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Sleep and Circadian Rhythms in Patients with Physical and Mental Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 12 September 2025 | Viewed by 3720

Special Issue Editors

Dr. Argyro Pachi

E-Mail Website
Guest Editor
Clinical Psychiatrist, Director of Psychiatric Department, “Sotiria” General Hospital of Chest Diseases, 11527 Athens, Greece
Interests: psychiatry; primary mental health care; psychopharmacology; consultation-liaison psychiatry
Special Issues, Collections and Topics in MDPI journals
Dr. Ioannis Ilias

E-Mail Website
Guest Editor
Department of Endocrinology, Hippocration General Hospital of Athens, 11527 Athens, Greece
Interests: circadian rhythms; stress; adrenals; thyroid; cortisol; diabetes; metabolism
Special Issues, Collections and Topics in MDPI journals
Dr. Athanassios Tselebis

E-Mail Website
Guest Editor
Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
Interests: clinical psychology; primary mental health care; community psychology; health psychology; psychometrics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sleep disorders and circadian rhythm dysregulation may severely compromise humans’ mental and physical health. Either due to genetic predisposition or as a result of environmental and behavioral manipulations (shift work, lifestyle factors, travel via different time zones, exposure to blue light devices), sleep and circadian rhythm disruption have been linked to some of the most prevalent and debilitating chronic diseases, namely neuropsychiatric, cardiometabolic, and immune disorders and cancer. Most of the circadian system disturbances associated with diseases are complicated, and, for mental disorders, they are more likely to be cross-diagnostic rather than disorder-specific. Insights into the mechanisms that regulate sleep circadian rhythms may advance therapeutic interventions, reducing the risk or altering the pathophysiology of the implicated diseases.

The purpose of this Special Issue is to gather research articles, reviews, and/or meta-analyses on sleep disorders and circadian rhythm dysregulation in patients with physical health conditions and mental disorders, alongside their treatment and management, including studies related to circadian medicine, sleep medicine, chronotherapy, cognitive behavioral therapy for insomnia, behavioral medicine, and consultation–liaison psychiatry.

Dr. Argyro Pachi
Dr. Ioannis Ilias
Dr. Athanassios Tselebis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep
  • circadian rhythms
  • insomnia
  • depression
  • physical health
  • mental health
  • circadian medicine
  • chronotype
  • chronotherapy
  • melatonin

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Published Papers (2 papers)

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Research

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23 pages, 1357 KiB  
Article
Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model
by Argyro Pachi, Christos Sikaras, Dimitrios Melas, Sofia Alikanioti, Nikolaos Soultanis, Maria Ivanidou, Ioannis Ilias and Athanasios Tselebis
J. Clin. Med. 2025, 14(4), 1145; https://doi.org/10.3390/jcm14041145 - 10 Feb 2025
Cited by 1 | Viewed by 2313
Abstract
Background/Objectives: Several studies have reported alarming rates of mental health issues and sleep problems among nurses even in the post-pandemic era. The objective was to investigate the prevalence of stress, anxiety and depressive symptoms, burnout and insomnia among nurses in Greece one [...] Read more.
Background/Objectives: Several studies have reported alarming rates of mental health issues and sleep problems among nurses even in the post-pandemic era. The objective was to investigate the prevalence of stress, anxiety and depressive symptoms, burnout and insomnia among nurses in Greece one year after the end of the pandemic and to construct a mediation model evaluating the impact of stress on insomnia, the chain mediating roles of depressive symptoms and burnout, as well as the moderating role of anxiety symptoms in the model. Methods: This cross-sectional study was conducted online in July 2024 and included 380 hospital nurses who completed the Depression Anxiety Stress Scale (DASS-21), the Copenhagen Burnout Inventory (CBI) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of stress, anxiety and depressive symptoms, burnout and insomnia were 33.9% with 95% confidence interval (CI): [0.292, 0.390], 33.3% (95% CI: [0.284, 0.381]), 35% (95% CI: [0.302, 0.400]), 46.8% (95% CI: [0.399, 0.502]) and 56.1% (95% CI: [0.509, 0.611]), respectively. Multiple regression analysis indicated that the Depression subscale of the DASS-21 explained 40.6% of the variance in the AIS, while an additional 7.6% was explained by the CBI and another 1.3% rate by the Stress subscale of the DASS-21. Mediation analysis revealed that stress affected insomnia both directly and indirectly through the chain mediating roles of depressive symptoms and burnout. Anxiety symptoms moderated the chain mediation path by enhancing the negative impact of stress on depressive symptoms. Conclusions: The proposed moderated chain mediation model introduces certain factors influencing insomnia and explains how changes in any one of these factors effectuate changes in the other factors, offering insights for individualized interventions. Full article
(This article belongs to the Special Issue Sleep and Circadian Rhythms in Patients with Physical and Mental Disorders)
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Review

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19 pages, 416 KiB  
Review
Narcolepsy Beyond Medication: A Scoping Review of Psychological and Behavioral Interventions for Patients with Narcolepsy
by Giorgia Varallo, Alessandro Musetti, Maria Filosa, Giada Rapelli, Fabio Pizza, Giuseppe Plazzi and Christian Franceschini
J. Clin. Med. 2025, 14(8), 2608; https://doi.org/10.3390/jcm14082608 - 10 Apr 2025
Viewed by 495
Abstract
Objectives: The present scoping review aims to map the existing evidence on psychological and behavioral interventions targeting patients with narcolepsy type 1 and type 2. Methods: A literature search was performed using the databases Scopus, PubMed, and PsycINFO. Studies were included [...] Read more.
Objectives: The present scoping review aims to map the existing evidence on psychological and behavioral interventions targeting patients with narcolepsy type 1 and type 2. Methods: A literature search was performed using the databases Scopus, PubMed, and PsycINFO. Studies were included if they (1) employed randomized controlled trials, non-randomized trials, or quasi-experimental studies; (2) were published in English; (3) were published in peer-reviewed journals; (4) examined the impact of psychological interventions on psychopathological (primary outcomes) and narcolepsy-related symptoms (secondary outcomes); and (5) involved patients with a diagnosis of narcolepsy using recognized diagnostic criteria regardless of whether they were receiving pharmacological treatment or were untreated. No restrictions were imposed on the publication date to comprehensively map the available evidence. Data were extracted to address the review aims and presented as a narrative synthesis. Results: The database search yielded six studies. Treatment options for individuals with narcolepsy encompass psychological and behavioral interventions, such as telehealth interventions, meditation/relaxation therapy, and scheduled napping. The primary outcomes were daytime sleepiness, wakefulness maintenance, sleep attacks, the severity of symptoms of narcolepsy, sleep paralysis episodes, depression, and psychological functioning. The secondary outcomes were sleep-problem-related quality of life, sleep inertia, and sleep quality. The psychological and behavioral interventions exhibited variability in terms of the intervention type, personnel involved, number of sessions, and duration. Most of the contributions also lack details regarding the training of professionals and the specifics of the interventions. Additionally, the evidence quality was deemed low based on the Crowe Critical Appraisal Tool. Conclusions: Although the importance of nonpharmacological approaches is well recognized, there is limited evidence to support the efficacy of psychological and behavioral interventions in narcolepsy. This is further complicated by the wide range of psychological and behavioral interventions available. Full article
(This article belongs to the Special Issue Sleep and Circadian Rhythms in Patients with Physical and Mental Disorders)
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