls receiving only pharmacological therapy. Post-test between-group differences favored the experimental group with t-values ranging from 8.25 to 10.12 (P < 0.05). For example, wound healing scores improved from 7.12 Ā± 0.88 to 17.1 Ā± 1.24 in the experimental group, while controls showed minimal changes.
Evening sugar intake (ā„6 PM) is associated with decreased sleep efficiency in professional male rugby league athletes
In a 7-day observational study of 28 professional male rugby league athletes, each 1 g increase in sugar consumed after 6 PM was associated with a 0.21% decrease in sleep efficiency, and each 1 g/kg increase was associated with a 0.22% decrease. No other significant associations between dietary intake and sleep outcomes were found.
Poor sleep quality is independently associated with increased odds of neck, upper-back, and knee pain among university employees
In a cross-sectional study of 460 university employees, poor sleep quality was independently associated with increased odds of neck pain (OR=1.13, 95% CI: 1.03-1.24), upper-back pain (OR=2.47, 95% CI: 1.08-5.67), and knee pain (OR=4.28, 95% CI: 1.70-10.80). The study also found high prevalence of musculoskeletal disorders, with low back (65.9%) and neck (65.0%) being most common.
Perampanel monotherapy may offer small additional benefits for sleep architecture compared to levetiracetam in children with SeLECTS, including a lower proportion of N1 sleep and a greater reduction in the number of awakenings.
In a pilot prospective cohort study of 35 children with SeLECTS, perampanel (PER) monotherapy was associated with a significantly lower proportion of N1 sleep (10.15% vs 12.03%, P=0.039) and a greater reduction in the number of awakenings (mean change -2.68 vs 1.13, P=0.036) compared to levetiracetam (LEV) at follow-up. Both drugs were tolerated and achieved short-term seizure control, with no significant differences in subjective sleep quality, daytime sleepiness, or quality of life.
Electricity loadshedding is associated with poorer self-reported sleep, studying habits, and grades in South African university students
In a cross-sectional survey of 1124 South African university students during 2023, 73% reported that loadshedding affected their sleep, with 80% of those reporting worse sleep. Access to alternative power was associated with nearly 60% reduced odds of worse sleep (OR=0.43, 95% CI: 0.32-0.56). Students with worse sleep more often reported a drop in grades (59% vs. 38%, P=0.015).
Meeting 24-hour movement behavior guidelines is associated with lower levels of adiposity in Portuguese children aged 6-10 years
In a cross-sectional study of 910 Portuguese children aged 6-10 years, meeting more 24-hour movement guidelines (MVPA ā„60 min/day, sleep 9-11 h/night, screen time ā¤2 h/day) was associated with lower body mass index z-scores, waist circumference, waist-to-height ratio, and percentage body fat. Children meeting all three guidelines had significantly lower adiposity markers, with significant linear trends across the number of guidelines met (0, 1, 2, 3).
Integrated TCM-Western 'Three-Team' co-management improves sleep quality and glycemic control in patients with type 2 diabetes and comorbid sleep disorders.
In a prospective non-randomized controlled study, patients with T2DM and sleep disorders receiving the integrated 'Three-Team' co-management model (endocrinologist, TCM physician, health manager) for 6 months showed significantly greater improvements in PSQI scores (group Ć time interaction ĻĀ²=32.59, P<0.001) and glycemic control (FBG and HbA1c) compared to conventional therapy. At 6 months, PSQI decreased by 2.44 points from baseline in the intervention group, a 2.4-fold greater reduction than controls, with significant between-group differences in FBG and HbA1c observed as early as 3 months.
Full-body red and near-infrared photobiomodulation is feasible and highly acceptable in a predominantly Hispanic/Latino population with musculoskeletal pain, and is associated with substantial perceived benefit.
In a single-arm pilot study of 40 adults with musculoskeletal pain, 92.1% reported global improvement, 74.3% reported immediate pain relief after the first session, and 95.0% would recommend PBM. Exploratory analysis estimated a reduction in total pain burden from median 6.0 to 3.5 (p < 0.001, r = 0.88).
Regular interactive gaming improves psychomotor speed and spatial reasoning in adolescent gamers, independent of sleep quality, but dietary caloric intake poses greater metabolic risks than gaming behavior.
In a comparative cross-sectional study of 200 male adolescents, gamers (ā„5 hours/week) showed faster auditory, visual, and aim reaction times (P < 0.001) and better spatial quotient (P = 0.001) compared to non-gamers. The benefit on visual reaction time persisted after adjusting for sleep quality (PSQI), but skinfold thickness was more strongly associated with caloric intake (Ī·Ā² = 0.19) than gaming status (P = 0.035).
Polysomnographic parameters, particularly sleep latency and arousal index, are sensitive early markers of neurocognitive dysfunction following cardiac surgery, and perioperative Citicoline mitigates neurocognitive decline and stabilizes sleep-wake cycles.
In a prospective study of 104 cardiac surgery patients, acute postoperative neurological complications occurred in 35.6% (n=37) on Day 3, and PSG alterations (increased sleep latency, elevated arousal index) on Day 10 correlated with cognitive impairment. In patients with POCD, Citicoline (Group I) showed significant recovery in MoCA scores and faster stabilization of sleep parameters by Day 30 compared to controls (p=0.0016).
Unclassified pulmonary hypertension most often reflects subclinical left heart and metabolic dysfunction consistent with unrecognized early-stage heart failure with preserved ejection fraction (HFpEF).
In a combined cohort of 2,248 participants, unclassified PH had a prevalence of 7.8%. Among those with unclassified PH, 59% (72/122) showed exertional pulmonary artery wedge pressure elevation consistent with undiagnosed HFpEF during exercise testing. The condition was associated with greater adiposity, higher HFpEF probability scores, left heart remodeling, and lower glycine metabolites indicative of metabolic dysfunction.
Glycine as an indirect structural inducer enhances silk fibroin piezoelectric performance for facial micromotion tracking during sleep
The study developed a fully green bioelectronic piezoelectric patch using silk fibroin with glycine as a structural inducer, which improved Ī²-sheet content and piezoelectric performance. The patch enabled dual-channel wireless monitoring of rapid eye movements and nasal flaring during sleep with high conformability and sensitivity.
Prediction models for psychological distress in patients with malignant tumors show high reported performance but lack external validation and have high risk of bias
This scoping review of 13 studies and 26 prediction models found that models using XGBoost, Random Forests, and Artificial Neural Networks reported high performance (AUCs 0.673-1.000, sensitivities 0.518-0.968, specificities 0.651-1.000). However, all studies had high risk of bias, none underwent external validation, and performance is likely inflated due to small sample sizes and low events per variable.
Adequate calcium intake and calcium-rich foods are modifiable contributors to skeletal accrual in children and adolescents.
The review finds that evidence is strongest for adequate calcium intake and calcium-rich foods as modifiable contributors to peak bone mass accrual in youth. Milk intake is best interpreted as a practical marker of calcium-rich dietary patterns rather than the only route to calcium adequacy.
B-group vitamin deficiencies increase neuronal excitability and interfere with sleep
The review states that B-group vitamins (B6, B12, folate) are cofactors in serotonin and GABA synthesis, and their deficiency increases neuronal excitability and disrupts sleep. No specific effect sizes or quantitative data are provided.
Exogenous melatonin enhances GABA activity, promoting non-REM sleep and reducing stress-related hyperarousal.
This scoping review of 58 studies found that exogenous melatonin enhances GABAergic activity through different mechanisms, promoting non-REM sleep and reducing stress-related hyperarousal. The review identified 20 studies on the GABAergic system supporting this effect.
EEG-based measures show good to excellent test-retest reliability in clinical high risk for psychosis and control participants, supporting their use in CHR studies.
In an interim analysis of the AMP SCZ Program, EEG-based measures (including MMN, P300, 40-Hz ASSR, and resting PSD) demonstrated generally good to excellent test-retest reliability in CHR (n=654) and control (n=87) participants, with mean G-coefficients of 0.72 and 0.71, respectively. Small systematic decreases in measure magnitudes over sessions were observed, consistent with habituation effects.
Melatonin supplementation improves sleep quality in individuals with sleep disturbances
The narrative review summarizes evidence that melatonin, a key regulator of circadian rhythms, can act as a subsidiary sleep aid when used alongside good sleep hygiene practices. The paper highlights melatonin's role in promoting restful sleep, though specific effect sizes are not provided in the abstract.
Dietary intake of zinc, magnesium, B-group vitamins, vitamin D, and vitamin C is associated with better mental health, memory function, and sleep quality in medical university students.
In a cross-sectional study of 985 medical university students, network analyses identified zinc, magnesium, B-group vitamins, vitamin D, and vitamin C as central micronutrients associated with mental health, memory function, and sleep quality. The study found high prevalence of depression (49.2%), anxiety (49.7%), stress (62.9%), and sleep disturbances (54.3%) among participants.
Plant-derived compounds, including phenylpropanoids, tetracyclic triterpenoids, and lignans, improve sleep patterns in stressed individuals
This review reports that recent clinical trial data confirm the efficacy of plant-derived compounds in managing stress symptoms, including improvement in sleep patterns. The review highlights adaptogenic herbs such as Withania somnifera (ashwagandha) for enhancing stress resilience and quality of life.
Increased intake of EPA and DHA improves brain function during the menopausal transition
The paper reviews evidence that omega-3 fatty acids EPA and DHA may benefit brain health during the menopausal transition, including cognitive function, mood, and sleep. The evidence is based on preclinical, epidemiological, and accumulating RCT data, though it is described as relatively sparse. Future RCTs are needed to establish dose-response relationships and optimal timing of intervention.
Valeriana officinalis improves sleep quality in individuals with insomnia
The review found that Valeriana officinalis demonstrated sedative effects and improvements in sleep quality in clinical studies. Proposed mechanisms include modulation of GABAergic pathways. However, clinically relevant risks such as excessive sedation and herb-drug interactions were identified.
Lansoprazole discontinuation improves restless legs syndrome and periodic limb movement disorder symptoms in a hemodialysis patient
A 76-year-old hemodialysis patient with dopaminergic-refractory RLS/PLMD experienced near-complete symptom resolution within 14 days after discontinuing lansoprazole and switching to vonoprazan. The RLS-6 score dropped from 28 to 4, and the Naranjo score was 5, indicating a probable adverse drug reaction.
Site-related variance is generally small (typically <10%) for MRI measures in the AMP SCZ multi-site neuroimaging protocol, while participant variance dominates for structural and fMRI SNR/CNR (40-76%), but platform-related variance is substantial for diffusion scan SNR/CNR (>55%) and spatial smoothness.
In the AMP SCZ multi-site neuroimaging study of individuals at clinical high risk for psychosis, site-related variance in MRI measures was small (<10%). Participant variance was the largest component for structural and fMRI signal-to-noise and contrast-to-noise ratios (40-76%), but platform (scanner model) variance dominated for diffusion imaging SNR/CNR (>55%) and spatial smoothness due to hardware and vendor differences.
Energy drinks and prescription stimulants act as arrhythmogenic triggers that can precipitate sudden cardiac death in susceptible individuals with inherited channelopathies or occult cardiac disease.
The review integrates mechanistic, clinical, epidemiological, and forensic evidence showing that energy drinks (caffeine-taurine combinations) shorten action potential duration and effective refractory period, facilitating re-entry arrhythmias. Clinical and forensic case reports describe SCD or near-fatal arrhythmias shortly after ED intake, particularly in individuals with long-QT syndrome, catecholaminergic polymorphic ventricular tachycardia, or other inherited channelopathies, supporting a trigger-on-substrate mechanism. Prescription smart drugs increase sympathetic tone and myocardial oxygen demand, especially under dehydration, sleep deprivation, or strenuous exercise, lowering the arrhythmic threshold in vulnerable populations.
Early treatment improves clinical outcomes in primary BH4 deficiencies, with the best outcomes in AD-GTPCHd and variable outcomes in recessive conditions depending on timing and metabolic severity.
This review of primary BH4 deficiencies reports that early identification through neonatal screening and treatment can prevent typical disease symptoms, while late diagnosis often leads to neurodevelopmental impairment and movement disorders. The best clinical outcomes are seen in autosomal dominant GTPCH deficiency, whereas recessive conditions show outcomes variably associated with treatment timing and metabolic derangement severity. Neurocognitive, psychiatric, and sleep disorders are underestimated and affect quality of life.
Perioperative sleep disturbance research has expanded substantially from 2004 to 2024, with China and the United States leading in publication output and the United States having the highest citation influence.
This bibliometric analysis identified 3178 publications on perioperative sleep disturbance from 2004 to 2024, showing an increase from 42 publications in 2004 to 441 in 2024. China (847 publications) and the United States (688 publications) were the most productive countries, while the United States had the highest total global citation score (21,283).
An 8-week multicomponent group exercise program improves muscle strength and sleep quality in community-dwelling older adults in Taiwan.
This quasi-experimental study found that an 8-week multicomponent group exercise program significantly improved gait speed, upper limb muscle strength, sleep quality, and heart rate recovery in the intervention group compared to baseline. Between-group posttest comparisons showed significant differences in arm curls, grip strength, and sleep quality favoring the intervention group.
Nutrition, micronutrients, and phytochemicals reduce heat stress-induced depression and related neuropsychological disorders
This review suggests that chronic heat stress induces depression and neuropsychological disorders through HPA axis hyperactivation, oxidative stress, neuroinflammation, mitochondrial dysfunction, and altered neurotransmitter signaling. It proposes that adequate macronutrient intake, micronutrients (B vitamins, vitamin D, magnesium, zinc, selenium, iron), and phytochemicals (polyphenols, flavonoids, carotenoids) can modulate these pathways and enhance resilience against heat-induced depression.
Age-related attenuation of muscle endocrine signaling, together with insulin resistance and low-grade inflammation, may lower the threshold at which sleep fragmentation translates into amyloid/tau dyshomeostasis, glial activation, and network dysfunction in Alzheimer's disease.
This review proposes a sleep-muscle-brain framework where sarcopenia, sarcopenic obesity, and insulin resistance are modifiable conditions that bias sleep continuity and amplify the neurodegenerative impact of sleep disruption. The framework suggests that peripheral muscle-metabolic aging processes lower the threshold for sleep fragmentation to trigger Alzheimer's-related pathology, though direct causal evidence in humans is insufficient.
Repurposed drugs targeting multiple pathophysiological mechanisms may improve therapeutic outcomes in fibromyalgia.
This review discusses repurposed drugs for fibromyalgia, including NMDA receptor antagonists, neurokinin-1 receptor antagonists, GABA system drugs, antiepileptics, antidepressants, opioids, cannabinoids, dopamine receptor agonists, melatonin receptor agonists, and antidiabetics. It emphasizes a multi-target strategy addressing neurochemical alterations, central sensitization, neuroinflammation, oxidative stress, mitochondrial dysfunction, gut microbiota disturbances, and autoimmunity.
The article 'Melatonin and Cortisol Concentration Before and After CPAP Treatment of Obstructive Sleep Apnea' has been retracted.
This paper is a retraction notice for the original article DOI: 10.2147/NSS.S553499. No new findings are presented; the retraction indicates that the original study's results are no longer considered valid.
Acute sleep deprivation disrupts the tryptophan-serotonin-melatonin axis, with effects differing by mood response, and these changes may influence cognitive outcomes after sleep loss.
In 80 healthy adults, a single night of sleep deprivation significantly decreased tryptophan and melatonin levels overall. Non-responders (based on mood change) showed increased serotonin and decreased melatonin, while responders showed different patterns; changes in serotonin and melatonin correlated with cognitive test performance.
Standardized ashwagandha extracts improve sleep quality in adults with stress-related sleep complaints
Clinical trials with standardized ashwagandha extracts have shown reductions in stress-related biomarkers and improvements in sleep quality. The review notes improvements in sleep parameters, though specific effect sizes are not provided in the abstract.
Lipophilic agents exhibit increased volumes of distribution with risk of accumulation in patients with obesity
The paper reports that excess adiposity induces drug-specific alterations in distribution, with lipophilic agents showing increased volumes of distribution and a consequent risk of accumulation. This finding is based on a review of recent pharmacokinetic data in perioperative patients with obesity.
Worse executive function in Alzheimer's disease patients is associated with more severe impairment in activities of daily living
This study found that Alzheimer's disease patients showed significant deficits in executive control as measured by the stop-signal task and event-related potentials compared to healthy controls. Specifically, Go accuracy and overall accuracy in the AD group were negatively correlated with activities of daily living scores (r = -0.603 and r = -0.624, respectively), indicating that poorer executive function relates to greater ADL impairment.
Oral lichen planus is associated with lower salivary melatonin levels and poorer sleep quality
OLP patients had significantly lower salivary melatonin levels (p=0.015) and higher scores in the sleep disturbances component of the PSQI (p=0.021) compared to controls. Salivary cortisol levels did not differ between groups (p=0.402).
Ashwagandha improves sleep quality in adults
Ashwagandha (Withania somnifera) is reported to improve sleep quality, as part of its adaptogenic and stress-reducing effects. The narrative review highlights its efficacy in mitigating stress-related markers and enhancing sleep, though specific numerical data are not provided in the abstract.
Community pharmacists in Saudi Arabia frequently recommend OTC melatonin for insomnia but provide brief consultations, incomplete history taking, limited safety counseling, and rare non-pharmacological advice.
In a cross-sectional study using 251 simulated patient visits across Saudi Arabia, community pharmacists recommended OTC melatonin in 64.5% of cases, but consultations lasted only a median of 1.5 minutes. History taking was incomplete (e.g., sleep patterns inquired in 55.4%, triggers in 51%), safety information was provided in only 4.9% of visits, and non-pharmacological advice was given in just 9.6%.
Lifestyle practices including diets, physical exercise, sleep quality, and cognitive activity can help minimize aging effects on the brain.
The paper reviews evidence that lifestyle factors such as nutrition, exercise, sleep, and cognitive activity may reduce or delay negative effects of brain aging. It emphasizes the role of specific nutrients (lipids, glucose, vitamins, protein, flavonoids) and metabolic regulation in supporting brain health across the lifespan.
Specific nutrients (e.g., magnesium, tryptophan, omega-3 fatty acids) and dietary patterns rich in anti-inflammatory and antioxidant compounds improve sleep outcomes.
This review synthesizes evidence from clinical trials, observational studies, and mechanistic research over the past two decades, indicating that nutrients like magnesium, tryptophan, and omega-3 fatty acids, along with anti-inflammatory dietary patterns, enhance sleep quality. Functional foods such as tart cherry juice and kiwifruit also show potential benefits. The gut microbiome is identified as a significant regulator of sleep physiology, suggesting probiotics and prebiotics as novel interventions.
Melatonin affects sleep outcomes in research
Prescription patterns of sleep medications for critically ill patients: A nationwide retrospective observational cohort study in Japan.. Published in Australian critical care : official journal of the Confederation of Australian Critical Care Nurses (2026). PMID: 42492347.
Gut microbiota-driven metabolic reprogramming, including accumulation of toxic aromatic amino acid catabolites, is a key contributor to Parkinson's disease with REM sleep behavior disorder and idiopathic RBD.
