Search Results (245)

Sleep is crucial to overall health and plays a significant role in skin function. While the circadian rhythm has been extensively researched for its impact on the body’s optimal functioning, the skin also possesses an independent circadian system that serves many important functions. Sleep disruptions or deprivation can significantly affect skin conditions, by compromising the skin barrier and impairing processes such as collagen production, cellular repair, and wound healing. Given the commonality of sleep disturbances, it is crucial to understand the connection between sleep, circadian regulation, and skin health. This is particularly important in understudied populations, such as those with occupational sleep disruption and individuals with hormone-related conditions like PCOS and menopause. Bidirectional relationships have been established between sleep and several inflammatory skin conditions, including atopic dermatitis, psoriasis, rosacea, and hidradenitis suppurativa. While acne is influenced by sleep, the reverse relationship, how acne affects sleep quality, has not been well established. Chronic sleep disruption can increase cortisol levels and oxidative stress, both of which contribute to skin aging and the progression of autoimmune skin conditions, including systemic lupus erythematosus. As sleep is a modifiable risk factor, it is crucial to consider therapeutic options and interventions to prevent or alleviate skin conditions. This review discusses various therapeutic approaches, including melatonin, L-Theanine, Magnesium-L-threonate, Inositol, Cinnamomi cortex, nervous system regulation, and proper sleep hygiene. These therapeutic options have been studied for their impact on sleep, and importantly, several have been evaluated for their utility as adjuncts for treating skin conditions. Overall, the relationship between sleep and skin health is clear, and incorporating sleep-focused therapeutic interventions offers potential to improve both sleep quality and skin health in individuals with a variety of skin conditions. Full article

This study investigated the effects of a single-night sleep extension protocol on physical performance and cognitive function in physically active university students across different times of day. Using a within-subjects, counterbalanced crossover design, 24 physically active university students (17 males, 7 females; age: 22.7 ± 1.6 years) completed performance assessments under normal-sleep and sleep-extension conditions. Participants’ sleep was monitored via wrist actigraphy, and a comprehensive assessment battery comprising vertical jumps, Y-Balance tests, medicine-ball throws, 5 m shuttle-run tests, reaction-time tests, and digit-cancellation tests was administered at baseline (8 PM), morning (8 AM), and afternoon (4 PM). Sleep extension increased total sleep time by approximately 55 min (531.3 ± 56.8 min vs. 476.5 ± 64.2 min; p < 0.001, d = 0.91). Significant improvements were observed in 5 m shuttle-run performance at 8 AM (best distance: 102.8 ± 11.9 m vs. 93.3 ± 8.5 m, p < 0.001, d = 0.93; fatigue index: 13.1 ± 8.3% vs. 21.2 ± 9.5%, p < 0.001, d = 0.90), squat-jump heights (28.2 ± 8.0 cm vs. 26.3 ± 7.2 cm, p = 0.005, d = 0.25), simple reaction time (252.8 ± 55.3 ms vs. 296.4 ± 75.2 ms, p < 0.001, d = 0.66), and digit-cancellation performance (67.6 ± 12.6 vs. 63.0 ± 10.0 targets, p = 0.006, d = 0.40). Sleep extension significantly enhances both physical and cognitive performance in physically active individuals, with effects more pronounced during morning hours, partially attenuating typical circadian performance decline and establishing sleep extension as an effective, non-pharmacological strategy for optimizing performance capabilities. Full article

Tobacco use disorder remains a leading cause of preventable mortality, with nicotine playing a central role in the development and maintenance of dependence, mainly through its action on α4β2 nicotinic acetylcholine receptors (nAChRs). Smoking cessation treatments must address both physiological withdrawal and the affective disturbances (such as anxiety, irritability, and mood lability) which often facilitate relapses. This review compares two pharmacotherapies used in smoking cessation, varenicline and cytisinicline (cytisine), with particular focus on their impact on emotional regulation, psychological symptoms, and neuropsychiatric safety. Varenicline, a high-affinity partial agonist at α4β2 nAChRs, has demonstrated superior efficacy in maintaining abstinence and is well-supported by robust clinical data, including in psychiatric populations. However, its use may be limited by adverse effects such as nausea and sleep disorders. Cytisinicline, a structurally similar but less potent partial agonist, has recently gained renewed interest due to its lower cost, favorable tolerability profile, and comparable effectiveness in the general population. Although less extensively studied in patients with serious mental illness, preliminary data suggest cytisinicline may offer a better side effect profile, particularly regarding sleep disturbances and emotional reactivity. Both agents appear to ameliorate withdrawal-related affective symptoms without significantly increasing psychiatric risk. Ultimately, pharmacotherapy choice should be guided by individual clinical features, mental health status, treatment tolerability, and resource availability. Further research is needed to establish cytisinicline’s efficacy and safety across diverse clinical contexts, particularly among individuals with severe psychiatric comorbidities. Full article

