Search Results (10,880)

Objectives. The objectives of this study were (i) to design in detail an exercise program for individuals with sleep-disordered breathing (SDB) that would be reproducible, and (ii) to present a system for monitoring training load (volume × intensity) within such a program. Methods. A comprehensive exercise program was developed for individuals with SDB, detailing not only the session structure (warm-up, main part—circuit training and brisk walking—and cool-down) but also the specific exercises, training volume (actual exercise time excluding rest), intensity (Borg Rating of Perceived Exertion—RPE), and training load (calculated as time × RPE, in arbitrary units). This detailed program was previously implemented in a RCT (ISRCTN16974764). A comparison was also made between the planned and performed intensity, and training load through a paired t-test. Results. A fully replicable program was presented. No significant difference was found between the planned and performed training load (p = 0.482). When analyzed by week, a significant difference was found only for overestimation in weeks 9–12 (p < 0.001). Conclusions. In general terms, it can be concluded that a detailed exercise program was described for individuals with SDB. The program is reproducible in terms of content, training volume, intensity, and load. Moreover, the RPE proved to be a valid parameter for quantifying intensity, allowing for the integration of all parts of the session, as well as various types of content. The planned and performed programs (as quantified via participants’ RPE) matched appropriately. Therefore, this program can be reproduced and applied to this type of population. Full article

This paper focuses on clarifying the relationship between noise exposure and the prevalence of highly sleep-disturbed (HSD) people due to road traffic and railway noise in Japan. The authors accumulated 22 datasets, which were provided by the Socio-Acoustic Survey Data Archive and derived from the other surveys conducted in Japan. All the datasets include the following micro-data: demographic factors, exposure, and sleep disturbance data associated with specific noise sources. We performed secondary analyses using the micro-data and established relationships between noise exposure (L_night) and the percentage of HSD people (%HSD) for road traffic, conventional railway, and Shinkansen railway noise. There were no large differences in %HSD responses between noise sources, although the response to road traffic noise was slightly higher than the responses to other noise sources. In addition, the results for road traffic noise were generally consistent with those reported in the World Health Organization guidelines and previous studies conducted in Asia. In contrast, responses to railway noise, particularly in high-exposure areas, in Japan were lower than those reported in the World Health Organization guidelines and South Korean studies. Full article

Obstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed sleep disorder with significant cardiovascular implications, namely in atrial fibrillation (AF) patients. Despite its clinical relevance, OSA prevalence among AF patients and the diagnostic strategies used remain heterogeneous across studies, complicating screening, and treatment pathways. Our aim was to synthesize recent evidence on OSA prevalence in AF populations and to critically evaluate the diagnostic methods and screening strategies employed in clinical studies, by conducting a systematic review using PubMed and Google Scholar to identify original clinical studies published between January-2019 and December-2024. Inclusion criteria targeted adult AF populations assessed for OSA or sleep-disordered breathing. The results were analyzed by two independent reviewers. Non-concordances were resolved by consensus. Data extracted included study characteristics, population profiles, diagnostic approaches, prevalence rates, symptom profiles, and clinical correlates. Thirty-eight studies were included, comprising predominantly observational studies. Prevalence estimates of OSA in AF populations ranged from 5% to 90%, with most studies reporting rates >60%. A consistent burden of moderate-to-severe OSA was observed. Diagnostic methods varied widely, from polysomnography (PSG) and home sleep apnea testing to pacemaker-derived monitoring and questionnaires such as STOP-Bang and Epworth Sleepiness Scale (ESS). Underdiagnosis was attributed to minimal symptomatology, lack of physician awareness, and reliance on subjective tools. Several studies highlighted the limited sensitivity of standard screening instruments in AF populations and advocated for objective testing even in asymptomatic patients. Marked heterogeneity in study designs, diagnostic methods, and populations precluded quantitative synthesis and limited direct comparisons. Objective diagnostic testing, particularly PSG, is essential to improve OSA detection rates and guide individualized management. Integration of structured screening protocols into AF care—especially for high-risk patients—and interdisciplinary collaboration are critical. Full article