This study found that Parkinson's disease patients with RBD exhibit distinctive metabolic disturbances, including accumulation of gut microbiota-derived toxic aromatic amino acid catabolites, which were also observed in idiopathic RBD patients. Gut microbial dysbiosis in these groups drives a functional shift away from dietary fiber fermentation toward enhanced degradation of protein, aromatic amino acids, glycine, and intestinal mucin glycans, associated with exacerbated oxidative stress, neuroinflammation, and accelerated pathological progression.
Intravenous lidocaine shows heterogeneous analgesic effects in laparoscopic bariatric surgery, with more consistent antiemetic and anti-inflammatory benefits when infusion is limited to the intraoperative period.
The review found that evidence for intravenous lidocaine in laparoscopic bariatric surgery is heterogeneous and depends on dosing strategy, infusion duration, and perioperative context. Its antiemetic and anti-inflammatory effects may be more consistent than its analgesic benefit when infusion is limited to the intraoperative period.
Herbal supplements such as Valeriana officinalis demonstrate sedative effects and improve sleep quality in clinical studies.
This narrative review found that herbal supplements including Valeriana officinalis (valerian) showed sedative effects and improvements in sleep quality in clinical studies. The review highlighted risks such as excessive sedation and herb-drug interactions, particularly via cytochrome P450 pathways. No specific effect sizes or sample sizes were reported for valerian alone.
Sexual activity does not meaningfully impair athletic performance or recovery when occurring several hours or more before competition
Sexual activity typically elicits mild physiological responses comparable to light physical exertion and does not meaningfully deplete energy stores or impair strength, endurance, power, or coordination when occurring several hours or more before competition. The review found no consistent evidence supporting universal sexual abstinence before competition, with sexual activity appearing largely neutral or potentially beneficial for recovery when appropriately timed.
Gut microbiota-driven metabolic reprogramming contributes to Parkinson's disease with REM sleep behavior disorder
This study found that Parkinson's disease patients with REM sleep behavior disorder (RBD-PD) exhibit distinctive metabolic disturbances, including accumulation of gut microbiota-derived toxic aromatic amino acid catabolites. These alterations were also observed in idiopathic RBD patients, representing the prodromal stage of PD. The findings suggest gut microbial dysbiosis drives a functional shift away from dietary fiber fermentation toward enhanced degradation of protein, aromatic amino acids, glycine, and intestinal mucin glycans.
Ultrasound-guided prolotherapy with adjunctive nutritional and metabolic support may lead to rapid radiographic improvement in large multilobulated shoulder calcific tendinitis
A 49-year-old man with acute severe shoulder pain (10/10 VAS) and a large 3 cm multilobulated calcific deposit received ultrasound-guided prolotherapy (10% dextrose with 0.2% lidocaine) plus adjunctive nutritional and metabolic support (vitamin C, vitamin D, magnesium, MSM, L-arginine). At two weeks, pain improved to 2/10, range of motion normalized, and radiographs showed near-complete resorption of the calcific deposit.
Site-related variance in MRI measures is generally small (typically <10%) in the AMP SCZ multi-site neuroimaging protocol, but platform-related variance is substantial for diffusion imaging SNR/CNR (>55%) and spatial smoothness.
In the AMP SCZ multi-site neuroimaging protocol, site-related variance is generally small (typically <10%) for most MRI measures. However, for diffusion-weighted imaging, platform-related variance accounts for >55% of the variance in signal-to-noise and contrast-to-noise ratios due to hardware differences, and spatial smoothness also shows large platform-related variance.
Ventilatory response to CO2 during exercise remains profoundly low in patients with Congenital Central Hypoventilation Syndrome, with no significant difference from resting values.
In 10 patients with CCHS, the ventilatory response to CO2 during exercise was 2.27 mL/min/mmHg/kg, which was not significantly different from the resting value of 1.56 mL/min/mmHg/kg (p=0.85). Both values were markedly lower than the reference value in healthy children (34.6 mL/min/mmHg/kg), indicating persistent impairment of CO2-driven ventilatory control despite increased metabolic demand.
Tart cherry supplementation protocols are highly variable and poorly characterized, preventing reliable extrapolation of efficacy for health, exercise performance, and sleep outcomes.
This review of 43 studies found that tart cherry supplementation protocols varied widely in duration (acute to 84 days) and polyphenol dose (143ā2,140 mg/day) and anthocyanin dose (15ā547 mg/day). Only 20 studies analyzed their own supplement batch, while 17 relied on previously published data from different batches, and 6 did not report polyphenol content at all. The use of diverse analytical methods further undermines the ability to compare doses or blends across studies.
Magnesium supplementation improves sleep quality in adults with type 2 diabetes
In a cross-sectional survey of 132 participants from a randomized, double-blind clinical trial on magnesium supplementation in type 2 diabetes, over half reported symptom improvements including in sleep quality. Satisfaction was high, with 75% willing to join future trials and 87.88% would recommend participation.
Diagnostic labels alone provide limited guidance for assessment or treatment of sleep disorders in children with neurodevelopmental disorders; a diagnosis-informed, phenotype-directed framework is proposed.
The paper reviews evidence that sleep disorders are highly prevalent in children with neurodevelopmental disorders (NDDs) and that diagnostic labels are insufficient for guiding care. It proposes a framework that integrates diagnosis-informed risk recognition with phenotype-directed assessment, focusing on sleep phenotypes such as insomnia, circadian dysregulation, sleep-disordered breathing, movement disorders, hypersomnolence, and parasomnias. Melatonin has the strongest pharmacological evidence, particularly for insomnia in ASD and selected neurogenetic conditions.
Withania somnifera (ashwagandha) improves sleep patterns and stress resilience in adults with stress-related symptoms
This review highlights that adaptogenic herbs like Withania somnifera (ashwagandha) show consistent efficacy in enhancing stress resilience and improving quality of life, including improvement in sleep patterns. Clinical trial data confirm the role of plant-derived compounds in modulating cortisol levels and reducing anxiety, with ashwagandha being a key example.
Psychological self-report questionnaires are not associated with decrements in physical performance following Special Operations Forces unit training.
In a study of 54 male active-duty SOF operators, an 8-month training phase led to decrements in body fat, agility, vertical jump, anaerobic capacity, and sprint times, with improvements in isometric midthigh pull and pain subscales. However, correlations between changes in psychological self-report measures (depression, sleep quality, alertness, post-traumatic stress, pain) and performance changes were mostly weak and inconsistent, with only a few significant correlations (e.g., agility with alertness; aerobic capacity with alertness; post-training agility with depression; post-training anaerobic capacity with overall pain; post-training sprints with sleep quality). The authors conclude that PSR tools should be used with caution as screens for nonfunctional overreaching in SOF.
Nutritional interventions, including specific nutrients and dietary patterns, improve sleep quality and manage sleep disorders.
This review synthesizes evidence from clinical trials and observational studies over the past two decades, indicating that nutrients like magnesium, tryptophan, and omega-3 fatty acids, along with dietary patterns such as the Mediterranean diet, enhance sleep outcomes. Functional foods like tart cherry juice and kiwifruit show potential benefits, and the gut microbiome is identified as a key regulator of sleep physiology.
Duloxetine treatment improves sleep quality and reduces pro-inflammatory cytokine levels in patients with major depressive disorder
After 4 weeks of duloxetine treatment (40-60 mg/day), patients with MDD showed significant improvements in sleep parameters including increased total sleep time (TST) and sleep efficiency (SE), and decreased wake after sleep onset (WASO). Serum levels of IL-1Ī², IL-8, IL-12, and IFN-Ī³ were significantly reduced. Baseline and post-treatment correlations suggest a link between sleep improvement and inflammatory changes.
Circadian rhythm disruption is a core pathophysiological mechanism in anxiety and depression, not merely a secondary symptom
This review synthesizes evidence that circadian rhythm disruption plays a central mechanistic role in anxiety and depressive disorders, rather than being a mere epiphenomenon. It identifies five key pathways linking circadian disruption to emotional and sleep abnormalities: the SCN-limbic circuit, HPA axis, immune inflammation, neurotransmitter plasticity, and the gut-brain axis. The paper also defines actionable subtypes of disruption and discusses chronotherapies such as light therapy and melatonin.
Children's quality of life with allergic diseases is influenced by an interacting system of disease symptoms, impaired psychological and social functions, family care factors, and medical support.
This qualitative study of 16 caregivers of children aged 7-14 with allergic diseases identified four themes influencing quality of life: disease symptoms (symptom distress, sleep, exercise and dietary restrictions), impaired psychological and social functions (negative emotions, limited social participation), family care (protective resistance, caregiver cognitive misunderstandings, family coping failure), and medical support (lack of medical trust, medication and emergency attack guidance needs). The findings suggest quality of life is shaped by the interaction of physical distress, child's psychological state, caregiver knowledge and emotional burden, and health system responsiveness.
The D178N mutation in the PRNP gene with methionine at codon 129 causes fatal familial insomnia, a prion disease characterized by progressive neurodegeneration and sleep loss.
Fatal familial insomnia (FFI) is a rare genetic prion disease caused by the D178N mutation in the PRNP gene combined with methionine at codon 129. The disease progresses through four stages, from initial insomnia to complete sleep loss and death within approximately 18 months of symptom onset, due to prion protein misfolding and accumulation in the thalamus.
The PSQI demonstrates better psychometric performance as a multidimensional measure, particularly a two-factor structure, than as a single global score in young South African women.
In a large sample of 7182 young women in Soweto, South Africa, the PSQI showed modest internal consistency (Ī±=.57, Ļ=.57) and poor fit for the one-factor model (CFI=.65, RMSEA=.13), but good fit for the two-factor (CFI=.94, RMSEA=.05) and three-factor (CFI=.94, RMSEA=.06) models. The two-factor model was slightly better and recommended for use in this population.
Gestational diabetes mellitus is associated with higher urinary 6-sulfatoxymelatonin and serum TNF-Ī± levels despite increased consumption of tryptophan-rich foods
In a cross-sectional study of 34 women with GDM and 18 with normal-risk pregnancies, those with GDM reported higher consumption of tryptophan-rich foods (especially milk/dairy and fruits) yet had significantly higher urinary 6-sulfatoxymelatonin (p=0.002) and serum TNF-Ī± levels (p=0.023). Multivariable models confirmed GDM remained associated with higher melatonin metabolite levels, while TNF-Ī± was linked to maternal characteristics and interactions.
Nutraceuticals such as valerian, chamomile, and ashwagandha improve sleep quality in individuals with sleep disorders
This review paper reports that nutraceuticals including Artemisia annua, valerian, rosemary, jujube, passionflower, lemon balm, ashwagandha, kava-kava, lavender, and chamomile have shown remarkable benefits in the therapy of sleep disorders. These remedies modulate neurotransmitter and hormonal pathways within sleep circuits and enhance sleep quality by alleviating stress, inflammation, and oxidative stress. The paper is a narrative review summarizing clinical studies that validated the efficacy of natural sleep aids.
A phenotype-guided pharmacologic management framework may be clinically useful for postoperative sleep disturbance after breast cancer surgery, but it remains conceptual and has not been prospectively validated.
This narrative review proposes a phenotype-guided approach to managing postoperative sleep disturbance (PSD) in breast cancer patients, where treatment selection is based on symptom presentation: short-course hypnotics for acute insomnia with hyperarousal, melatonin receptor agonists for circadian disruption, and gabapentinoids or multimodal analgesia for pain-dominant presentations. The framework is conceptual and lacks prospective validation in postoperative breast cancer populations.
Polysomnography in systemic mastocytosis patients shows frequent sleep-disordered breathing, REM-related changes, and variable arousal burden, but findings cannot be attributed directly to SM due to overweight/obesity predominance and lack of control group.
In a single-center observational study of nine adult patients with systemic mastocytosis (SM), polysomnography revealed that eight of nine patients met criteria for obstructive sleep apnea (OSA), with five mild and three severe cases. Median AHI was 8.2 events/hour, and all overweight/obese patients had OSA, while the only normal-weight patient did not. Brain fog-like complaints were common (six patients), but excessive daytime sleepiness was present in only two patients.
Community pharmacists in Saudi Arabia provide brief consultations and frequently recommend OTC melatonin for insomnia, but often fail to provide safety counseling or non-pharmacological advice.
In a cross-sectional study using simulated patient visits across Saudi Arabia, 251 pharmacy consultations were observed. The median consultation duration was only 1.5 minutes, 64.5% of pharmacists recommended melatonin, but safety information was provided in only 4.9% of visits and non-pharmacological advice in 9.6%.
Tirzepatide may trigger exercise-induced anaphylaxis, which resolves upon discontinuation of the drug.
A patient developed exercise-induced anaphylaxis after initiating tirzepatide, a dual GIP/GLP-1 receptor agonist. After discontinuing tirzepatide, the exercise-induced anaphylaxis resolved. This suggests a causal relationship between tirzepatide and exercise-induced anaphylaxis.
Physiotherapists perceive fibromyalgia management as a multidimensional process involving validation, pain neuroscience education, individualized exercise, and group-based support to facilitate adherence and functional recovery.
This qualitative study of 13 physiotherapists in Spain identified three overarching themes: clinical validation, shifting therapeutic goals from pain reduction to function and autonomy, and the use of pain neuroscience education and individualized exercise as main strategies. Group-based interventions were noted to promote social support, motivation, and adherence, while lifestyle recommendations complemented treatment.
Standardized ashwagandha extracts improve sleep quality in clinical trials
Clinical trials with standardized ashwagandha extracts have shown improvements in sleep quality and mood parameters, along with reductions in stress-related biomarkers. The review highlights these effects as part of ashwagandha's adaptogenic and neuroimmune regulatory properties.
Sleep disturbance is consistently associated with elevated C-reactive protein and interleukin-6 in insomnia disorder
The abstract reports that sleep disturbance in insomnia disorder is more consistently associated with selected inflammatory markers, particularly C-reactive protein (CRP) and interleukin-6 (IL-6), while findings for tumor necrosis factor-alpha (TNF-Ī±) remain less consistent. This suggests a link between insomnia and low-grade inflammation, which may contribute to the chronicity and multisystem associations of the disorder.
Evening chronotype is more frequent in children and adolescents with OCD and is associated with lower symptom severity
In a case-control study of 29 children/adolescents with OCD and 30 matched controls, evening chronotype was significantly more common in the OCD group (p<0.05). Within the OCD group, those with evening chronotype had significantly lower CY-BOCS scores (p<0.05) and higher morning salivary melatonin levels (p<0.05), while cortisol did not differ.
Magnesium supplementation improves sleep quality in type 2 diabetes patients
A cross-sectional survey of 132 participants from a randomized, double-blind clinical trial on magnesium supplementation in type 2 diabetes found that over half reported symptom improvements, including in sleep quality. Satisfaction was high, with 75% willing to join future trials and 87.88% would recommend participation.
Artificial stone dust is highly toxic and causes severe, rapidly progressive silicosis in workers
Artificial stone-associated silicosis (AS silicosis) is a severe, rapidly progressive occupational lung disease affecting workers who manufacture, fabricate, and install artificial stone countertops. It is characterized by short latency, accelerated progression, high morbidity and mortality, and disproportionately affects young workers in precarious conditions.
Nummular eczema causes sleep disturbance in affected patients.
The paper states that nummular eczema (NE) is characterized by intense pruritus, which can lead to sleep disturbance, reduced quality of life, and psychological distress. This claim is based on expert consensus from a Delphi study involving 63 experts.
Plant-derived compounds, particularly phenylpropanoids, improve sleep patterns in stressed individuals
This review reports that recent clinical trial data confirm the efficacy of plant-derived compounds (phenylpropanoids, tetracyclic triterpenoids, lignans) in managing stress symptoms, including improvement in sleep patterns. Adaptogenic herbs like Withania somnifera (ashwagandha) show consistent efficacy in enhancing stress resilience and quality of life.
Sleep disturbances and sleep latency predict metabolic syndrome in male Taiwanese workers
In a cross-sectional study of 348 Taiwanese workers, the prevalence of metabolic syndrome was 26.4%, with higher rates in men (33.3%) than women (19.3%). Among men, sleep disturbances and sleep latency were significant predictors of metabolic syndrome, while among women, shift work and body mass index were associated.
Lower sleep quality predicts one-year low back pain incidence in healthy adults
A supervised machine learning model identified lower sleep quality as one of the most important predictors of one-year low back pain incidence among 156 healthy participants. The model achieved an accuracy of 0.815 and an ROC AUC of 0.839 for out-of-sample predictions.
Sighted non-24-hour sleep-wake disorder is a heterogeneous condition caused by distinct dysfunctions in the circadian photic entrainment pathway
This multimodal phenotyping of two sighted N24SWD patients revealed two distinct pathophysiological mechanisms: one patient had preserved melanopsin function but absent light-induced melatonin suppression and a markedly prolonged intrinsic period (~25 h), while the other had impaired melanopsin response (reduced PIPR) but retained melatonin suppression and a period within the upper physiological range (24.20 h). These findings indicate that N24SWD in sighted individuals is not a unitary disorder but results from dysfunction at different levels of the circadian photic entrainment pathway.
Melatonin alleviates polycystic ovary syndrome, premature ovarian insufficiency, ovarian injury, and age-related ovarian function decline
This review establishes an integrated mechanistic model in which oxidative stress, mitochondrial dysfunction, inflammatory responses, and autophagic imbalance contribute to ovarian disorders, while melatonin acts as a pleiotropic regulator counteracting these pathways. The paper reports that melatonin alleviates PCOS, POI, ovarian injury, and age-related ovarian function decline, but no specific effect sizes or sample sizes are provided.
Conserved sleep orthologs, including DnaK, SHMT, and potassium channel proteins, are present in Epsilonproteobacteria and show sequence similarities of 39.13% to 61.45%.
Phylogenomic analysis of Sulfurimonas paralvinellae identified conserved sleep-related orthologs such as DnaK (Hsp70), serine hydroxymethyltransferase, and potassium channel family proteins, with sequence similarities ranging from 39.13% to 61.45%. Proteins with fewer domains, like adenylate kinase, showed greater conservation, while bifunctional protein-serine/threonine kinases and phosphatases exhibited adaptations linked to the extremophilic environment. Gene Ontology analysis highlighted catalytic activity, potassium channel function, and cellular processes, emphasizing ion channels in sleep-wake regulation.
Home-based, self-collected salivary dim light melatonin onset (DLMO) assessment can classify circadian phase profiles into distinct endotypes in a real-world clinical population.
In two studies totaling 553 patients, a pragmatic home-based DLMO protocol identified six profile types: within predicted onset window, delayed, advanced, hypermelatoninemia, hypomelatoninemia, and irregular/multipeak. Among 159 patients with atypical profiles who self-reported symptoms, 94.3% showed concordance between their circadian profile and at least one presenting complaint.
Melatonin is widely used and generally perceived as a safe and effective sleep aid, though notable variations in dosing, reliance, and misuse exist across demographic groups.
In a cross-sectional study of 335 adults in Baghdad, Iraq, 83.8% of participants agreed that melatonin improved their sleep quality, 78.2% considered it safe, and 75.6% recommended it to others. The most common dose was 5 mg (33.6%), and 56.5% used melatonin as needed. Side effects were common, with drowsiness (28.8%) and headache (25.1%) reported, and only 1.5% had no side effects.