Background. Major Depressive Disorder (MDD) is a highly prevalent and disabling condition frequently accompanied by cognitive deficits, impaired psychosocial functioning, and biological rhythm disturbances. Despite extensive literature on individual associations between depression and circadian disruptions, the mediating role of biological rhythms in the functional outcomes of MDD remains underexplored. Objectives. This study aimed to explore the associations between depression severity, biological rhythms, sleep quality, and psychosocial functioning, and to assess whether biological rhythm disturbances mediate the impact of depression on functioning. Methods. Sixty-one inpatients diagnosed with moderate-to-severe MDD were assessed using standardized instruments: BDI-II for depressive symptoms, BRIAN for biological rhythms, PSQI for sleep quality, and FAST for global functioning. Group comparisons, non-parametric correlations, and a mediation analysis were conducted to test direct and indirect effects. Results. Participants showed severe depressive symptoms, impaired functioning, disrupted biological rhythms, and poor sleep. Women reported more depressive episodes, reduced autonomy, and worse sleep than men. Depression severity was associated with circadian and sleep disturbances, which in turn related to functional impairment. Mediation analysis suggested that biological rhythms partially mediate the impact of depression on functioning. Conclusions. Findings from this preliminary analysis suggest that biological rhythm disturbances may play a mediating role in the relationship between depressive symptoms and daily psychosocial functioning. While not conclusive, these results highlight the potential relevance of chronobiological factors in understanding functional outcomes in MDD. Further research using longitudinal and controlled designs is needed to clarify these associations and their clinical implications. Full article

Long- or post-COVID-19 syndrome, which is also designated by WHO as Post COVID-19 Condition (PCC), is characterized by the persistent symptoms that remain after recovery from SARS-CoV-2 infection. A worldwide consortium of Long COVID-19 Host Genetics Initiative (Long COVID-19 HGI) identified an SNP rs9367106 (G>C; chr6:41,515,652, GRCh38, p = 1.76 × 10⁻¹⁰, OR = 1.63, 95% CI: 1.40–1.89) that is associated with PCC. Unraveling the functional significance of this SNP is of prime importance to understanding the development of the PCC phenotypes and their therapy. Here, in Silico, I explored how the risk allele of this SNP alters the functional mechanisms and molecular pathways leading to the development of PCC phenotypes. Bioinformatic methods include physical interactions using HI-C and Chia-PET analysis, Transcription Factors (TFs) binding ability, RNA structure modeling, epigenetic, and pathway analysis. This SNP resides within two long RNA genes, LINC01276 and FOXP4-AS1, and is located at ~31 kb upstream of a transcription factor FOXP4. This DNA region, including this SNP, physically interacts with FOXP4-AS1 and FOXP4, implying that this regulatory SNP could alter the normal cellular function of FOXP4-AS1 and FOXP4. Furthermore, rs9367106 is in eQTL with the FOXP4 gene in lung tissue. rs9367106 carrying DNA sequences act as distant enhancers and bind with several transcription factors (TFs) including YY1, PPAR-α, IK-1, GR-α, and AP2αA. The G>C transition extensively modifies the RNA structure that may affect the TF bindings and enhancer functions to alter the interactions and functions of these RNA molecules. This SNP also includes an ALU/SINE sequence and alteration of which by the G>C transition may prevent IFIH1/MDA5 activation, leading to suppression of host innate immune responses. LINC01276 targets the MED20 gene that expresses mostly in brain tissues, associated with sleep disorders and basal ganglia abnormalities similar to some of the symptoms of PCC phenotypes. Taken together, G>C transition of rs9367601 may likely alter the function of all three genes to explain the molecular basis of developing the long-term symptomatic abnormalities in the lungs and brain observed after COVID-19 recovery. Full article