This study described and analyzed the results of cardiorespiratory polygraphic studies in infants under three months who were hospitalized and monitored due to suspected apneas. Methods: Cross-sectional study. Patients aged <3 months hospitalized from 2011 to 2023 were included. All were referred for suspected apneas, and cardiorespiratory polygraphies (PG) were conducted simultaneous to non-invasive monitoring. Demographic, PG, and diagnostic variables were recorded. PG values were obtained and compared between diagnostic groups. Association was evaluated according to diagnosis, prematurity, presence, and alteration type with Kruskal–Wallis, Wilcoxon, and Fisher tests. Association between quantitative variables was assessed with Spearman’s rho and the presence of alteration with binomial logistic regression. Analysis was performed with Jamovi v.2.3, and statistical significance was defined as p < 0.05. Results: A total of 155 studies were included. Median age was 41.0 days (IQR 22.0–59.0), median gestational age was 38 weeks (IQR 32.0–42.0), and 52.3% were premature. Diagnosis: brief resolved unexplained events (BRUE) (58.1%), apnea of prematurity (27.1%), hypotonic syndrome (7.1%), laryngomalacia (LGM) (3.9%), and craniofacial alterations (CFA) (3.9%). Altered results in 21.9% polygraphies: 44.1% with AHI ≧ 5/h and 20.6% with SpO₂ ≦ 90% in >5% of the record. CFA and LGM patients had a higher risk of an altered polygraph than those with apnea of prematurity (OR 21.3/8.5) and BRUE (OR 35.9/14.3), respectively. Conclusions: Infants under three months of age referred for apnea showed often abnormal polygraphic indices, showing significant differences between diagnostic groups. Performance of sleep studies in these groups was feasible and allowed to confirm the presence of apneas and their level of severity. Particular attention should be considered in children with CFA and LMG, since their risk is significantly higher. Age-specific apnea patterns seem to be of interest, as this may possibly lead to future consequences. Full article

Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway collapses during sleep, contributing to oxygen desaturation, arousals, and significant cardiovascular complications. This meta-analysis aims to evaluate the association between blood ICAM-1 levels and OSA, exploring its potential as a biomarker for cardiovascular disease (CVD) and for identifying factors contributing to result heterogeneity. Following PRISMA guidelines, this meta-analysis addressed a PECO framework to assess circulating ICAM-1 levels in adults with OSA compared to controls. A systematic search was conducted across PubMed, Web of Science, Scopus, Cochrane Library, and CNKI until 23 April 2025, complemented by citation reviews and Google Scholar. Statistical analyses, including subgroup and meta-regression, were performed using RevMan, CMA 3.0, and TSA software to calculate mean differences, assess heterogeneity, and evaluate publication bias. Results were analyzed under random-effect models, with significance set at p < 0.05 for all metrics except publication bias (p < 0.10). This systematic review and meta-analysis included 34 articles. The pooled mean difference (MD) of ICAM-1 levels was 184.06 ng/mL (95% CI: 143.83 to 224.28; p < 0.00001), significantly higher in OSA patients with high heterogeneity (I² = 100%). Subgroup analysis highlighted larger MDs in Asians and plasma samples, as well as greater ICAM-1 elevations in severe OSA cases. Despite publication bias indicated by Begg’s (p = 0.036) and Egger’s (p = 0.016) tests, the findings remained robust, supported by sensitivity and meta-regression analyses. This meta-analysis underscores a significant association between elevated ICAM-1 levels and OSA, highlighting its potential as a biomarker for CVD risk stratification in OSA patients. Full article

Background and Objectives: Sleep complaints are particularly relevant in the development of children, affecting cognitive development, neuropsychological functioning, and learning abilities. The aims of this study were as follows: (i) to determine the incidence of sleep disorders in low-risk infants and toddlers with hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH), using the Italian version of the Sleep Disturbance Scale for Children (SDSC); and (ii) to compare the data with those of a healthy control group. Materials and Methods: This is a cross-sectional case–control study involving a total of 167 infants and toddlers (aged 6–36 months) with HIE treated with TH and 160 typically developing infants assessed using the SDSC filled out by the mother. A neurocognitive assessment was also performed. Exclusion criteria were mild perinatal asphyxia, major brain lesions, congenital malformations, severe postnatal infectious diseases, metabolic complications, cerebral palsy, neurodevelopmental impairment, and epilepsy. Results: In the study group, an abnormal total SDSC score was found in 1.8% of infants; 10% of infants had an abnormal score on at least one of the SDSC factors. No specific differences in the SDSC total and the factor scores were observed between the study and control group, with the exception of difficulties in maintaining sleep and sleep hyperhidrosis, with higher scores in HIE infants. Conclusions: Low-risk infants and toddlers with HIE showed a low incidence of sleep disorders, similar to those observed in control group, with some exceptions. As these incidences may increase significantly with age, further clinical assessments will be needed to confirm these data at older ages. Full article