Site-related variance is generally small (typically <10%) in the AMP SCZ neuroimaging protocol, but platform-related variance is substantial for diffusion scan SNR/CNR (>55%) and spatial smoothness measures.
The AMP SCZ neuroimaging protocol, applied to a multi-site, multi-vendor cohort of individuals at clinical high risk for psychosis, found that participant variance was the largest component for structural and fMRI SNR/CNR (40-76%), while site variance was small (<10%). However, diffusion scans showed substantial platform-related variance (>55%) due to hardware differences, and spatial smoothness had large platform-related variance from vendor-specific acquisition and reconstruction differences.
Multi-level interventions reduce emotional exhaustion and depersonalization in nurses
This narrative review found that interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety among nurses. The review highlights that effective strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training, with improved effectiveness in supportive environments with allocated participation time and leadership engagement.
Custom Plaso plugins outperform iLEAPP in extracting Apple Health records across multiple iOS versions
The study developed custom plugins for the log2timeline Plaso framework that successfully extracted Apple Health data from iOS versions 13.3.1 through 17.3, outperforming iLEAPP by recovering previously unrecoverable features. The plugins integrated disparate database schema variations into a unified timeline, reducing manual analysis effort.
Self-tracking via remote measurement technology mirrors illness stage in individuals with or at risk of eating disorders, supporting recovery among those further from illness but risking reinforcement of compulsive patterns among those with residual or emerging symptoms.
In a qualitative interview study of 14 participants with lived experience or at risk of eating disorders, self-tracking via smartphones and wearables (Fitbits) was found to mirror illness stage. Those further from recovery benefited from healthy routine formation, while those with residual or emerging symptoms experienced reinforcement of compulsive patterns.
Withania somnifera preparations may influence sleep-related outcomes in humans
The review summarizes evidence from preclinical and human studies suggesting that Withania somnifera (Ashwagandha) preparations may affect stress-related and sleep-related outcomes. However, heterogeneity in extract composition and study design limits firm conclusions, and the overall strength of evidence varies across indications and products.
Probable depression is prevalent among parents and primary caregivers of children with specific learning disorders in Saudi Arabia, and machine-learning models can predict it with high accuracy.
The study found that 35.6% of 612 caregivers met criteria for probable depression (PHQ-9 ā„ 10). XGBoost achieved an ROC AUC of 0.916, sensitivity of 0.858, and specificity of 0.830 at a screening threshold of 0.425, with key predictors including parenting stress, anxiety, sleep quality, and child difficulties.
Lifestyle habits including age, BMI, smoking status, and treatment pill intake predict breast cancer survival in female patients
This study analyzed 21,219 female breast cancer patients from the UK Biobank and found that age, BMI, smoking status, and treatment pill intake are key lifestyle-related factors influencing survival. The XGBoost model achieved AUCs of 0.748, 0.749, and 0.765 at 3, 6, and 9 years, respectively, and high-risk patients had significantly worse survival (P < 0.0001).
Ayurvedic Vata-pacifying and Rasayana interventions improve visual acuity and anatomical resolution in CSR patients with Vata Prakriti
Three CSR patients (two males aged 65 and 46, one female aged 40) with confirmed Vata Prakriti received a standardized Ayurvedic regimen including Ashwagandha, Punarnavadi Kashaya, Tiktaka Ghrita, Kalyanaka Ghrita, Triphala Churna, and local ocular therapies. All three showed marked improvement in visual acuity and complete anatomical resolution of macular fluid on OCT within 4-17 months, with no recurrence over 1 year follow-up.
Semaglutide 2.4 mg is cost-effective for obesity disease management in Japan under retreatment scenarios
Semaglutide 2.4 mg plus diet and exercise reduced the incidence of obesity-related complications including type 2 diabetes, cardiovascular events, obstructive sleep apnea, and gout. The incremental cost-effectiveness ratio was Ā„5,300,580/QALY for patients without type 2 diabetes and Ā„7,077,984/QALY for patients with type 2 diabetes, with retreatment improving QALY gains.
Theanine alleviates sleep disturbances and depression induced by sleep deprivation through neuroinflammation reduction
Theanine, a phytochemical from Camellia sinensis, exerts therapeutic effects on mental disorders caused by cumulative stress, including mild sleep disturbances and depression induced by sleep deprivation. The neuroprotective mechanism involves alleviating neuroinflammation. The paper reviews literature from the past 5 years.
The addition of trazodone to lurasidone and valproic acid can precipitate serotonin syndrome.
A patient developed probable serotonin syndrome (SS) within hours of adding 100 mg trazodone to a regimen including lurasidone and valproic acid. Symptoms included chills, nausea, sweating, dizziness, muscle stiffness, and tremor, which resolved over 48 hours. The case suggests that this drug combination can cause excessive serotoninergic activity via multiple mechanisms.
Sugemule-4 exerts anti-insomnia effects through multi-target and multi-pathway mechanisms, with apigenin, luteolin, and piplartine as core active components and EGFR as a central target.
This study identified 106 active compounds and 364 overlapping targets for Sugemule-4 in insomnia treatment. Network pharmacology and molecular docking revealed that apigenin, luteolin, and piplartine are core active components, and EGFR is a central target, potentially acting through serotonergic synapse and calcium signaling pathways.
Ashwagandha improves sleep quality in older adults
The review reports that clinical trials have consistently shown Ashwagandha's efficacy in improving sleep quality in older adults. This is part of its broader geroprotective benefits, including enhanced muscle strength, cardiorespiratory fitness, and cognitive function.
Withania somnifera preparations may influence stress-related and sleep-related outcomes
This narrative review of literature from 2015 to 2026 suggests that Withania somnifera (Ashwagandha) preparations may affect stress and sleep outcomes, based on preclinical and human studies. However, heterogeneity in extract composition and study design limits firm conclusions, and the overall strength of evidence varies across indications and products.
Herbal supplements such as Valeriana officinalis improve sleep quality in individuals with insomnia.
This narrative review found that herbal supplements including Valeriana officinalis demonstrated sedative effects and improvements in sleep quality in clinical studies. The review highlighted modulation of GABAergic pathways as a key mechanism, but also noted risks such as excessive sedation and herb-drug interactions.
Nurexan contains flavonoids (vitexin, isovitexin, orientin, isoorientin, apigenin) and alkaloids (caffeine, trigonelline) with potential pharmacological relevance for stress and sleep regulation.
Chemical analysis of Nurexan, a multicomponent natural veterinary medicinal product, identified flavonoids such as vitexin (1-2 ng per tablet) and isovitexin (4-11 ng per tablet) along with other compounds from Passiflora incarnata, Avena sativa, and Coffea arabica. These constituents may have anxiolytic and sleep-regulating effects, but their functional roles require further study.
Herbal products such as Bacopa monnieri, Crocus sativus, and Ginkgo biloba show clinical promise for mental health symptoms in children and adolescents
A systematic review of 29 clinical trials identified several herbal products with clinical promise for pediatric mental health, including attention deficit/hyperactivity disorder (ADHD), anxiety, and depression. Eighteen trials targeted pathological conditions and eleven addressed borderline symptoms like nervous agitation, restlessness, or sleep disturbances.
L-theanine supplementation at 200-450 mg/day supports healthy sleep in adults
A systematic review of 13 trials (n=550) found that L-theanine at 200-450 mg/day appears safe and effective for improving sleep in adults. Beneficial effects were reported on sleep latency, maintenance, efficiency, perceived satisfaction, and feelings of refreshment upon waking.
Ashwagandha extract improves sleep quality in adults with stress-related sleep complaints
Clinical trials with standardized ashwagandha extracts have shown reductions in stress-related biomarkers along with improvements in sleep quality. The review highlights that ashwagandha's effects on sleep are mediated through modulation of the HPA axis and GABAergic signaling.
Breast cancer survivors with sleep disturbances have positive attitudes toward text messaging-based mobile health interventions for improving sleep and physical activity.
This qualitative study explored preferences of 16 breast cancer survivors (mean age 59.3 years) with sleep disturbances for SMS text messaging-based interventions targeting sleep and physical activity. Most participants reported positive attitudes and high acceptance of text messaging and mobile apps, but not voice interactions, with daily reminders scheduled 1 hour before bedtime being acceptable.
Sleep quality mediates the relationship between mental health and functional outcomes in early adolescence
Sleep quality mediated 18.5%, 36.3%, and 8.3% of the relationships between depression, anxiety, and psychotic-like experience distress with academic functioning, respectively, and 19.6-23.3% of the relationships with social problems. Screen time was the second strongest mediator, but only sleep quality showed >3% mediation for social problems.
Apigenin, luteolin, and piplartine are core active components of Sugemule-4 that bind to EGFR, potentially treating insomnia through serotonergic synapse and calcium signaling pathways.
The study identified 106 active compounds and 364 overlapping targets for Sugemule-4 in insomnia treatment. Network pharmacology and molecular docking revealed that apigenin, luteolin, and piplartine bind strongly to EGFR, with molecular dynamics confirming stable interactions, suggesting multi-target mechanisms via serotonergic synapse and calcium signaling pathways.
Comorbidities complicate multiple sclerosis management by exacerbating symptoms and influencing clinical decision-making
This qualitative pilot study found that comorbidities significantly complicate MS management, as reported by both individuals with MS and healthcare professionals. Participants emphasized the need for enhanced coordination between providers and more comprehensive, interdisciplinary care models.
Custom Plaso plugins outperform iLEAPP by extracting previously unrecoverable Apple Health features across multiple iOS versions
The study developed custom plugins for the log2timeline Plaso framework to automate extraction of Apple Health records. Tested across iOS versions 13.3.1, 13.4.1, 15.3.1, 16.1.2, and 17.3, the plugins successfully extracted features that iLEAPP could not recover, integrating disparate schema variations into a unified timeline.
Magnesium supplementation is associated with high participant satisfaction and perceived improvements in sleep quality in adults with type 2 diabetes
In a cross-sectional survey of 132 participants from a randomized, double-blind clinical trial on magnesium supplementation in type 2 diabetes, 87.88% would recommend participation and over half reported symptom improvements, including in sleep quality. Satisfaction scores were consistently positive, with high internal consistency (Cronbach's alpha=0.93) and strong construct validity.
Controlled intermittent hypoxia training increases mitochondrial biogenesis and oxidative capacity, while chronic intermittent hypoxia in obstructive sleep apnea promotes oxidative stress, endothelial injury, and periodontal inflammation.
This narrative review contrasts the effects of controlled intermittent hypoxia training (IHT) and uncontrolled chronic intermittent hypoxia (CIH) in obstructive sleep apnea (OSA) on mitochondrial health. Appropriately dosed IHT enhances mitochondrial biogenesis and oxidative capacity via PGC-1alpha and hypoxia-inducible signaling, whereas CIH in OSA drives oxidative stress, sympathetic activation, endothelial injury, and is associated with worse periodontal status and altered salivary microbiome. The paper positions these as opposite ends of a hypoxia continuum, with sphingolipid signaling linking CIH to mitochondrial fragmentation and insulin resistance.
Tart cherry consumption improves sleep quality and increases melatonin levels in adults with sleep disorders
A systematic review of seven interventional studies found that tart cherry consumption significantly improved sleep indicators such as sleep duration, sleep efficiency, or sleep onset time in three studies, and increased melatonin levels in three studies. Two studies also reported decreases in inflammatory markers like CRP and MDA. However, the evidence is limited and heterogeneous due to variations in dose, duration, and population characteristics.
Clinicians managing pediatric HSCT inpatients estimate 58% develop sleep issues, and they most commonly implement patient-level interventions like melatonin despite rating external factors like noise as most impactful.
A survey of 111 pediatric HSCT clinicians (prescribers, nurses, psychosocial staff) across the US found they estimate 58% of inpatients develop sleep issues. Although clinicians rated external factors (e.g., noise) as most impactful, they were most likely to implement patient-level interventions such as melatonin. The study highlights the lack of clinical guidelines and the need for research on treatment efficacy and systems-level changes.
Pain severity peaks during early menopause and declines postmenopause, with trajectories varying by pain type and comorbidity.
The review found that across five major pain categories (musculoskeletal, urogenital, gastrointestinal, oral/orofacial, and multisite pain), pain severity is commonly reported to peak during early menopause and decline postmenopause. However, trajectories vary by pain type and comorbidity. This pattern was identified from 115 studies published between 2014 and 2024.
Tart cherry juice promotes sleep quantity in team-sport athletes and healthy adults
The narrative review reports that tart cherry juice can promote sleep quantity in athletes and healthy adults. This finding is based on a semi-systematic review of studies up to November 2020, though specific effect sizes are not provided in the abstract.
Melatonin administration at around 6 PM (1-2 hours before bedtime) optimizes sleep cycle regulation and reduces bedtime resistance in elderly patients
The paper recommends administering melatonin 1-2 hours before bedtime (around 6 PM) to regulate sleep cycles and improve bedtime compliance in elderly patients. This timing is proposed as the standard of care in hospitals, nursing homes, and at home for managing insomnia and circadian rhythm disruption.
The FNPA-PT screening tool demonstrates strong face and content validity for assessing obesogenic family environments in Portuguese well-child visits
The study translated and culturally adapted the Family Nutrition and Physical Activity (FNPA) screening tool for Portugal (FNPA-PT). Cognitive interviews with 10 parents of 5-year-old children showed 85% semantic equivalence and high acceptability, with minor revisions to three items.
Adenotonsillectomy improves most children with pediatric obstructive sleep apnea, although residual disease remains common.
Pediatric obstructive sleep apnea (OSA) affects approximately 2-5% of children. Adenotonsillectomy is the first-line therapy and improves most patients, but residual disease is common.
Shift work exposure is associated with adverse sleep-related and mental health outcomes in adult workers
This systematic review of 11 studies found that shift work exposure is associated with sleep-related outcomes such as insomnia, poor sleep quality, and shift work sleep disorder, as well as mental health outcomes including depression, anxiety, stress, and fatigue. The review included diverse occupational groups across Europe, North America, Asia, and Australia, with overall moderate to high methodological quality.
Immersive VR exercise (exergaming) generates moderate-to-vigorous physical activity comparable to traditional exercise and may enhance NAD+ metabolism via NAMPT activation.
The review finds that immersive VR exercise (exergaming) produces levels of moderate-to-vigorous physical activity similar to traditional exercise. It suggests that such activity may enhance NAD+ metabolism through NAMPT activation, though no human study has yet measured blood NAD+ levels alongside VR interventions.
Bone stress injury healing in runners is assessed inconsistently across clinical, functional, and imaging outcomes, limiting comparability and evidence-based return-to-sport guidelines.
This protocol describes a 1-year multi-site prospective observational cohort study of runners with MRI-confirmed bone stress injuries (BSIs) of the tibia, metatarsals, femoral neck, or sacrum. The study aims to characterize candidate outcomes for BSI healing, including time to pain-free functional milestones, return-to-run protocol completion, medical clearance, and changes in MRI grade and clinical severity scores, along with their time course and variability.
Sleep deprivation disrupts the function of multiple organ systems including the nervous, cardiovascular, respiratory, digestive, immune, and endocrine systems.
This narrative review synthesizes findings from epidemiological, clinical, and preclinical studies showing that sleep deprivation profoundly disrupts multiple organ systems. The review covers nervous, cardiovascular, respiratory, digestive, immune, and endocrine systems, with underlying mechanisms including neuroinflammation, gut barrier disruption, and impaired hippocampal structure.
Sleep continuity is crucial for fatigue and sustained attention during cold-environment military training
First-year cadets with higher physical activity and less total sleep showed increased fatigue and declines in sustained attention (PVT reaction time) and jump performance, while second-year cadets with more sleep showed partial recovery. Perceived fatigue increased post-first training block only in first-year cadets (p=0.003), and increased fatigue correlated negatively with PVT performance (all p<0.043).
Undergraduate medical students show a mismatch between awareness of OSA symptoms and help-seeking behavior, with most opting for self-directed changes instead of professional help.
A qualitative study of 36 undergraduate medical students found that only a few demonstrated accurate knowledge of OSA, while the majority reported symptoms like daytime sleepiness due to academic burden. Despite this, help-seeking behavior was low, with most students choosing self-directed changes such as increasing exercise and adjusting sleep schedules.
Smartphone screen time fails as a momentary proxy for sedentary behavior because a substantial proportion occurs during non-sedentary behavior
In a sample of 63 adult caregivers, a median of 25.9% of smartphone screen time occurred during non-sedentary behavior, with individual variability ranging from 5.6% to 73.7%. Among non-sedentary screen-use epochs, 52.1% were inactive and 47.9% were active, and app type influenced the proportion of non-sedentary use.
Fatigue in inflammatory rheumatic diseases frequently persists after clinically visible inflammation has improved, a mismatch termed the 'fatigue remission gap'.
This narrative review of evidence through July 2026 finds that fatigue in RA, SLE, and SjD is more strongly associated with pain, sleep disturbance, mood, and central pain sensitivity than with conventional inflammatory measures. In a 2026 RA cohort of 253 patients, 80% reported fatigue and 10% had severe fatigue, with fatigue present even in remission. The authors propose a treatable-traits framework to address this gap rather than escalating immunosuppression.
Phytochemicals such as resveratrol, epigallocatechin gallate, curcumin, jaceosidin, cucurbitacin, apigenin, and genistein trigger activation or inactivation of ATM in different cancer cells, modulating DNA damage response.
This review summarizes evidence from cell-based studies that various phytochemicals can modulate ATM signaling, a master regulator of DNA double-strand break repair. These compounds either activate or inhibit ATM in different cancer cell lines, potentially influencing cell cycle checkpoints, DNA repair, and apoptosis. The paper highlights the therapeutic potential of targeting ATM to enhance responses to DNA damage-inducing therapies.
Nightly melatonin supplementation improves sleep quality and selected oxidative or circadian surrogate endpoints in hemodialysis patients, but its effect on slowing CKD progression or preserving renal function remains unproven.
Current clinical studies suggest that nightly melatonin supplementation can improve sleep quality and certain oxidative or circadian surrogate markers in hemodialysis patients. However, whether melatonin slows chronic kidney disease progression or preserves renal function has not been established.
Energy drink consumption in youth causes acute cardiovascular changes including elevated blood pressure, autonomic dysregulation, and cardiac rhythm disturbances
Randomized pediatric trials demonstrate that commercially available doses of energy drinks produce acute changes in blood pressure, autonomic regulation, and cardiac rhythm in youth. Systematic reviews, poison-center surveillance, and sudden-cardiac-arrest series identify a consistent cardiovascular signal with rare severe events, particularly when combined with exercise, heat, dehydration, illness, sleep loss, or other stimulants.
Sleep deprivation profoundly disrupts the function of multiple organ systems, including the nervous, cardiovascular, respiratory, digestive, immune, and endocrine systems.
This narrative review synthesizes evidence from epidemiological, clinical, and preclinical studies showing that sleep deprivation disrupts multiple organ systems. The review highlights mechanisms such as neuroinflammation, gut barrier disruption, and impaired hippocampal structure.
A fully integrated wireless facemask with mCP/ZIF-8-NH2@fCOF nanocomposite enables ultrafast, humidity-resistant exhaled CO2 monitoring for breathing pattern classification and disease diagnosis.