Background/Objectives: Dyskinetic cerebral palsy (DCP) often implies severe motor impairment and risk of health problems. Our aim was to follow up a group of young adults with DCP that we previously examined as children, to describe health, function, and living conditions. Methods: Interviews regarding health issues, treatments, and living conditions, and quality of life (RAND-36) and fatigue questionnaires were completed. Gross and fine motor function, communication, and speech ability were classified, and weight, height, spasticity, and dystonia were assessed and compared to previous data. Joint range of motion (ROM) was compared to older adults with DCP. Results: Dystonia was present in all fifteen participants, and spasticity in all but two. A decrease was found mainly in those who received intrathecal baclofen (ITB). ROM limitations were most pronounced in shoulder flexion, abduction and inward rotation (while outward rotation was hypermobile), hip abduction, hamstrings, and knee extension. The majority had frequent contact with primary and specialist healthcare. Seven participants were underweight, eight had a gastrostomy, and seven had ITB. Upper gastrointestinal and respiratory problems were frequent. Orthopedic surgery for scoliosis was reported in five, and lower extremity in nine, while fractures were reported in six participants. RAND-36 revealed physical functioning, general health, and vitality as the greatest problem areas. Fatigue was significant in 64%. Eight participants lived with their parents. Participants at more functional levels completed tertiary education and lived independently. Conclusions: Most participants had severe impairment and many health issues, despite decreased dystonia and spasticity due to ITB. Sleep problems and pain were uncommon. Full article

Background: Comprehensive geriatric assessments (CGAs) are necessary to address the needs of people with human immunodeficiency virus infection (PWH) aged ≥ 50 years and ensure that they receive high-quality care. We aimed to identify the most effective tests from an extensive CGA to develop a short CGA. Methods: This observational, cross-sectional, and analytical study was conducted in three phases: (1) describing PWH aged ≥ 50 and matched controls; (2) jointly analyzing data to identify the most effective tests from the original CGA and develop a short version; and (3) applying the short CGA separately to both groups. Results: The most effective tests—the Lawton scale, SPPB, Barber questionnaire, Pittsburgh Sleep Quality Index, and Cognitive Complaints questionnaire—were used to create a short CGA. It identified abnormalities in 77% of PWH flagged by the full CGA, though 65% with the normal short CGA results had at least one abnormal result in the full version. Most false negatives were due to the excluded Hearing-Dependent Activities scale. Conclusions: These findings represent an initial step toward developing a short CGA for an easy and rapid identification of PWH aged ≥ 50, beyond a frailty assessment, who may benefit from early clinical management. Full article

The bidirectional relationship between chronic pain and poor sleep are well reported. Disrupted sleep and chronic pain, either alone or in conjunction, are often associated with poor post-surgical outcomes. However, the relationship between peripheral blood biomarkers and chronic pain and sleep disturbances after orthopedic surgery has not been extensively studied. The goal of this observational prospective study was to conduct an analysis on the relationship of blood cytokines and chemokines with chronic pain and sleep outcomes among US service members undergoing orthopedic surgery. Active-duty service members (N = 114) who underwent orthopedic extremity or spinal surgery were recruited, of whom 69 completed pre-surgery and 64 completed 6-week post-surgery surveys and blood draws. Blood cytokine and chemokine analyses were performed using multiplex immunoassays. Non-parametric correlations with blood cytokine and chemokine showed significant associations with both pre- and post-surgical pain scores whereas no significant correlations were observed with sleep disturbance scores. Increased pain intensity 6 weeks after surgery was positively associated with increased hepatocyte growth factor (ρ_s = 0.11; p < 0.05) and negatively correlated with interleukin-2r (ρ_s= −0.42; p < 0.001). This study found that inflammatory biomarkers are associated with pre- and post-surgical pain but not sleep disturbances. Full article

Poor sleep quality and excessive daytime sleepiness are commonly reported by individuals with cystic fibrosis. The potential impact of comorbid sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), has not been extensively studied in the CF population. At present, there are no specific recommendations available to help clinicians identify patients with CF who are at increased risk of sleep disorders. Home sleep apnea testing using a validated peripheral arterial tonometry (PAT) device may offer an accurate diagnosis of OSA in a more convenient and low-cost method than in-lab polysomnography. In this single-center study of 19 adults with CF, we found an increased prevalence of OSA among individuals with CF compared to general population estimates. Although associations with an FEV < 70% predicted and a modified Mallampati score ≥ 3 were observed, these odds ratios did not reach statistical significance, likely reflecting limited power in this small pilot sample. There was no association found between the self-reported presence of nocturnal cough or snoring and OSA. We also found no association between OSA and abnormal scores on commonly used, validated sleep questionnaires, suggesting that CF-specific scales may be needed for effective screening in the CF clinic. Full article