The aim of this paper was to evaluate health, psychological distress, and functioning during the COVID-19 pandemic among Danish adults with and without a history of mental illness. Data were drawn from three online surveys conducted in May 2020 (n = 3134), January 2021 (n = 1170), and January 2022 (n = 1174) as part of the Danish contribution to the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT). The prevalence of mental and physical health issues, psychological distress (stress, sleep problems, loneliness, and boredom) and levels of functioning (self-care, interpersonal relationships, hobbies/leisure, and work/education) were evaluated at four different time points stratified by history of mental illness. Findings indicated that physical health was not differentially affected between people with and without prior mental illness. However, mental health declined significantly more among respondents with a history of mental illness. While levels of stress did not differ between the two groups, boredom was more pronounced in May 2020 among those with prior mental illness. Loneliness was significantly higher in this group in January 2021. Sleep disturbances were more pronounced for respondents with former mental illness during the whole period. A decline in functioning was observed in people both with and without a former mental illness. It seemed a little more pronounced for people with mental illness but seldom reached statistical significance. For all measures of health, distress, and functioning, 10–20% of respondents reported improvements in health, distress, and functioning during the pandemic, with stress showing the most improvement—one third of participants reported feeling less stressed. In most of the parameters measured, the influence of the COVID-19 pandemic seemed to decrease with time. However, the effects were not uniform, and more investigations are needed to understand the whole picture. Full article

Background/Objectives: The rapid development of artificial intelligence is transforming the face of medicine. Due to the large number of imaging studies (pre-, intra-, and postoperative) combined with histopathological and molecular findings, its impact may be particularly significant in neurosurgery. We aimed to perform a scoping review of recent applications of deep learning in MRI-based diagnostics of brain tumors relevant to neurosurgical practice. Methods: We conducted a systematic search of scientific articles available in the PubMed database. The search was performed on 22 April 2024, using the following query: ((MRI) AND (brain tumor)) AND (deep learning). We included original studies that applied deep-learning methods to brain tumor diagnostics using MRI, with potential relevance to neuroradiology or neurosurgery. A total of 893 records were retrieved, and after title/abstract screening and full-text assessment by two independent reviewers, 229 studies met the inclusion criteria. The study was not registered and received no external funding. Results: Most included articles were published after 1 January 2022. The studies primarily focused on developing models to differentiate between specific CNS tumors. With improved radiological analysis, deep-learning technologies can support surgical planning through enhanced visualization of cerebral vessels, white matter tracts, and functional brain areas. Over half of the papers (52%) focused on gliomas, particularly their detection, grading, and molecular characterization. Conclusions: Recent advancements in artificial intelligence methods have enabled differentiation between normal and abnormal CNS imaging, identification of various pathological entities, and, in some cases, precise tumor classification and molecular profiling. These tools show promise in supporting both diagnosis and treatment planning in neurosurgery. Full article

The automatic classification of sleep stages and Cyclic Alternating Pattern (CAP) subtypes from electroencephalogram (EEG) recordings remains a significant challenge in computational sleep research because of the short duration of CAP events and the inherent class imbalance in clinical datasets. Background/Objectives: The research introduces a domain-specific deep learning system that employs an LSTM network optimized through a PSO-Hyperband hybrid hyperparameter tuning method. Methods: The research enhances EEG-based sleep analysis through the implementation of hybrid optimization methods within an LSTM architecture that addresses CAP sequence classification requirements without requiring architectural changes. Results: The developed model demonstrates strong performance on the CAP Sleep Database by achieving 97% accuracy for REM and 96% accuracy for stage S0 and ROC AUC scores exceeding 0.92 across challenging CAP subtypes (A1–A3). The model transparency is improved through the application of SHAP-based interpretability techniques, which highlight the role of spectral and morphological EEG features in classification outcomes. Conclusions: The proposed framework demonstrates resistance to class imbalance and better discrimination between visually similar CAP subtypes. The results demonstrate how hybrid optimization methods improve the performance, generalizability, and interpretability of deep learning models for EEG-based sleep microstructure analysis. Full article