The smart facemask uses a nanocomposite colorimetric sensing material with a 60 ms response time and hydrophobic shell to resist humidity. Coupled with a convolutional neural network, it identifies breathing patterns with 94% accuracy and diagnoses chronic obstructive pulmonary disease with 93% accuracy. It also proves effective for exercise monitoring and sleep apnea detection.
Sleep dysfunction is common and clinically meaningful in patients with chronic spontaneous urticaria (CSU), supporting routine sleep assessment.
Patients with CSU consistently report worse global sleep quality, shorter sleep duration, longer sleep latency, and greater insomnia severity compared to controls. Poor sleep is associated with higher disease activity (UAS7), lower disease control (UCT), and worse quality of life, along with co-occurring anxiety, depression, fatigue, and headache.
Post-COVID paediatric dysautonomia arises from complex brain-heart-vascular network dysfunction, with tachycardia as a compensatory response rather than primary cardiac abnormality
The paper argues that post-COVID dysautonomia in children is primarily a disorder of central autonomic network dysfunction and neurovascular dysregulation, not a primary cardiac condition. Tachycardia is described as a compensatory physiological response to impaired venous return, endothelial injury, hypovolemia, and altered cerebral perfusion.
Custom Plaso plugins outperform iLEAPP by successfully extracting previously unrecoverable Apple Health features across multiple iOS versions
The study developed custom plugins for the log2timeline Plaso framework to automate extraction of Apple Health records. Tested across iOS 13.3.1, 13.4.1, 15.3.1, 16.1.2, and 17.3, the plugins outperformed iLEAPP by recovering features that were previously unrecoverable, integrating disparate schema variations into a unified timeline.
Post-COVID paediatric dysautonomia arises from complex interactions among central autonomic network dysfunction, neurovascular dysregulation, impaired venous return, endothelial injury, hypovolemia, and altered cerebral perfusion, with tachycardia often representing a compensatory physiological response rather than a primary cardiac abnormality.
This paper argues that post-COVID dysautonomia in children is primarily a brain-vascular network disorder, not a primary cardiac condition. Tachycardia is described as a compensatory response to underlying autonomic and vascular dysfunction. The authors emphasize the need for standardized assessment and exclusion of structural heart disease.
The translated and culturally adapted FNPA-PT screening tool demonstrates strong face and content validity for assessing obesogenic family environments in Portuguese well-child visits.
The FNPA-PT was developed through a rigorous seven-stage translation and cross-cultural adaptation process, achieving high semantic equivalence (85% of items with satisfactory or perfect equivalence). Cognitive interviews with 10 parents of 5-year-old children showed the tool was well understood, acceptable, and feasible for use during well-child visits.
Higher training intensity and volume are associated with lower depressive symptoms in young adults
In a cross-sectional study of 349 predominantly young adults (median age 21), higher training intensity and volume were associated with lower depressive symptoms as measured by the Beck Depression Inventory. Sleep quality did not mediate this relationship except for the daytime dysfunction domain. Participants with 3-5 years of training experience had lower BDI scores than those with less than 12 months of experience.
The Family Nutrition and Physical Activity screening tool was successfully translated and culturally adapted for Portuguese parents, demonstrating strong face and content validity.
The FNPA-PT was developed through a rigorous seven-stage translation and cross-cultural adaptation process, achieving 85% semantic equivalence between forward and back translations. Cognitive interviews with 10 parents of 5-year-old children showed the tool was well understood, acceptable, and feasible for use during well-child visits.
Melatonin-rich foods improve sleep quality, duration, and efficiency in individuals with sleep disturbances
A scoping review of 19 articles (14 interventional trials and 5 cross-sectional studies) found that consuming melatonin-rich foods such as Montmorency tart cherries, Jerte Valley cherries, tomatoes, and kiwifruit may improve sleep quality, duration, and efficiency, particularly in individuals with sleep disturbances. Findings were heterogeneous across studies.
Adaptive forensic plugins for Apple Health data extraction outperform existing tools across multiple iOS versions
The study developed custom plugins for the log2timeline Plaso framework to automate extraction of Apple Health records across iOS versions 13.3.1, 13.4.1, 15.3.1, 16.1.2, and 17.3. The plugins successfully extracted previously unrecoverable Apple Health features and outperformed iLEAPP by integrating disparate schema variations into a unified timeline, reducing manual analysis effort.
Gut microbiota taxa Enterorhabdus, Family XIII AD3011 group, Paraprevotella, and Lachnospiraceae UCG004 are associated with increased insomnia risk, while Coprococcus1, Coprobacter, Desulfovibrio, Flavonifractor, Olsenella, Odoribacter, and Oscillibacter are linked to decreased insomnia risk.
A Mendelian randomization study of European ancestry individuals identified multiple genus-level gut microbial taxa with potential causal effects on insomnia risk. Four taxa were associated with increased risk, and seven with decreased risk, with results robust across sensitivity analyses.
Kiwifruit, Tart Cherry Juice, and high dairy intake promote sleep in elite athletes
This scoping review identified that kiwifruit, Tart Cherry Juice, and high dairy intake (limited to females) demonstrated the highest potential to promote sleep in elite athletes, despite limited sample sizes. Protein-based interventions may have a ceiling effect when athletes already consume >2.5 gĀ·kgā»Ā¹ body mass or meet sleep duration needs.
Dexmedetomidine reduces perioperative neurocognitive disorders in older surgical patients
Dexmedetomidine is a pharmacologic agent extensively studied for perioperative neurocognitive disorders (PNDs) in older patients, with relatively strong supporting evidence. PNDs include postoperative delirium, delayed neurocognitive recovery, and long-term cognitive impairment, leading to prolonged hospital stay and reduced quality of life.
Medical students report a significant decline in healthy dietary, exercise, and sleep habits compared to their pre-matriculation status.
A cross-sectional survey of 401 medical students found that 70% did not eat as healthy and 79% did not exercise as much as they would like, with 48% and 57% perceiving their diet and exercise habits as healthier before medical school. Time constraints (88%), fatigue (73%), and cost (62%) were the most commonly cited barriers.
Carbohydrate intake of ~1.2 g/kg body mass per hour for up to 4 hours post-exercise is essential for restoring glycogen reserves, supporting immune system energy needs, and facilitating tissue repair in athletes.
The paper recommends consuming approximately 1.2 grams of carbohydrate per kilogram of body mass per hour for up to four hours after exercise to optimize glycogen restoration, immune function, and tissue repair. This is part of the 'Refuel' component of the 4Rs framework for post-exercise recovery within an allostasis paradigm.
At-home caregiver-operated dry-electrode EEG monitoring reveals significant sleep architecture disruptions in people with Lennox-Gastaut syndrome compared to neurotypical controls
The HEADFIRST study found that individuals with Lennox-Gastaut syndrome (LGS) had significantly more wake after sleep onset (43.0 min vs 18.0 min), reduced REM sleep duration (51.3 min vs 100.6 min), and fewer sleep cycles (2.6 vs 4.6) compared to neurotypical sibling controls. Caregivers successfully recorded usable EEG data in 83% of LGS participants and 90% of controls over multiple nights at home.
Persistent physical problems, including pain, sleep disturbance, and activity limitations, form the functional context of posttreatment survivorship among Korean breast cancer survivors.
This integrative review of 12 publications found that persistent physical problems such as pain, sleep disturbance, and activity limitations are central to the posttreatment experience of Korean breast cancer survivors. These issues form the functional context within which survivors rebuild everyday life, alongside psychological concerns like body-image issues and fear of recurrence.
Postgraduate medical residents have an alarmingly high prevalence of low back pain, with significant associations to exercise, lifestyle, work satisfaction, and anxiety.
The study found a 1-year prevalence of low back pain of 67.2% among 195 postgraduate medical residents. Key risk factors included long hours of sitting (74.4%), improper posture (72.8%), fatigue (64.6%), and bad mattress (53.8%).
A multimodal personalised precision geromedicine intervention improves muscle strength, immune function, and cognitive performance in middle-aged-to-older adults
The PROMETHEUS protocol tests an 8-week multimodal intervention including sleep and dietary recommendations, supplements, exercise, and cognitive therapy in 20 middle-aged-to-older participants. Primary outcomes measure muscle strength and mass, immune function, and cognitive performance, with feasibility indicators such as adherence and trial completion. The study aims to inform a subsequent 12-month randomised controlled trial.
Hericium erinaceus improves symptoms of sleep disorders
This systematic review found that Hericium erinaceus (Lion's Mane mushroom) supplementation reduced symptoms of sleep disorders in human and animal studies. The review included five randomized controlled trials and three pilot clinical trials, though specific sleep-related effect sizes were not reported.
Shared decision-making platforms can optimize oxybate therapy selection and outcomes in narcolepsy patients
The review suggests that involving patients in decision-making through shared decision-making (SDM) platforms can be effective for optimizing oxybate therapy in narcolepsy. It highlights the availability of three oxybate formulations (OXB, LXB, SO-ER) and the need for tailored treatment. No quantitative outcomes or effect sizes are reported.
Physical fatigue and depression are prioritized intervention targets for breaking the vicious cycle of psychoneurological symptom cluster interactions in breast cancer patients
In a cross-sectional study of 304 breast cancer patients, network analysis identified physical fatigue (EI=1.883) and depression (EI=0.794) as core symptoms, while computer-simulated interventions showed that targeting depression produced the largest reduction in symptom sum scores (from 5.98 to 4.67). The findings suggest that physical fatigue and depression should be prioritized as intervention targets to disrupt symptom interactions within the psychoneurological symptom cluster.
The OPN4 I394T variant (C allele) is associated with altered non-image-forming physiology in young adults, including phase-delayed rhythms, reduced rhythm robustness, and lower nocturnal melatonin levels.
In 25 healthy young adults, carriers of the I394T-C allele showed a phase delay in habitual sleep and wrist temperature rhythms, reduced wrist temperature amplitude, greater internal desynchronization, and lower nocturnal melatonin concentrations under dim light compared to the TT group. Circadian phase (DLMO) remained preserved, leading to an increased phase angle of entrainment, and on free days they showed greater melatonin suppression despite similar light exposure.
Synchronous tele-pulmonary rehabilitation may enhance safety and group camaraderie, while asynchronous delivery offers flexibility and individualized engagement.
This narrative review from a 2025 ATS symposium discusses unresolved issues in tele-pulmonary rehabilitation, comparing synchronous vs. asynchronous delivery, equipment needs, and outcomes. Synchronous tele-PR may improve safety and real-time feedback, whereas asynchronous delivery provides flexibility. The review emphasizes that all PR models must deliver core components and be rigorously evaluated.
Continuous glucose monitoring identifies asymptomatic hypoglycemia and improves glycemic control in hepatic glycogen storage diseases
CGM consistently detected asymptomatic hypoglycemia in GSD patients, with adult cohorts spending up to 12% of time below 70 mg/dL despite normal spot checks. CGM-guided dietary titration improved Time in Range from 72% to 86% in gene therapy trials and reduced serum triglycerides and liver size.
Sex-specific associations exist between work-related factors, sleep problems, and metabolic syndrome in Taiwanese workers, with sleep disturbances and sleep latency predicting metabolic syndrome in men, and shift work predicting metabolic syndrome in women.
In a cross-sectional study of 348 Taiwanese workers, the prevalence of metabolic syndrome was 26.4%, higher in men (33.3%) than in women (19.3%). Among men, sleep disturbances and sleep latency were significant predictors of metabolic syndrome, while among women, shift work and body mass index were associated with metabolic syndrome.
Moderate-to-severe obstructive sleep apnea is associated with selective prolongation of the long-latency reflex component LLR2, indicating altered cortical sensorimotor processing.
In a study of 39 OSA patients and 21 healthy controls, LLR2 latency was significantly prolonged in moderate-to-severe OSA compared to controls (53.1 vs. 50.4 ms, p=0.014). This effect remained significant after adjusting for age and BMI (F=3.686, p=0.032), suggesting a selective slowing of cortical sensorimotor integration in more severe OSA.
Nature-based physical activity may improve sleep disturbances in breast cancer survivors
The paper discusses that breast cancer survivors frequently experience sleep disturbances, and nature-based physical activity (NBPA) is proposed as a promising complementary approach to improve these outcomes. However, direct evidence specifically addressing breast cancer survivors remains limited, and the proposed mechanisms are considered plausible hypotheses requiring further validation.
Earlier or more regular eating patterns, postprandial physical activity, and stable sleep-wake schedules are associated with more favorable cardiometabolic profiles, but integrated eating-activity-sleep coherence is not yet validated.
This narrative review proposes 'rhythm coherence' as a framework for the temporal stability and alignment of eating, physical activity, and sleep. Based on a staged evidence-identification process, 131 high-priority records were synthesized, and selected studies showed associations between regular eating, postprandial activity, and stable sleep with better cardiometabolic profiles. However, the evidence is heterogeneous and does not establish an effect of the integrated framework or the proposed Rhythm Coherence Index (RCI).
Sleep disturbances and sleep latency are significant predictors of metabolic syndrome in male Taiwanese workers
In a cross-sectional study of 348 Taiwanese workers, the prevalence of metabolic syndrome was 26.4%, with higher rates in men (33.3%) than women (19.3%). Among men, sleep disturbances and sleep latency were significant predictors of metabolic syndrome, while shift work and body mass index were associated in women.
Poor sleep health dimensions are associated with a higher risk of hypertension.
This review synthesizes evidence that prolonged sleep latency, greater wake after sleep onset, both short and long sleep duration, poor overall sleep quality, and reduced sleep efficiency are associated with a higher risk of hypertension. Most studies are cross-sectional and rely on subjective measures, limiting causal inference.
Nurses' professional quality of life profiles are significantly associated with posttraumatic growth.
A latent profile analysis of 1010 nurses from 10 tertiary hospitals in Sichuan, China identified three professional quality of life profiles: 'Depleted' (12.48%), 'Balanced' (63.96%), and 'Thriving' (23.56%). Hierarchical regression showed that these profiles were significantly associated with posttraumatic growth, indicating that nurses with different professional quality of life profiles experience different levels of posttraumatic growth.
Bedtime rumination mediates the association between burnout and insomnia in emergency department staff
This study found that cognitive pre-sleep arousal, specifically bedtime rumination, fully mediated the relationship between burnout and insomnia in emergency department staff. Vulnerable shift adaptors, identified by lower-than-expected sleep metrics given their schedule load, reported higher burnout, emotional exhaustion, and insomnia. The findings support a cognitive-behavioral framework linking stress-related cognition to both subjective sleep complaints and objective shift adaptation.
Prader-Willi Syndrome presents with initial growth failure followed by progressive weight gain, excessive eating, and cognitive impairment in children
This case report describes a 7-year-old Nigerian girl with Prader-Willi Syndrome confirmed by DNA analysis, who presented with a 4-year history of progressive weight gain, voracious appetite, snoring during sleep, and poor academic performance. She had feeding difficulties and growth failure in the first year of life, followed by excessive eating and weight gain from age 3. Dietary modification and planned exercises led to a 3 kg weight loss over eight months.
VA Whole Health coaching improves sleep quality in veterans with complex health needs
This pilot study found that VA Whole Health coaching significantly improved sleep quality among veterans with complex health concerns. Sleep quality was measured as a secondary outcome, and the improvement was statistically significant with corrected P-values ā¤0.0045.
Strict alcohol reduction to three or fewer drinks per week decreases the risk of arrhythmia recurrence in atrial fibrillation patients
The paper states that limiting alcohol intake to three or fewer drinks per week reduces the risk of arrhythmia recurrence in patients with atrial fibrillation. This is presented as a key lifestyle intervention for secondary prevention of AF.
Family home-based intervention improves physical quality of life in guardians with overweight/obesity and reduces BMI z-score in children with overweight/obesity
A 12-month home-based family intervention was tested in 142 families with at least one child with overweight/obesity. Children with overweight/obesity showed decreased BMI z-score over time (p = 0.001), and guardians with overweight/obesity improved physical quality of life at the end of the program (p = 0.002). The study suggests family-centered strategies may be effective for childhood obesity.
Sexual activity does not impair athletic performance or recovery when occurring several hours or more before competition
This narrative review synthesizes evidence that sexual activity elicits mild physiological responses comparable to light physical exertion and does not meaningfully deplete energy stores or impair strength, endurance, power, or coordination when occurring several hours or more before competition. Psychological outcomes such as reduced anxiety and improved mood may support readiness and recovery, while negative effects are more often linked to sleep disruption or maladaptive timing rather than sexual activity itself.
Higher average levels of pre-sleep cognitive arousal, rumination, and anticipatory stress are associated with poorer sleep quality and shorter sleep duration in emerging adults
In a 7-day smartphone-based diary study of 166 emerging adults (mean age 20.36 years, 80.1% female), higher between-person average levels of pre-sleep cognitive arousal, rumination, and anticipatory stress were associated with poorer sleep quality and shorter sleep duration. No significant associations were found for sleep onset latency, and within-person day-to-day variations in these cognitive processes were not related to next-morning sleep outcomes.
Ashwagandha supplementation at 330-1000 mg daily increases endurance and facilitates quicker recoveries in athletes
The narrative review reports that ashwagandha dosages of 330-1000 mg daily increase endurance and speed recovery, with a twice-daily dose of 300 mg combined with weight training enhancing muscular strength and hypertrophy. Typical dosage in sports is approximately 600 mg/day, with lower doses for less active individuals.
Sleep disruption amplifies neuroendocrine and inflammatory pathways contributing to skin aging
The review finds that chronic stress and sleep disruption amplify neuroendocrine and inflammatory pathways, which are linked to skin aging. These lifestyle factors modulate redox balance, inflammatory signaling, and dermal matrix integrity.
Post-COVID paediatric dysautonomia is best conceptualised as a distributed brain-heart-vascular network disorder rather than a primary cardiac abnormality
The paper argues that post-COVID dysautonomia in children arises from complex interactions among central autonomic network dysfunction, neurovascular dysregulation, and impaired venous return, with tachycardia representing a compensatory physiological response. Clinical phenotypes include POTS, neurocardiogenic syncope, and orthostatic intolerance, often accompanied by fatigue, cognitive dysfunction, and sleep disturbances.
Poor sleep health dimensions, including prolonged sleep latency, greater wake after sleep onset, short and long sleep duration, poor sleep quality, and reduced sleep efficiency, are associated with a higher risk of hypertension.
This review synthesizes evidence linking multiple sleep health dimensions to hypertension risk. Prolonged sleep latency, greater wake after sleep onset, both short and long sleep duration, poor overall sleep quality, and reduced sleep efficiency are each associated with a higher risk of hypertension. The findings suggest a multidimensional approach to sleep health may reduce hypertension risk and improve blood pressure control.
CGM-guided dietary titration improves Time in Range in hepatic GSD patients
In interventional settings, CGM-guided dietary titration improved Time in Range from 72% to 86% in gene therapy trials, and reduced serum triglycerides and liver size. CGM consistently identified asymptomatic hypoglycemia, with adult cohorts spending up to 12% of time below range despite normal spot checks.
Nutritional interventions such as carbohydrate, caffeine, creatine, kiwifruit, magnesium, meal timing, protein, and tart cherry may improve sleep duration and quality in athletes.