Sleep deprivation (SD) is known to impair cognitive functions, and its effect on vigilance and concentration has been explored extensively. However, its effect on the decision-making ability has been researched to a lesser extent. With varying methodologies and conflicting findings in the literature, the effect of SD on decision-making remains complex and inconsistent. Given the critical implications for fields where decision-making is essential, such as medicine, understanding the impact of SD on this cognitive process is crucial. This scoping review aimed to map the existing literature on the effects of SD on decision-making, identify research trends, and highlight inconsistencies to provide implications for practice and research. The review was conducted following PRISMA-ScR guidelines. Databases searched include APA Psych, Web of Science, Scopus, Academic Search Complete, and PubMed. Inclusion criteria focused on peer-reviewed studies from 2014 onward, exploring the impact of SD on decision-making across various tasks and designs. The final selection included 25 articles, representing 2276 participants. The review may suggest that SD, whether partial or total, impairs decision-making ability, with many studies reporting increased risky decisions. The severity of impairment varied based on the type of decision-making task and the duration of SD. However, a few studies reported insignificant effects, particularly in economic decision-making tasks. Moderating factors, such as gender and the origin of sleep loss (voluntary vs. involuntary), were also identified as influential. Sleep deprivation commonly impairs the decision-making ability, with significant implications for high-stakes professions. However, the variability in findings suggests a need for further research into the moderating factors. The review underscores the importance of adequate sleep for cognitive function and the need for policies that mitigate the risks of SD in critical decision-making environments. Full article

Objective: The development of a normal sleep–wake rhythm in the first weeks of life depends on the physiological sensory needs of the newborn as well as the environment surrounding them. This includes, for example, avoiding pain, exposure to bright light at night and high noise levels. In high-risk newborns, this process can be influenced by immaturity of the central and peripheral nervous systems, therapeutic strategies and the work organization of an intensive care unit. Methods: This study used a narrative review to examine the literature on the interrelationship of sensory modalities on sleep–wake behavior in the context of neonatal intensive care. The current Cochrane reviews on cycled lighting’s effect on premature infants’ circadian rhythm development and noise or sound management in the neonatal intensive care unit, as well as the World Health Organization (WHO) global position paper on kangaroo mother care, were included. Results: An extensive body of literature relates to fetal and neonatal development of the five sensory modalities: touch, taste, smell, hearing and sight. In contrast, there is a lack of evidence regarding the choice of optimal lighting and suitable measures for noise reduction. Since 2023, the WHO has recommended that, from the moment of birth, every “small and sick” newborn should remain in skin-to-skin contact (SSC) with their mother. Developmental support pursues a multimodal approach with the goal of fostering early parent–child bonding, including the child’s needs and environmental conditions. Discussion: The implementation of early SSC and attention to the sleep–wake cycle require systemic changes in both the obstetric and neonatal settings to ensure seamless perinatal management and subsequent neonatal intensive care. Since there is a lack of evidence on the optimal sensory environment, well-designed, well-conducted and fully reported randomized controlled trials are needed that analyze short-term effects and long-term neurodevelopmental outcomes. Full article

Alzheimer’s Disease (AD) is a global issue, with increasing incidence and prevalence as the world’s population ages and life expectancy increases. Projections indicate that by 2050, over 150 million individuals worldwide will be personally living with AD, an impending crisis made worse by the absence of cure therapies. Moreover, the risk factor relationship of dementia with rising global temperatures and air pollution further necessitates the urgency of a coordinated international response. With an extensive economic and emotional burden, AD is no longer just a disease; it is a worldwide societal crisis. This review presents five calls to action to address the AD global health emergency. First, AD research must be approached as an internationally performed activity, involving standardized data sharing, collaborative innovation, and improved access to pharmaceutical studies in low- and middle-income countries (LMICs), alongside increased diversity, inclusion, and equity in research. Second, there must be a commitment to develop universally accessible, affordable, and non-invasive diagnostic tools for AD. Third, advancements in AD therapeutics should prioritize the development of affordable agents, allowing for widespread geographic distribution. Fourth, we identify focus areas for global dementia risk reduction: sleep, head injury prevention, exercise, learning, and diet (SHIELD risk reduction strategy). Fifth, improving care for individuals with AD requires eliminating stigma through educational programs for both the public and caregivers. The escalating AD crisis demands an unprecedented global coalition in research, diagnostics, therapeutics, prevention, and education to avoid a future where the disease becomes the defining crisis of our era. Full article