Background/Objectives: Chronic musculoskeletal pain without a clearly identifiable medical cause is characterised by significant emotional distress and/or functional disability. Given the relatively limited research specifically addressing chronic primary musculoskeletal pain (CPMP), as defined in the latest revision of the International Classification of Diseases (ICD-11), the present study aimed to examine its psychopathological and sleep-related implications, and to explore whether pain intensity is associated with psychological distress and poor sleep quality. Methods: This observational study included 60 adult participants, comprising 30 patients diagnosed with CPMP and 30 healthy controls without any diagnosis. Participants completed the Numeric Pain Rating Scale (NPRS), the Symptom Checklist-90-R (SCL-90-R), and the Pittsburgh Sleep Quality Index (PSQI). Results: Patients with CPMP exhibited significantly higher levels of psychopathological symptomatology on the SCL-90-R and poorer sleep quality on the PSQI compared to controls (p < 0.05 for most dimensions). Greater pain intensity on the NPRS was strongly associated with psychological distress (e.g., GSI: r = 0.838, p < 0.01) and poor sleep quality (r = 0.785, p < 0.01). Hierarchical regression analyses revealed that pain intensity may play a meaningful role in both psychological distress and sleep quality (p < 0.05 across all models), even after statistically controlling for sex, age, and pain duration. Conclusions: These findings suggest that pain intensity is not only a key physical symptom, but also a relevant factor in understanding the broader psychological vulnerability in patients with CPMP. The present study contributes to a deeper understanding of the psychopathological and functional impact of CPMP and underscores the need for tailored psychological interventions to address the comorbid symptoms associated with this condition. Full article

This opinion article aims to highlight the potential mechanisms behind a specific stage of Yoga Nidra (YN) practice, i.e., the formulation and repetition of Sankalpa, encouraging scholars to further study it and providing athletes with suggestions on how to use it for their sport and health. YN can be defined as a meditation practice encompassing a sequence of breathing, guided body awareness, visualization and cognitive restructuring process exercises. According to preliminary results, YN stimulates a hypnagogic state generally associated with improvements in sleep parameters, thus enhancing recovery and health in different populations including athletes. Cognitive restructuring processes can be stimulated by the formulation of Sankalpa, a YN element comparable to positive self-instructions used to counteract dysfunctional cognitions. From a practical standpoint, the formulation of Sankalpa involves expressing an intention that could positively influence body, mind and emotions. For example, Sankalpa might stop or reverse unhealthy thought patterns, resulting in greater mental health. It might also foster intrinsic motivation and enhance emotional intelligence by strengthening mental resilience. In particular, athletes could use Sankalpa as an affirmation to awaken any strength they may feel is necessary to provide them with stress–recovery balance and mental health. However, additional research on this topic is needed to better elucidate Sankalpa’s mechanisms/effects and better integrate its formulation into sport programs. Full article

Objectives: The health of the adult population is the result of many interacting variables, with health behaviors and lifestyle playing a key role. This study aimed to identify associations among health-related behaviors and health and hydration status in Polish adults. Methods: The completion of a beverage frequency questionnaire (FFQ) was undertaken by a total of 337 participants. Blood pressure (BP), anthropometric parameters, and body composition were measured. Urine samples were analyzed for specific gravity (USG), osmolality (Uosm), and potential hydrogen value (pH). Health-related behaviors were assessed using the Health Index Score (HIS), classifying participants into two groups: unhealthy habits (0–2 HIS group) and healthy habits (3–5 HIS group). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Approximately 30% of participants (n = 115) exhibited unhealthy habits. Individuals in the 0–2 HIS group were more likely to be male, smoke, have low physical activity, be overweight or obese, sleep < 6 h, and/or consume alcohol ≥ 2 times/week. In contrast, higher HIS (3–5) was associated with female gender, non-smoking, moderate-to-high physical activity, normal body mass index (BMI), adequate sleep, and consuming alcohol < 2 times/week. Fatigue during the day (OR: 1.45), waist circumference (WC) (OR: 1.35), and Uosm (OR: 1.87) increased un-healthy habits. Conversely, greater consumption of non-carbonated mineral water (OR: 0.54) was linked to lower unhealthy habits. Conclusions: The HIS and hydration-related parameters can complement the assessment of the health status of the adult population and the identification of groups requiring special support in health promotion interventions. Full article

This study presents the development and the mechanical and clinical characterization of a flexible biodegradable chitosan–glycerol–graphite composite strain sensor for real-time respiratory monitoring, where the main material, chitosan, is derived and extracted from Tenebrio Molitor larvae shells. Chitosan was extracted using a sustainable, low-impact protocol and processed into a stretchable and flexible film through glycerol plasticization and graphite integration, forming a conductive biocomposite. The sensor, fabricated in a straight-line geometry to ensure uniform strain distribution and signal stability, was evaluated for its mechanical and electrical performance under cyclic loading. Results demonstrate linearity, repeatability, and responsiveness to strain variations in the stain sensor during mechanical characterization and performance, ranging from 1 to 15%, with minimal hysteresis and fast recovery times. The device reliably captured respiratory cycles during normal breathing across three different areas of measurement: the sternum, lower ribs, and diaphragm. The strain sensor also identified distinct breathing patterns, including eupnea, tachypnea, bradypnea, apnea, and Kussmaul respiration, showing the capability to sense respiratory cycles during pathological situations. Compared to conventional monitoring systems, the sensor offers superior skin conformity, better adhesion, comfort, and improved signal quality without the need for invasive procedures or complex instrumentation. Its low-cost, biocompatible design holds strong potential for wearable healthcare applications, particularly in continuous respiratory tracking, sleep disorder diagnostics, and home-based patient monitoring. Future work will focus on wireless integration, environmental durability, and clinical validation. Full article