The review indicates that certain nutritional strategies and supplements have an evidence base for improving sleep in athletes, including carbohydrate, caffeine, creatine, kiwifruit, magnesium, meal make-up and timing, protein, and tart cherry. However, further research is needed to clarify interactions between nutrition and the circadian system. The paper does not provide specific effect sizes or quantitative outcomes.
Single-team models using machine learning identify influential predictors of athlete availability in elite female athletes, with differing predictors between lacrosse and soccer teams.
This study used elastic net regression to identify predictors of athlete availability (percentage of unmodified practices and games) in 52 NCAA Division I female lacrosse and soccer athletes. Combined model RMSE was 17.8%, while single-team models showed RMSEs of 8.9% (lacrosse) and 17.8% (soccer), with no force plate variables selected for lacrosse and no body composition variables for soccer.
K-means clustering combined with latent structure analysis identifies 9 depression subtypes with distinct medication patterns in Traditional Chinese Medicine
This study analyzed 4434 prescriptions from 3537 publications and used K-means clustering with latent structure analysis to classify depression patients into 9 subtypes. The most common symptoms were insomnia and depressed mood, and the most frequently used herbs were Radix Bupleuri, Radix Paeoniae Alba, Poria, Rhizoma Chuanxiong, and Radix Curcumae. Medication patterns varied by subtype, with blood-activating herbs used for Clusters 1, 2, and 6; qi-regulating herbs for Clusters 3, 4, 5, 8, and 9; and qi-supplementing herbs for Cluster 7.
Seizure forecasting algorithms show promising performance in retrospective datasets but lack prospective real-world validation and regulatory approval for clinical translation.
The paper reviews advances in seizure forecasting, including algorithm development and chronic EEG, but notes that prospective validation and regulatory approval remain rare. Clinical translation is hindered by barriers like reliable annotation, nonstationarity, and ethical concerns.
Obstructive sleep apnea increases sarcopenia risk in the elderly
Population studies, including NHANES data, show sarcopenia prevalence of 12% in patients with OSA versus 5.5% in those without. Mendelian randomization studies suggest a bidirectional causal relationship between OSA and sarcopenia.
Bedtime rumination mediates the burnout-insomnia link in emergency department staff
This study found that cognitive pre-sleep arousal (bedtime rumination) fully mediated the association between burnout and insomnia in emergency department physicians and nurses. Vulnerable shift adaptors, defined by lower-than-expected sleep metrics given their schedule load, reported higher burnout, emotional exhaustion, and insomnia.
Nighttime low-frequency noise in the ICU is associated with sleep structure disturbance and increased delirium risk in patients with multiple organ dysfunction syndrome
In a study of 172 MODS patients, 72-h LAeq was highest in the low-frequency band, and delirium incidence was 47.67%. Nighttime low-frequency noise was positively correlated with sleep latency and awakenings, and negatively correlated with slow-wave sleep and REM sleep proportions. Multivariate logistic regression identified elevated nighttime low-frequency noise and decreased SWS and REM proportions as independent risk factors for delirium.
Single-dose stimulant medication causes apparent increases in gray matter volume and cortical thickness in adults with ADHD within 1-2 hours.
In 78 participants (42 healthy controls, 36 adults with ADHD), acute ingestion of a single dose of stimulant medication led to apparent increases in gray matter volume in multiple brain regions and widespread right-lateralized increases in cortical thickness, which were observed in ADHD patients but not healthy controls. The study is the first to show such apparent structural brain changes within 1-2 hours after stimulant ingestion in adults with ADHD.
Contactless ballistocardiography overestimates total sleep time and underestimates deep and REM sleep compared to polysomnography in older adults
In 17 older male participants (aged 50-80), the BCG-based device Dozee overestimated total sleep time by 83.00 minutes and underestimated deep sleep by 29.53 minutes and REM sleep by 45.63 minutes compared to polysomnography. The apnea-hypopnea index was modestly overestimated by 7.18 events/hour, with wide limits of agreement indicating substantial discrepancies.
Ashwagandha supplementation increases endurance and facilitates quicker recoveries in athletes
Studies suggest that Ashwagandha dosages of 330-1000 mg daily increase endurance and facilitate quicker recoveries. A twice daily dose of 300 mg in combination with weight training increases muscular strength and hypertrophy. Typical dosage in the sporting field is approximately 600 mg/day.
Loop-region mutations in CSNK2A1 are associated with higher symptom burden in OCNDS
In 48 individuals with OCNDS, variants in loop regions of CK2Ī± were associated with significantly younger age at diagnosis and higher frequency of hypotonia. Mutations in the glycine-rich loop were linked to significantly higher symptom burden and more non-seizure neurological symptoms.
Exogenous melatonin exhibits both therapeutic benefits and potential toxicological concerns, particularly in specific populations
This review explores melatonin's dual role as a therapeutic agent for conditions like insomnia and gastrointestinal disorders, while highlighting emerging toxicological concerns. The paper emphasizes the need for further studies to balance therapeutic benefits with safety, especially in susceptible groups.
Hub herb pairs (Radix Astragali-Radix et Rhizoma Ginseng, Rhizoma Chuanxiong-Radix Glycyrrhizae, Seman Platycladi-Semen Ziziphi Spinosae, Pericarpium Citri Reticulatae-Radix Glycyrrhizae, Radix Polygalae-Semen Ziziphi Spinosae, and Radix Astragali-Semen Ziziphi Spinosae) may treat insomnia via the cAMP signaling pathway synergistically with HIF-1, prolactin, chemical carcinogenesis receptor activation, and PI3K-Akt signaling pathways.
This study analyzed 104 TCM prescriptions for insomnia using data mining, network pharmacology, and molecular docking. Six hub herb pairs were identified, and network pharmacology suggested they may act through the cAMP signaling pathway in synergy with other pathways. Molecular docking indicated good binding between active ingredients and hub targets.
Hub herb pairs (e.g., Radix Astragali-Radix et Rhizoma Ginseng) may treat insomnia through the cAMP signaling pathway synergistically with HIF-1, prolactin, chemical carcinogenesis receptor activation, and PI3K-Akt signaling pathways.
This study analyzed 104 TCM prescriptions for insomnia and identified six hub herb pairs using data mining. Network pharmacology suggested that these pairs may act via the cAMP signaling pathway in coordination with HIF-1, prolactin, chemical carcinogenesis receptor activation, and PI3K-Akt pathways, with molecular docking confirming good binding affinity between active ingredients and hub targets.
Better sleep is associated with higher physical activity the next day in adults with autism
In a cohort study of 17 adults with autism, better sleep was significantly associated with higher physical activity (step count) the next day. No consistent effect was found of sleep on stress the next day or of stress on sleep quality the following night, with substantial individual variability.
CNS-focused interventions support CNS quiescence and return to homeostasis in fibromyalgia
The paper states that successful pharmacologic and nonpharmacologic interventions for fibromyalgia focus on the central nervous system to support CNS quiescence and a return to homeostasis. Fibromyalgia is characterized by CNS hyperresponsiveness to sensory stimuli, and management aims to reduce this hyperresponsiveness.
Patients with late-life depression exhibit subjective-device-estimated discrepancies in sleep parameters, with greater depressive symptom severity associated with greater underestimation of total sleep time
In a cross-sectional study of 94 patients with late-life depression, subjective reports significantly differed from device-estimated measures for total sleep time (TST), sleep onset latency (SOL), and sleep efficiency (SE). Greater depressive symptom severity was associated with greater subjective underestimation of TST (p = 0.037), while later age at first onset was associated with greater subjective underestimation of SE (p = 0.013).
Higher academic stress is longitudinally associated with less favorable eating-related patterns, nutritional and somatic indicators, higher depressive symptoms, and altered cortisol dynamics in university students.
This study protocol hypothesizes that within-semester academic stress in university students is associated with adverse changes in eating patterns, nutritional status, somatic health, depressive symptoms, and stress-related physiological markers (lower cortisol awakening response, higher salivary alpha-amylase). The study uses a longitudinal, observational design with repeated measures across three assessment cycles in a convenience sample of undergraduate students.
Therapies targeting the neuro-vascular-immune triad show promise for treating rosacea but lack large-scale randomized controlled trials.
This review summarizes rosacea treatments targeting the neuro-vascular-immune triad, including Ī³-aminobutyric acid derivatives, antidepressants, anti-calcitonin gene-related peptide agents, physical neuromodulation, botulinum toxin type A, and Ī²-blockers. The authors note that while these therapies can specifically regulate different stages of the pathway, their evidence lacks large-scale randomized controlled trials and clarity regarding optimal dosing regimens and treatment durations.
Weekly physical activity trajectories differ between adolescent and adult childhood cancer survivors and controls, with weekend drops in activity common across groups.
The study identified four weekly physical activity trajectories among adolescent and adult childhood cancer survivors using accelerometer data. Key factors associated with different trajectories included sex, age, sleep, and parental education, with diagnosis important only in adolescents. Adolescent survivors had fewer individuals in the low activity trajectory compared to controls, while adult survivors showed no low regular MVPA trajectory.
Poor sleep and circadian health are linked to increased risk for cardiovascular disease, metabolic dysfunction, and cognitive performance decrements in midlife women.
The paper reports that midlife women, especially during the menopausal transition, experience sleep and circadian disturbances driven by hormonal changes, vasomotor symptoms, and aging. These disturbances are associated with elevated risks for cardiovascular disease, metabolic dysfunction, and cognitive decline.
Stakeholder-informed digital interventions addressing physical health, sleep, emotional well-being, social connectedness, and self-care practices may enhance engagement, accessibility, and preventive mental healthcare among older adults in India.
This qualitative study gathered perspectives from older adults, caregivers, and experts to inform the design of a digital self-help intervention for healthy aging and mental well-being in urban India. Participants identified regular sleep routines, balanced diet, physical activity, stress management, and meditation as beneficial. The findings suggest that culturally tailored digital modules may improve engagement and preventive mental healthcare, but effectiveness and sustainability require further research.
Intensified endurance training increases nocturnal proximal skin temperature and sleep latency in male long-distance runners
Eight days of intensified endurance training (209.2 km vs 118.5 km) significantly elevated maximum nocturnal proximal skin temperature (p=0.045), especially during the first 180 minutes after bedtime (p=0.03), and increased sleep latency (8.4 min vs 2.6 min, p=0.003) compared to normal training. The delta skin temperature during sleep was also higher in the intensified training group (p=0.004).
Positional obstructive sleep apnea is highly prevalent and associated with lower BMI and a more favorable sleep and oxygenation profile independent of AHI.
Among 12,036 OSA patients, 66.3% had positional OSA (POSA) and 27.8% had supine-exclusive POSA. POSA patients had lower AHI (24.1 vs. 44.4 events/h), lower BMI (29.2 vs. 31.4 kg/mĀ²), and were slightly younger than non-POSA patients, with differences more pronounced at lower AHI levels.
Machine learning models using demographic and clinical features can differentiate bipolar depression from unipolar depression with moderate accuracy (ROC-AUC ~0.78), with sleep disturbance, fatigue, and sleep medication use among the top predictive features.
Three machine learning classifiers (logistic regression, random forest, support vector machine) achieved a consistent ROC-AUC of approximately 0.78 in distinguishing bipolar depression from unipolar depression among 449 patients. The top six predictive features included family history, age, sleep disturbance, fatigue, use of sleep medication, and suicidal ideation, with younger age and sleep medication use pushing predictions toward bipolar depression.
Salivary IL-6/cortisol ratio and RSImod may serve as non-invasive indicators of non-functional overreaching in NCAA Division I American football athletes, with role-specific physiological signatures.
In a 15-week observational study of 39 NCAA Division I American football players, both starters and non-starters exhibited patterns consistent with non-functional overreaching (NFOR), but with distinct physiological signatures. Higher IL-6/cortisol ratios were associated with higher RSImod in starters, while in non-starters, higher IL-6/cortisol ratios were associated with poorer recovery despite lower external loads. Mid-season declines in countermovement jump performance coincided with biomarker changes suggestive of accumulated fatigue.
Omaveloxolone is the most effective pharmacological intervention for Friedreich's ataxia, showing biological improvements without clear clinical benefit.
This systematic review of 90 studies found that omaveloxolone was the most effective pharmacological intervention for Friedreich's ataxia. However, pharmacological studies generally showed biological improvements without clear clinical benefit, while nonpharmacological therapies yielded more consistent patient-relevant gains.
Non-pharmacological interventions, particularly physical activity and cognitive rehabilitation, are first-line management for cancer-related cognitive impairment in adult cancer survivors
This clinical practice review found that non-pharmacological interventions are recommended as first-line management for cancer-related cognitive impairment (CRCI), with physical activity and cognitive rehabilitation showing the strongest benefits. CRCI affects approximately 60-75% of individuals with cancer and is multifactorial, involving biological and psychosocial contributors.
Food-based antioxidant strategies may support recovery and redox homeostasis without suppressing exercise-induced redox signals that contribute to training adaptation.
This narrative review suggests that food-based antioxidant nutrition, such as tart cherry, berries, pomegranate, cocoa, green tea, beetroot, extra virgin olive oil, and Mediterranean-style dietary patterns, can influence recovery-related outcomes through mechanisms beyond direct radical scavenging, including inflammatory regulation, vascular function, and gut-derived metabolism. The evidence is strongest during periods of elevated recovery demands, such as heavy training blocks or environmental stress, but does not support universal daily antioxidant use.
Mantra meditation may help athletes regulate attention, cope with fatigue and psychological stress, and support psychological well-being in sport contexts.
This scoping review of six studies found that athletes reported using mantra meditation to regulate attention, maintain pace or rhythm, cope with fatigue and psychological stress, and support spiritual meaning and mental well-being. The limited number of studies highlights the early stage of research, with no quantitative effect sizes reported.
Smartphone-related addictive behaviors in older adults are associated with poorer sleep quality, depressive symptoms, anxiety, and loneliness, but evidence for cognitive decline is insufficient.
A scoping review of 22 studies (mostly cross-sectional) found consistent associations between smartphone addiction and poorer sleep quality, depressive symptoms, anxiety, and loneliness in adults aged 60+. Evidence for physical activity, daily living, posture, visual fatigue, and social participation was limited, and cognitive decline claims were unsupported. Direct intervention evidence was restricted to one small RCT showing improvements in posture and neck function.
Self-perceived readiness and objective performance represent distinct but complementary aspects of military readiness in ROTC cadets
This exploratory mixed-methods study of 25 ROTC cadets found few significant correlations between self-perceived readiness (measured by ARMS) and objective performance on a dual-task treadmill protocol. Qualitative findings revealed that cadets view readiness as multidimensional, influenced by sleep, fitness, nutrition, emotional regulation, commitment, and mindset, suggesting that self-perceived readiness and objective performance capture different facets of readiness.
A machine learning model using routinely available variables can identify COPD patients at increased risk of exercise-induced desaturation during the 6-minute walk test.
The study developed a screening-oriented machine learning approach to identify COPD patients at risk of exercise-induced desaturation (EID), defined as SpO2 < 90% with a decrease of ā„ 4%p. Among 1,788 patients, 10.3% exhibited EID. The XGB model achieved the highest sensitivity and stable performance in the test set, with baseline SpO2 and diffusion capacity of the lung for carbon monoxide as the most influential predictors.
Long sleep duration and low physical activity are associated with sarcopenia in older adults, supporting a 24-hour exercise rehabilitation framework.
This observational study found that long sleep duration and low physical activity are linked to sarcopenia in older adults. The findings suggest that a 24-hour approach integrating sleep and activity may be beneficial for rehabilitation. Specific numbers were not provided in the abstract.
Exercise affects sleep outcomes in research
Probable Serotonin Syndrome Precipitated by the Addition of Trazodone to Lurasidone and Valproic Acid: A Case Report.. Published in Sante mentale au Quebec (2026). PMID: 42490704.
Sleep intervention shows effects in research
Exploring the Prevalence and Key Predictors of Probable Depression Among Parents and Primary Caregivers of Children and Adolescents With Specific Learning Disorders in the Kingdom of Saudi Arabia: A Cross-Sectional Explainable Machine-Learning Study.. Published in Clinical psychology & psychotherapy (2026). PMID: 42490731.
Substituting screen or sedentary time with physical activity reduces irritability in early childhood
In a longitudinal study of 1,266 children aged 2-4 years, those who typically spent more time in physical activity were irritable significantly less often, while more screen time was linked to greater irritability. Substituting screen or sedentary time with physical activity was associated with reduced irritability.
High role overload among nursing students is associated with frequent night shifts, irregular sleep, and lack of physical exercise.
A cross-sectional study of 512 nursing students identified three latent profiles of role overload (low, moderate, high). Students in the high overload group reported significantly more frequent night shifts, irregular sleep, and less physical exercise compared to other groups (all p < 0.05).
High-intensity aerobic exercise improves cardiorespiratory fitness and selected motor outcomes in carefully screened and supervised Parkinson's disease patients
The review suggests that high-intensity aerobic exercise and high-intensity interval training may improve cardiorespiratory fitness and selected motor outcomes in Parkinson's disease patients. However, this is based on limited clinical evidence with heterogeneous definitions of exercise intensity, small samples, and short intervention periods.
Exercise interventions that satisfy students' basic psychological needs for autonomy, competence, and relatedness are more decisive for weight reduction than the specific exercise modality prescribed.
This paper argues that the effectiveness of exercise interventions for weight reduction among university students depends more on whether the delivery of exercise satisfies psychological needs (autonomy, competence, relatedness) per Self-Determination Theory than on the specific type of exercise. It reinterprets barriers like weight-related self-stigma, low exercise self-efficacy, academic time pressure, and digital overload as threats to these needs.
Saliva cell-free mitochondrial DNA (cf-mtDNA) increases in response to acute physical and cognitive stress, with individual differences linked to fitness, sleep quality, and stress perception.
In a crossover study of 47 participants, saliva cf-mtDNA levels increased by 90% after baseline during exercise and peaked 160% above baseline during cognitive stress. Higher cf-mtDNA elevations during exercise were associated with fewer recent stressful incidents, lower alcohol use, higher VO2 max, and lower BMI; more dynamic responses to cognitive stress were seen in those with poorer sleep quality and greater blood pressure reactivity.
Caregiving burden is associated with perceived changes in health behaviors, including sleep disruption, in neuro-oncology caregivers.
This study of 116 caregivers of patients with primary brain tumors found that 71% reported impacts to their sleep. Caregiving burden was consistently associated with perceived changes in multiple health behaviors, even after controlling for depression and anxiety.
Higher physical activity and lower sedentary behavior are associated with better quality of life in cardiac rehabilitation participants, but sleep duration shows no significant association.
In a cross-sectional study of 105 cardiac rehabilitation participants, only 2.9% met all three Canadian 24-Hour Movement Guidelines recommendations. Higher physical activity was positively associated with functional capacity, vitality, and social aspects, while sedentary behavior was negatively associated with functional capacity; sleep duration was not associated with any quality-of-life domain.