Measurement of respiratory patterns during sleep plays a critical role in assessing sleep quality and diagnosing sleep disorders such as sleep apnea syndrome, which is associated with many adverse health outcomes, including cardiovascular disease, diabetes, and cognitive impairments. Traditional methods for measuring breathing often rely on expensive and complex sensors, such as polysomnography equipment, which can be cumbersome and costly and are typically confined to clinical settings. These factors limit the performance of respiratory monitoring in routine settings and prevent convenient and extensive screening. Recognizing the need for accessible and cost-effective solutions, we developed a portable sleep sensor that uses an electret condenser microphone (ECM), which is inexpensive and easy to obtain, to measure nasal airflows. Constant current circuits that bias the ECM and circuit constants suitable for measurement enable special uses of the ECM. Furthermore, data transmission through the XBee wireless communication module, which employs the ZigBee short-range wireless communication standard, enables highly portable measurements. This customized configuration allows the ECM to detect subtle changes in airflow associated with breathing patterns, enabling the monitoring of respiratory activity with minimal invasiveness and complexity. Furthermore, the wireless module not only reduces the size and weight of the device, but also facilitates continuous data collection during sleep without disturbing user comfort. This portable wireless sensor runs on batteries, providing approximately 50 h of uptime, a ±50 Pa pressure range, and 20 Hz real-time sampling. Our portable sleep sensor is a practical and efficient solution for respiratory monitoring outside of the traditional clinical setting. Full article

Allergic diseases represent a major and growing global health concern, with increasing prevalence among both children and adults. This manuscript presents an extensive review of allergy mechanisms, epidemiology, diagnostics, and clinical challenges, highlighting the complex interplay between immune system dysregulation and environmental exposures. The authors provide a structured analysis of hypersensitivity types, with particular focus on IgE-mediated responses, and emphasize the role of immune barrier defects, epigenetics, and the microbiota in allergic pathogenesis. This manuscript explores diagnostic limitations, including test sensitivity, specificity, and the presence of hidden allergens, as well as challenges in identifying food-related or atypical allergic reactions. A novel and valuable aspect is the discussion of allergy as a potential clinical manifestation of primary immunodeficiencies, such as selective IgA deficiency, Wiskott–Aldrich syndrome, hyper-IgE syndrome, and Netherton syndrome. This review also outlines challenges in treatment, especially among polysensitized patients, and examines the psychosocial burden and complications of allergic diseases, including mental health, nutritional deficiencies, and impaired sleep. This comprehensive synthesis underscores the need for early diagnosis, multidisciplinary management, and personalized therapeutic strategies to improve quality of life of allergic patients. Full article

With positron emission tomography followed by functional magnetic resonance imaging (fMRI), we demonstrated that rapid eye movements (REMs) in sleep are saccades that scan dream imagery. The brain “sees” essentially the same way while awake and while dreaming in REM sleep. As expected, an event-related fMRI study (events = REMs) showed activation time-locked to REMs in sleep (“REM-locked” activation) in the oculomotor circuit that controls saccadic eye movements and visual attention. More crucially, the fMRI study provided a series of unexpected findings, including REM-locked multisensory integration. REMs in sleep index the processing of endogenous visual information and the hierarchical generation of dream imagery through multisensory integration. The neural processes concurrent with REMs overlap extensively with those reported to be atypical in autism spectrum disorder (ASD). Studies on ASD have shown atypical visual processing and multisensory integration, emerging early in infancy and subsequently developing into autistic symptoms. MRI studies of infants at high risk for ASD are typically conducted during natural sleep. Simply timing REMs may improve the accuracy of early detection and identify markers for stratification in heterogeneous ASD patients. REMs serve as a task-free probe useful for studying both infants and animals, who cannot comply with conventional visual activation tasks. Note that REM-probe studies would be easier to implement in early infancy because REM sleep, which is markedly preponderant in the last trimester of pregnancy, is still pronounced in early infancy. The brain may practice seeing the world during REM sleep in utero before birth. The REM-probe controls the level of attention across both the lifespan and typical-atypical neurodevelopment. Longitudinal REM-probe studies may elucidate how the brain develops the ability to “see” and how this goes awry in autism. REMs in sleep may allow a straightforward comparison of animal and human data. REM-probe studies of animal models of autism have great potential. This narrative review puts forth every reason to believe that employing REMs as a probe into the development of the visual brain will have far-reaching implications. Full article