Objectives: Depressive symptoms are highly prevalent among individuals with chronic kidney disease (CKD). This study explores their associated factors and gender differences among middle-aged and older CKD patients in China. Methods: Based on the health ecology model (HEM), this study utilized the 2018 cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) to examine gender differences in CKD patients across demographic groups. A multivariate logistic regression identified factors associated with depressive symptoms and gender differences among middle-aged and older patients with CKD in China. Additionally, a random forest model was constructed to rank the importance of key predictors based on the Gini index. Results: Among 1422 CKD patients, 50.35% reported depressive symptoms (42.97% of males and 59.56% of females). Factors significantly associated with higher depressive symptoms included female gender, rural residence, poor self-reported health, sleep duration < 7 h, and limitations in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The association of smoking and ADLs on depressive symptoms in CKD patients varied considerably between genders. Self-reported health and life satisfaction were the two variables most strongly associated with depressive symptoms among CKD patients. Conclusions: The study shows that female CKD patients have a higher prevalence of depressive symptoms than males. Several factors are significantly associated with depressive symptoms in patients with CKD. These findings provide valuable insights that potentially inform the development of targeted prevention and management strategies for depressive symptoms in middle-aged and older CKD patients in China. Full article

Background: A negative lifestyle has been reported to be associated with poor quality of life (QoL). However, there is limited information regarding the relationship between satisfaction with life (SWL) and lifestyle factors in university students. Objective: The aim of the present study was to determine the association between lifestyle parameters, quality of life (i.e., physical, psychological, social, and environmental dimensions), and categories of satisfaction with life (i.e., extremely satisfied, satisfied, slightly satisfied, dissatisfied, extremely dissatisfied) in Chilean university students. Methods: This cross-sectional study included a total of 212 university students (128 females and 83 males), aged between 18 and 28 years. Physical activity (PA), screen time (ST), dietary habits, sleep quality, QoL, and SWL were assessed using validated questionnaires. Results: SWL presented inverse association with unhealthy diet (β = −0.18, 95%CI; −0.28 to −0.09, p < 0.001), sleep < 6 h (β = −0.21, 95%CI; −0.31 to −0.11, <0.001), ST > 4 h (β = −0.10, 95%CI; −0.18 to −0.01, 0.015) and non-PA (β = −0.10, 95%CI; −0.19 to −0.01, p = 0.027). Regarding the association between lifestyle parameters and QoL, unhealthy diet was inversely associated with the physical (β; 0.18, 95%CI; −0.27 to −0.09, <0.001), psychological (β = −0.18, 95%CI; −0.27 to 0.09, p < 0.001), and environmental (β = −0.14, 95%CI; −0.23 to −0.06, 0.001) dimensions, and overall QoL score (β = −0.06, 95%CI; −0.09 to −0.03, p < 0.001). Sleep duration < 6 h showed inverse associations with the physical (β = −0.21, 95%Ci; −0.30 to −0.11, <0.001), psychological (β = −0.20, 95%CI; −0.30 to −0.10, <0.001), social (β = −0.30, 95%CI; −0.47 to −0.14, p < 0.001), and environmental (β = −0.13, 95CI; −0.21 to −0.04, p = 0.004) dimensions, and overall QoL score (β = −0.07, 95%CI; −0.10 to −0.04, p < 0.001). Non-PA was associated with physical dimensions (β = −0.09, 95%CI; −0.17 to −0.01, p = 0.019). Non-PA reported association with physical (β = −0.16, 95%CI; −0.25 to −0.07, p < 0.001), psychological (β = −0.20, 95%CI; −0.30 to −0.10, p < 0.001), social (β = −0.25, 95%CI; −0.41 to −0.09, p = 0.002), and environmental (β = −0.11, 95%CI; −0.19 to −0.02, p = 0.010) dimensions, and QoL overall score (β = −0.06, 95%CI; −0.09 to −0.03, p < 0.001). Conclusions: Poor diet, inadequate sleep, excessive ST, and non-PA are all associated with negative impacts on SWL and QoL in Chilean university students. Full article