Psychobiotics, prebiotics, and botanicals improve subjective sleep quality and restore neurochemical markers in insomnia
This systematic review of 56 studies (33 human, 23 animal) found that interventions targeting gut microbiota, including psychobiotics (e.g., Bifidobacterium breve, Lacticaseibacillus paracasei), prebiotics (GOS/PDX), and Traditional Chinese Medicine formulas, significantly improved subjective sleep metrics such as PSQI and ISI scores. Animal models showed restoration of GABA/5-HT profiles, lowered morning cortisol, and REM rebound in PCPA-induced insomnia models.
Residential medical students demonstrate a knowledge-practice gap in healthy lifestyle behaviours, with high health awareness but poor adherence to healthy practices.
Among 199 residential undergraduate medical students, 65.3% reported sometimes or often skipping breakfast, 45.7% slept less than six hours per night, and 94.5% used digital devices before bedtime. Despite 69.8% reporting physical activity, only 25.1% exercised daily, indicating a significant gap between health awareness and actual lifestyle practices.
Non-pharmacological pain care with supportive trial evidence is underused in people with inflammatory arthritis, while long-term opioids and gabapentinoids are commonly prescribed despite absent trial evidence for efficacy.
The guideline highlights that UK electronic health record data show long-term opioid and gabapentinoid prescribing is common in people with inflammatory arthritis, despite a lack of trial evidence supporting their efficacy. Patient survey data indicate that non-pharmacological pain management approaches with supportive trial evidence are underutilized.
The Integrated Resilience Method improves chronic low back pain management in women over 50
The Integrated Resilience Method is a six-pillar framework for postmenopausal women with chronic low back pain, integrating exercise, pain education, and self-efficacy as core components with the strongest evidence. It addresses biopsychosocial factors including hormonal change, sarcopenia, sleep disruption, fear-avoidance, and caregiving stress.
Circadian disruption is closely associated with Alzheimer's disease pathology and therapeutic response, supporting chronotherapeutic strategies.
This narrative review synthesizes evidence that circadian dysfunction contributes to Alzheimer's disease pathogenesis through interactions between core clock genes and neurodegenerative cascades involving oxidative stress, neuroinflammation, glial reactivity, and proteostasis. Emerging evidence suggests distinct circadian patterns in AD-relevant biomarkers, including melatonin, cortisol, orexin, core body temperature, blood-brain barrier permeability, and glial marker oscillations, which may have diagnostic and prognostic relevance.
Exploding head syndrome is associated with reduced sleep quality and altered sleep architecture, including lower total sleep time, sleep efficiency, and REM percentage, and higher sleep latency, wakefulness after sleep onset, N1 percentage, and PSQI score.
In a retrospective study of 26 EHS patients and 22 controls, PSG data from 16 patients showed significantly lower total sleep time (p=0.001), sleep efficiency (p<0.001), and REM percentage (p=0.019), and significantly higher sleep latency (p=0.001), wakefulness after sleep onset (p=0.001), N1 percentage (p=0.010), and PSQI score (p=0.016). Additionally, 96% of patients reported stress and 84% had difficulty falling asleep.
A standardized multicomponent respiratory guidance and nursing care protocol improves sleep quality in elderly patients with COPD
This paper describes a 12-week multicomponent intervention integrating breathing training, respiratory muscle training, aerobic exercise, and continuous nursing support based on Orem's self-care deficit theory. Sleep quality measurement is included as a standardized outcome, but no numerical results are reported in the abstract.
AI and chatbot-supported interventions for pediatric physical activity and obesity-related lifestyle behaviors show mixed effectiveness, with 4 of 8 studies reporting significant improvements in physical activity or fitness outcomes.
This scoping review of 14 studies found that AI-enabled chatbot interventions for pediatric physical activity and obesity-related behaviors are a rapidly emerging field, with most studies published since 2023. Among 8 studies reporting direct physical activity or fitness outcomes, 4 showed significant improvement, 2 found no significant change, and 2 reported mixed or indirect findings. Family involvement was present in 71.4% of studies, and feasibility and acceptability were generally favorable.
Sport-related activities may facilitate post-disaster mental health recovery through physiological regulation, psychological empowerment, and social reconnection.
This narrative review of 11 studies proposes that sport-related activities (participatory and spectator-based) can aid mental health recovery after natural disasters by modulating the HPA axis, restoring self-efficacy, and rebuilding social networks. The evidence is observational and heterogeneous, so causal effects cannot be established.
Nutraceuticals such as Artemisia annua, valerian, rosemary, jujube, passionflower, lemon balm, ashwagandha, kava-kava, lavender, and chamomile improve sleep quality and duration in individuals with sleep disorders.
This review paper summarizes evidence that various nutraceuticals (herbal and dietary supplements) have remarkable benefits in treating sleep disorders. These remedies modulate neurotransmitter and hormonal pathways in sleep circuits and indirectly improve sleep by alleviating stress, inflammation, and oxidative stress. The paper notes that conventional sleep medications are habit-forming with withdrawal effects, making nutraceuticals a non-toxic, non-habit-forming alternative.
Patients after ACL reconstruction perceive significant sleep disturbances leading to poor sleep quality, which negatively impacts health outcomes in the early postoperative phase.
This qualitative study of 12 participants aged 18-35 years, 1-3 months post-ACLR, found that patients perceived significant sleep disturbances and poor sleep quality, which they believed negatively affected their physical recovery and psychological functioning. Three major themes emerged: sleep disturbances, repercussions of sleep disturbances, and prior knowledge of sleep hygiene.
Urban Indian young adults perceive adequate sleep as a component of a healthy lifestyle.
In a qualitative study of 79 urban Indian young adults (aged 21-30) from eight metropolitan cities, participants identified adequate sleep as one of three key perceptions of a healthy lifestyle, alongside consuming a balanced diet and leading an active life. The study used in-depth interviews and thematic analysis to explore barriers and facilitators of a healthy lifestyle.
Chronic sleep deprivation and circadian disruption flatten cortisol circadian patterns and alter ultradian glucocorticoid pulsatility
This narrative review synthesizes evidence that chronic exposure to sleep deprivation and circadian disruption alters HPA axis function, leading to flattened daily cortisol rhythms and disrupted ultradian glucocorticoid pulsatility. These changes are associated with allostatic load and psychological/metabolic maladaptation.
Children under 3 years with feeding disorders have inadequate nutrient intake in quantity and quality
This study of 40 children under 3 years with feeding disorders found that average daily energy intake was below recommended values, with 62.5% of children in the insufficient intake range. Micronutrient deficiencies were observed for vitamin B6, vitamin D, calcium, magnesium, iron, and zinc, while vitamin K intake was excessive.
Physical activity improves mental well-being in esports practitioners through improved sleep quality and reduced cognitive fatigue
Physical activity (PA) positively predicted mental well-being in esports players, serially mediated by improved sleep quality and reduced cognitive fatigue. SHAP analysis revealed a non-linear dose-response pattern, with the steepest benefits at 600-1,200 MET-min/week and plateauing beyond approximately 1,800 MET-min/week.
Expert evaluation improves clarity, safety, and athlete-specific relevance of GPT-4-generated sleep and jet lag guidance
In a two-round Delphi process with 17 sleep experts, GPT-4-generated FAQ responses on sleep and jet lag were evaluated and revised. Consensus increased from 75% (15/20 items) in round 1 to 90% (18/20 items) in round 2, with qualitative feedback indicating improved clarity, accuracy, and athlete-specific relevance after expert revision.
Subjective sleepiness and objective sleep propensity do not closely align in adults with ADHD referred for sleep evaluation
In adults with ADHD referred for MSLT, subjective sleepiness (ESS scores) did not correlate with objective sleep propensity (mean MSLT sleep latency), while a significant inverse correlation was observed in the EDS-only subgroup. Median ESS scores were similar between groups (14.0 vs 13.0), but objective sleep latency was longer in the ADHD group (432.0 s vs 322.0 s, p=0.008) and MSLT positivity was less frequent (61.8% vs 87.1%, p=0.001).
Respiratory muscle training is insufficient as a standalone intervention for treating objective sleep-disordered breathing outcomes in heterogeneous spinal cord injury cohorts
A scoping review of six studies found that while case reports showed clinically significant reductions in global sleep-disordered breathing indices, larger experimental trials found no significant between-group differences in objective SDB severity or nocturnal oxygenation. A randomized pilot trial suggested combined RMT and oropharyngeal exercises could reduce upper airway collapsibility, and a prospective cohort study found modest improvements in nocturnal gas exchange among those who gained maximal inspiratory pressure.
Older adults and people with limited mobility perceive more barriers than facilitators to physical activity, with environmental factors and safety concerns being primary barriers, while social support and routine-based strategies facilitate healthier movement and sleep behaviors.
In a cross-sectional focus group study of low-income older adults and people with limited mobility in urban and rural Mexico, participants reported more barriers than facilitators to physical activity, citing poor infrastructure, medical instructions, physical fatigue, and safety concerns. Barriers to sleep included noise, hot weather, insects, and screen use, while facilitators for sleep included relaxation techniques and consistent bedtime routines. Social support encouraged physical activity, and active breaks reduced sedentary behavior, but family overprotection increased sedentary behavior in people with limited mobility.
Melatonin administration at 6 PM (1-2 hours before bedtime) optimizes sleep cycle regulation and reduces bedtime resistance
The paper recommends administering melatonin around 6 PM, which is 1-2 hours before bedtime, to optimize sleep cycle regulation and help with bedtime resistance. This timing is proposed as the standard of care in hospitals, nursing homes, and at home.
Kynurenine pathway activation is associated with possible bruxism, with elevated cortisol, TNF-Ī±, and KYN/Trp ratio in affected individuals
Saliva cortisol, TNF-Ī±, KYN, and KYN/Trp ratio were significantly higher, while Trp and IFN-Ī³ were lower in individuals with possible bruxism compared to healthy controls (p<0.001 for all). Within bruxism subtypes, possible sleep bruxism showed higher cortisol, KYN, KTR, and TNF-Ī± and lower melatonin than possible combined bruxism (p<0.01 to p<0.001).
Cognitive behavioral therapy (CBT) is recommended as a first-line therapy for post-concussion sleep disturbances
A scoping review of 19 studies found that CBT was the most commonly studied intervention for post-concussion sleep disturbances (n=3). The review supports current guidelines recommending CBT as first-line therapy, but notes that higher-quality evidence is needed before other interventions are incorporated into routine practice, especially for children.
Physical activity interventions are associated with the broadest range of health benefits among female cancer survivors, including improved quality of life, cardiorespiratory fitness, physical functioning, mental health, sleep, and survival.
This review found that physical activity interventions among female cancer survivors are associated with improvements across multiple outcomes, including quality of life, cardiorespiratory fitness, physical functioning, mental health, sleep, and survival. The evidence is based on large observational studies and intervention trials, with physical activity showing the broadest benefits compared to other lifestyle pillars.
Sleep disturbance is the strongest bridge symptom linking athlete burnout, depression, and anxiety in collegiate athletes.
In a network analysis of 1,226 Chinese collegiate athletes, sleep disturbance (PHQ-3) emerged as the strongest bridge symptom (bEI = 0.47) connecting the three clusters of burnout, depression, and anxiety. The most central nodes were depressed mood (PHQ-2; EI = 1.22), physical exhaustion (ABQ-E8; EI = 1.11), and uncontrollable worry (GAD-2; EI = 1.07).
Caffeine exerts analgesic effects in headache disorders through adenosine receptor antagonism and enhances the efficacy of analgesics such as NSAIDs, acetaminophen, and opioids.
Caffeine demonstrates analgesic properties via adenosine receptor antagonism, prostaglandin inhibition, GABA-A modulation, and cholinergic facilitation. It also enhances the efficacy of common analgesics including NSAIDs, acetaminophen, and opioids. The abstract does not provide specific numerical effect sizes.
Theanine alleviates sleep disturbances caused by cumulative stress
Theanine exerts therapeutic effects on mental disorders caused by cumulative stress, ranging from mild sleep disturbances to depression induced by sleep deprivation. The review covers literature from the past 5 years on the neuroprotective functions of theanine.
Gas-exchange derived pulmonary vascular capacitance (GXCAP) and ventilatory efficiency (VE/VCO2) measured during submaximal exercise testing can identify non-severe PH-ILD patients with exercise-induced increases in pulmonary vascular resistance.
In 16 patients with non-severe pulmonary hypertension associated with interstitial lung disease, GXCAP was significantly higher in those with static PVR (471 Ā± 85 mLĀ·mmHg) versus dynamic PVR (311 Ā± 38 mLĀ·mmHg, p < 0.01), while VE/VCO2 was lower in static PVR (33 Ā± 2 vs 37 Ā± 2.5, p < 0.01). ROC analysis showed excellent discrimination for GXCAP (AUC 0.98) and good discrimination for VE/VCO2 (AUC 0.90) in identifying the dynamic PVR phenotype.
Balance and sleep quality are significantly associated with attentional processing in Parkinson's disease, as measured by P300 latency
In a cross-sectional study of 28 individuals with Parkinson's disease and 27 healthy controls, balance (B = -4.909, P = 0.001) and sleep quality (B = 12.704, P = 0.007) were significantly associated with P300 latency, indicating their relevance to attention. Depression was not significantly associated with P300 latency (B = 3.472, P = 0.084).
Automated algorithms identify IN and OUT of bedtimes more consistently than patient-reported methods in adults with advanced cancer
Automated accelerometry algorithms identified IN and OUT bedtimes with 93-100% consistency compared to 48-83% for patient-reported methods (sleep diaries and event markers). All methods showed significant correlations (p < 0.001), but choice of method influenced sleep onset latency, percent sleep, and dichotomy index values.
Poor sleep quality (PSQI > 5) is highly prevalent in adults attending a community health center in Buenos Aires
In a cross-sectional study of 208 adults (mean age 48.3 years, 76.9% women) at a community health center, 65.4% had a PSQI score > 5, indicating poor sleep quality. Key findings included sleep latency > 15 minutes in 81.3%, daytime dysfunction in 66.3%, and sleep duration < 7 hours in 58.7%.
Phenotype-supported diagnosis and combined immunotherapy improve sleep and neuromuscular symptoms in seronegative Morvan syndrome
A 63-year-old man with seronegative Morvan syndrome presenting with agrypnia excitata (2-3 h/night sleep, ISI 24/28) and peripheral nerve hyperexcitability was treated with combined immunotherapy (intravenous methylprednisolone, prednisone taper, azathioprine) and symptomatic therapy (carbamazepine, melatonin). At 6 months, sleep restored to 7-8 h/night, ISI decreased from 24 to 4, MRC sum score improved from 48 to 58/60, and CK dropped from 928 to 185 U/L.
Biomarkers should refine, not replace, clinical reasoning and athlete monitoring, with interpretation requiring individual baseline, sampling conditions, recent workload, nutrition, hydration, sleep, illness, sex-specific physiology, and performance.
This narrative review argues that routine biomarkers like lactate, creatine kinase, and cortisol are only useful when interpreted contextually, not against population reference ranges. Metabolomics expands interpretation by identifying pathway-level signatures, but omics-derived markers require standardization before routine use.
Psychiatric and cardiometabolic disorders are associated through bidirectional and overlapping pathways involving chronic low-grade inflammation, HPA axis dysregulation, insulin resistance, and sleep/circadian disturbance.
This narrative review synthesizes evidence that psychiatric disorders (depression, anxiety, schizophrenia, SMI) and cardiometabolic disease share bidirectional biological pathways, including inflammation, HPA axis dysregulation, insulin resistance, oxidative stress, mitochondrial dysfunction, altered brain energy metabolism, gut microbiome disruption, and sleep/circadian disturbance. The review emphasizes that metabolic dysfunction may worsen psychiatric symptoms and vice versa, supporting integrated care and routine metabolic screening.
Alternative therapies such as mindfulness, meditation, yoga, music therapy, herbal supplements, aromatherapy, and hypnosis may serve as effective adjuncts or alternatives for managing sleep disorders.
The review indicates that complementary and alternative medicine approaches have gained attention for managing sleep disturbances, particularly when conventional treatments are limited by side effects, accessibility, or patient preference. No specific quantitative results are provided in the abstract.
Circadian rhythm disturbances are associated with increased risk of cognitive decline and progression from MCI to dementia in elderly individuals aged 60 years and older.
This systematic review of 10 studies (5,707 participants) found that circadian dysregulation, measured via actigraphic rest-activity metrics, sleep quality parameters, and lifestyle exposures, was consistently associated with a higher risk of developing or progressing MCI and dementia in adults aged ā„60 years. The findings support a negative impact of circadian and sleep disturbances on cognitive health in the elderly.
Heat stress disrupts sleep in older adults by prolonging sleep onset, fragmenting slow-wave and REM sleep, and suppressing melatonin secretion.
This narrative review synthesizes evidence that elevated nighttime temperatures disrupt sleep in older adults through multiple mechanisms, including prolonged sleep onset, fragmentation of slow-wave and REM sleep, and suppression of melatonin secretion. Age-related declines in thermoregulatory capacity, such as reduced sweating and impaired vasodilation, exacerbate these effects. The review notes that sex-related differences, particularly menopause-associated vasomotor instability in women and testosterone-related autonomic changes in men, further modulate individual vulnerability.
Mucuna pruriens improves motor symptoms in Parkinson's disease with benefits comparable to levodopa
Mucuna pruriens was supported by Grade A evidence for motor improvement in Parkinson's disease, showing benefits comparable to levodopa and increased ON time without worsening dyskinesia. It also reduced dyskinesia with Grade B evidence.
Rett syndrome imposes a substantial, lifelong multisystem burden requiring continuous surveillance and anticipatory, multidisciplinary care rather than symptom-driven management.
A global literature review of 148 studies across 24 countries found that Rett syndrome is associated with high prevalence of neurological, musculoskeletal, and gastrointestinal comorbidities, including epilepsy (15-91%), scoliosis (8.9-100%), constipation (16.4-82.8%), and gastroesophageal reflux (15.8-100%). Medication use is common, with antiepileptic drugs being the most frequent (monotherapy 14.3-33.0%), followed by proton-pump inhibitors (37-61%), melatonin (7.7-30%), and anti-anxiety agents (10-21.4%). The findings support proactive, coordinated care and routine medication review.
Wearable HRV monitoring indicates autonomic dysfunction and delayed sympathovagal recovery after exercise above VT1 in long COVID patients, suggesting increased risk of post-exertional malaise.
Continuous multi-day HRV recordings showed lower HRV in long COVID patients compared to healthy controls during daily activities and sleep (p=0.027). Nighttime HRV decreased with intense exercise and longer durations in patients (p=0.018), indicating exercise-induced autonomic disturbances. The delayed recovery of sympathovagal balance after exercise close to and above VT1 suggests that the risk of PEM rises above this threshold.
Patients with thoracic aortic aneurysm express strong interest in sleep management programs, but structural barriers limit participation.
In a survey of 106 patients with thoracic aortic aneurysm, over 80% endorsed sleep management programs as helpful. However, only a minority indicated willingness to attend such programs, with distance (43%) and time (36%) being the most common barriers.
Caffeine improves aerobic endurance exercise performance via central adenosine receptor antagonism
Caffeine is a well-established ergogenic aid that enhances performance primarily through antagonism of central adenosine A1 and A2a receptors. The most robust and consistent benefits are observed for aerobic endurance exercise, with effects on strength and power being more variable.
20-minute naps reduce subjective sleepiness and improve cognitive vigilance during extreme sleep deprivation in ultramarathon runners
In an observational field study of 52 finishers of the Ultra-Trail du Mont-Blanc (170 km, ~10,000 m elevation gain), 20-minute naps produced immediate reductions in subjective sleepiness (Karolinska Sleepiness Scale) 1 km post-checkpoint, while cognitive benefits (Psychomotor Vigilance Test reaction times) appeared more gradually, with significantly faster reaction times at subsequent checkpoints. Naps served as an effective reactive strategy to reduce perceived drowsiness and partially protect against late-race performance decline without compromising overall race completion times.
Melatonin should be approached as a pharmacological intervention requiring diagnostic rigor, individualized dosing, and longitudinal assessment, particularly when integrated with behavioral and circadian interventions.
The paper argues that melatonin's clinical use is often undermined by diagnostic imprecision, inappropriate dosing, mistimed administration, inconsistent formulations, and inadequate patient counseling. It emphasizes that melatonin acts primarily as a chronobiotic whose effects depend more on timing than dose, and that supraphysiological doses and reflexive bedtime administration have become normalized despite evidence to the contrary.
Dietary apigenin intake positively correlates with sleep quality in a large cohort of adults
A large cohort study found that higher dietary intake of apigenin, a natural flavonoid found in chamomile and other plants, is associated with better sleep quality in adults. This supports apigenin's potential role in improving sleep, though the abstract does not provide specific correlation coefficients or effect sizes.
Indigenous people who use drugs in northern Ontario have high rates of precarious sleeping situations and polysubstance use, with strong awareness of harm reduction and cultural practices influencing harm reduction behaviors.
Among 356 Indigenous participants across three northern Ontario cities, 39.0% slept on the street, 28.3% in shelters, and 92.1% smoked drugs. Despite high substance use, 84.0% knew what harm reduction was, 82.3% had HIV testing, and 71.3% engaged in cultural ceremonies, with 22.2% reporting cultural teachings affected their harm reduction practices.
Comorbid sleep disturbance in alcohol use disorder is associated with disrupted energetic regulation of limbic-to-subcortical network state transitions
In individuals with alcohol use disorder (AUD) and comorbid sleep disturbances, the energetic cost of transitions from limbic to subcortical brain networks is altered compared to healthy controls. A significant Group Ć PSQI interaction (Bonferroni-corrected p = 0.020) showed that in healthy controls, poorer sleep was linked to lower transition energy, but this coupling was absent in AUD. Eleven specific ROI pairs, including parahippocampal, amygdalar, and temporal regions to thalamic subnuclei, survived correction.
Endovenous ablation with concomitant phlebectomy improves sleep quality in patients with chronic venous disease
In a prospective observational study of 77 patients with lower extremity CVD, endovenous ablation (frequently combined with phlebectomy) was associated with significant improvement in sleep quality at 1-month follow-up. The median PSQI score decreased from 6 to 5 (P < .001), and the proportion of patients with poor sleep quality (PSQI > 5) declined from 66.2% to 41.6%.
Research on light exposure and type 2 diabetes mellitus has expanded from a 'sunlight-vitamin D-glucose metabolism' framework to include circadian rhythm disruption, sleep behavior, and environmental chronomedicine.
A bibliometric analysis of 2491 publications from 2001 to 2025 shows a sustained increase in research on light exposure and type 2 diabetes, with a marked acceleration after 2019 and a peak in 2024. The research focus has shifted from early topics like vitamin D and obesity to light exposure, circadian rhythm disruption, and sleep behavior, indicating an emerging field of environmental chronomedicine.
Excessive screen time is associated with unhealthy eating behaviors and sleep disturbances in children and adolescents
This narrative review found that excessive screen time in children and adolescents is consistently associated with unhealthy eating behaviors such as increased snacking, mindless eating, breakfast skipping, and higher consumption of ultra-processed foods. It is also linked to sleep disturbances, circadian dysregulation, and altered appetite-related hormones like leptin and ghrelin.
A comprehensive, multidomain approach to sleep quality assessment integrates multiple sleep parameters to provide a holistic characterization of sleep
This paper reviews parameters influencing sleep quality, including total sleep duration, sleep latency, continuity, efficiency, deep sleep duration, REM sleep duration, and sleep timing/regularity. It argues that a comprehensive multidomain approach is necessary for quantitative data interpretation, longitudinal monitoring, and comparative analyses across populations. Such an approach may help standardize evaluation methods and inform research, clinical practice, and daily life.
Breakfast intake and physical activity are associated with skeletal muscle mass and SMI in male Japanese workers
In a cross-sectional study of 377 male Japanese workers, multiple regression analysis revealed that skeletal muscle mass and skeletal muscle index (SMI) were associated with age, BMI, breakfast intake, and waist circumference, with skeletal muscle mass also associated with heavy physical activity. The findings suggest that prioritizing breakfast intake and physical activity may help maintain muscle mass.
Perioperative circadian rhythm disruption is associated with adverse outcomes following skull base surgery
This prospective cohort study of 82 patients undergoing skull base tumor resection found significant perioperative disruption of circadian rhythms, marked by suppressed melatonin and elevated cortisol, which was associated with higher complication rates and longer hospital stays. Patients with the highest circadian disruption had significantly more overall complications (73.9% vs. 39.0%, p=0.042) and longer hospital stay (8.0 vs. 7.9 days, p=0.018).
Endurance training attenuates acute exercise-induced monocyte transcriptomic responses in adolescents, with sex-specific molecular adaptations
In adolescents aged 14-17, an 8-week endurance training program markedly reduced the number of differentially expressed monocyte transcripts in response to acute exercise, from 5,135 to 94 in females (98% reduction) and from 567 to 165 in males (70% reduction). Pre-training, females showed a much larger transcriptomic response than males, with pathway enrichment related to adipose tissue crosstalk and oxidative metabolism, while males showed vascular function-related pathways.
Better habitual sleep quality is associated with increased brain entropy in sensory and sensorimotor cortices and decreased brain entropy in frontoparietal control regions.
In a large observational study using UK Biobank resting-state fMRI data (replicated in HCP and a sleep deprivation experiment), better self-reported sleep quality was linked to increased regional brain entropy (BEN) in sensory and sensorimotor cortices and decreased BEN in frontoparietal control regions. Sleep amount predicted increased BEN in visual and somatomotor regions in the HCP cohort.
Increased intake of EPA and DHA is associated with improved brain function during the menopausal transition
The paper reviews evidence that omega-3 fatty acids EPA and DHA may benefit brain health during menopause, including sleep, cognition, and mood. The evidence is described as relatively sparse but indicative of benefit, with future RCTs needed to establish dose-response relationships.
Circadian misalignment and reduced rest-activity amplitude are candidate phenotypes in insomnia disorder, warranting phenotype-stratified trials of circadian interventions.
This narrative review proposes that some insomnia patients have circadian misalignment, reduced rest-activity amplitude, increased sleep-timing variability, or abnormal light exposure, which may require circadian-targeted adjunctive treatments. It suggests a phenotyping framework combining sleep diaries, actigraphy, light exposure, DLMO, and core body temperature to distinguish CRSWD-dominant insomnia, insomnia with circadian modifiers, and comorbid insomnia and CRSWD. CBT-I remains first-line, with fixed wake time, morning light, evening light restriction, timed low-dose melatonin, and scheduled activity as candidate adjunctive modules for future phenotype-stratified trials.
Ultra-trail endurance racing causes objective sleep disruptions lasting up to four nights post-race, despite only modest subjective sleep complaints.
In a field study of 18 ultra-trail runners, actigraphy revealed significant objective sleep changes including reduced sleep efficiency, longer nocturnal wake time, increased awakenings, and increased wake after sleep onset, persisting up to four nights after the race. Subjective sleep alterations were modest, mainly later wake-up time and reduced sleep quality on the night following the race.
Zolpidem is associated with a high likelihood of neuropsychiatric adverse effects, including hallucinations, complex sleep-related behaviors, and amnesia, particularly in women, the elderly, psychiatric patients, and those on polypharmacy.
This narrative review found that zolpidem is commonly linked to serious neuropsychiatric adverse effects such as hallucinations, perceptual disturbances, and complex sleep behaviors (e.g., sleep-driving, sleep-eating), especially at high doses and in patients with psychiatric comorbidities. These events can lead to severe personal injury and litigation, and are often unnoticed by the patient.
Visual attention to emotional faces in children shows region-specific modulation, with prioritization of the eye region for angry expressions and increased attention to the mouth for happy and surprised expressions.
In a study of 20 neurotypical children aged 8-12 years, eye-tracking revealed that visual attention to emotional faces is characterized by preferential processing of the eye region, especially for angry expressions, while happy and surprised expressions increase attention to the mouth. Observer sex, stimulus sex, and stimulus race/ethnicity modulated region-specific attention, but global saccadic dynamics remained stable across conditions.
Melatonin supplementation may influence the developing sleep system in pediatric populations.
The paper reviews the role of melatonin in the developing sleep system, focusing on its effects on sleep regulation in children and adolescents. It discusses the potential benefits and risks of melatonin use in this population, though specific quantitative outcomes are not provided in the abstract.
Sleep disturbance in atopic dermatitis is not merely a secondary symptom of pruritus but a complex disease domain associated with higher inflammatory activity, sleep fragmentation, impaired quality of life, daytime fatigue, and anxiety or depressive symptoms, and a bidirectional relationship exists where poor sleep may exacerbate dermatitis.
This narrative review synthesizes evidence that sleep disturbance in atopic dermatitis is a complex disease domain, not just a secondary symptom of itch. It supports a bidirectional model where active dermatitis impairs sleep, and insufficient or fragmented sleep may impair barrier repair, increase transepidermal water loss, and alter neuroimmune itch signaling, potentially amplifying cutaneous inflammation. The review concludes that sleep should be assessed as a core treatment outcome and persistent sleep disruption should be interpreted as a marker of undercontrolled disease.
General health dysfunction is highly prevalent among medical residents at Tehran University of Medical Sciences
A cross-sectional study of 349 residents at TUMS in 2016 found that 54.7% (95% CI, 49.4-59.8) exhibited general health dysfunction as measured by the GHQ. The prevalence of anxiety was 57.6%, depression 51.5%, somatic symptoms 44.1%, and social dysfunction 23.8%.
A composite readiness index (4-dRI) decreases by approximately 30% at 24 hours post-match in youth rugby players
The study found that a composite readiness index (4-dRI), integrating subjective measures of fatigue, mood, sleep quality, and muscle soreness, decreased by about 30% at 24 hours after a match (p < 0.001). Higher GPS-derived match loads were associated with lower readiness on the day after the match. The Adductor Squeeze Test showed moderate associations with the 4-dRI, while the Sit-and-Reach Test was less responsive.
The DREAMS framework operationalizes the six pillars of lifestyle medicine into an integrative, memorable acronym for clinical practice, education, research, and community outreach.
The paper introduces the DREAMS framework (Diet and Nutrition, Relationships and Social Connectedness, Exercise and Physical Activity, Avoidance of Harmful Substances, Mental Wellbeing and Stress Management, and Sleep Optimization) as a practical and scalable approach to unify and apply the six pillars of lifestyle medicine. The framework aims to enhance recall, support education, and facilitate delivery of multimodal lifestyle interventions across diverse settings.
Obstructive sleep apnea is associated with disturbances in nutrition-related biochemical markers among eutrophic adults
In eutrophic adults, moderate-to-severe OSA was linked to higher VLDL and triglyceride levels, and zinc levels differed across OSA severity groups. Higher AHI was independently associated with higher VLDL and triglycerides and lower magnesium after full adjustment, with sex-specific patterns.
A hybrid machine learning framework integrating Vision Transformer and XGBoost achieves 99.0% accuracy in classifying muscle strain severity from EMG and posture data.
The study introduces a low-cost IoT-based system combining posture and EMG sensors to classify muscle strain severity into three categories (baseline, compensatory strain, overload). The hybrid ViT-XGBoost model achieved 99.0% classification accuracy (95% CI: 98.5-99.5%) with an inference latency of 15.2 ms.
Severe psychosocial distress profiles are associated with higher levels of deliberate self-harm and suicidality among Chinese university students
A latent profile analysis of 30,992 Chinese university students identified three psychosocial distress profiles: minimal (60.08%), moderate (34.72%), and severe (5.20%). Students in the severe distress profile reported significantly higher deliberate self-harm (mean=7.47) and suicidality (mean=1.98) compared to moderate (DSH: 2.10, suicidality: 0.44) and minimal (DSH: 0.32, suicidality: 0.05) profiles, all p<0.001.
Repeated engagement with task-irrelevant digital stimuli is associated with cortico-striatal strengthening and prefrontal-parietal under-consolidation, producing a plasticity paradox in which attentional fragmentation becomes self-reinforcing.
The paper reports that repeated exposure to task-irrelevant digital interruptions leads to neuroplastic changes: strengthening of cortico-striatal circuits and under-consolidation of prefrontal-parietal networks. This creates a self-reinforcing cycle of attentional fragmentation, impairing deep thinking.
Home parenteral support with compounded nightly infusions reduces catheter-related bloodstream infections and treatment burden in severe Gitelman syndrome.
A 65-year-old woman with severe Gitelman syndrome was managed with home parenteral support (HPS) for 15 years, experiencing multiple catheter-related bloodstream infections and thromboses. Transition to a shared care model with compounded nightly infusions eliminated further infections and catheter exchanges, and improved quality of life by allowing uninterrupted sleep.
The Health Mode On and Health Mode On Plus protocols implement a stepped, integrated model of prevention and care to assess and promote mental wellbeing and healthy lifestyles among Italian university students.
The paper describes a multisite protocol (HMO and HMO+) funded by the Italian Ministry of University and Research, which combines harmonized surveillance with a stepped care model aligned with the WMH-ICS framework. It includes a cross-sectional survey, longitudinal follow-up, and an embedded randomized evaluation of digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual for students with anxiety risk. Primary outcomes are DSM-5 disorder status and safety outcomes, with secondary outcomes including sleep, physical activity, and other lifestyle factors.
Dietary quality and nutrient adequacy are consistent determinants of healthy longevity, with plant-based diets and fermented foods modulating gut microbiota to support sleep quality and cognitive performance.
This narrative review synthesizes evidence that dietary quality, particularly plant-based and Mediterranean diets, is consistently linked to favorable cardiometabolic, cognitive, and musculoskeletal functions. Key nutrients like omega-3 fatty acids, fiber, vitamins D and B, magnesium, potassium, and polyphenols are associated with these outcomes, while gut microbiota diversity may mediate effects on sleep quality and cognitive performance.
Ashwagandha supplementation improves athletic performance and recovery by increasing endurance, strength, and hypertrophy while reducing cortisol levels and anxiety
Studies indicate that ashwagandha dosages of 330-1000 mg daily increase endurance and facilitate quicker recoveries. A twice-daily dose of 300 mg combined with weight training increases muscular strength and hypertrophy, and the supplement is believed to regulate cortisol levels and relieve anxiety and insomnia.
EmOcean, a transdiagnostic digital intervention developed using the person-based approach, is hypothesized to support stress and emotion management and enhance mental health in Portuguese adults.
The paper describes the development of EmOcean, a guided self-help digital intervention for stress and emotion management, based on evidence from quantitative studies, qualitative interviews, a scoping review, and expert consultation. The intervention comprises eight integrated and five optional modules delivered weekly, targeting emotional schemas and psychological flexibility as mediators of mental health. The study found that stress responses, emotional schemas, and psychological flexibility were key predictors of mental health, informing the intervention's design.
K-means clustering combined with latent structure analysis categorizes depression patients into 9 subtypes with distinct medication patterns
This study analyzed 4434 TCM prescriptions from 3537 publications and used K-means clustering with latent structure analysis to classify depression patients into 9 subtypes. The most common symptoms were insomnia and depressed mood, and the most frequently used herbs were Radix Bupleuri, Radix Paeoniae Alba, Poria, Rhizoma Chuanxiong, and Radix Curcumae. Different subtypes showed distinct medication patterns, with blood-activating herbs used for Clusters 1, 2, and 6; qi-regulating herbs for Clusters 3, 4, 5, 8, and 9; and qi-supplementing herbs for Cluster 7.
Melatonin and its receptor agonists may help regulate circadian rhythms and improve subjective sleep quality in cardiac surgery patients, but effects on delirium, length of stay, and objective sleep architecture are inconsistent.
The review indicates that melatonin and its receptor agonists can improve subjective sleep quality and help regulate circadian rhythms in patients undergoing cardiac surgery. However, their effects on key clinical outcomes such as postoperative delirium, length of hospital stay, and objective measures of sleep architecture remain inconsistent across studies.
Incretin-based medications do not increase congenital anomalies in exposed pregnancies
A systematic scoping review of 34 articles found no studies reporting an increase in congenital anomalies with incretin-based medication use during pregnancy. The evidence included 11 randomized trials and 9 observational studies, with exposed pregnancy sample sizes ranging from 1 to 4267.
Salivary biomarkers such as cortisol, melatonin, alpha-amylase, chromogranin A, C-reactive protein, and immunoglobulin A offer a non-invasive method for monitoring stress, sleep quality, and disease severity in patients with atopic dermatitis.
This review highlights the potential of salivary biomarkers as non-invasive tools for monitoring stress, sleep quality, and disease severity in atopic dermatitis patients. The biomarkers include cortisol, melatonin, alpha-amylase, chromogranin A, C-reactive protein, and immunoglobulin A. The paper does not provide quantitative effect sizes or specific clinical thresholds.
Exercise dose architecture, rather than modality alone, may determine therapeutic benefits in autism spectrum disorder, with potential effects on executive function, stereotyped behaviors, sleep, motor competence, social communication, and quality of life.
This narrative review proposes that the therapeutic value of exercise in ASD depends on dose architecture (including motor complexity, cognitive demand, social embeddedness, sensory load, predictability, progression rate, and adherence burden) rather than just modality labels. The review synthesizes clinical and indirect evidence, but does not provide specific effect sizes or quantitative results.
Multidimensional fatigue interactions are associated with autonomic and cardio-respiratory changes in post-COVID-19 patients
In post-COVID-19 patients, daily changes in fatigue dimensions (physical, cognitive, emotional) were associated with fluctuations in heart rate variability and respiratory measures, particularly during sleep. The interaction of multiple fatigue dimensions showed more consistent associations than single dimensions, with patterns suggesting sympathetic dominance with higher physical fatigue and parasympathetic dominance with increases in cognitive and emotional fatigue.
Herbal supplements including Valeriana officinalis improve sleep quality in patients with anxiety, depression, and insomnia.
This narrative review found that herbal supplements such as Valeriana officinalis, Passiflora incarnata, and Withania somnifera demonstrated sedative effects and improvements in sleep quality in clinical studies. The review highlights that these benefits are accompanied by risks including excessive sedation and herb-drug interactions.
Circadian rhythm disruption is closely associated with obesity and chronic inflammation, and regular exercise can serve as an effective zeitgeber to realign disrupted biological rhythms and reduce obesity-related inflammation.
This review paper summarizes evidence that circadian clock disruption contributes to a vicious cycle involving rhythm disturbance, obesity, and inflammation. Regular exercise acts as a zeitgeber to help realign disrupted biological rhythms and reduce obesity-related inflammation, though the optimal exercise timing remains unclear.
Cannabis or cannabidiol may improve or prevent symptoms of Restless Leg Syndrome in adults
This scoping review synthesized evidence from seven studies (case reports, cross-sectional surveys, post hoc analyses) out of 5,370 records identified up to April 30, 2025. The findings suggest cannabis or CBD may alleviate or prevent RLS symptoms, but the evidence is insufficient for clinical recommendations due to lack of high-quality RCTs.
Family-centred nonpharmacological sleep interventions effectively address severe chronic sleep concerns in youth with neurodevelopmental disorders
A case report demonstrates that a family-centred, nonpharmacological sleep intervention focusing on behavioural, environmental, and circadian factors can effectively address sleep concerns, maintain improvements long term, and transform daytime functioning in youth with neurodevelopmental disorders. The intervention led to resolution of symptoms requiring medications prescribed for behaviour and medical conditions.
The 24HMBQ shows good criterion validity for sleep and moderate validity for sedentary behavior, but limited validity for physical activity in Chinese college students.
The 24HMBQ was validated against accelerometer data in 88 Chinese college students. Strong correlations were found for sleep (weekdays Rho=0.77, weekends Rho=0.68), moderate for sedentary behavior (weekdays Rho=0.55, weekends Rho=0.33), but weak for light PA (Rho=0.30) and non-significant for MVPA (Rho=0.15).
Integration of clinical data, subjective assessments, and objective measures enables accurate diagnosis of common sleep disorders.
The paper presents a structured approach to diagnosing sleep disorders, emphasizing the combination of clinical data, validated screening instruments, objective diagnostic modalities, physical examination, and targeted biomarkers. This integrative method supports accurate diagnosis and management of insomnia, hypersomnolence disorders, obstructive sleep apnea, and circadian rhythm sleep-wake disorders.
Chrononutrition strategies, including time-restricted eating and Mediterranean dietary patterns, improve sleep quality, glycemic control, inflammation, and metabolic health.
This narrative review of 112 studies found that chrononutrition approaches such as time-restricted eating and Mediterranean diets are associated with beneficial effects on sleep quality, glycemic control, inflammation, and metabolic health. The evidence suggests these strategies may help prevent and manage cardiometabolic diseases, with sex-specific differences noted.
A VR-based nature intervention is feasible and acceptable in long-term care facilities, with potential psychosocial effects including improved sleep quality.
This feasibility study protocol will assess the feasibility and acceptability of a 12-session VR-based nature intervention (360Ā° forest video) in two long-term care facilities, involving 10 residents and 10 nursing staff. The primary outcome is qualitative feasibility, while secondary outcomes include sleep quality, anxiety, depressive symptoms, wellbeing, loneliness, and trust in nursing staff. The study is not yet completed, so no effect sizes are reported.
Gut microbiota-driven metabolic reprogramming is a key contributor to Parkinson's disease with REM sleep behavior disorder
This study found that PD patients with RBD exhibit distinctive metabolic disturbances, including accumulation of gut microbiota-derived toxic aromatic amino acid catabolites, which were also observed in idiopathic RBD patients. The research integrated metabolomics, proteomics, and metagenomics to show that gut microbial dysbiosis drives a functional shift from fiber fermentation to enhanced protein and mucin degradation, associated with exacerbated oxidative stress and neuroinflammation.
Wearable-derived sleep data clustering identifies three distinct sleep disturbance subtypes among dementia caregivers
Clustering analysis of 14-day Oura Ring sleep data from 143 dementia caregivers identified three distinct sleep disturbance subtypes: Optimal Sleep, Disturbed Onset & Maintenance, and Insufficient Sleep. Cluster 2 (Disturbed Onset & Maintenance) had the highest prevalence of comorbid conditions, while Cluster 3 (Insufficient Sleep) was predominantly male with the lowest support availability.
Daytime dysfunction predicts poorer cognitive flexibility only in children with ADHD who engage in low physical activity levels
In a cohort of 282 children with ADHD (mean age 8.59 years, 78.4% boys), approximately 60% had sleep problems. Children with sleep problems had longer sleep latency, poorer cognitive flexibility, and less moderate-to-vigorous physical activity (MVPA). The relationship between daytime dysfunction and cognitive flexibility was moderated by MVPA guideline attainment, such that daytime dysfunction predicted poorer cognitive flexibility only in children with low PA levels.
Nighttime screen use is hypothesized to attenuate the physiological nocturnal fall in blood pressure, contributing to the non-dipper phenotype in adolescents.
This narrative review proposes that intensive nighttime screen use, through mechanisms such as melatonin suppression and sympathetic activation, disrupts circadian control of the cardiovascular system, leading to a reduced nocturnal blood pressure dip (non-dipper phenotype). The paper positions 24-hour ambulatory blood pressure monitoring as the reference standard for detecting this at-risk phenotype and masked hypertension, which are invisible to office readings. The review integrates subclinical biomarkers and emerging wearable/AI tools into a proposed screening pathway.
Nocturnal heat exposure impairs sleep architecture and autonomic activity in young men, with BMI-dependent effects on sleep disruption patterns
A single night of heat exposure at 30Ā°C compared to 22Ā°C reduced total sleep time, sleep efficiency, and overnight cardiac parasympathetic activity in both normal-weight and overweight young men. However, sleep architecture showed BMI-dependent effects: normal-weight individuals experienced heat-sensitive reductions in average slow-wave sleep period duration and increased N1%, while overweight individuals had shorter average slow-wave sleep periods at 22Ā°C with no further heat-related reduction at 30Ā°C.
Endurance runners experience a higher prevalence of several mental health symptoms, including anxiety, exercise addiction, sleep disorders, and suicidal ideation, which is multifactorial and involves self-selection, sport-specific demands, and biopsychosocial factors.
This commentary highlights that endurance runners have a higher prevalence of mental health symptoms such as anxiety, exercise addiction, sleep disorders, and suicidal ideation. The authors argue that these outcomes are multifactorial, involving self-selection processes, sport-specific demands, and broader biopsychosocial factors, and emphasize the need for longitudinal and qualitative research.
Insufficient sleep is consistently associated with weight gain through hormonal, behavioral, and metabolic mechanisms
The review finds consistent evidence linking insufficient sleep to weight gain, mediated by hormonal, behavioral, and metabolic pathways. The relationship is bidirectional, with obesity also contributing to sleep disorders, particularly obstructive sleep apnea.
Virtual reality combined with biofeedback improves sleep quality and daytime function in patients with chronic insomnia
In a retrospective study of 83 patients with chronic insomnia, those receiving VR combined with biofeedback showed significantly greater improvements in PSQI and ISI scores compared to biofeedback alone (P < 0.01). Polysomnography revealed shortened sleep latency, prolonged total sleep time, and reduced awakenings (P < 0.05). Daytime function improved with decreased MFI fatigue scores and increased DFSS scores (P < 0.05), with no significant difference in adverse reactions at 1-month follow-up.
Australian healthcare professionals report diagnostic delays, difficulties accessing timely multidisciplinary support, and challenges coordinating care for people living with motor neurone disease, particularly outside MND clinic catchment areas.
A survey of 50 Australian healthcare professionals (55% response rate) identified key challenges in MND clinical assessment and management, including diagnostic delays, access to multidisciplinary care, and coordination issues. Respondents also perceived uncertainty in respiratory support, nutrition, saliva management, and psychological/cognitive care, with variations from guidance due to evidence gaps, need for individualized care, and systemic constraints.
Gradual tapering of benzodiazepine receptor agonists, antidepressants, antipsychotics, and gabapentinoids after medium- or long-term use (>2 weeks) is recommended to discontinue hypnotic medications.
The paper recommends that hypnotic medications such as benzodiazepine receptor agonists, antidepressants, antipsychotics, and gabapentinoids should be tapered gradually after use exceeding 2 weeks, with a weekly dose reduction of 10-25%. Abrupt discontinuation is only recommended for short-term use (1-2 weeks) or for drugs without withdrawal symptoms like daridorexant, melatonin, antihistamines, and phytotherapeutics. A longer taper is advised for high-dose (ā„2/3 of maximum) or long-term (ā„1 year) use.
Mind Sound Resonance Technique (MSRT) improves sleep quality and reduces stress, anxiety, and chronic pain in diverse populations
This narrative review of 21 clinical studies found that MSRT, a yoga-based guided meditative technique, significantly reduced anxiety, stress, and chronic pain, and improved sleep quality. It also enhanced cognitive performance, autonomic balance, cardiovascular health, and respiratory function, and supported smoking cessation.
Fatigue and sleep quality, rather than pain severity, are central in the symptom network of breast cancer survivors with pain, with fatigue linking sleep problems to perceived injustice.
In a cross-sectional network analysis of 278 breast cancer survivors with pain, fatigue and sleep-related symptoms occupied central positions in the symptom network, while pain severity showed no directionality. Fatigue appeared to be a key linking mechanism between perceived injustice and sleep, and pain catastrophizing was primarily associated with perceived injustice unfairness.
Tart cherry juice promotes sleep quantity in athletes and healthy adults
The narrative review found that tart cherry juice can promote sleep quantity in athletes and healthy adults. This conclusion is based on studies that measured sleep duration and efficiency, though specific effect sizes were not reported in the abstract.
Sleep quality does not significantly affect cardiorespiratory fitness (VO2 max) in apparently healthy young adults
This cross-sectional study compared VO2 max between normal and poor sleep categories in young medical students. Mean VO2 max was 42.50 mL/kg/min for normal sleepers and 41.89 mL/kg/min for poor sleepers, with no significant difference (p=0.77). No correlation was found between PSQI score and VO2 max (r=0.029, p=0.591).
Hainan centenarians exhibit healthy longevity through a multifactorial model (HLM) combining environmental, genetic, and lifestyle factors, including reasonable sleep, which may confer resistance to senile degeneration and cognitive disability.
The paper proposes the Hainan longevity model (HLM) as a framework for healthy longevity, based on observations of Hainan centenarians who live in high-oxygen, green environments and adopt healthy lifestyles including social participation, balanced nutrition, moderate exercise, and reasonable sleep. This model is expected to provide scientific evidence for promoting healthy longevity in aging populations, though no quantitative data are provided in the abstract.
Suicidal ideation and suicide attempt share genetic architecture with sleep regulation-related gene sets
Stratified analyses showed that suicide attempt pairs were enriched for gene sets related to sleep regulation, among other traits. The study used genome-wide association study summary statistics from 15 studies (N=46,350-975,353) and identified shared loci mapping to 798 unique genes.
A ketogenic diet generally has neutral or negative effects on athletic performance compared to carbohydrate-rich diets.
The paper states that, despite changes in substrate utilization, a ketogenic diet generally has neutral or negative effects on athletic performance when compared to carbohydrate-rich diets. This claim is made in the context of post-exercise refueling recommendations within the 4Rs framework for sports nutrition.
Herbal products including Bacopa monnieri, Crocus sativus, Ginkgo biloba, Hypericum perforatum, Lavandula angustifolia, Melissa officinalis, Panax ginseng, Passiflora incarnata, Pinus pinaster, Valeriana officinalis, and Withania somnifera show clinical promise for mental health symptoms in children and adolescents.
A systematic review of 29 clinical trials identified 11 herbal products with clinical promise for pediatric mental health conditions including ADHD, anxiety, depression, nervous agitation, restlessness, and sleep disturbances. The review highlights both potential benefits and current limitations, emphasizing the need for standardized preparations and clinical oversight.
Migraine subtypes exhibit distinct interictal cognitive event-related potential (CERP) alterations, with migraine without aura showing prolonged N200/P300 latencies and reduced P300 amplitude, while migraine with aura shows the longest latencies, and migraine aura without headache shows increased amplitudes correlated with neuropsychiatric symptoms.
This cross-sectional study compared cognitive event-related potentials (N200, P300) in 173 participants across migraine subtypes and healthy controls. Migraine without aura (MwoA) showed significantly prolonged N200 and P300 latencies and decreased P300 amplitudes compared to controls, while migraine with aura (MwA) had the longest latencies among all subtypes. Migraine aura without headache (MAwH) showed higher N200/P300 amplitudes than MwoA, and these amplitudes correlated positively with anxiety, depression, and insomnia scores.
Sleep difficulties are associated with lower health-related quality of life in adults with pulmonary hypertension, partially mediated by depressive symptoms.
In a cross-sectional survey of 111 adults with pulmonary hypertension, 79.8% had poor sleep quality, and insomnia and daytime sleepiness were elevated (35% and 33.6%, respectively). All types of sleep difficulties were associated with lower HRQoL, and this association was partially mediated by depressive symptoms.
Structured lifestyle and behavioural interventions reduce OSA severity and daytime sleepiness in adults with obstructive sleep apnoea.
Randomised controlled trials consistently show that healthy dietary patterns, structured physical activity, alcohol reduction, and interdisciplinary lifestyle programmes can reduce OSA severity, daytime sleepiness, and cardiometabolic risk markers. Some benefits occur without substantial weight loss, suggesting additional mechanisms such as improved ventilatory stability, reduced rostral fluid shift, enhanced upper-airway neuromuscular responsiveness, and lower systemic inflammation.
Integrating sleep and circadian health assessment into cardiac rehabilitation may enhance cardiac recovery, improve exercise tolerance and adherence, and support comprehensive secondary prevention.
This narrative review argues that systematic assessment and management of sleep and circadian health are underutilized in cardiac rehabilitation (CR) programs, despite evidence linking sleep disorders and circadian disruption to impaired cardiac recovery and increased adverse events. The authors propose practical strategies including sleep screening, sleep hygiene education, and chronotype-informed exercise scheduling, which may improve CR outcomes. No quantitative effect sizes are provided as this is a narrative review.
Participation in cardiac rehabilitation and younger age are associated with increased physical activity in coronary heart disease patients
This systematic review of 24 observational studies found that the primary explanatory variables for 24-hour movement behaviors in coronary heart disease patients were concentrated at the intrapersonal level. Aging was significantly associated with reduced physical activity, while participation in cardiac rehabilitation was linked to increased physical activity. No significant associations were found at the policy level.
Public health measures during COVID-19 reduced children's physical activity and increased sedentary time, with variable impacts on sleep
A rapid global scoping review of 182 studies across 48 countries (2020-2023) found consistent declines in children's physical activity and increases in sedentary time during COVID-19 public health measures, with variable impacts on sleep. The review highlights that movement behaviours were insufficiently considered in emergency response planning, and recommends embedding movement opportunities in future preparedness efforts.
CSNK2A1 gene variant (c.149A>G:p.Tyr50Cys) causes Okur-Chung neurodevelopmental syndrome with sleep disorders as a key clinical feature
This study identified a de novo heterozygous mutation (NM_001895.4: c.149A>G:p.Tyr50Cys) in the CSNK2A1 gene as a cause of Okur-Chung neurodevelopmental syndrome (OCNDS) in a child. A retrospective analysis of 65 OCNDS patients found that sleep disorders, along with autism spectrum disorders, short stature, and developmental delays, were significant clinical characteristics. The variant is located in the Glycine-Rich loop domain of the kinase, disrupting protein spatial conformation and function.
Dietary and supplementation protocols focused on sleep-promoting nutraceuticals can act as subsidiary sleep aids in complementing behavioral sleep hygiene changes.
This narrative review summarizes evidence that selected nutraceuticals, including melatonin, magnesium, omega-3 fatty acids, tart cherry juice, kiwifruit, apigenin, valerian root, L-theanine, glycine, ashwagandha, myoinositol, Rhodiola rosea, and phosphatidylserine, may improve sleep quality and quantity. The paper suggests these compounds can serve as adjuncts to good sleep hygiene practices for individuals with circadian rhythm and sleep disturbances.
A six-week Pythagorean Self-Awareness Intervention improves dietary habits, psychological outcomes, and biomarkers of oxidative stress and telomere length in adults
In a quasi-experimental pre-post study of 30 healthy adults, a six-week Pythagorean Self-Awareness Intervention was associated with significant improvements in Mediterranean diet adherence (p=0.001), reduced perceived stress (PSS-14, p=0.004), reduced depressive symptoms (DASS-21, p=0.005), improved sleep quality (PSQI, p<0.001), decreased oxidative stress (p=0.023), increased antioxidant capacity (p=0.009), and increased leukocyte telomere length (p<0.001). The intervention also led to reductions in body weight, BMI, waist and hip circumference, and intermuscular adipose tissue (all p<0.05).
Conserved sleep orthologs, including DnaK (Hsp70), serine hydroxymethyltransferase (SHMT), and potassium channel family proteins, are present in Sulfurimonas paralvinellae of the Epsilonproteobacteria class, with sequence similarities ranging from 39.13% to 61.45%.
The study identified conserved sleep-related orthologs in the extremophilic bacterium Sulfurimonas paralvinellae, including DnaK (Hsp70), SHMT, and potassium channel proteins, with sequence similarities between 39.13% and 61.45%. Proteins with fewer domains, such as adenylate kinase, showed greater conservation, while bifunctional protein-serine/threonine kinases and phosphatases exhibited adaptations linked to high-pressure/high-temperature environments. Gene Ontology analysis highlighted catalytic activity, potassium channel function, and cellular processes, emphasizing ion channels in sleep-wake regulation.
Transvenous phrenic nerve stimulation improves apnoea indices, oxygenation, and quality of life in adults with central sleep apnoea, including those with heart failure.
The 2025 American Academy of Sleep Medicine Clinical Practice Guideline recognizes transvenous phrenic nerve stimulation as an evidence-based therapy for central sleep apnoea in adults, including heart failure patients. Current evidence indicates improvements in apnoea indices, oxygenation, and quality of life, though effects on mortality and hospitalisation require further prospective randomized data.
Amphetamine-type stimulants may influence sleep and circadian regulation in young adults with ADHD, potentially increasing susceptibility to circadian misalignment and sleep disruption.
This mini-review synthesizes current literature on the relationship between amphetamine-type stimulant use, sleep/circadian dysregulation, and neuropsychiatric outcomes in young adults with ADHD. It suggests that stimulant pharmacology interacts with the circadian system, and combined with the biologically delayed circadian phase in young adulthood and high prevalence of delayed circadian rhythms in ADHD, may increase susceptibility to sleep disruption.
Physical fatigue is a central symptom linking psychological and functional domains in adults with chronic medical conditions, suggesting that targeting fatigue may improve mental health and functional outcomes.
In a baseline analysis of 825 adults with chronic medical conditions, network analysis identified three symptom clusters: mental health, fatigue/frailty, and quality of life, with physical fatigue as the most central node. The findings suggest that fatigue, demoralization, and frailty are interconnected drivers of symptom burden, and targeting fatigue may be a key strategy for improving outcomes.
A combined school- and home-based sleep promotion program for young children is acceptable and desired by teachers and parents
Teachers and parents of children aged 4-6 years were engaged to inform the development of a combined school- and home-based sleep promotion program. Teachers (n=34) expressed concerns about suboptimal sleep impacting children during the school day and identified barriers, while parents (n=61) reported challenges with their child's sleep and conveyed interest in a tailored program. The findings suggest that a collaborative school-home sleep program would be well-received by families.